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In part two of the GLP-1 series, Melissa gets practical. What does it actually feel like to be on this medication? What does responsible use look like day to day? And how do you get the best results at the lowest effective dose possible?Whether you just started, you're a few months in, or you're wondering why you're not seeing the results you expected — this episode is for you.IN THIS EPISODE, YOU'LL LEARN:Why you forget about food on a GLP-1 and why that feeling of relief is also where your responsibility beginsWhat the flat affect actually is, why it happens, and what it tells you about your doseWhy GLP-1 receptors live in the brain's reward center — and what that means for your dopamine, your drive, and your nervous systemThe difference between microdosing and the lowest effective dose (and why that distinction matters more than the label)FDA-approved dosing for semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) — and where Melissa would actually startWhy digestion has to come first before or while on this medicationThe truth about blood sugar stability on a GLP-1 and why the medication doesn't do that work for youWhy women on GLP-1 are losing muscle without realizing it — and exactly what to do about itProgressive overload: what it actually means and why going through the motions isn't enoughWhy Melissa recommends Cronometer over MyFitnessPal for tracking on a GLP-1Hair loss — medication side effect or weight loss side effect? Melissa breaks down the differenceFatigue — why it's actually both, and what to do depending on which one it isWhy perimenopause symptoms can get louder on a GLP-1 and what's happening hormonallyHow to know if you're actually at a plateau (hint: four weeks is the threshold)What to do when you're at max dose and the scale still isn't movingHow long is it okay to stay on a GLP-1 — and what the long-term concerns actually areTIMESTAMPS:00:00 — Welcome back + recap of episode one 01:45 — What it actually feels like when you first start 03:30 — The flat affect and the dopamine loop 07:50 — Strength training as a natural dopamine regulator 10:00 — The lowest effective dose and what microdosing actually means 12:00 — Semaglutide dosing overview (Wegovy, Ozempic) 13:45 — Tirzepatide dosing overview (Zepbound, Mounjaro) 15:00 — How to advocate for a lower starting dose with your provider 16:00 — Melissa's personal experience: 1 mg tirzepatide for inflammation 23:30 — Making the medication work hard for you: the foundation 25:00 — Digestion first — why gut health matters before you start 26:30 — Blood sugar stability is your responsibility 29:00 — Protein first, always 31:00 — Why women on GLP-1 are losing muscle 33:30 — Progressive overload — what it actually looks like 35:00 — Track your food — why Cronometer and why it's non-negotiable 38:30 — Side effects: medication vs. weight loss (two different categories) 39:00 — Hair loss explained 40:50 — Fatigue explained 42:00 — Nausea, constipation, gut symptoms 42:45 — Perimenopause, hormonal shifts, estrogen dominance44:30 — How to know if you're actually at a plateau 48:00 — Max dose: what to do when you're there 48:30 — How long is it okay to stay on a GLP-51:00 — Download the GLP-1 Support Guide + closeRESOURCES:Download the GLP-1 Support Guide — everything you need to use this medication responsibly: workouts with logging space, protein meal plan, nutrition framework, and tracking tools. melissaeichwellness.com/GLP1guideBook a free consultation with Melissa — whether you're considering GLP-1, already on it, or wanting gut or hormone support while on it: https://melissaeichcoaching.practicebetter.io/#/6490bd200e37c64b346b25c8/bookings?s=6a0cb936104f4243883a46dfGut Healing Program or Complete Hormone Program: https://melissaeichcoaching.practicebetter.io/#/6490bd200e37c64b346b25c8/bookings?s=69fe864f4b36932a1ec4aba4Related episodes:Episode [#179]: GLP-1 Series, Part 1 — The Shame, the Gray Area, and Weight Loss Resistance: https://podcasts.apple.com/us/podcast/179-glp-1-for-midlife-women-where-to-begin-part-1-3/id1650475536?i=1000771142749DUTCH test series — perimenopause, weight loss resistance, and estrogen detox - https://podcasts.apple.com/us/podcast/176-perimenopause-weight-gain-and-the-dutch-test/id1650475536?i=1000767363294CONNECT WITH MELISSA:Instagram: @melissa_eich Website: melissaeichwellness.com Email: melissa@melissaeichwellness.comABOUT THE SHOW:Body-Led by Design is a podcast for women who are done guessing and ready to understand what's actually happening in their bodies. Hosted by Melissa Eich, registered nurse, hormone and nervous system coach, and somatic practitioner, each episode brings the real conversations from her practice so you can walk away more informed, more empowered, and a little less alone in what you're navigating.LEAVE A REVIEW:If this episode resonated with you, a five-star review means the world. It helps more women find this podcast and get the information they actually need.SEO KEYWORDS:GLP-1 side effects, semaglutide weight loss, tirzepatide lowest effective dose, microdosing GLP-1, hair loss on Ozempic, muscle loss GLP-1, weight loss plateau GLP-1, GLP-1 fatigue, Wegovy responsible use, perimenopause GLP-1, how long to stay on GLP-1, GLP-1 support women over 40
Today I share 4 tips to help you get by and cope when time during pregnancy seems to slow down. Please share this with a pregnant friend who you think needs it! Listen to the Scriptures Get My FEEL it to HEAL it video for FREE: https://positivityinpregnancy.com/products/feel-it-to-heal-it-5-05?variant=42591145001037 Success in Second Trimester INTIMACY: https://mcdn.podbean.com/mf/web/93uz44/Success_in_Sex_Second_Trimester_Pregnancy_-_12_8_23_328_PM652sb.mp3 Pregnancy Affirmation Episodes: Pregnancy affirmations and their importance during pregnancy: https://mcdn.podbean.com/mf/web/wz5j79/Pregnancy_Affirmations_and_their_Importance_during_pregnancy_-_5_9_23_1212_PMapb4y.mp3 Love Focused Free Affirmations on Pregnancy https://mcdn.podbean.com/mf/web/iqm7pf/Love_Focused_FREE_Affirmations_on_Pregnancy_Happy_Valentines_Day_Mama_-_2_14_23_501_PMata0m.mp3 Pregnancy Affirmations for When it Feels Heavy: https://mcdn.podbean.com/mf/web/hxapdseu4v284eqg/Pregnancy_Affirmations_for_When_it_feels_Heavy_-_10_30_24_502_PM9iy8c.mp3 Intimacy in the First Trimester Episode: https://mcdn.podbean.com/mf/web/kvj6kz/first_trimester_intimacy_tip_bsiwp.mp3 Other episodes on Dealing with Nausea in the first trimester: Puking and Feeling Like I Can't Coping with Nausea in Pregnancy Pills I have Taken My First Trimester and Why Give Yourself Grace FREE Video/ Audio Download: https://positivityinpregnancy.com/products/give-yourself-grace-0-04-06?variant=42590920966221 You Reap What You Sow FREE Video/ Audio Download: https://positivityinpregnancy.com/products/you-reap-what-you-sow-8-01?variant=42591123603533 Pregnancy Affirmation Episodes: Pregnancy Affirmations for Mindset Domination Podcast episode Pregnancy Affirmations and Their Importance Podcast Episode Pregnancy Affirmations for When it Feels Heavy Podcast Episode Email me: positivityinpregnancy@gmail.com Website: www.positivityinpregnancy.com MENTAL HEALTH MINI VIDEOS for pregnancy: What once made up my ‘Morning Sickness Mini Course for Mental Health' is now divided into individual videos(and each video comes with the audio) that you can now buy individually instead of purchasing the whole course! Discover a beautiful collection of short, heartwarming positivity videos (ranging from 1–8 minutes) thoughtfully designed to nurture your mind, body, and spirit throughout pregnancy. Each video focuses on one of four powerful pillars: Mental Health (to support emotional well-being), Pregnancy Affirmations (that uplift and empower), Gratitude practices (that fill your heart with joy), And simple yet transformative ways to shift negative thoughts into positive light (These gentle reminders celebrate the incredible journey you're on). Here is the link to all the videos: https://pregnancyishard.com/collections/all I recommend starting with the Mental Health section! Visit My Pregnancy Week-by-Week Page:https://pregnancyishard.com/pages/week-by-week-pregnancy Here is the Facebook Page for Pregnancy is hard: I have documented my journey of my fourth baby on this page and have other juicy and good tips for enjoying pregnancy better. https://www.facebook.com/pregnancyishard Here is the Pregnancy is Hard Support Group on Facebook: Let's offer support, help and fun for those in the trenches of pregnancy! https://www.facebook.com/groups/165102315544693 YouTube for Positivity in Pregnancy: https://www.youtube.com/@PregnancyisHardwithJosly-nd8wd Instagram: @positivityinpregnancy
AFB, Anna-G, Josh and Phred welcome back ultrarunner, hospice nurse, and Vermont mountain crusher Lila Gaudrault back to the Cultra Trail Running Podcast to break down her experience at the legendary Cocodona 250. Lila takes us deep into the Arizona suffering machine, explaining how she showed up to a 250-mile race with a surprisingly loose game plan, then spent the better part of the first half battling nausea, dehydration, and the reality that 250 miles is a very long way to travel on foot. We talk about sleep deprivation, hallucination-adjacent trail weirdness, crew and pacer support, and the problem-solving mindset required when you're three days into a race and still have mountains to climb. The conversation explores how Cocodona differs from 100-milers, why the atmosphere at 200+ mile races feels more collaborative than competitive, and what Lila learned about managing fatigue, recovery, and the physical toll of multi-day events. We also dive into the science of gender differences in ultrarunning, pacing strategies, and the unique culture that develops when everyone is equally exhausted. Along the way, we discuss * Cocodona 250 race recap * Sleep strategy and managing fatigue * Nausea, dehydration, and race-day troubleshooting * Crew and pacer support in 200+ mile races * Hallucinations and sleep deprivation * Gender dynamics in ultrarunning * Vermont 100 and Backyard Ultras * Balancing hospice nursing and elite ultrarunning * Future race plans and FKTs * The upcoming CUT112 fundraiser for Connecticut Forest & Parks A four-day journey through the Arizona desert, countless lessons learned, and proof that sometimes the best race plan is figuring it out one aid station at a time. Subscribe to Lil's Substack "Running too Much" Cocodona 250 Get your official Cultra Clothes and other Cultra TRP PodSwag at our store! Outro music by Nick Byram Become a Cultra Crew Patreon Supporter basic licker. If you lick us, we will most likely lick you right back Cultra Facebook Fan Page Go here to talk shit and complain and give us advice that we wont follow Cultra Trail Running Instagram Don't watch this with your kids Twitter @BlueBlazeRunner Buy Fred's Book Running Home More Information on the #CUT112
A guide to diagnosing, imaging, and managing acute renal colic and nephrolithiasis in the ED. Hosts: Brian Gilberti, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Nephrolithiasis.mp3 Download Leave a Comment Tags: Kidney Stones, Urology Show Notes 1. CLINICAL CORE & PHYSIOLOGIC FRAMEWORK Epidemiologic Risk Profiles Lifetime incidence parameters hover around 1 in 11, presenting with a prominent male sex skew. Peak demographic manifestation concentrated within the 30–60 age band. High-yield temporal parameter: 50% recurrence vector within a 5-year post-initial-insult window. Mineralogical Composition Vectors Calcium oxalate crystals represent the predominant structural matrix. Struvite configurations (magnesium ammonium phosphate matrix) account for 1–2% of cohorts. Struvite stones function explicitly as infection-driven configurations secondary to upper tract proliferation; higher distribution index noted in female cohorts. Etiological & Modifiable Relational Dynamics Profound systemic dehydration or low baseline fluid throughput states. High-sodium diet structures and heavy animal-protein consumption loads. Positive genetic/familial history variables. Relative risk modulation: Each variable independently operates to expand baseline risk by a factor of 2x to 3x. Pathophysiologic Symptom Complexes Acute, sudden-onset, maximum-intensity (10/10) unilateral flank pain. Classic structural radiation vector tracking downward toward the ipsilateral groin/genitourinary dermatomes. Distinctive behavioral marker: Renal colic pacing/writhing behavior with zero antalgic position availability. Concomitant autonomic triggers: Nausea and emesis manifest in 50% of acute presentations. Physical Exam Discordance Metrics Severe subjective distress contrasted with a characteristically soft, completely non-tender abdominal palpation exam. CVA tenderness is completely variable and lacks reliable negative predictive value. Atypical Presentation Classifications Vague, poorly localized abdominal pain presentations occurring in up to 20% of active cases. Isolated lower urinary tract irritative signs including acute frequency or severe urgency. Incidental & Asymptomatic Dynamics Silent intrarenal or ureteral stones found incidentally. Longitudinal tracking demonstrates up to 33.3% of initially asymptomatic cohorts convert to fully symptomatic renal colic within a multi-year tracking window. 2. EXCLUSION DIAGNOSES & CRITICAL PATHWAY RED FLAGS Vascular Mimics: AAA rupture/expansion. This is a mandatory exclusion pathway in elderly cohorts presenting with acute flank or back pain. Physical tracking requires active exploration for an expansile, pulsatile abdominal mass. Gynecologic Emergencies: Ruptured ectopic pregnancy. Demands universal screening protocols via rapid beta-hCG testing in all female patients of childbearing potential presenting with lower abdominal/pelvic localization. Infectious Upper Tract Decompensation: Acute uncomplicated pyelonephritis. Differentiated via persistent high spikes, high fevers, systemic shaking chills, and profound pyuria. Genitourinary Structural Crises: Acute testicular torsion. Mandates a thorough, explicit scrotal/testicular structural exam if the flank pain radiates into the scrotum. Gastrointestinal and Adnexal Torsional Confounds: Acute appendicitis variants, acute mesenteric/bowel ischemia, and ovarian torsion syndromes. 3. LABORATORY TESTING & PHYSIOLOGIC EVALUATION Urinalysis Interpretation Nuances Microscopic or gross hematuria presents in approximately 66% to 90% of acute cases. Critical Pathological Caveat: Complete absence of hematuria documented in 20% to 33.3% of confirmed, acute obstructing ureteral stones. Diagnostic rule: A pristine urinalysis with zero red blood cells is entirely insufficient to exclude acute ureterolithiasis. Urinary pH as a Composition Clue Consistently low urinary pH parameters (pH < 5.5) point strongly toward a uric acid crystalline composition. Elevated urinary pH parameters (pH > 7.5) indicate the presence of urease-producing microbial pathogens, pointing toward a struvite infection stone. Infectious Screening Metrics Active tracking for marked pyuria, positive leukocyte esterase, and bacterial nitrites to rule out an obstructed, infected upper urinary tract system. BMP Immediate quantification of baseline serum creatinine to establish accurate eGFR values. Targeting detection of post-renal AKI from bilateral obstruction, unilateral obstruction in a single functioning kidney, or severe volume depletion. CBC Evaluation for marked leukocytosis. Physiologic Nuance: Mild-to-moderate white blood cell count elevations frequently represent non-specific stress demargination driven by severe pain and repetitive vomiting. High-grade white blood cell shifts demand immediate exclusion of systemic bacteremia or an infected, obstructed urinary system. Adjunctive Lab Pathways Rapid qualitative urine hCG testing. Reflex urine culture execution whenever urinalysis metrics display significant inflammatory profiles or clinical suspicion of UTI is high. 4. IMAGING MODALITIES & ALGORITHMIC CLINICAL SELECTION Non-Contrast CT Diagnostics Gold standard; diagnostic sensitivity and specificity parameters exceed 95% for stones >2 mm. Provides precise quantification of stone diameter (mm), exact localization (proximal, mid, or distal ureter), and degree of secondary hydronephrosis. Excellent structural visualization for detecting or ruling out alternate retroperitoneal, vascular, or intra-abdominal pathologies. Contrast-Enhanced CT Protocols Indicated when alternative intra-abdominal surgical pathology is highly suspected over isolated renal colic. Retains diagnostic capability to identify urinary tract stones >3 mm even within contrast-enhanced phases. NCCT Structural Architecture Limitations Standard stone protocol CT scans are executed in a prone position without IV contrast enhancement. It does not opacify the ureteral lumen. Presents a cumulative radiation exposure penalty when utilized serially across recurrent ED presentations. POCUS / Radiology Ultrasound Direct stone visualization capabilities are modest, operating at approximately 50% to 60% sensitivity, and is highly dependent on anatomical positioning at the extreme proximal ureter or the UVJ. Secondary obstruction tracking: Demonstration of hydronephrosis operates at a high sensitivity of approximately 80%. POCUS Clinical Utility Metrics Eliminates ionizing radiation exposure and allows immediate, rapid real-time execution directly at the patient’s bedside. Confirmation of significant hydronephrosis within a classic clinical presentation yields high post-test probability for stone presence while lowering suspicion for vascular catastrophes like a AAA. KUB Radiography Extremely poor overall diagnostic sensitivity, hovering around 57%. Fails to image radiolucent configurations (pure uric acid matrices) or small stones measuring
There are so many difficult things that pregnancy brings, today we can implement this tool to help begin the healing process. Get My FEEL it to HEAL it video for FREE: https://positivityinpregnancy.com/products/feel-it-to-heal-it-5-05?variant=42591145001037 Success in Second Trimester INTIMACY: https://mcdn.podbean.com/mf/web/93uz44/Success_in_Sex_Second_Trimester_Pregnancy_-_12_8_23_328_PM652sb.mp3 Pregnancy Affirmation Episodes: Pregnancy affirmations and their importance during pregnancy: https://mcdn.podbean.com/mf/web/wz5j79/Pregnancy_Affirmations_and_their_Importance_during_pregnancy_-_5_9_23_1212_PMapb4y.mp3 Love Focused Free Affirmations on Pregnancy https://mcdn.podbean.com/mf/web/iqm7pf/Love_Focused_FREE_Affirmations_on_Pregnancy_Happy_Valentines_Day_Mama_-_2_14_23_501_PMata0m.mp3 Pregnancy Affirmations for When it Feels Heavy: https://mcdn.podbean.com/mf/web/hxapdseu4v284eqg/Pregnancy_Affirmations_for_When_it_feels_Heavy_-_10_30_24_502_PM9iy8c.mp3 Intimacy in the First Trimester Episode: https://mcdn.podbean.com/mf/web/kvj6kz/first_trimester_intimacy_tip_bsiwp.mp3 Other episodes on Dealing with Nausea in the first trimester: Puking and Feeling Like I Can't Coping with Nausea in Pregnancy Pills I have Taken My First Trimester and Why Give Yourself Grace FREE Video/ Audio Download: https://positivityinpregnancy.com/products/give-yourself-grace-0-04-06?variant=42590920966221 You Reap What You Sow FREE Video/ Audio Download: https://positivityinpregnancy.com/products/you-reap-what-you-sow-8-01?variant=42591123603533 Pregnancy Affirmation Episodes: Pregnancy Affirmations for Mindset Domination Podcast episode Pregnancy Affirmations and Their Importance Podcast Episode Pregnancy Affirmations for When it Feels Heavy Podcast Episode Email me: positivityinpregnancy@gmail.com Website: www.positivityinpregnancy.com MENTAL HEALTH MINI VIDEOS for pregnancy: What once made up my ‘Morning Sickness Mini Course for Mental Health' is now divided into individual videos(and each video comes with the audio) that you can now buy individually instead of purchasing the whole course! Discover a beautiful collection of short, heartwarming positivity videos (ranging from 1–8 minutes) thoughtfully designed to nurture your mind, body, and spirit throughout pregnancy. Each video focuses on one of four powerful pillars: Mental Health (to support emotional well-being), Pregnancy Affirmations (that uplift and empower), Gratitude practices (that fill your heart with joy), And simple yet transformative ways to shift negative thoughts into positive light (These gentle reminders celebrate the incredible journey you're on). Here is the link to all the videos: https://pregnancyishard.com/collections/all I recommend starting with the Mental Health section! Visit My Pregnancy Week-by-Week Page:https://pregnancyishard.com/pages/week-by-week-pregnancy Here is the Facebook Page for Pregnancy is hard: I have documented my journey of my fourth baby on this page and have other juicy and good tips for enjoying pregnancy better. https://www.facebook.com/pregnancyishard Here is the Pregnancy is Hard Support Group on Facebook: Let's offer support, help and fun for those in the trenches of pregnancy! https://www.facebook.com/groups/165102315544693 YouTube for Positivity in Pregnancy: https://www.youtube.com/@PregnancyisHardwithJosly-nd8wd Instagram: @positivityinpregnancy
In this episode, Sue Meyer takes you by the hand and walks you through the entire arc of pregnancy, labor, delivery, and the often-overlooked postpartum weeks — with a homeopathic remedy ready for every stage. This is an excerpt of session 2 inside her course, Homeopathy: Pregnancy, Birth and Beyond. This episode is for the […] The post From the First Wave of Nausea to Skin-to-Skin: A Homeopathic Roadmap for Pregnancy, Birth & Postpartum appeared first on Ultimate Homeschool Podcast Network.
Send a text to Melissa and she'll answer it on the next episode. Nausea that won't quit has a way of hijacking joy, sleep, and every meal plan. We're pulling the curtain back on what actually drives “morning” sickness—and how to find real relief with safe homeopathy, steady nutrition, and smart daily habits that work in the real world. From hormonal surges to blood sugar swings after a long night's fast, we map the common traps and the simple moves that flip the script.We walk through a clear, symptom-matching guide to top remedies. Nux vomica fits the irritable, smell-sensitive mornings; Ipecac helps when vomiting doesn't ease the nausea; Cocculus shines for exhaustion-induced queasiness; Pulsatilla supports the tender, weepy moments in need of fresh air; Phosphorus matches the ice-cold drink cravings with quick regurgitation; Colchicum targets overpowering cooking odors; Symphoricarpus offers relief for hyperemesis when motion worsens everything; and Sepia, used with professional guidance, addresses deeper hormonal overwhelm. Alongside remedies, we share practical strategies: protein first and often, pairing with complex carbs to stabilize blood sugar, nightstand snacks to prevent that dawn crash, ginger support, cautious peppermint use, and replenishing B6, magnesium, and electrolytes.You'll also hear when to escalate care. If fluids won't stay down, weight is dropping, dizziness spikes, or urine turns dark, it's time for IV hydration and targeted help. No guilt—just a plan that gets your head above water so you can layer remedies and food back in. Our goal is simple: help you decode your exact pattern and build a routine that brings steady relief, reduces overwhelm, and restores confidence during early pregnancy.Ready for tailored support? Book a free 15-minute call to start a pregnancy consult, or join our Inner Healing Circle at join.melissacrinshaw.com for deeper courses and community. If this episode helped, tap follow, share it with a friend who's queasy, and leave a review so more moms can find relief.You may also gain Access to my Fullscript dispensary and save 30% by going to: https://us.fullscript.com/welcome/mcrenshawFIND ME!
Dealing with constipation, nausea, or bloating on a GLP-1 like Ozempic, Wegovy, Mounjaro, or Zepbound?You are definitely not alone.Digestive side effects are some of the most common challenges people experience on GLP-1 medications—but there's a huge difference between expected side effects and feeling miserable all the time.In this episode, Registered Dietitian and GLP-1 expert Gianna breaks down the science behind GLP-1 digestive side effects, including why they happen, what evidence-based strategies can actually help, and the biggest mistakes that may be making symptoms worse.We're covering:Why GLP-1 medications can cause constipation, nausea, and bloatingHow delayed gastric emptying impacts digestionWhy under-eating can actually worsen side effectsWhat to eat when nausea makes food unappealingEvidence-based strategies for constipation reliefHow hydration and meal structure affect symptomsThe truth about fiber on GLP-1sWhen side effects are no longer considered “normal”The social media advice you should probably ignoreWhether you're taking Ozempic, Wegovy, Mounjaro, or Zepbound, this episode will help you better understand what's happening in your body—and how to support your digestion without extreme restriction or fear.
Pregnancy has a way of stripping everything down to what's real. In this episode, we sit with a Tesia's story of radical dependence on the Lord through pregnancy, birth, and postpartum. From shopping for a midwife before conception to receiving unexpected prophetic words, navigating housing chaos while heavily pregnant, and wrestling with the physical cost of carrying and birthing a baby, this conversation is honest & deeply hope-filled.We talk about seeing God's hand in the details. The premature congratulations that foreshadowed pregnancy before she even knew. Praying for guidance toward birth resources and watching doors open one by one. Feeling profoundly seen by the Lord through the provision of baby supplies at just the right moments and the surprising ways He continued speaking throughout pregnancy, labor, and postpartum.This episode also holds space for the harder parts of the journey & the struggle of feeling physically limited and disconnected from your own body. Nausea that lasted through the entirety of labor, the emotional weight of changing a birth team late in pregnancy, delayed placenta delivery, moments of fear that led to a 911 call that ultimately wasn't needed, and the sacred tension between intervention and listening for the Lord's direction in the moment.We also talk about:doing evangelism outreaches during the first trimesterhome buying and renovation disasters in late pregnancya truly iconic pregnancy diet of milk, potstickers, donuts, and protein shakesprophetic imagery surrounding Mary and Joseph and how it shaped their perspective on birtha very fast pushing stage where the midwife barely made it in timeusing saline and cayenne with the umbilical cordrepurposing birth affirmations and Scripture during postpartum survivalthe raw honesty of postpartum strugglesand the deep significance behind their daughter's nameThis conversation is a reminder that birth stories are rarely neat or polished. Sometimes they are messy, exhausting, holy, funny, frightening, and full of unexpected grace all at once.Links:I'll Praise You In This StormHow to get in touch with Tesia and David:Instagram: https://www.instagram.com/lifereallyisbeautyfull?igsh=eHI0ZXg5eHl5dXd2Facebook:https://www.facebook.com/share/18XKb4Foea/YouTube:https://youtube.com/@lifeisbeauty-full?si=Z78M1ZP8aBRngpXANYC Missions Trip:https://www.jesuslovesnyc.org/Connect:Email us to say hi: hello@hearthmotherministries.comPut in a request for future topics and/or submit a question for future Q&A episodes: Fill out the formApply to tell your birth story on the podcast: Holy Wild Birth Podcast : Guest ApplicationHang out with us and other Holy Wild Women in our private community (off Facebook): Rooted in Eden PMABecome a holy, wild birthkeeper with us inside Hearthmother JourneyFrom Lauren:InstagramMidwifery consults: Email rootedinedenpma@gmail.comFrom Brooke:InstagramTrust God, Trust Birth Workshop - a 5-part high-level roadmap to a confident home birth (pay what you can)Faith-Filled Home Birth Workshop - a free, 3-part video series delivered to your inboxEmbrace Birth Journey - comprehensive and holistic faith-based home birth preparation (courses + private community)Sister Birth: The Podcast - short, beautifully scripted episode to encourage your along the wayIntro and Outra Music Credit -Betty Dear By Blue Dot Sessions is licensed under a Creative Commons License. BIRTH STORY DISCLAIMER:The choices, beliefs, and opinions of the mamas sharing their stories are as individual as the storyteller herself and do not necessarily reflect the beliefs or recommended choices of Lauren and/or Brooke.
This week on Happy Hour, Keith and Jenny talk about their first pets, test out a sequin surprise pillow, and Jenny having more ASU moms in her feed. Presented by Iowa Distilling Company. Learn more about your ad choices. Visit megaphone.fm/adchoices
Almost every reporting trip has its pitfalls. Andrew Leland's story for Radiolab in 2022 had more than most including nausea, flying in the equivalent of zero gravity, and his blindness. On this encore episode of Sound School, Andrew lays out how he navigated it all.
Nausea is one of the most common complaints for expectant mothers, and one Northshore mom-turned-entrepreneur has created a tasty remedy for it. Jamie Steele is the creator of YumMum, ginger-based gummies designed to get the job done while tasting like an actual treat. Not just for pregnancy, these gummies are good for all forms of nausea — traveling kids, chemotherapy treatment, you name it.Steele shares the lessons she learned creating her innovative product and the surprising other ingredients she insisted they include.
Beating Cancer Daily with Saranne Rothberg ~ Stage IV Cancer Survivor
In today's episode, Saranne takes us on a personal journey as she reflects on her experiences with nausea during cancer treatment and a recent bout of food poisoning. She shares her insights on managing and reframing these challenging moments, highlighting the importance of quality of life and the advancements in anti-nausea medications. Join Saranne as she discusses the power of resilience and self-care in overcoming difficult times.2025 People's Choice Podcast Awards Best Health Series FinalistRanked the Top 5 Best Cancer Podcasts by CancerCare News in 2024 & 2025,and #1 Rated Cancer Survivor Podcast by FeedSpot in 2024 to 2025. Beating Cancer Daily is listened to in 140 countries across 7 continents and features over 400 original daily episodes hosted by Stage IV survivor Saranne Rothberg. To learn more about Host Saranne Rothberg and The ComedyCures Foundation:https://www.comedycures.org/ To write to Saranne or a guest:https://www.comedycures.org/contact-8 To record a message to Saranne or a guest:https://www.speakpipe.com/BCD_Comments_Suggestions To sign up for the free Health Builder Series live on Zoom with Saranne and Jacqui, go to The ComedyCures Foundation's homepage:https://www.comedycures.org/ Please support the creation of more original episodes of Beating Cancer Daily and other free ComedyCures Foundation programs with a tax-deductible contribution:http://bit.ly/ComedyCuresDonate THANK YOU! Please tell a friend whom we may help, and please support us with a beautiful review. Have a blessed day! Saranne
Hosts: Ed Jones (Owner – Nutrition World) & Clint Powell A variety of topics all related to living a healthy life Presented by: Nutrition World www.nutritionw.com Broadcasting from the Nooga Dentistry Studio www.noogadentistry.com Production of: Whitfield Media Group www.vitalhealthradio.com Title: All About Peptides, & The Good, Bad & Ugly of GLP-1's [0:00:00] Ed's Restaurant Story & Healthy Eating Choices Ed's recurring bit: “Where did Ed eat this week?” Long‑time favorite restaurant Epicurean. Discussion of consistent healthy ordering and making good choices at long‑standing, family‑owned restaurants. [0:03:13] Building a Health “Team” & Ed's Top Learning Resources Tease of today's main topic: peptides with local expert Noel Lawson, NP. Ed stresses “team approach” to aging—no single practitioner has all the answers. Learners vs. non‑learners: why ongoing self‑education is critical for health. Ed's 4 favorite online resources: Mercola.com – more cutting‑edge, sometimes controversial content. DrJockers.com – accessible, visual education on ailments and nutrients. GreenMedInfo.com – indexed medical literature backing natural claims. Nutrition World Instagram – short, practical health “snippets”. Story: Nutrition World wins a surprise $10,000 award from Ancient Nutrition for #1 sales growth in the U.S., tied to belief in product quality. [0:10:38] Introducing Noel Lawson & “What Are Peptides?” Introduction of Noel Lawson, NP (Double Bridges Health & Wellness), now practicing on the Nutrition World campus. Noel's background: Transition from traditional medicine to functional medicine due to patient frustration, worsening chronic illness, and provider burnout. Goal: more prevention and root‑cause care. Orthopedic background led her to peptides. What is a peptide? Peptides are like the body's Morse code—specific chains of amino acids acting as signals. Under ~40 amino acids = peptide; longer chains = protein. Body breaks down dietary protein into amino acids and re‑assembles them into peptides as needed (e.g., for repair). As we age, the body produces fewer peptides, which is why we heal slower and are more prone to injury and inflammation. [0:19:26] Functional Medicine + Peptides: Approach, Expectations & Use Noel's approach: Combines functional medicine with peptides. Peptides only work well if the materials (sleep, nutrients, stress management, movement) are in place. Uses comprehensive labs to optimize baseline health first. Delivery & protocols: ~90% of peptides are injectable (tiny insulin‑type needle, usually daily). Some oral options exist Local injections near the injury area Expectations & timelines First 2–3 weeks: less inflammation, modest improvement in pain, sleep, and energy. 6–8 weeks: improved range of motion and strength. After 3 months: realistic minimum for true tissue change; peptides can't shortcut normal cell‑turnover timelines. [0:21:41] Specific Peptides & Treatment Logistics High‑demand musculoskeletal peptides: BPC‑157 and TB‑500: commonly used for tendons, ligaments, muscle and injury recovery. Growth hormone related peptides: Examples: samorelin, CJC, ipamorelin, tesamorelin. Stimulate the pituitary to release natural human growth hormone (HGH) rather than supplying exogenous HGH. Potential benefits: lean muscle mass, better body composition, cardiometabolic support. Monitored via IGF‑1 levels to avoid excess. PT‑141 for sexual health: Crosses the blood–brain barrier and activates pleasure/desire centers. Can cause nausea in some people; alternative forms (nasal spray, sublingual troche) may reduce side effects. How Noel works with patients: Website: doublebridgeswellness.com Contact form → email → optional free 20‑minute expectations call to see if there's a good fit. 1‑hour new patient visits, not rushed; she practices on the Nutrition World campus. [0:35:01] GLP‑1 Drugs (Ozempic, Trulicity, Mounjaro): Good, Bad & Ugly Case study: 65‑year‑old woman with pre‑existing gastroparesis put on Trulicity. Developed severe vomiting, dehydration, abdominal pain; was initially reassured to “get used to it.” Second dose led to life‑threatening pancreatitis, requiring hospitalization. Later prescribed Mounjaro by same clinic despite this history. The “Good” of GLP‑1s: In Curt's clinic, used selectively for: Poorly controlled diabetes (A1c > 10, average sugars in the 300s). Significant obesity. Can lower blood sugar and drive weight loss, by suppressing appetite The “Bad”: Common GI side effects (up to ~50% of users): Nausea, vomiting, constipation. Worsening gastroparesis (slow gut motility). Rapid weight loss often includes loss of muscle and bone, not just fat—hurts longevity and functional strength. Ozempic face: gaunt facial appearance from aggressive fat/muscle loss. Risk of hypoglycemia Visual issues, including increased macular degeneration risk. Psychiatric concerns: Emerging data on increased suicidal ideation, especially notable because trials excluded psychiatric patients. The “Ugly”: Pancreatitis, gallbladder problems. Thyroid tumors in some models. Possible cardiac atrophy. Massive growth in use: tens of millions prescribed, with many discontinuing within a year due to side effects or cost. Risk that people treat GLP‑1s as a “magic bullet” without nutrition or lifestyle change—and regain ~85% of lost weight after stopping. Curt's conclusion: GLP‑1s should be reserved for specific, high‑risk cases and paired with close coaching. For most people, there are safer, natural options. [0:50:12] “Nature's Ozempic,” Gut Health & Upcoming Events Ed and Curt on supporting GLP‑1 pathways naturally: Berberine – “nature's Ozempic” for blood sugar and metabolic support. Akkermansia (probiotic strain) – gut health, metabolic benefits, GLP‑1 stimulation. Butyrate – short‑chain fatty acid that: Supports gut lining / leaky gut repair. Improves colon health and may help increase GLP‑1. Ed reports best bowel function of his life using 2 caps/day. People who start GLP‑1s often increase supplement use, but tend to stop supplements when the drug stops. Coaching is needed so they maintain nutrition and supplementation after GLP‑1 discontinuation. Practical tips & announcements: Colonoscopies: clear protein drinks are now typically allowed on prep day—can help preserve muscle and stabilize blood sugar. Upcoming Lunch & Learn (online): Topic: “The Microbiome's Impact on Longevity”. Format: Instagram Live (@NutritionWorld), Tuesday, May 5 at 12:15 PM. Upcoming in‑person lecture at Nutrition World campus: Topic: “Taming the Yeast: Candida‑Reducing Strategies”. Thursday, May 21 at 5:30 PM. Registration via nutritionw.com → Events. Closing: Ed and Clint wrap up, reiterating their mission of clear, actionable health guidance and noting the show will be out on major podcast platforms. The post Radio Show / Podcast – May 3, 2026 first appeared on Vital Health Radio.
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! In this final installment of our CLOUD EMPRESS actual play of PIT'S PEAK, do our players come face to face with certain doom?! WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! In this final installment of our CLOUD EMPRESS actual play of PIT'S PEAK, do our players come face to face with certain doom?! WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode, Dr. Jockers reveals why ginger is one of the most effective natural tools for gut health, joint pain, and heartburn. You'll learn the surprising reason heartburn is often caused by low stomach acid, not excess. He explains how ginger helps restore proper digestion at the source. You'll also uncover how ginger's compounds help reduce inflammation and support joint health. From calming pain pathways to protecting your cells, this root works on multiple levels in the body. It's not just about relief—it's about supporting long-term healing. Finally, you'll get simple ways to use ginger in your daily routine to improve digestion and absorption. Whether it's fresh, in tea, or fermented, these strategies are easy to implement. There's more to this herb than most people expect—and you'll start seeing why. In This Episode: 00:00 Heartburn and Low Acid 00:31 Podcast Intro and Coaching 03:44 Why Ginger Works 05:25 Key Ginger Compounds 08:31 Digestion and Nausea 16:40 Pain Relief and Inflammation 19:38 How to Use Ginger 21:36 Fermented Ginger Ale Recipe 24:10 Alternatives and Wrap Up 25:29 Final Podcast Outro Hair loss isn't just about age—it's about hair follicles getting stuck. AnaGain Nu by Purality Health uses a pea sprout extract clinically shown to reactivate follicles and boost regrowth. With their micelle liposomal delivery, your body absorbs it fast and effectively. Try it risk-free with a 180-day money-back guarantee and get a buy-one-get-one-free deal at RenewYourHair.com - https://renewyourhair.com/drj. Quality sleep is crucial for healing, recovery, and overall health. Paleovalley's Superfood Sleep Protein supports your body's natural sleep process with whole food ingredients like melatonin from tomatoes, magnesium for relaxation, and chamomile for stress relief. Say goodbye to grogginess and hello to restorative rest. For a limited time, save 15% on your purchase at paleovalley.com/jockers with the code JOCKERS. "If you struggle with heartburn, try supporting stomach acid first—adding ginger before meals can improve digestion and reduce reflux" ~ Dr. Jockers Subscribe to the podcast on: Apple Podcast Stitcher Spotify PodBean TuneIn Radio Resources: Reignite hair growth with AnaGain Nu, risk-free with a 180-day guarantee and a buy-one-get-one-free deal! https://renewyourhair.com/drj Visit http://paleovalley.com/jockers and save 15% with code DrJockers. Connect with Dr. Jockers: Instagram – https://www.instagram.com/drjockers/ Facebook – https:/www.facebook.com/DrDavidJockers YouTube – https://www.youtube.com/user/djockers Website – https://drjockers.com/ If you are interested in being a guest on the show, we would love to hear from you! Please contact us here! - https://drjockers.com/join-us-dr-jockers-functional-nutrition-podcast/
The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy
How Therapists Can Help Clients With IBS, Chronic Nausea, and Gut-Brain Disorders: An Interview with Dr. Ali Navidi, PsyD Curt and Katie talk with Dr. Ali Navidi, PsyD about disorders of gut-brain interaction, including IBS, chronic nausea, and other GI conditions that therapists may see more often than they realize. They explore how the gut-brain axis works, which clients may be more likely to struggle with these concerns, how therapists can stay within scope, and why specialized behavioral health treatment can directly improve symptoms rather than only helping clients cope with them. About Our GuestDr. Ali Navidi, PsyD is a licensed clinical psychologist and co-founder of GI Psychology, a national telehealth practice specializing in the treatment of gastrointestinal (GI) disorders and chronic pain. In addition to providing patient care, Dr. Navidi oversees clinical training and outreach initiatives at the practice. He has presented on GI disorders and chronic pain to organizations across the country, including the American College of Gastroenterology, UNC School of Medicine, George Mason University, Georgetown University (Grand Rounds), INOVA, as well as through podcasts, television appearances, and multiple State Academies of Nutrition and Dietetics. Key Takeaways Therapists are in a strong position to notice GI issues, especially in clients with anxiety, trauma histories, autism, or eating disorders. Disorders of gut-brain interaction are not just “in someone's head.” The pain and symptoms are real, even when there is no visible structural problem. Therapists should encourage appropriate medical evaluation and collaborate with gastroenterologists rather than trying to diagnose IBS or other GI disorders on their own. Specialized CBT and clinical hypnosis can directly treat gut-brain disorders, not just the anxiety that surrounds them. Dr. Navidi, PsyD describes a treatment model focused on hypervigilance, catastrophizing, and visceral hypersensitivity. When diet questions come up, therapists should be cautious and refer to GI-focused dietitians when appropriate. Therapists should also be careful about overconfident claims related to the microbiome, SIBO, and other popular gut-health conversations. For full show notes and the transcript for this episode, visit mtsgpodcast.com. Join the Modern Therapist Community Linktree: https://linktr.ee/therapyreimagined Patreon: https://www.patreon.com/c/mtsgpodcast Podcast Homepage: mtsgpodcast.com Facebook Group: https://www.facebook.com/groups/therapyreimagined Modern Therapist's Survival Guide Creative Credits Voice Over by DW McCann: https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano: https://groomsymusic.com/
Peaches are sweet, juicy, and familiar—but what if there has been medicine hiding in the leaves all along?In this episode, I sit down with herbalist and nutritionist Betsy Miller to explore the often-overlooked medicine of peach leaf (Prunus persica). While peaches are widely celebrated as food, Betsy shares how the leaves of the tree offer powerful support for patterns of heat and irritation in the body, especially when it comes to nausea, digestive discomfort, and nervous system overwhelm.Weaving together clinical insight, personal experience, and a deep appreciation for the subtle ways plants support healing, Betsy offers a closer look at the medicine of peach leaf. From tongue diagnosis (yes, she even sticks out her tongue on the show!) to herbal formulation, she shares practical and insightful ways to know when peach leaf is the right fit.If you're inspired to try peach leaf yourself, you'll love Betsy's simple and delicious recipe for Peach Leaf Elixir! You can download your beautifully illustrated recipe card here.By the end of this episode, you'll know:► What the classic “peach leaf tongue” looks like—and what it can reveal about what's going on in your body► Why peach leaf shines in situations where more commonly recommended herbs (like ginger) fall short► Betsy's go-to herbal formula for easing nausea during pregnancy► The type of anxiety that is best supported by peach leaf► The best time to harvest peach leaves—and tips for sourcing them if you don't grow your own► and so much more…For those of you who don't know her, Betsy Miller is a clinical herbalist and nutritionist in northern Virginia. She loves working with women's health, particularly fertility challenges, prenatal care and postpartum support, and has also begun working more with pediatric clients since becoming a mother. In addition to her clinical practice, Betsy teaches at the Maryland University of Integrative Health, and enjoys mentoring budding herbalists as they begin practicing in a clinical setting.Whether you're new to peach leaf or are already familiar with its gifts, I hope this conversation inspires you to look at peach with fresh eyes—and perhaps discover even more to love about this familiar fruit tree!----Get full show notes, transcript, and more information at: herbswithrosaleepodcast.comWould you prefer watching this episode? If so, click here for the video.You can find Betsy at PlantWisdomWellness.com.For more behind-the-scenes of this podcast, follow @rosaleedelaforet on Instagram!Working successfully with herbs requires three essential skills. Get introduced to them by taking my free herbal jumpstart course when you sign up for my newsletter.If you enjoy the Herbs with Rosalee podcast, we could use your support! Please consider leaving a 5-star rating and review and sharing the show with someone who needs to hear it!On the podcast, we explore the many ways plants heal, as food, as medicine, and through nature connection. Each week, I focus on a single seasonal plant and share trusted herbal knowledge so that you can get the best results when using herbs for your health.Learn more about Herbs with Rosalee at herbswithrosalee.com.----Rosalee is an herbalist and author of the bestselling book Alchemy of Herbs: Transform Everyday Ingredients Into Foods & Remedies That Heal and co-author of the bestselling book Wild Remedies: How to Forage Healing Foods and Craft Your Own Herbal Medicine. She's a registered herbalist with the American Herbalists Guild and teaches many popular online courses. Read about how Rosalee went from having a terminal illness to being a bestselling author in her full story here.
In this episode, Tracey Davidoff, MD and Joe Toscano, MD discuss the April 2026 Evidence-Based Urgent Care article, Management Considerations for Complications of Weight-Loss Medications in Urgent Care featuring Erin Loo PA-C.Introduction & Housekeeping — 0:22Guest Introduction: Erin Loo PA-C — 2:47Why This Topic Matters — 3:22Common Side Effects Seen in Urgent Care — 5:36Workup for Nausea & Vomiting — 9:28Treatment of GLP-1-Related Nausea & Vomiting — 11:58When to Send to the ED — 16:01Other Serious Complications — 17:56Managing Constipation — 18:43Other Weight Loss Medications — 21:04Key Takeaways — 23:23Closing & Outro — 28:04Subscribers, take the CME test here.Not a subscriber? Join here!
Radiologists break down exactly how long iodine contrast side effects last - from immediate reactions that fade in minutes to delayed rashes appearing days later. Plus, the surprising truth about breastfeeding after contrast, and which patients face extended recovery times. Learn more at https://www.contrast-connect.com/blog-post/how-long-do-side-effects-of-iodine-contrast-last-reactions-explained ContrastConnect City: Las Vegas Address: Las vegas Website: https://www.contrast-connect.com/
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! We continue our descent into Pit's Peak this week... what horrors await us?WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! We continue our descent into Pit's Peak this week... what horrors await us?WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
THC isn't the same drug it was 20 years ago, and pregnancy counseling hasn't caught up. We sit down with Dr. Nazanin Amadieh, a board-certified OBGYN who also trained in addiction medicine, to map what today's high-potency cannabis means for conception, the placenta, fetal development, and the newborn period. If you've heard “it's legal” or “it's just a plant” as proof of safety, this conversation offers a clearer, evidence-informed way to think about marijuana during pregnancy without stigma and without hand-waving. We dig into the endocannabinoid system, why fetal receptors show up as early as five to six weeks, and how cannabis exposure may affect implantation, placenta formation, and early brain development. Then we get practical about the outcomes clinicians track: miscarriage risk signals, the stronger association with low birth weight or small for gestational age babies, and what NICU admission can mean for families. Because so much research is dated and modern THC concentrations can reach levels older studies never measured, we also talk openly about uncertainty and why “no proof of harm” is not the same as “safe.” Nausea and vomiting gets its own spotlight, including the tricky overlap between hyperemesis gravidarum and cannabinoid hyperemesis syndrome, plus the hot shower clue that can point toward CHS. We also cover breastfeeding and THC in breast milk, what parents should watch for, and why postpartum relapse to cannabis is common when anxiety and overwhelm hit after the first few months. If you care about maternal health, prenatal care, addiction medicine, or harm reduction, you'll leave with better questions and clearer next steps. Subscribe, share this with someone who's pregnant or caring for pregnant patients, and please leave a review so more people can find the show.To contact Dr. Grover: ammadeeasy@fastmail.com
In this episode, I break down everything you need to know about GLP-1 medications like Ozempic, Wegovy, and Mounjaro—including the real-world side effects I see in clinical practice. While these medications can be incredibly effective for improving metabolic health, there's often confusion online: some people are scared away by exaggerated side effect stories, while others underestimate what to expect when starting treatment. My goal here is to give a balanced, evidence-informed perspective so patients can make informed decisions without fear or misinformation. This episode is for educational purposes only and does not replace personalized medical advice. Always speak with your licensed healthcare provider before starting or changing any treatment. We cover side effects and how to manage them, like: Nausea, bloating, diarrhea, constipation Sulphur burps and reflux Appetite suppression and food aversions Injection site reactions Gallbladder disease Hair thinning Ozempic face Rare: NAION If you're in Ontario and need support with obesity or metabolic health, you can request a referral to my multidisciplinary clinic, the High Metabolic Clinic. Learn more at www.highmetabolicclinic.com.
Adam works with a younger client suffering from anxiety, nausea, and intense acid reflux. Adam uses regression and super-power metaphors to help access a more resourceful state.
Hosts: Ed Jones (Owner – Nutrition World) & Clint Powell A variety of topics all related to living a healthy life Presented by: Nutrition World www.nutritionw.com Broadcasting from the Nooga Dentistry Studio www.noogadentistry.com Production of: Whitfield Media Group www.vitalhealthradio.com Show Summary & Time Stamps: Title: Saffron as “Nature's SSRI”, GLP-1 Side Effect Mitigation, Holistic Oral Health, & More [0:00:00] – Show Intro [0:01:44] – Ed's Fitness Goal & Using AI Ed's 4:00 a.m. gym routine and training structure. Goal: 14 weeks out from Chattanooga fitness/bodybuilding contest (men's classic over 50/55). Uses AI as a “thinking partner”: Uploads body and meal photos daily. Gets macro/meal feedback and accountability in ~7–8 minutes/day. Reports better progress in 3 weeks with AI than all of last year's prep. [0:05:08] – GLP‑1 / Weight‑Loss Drugs & Protein Strategy Conversation with Be Well Labs about GLP‑1/ozempic‑type drugs: ~1 in 8 people currently on weight‑loss meds; pill form may push toward 1 in 2. Concerns: long‑term side effects, muscle loss, “hijacking” normal physiology. Ed's mitigation tips for those on GLP‑1s: Aim for ~1 g protein per pound of body weight. Most will need two protein shakes/day plus weight training. [0:06:47] – Butyric Acid, Hydrogen Water & Sleep Gains Ed's last 3 weeks: More energy, best sleep/Oura Ring scores he's ever had (scores from ~71 → ~82). Two main changes: Butyric acid (from butter/fiber fermentation): 2 capsules in the morning. Supports gut lining, may have GLP‑1‑like effects. Hydrogen water: Uses a hydrogen bottle and tablets; must drink quickly after dissolving. Hypothesis: combination is improving gut health, inflammation, and overall well‑being. [0:10:18] – Dollar General “Stranded” Series New mini‑series concept: “What would Ed Jones do if stranded in a rural town and only had Dollar General for meals?” Finds ~12 foods (out of ~2000) he'd eat regularly. Message: even in limited environments (Dollar General, fast food), you can still find better choices. Content to appear on Instagram, Facebook, (possibly YouTube). [0:15:58] – Tallow, French Fries & Processed Carbs Rib & Loin (local BBQ restaurant) reportedly using beef tallow. Ed on fats: Prefers tallow (stable saturated fat) over seed/vegetable oils. Critiques decades of low‑fat dogma and resulting high‑carb intake and heart disease. Notes potato farmers discarding crops: Impact of GLP‑1 drugs on restaurant demand. Growing awareness of harm from processed carbs. Hydrogen‑rich “healing” waters story (German mine, Mexico, Japan) → dissolved molecular hydrogen theme. [0:22:17] – Oral Health, Tooth Powder & Mouth Microbiome Ed's dental routine: cleanings every 3 months. References his oral health e‑book (searchable via NutritionW.com). Product mention: Echo Dent Daily Care Tooth Powder: Chosen because it does not annihilate mouth bacteria. Key idea: chronic use of strong mouthwashes (even “natural” ones) may: Damage oral microbiome. Be linked to higher Alzheimer's risk via “bad” oral bacteria. Occasional disinfecting is fine (e.g., sore throat), but avoid twice‑daily “scorched earth” approach. [0:26:33] – Niacinamide, Glioblastoma & High Iron Study highlight: High‑dose niacin/niacinamide (B3) may support immune activity and short‑term outcomes in glioblastoma. Niacinamide boosts NAD (cellular energy/anti‑aging cofactor). Already used by dermatologists to help lower skin‑cancer risk. High iron / ferritin: Ferritin >100: likely inflammation or iron overload. Ferritin >200: pathological; associated with shorter lifespan. Action step: Test iron/ferritin (e.g., at Be Well Labs / beginwithlabs.com). If high, consider regular blood donation to lower iron. [0:34:42] – SSRIs & Antidepressants with Dr. Kurt Deering Guest: Dr. Curt Dearing, clinical pharmacist (30+ years). SSRIs discussed: Prozac, Celexa, Lexapro, Paxil, Zoloft. Effectiveness vs placebo: Placebo response in depression is high (~40%+). SSRIs only modestly better than placebo in many trials. Typical course: Weeks 1–2: patients often feel worse. Weeks 3–4: back to baseline. Weeks 4–6: if helpful, benefits show here. [0:40:44] – SSRI Side Effects, Withdrawal & Risks Common side effects: Nausea, vomiting, diarrhea, sweating, headaches. Sleep disturbance (insomnia or excessive sleepiness). Anxiety, jitteriness, tremors, dry mouth. Long‑term issues: Sexual dysfunction (very common). Weight changes (often weight gain). Withdrawal (if stopped abruptly): Anxiety, dizziness, flu‑like symptoms, insomnia. “Brain zaps” – electric‑shock sensations that strongly discourage abrupt stopping. Boxed warning: Increased suicidal thoughts/behaviors, especially 18–24‑year‑olds. [0:48:03] – Natural & Lifestyle Alternatives (Green Pharmacy) Strong caveat: never stop/taper SSRIs without coordinating with the prescribing clinician. Nutrient foundations: Vitamin D adequacy for mood and depression. Low‑dose lithium (as a micronutrient, e.g., lithium orotate): Supports brain health, reduces inflammation, may aid depression/anxiety/cognitive health. Omega‑3s, especially EPA, for mood support. Herbs & natural options: St. John's Wort, ashwagandha, saffron. Lifestyle interventions: Exercise (research shows it can match or beat standard depression care). Sunlight, sleep quality, mindfulness/prayer, overall holistic changes. Team approach: Add trainers, nutritionists, holistic practitioners alongside psychiatrists/MDs. [0:50:52] – Saffron as “Nature's SSRI” Clinical evidence: Meta‑analyses: saffron ≈ SSRIs in effect for mild–moderate depression. Faster onset (often 1–2 weeks). Side‑benefits: Heart health, anti‑inflammatory, lipid‑lowering. Cognitive support (including in Alzheimer's studies). PMS symptom relief. Eye health (age‑related macular degeneration support, intraocular pressure). Better sleep (duration and quality). Weight management (reduced appetite, body weight, waist circumference). Improved libido and sexual satisfaction (opposite of many SSRIs). [0:56:44] – Offers, Products & Closing WishGarden immune products: Immune boost for pregnancy. Kids' immune support formula (often mixed with honey for taste). Free bottle for the first 10 in‑store visitors mentioning the show (time‑limited). NoogaPodcasts.com: Clint promotes his local podcast network (crime, politics, adventure, health, faith, veterans, etc.). Fireside Herbicide: Plant‑desiccating herbicide that dehydrates weeds instead of poisoning soil. Less harmful to earthworms and soil life vs glyphosate products. Sign‑off: Radio airing on Sundays, podcast version (“Vital Health Radio”) drops Tuesdays. Thanks to listeners and mention of Nutrition World as primary sponsor. The post Radio Show / Podcast – April 5, 2026 first appeared on Vital Health Radio.
Send us Fan MailIn this episode, Lasche shares her two birth stories, one in hospital and one at home. Throughout both of her pregnancies, she experienced ongoing nausea and vomiting right up until birth.With her first, she chose to birth through the MGP program and went beyond 42 weeks before going into spontaneous labour. During labour, she was sent home as she wasn't yet in active labour. After her waters broke, she returned to hospital where meconium was found in the waters. Her care team recommended starting syntocinon, and she gave birth not long after, with contractions becoming intense and close together.After reflecting on and questioning her first birth experience, Lasche decided she wanted something different the next time.For her second pregnancy, she chose a home birth with a private midwife. Her labour was fast, lasting just 2.5 hours, and her baby was born before the midwife arrived.Links: - Court Case Support the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.
Hosts: Don Stader, Nate Novotny, Travis Barlock, and Jeffrey Olson In this episode, we reminice about the first 1000 medical minutes presented by EMM and what the next 1000 might hold. Below are all of the episodes referenced in this episode. Please go back and give them all a listen. Segment 1- Recap and Facts 1st medical minute o April 29, 2016. Almost exactly 10 years ago. o Diverticulitis and Antibiotics by Dr. Chris Holmes 1000th Medical Minute o March 30, 2026 o Treatment of burns by Aaron Lessen o Edited by Ashley Lyons and published by Jorge Chalit Favorite sub-topics have included: o Cardiovascular topics- 150 episodes o Pharmacology- 97 episodes o Toxicology- 85 episodes o Neurology- 75 episodes The "Hunting for…" cinematic universe. -Michael Hunt o 399: Hunting for Pancreatitis o 424: Hunting for Measles o 432: Hunting for UTIs o 445: Hunting for the Endotracheal Tube o 455: Hunting for PeeCP o 460: Hunting for PE in Syncope o 487: Hunting for Epiglottitis Obsession with 1966- Chris Holmes o 120: The State of Sepsis in 1966 o 125: Old School CPR - 1966 o 138: Bromide Toxicity - 1966 o 147: GI Bleed - 1966 o 675: CHF like it's 1966 Favorite drug: naloxone/narcan (9) o 7: Heroin Overdose and OTC Narcan o 464: Narcan't? o 516: Narcan and Pulmonary Edema o 931: Naloxone in Cardiac Arrest Favorite disease state: Sepsis (13) o 22: Sepsis Sofa o 219: History of Sepsis o 244: Fever in Sepsis o 263: Early Antibiotics in Sepsis o 272: More on Temperature in Sepsis o 287: Sepsis Bundles o 544: C is for Sepsis Unhinged title combinations o 84: Hypothermia and Lightning Strike: Code Blue o 203: Wine, Milk and… Vaccines!? o 216: Roller Coasters and Kidney Stones o 299: Black Death, Lice, Math, and Pottery o 427: Cookie Dough is Delicious o 670: Operation Tat-Type o 695: Einstein and Cellophane o 777: Grass, weed and ancient Rome o 781: Foxglove, dropsy, and Salvador Dali o 959: The KLM Flight Disaster and Lessons in Healthcare Communication Most frequent contributors - Aaron Lessen- 192 - Don Stader- 84 - Jarod Scott- 83 - Peter Bakes- 53 - Samuel Killian- 45 - Dylan Luyten- 41 - Erik Verzemnieks- Dozens - Michael Hunt- 34 - Travis Barlock- 30 - Ricky Dhaliwal- 25 Top female voices o Rachael Duncan, PharmD o Rachel Beham, PharmD o Meghan Hurley o Gretchen Hinson o Suzanne Chilton o Katie Sprinkle Most listened to - 8. Podcast 835: Syncope Review - 7. Podcast 766: Truth about Tramadol - 6. Podcast 839: Causes of Pancreatitis - 5. Podcast 760: Why Fentanyl is the Worst - 4. Podcast 844: Dental Infections - 3. Podcast 846: Early Repolarization vs. Anterior STEMI - 2. Podcast 845: Hyperkalemic Cardiac Arrest - 1. Podcast 847: ECMO CPR Mini-game: who has actually seen our most rare diagnoses? o 18: Lemierre's Syndrome – Septic thrombophlebitis of the internal jugular vein after oropharyngeal infection leading to septic emboli. o 139: Locked-in Syndrome – Ventral pontine lesion causing quadriplegia and inability to speak with preserved consciousness and eye movements. o 144: Moyamoya Disease – Progressive stenosis of intracranial carotids with development of fragile collateral vessels causing strokes. o 221: Cotard Delusion (Walking Corpse Syndrome) – Psychiatric disorder where patients believe they are dead or do not exist. o 240: Pott's Puffy Tumor – Frontal bone osteomyelitis with subperiosteal abscess from sinusitis causing forehead swelling. o 277: Mucormycosis (Rhizopus) – Angioinvasive fungal infection in immunocompromised patients causing rapid tissue necrosis. o 293: Transient Global Amnesia – Sudden, transient loss of ability to form new memories that resolves within 24 hours. o 329: Hypokalemic Periodic Paralysis – Episodic muscle weakness due to intracellular potassium shifts. o 374: Iliac Artery Endofibrosis – Exercise-induced fibrosis of the iliac artery causing claudication in athletes. o 466: Subacute Sclerosing Panencephalitis (SSPE) – Progressive, fatal neurodegenerative disease from persistent measles infection. o 477: Postpolypectomy Electrocoagulation Syndrome – Transmural burn of the colon after polypectomy causing localized peritonitis without perforation. o 578: Brown-Séquard Syndrome – Hemisection of the spinal cord causing ipsilateral motor/proprioception loss and contralateral pain/temperature loss. o 697: Kounis Syndrome – Acute coronary syndrome triggered by allergic reaction causing coronary vasospasm or plaque rupture. o 973: Meningitis Retention Syndrome – Acute urinary retention due to sacral nerve dysfunction during meningitis. Segment 2- Individual Interviews Segment 3- Looking forward Segment 4- Trivia Podcast 38, what is significant about diphtheria and March 18th? o On March 18th, the Iditarod is run in Alaska to commemorate a sled dog team, led by Balto, that ran from Nome to Anchorage and back to provide children in Nome with the diphtheria anti-toxin serum. Podcast 52: Syphilis the Great Imitator. The study of Syphilis or "Syphilology" evolved into the field of what? o Dermatology Podcast 121: The Poor Man's Methadone. What is the poor man's methadone? o Imodium Podcast 136: James Lind, conducted the first clinical trial in 1747 and proved that what cure what? Hint: think vitamins. o Citrus fruits cure scurvy. Podcast #213: --- and Potatoes. What food has been shown to lower LDL? o Oats Podcast #216: Roller Coasters and Kidney Stones. A study used a model of a kidney and ureter with different sized stones and put it on ------ roller coaster in Disney World. o Thunder Mountain Podcast #261. ---- was introduced to treat ACE-inhibitor induced angioendema. but later, better-powered studies showed that it had no benefit compared to standard treatment. o Icatibant Podcast #304: ---. ---- was a formal medical diagnosis, and one that dates back to 17th century when soldiers had longing for home and melancholy with a constellation of symptoms including lethargy, sadness, disturbed sleep, heart palpitations, GI complaints, and/or skin findings for which the only cure was to return home. o Nostalgia Podcast # 351: Steakhouse Syndrome. What is steakhouse syndrome? o Impacted food bolus 2/2 esophageal stricture Podcast # 362: Giant Hogweed. What can Giant Hogweed cause. o Photosensitivity, severe blisters, and burns Podcast #398: Who is gonna fail your antibiotic plan? What vital sign abnormality at triage had the highest odds ratio for treatment failure for the treatment of cellulitis with antibiotics. o Tachypnea Podcast # 458: A Tylenol a Day Keeps the ---- Away? A recent study investigated the effect of scheduled IV acetaminophen on the incidence of ---- in post-CABG patients in the ICU o Delerium Podcast 554: Sleeping Away Alzheimer's. What is the difference between white noise and pink noise? o White noise is all the surrounding sound frequencies mixed together that your brain tunes down so you don't get distracted while you're sleeping o Pink noise, or deep soothing noises, is the accentuated bass sounds like falling rain or waves crashing your brain keys into while sleeping. o Pink noise during sleep has been shown to increase stage 4, creating more CSF washout of beta amyloid. Podcast 580: Origin of PPE. Why were rubber gloves invented? o The invention of surgical gloves are credited to surgeon William Halsted. He developed gloves because one of his assistants (and later wife), Carol Hampton, was having severe irritation due to a caustic pre-op disinfecting process. They developed the rubber glove for Hampton which garnered popularity, and by the early 20th century, half of surgeons were using rubber gloves. Podcast 587: Puppies Preventing Burnout? Puppies lower stress, what activity in that study increased stress? o Coloring, because they were denied a chance to play with a puppy Podcast 596: Weather Can be a Headache. What are the three weather events that can increase the frequency of headaches? o High temp o Low humidity o High air pollution Podcast 612: Origin of Vaccines. Guess both diseases. The potential of vaccinations was first observed in the late 1600s when Jenner observed people who had cowpox never contracted ----. Years later, Louis Pasteur inoculated chickens with ---- after his assistant accidently created the first live attenuated vaccine by creating a weakened bacteria when he left the bacteria out while he went on vacation o Smallpox, cholera Podcast 670: Operation Tat-Type. In 1951, Operation Tat-Type began tattooing adults with their ---- in an effort to prepare for ---- in the time of the Cold War and the Korean War o Blood type, rapid transfusions Podcast 695: Einstein and Cellophane. Albert Einstein had ----- as a middle-aged man. Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found a ---- - The only treatment for an AAA at that time was to----, causing a fibrotic response to prevent rupture - Einstein died 7 years after this surgery, likely from his leaking abdominal aortic aneurysm o chronic abdominal pain o AAA o wrap the vessel in cellophane Podcast 748: -----. Whale blubber, honey, home fermented foods, homemade wine (especially the wine made in prison), and improperly stored canned food can all contain the toxin o Botulism Podcast 777: Grass, Weed, and Ancient Rome. Wine and wormwood and white hellborn were used in ancient rome to treat ----. o Nausea, sea sickness Podcast 821: EKGs in Syncope. Travis suggests a mnemonic for remembering additional EKG findings to look for in syncope o WOBBLER § Wolff-Parkinson-White (WPW) § Obstructed AV node § Brugada syndrome § Bifascicular block § Left Ventricular Hypertrophy (LVH) § Epsilon waves § Repolarization abnormalities Podcast 890: Outdoor Cold Air for Croup A 2023 study, published in the Journal of Pediatrics, investigated whether a 30-minute exposure to outdoor cold air could improve mild to moderate croup symptoms before the onset of steroid effects. In what country was this study conducted. o Switzerland Podcast 925: Pediatric Tongue Entrapment. Case study of a peds patient with his/her tongue stuck in a drinking cap. What was the substance that finally set it free? o Table sugar Podcast 960: Frank's Sign - A Marker for Coronary Artery Disease. What is Frank's Sign? o Bilateral earlobe crease Thank you to all that make the EMM awesome! Hosted and editted by Jeffrey Olson MS4 | Additional editting by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! We are once again the Cloud Empress Lorecast and this time we're actually playing the game! Buckle up for part one of... PIT'S PEAK!WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
That Dastardly Adam Seats™ is BACK and has taken over The Tower once again! We are once again the Cloud Empress Lorecast and this time we're actually playing the game! Buckle up for part one of... PIT'S PEAK!WARDEN: ADAM SEATS PLAYERS: CLASSICAL GLAIZA, GNOME ANNE, HELENA HENBASKET, LOREMASTER SERGIO Thank you SO much to watt and make to check out ALL things Cloud Empress (DTRPG and itch.io) as well as taking a look at Alfred Valley's work HERE and following him on Bluesky. CONTENT WARNINGS: EXPLICIT LANGUAGE, LARGE BUGS, MENTAL ILLNESS, BLOOD, AMPUTATION, MILITARY OCCUPATION, GUN VIOLENCE, VIOLENCE TO INSECTS, NAUSEA, CULT-LIKE BEHAVIOR, RITUAL GROUP SUICIDE, LOSS OF HEARING, CONFINEMENT, TEMPORARY LOSS OF BODILY AUTONOMY/FORCIBLE BODILY MUTATION DnD Lorecast Discord | DnD Lorecast t-shirts, stickers and more! Order Lore TA Shaun's Alien novel, PERFECT ORGANISMS Order Lore TA Shaun's Solomon Kane novel, SUFFER THE WITCH! Links: Lore TA Shaun's second novel, The Dissonance, is out NOW Pantheon/PRH! Buy it ANYWHERE books are sold! And pick up Shaun's Conan the Barbarian ebook short story, also available now! The 616 Files - Shaun and Sergio's OTHER nerdy podcast! A deep dive into the 616 Marvel Universe, comic by comic, year by year Fandom University - And yet ANOTHER nerdy podcast! Multi-episodes arcs deep-diving into various nerdy topics *SEASON 1 NOW COMPLETE* Check out all the socials at dndlorecast.com And send us a note! Email us at dndlorecast@gmail.com ROBOTSRADIO.net - Smart Shows for Interesting People. Explore all the awesome shows on the network. Robots Radio Network Discord: discord.gg/JXKfVhM Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 Licensehttp://creativecommons.org/licenses/by/4.0/ Learn more about your ad choices. Visit megaphone.fm/adchoices
Nausea is a common side effect when ingesting psilocybin mushrooms, usually most pronounced during the “come up” and typically leveling out for the remainder of the trip, although the extent and duration of nausea can vary greatly among individuals.Today, we'll look at a few different perspectives on why nausea can happen, as well as some tips for avoiding it. We'll also share how nausea played an integral part in one client's intentional psychedelic experience, so tune in for a comprehensive conversation surrounding nausea and psilocybin!Key TakeawaysDiverse Biological Triggers: Nausea is primarily caused by the interaction of fungal compounds (like indigestible chitin, tannins, and beta-glucans) with the human body, as well as the activation of 5-HT2A and 5-HT3 receptors in the gut.Physiological vs. Psychospiritual Lenses: Identifying the specific causes of discomfort is essential for choosing the right approach; symptoms may stem from physical digestion or from "somatic resistance" and emotional baggage.Strategic Remedies: Depending on the trigger, the transition can be managed through remedies like lemon tekking and dietary preparation, or by intentionally "leaning in" to the experience as a beneficial psychospiritual purge.-This episode is supported by North Spore, helping people explore the wellness benefits of legal functional mushrooms. Try a variety of ready-to-go supplements and wellness products, or learn to cultivate mushrooms at home with their range of grow kits and supplies.Shop now with code PSYCHEPASSAGE for 10% off -Psychedelic Passage is your partner in safe, supported, and effective psychedelic journeys. As the first concierge service in the U.S., we connect you with vetted facilitators who value integrity and expertise. We're glad you're here, and we look forward to supporting you on your journey.No mushroom source? No problem. Download our Free Psilocybin Sourcing Guide. Want guidance tailored to your need? Book a free Pathfinding Call for personal support. Curious or seeking connection? Join our online care community to learn, share, and grow with others. Join our next Q&A or Facilitator Chat for free.
Up to 50% of homes are at risk of mold exposure, and knowing the warning signs could protect you from the harmful effects of black mold and mycotoxins. In this episode, I share the latest research and my personal experiences with mold symptoms and testing to help you identify hidden mold in your home — including how to choose the right testing option for your situation. I also cover the most common mold mistakes to avoid, so you can find mold, test for it, and confidently take the right next steps.
We are rebranding from Game-Changing Health to Your GLP-1 Bestie- stay tuned!
Send a textProfessional gravel cyclist and NR athlete Sarah Sturm is pregnant! This is first in a series of five episodes where we dive into first trimester nutrition and some of the biggest challenges that can come with it. In Episode 1 we dive into:The surprising role of blood sugar in managing nausea and fatiguePractical tips for balancing carbs, proteins, and fats to keep energy steadyHow to use simple, shelf-stable snacks to combat cravings and support growthThe key nutrients your body prioritizes during pregnancy — and how to optimize themWhy managing body perception and mental health matters just as much as nutritionWhether you're currently pregnant, planning to be, or supporting someone through early pregnancy, Sarah's candid stories and Kyla's expert guidance provide tools to navigate with grace, knowledge, and a little more patience. Please note that this podcast is created strictly for educational purposes and should never be used for medical diagnosis or treatment.Mentioned:Thorne Prenatal: https://nutritional-revolution.com/product/thorne-basic-prenatal/Momentous Omega-3: https://go.shopmy.us/p-46970780Folic Acid: https://nutritional-revolution.com/product/pure-encapsulations-folic-acid/Follow Sarah's Pregnancy Journey:IG: https://www.instagram.com/sarahsturmyMORE NR Save 10% on our website with code NEWPOD10 Apply to work with us, click here: https://nutritional-revolution.com/ Interested in having your biomarkers or nutrigenomics checked? Email us at nutritionalrev@gmail.com Follow us @nutritionalrevolution Save 20% on supplements at our trusted online source: https://us.fullscript.com/welcome/kchannell Join Nutritional Revolution's The Feed Club to get $20 off with an extra $20 Feed credit drop every 90 days.: https://thefeed.com/teams/nutritional-revolution Shop NR founder Kyla Channell's top picks: https://shopmy.us/shop/nutrev If you're interested in sponsoring Nutritional Revolution Podcast, shoot us an email at nutritionalrev@gmail.com.
If you've ever been pregnant or currently going through it now... IYKYK!!! Pregnancy nausea is real and can be very severe for some people. Plus the term "morning sickness" is so deceiving because it truly lasts all day.Although I'm lucky enough to have only had nausea for a few weeks in the beginning of my pregnancy, it still SUCKED going through it.So I want to share some tips I learned that helped me manage the nausea as much as possible!Tune in to hear more about what you can do to keep it at bay!---------------------------------------------------------Find me on IG: @jfaye_rdWork with me! More info here or APPLY hereFREE RESOURCE: Balancing hormones and reducing pms here
This is a free preview of a paid episode. To hear more, visit rethinkingwellness.substack.comChristy delves into the science to answer several questions she's gotten (and asked herself) about pregnancy. We discuss whether the sex of the baby predicts nausea levels, whether methylated folate is better than folic acid (in pregnancy or otherwise), whether dates (the fruit) have really been shown to induce labor, and whether there's an increased risk of stillbirth after 39 weeks for IVF babies.The full version of this episode is for paid subscribers. Listen to the first question here, and sign up for a paid subscription to hear the rest!Get full show notes and references here.
If you've ever thought, “Why didn't anyone prepare me for this?” — this episode is for you. So many women are doing all the “right” things, yet still feel exhausted, inflamed, foggy, or just off in ways they can't quite explain. Too often, we're told it's simply part of aging. In this episode of HEAL with Kelly, I'm joined by Dr. Amy Shah, whose work — and new book, Hormone Havoc — is helping change the conversation around women's health. We talk about why women's health has been historically overlooked, how nutrition has been left out of critical medical education, and why so many women feel dismissed when they seek real answers — especially during perimenopause and menopause. Dr. Shah explains how hormonal shifts affect the brain, gut, metabolism, mood, and nervous system — and why symptoms like hot flashes, night sweats, brain fog, cravings, and poor sleep are signals, not failures. We explore simple, science-backed ways to support hormones through food, movement, and lifestyle, including walking, strength training, gut health, stress resilience, and why alcohol affects women differently in midlife. We also talk about purpose, community, and connection, and why women are evolutionarily wired to thrive in this next phase of life. If you've been searching for clarity, validation, or a more compassionate roadmap for this chapter, this episode offers exactly that. Key Moments You'll Love ✨:
In the first episode of Giana's Corner, Giana sits down with Joe to talk about the decision to start trying (or not try) for a baby and what actually happened once It all worked out. From the shock of finding out about the pregnancy to the unexpected reality of the first trimester, they share the honest, messy, and sometimes chaotic side to early pregnancy.They talk about everything from their decision to try, how quickly things changed, and what those first few weeks really felt like. Nausea, extreme hunger, shifting identity, and the strange in-between space of holding a big secret while your body is going through something huge. Plus, news about potentialy having twins!Joe chimes in throughout the conversation, offering his perspective on supporting a pregnant partner and navigating the transition into parenthood together.This episode is a candid look at the beginning of a major life shift. The funny thing about the first trimester is that no one really prepares you for how much it changes you before anyone else can even see it. Hosted on Acast. See acast.com/privacy for more information.
Dr. Deb Muth 0:00 Welcome back to Let’s Talk Wellness Now. I’m your host, Dr. Zab, and we are continuing our discussion this week on 0:08 peptides. And so, if you haven’t heard our first conversation about peptides, 0:13 please go back and look at that episode. We talk all about the manufacturing, the safety, the quality of peptides, and we 0:20 dove into GLP1s. And today we’re going to dive into peptides for sexual 0:26 wellness, immune function, growth hormone, and all the amazing fun things 0:32 we can do with peptides. So, as usual, grab your cup of coffee or tea, settle 0:37 in, and let’s talk wellness now. And we’re going to take a short pause from our sponsor. I know we’ve got to do 0:44 that, you guys. They’re who keep us on the air. So, I’m going to pause for just a minute and be right back after this 0:50 message from our sponsor. Ladies, it’s time to reignite your vitality. Primal 0:56 Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that 1:03 lasts. Get 25% off at primal queen.com. Serenity Health. That’s primalqueen.com. 1:10 Serenity Health. Because every queen deserves to feel in her prime. All 1:15 right, everybody. We are back. And are you ready? We are talking all things peptide and I am opening the show today 1:23 with sexual wellness. Yes, I’m going there, you guys. I am going there. You 1:29 know, this has really become a big issue for people um of all ages. It’s not just 1:3 4us older people. It’s younger people, too. And there’s a whole variety of reasons why we have sexual dysfunction. 1:42 And when we’re talking about sexual dysfunction, we’re not just talking about it doesn’t work, right? Or I can’t 1:48 reach orgasm. A lot of it is around desire and um the thought of it and 1:54 wanting to connect, wanting to be kinder to one another, wanting to be touching 2:00 one another. A lot of it resolves or revolves around that. And so there are some peptides that can help us and I’m 2:08 really excited to be able to talk about those today. So the first one is called PT-141. 2:14 This targets the brain not the periphery. Right? So for many women I 2:20 will always tell you sex starts between here. It is a brain thing for us. It is 2:26 not necessarily a physical thing. For guys that’s a little different. It’s very physical. For women it’s all in our 2:32 brain. So tip for you men that are listening. You have to prime your woman’s brain first if you want her to 2:38 have sex with you that night. You have to be nice to her. You have to bring her flowers. Do the dishes for her. Do 2:45 something kind. Bring her a cup of coffee or tea or a glass of wine. Take her to dinner. You have to woo her. And 2:51 I don’t care how long you’ve been married. That has to happen. And tip number two, don’t say anything stupid 2:57 that day. I’m just being honest. When you guys say things that make us upset, 3:03 that lingers with us for the rest of the day. And it’s it’s a turnoff for us. And 3:08 for a lot of women, we can’t get past that when it comes time to snuggle at night. And sex doesn’t always have to be 3:14 at night either. So, you can tell I really love talking about this conversation, but we’re going to get into the peptide part of it because this 3:21 is going to help people. So, um, PT-141 is marketed as I’m going to slaughter 3:28 this name, Vali, and it represents a fundamentally different approach to 3:34 sexual dysfunction than the PDE5s inhibitors like Slenden, Viagra, 3:40 Tedataphil, which is Seialis. And while the PDE5 inhibitors work specifically by 3:47 enhancing blood flow to the genital tissues, PT-141 works centrally in the brain by 3:54 modulating neural s neural circuits involved in the sexual desire and 4:00 arousal. Now PT-41 is a cyclic hpatipeptide. It’s seven amino acid 4:07 peptide arranged in a cyclic structure that acts as a melanoortin receptor 4:13 agonist and with particularly the infinity for MC3R and MC4R subtypes. 4:20 It’s actually a metabolite of the melanotan 2, a peptide originally 4:26 developed for tanning that was also found to enhance sexual desire in early 4:31 studies. Now the melanoortin system in the brain is involved in multiple functions including energy homeostasis 4:39 but it also is involved in sexual motivation and arousal behaviors. The FDA approved PT-141 in 2019 specifically 4:48 for the treatment of acquired generalized hypoactive sexual desire 4:54 HSDD in permenopausal women. So for the first time we have a medication that was 5:01 approved by the FDA to use for women for sexual dysfunction. We have had all of 5:07 these seialis tedataphil viagros for men but we had nothing for women. And so 5:12 this is amazing that this is available for women and approved by the FDA. It’s a big deal. This represents the first 5:19 and only FDA approved medication specifically targeting these circuits of sexual desire rather than the peripheral 5:27 arousal mechanisms. And this indication is quite specific, meaning it was developed at some point, not lifelong. 5:35 So I if you’ve had sexual dysfunction your entire life, this medication was 5:40 not approved for you. But if it’s something that you developed over time, like when you went through pmenopause or 5:46 menopause or some women have this experience happen after childirth, that’s what we’re talking about here. 5:53 Now, it’s also not just um supposed to be used if you dislike your partner, 5:59 right? If your relationship is bad and you dislike your partner, this probably isn’t going to fix a ton. It might help 6:05 a little bit, but that’s not what it’s meant for. So, you really have to know what you’re using it for and why. And 6:11 the other thing that I would say is this is something that we don’t go to if your hormones are not balanced properly. You 6:17 have to balance your hormones properly before using something like this because it still may not work. Now, the only 6:24 caveat to that is if you’re a woman that has a risk of breast cancer and can’t use hormones, then that’s a different 6:31 story and we would have that conversation about whether or not this medication would be appropriate for you. Now, the FDA label specifies PTA1 uh 6:39 PT-141 as it not being indicated for HSDD in causes where low sexual desire 6:46 is due to coexisting medical or psychiatric conditions, problems with relationships, like we had talked about, 6:53 side effects to medications or other substance use. This specifically reflects the importance of differential 6:59 diagnosis. Low sexual desire can have many root causes and PT-41 is only 7:05 appropriate when those causes have been ruled out. Now, I have I used PT41 in 7:10 people who have sexual dysfunction issues as a result of using 7:16 anti-depressants. Yes, I have. I’ve used Flynn in that effect as well. And it 7:21 does work sometimes, but it doesn’t work completely. But you need to know that that is not what the approval is for the 7:27 FDA. So that is done in something that we call off label use. So very important 7:33 to know. Now in these clinical trials leading to FDA approval, this was published by Kinsburg and colleagues in 7:40 obstetrics and gyne gynecology in 2019. PT-141 demonstrated statistically 7:46 significant improvements in sexual desire and decreases in distress related 7:51 to low desire compared to placebo. The effects manifest over 45 minutes to 7:56 several hours after the injection and the mechanisms involved modulation of dopamine and melanoorton pathways in the 8:04 hypothalamus and the brain regions that involved sexual motivation. Now cardiovascular effects of PT 141 require 8:12 careful attention. This drug causes transient increases in blood pressure about 3 to four points and transient 8:20 decreases in heart rate. And because of this, it is contraindicated in patients 8:25 with uncontrolled hypertension or known cardiovascular disease. And it has been studied in patients who’ve had recent 8:32 cardiovascular events or sorry hasn’t been studied hasn’t been studied in patients who’ve had recent 8:39 cardiovascular events. So patients need to have their blood pressures checked before starting therapy. Nausea is 8:45 extremely common. It is one of the biggest things I often will tell people to take an anti-nausea medicine if 8:52 they’re going to do this because the last thing you want to do is inject this medication and think it’s going to give 8:57 you this great time with your partner and you’re so nauseated that you can’t even perform, don’t want to kiss, don’t 9:05 want to do anything. It it can be pretty profound for some people. um it does affect about 40% of the patients in 9:12 clinical trials which is why many clinicians require or recommend an 9:17 anti-nausea medication like I had just said other common adverse effects include flushing injection site 9:24 reactions headache in about 13% of the population which I have seen worse if 9:30 people are prone to headaches and the headaches are pretty intense so I will also have them premedicate if they have 9:36 that um sensitivity ity with a Tylenol or Advil, Alie, whatever it is they 9:42 typically use for their headaches to help prevent that from occurring. Now, some patients also experience a 9:50 generalized hyperpigmentation of their skin, particularly in areas with chronic friction, and this may not be reversible 9:57 after discontinuation. So from an integrative perspective, PT-41 10:03 represents one tool in addressing female sexual dysfunction, but it should never be the first or only intervention. And 10:11 low sexual desire in women is complex. Multiffactorial involving hormonal imbalances, low testosterone, estrogen 10:18 deficiency, progesterone imbalances, thyroid dysfunction, adrenal dysfunction, and with elevated or 10:24 disregulated cortisol levels, sleep deprivation, relationship issues, unresolved trauma, including sexual 10:31 trauma, chronic pain, body image concerns, and medication side effects such as SSRIs are notorious for this. So 10:39 a comprehensive hormone panel including total and free testosterones, estradile, 10:45 progesterone, DHEA, thyroid function in cortisol assessment, ideally four-point 10:51 cortisol, salivary should precede any pharmacological intervention. And additionally, addressing the 10:57 psychological component and relationship dimensions through appropriate therapy is necessary. I have a lot of patients 11:03 that say, “This is just too much work for sex. I don’t want the side effects. I don’t want to deal with this.” and that’s totally fine. But for some 11:09 people, their sexual dysfunction is actually causing more problems on their 11:14 relationship and they want to do something to fix that. And just know that if you’re using a peptide like this 11:20 that comes with some of these side effects and you have to premedicate for it, it is not the end of the world. Um, 11:27 but it may be a possibility that you may need that. So, let’s dive into body composition and growth hormone access. 11:34 So Tesmarellin is the only FDA approved GH 11:40 analog. Tesarelin is marketed as Agrifta and Agria SV. It is a synthetic analog 11:48 of human growth hormone releasing hormone. So GH RH human growth hormone 11:53 releasing hormone. These things are such long names it’s confusing and it’s difficult to spit out, right? It 11:59 consists of 44 amino acids. The structure is identical to our own 12:05 body’s growth hormone GHR um with the addition of trans3 hexonol group which 12:14 stabilizes the molecule that extends its half-life compared to the native GHR. 12:19 The mechanism of tesmarellin is elegant in its preservation of physiological 12:24 growth hormone GH secretion patterns and rather than administering an exogenous 12:30 growth hormone directly, tesmarillin binds to the GH receptor in the anterior 12:36 pituitary gland stimulating the indogenous pulsatile release of GH. So 12:42 you know it it’s slower in that stimulation and it pulsates instead of a direct rise and fall. This pusile 12:49 pattern more closely mimics natural GH secretion which occurs in bursts 12:54 primarily during sleep. The GH then stimulates the liver to produce insulin-like growth factor IGF-1 which 13:01 exerts many of the downstream metabolic effects including lipolytic effects on 13:07 the atapost tissue. So fat atapose and how we break that down. The FDA approved 13:13 tesmarellin in 2010 for a very specific narrow indication, the reduction of 13:19 excess abdominal fat in HIV infected patients with lipodistrophe. This 13:25 condition characterized by abnormal fat redistribution with accumulation of visceral body fat and the loss of 13:32 subcutaneous fat in face and limbs developed as a complication of an 13:37 antiviral therapy particularly with older protease inhibitor reg uh 13:42 regimens. The visceral fat accumulation in patients is not just cosmetic. It’s associated with increased cardiovascular 13:49 risk, insulin resistance, and inflammatory markers. The pivotal trial that led to the FDA approval included 13:56 work by Stanley and colleagues published in the annuals of internal medicine in 2014. It demonstrated that tesmarillan 14:03 significantly reduced the visceral atapose measured by CT scan by approximately 15 to 20% which is a 14:10 significant difference to placebo over a short period of time only 26 weeks. Now, 14:16 interestingly, the total body uh weight typically remained stable or even 14:21 increased slightly as the reduction of visceral fat was sometimes offset by increases in lean body mass or 14:28 subcutaneous fat. This highlights an important point. Tesmearellin is not a weight loss drug in its conventional 14:34 sense. Its effects are specifically on body composition and fat redistribution. 14:40 Now the glucose metabolism effects of tesmarellin do require careful monitoring because GH and IGF1 can 14:47 induce insulin resistance. Tesmearellin can increase glucose levels and hemoglobin A1C and in these clinical 14:54 trials glucose tolerance and new onset diabetes occurred in some patients. So 14:59 this creates a therapeutic paradox while res reducing visceral fat we should theoretically improve metabolic health. 15:07 The GH mediated insulin resistance can worsen the glycemic control and patients 15:12 with diabetes require particularly close monitoring. The potential need for adjustment in diabetic medications can 15:19 occur. So I already know what you guys are thinking. Can I use Tesmarellin and 15:24 GLP1 at the same time? And the answer is yes. Especially in those people that we 15:30 know have an insulin resistance already or are prone to that, we can use lowd 15:36 dose micro doing GLP-1 along with tesmarellin to help prevent this from 15:42 occurring um or reduce the risk of it occurring. Now there are some other adverse related problems to growth 15:49 hormone access which include fluid retention which can uh manifest as uh 15:55 ankle swelling, joint pain, muscle pain, paristhesas, carpal tunnel syndrome is 16:01 common to see. Of course you can always see injection site reactions reported about 26 to 30% of the time in the trial 16:08 participants. And this also theoretically has a concern about IGF-1 elevation potentially promoting 16:14 malignancy through long-term data is limited. So we have to be cautious about 16:20 this but it is a growth hormone and anything that is a growth hormone can cause cells to grow and it cannot 16:26 necessarily differentiate between healthy cells and bad cells. So the drug is contraindicated is contraindicated in 16:33 patients with active cancer and in patients with the disruption of the HPA access from conditions like pituitary 16:40 tumors, pituitary surgery, head of radiation um and traumatic brain injury. 16:46 Now off label use of tesmarellin for general anti-aging or body composition 16:51 optimization in non-HIV population, it doesn’t have FDA approval. There is no 16:58 FDA studies. um that promote this, but practitioners do prescribe it for these 17:04 purposes under an experimental and not supported by FDA approved indications. 17:10 And um from an integrative medical standpoint, optimizing natural growth 17:15 hormone secretion through lifestyle interventions, high quality sleep is important. GH primarily is excreted 17:22 during sleep and deep sleep waves. So improving your deep sleep is important. Intermittent fasting can also increase 17:28 growth hormone by five-fold as demonstrated in a Hartman and colleagues uh study from the journal of clinical 17:35 endocrinology and metabolism in 1992. And highintensity interval training, adequate dietary protein, blood sugar 17:42 control, these all can help naturally increase your growth hormone. So, let’s 17:47 dive in now and talk about bone health. peptide hormones um such as oh I’m gonna 17:54 I’m gonna really slaughter this name. Terraparatide is a true bonebuilding 18:01 peptide. It’s marketed as forio. It’s a recumbent form of the first 34 amino 18:08 acids out of 85 of the human parathyroid hormone PTH. It represents a unique 18:13 approach to osteoporosis treatment because it’s one of the few truly anabolic anabolic bone therapies meaning 18:21 it actively binds new bone rather than simply preventing bone loss. The biology 18:26 of parathyroid is fascinating and seemly contraindicated or uh contradictory. 18:32 Continuously sustained elevations of PTH as occurs in hyperarathyroidism 18:37 is catabolic to bone. So people who have hyperarothyroidism typically have significant bone loss 18:44 especially before it’s diagnosed and it causes causes increased bone 18:49 reabsorption loss of bone density increased fracture risk and however 18:55 intermittent exposure to PTH as achieved with once daily uh injections of forio 19:01 has the opposite effect. This intermittent exposure preferentially stimulates osteoblasts bone building 19:08 cells over osteoclasts bone reabsorbing cells and it leads to 19:13 the net bone formation. So terraparatide binds to the PTH receptors on 19:20 osteoblasts and renal tubular cells in bone. It increases the number of 19:25 activity of osteoblasts stimulating the differentiation of osteoblast precursor cells and may 19:32 reduce osteoblast apoptosis basically programmed cell death allowing this bone 19:37 building cell to work longer. The result is increased bone formation, improved bone architecture and tbacular 19:45 connectivity and ultimately increased bone mineral density um particularly in the hip and the spine which is so 19:51 difficult to regain. The FDA approved this medication in 2002 based on pivotal 19:57 studies by Near and colleagues published in the New England Journal of Medicine in 2001 which demonstrated significant 20:05 reductions in vertebral and non-vebral fractures in post-menopausal women with 20:11 osteoporosis. specifically uh reduced new vertebral fractures by 20:17 65% and nonvettebral fragility fractures by 53% 20:23 compared to placebo over a median followup of 21 months. This is really 20:29 incredible because we have not seen this kind of um change uh in other 20:35 medications that we’ve used for osteoporosis. So current FDA approval 20:40 indicates uh this for post-menopausal women with osteoporosis at high risk for 20:46 fracture, men with primary or hypoconatal osteoporosis at high risk for fracture 20:53 and men and women with glucocord cord glucocordide 21:00 induced osteoporosis at high risk for fracture. The high risk qualifier is 21:05 important. uh terrapeptide is reserved for patients with severe osteoporosis, 21:11 multiple fractures, very low low bone density and those who have failed or are 21:16 intolerant of other therapies. The most significant concern for this medication 21:21 is highlighted in a boxed warning with rat toxicology studies where it caused 21:27 osteioaroma which is a bone cancer in a dose dependent and treatment duration dependent manner. The revolence of this 21:34 finding to humans is debated. Rats have fundamentally different bone biology than humans with continuous bone growth 21:41 throughout life and different PTH receptors. Now post marketing 21:46 surveillance in humans hasn’t shown a clear increase in osteocaroma risk but 21:51 theoretically concerns persist and because of this terapeptide is 21:57 contraindicated in patients at risk baseline risk for osteioaroma 22:02 including those with pageantss disease of the bone unexplained elevations of alkaline phosphate prior skeletal 22:10 radiations bone metastases or skeletal malignancies and pediatric patients or young adults 22:16 with open hyes. There’s also a lifetime treatment duration of only 2 years and 22:22 terrapeptide can cause transient hypercalcemia. So an elevated blood calcium and as PTH normally increases 22:31 calcium levels by enhancing bone reabsorption, increasing renal calcium 22:36 reabsorption and promoting activation of vitamin D which increases intestinal calcium absorption. Some patients 22:43 experience orthostatic hypotension within 4 hours of injecting requiring 22:48 caution in at risk populations for blood pressure. Common side effects include 22:53 muscle pain, joint pain, pain in the limbs, nausea, headache, and dizziness. So from an integrative bone health 23:00 perspective, terrapeptides should be part of a comprehensive strategy. Adequate calcium intake, 500 to a,000 23:08 milligrams of calcium a day from food and supplements combined. and vitamin D. 23:13 Getting vitamin D levels of at least 50 to 80 are essential for the drug to work 23:20 optimally. But beyond this, bone health requires vitamin K2, which directs calcium into the bones rather than soft 23:27 tissues, magnesium as a co-actor in bone metabolism, trace minerals like boron, 23:33 copper, silica, and of course, adequate protein intake, which many of us, especially as women, don’t do 0.8 8 to 1 23:42 gram of protein per kilogram of body weight, weightbearing exercise. Of 23:47 course, these all provide mechanical signals that complement the biochemical 23:52 symbol uh signals of terrapeptide. Sequential therapy is also critical. The 23:58 bone mass gains from terraparatide can be lost if patients don’t transition to 24:05 an anti-resorbbitive agent a bisphosphinate after completing this therapy and the anabolic effects to 24:12 build bone but maintaining the new bone requires preventing excess reabsorption. 24:18 So positive things about this but there are definitely some concerns as well. So 24:23 the next one we’re going to talk about is Lu Prolrooide. It is marketed under 24:29 the multiple brand names of Lupron, Depo, Eligard, and it’s a synthetic 24:34 nonapeptide analog of naturally occurring ginonadotropen releasing 24:39 hormone G&R, also called luteinizing hormone releasing hormone, LHR. 24:46 It’s a fascinating example of how manipulating natural hormonal feedback systems can create therapeutic effects. 24:53 So, G&RH is normally secreted in a pulsatile fashion by the hypothalamus 24:59 and travels to the anterior pituitary where it binds to G&R receptors and 25:05 stimulates the release of luteinizing hormone LH and follical stimulating hormone FSH. These ginatotropins signal 25:13 the ovaries or the testes to produce sex hormones, estrogen, progesterone in 25:18 women, testosterone in men. Uh, luoprololi lupron as a GNR agonist 25:26 initially mimics the action of natural G&R causing an acute flare response with 25:33 uh increased LHFSH secretion which temporarily increases sex hormone 25:38 production. However, the continuous administration which is in the depo 25:44 formulations, the GNR receptors in the pituitary become desensitized and 25:50 downregulated. And after about 2 to four weeks of continuous exposure, LH and FSH 25:56 secretion is profoundly suppressed, leading to what’s termed as chemical 26:01 castration. Testosterone levels in men drop to castrated levels less than 50 26:08 and estrogen production is marketkedly suppressed in women. This bifphasic 26:13 response creates both therapeutic applications and management challenges in prostate cancer where tumor growth is 26:20 typically androgen dependent and the ultimate goal is testosterone suppression. However, the initial 26:27 testosterone surge during the flare phase can temporarily worsen symptoms potentially causing increased bone pain, 26:34 urinary obstruction, or even spinal cord compression in patients with metastatic 26:40 disease. This is why uh luoprolide is often started with an anti-ad androgen 26:47 like bicladamide for the first two to four weeks to block the effects of the 26:52 testosterone surge. The FDA has approved lupalide for multiple indications across 26:59 formulations. In oncology, it’s used for palletive treatment of advanced prostate cancers. In gynecology, various 27:06 formulations are approved for endometriosis, for pain management and lesion reduction and for fibroids. 27:13 Typically for pre-operative uh hematological improvement in anemic patients. In pediatrics, it’s used for 27:20 central precocious p puberty basically to halt the premature sexual development of these young people. Now, there are 27:28 adex uh adverse effect profile that reflects profound hormonal suppression. 27:34 In men treated for prostate cancer, hot flashes affect about 59% of the patients. Other common effects include 27:41 general pain, swelling, bone pain. Um long-term use of these medications leads 27:47 to metabolic changes. It increases fat mass. It decreases lean mass. It worsens 27:53 insulin sensitivity, disrupts the cholesterol uh lipid panels, increases 27:59 diabetic risk, has some concerns over cardiovascular disease. And the metaanalysis have shown increased risks 28:06 of heart infarction, myocardial inffection, sudden cardiac death, and stroke in populations receiving 28:13 long-term androgen deprivation therapy. The bone effects are particularly dramatic. Without sex hormones, bone 28:20 density decreases significantly, typically 3 to 4% per year during the 28:26 first two to three years of therapy. And this bone loss may not fully be reversible after the the therapy 28:32 discontinues. The American Society of Clinical Oncology recommends bone density monitoring and consideration of 28:39 bisphosphinates uh in men receiving long-term androgen deprivation. In women treated for 28:46 endometriosis or fibroids, the estrogen suppression creates a hypoestrogenetic state similar 28:54 to menopause. Hot flashes affect 90% of patients with other common effects 29:00 including headaches, emotional irritability, decreased sex drive, vaginal dryness, bone density loss. And 29:08 because of these bone concerns and treatment duration with endometriosis, typically limited to six months, though 29:14 some formulations allow for longer use with adback hormonal therapy to 29:20 partially mitigate these side effects. The mood and cognitive effects can be s 29:25 significant. I’ve seen it over the years. the depression, the memory impairment, difficulty focusing and 29:31 concentrating. It can be very very traumatic and the quality of life that 29:37 happens for these uh women and men can be unbearing for many of them. Um, from 29:44 an integrative perspective, patients receiving this medication need comprehensive support care. Bone health 29:51 interventions using calcium, vitamin D, vitamin K2, weightbearing exercise, 29:58 cardiovascular risk management becomes critical, including blood pressure monitoring, lipid management, diabetes 30:05 screening. For hot flashes management, some patients respond to black coohos, 30:10 sage, or vitamin E. Though evidence is mixed and individual response varies, 30:16 omega-3s may help with the mood and the inflammation, resistance training becomes specifically important to 30:22 preserve lean muscle mass in the face of hormonal suppression. 30:27 Now there’s something called calcetonin salamon which is marketed as miaelin. 30:34 It is a nasal spray. It is now discontinued. And foral is the new 30:39 synthetic polyeptide hormone of 32 amino acids identical to calcetonin of salamon 30:47 origin. It represents an interesting case study in how initial promise gives 30:52 way to safety concerns that regulate a therapy to historical footnote status. 30:58 Calcetonin is naturally occurring hormone in humans. It’s secreted by the paraphalicular sea cells in the thyroid 31:04 gland. Its primary physiological role is to lower blood calcium levels by 31:10 directly inhibiting osteoclast activity, reducing bone reabsorption, increasing 31:16 renal calcium secretion or excretion, and possibly reducing the intestinal 31:21 calcium absorption. So, salamon calcetonin is used therapeutically because it’s more potent and longer 31:27 acting than human calcetonin. The FDA initially approved calceton and salmon 31:34 for several indications post-menopausal osteoporosis in women more than five 31:39 years post-menopausal when alternative treatments are not sustainable. Padet’s 31:44 disease for bone and hypercalcemium as emergency treatments. The nasal spray formulation is particularly popular for 31:53 osteoporosis because it offered a non-injectable alternative to bisphosphinates. 31:58 However, in 2012, the European Medicine’s Agency, EMA, conducted a 32:05 comprehensive safety safety review after a poolled analysis of 21 clinical trials 32:10 involving over 10,000 patients showed a statistically significant increase in 32:15 malignancy risk in patients treated with calceton salamon compared to compared to 32:21 placebo. The overall malignancy rate was 4.1% in calcetonin treated patients 32:28 versus 2.9% in placebo patients. The types of cancer 32:34 varied with no single cancer type predominating, making it difficult to establish a clear mechanistic link. 32:41 However, the signal was concerning enough that the EMA restricted the use of calcetonin containing medicines. In 32:48 the United States, the FDA issued communications about malignancy signal and conducted its own review. While they 32:56 didn’t fully withdraw the drug, the cons consensus shifted dramatically. The nasal spray formulations miaelson was 33:03 voluntarily discontinued by the manufacturer and current clinical practice guidelines now consider 33:10 calcetonin salamon as a second line or lower option for osteoporosis. While 33:15 behind bisphosphinates, dennism mob, uh, terrapeptide, the analesic effect of 33:21 calcetonin in bone pain, particularly in acute vitibbral, uh, compression 33:26 fractions from osteoporosis or pageantss disease may still provide a role for short-term use in these selected 33:32 patients. The mechanism of this pain relief is unclear, but may involve 33:38 effects of endorphin systems and/or direct actions on pathways. The history serves as an important reminder in 33:45 peptide medicine. Initial approval and early clinical use does not guarantee 33:50 long-term safety effects. Post marketing surveillance and poolled analysis of the clinical trial data can reveal adverse 33:58 effects that weren’t apparent in initial studies. It also underscores why newer 34:04 agents with better safety profiles um have largely replaced calcetonin in 34:10 clinical practice. So this is really an important thing. Not one thing stays the same forever. We have to change as we 34:18 identify new and better products as we identify problems and concerns. I will 34:24 always tell my patients if you are uncertain of taking a new drug which we 34:30 all should be wait five years. Within five years we are going to find the 34:36 problems that they didn’t find in the clinical studies. Remember, a lot of these clinical studies are small, small 34:43 groups, short periods of time. It’s expensive to do these trials. So, if you 34:49 wait for five years, in the first two to three years, you will see the problem start to emerge. And what are you going 34:55 to look for? You’re going to look for the the news um commercials from lawyers 35:02 suing a drug. And they will tell you what the problem is. and then you can decide, is this something that I want to 35:09 use or not. Don’t jump on bandwagon and be the first one to do this, especially 35:14 if you’re sensitive. You know, give it time so you can see exactly what’s going on. So, I’m going to end our show on 35:22 this and we are going to pick up on part three of peptide therapy in our next 35:28 segment where we’re going to talk about the investigational peptides and some 35:34 exciting things that are happening with that. So, I want to thank you for joining me today on Let’s Talk Wellness 35:39 Now. It’s always a pleasure having a conversation with you guys and I hope this brings value to you with what we’re 35:45 talking about. If you have ideas for topics that you want me to discuss, 35:51 please message us, you can share your comments on Facebook, you can email us, 35:58 um you can get a hold of us however you would like to share that. I do look at the comments below in the episodes as 36:04 well. So you can place your comments there. And once again, one of the best things you can do for me is like, 36:11 subscribe, and share so that we can spread the messages of what we’re doing. 36:16 I do this at no cost. I don’t make any money out of this. I do this as an 36:21 educational purpose for everybody else. I love doing it, but it really helps us 36:28 on the algorithms if you would be just willing to like, subscribe, and share. 36:33 So, thank you for spending your time with me. I know time is important.The post Episode 257 – Peptides for Sexual Wellness & Hormonal Health: PT-141, Growth Hormones, Bone Health & More! first appeared on Let's Talk Wellness Now.
What if the reason you’re not healing isn’t that you need another diagnosis? 0:08 It’s that your cells aren’t receiving the right signals. Because the body doesn’t run on diagnosis, it runs on 0:16 communication. And peptides are one of the most powerful, most misunderstood 0:21 tools we have for cellular signaling, immune balance, tissue repair, gut 0:27 lining support, metabolic control, brain signaling, sleep cycles, and even sexual 0:35 wellness. Today, I’m going to do what most people won’t. Define peptides in 0:41 plain English for you. break them into categories by what they’re best at and 0:47 tell you which ones are FDA approved on the list and which ones are commonly 0:53 used off label or investigational with the evidence that actually says these 1:00 work. This is going to be a powerful episode and if you’ve ever felt like you’re hearing hype without clarity, 1:07 this one’s for you. So, as usual, grab your cup of coffee or tea and settle in 1:13 as we talk about peptides that can fit into your healing journey. We’re going 1:19 to have a short word from our sponsor. You know, we got to do that. That’s how we stay on the air here. So, we will be 1:26 right back after this. Did you know sweating can literally heal your cells? 1:32I nfrared saunas don’t just relax you. They detox your body, balance hormones, 1:37 and boost mitochondrial energy. I’m obsessed with my health tech sauna. And 1:42 right now, you can save $500 with my code at healthtechalth.com/drmuthqen25. 1:54 All right, here we go, guys. I am excited to dive into peptides with you. 2:00 So understanding peptides is foundational, right? And I’ve been 2:06 studying peptides now for about nine years. Um, and I find that they are 2:13 incredible. Um, so I want to break down for you what peptides actually are, what 2:19 they do, and some of the top peptides that are available today, and how they 2:25 can be utilized. Because I think it’s really important. And I think it’s it’s there’s a lot of confusion out there about what these things actually are and 2:32 are they safe? Are they not? When do we use them? What’s the science behind them? So, we’re going to dive in and 2:38 we’re going to talk about all things peptides. So, let’s get ready here. Here we go. So, peptides are short chains of 2:45 amino acids and they typically range anywhere from 2 to 50 amino acids and 2:51 they’re linked by peptide bonds. So think of them as the superglue that holds the amino acids together. They sit 2:58 between the amino acids and they are full proteins in terms of their size and 3:04 their complex structure. And what makes peptides particularly interesting in 3:10 medicine is their role as signaling molecules. They’re essentially the 3:15 body’s text messages carrying specific instructions to cells and tissues. And 3:21 unlike our proteins which often serve as structural roles or act as enzymes, 3:28 peptides typically function as hormones, neurotransmitters and growth factors and 3:33 they bind to specific receptors on the cell’s surfaces or within the cells and 3:39 they trigger this effect. It’s like a cascade effect of a biochemical reaction 3:45 that ultimately changes the cellular behavior. So basically, it’s changing 3:50 the way the body’s cell structure acts. And this is why peptides can be so 3:56 incredibly powerful and therapeutic when you introduce the right peptide signal. 4:02 Now, you could theoretically redirect cellular processes toward healing, 4:07 towards metabolism, immune balance, tissue repair. Any of those things can 4:14 be manipulated to do a certain thing once we add the peptide. The challenge 4:19 in peptide medicine though lies in distinguishing between those peptides that have been rigorously studied, 4:26 proven safe and effective and approved by regulatory bodies like the FDA versus 4:31 those that exist in what we call the gray zone of a promising clinical data. 4:36 But they really lack human validation so far. And this distinction is critical because the presence of a plausible 4:43 mechanism does not guarantee safety or efficacy in living humans. So, this is 4:50 really important and we’re going to dive in and look at some of the research on all of these different peptides that are 4:56 available and I’m excited to say there’s some amazing peptides being studied right now that unfortunately are not 5:01 available. But I can’t wait to see them hit the market for us because it is going to be a gamecher as far as health 5:09 and longevity. So there is a quality control issue and there is a hidden 5:14 variable in peptide medicine with this and it’s one of the most underappreciated aspects of peptide 5:21 therapy particularly for non-FDA approved peptides. It’s quality control. 5:26 When we discuss pharmaceutical medicines, we take for granted that the pill contains what the label says. Not 5:32 always true depending on where it comes from. You guys, if you’ve heard my episodes before talk about how many of our medications are made in China and 5:41 have been contaminated with other things, you will realize that that is not always true. So, just because it has 5:48 the FDA stamp of approval on the medication, it still does not necessarily mean it’s safe and we still 5:54 need to do our homework on it. So, sorry for digressing on you guys, but you know, when we get a medication, we we 6:00 think that what the amount says is what is there, doesn’t have contaminants, it’s manufactured with good 6:06 manufacturing practices. You’ll see that listed as GMP on the bottle, and it’s been stored properly, it’s been 6:12 maintained stable, and with research peptides and compounded formulations, 6:17 none of this can be assumed. So, I will share a story with you. There was a gentleman that was purchasing these 6:24 peptides online from a research facility and um did not know that they were 6:30 coming from China and he was ordering a particular growth hormone peptide and 6:35 after a little while he had he had done fine for the few first few bottles. After a little while he started having 6:42 some complications. He started getting really irritable and angry and ragy and 6:47 he didn’t quite know what was going on. And so he decided to go get some testing done. He had some blood testing done and 6:53 his testosterone level was over 5,000. So for those of you who know what testosterone level should be for a guy, 7:00 they really shouldn’t be any higher than about 1,00200 would be absolute max that we’d want to see. Now he was taking 7:06 testosterone but not to that degree. And prior to adding this peptide, his 7:12 testosterone was very stable. What they ended up finding out was the peptide that he was getting, whoever was 7:18 manufacturing it added testosterone to the peptide. They felt like if if it had growth hormone, that was great, but if 7:25 it had growth hormone and tes testosterone, all the better. And he didn’t know that. And this is the 7:31 problem that we can have with peptides if you don’t source them properly. if you’re not working with somebody that 7:37 knows how to source them and can prove that they are what they say they are. Um, I’m sure there’s a whole bunch of 7:42 studies out there too of people getting these peptides and paying hundreds of thousands of dollars for them over their 7:48 lifetime and finding out they were nothing more than just sterile water. So, you really do need to be careful 7:53 with your quality control. Now, this kind of leads us right into the next topic that we’re going to talk about and that’s the manufacturing question, 8:00 right? The FDA approved peptides are manufactured in facilities subject to 8:05 the FDA inspection rules following our GMP regulations and these facilities 8:11 must validate their manufacturing process, demonstrate consistency batch to batch, test for purity and potency. 8:18 They need to test for bacterial endotoxins and sterility and they need to maintain detailed records. So, when a 8:25 pharmaceutical company submits a drug application, the FDA inspects the manufacturing facility as part of the 8:32 approval process. If you’re getting peptides from a different country, none of that is happening. And there are some 8:38 ways for us to determine if that is what you’re getting. Typically, the rule of thumb is if your peptides are coming 8:44 with a different colored top, every one of them has a different colored top. Those are typically being sourced out of 8:49 China. I wouldn’t say that’s 100% but that’s kind of the rule of thumb that people follow. So compoundingies these 8:56 are thearmacies that make our bio identical hormones. They can make medications in any dose or strength or 9:02 route. There are thousands of them in every not that not in every state but 9:08 there are thousands of them around the country right now. So these compoundingies are registered as 503A 9:15 facilities. They do traditional compounding for individual prescriptions, right? Like they can make 9:20 thyroid, they can make LDN, they can make estrogen. You can also have a 503b 9:27 facility, which is an outsourcing facility. And these companies produce larger batches of products. They’re they 9:34 have some oversight, but they’re less stringent than for FDA approved 9:40 manufacturers. And state boards of pharmacy regulate a 503A pharmacy. And 9:45 the FDA can inspect the 503b facility, but doesn’t preapprove any of their 9:52 compounding products. So, they can inspect it, but they don’t approve them. So, research chemicals and these 9:58 suppliers operate essentially with no oversight. They explicitly market products for research use only, not for 10:06 human consumption to avoid FDA regulation. If they put that on their 10:12 product, they don’t have to comply to what the FDA is saying. And there is no required manufacturing strategies or 10:19 standards, no required testing, no required sterility assurance, and no enforcement mechanisms if products are 10:26 mislabeled or contaminated. So basically, they don’t have the liability, but that doesn’t mean that 10:31 all of them are badies or bad suppliers. It just means they don’t have to comply 10:37 to the FDA rules. Now, there are many of these companies that I’ve seen and I’ve talked to that do do a lot of this. They 10:44 do test their product for sterility. They do test their product to make sure it is what it says it is. They don’t 10:51 have to, but they do. So, if you’re going to decide to use a company that 10:56 has research only, not for human consumption, at least ask for their 11:02 proof of testing so that you know that the product you’re getting is what it says it is and that it’s clean. Because 11:08 this is where we run into the problem is in purity. So in purity peptide 11:13 synthesis can produce not just the targeted peptide but also related 11:19 peptides with deletions, substitutions, truncations or truncations of amino 11:25 acids. Sorry. And this high performance liquid we call it uh chromatography can 11:30 separate these related impurities and quality and quantify the actual target 11:35 of the peptide content. So a certificate of analysis is what you want to ask these companies for. This shows the HPLC 11:44 the testing mechanism with greater than 95% or ideally 98% purity which 11:51 indicates a higher quality product. So this certificate of analysis can be fabricated may not represent the 11:57 specific batch being sold. It happens. We need to know not everybody is honest. Not everybody, you know, does what they 12:03 say and it does what’s right. But at least you at least they’re giving you something and you have some security. 12:10 and then choose a company that was referred to by someone else that has done some homework as well. In in 12:16 commercial research, there’s independent testing and they research peptides and this has been really shocking 12:23 variability that they’ve seen. Some products contain 50% or less of the 12:29 claimed peptide and some contained primarily degradation of the product or manufacturing impurities and some 12:36 contained bacterial endotoxins at levels that could cause fever and systemic 12:42 inflammation if it was truly injected. And I would also worry with some of those problems, you know, depending on 12:48 what impurity or bacterial endotoxin was there. If you’re using a product to boost your immune system and your immune 12:54 system is already compromised, these bacterial endotoxins can actually make you sicker instead of what you want it 13:02 to do, which is making you better. So, sterility is always an issue with anything that is manufactured, 13:08 especially things that we’re doing as an injection. Peptides are intended for injection. They must be sterile. They 13:16 must be kept safe. And pharmaceutical manufacturers conduct this sterility testing on every batch. 13:22 Compoundingarmacies should conduct sterility testing particularly for high-risisk compounded 13:28 sterile preparations and research chemical suppliers may or may not conduct any testing. So injecting 13:35 non-sterile material can cause local infections, abscesses at the injection 13:41 site and or if the bacteria enters the bloodstream could potentially be 13:46 life-threatening and you could have sepsis. Now, excuse me. We saw this 13:52 happen in a compounding pharmacy uh gosh, it’s probably been 10 years ago 13:57 now, I think. um they unfortunately had a strep uh contamination in their 14:03 product and they weren’t testing it. It was a large compounding pharmacy out of Florida and they were making products 14:08 that were being injected into the joints and um these people got very very sick 14:14 and some of them died and um some of them got very very injured by this uh 14:21 complication that happened. So it’s not like this doesn’t happen. It does, but it doesn’t happen often. And that’s what 14:28 we have to know about. And so, when we’re talking with you guys about storage and stability, it’s really 14:34 important to make sure you maintain your peptides well. So, many peptides are unstable at room temperature. They 14:41 require refrigeration or freezing. We tell everyone to make sure you’re refrigerating your peptides. That way, 14:48 there’s no question about it. when it stays cold um it prevents or slows down 14:54 the process of uh bacteria growing in it. So some of these peptides actually 14:59 degrade very rapidly in the solution and they must be reconstituted immediately before use and reconstitution of the 15:07 peptides really has limited stability often just days to weeks not months. So 15:13 improper storage, temperature, um changes during shipping or prolonged 15:19 storage of a reconstituted product can lead to degradation into inactivity or 15:25 potentially even a harmful breakdown of the product itself. So if you have a product that’s been sitting in your 15:30 refrigerator for a month or two months or 3 months or 6 months, just throw it away. It’s not going to be any good. 15:37 you’re not going to actually get the peptide and the uh potency that you’re looking for anyway out of it and the 15:44 potential of you introducing an endotoxin, a bacterial endotoxin is quite high at that point. So you just 15:50 really don’t want to take the risk, excuse me. So what practitioners, what 15:56 should we do and what should patients do? Well, for any peptide therapy, we 16:03 want to source our verification. know where the peptide product comes from. Is 16:08 it an FDA approved product? Is it a 503b compounding? A research chemical 16:14 supplier? Is there a certificate of analysis? Request and review this COA. 16:20 And you want it to show purity greater than 95% but ideally greater than 98%. 16:27 You want that identity be identity to be confirmed by mass spectromedy. Uh 16:33 sterility testing should be done. Bacterial endotoxin testing should be done. Batch number matching of the 16:39 product that you received should be done. Proper storage. You want to know that this has been refrigerated or 16:46 frozen as directed once it’s been mixed. Look at the expiration dates for reconstituting your peptides. Track that 16:53 reconstitution date and discarded accordingly like we just talked about. Monitor for your adverse effects. Even 17:01 with the perfect quality control, monitoring for adverse effects is essential with questionable quality and 17:08 vigilance is really critical here. I know it’s frustrating for a lot of patients when they have to get several 17:15 bottles and they only last a week or two. right here, you guys. This is why 17:21 they only last a short period of time because once they’re mixed, they start 17:26 to degrade and they won’t be good and you won’t get the benefit from it. So, 17:31 it’s really important with these research peptides specifically, practitioners should recognize that all 17:38 recommending products without quality assurance violates the fundamental medical principle of first do no harm. 17:45 If a patient is determined to use research peptides despite counseling, providing guidance on quality 17:52 verification, requesting those COAs, using pharmaceutical grade sources when available, proper testing, this all 17:59 reduces harm, but doesn’t constitute necessarily that recommendation. Now, 18:06 that being said, today it’s very difficult to find peptides by the compoundingies because of what the FDA 18:13 has done. So most of the peptides that are available to us have been labeled 18:18 not for human consumption, not because they’re not good products, but because 18:25 of what the FDA did. And this is how these companies have been able to 18:31 continue to provide peptides to the medical community. And if you know you 18:36 have a good company, then you’re, you know, you’re still taking the risk, right? But at the end of the day, the 18:42 reason they’re doing that is to protect themselves from the FDA, from liability. Um, so just kind of know that there is 18:50 some talk in the community with um Bobby Kennedy that this is going to change and 18:55 they are going to bring peptides back to the compounding pharmacies. Now, we don’t know which ones they’re going to 19:01 bring back. Uh, will it be all of them? Will it just be some of them? What’s going to happen here? Um, is it going to 19:07 go to the pharmaceutical companies like our GLP1s did? We don’t know what that’s going to look like quite yet. Um, but it 19:14 is coming and that is positive news. So, let’s talk now about FDA approved 19:21 peptide medications. So, this is the metabolic revolution, right? GLP1 19:28 and our dual increeting agonists. This is an exciting time. GLP-1s are amazing. 19:35 Um, a lot of people are skeptical, a lot of people love them, a lot of people hate them. Whichever side of the fence 19:42 that you’re on, I understand. But I want to talk about the science of it today 19:48 and what it actually means for people. So, the story of GLP1 glucagon like 19:54 peptide one represents one of the most significant advances in metabolic 19:59 medicine in the past several decades. GLP-1 is an accretin hormone. It’s 20:05 gutder derived peptide that potentiates insulin secretion in response to food 20:11 intake. And the body naturally produces GLP-1 in the intestinal L cells, but it 20:17 rapidly degraded by the enzyme DPP4 giving it a halflife of only about 2 20:24 minutes. So this rapid breakdown made in therapeutically impractical until 20:31 research was developed and modified the analoges that resist the enzyme degradation. So for those people who 20:39 never feel full when they’re eating, never feel satisfied when they’re done, this is because their body is either not 20:46 producing enough GLP1 or it’s not getting the signal right. And this is a 20:51 leptin issue. This is an insulin issue. It’s a GLP-1 issue. It’s a complicated 20:56 issue. This is not anything that the person is doing wrong. It’s what is happening to their body. And so GLP1s 21:03 have really revolutionized this. So one particular GLP-1 that we have is 21:09 semiglutide. And this GLP-1 agonist is what changed everything in the world of 21:16 metabolic medicine. Semiglutide is marketed as ompic for type 2 diabetes 21:23 and it’s marketed as WGOI for chronic weight management. It is a modified 21:29 GLP-1 analog with 95 or sorry 94% amino acid sequence uh homology to human 21:37 GLP-1. So it means that it’s it’s just like our own GLP-1 that we make. This 21:42 modification includes specific amino acid substitutions and the addition of C18 21:50 a fatty acid chain which allows the peptide to bind to albumin. Now this 21:56 albumin binding dramatically extends the half-life to approximately one week 22:01 enabling one weekly dosing which is a major advantage over the earlier GLP-1 22:07 agonists that require daily or twice daily injections. The mechanism by which 22:13 semiglutide works is multiaceted. At the pancreatin level, it binds to GLP-1 22:20 receptors on the pancreatic beta cells enhancing glucose depending sorry 22:27 enhancing glucose dependent insulin secretion. This glucose dependency is 22:33 crucial. It means the peptide only stimulates insulin release when blood glucose is elevated. This dramatically 22:41 reduces the hypoglycemic risk compared to insulin or even uh sulfuras. 22:47 Simultaneously semiglutide suppresses glucagon secretion from pancreatic alpha 22:53 cells further improving glycemic control. This is really amazing because 23:00 over the years when we’ve used insulin, which is also a peptide by the way, you 23:05 had to dose it just right because if you didn’t, you would produce so much insulin that it would crash the blood 23:12 sugar and then somebody would have too low of a blood sugar. They’d be hypoglycemic and they’d have to eat more 23:18 sugar and then they’d have to modify the insulin again and the person would be going up and down, up and down, up and 23:24 down all day long. And that created a lot of problems for people and so this 23:30 helps to stabilize that so it is not such an intense change. Now in the GI 23:36 tract semiglutide delays the gastric emptying particularly pronounced during 23:41 the initial weeks of therapy. This slowing of the gastric emptying contributes to the sensation of being 23:48 full and early satiety that patients often describe. However, this effect 23:54 tends to attend to weight over time as the body adapts through the appetite 24:00 suppressing effects generally persist through central mechanisms. So, when we 24:05 talk about what is actually happening, we’re slowing that digestive process down. That’s why people aren’t so 24:11 hungry. It’s why they’re not eating so much. This is why people can develop constipation with these products because 24:17 it’s slowing the body’s digestive tract down. Now some people will call this 24:22 gastroparesis. Um gastroparesis is actually different. 24:28 It is when we lose control over what’s happening in the in the colon like the 24:34 nerves and things like that just stop working. I have never seen that with the GLP1s that we prescribe in micro doing. 24:42 um it’s been documented. It can happen, but again it a lot of it is dosing and a 24:48 lot of it is staying on top of your client and what’s happening and what’s going on and what you’re doing and making sure that they do have good 24:54 motility still. So a lot of these things can be mitigated if you have problems 24:59 with them. Now one of the most profound effects of semiglutide occur in the 25:05 central nervous system. GLP-1 receptors are widely distributed in the brain 25:10 particularly in the hypothalamus and the brain stem area where we are involved in 25:15 appetite regulation. So when when wilding and colleagues published their 25:20 landmark step one trial in the New England Journal of Medicine in 2021, 25:25 they demonstrated that participants receiving 2.4 4 milligrams of semiglutide weekly achieved an average 25:32 weight loss of 14.9% of their body weight over 68 weeks. Now, I want you 25:39 guys to really understand this. We’re talking roughly 15% body weight loss 25:45 over a year, longer than a year. 52 weeks is a year, right? This is 68 25:50 weeks. So, it took longer for them to lose. We’re not talking about giving 25:55 somebody a dose to lose 15% of their body mass in a month or two. That that 26:01 is not healthy for any of us. That is not what we’re talking about doing here. Now, they compared this to placebo and 26:08 the placebo was only 2.4%. So, that is a significant difference. 26:14 And even beyond the numbers, patients reported something very qualitatively different, a reduction in what’s now 26:21 called food noise. Everybody knows what food noise is. We’ve talked about this long before GLP1. It’s that craving. 26:28 It’s that part of your brain that just keeps thinking about I want to eat something. You know, that was actually 26:34 reduced and they didn’t expect to see that happen. Now, this refers to the constant mental preoccupation with food, 26:42 the intrusive thoughts about eating, the difficulty in feeling satisfied. Semi-glutide appears to appears to 26:49 modulate reward pathways in the misolyic system reducing hedonic eating and food 26:57 cravings. Now there are also great cardiovascular effects of semiglutide 27:02 that extend beyond weight loss. Uh the sustained six and select trials 27:07 demonstrated significant reductions in major adverse cardiovascular events uh 27:14 mace in high-risisk populations. The select trial published in 2023 showed 27:20 that semiglutide reduced cardiovascular death, non-fatal myioardial inffection 27:25 and non-fatal stroke by 20% in adults with overweight or obesity and 27:31 established cardiovascular disease but without diabetes. So this suggests that 27:37 mechanisms beyond glucose control and weight loss possibly including 27:42 anti-inflammatory effects, improvements in endothelial function and favorable 27:47 changes to lipid profiles. Now I will tell you the clients that I work with that are on GLP1, 27:53 they will tell you that their inflammation has been significantly reduced. We are also seeing really 28:00 amazing results in lipid profiles. um part of its weight loss, but there is a 28:06 component to this that is lowering the triglyceride levels because it’s related to sugar and how the body’s processing 28:11 it. And we’re seeing better profiles, less need for statins as a result of 28:17 that. If if you want to listen to my episode on statins, I have one on that. Uh they are not my favorite medication. 28:24 I think it’s overprescribed and overused um and not really affecting or 28:29 addressing the problem. So these things can really be helpful. There’s also some 28:34 uh ramblings going on with GLP-1s saying that they may be able to help with 28:40 addiction in the future because of where they’re finding it affecting the brain and how it affects the food noise and 28:47 the cravings that we have for food and the addiction for food. Could it potentially help with other addictions 28:53 down the road? We’ll have to wait and see on that one. So semiglutide’s FDA prescribing information also includes a 29:00 box uh boxed warning about thyroid sea cell tumors. So in rodent studies 29:06 semiglutide caused dose dependent and treatment duration dependent sea cell 29:12 tumors at clinically relevant exposures. So while it’s unknown whether or not 29:17 semiglutide causes uh thyroid cancer tumors in humans and the rodent thyroid biology 29:26 differs significantly from humans, the drug is contraindicated in patients with a personal or family history of 29:33 medillary thyroid carcinoma or in patients with multiple endocrine neopl neoplasia syndrome type two. it is 29:42 uh contraindicated for safety effects with that. Um I have seen endocrinologists okay GLP1s to be used 29:50 in patients who’ve had other forms of thyroid cancer just not the meillary 29:55 thyroid cancer. So there is possibility there. Now the most common side effects 30:00 are gastrointestinal. It’s nausea affects about 20 to 44% of patients 30:06 depending on the formulation with diarrhea, vomiting, constipation, abdominal pain, and also frequently 30:13 reported in clinical trials. I see this in my clinic, too, especially dose dependent. Um, and it happens early on 30:20 when you’re first starting the medication, but seems to settle out over time. The one that I would add to this 30:26 that I don’t think they have on here is an increase in acid reflux. We also see that quite often uh especially in people 30:33 who suffer with acid reflux to begin with. Now these effects are typically most 30:40 pronounced during the escalation and they like I said often improve over time 30:45 but more serious but less common adverse effects include acute pancreatitis. 30:51 The medication needs to be discontinued immediately if this is confirmed. You can see some diabetic retinopathy 30:57 complications in patients with pre-existing retinopathy and acute kidney injury. Um, this usually happens 31:05 secondarily to dehydration from the GI effects. There are some gallbladder disease um that can occur and people who 31:13 have a sensitive gallbladder will describe uh discomfort with that. I’ve 31:18 even seen some people who’ve had their gallbladder out on GLP1s at the higher doses complain of similar pain that they 31:25 used to have when their gallbladder was in. So, really important to just kind of monitor these symptoms and work closely 31:32 with somebody that understands them and can be on top of them quite quickly if this happens. Excuse me. From an 31:39 integrative medicine perspective, semiglutide really represents a powerful tool, but it’s not a standalone 31:46 solution. Remember, the medication addresses one aspect of the metabolic dysfunction, the signaling systems 31:53 controlling appetite and glucose homeostasis, but it doesn’t address the root cause that led to the metabolic 32:00 disease in the first place. Patients who rely solely on the medication without addressing the ultrarocessed food 32:07 consumption, the ccadian disruptions, the chronic stress, the sleep apnea, or 32:12 underlying hormonal imbalances often experience weight regain when the medication is discontinued. 32:20 The drug is also not a substitute for addressing the emotional and psychological drivers of eating 32:26 behavior, including the unresolved trauma that may manifest as emotional eating. I think this is really important 32:33 because we don’t address the trauma issue enough with clients and we need to 32:38 be looking at that. There is a huge trauma effect out there these days that is I don’t want to say leading to or 32:45 causing but it is definitely contributing to chronic illness and it’s not being talked about enough. So we 32:52 really need to be talking about this and addressing this trauma aspect. Now the next GLP that one that I want to talk 32:59 about is trespathide. This is a dual agonist. It takes center stage. It is my 33:05 favorite GLP one. Trisepatide is marketed as Mangjaro for type 2 diabetes 33:11 and Zepbound for chronic weight management and it represents the next 33:16 evolution in increantbased therapy. This is a dual agonist a 39 amino acid 33:23 synthetic peptide structurally based on the human glucose dependent insulin tropic peptide so GIP sequence but 33:31 modified to activate both the GIP receptors and the GLP1 receptors. So the 33:37 addition of the GI GIP agonism to the GLP1 agonism appears to create this 33:46 synergistic effect that goes beyond simply adding the two mechanisms together. So the GIP like GLP-1 is an 33:55 increant hormone secreted by what is called the K cells in response to nutrient intake. It enhances glucose 34:02 dependent insulin secretion but it also effects on atapost tissue metabolism 34:09 potentially improving the insulin sensitivity in fat cells and influencing 34:14 how the body stores and metabolizes fat. So some research suggests that GIP may 34:20 also have effects on energy expenditure though this remains an area of 34:26 investigation. So basically what we’re saying is this drug may actually help 34:32 people who are insulin resistant or insulin sensitive, not just somebody who 34:38 has problems with glucose control. So, this is super exciting because it opens 34:43 up the door for all of these people for decades that we’ve been trying to manage with insulin resistance and trying to 34:50 prevent diabetes and honestly most of the time have been unsuccessful 34:56 unless you can keep your diet at 50 grams of carbs or less a day, which is extremely difficult. Um, and take some 35:04 supplements that may or may not work and or take some metformin that may or may not help. this drug actually really 35:11opens that up and helps in that capacity. So there was a clinical trial 35:17 called the surmount clinical trial which demonstrated that trespathide produces 35:22 even more substantial weight loss than semiglutide. In the surerount one trial published by uh J tree I might have said 35:31 that wrong. I apologize if I slaughtered your name and colleagues in the New York England Journal of Medicine in 2022. 35:38 Participants receiving the highest dose of trespide, which is 15 milligrams, achieved an average weight loss of 20.9% 35:47 of their body weight over 72 weeks, compared to 3.1% with placebo. This 35:54 level of weight loss approaches what’s typically only seen in beriatric surgery. So, this is amazing because if 36:02 this medication works and we don’t have to do beriatric surgery, stomach stapling basically, um, oh my gosh, it’s 36:11 amazing. There are so many complications and risks that go with stomach stapling and the different procedures that they 36:17 do these days. People don’t absorb their nutrients properly. They have to do liquid nutrients. It’s very complicated. 36:24 It’s very challenging. Many of these people gain their weight back. Um, and 36:30 this procedure is not fun to go through. So, if we could change that and change 36:35 the lives of people who’ve really been struggling, it is amazing. And I will tell you that I have seen this work. I 36:42 have seen people lose 100 150 pounds on these medications over a year or two 36:50 period of time. It is definitely slower than beriatric surgery on some standpoints, but that is okay. You don’t 36:56 want that rapid weight loss. It’s not good for you. It’s not healthy for you. It doesn’t look well. You know, we want 37:03 to do this safely and effectively in the best way that we can possibly do that for you. Now, the adverse effect profile 37:10 is similar to semiglutide. It’s dominated by gastrointestinal effects. 37:15 Nausea, diarrhea, decreased appetite, vomiting, constipation. These were all commonly reported in the surmount 37:22 trials. And like semiglutide, tricepide carries a blackbox warning regarding the 37:27 thyroid sea cell tumors based on the rodent data and it shares the same contra indications in patients with a 37:34 family history of thyroid cancer and men too. So the mechanism behind why 37:40 tepatide often produces more substantial weight loss than GLP-1. The agonism 37:45 alone remains under investigation, but it may relate to the complimentary effects on the different aspects of 37:51 energy homeostasis or to GIP’s effects on atapost tissue and potentially on 37:58 central central nervous system pathways that GLP1 alone doesn’t fully address. 38:03 Now patients often report even more profound reductions in food noise with tricepide compared to GLP1 and uh sorry 38:12 GLP1 the agonists through this is anecdotal and hasn’t been regularly 38:17 quantified in quality studies. So I’ve done both uh personally and in my 38:22 practice. I really like trespide better than semiglutide. For me I had too many side effects with semiglutide. uh I had 38:30 less side effects with trespathide. I also plateaued on semiglutide which I 38:35 didn’t really care for. And with Tresepide, I haven’t plateaued and I’ve been able 38:42 to lose about 25 pounds in um a year and a half and I’ve been able to maintain 38:49 that. Um and I continued to use it because I do have a strong family history of cardiovascular disease. And 38:56 if this could help me so that I don’t follow my family lineage with cardiovascular disease, I am all for 39:03 trying to do that. I’ve watched too many of my family members suffer from this. I’ve lost my dad at a very young age. I 39:09 lost my grandfather at a young age to it. All of their brothers to this. And I don’t want to be that same person. So 39:16 that is why I chose to do that. And I think it’s really important for us to take a look at that and understand that. 39:24 Now, I know this has been a really long podcast and I don’t typically do podcasts this long. I have a whole host 39:31 of information on additional peptides. So, I’m going to break this up for you 39:36 guys and I’m going to do another episode and we’re going to pick up where we left off here with these peptides so that we 39:43 can actually start to dive into different peptides as well. So, check 39:48 out my next podcast show when we’re going to dive into the peptides that 39:54 talk about sexual wellness, immune function, and all the other cool things 39:59 that we can do with peptides. So until then, remember to like, share, and 40:04 subscribe. It really helps us get out to other people and share our information, 40:10 and join us for our next episode as we continue the talk about peptides. 40:15 Welcome to Let’s Talk Wellness Now, where we bring expert insights directly to you. Please note that the views and 40:21 information shared by our guests are their own and do not necessarily reflect those of Let’s Talk Wellness Now, its 40:28 management, or our partners. Each affiliate, sponsor, and partner is an 40:34 independent entity with its own perspectives. Today’s content is provided forformational and educational 40:40 purposes only and should not be considered specific advice, whether financial, medical, or legal. While we 40:48 strive to present accurate and useful information, we cannot guarantee its completeness or relevance to your unique 40:56 circumstances. We encourage you to consult with a qualified professional to address your 41:01 individual needs. Your use of information from this broadcast is entirely at your own risk. By continuing 41:08 to listen, you agree to indemnify and hold Let’s Talk Wellness Now and its 41:14 associates harmless from any claims or damages arising from the use of this 41:20 content. We may update this disclaimer at any time and changes will take effect 41:26 immediately upon posting or broadcast. Thank you for tuning in. We hope you 41:31 find this episode both insightful and thought-provoking. Listener discretion 41:36 is advised.The post Episode 256 – How Peptides Work, Benefits, and FDA-Approved vs Off-Label Use Explained first appeared on Let's Talk Wellness Now.
We know shockingly little about what goes on in a mother's brain during pregnancy.For example, we know only a handful of the hormones involved—out of hundreds scientists think may exist—and very little about how they might impact the brain. This gap in our understanding is one of the reasons we don't have great treatments for pregnancy-related maladies, whether it's extreme nausea, or anxiety and depression.Closing this gap is the mission of the new Stanford Neuro-Pregnancy Initiative, part of the Wu Tsai Neurosciences Institute's Big Ideas in Neuroscience Program. Today on the show, we speak with initiative leaders Nirao Shah, a neuroscientist who studies sex differences in animal behavior, and Katrin Svensson is an expert in how our tissues use hormones to communicate in health and disease. Together with Longzhi Tan, an expert in gene regulation and 3d genome structure, the team aims to chart the cellular and molecular transformation that occurs in a mother's brain during pregnancy, in hopes of better understanding this fundamental event in a person's life and improving health outcomes for both mothers and infants. Learn more:Big Ideas in Neuroscience tackle brain science of everyday life and more (Wu Tsai Neuro, 2026)Nirao Shah labKatrin Svensson labLongzhi Tan labReferences:Hoekzema, E., et al. (2017) Pregnancy leads to long-lasting changes in human brain structure. Nat Neurosci 20, 287–296. This is the landmark neuroimaging study discussed in the episode that provided evidence of long-lasting, pregnancy-induced changes in the structure of the human brain. Fejzo, M., et al. (2024) GDF15 linked to maternal risk of nausea and vomiting during pregnancy. Nature 625, 760–767. This recent paper provides strong evidence that the hormone GDF15 acts on the brainstem to cause nausea and vomiting in pregnancy.Knoedler J, et al. A functional cellular framework for sex and estrous cycle-dependent gene expression and behavior. Cell. 185, e1–e18 (2022). This is the work from Dr. Shah's lab mentioned in the episode, identifying a specific circuit in the hypothalamus that changes its connectivity acrossSend us a text!Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. We want to hear from your neurons! Email us at at neuronspodcast@stanford.edu Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
Stroke Effects: What a Hemorrhagic Stroke Did to Jake Stroke effects aren't always obvious. Some show up immediately. Others arrive quietly, long after the hospital discharge papers are signed. For Jake, the stroke effects didn't end when his life was saved; they began there. Four months after a hemorrhagic stroke, Jake can walk, talk, think clearly, and hold a conversation that's thoughtful, articulate, and reflective. To someone passing him in the street, he might look “lucky.” But stroke effects don't ask for permission to be visible. They live beneath the surface, shaping movement, sensation, pain, identity, and recovery in ways few people prepare you for. This is what stroke did to Jake. The Stroke Effects That Came Without Warning Before his stroke, Jake's life was full and demanding. A husband. A father of four. An administrator coordinating drivers and operations. Active. Fit. Always moving toward the next opportunity. But in hindsight, the stroke effects were quietly signaling their arrival. Jake experienced severe headaches with a rapid onset. Nausea. Vomiting. Visual disturbances. At the time, they were dismissed as migraines. His blood pressure had been flagged as “pre-high” years earlier while living overseas, but after returning to Canada, he found himself without a regular doctor in an overloaded medical system. These were early stroke effects masquerading as manageable inconveniences. When the hemorrhagic stroke finally hit, it did so decisively, affecting the right side of his body, disrupting speech, movement, sensation, and cognition all at once. What Stroke Did to His Body One of the most misunderstood stroke effects is how specific and strange the deficits can be. Jake didn't just “lose strength.” He lost motor planning. When he tried to write the letter T, his brain sent the wrong instruction. Instead of a straight downward line, his hand looped as if writing an L. The muscles worked. The intention was there. The signal was wrong. To retrain that connection, he didn't practice ten times. He practiced thousands. This is one of the realities of stroke effects: recovery isn't about effort alone, it's about repetition at a scale most rehab programs don't explain clearly enough. Post-Stroke Pain: The Stroke Effect No One Warns You About If there's one stroke effect that dominates Jake's day-to-day experience, it's pain. Not soreness. Not discomfort. Neuropathic pain. Jake describes it as: Burning sensations Tingling Tightness, like plastic strapping wrapped around his limbs At its worst, a “12 out of 10” pain, like being tased while his hand is on fire This kind of post-stroke pain often resets overnight. One morning, he wakes up and feels almost normal. The next, the pain returns without warning, severe enough to stop him in his tracks. This is a stroke effect that confuses survivors and clinicians alike because it doesn't follow logic, effort, or consistency. It simply exists. And for many survivors, it's one of the hardest stroke effects to live with. The Non-Linear Reality of Stroke Effects Stroke recovery doesn't move forward in a straight line. Jake learned this quickly. One week brings noticeable gains. The next feels like a regression. Then progress returns quietly, unexpectedly. This non-linear pattern is itself a stroke effect. Early on, these fluctuations feel frightening. Survivors worry they're “going backwards.” But over time, patterns emerge. Rest days aren't failures. They're part of recovery. Silent healing days matter just as much as active ones. Understanding this changed how Jake viewed his recovery and how he measured progress. Identity Loss: An Overlooked Stroke Effect Some stroke effects don't show up on scans. Jake wasn't defined by his job, but work still mattered. Structure mattered. Contribution mattered. After the stroke, uncertainty crept in. Would he return to the same role? Could he handle the same responsibility? Should he? Stroke effects often force people to renegotiate identity, not because they want to, but because they must. The question shifts from “What do I do?” to “Who am I now?” For many survivors, this is one of the most emotionally demanding stroke effects of all. Recovery Begins With Action, Not Permission While hospitalized, Jake made a decision. He wouldn't wait passively. He brought in notebooks. Pencils. Hand grippers. Hair clippers. He practiced shaving, writing, and gripping, no matter how long it took. If writing the alphabet took all day, that was the day's work. By discharge, his writing had moved from scribbles to cursive. This wasn't luck. It was intentional engagement with stroke effects, meeting them head-on instead of avoiding them. What Stroke Effects Teach Us Jake's experience reveals something important: Stroke effects are not just medical outcomes. They are lived realities. They affect: How your body moves How pain shows up How progress feels How identity shifts How hope is tested And yet, understanding stroke effects, naming them, and normalizing them can reduce fear and isolation. That's why conversations like this matter. You're Not Alone With These Stroke Effects If you're early in recovery, you might recognize yourself in Jake's story. If you're years in, you might recognize where you've been. Either way, stroke effects don't mean the end of progress. They mean the beginning of a different kind of journey, one that rewards patience, repetition, and perspective. If you want to go deeper into recovery insights, lived experience, and hope-driven guidance: Learn more about the book here: The Unexpected Way That a Stroke Became the Best Thing That Happened Support the podcast and community here: Recovery After Stroke Patreon Final Thought Stroke effects don't define who you are, but they do shape how you recover. Jake's story reminds us that recovery isn't about returning to who you were. It's about learning how to live fully with what remains and discovering what's still possible. Disclaimer: This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Living With Stroke Effects You Can't Always See Jake reveals the stroke effects that remained after the hospital—pain, motor issues, fatigue, and how he's navigating recovery four months on. Highlights: 00:00 Introduction and Background 05:10 Health Awareness and Signs 16:56 Personal Health Journey and Challenges 23:11 Recovery Process and Emotional Impact 38:28 Attitude Towards Recovery 46:30 Long-Term Recovery and Reflection 55:06 Work and Identity Post-Stroke 01:07:40 Pain Management and Coping Strategies 01:16:16 Community and Shared Experiences Transcript: Introduction and Background Bill Gasiamis (00:00) Today’s episode is one that really stayed with me long after we finished recording. You’re going to meet Jake, a stroke survivor who is very early in recovery and navigating the reality of what stroke actually does to a person long after the emergency has What makes this conversation so powerful isn’t just the hemorrhagic stroke Jake experienced. It’s how openly he talks about the stroke effects that followed. The pain, the confusion. the nonlinear recovery and the parts of stroke that are hard to explain unless you’ve lived them. I won’t give away Jake’s story that’s his to tell, but I will say this. If you’re early in recovery or you’re trying to make sense of symptoms that don’t quite fit the brochures or discharge notes, there’s a good chance you’ll hear something in Jake’s experience that feels confronting and reassuring at the same time. Now, before we get into the conversation, want to pause for a moment and say this, everything you hear, the interviews, the hosting, the editing exists because listeners like you help keep this podcast going. When you visit patreon.com slash recovery after stroke, you’re supporting my goal of recording a thousand episodes. So no stroke survivor has to ever feel like they’re navigating this if you’re looking for something you can lean on throughout your recovery or while supporting someone you love my book, the unexpected way that a stroke became the best thing that happened is available at recovery after stroke.com slash book. It’s the resource I wished I’d had when I was confused, overwhelmed and trying to understand what stroke had done to my life. all right. Now let’s get into the conversation with Jake. Bill (01:40) Jake Bordeaux, welcome to the podcast. Jake (01:42) Hi Bill, how are you this evening? Bill (01:44) I’m very well my friend. It is morning here. Just gone past 9am. We had a late night last night. We went to the opera and we saw Carmen. Jake (01:57) Hmm. How’s that? Bill (01:59) And for those who haven’t seen it, it’s in French and you have to read the subtitles because it has subtitles. I couldn’t read them because I was just a little too far. So I was squinting the whole night. But it’s a great opera, it was a great show, but we got home late so I’m quite tired. Jake (02:20) I couldn’t imagine that. Luckily I do speak French. So I wouldn’t need the subtitles, but that’s something I was afraid of actually, you know, coming out of the stroke is I was afraid almost that I had forgotten how to speak French or that I’d forgotten how to speak both languages. But luckily I speak ⁓ English and French. Bill (02:40) With a name like Bordeaux, I would definitely expect you to at least have some idea of French. Jake (02:45) Yes, indeed, sir. Half English and half French. I’ve been using that largely to my advantage. I’d been working up here in Northern Ontario with Federal Express. So I was working in administration here and sort of coordinating the management and the drivers being the liaison during the two during the day. so, you know, anytime the drivers might have equipment that needs any kind of repair or any kind of issues they might come up with on road as well as when they leave the station and when they come back into the station, I’m the guy that they would deal with. Bill (03:22) Wow, that’s cool. So tell me what was life like before stroke for you? What were you up to? What kind of things did you do? How did you spend your time? Jake (03:33) Well, life has had a lot of ups and downs for me in the last year’s bill. So, ⁓ I had been living for many years in, in Hong Kong and I’m originally from Canada and, I was born in the seventies, born in Ontario here. And by 2009, I had had various, you know, done grit, various career, choices or opportunities, job opportunities here. And I decided to. try my hand at a little something overseas. ⁓ I had an opportunity with a fellow Canadian named Noah Fuller who brought me over wanting to show me how to get into the watch business. And being two ⁓ enthusiasts, you know, being, ⁓ you know, I’d say we were into watch modification, watch restoration, and we were wanting to get a little bit more into building custom parts and building out custom watches. ⁓ working with various ⁓ people, military groups, et cetera, at working on their watch project. So he asked me to come to Hong Kong, learn everything that he knew about the business, and hopefully show me what I was gonna get into over there. That worked out, and while I was over there, I met my wife, I love my wife, I’m still with her. Stroke Effects: Health Awareness and Signs I got together with my wife in 2009 when I had first arrived in Hong Kong and I got married to her in 2010. During that time, Noah unfortunately passed away, so I lost my business partner, but the business continued to grow. So over the years, the business grew with my wife and I running that on our own. ⁓ Unfortunately, maybe it got some of the attention on the world stage. There’s been a lot of political, we’ll say issues in Hong Kong and leading into the pandemic, business was already suffering. ⁓ Once the pandemic hit and Hong Kong was locked down for a ⁓ big chunk of time. that really affected our business and took it down. By the time the pandemic had played its way out, our life over there was looking like it wasn’t panning out the way we’d wanted it to. And a lot of the opportunities that had been unfolding for us all of a sudden came to a close. ⁓ So we moved back to Canada. about two years ago and I started working up here and thinking about our next business opportunity. I’m a lot like you and I’m never really satisfied with what I’m doing and I kind of want to reach for the next thing and I kind of want to reach for more. So I like to work a lot. So while I was working on getting the next thing started, I was working with Federal Express. My days would be really, really busy. I would get up quite early in the morning and I’d chop wood here. I have a dog that I like to walk. I have a golden retriever. I have four children. So I have three girls and a boy and they’re ranging from four years old to 14 years old. They’re all in school. And of course, I was working full time at Federal Express and ⁓ working towards the next thing. So I guess life was pretty active. Bill (07:27) Pretty helpful. Did you have any sense that, you know, with regards to your health, things might take a turn? Was there any information coming to you that you might see now kind of in hindsight and go, well, that was probably a sign. Jake (07:45) Yeah, Bill. So I’ve watched a lot of your podcasts and I found them particularly helpful, especially a lot of the ones relating to hemorrhagic stroke. ⁓ Reason being that’s what happened to me. So ⁓ I had a hemorrhagic stroke ⁓ and it took out a large part of ⁓ my capabilities, I guess, mobility on my right side. So a lot of my body that’s affected is my right side. ⁓ Now, when I got back here from Hong Kong to Canada, unfortunately, I came here to a little bit of an overloaded medical system, to say the least. So I’m hoping that maybe some of what we’re talking today might help people who are in Canada if they suffer the ⁓ same thing as I did to try and get them on track for us, get them back into recovery. ⁓ When I arrived here, the system was overloaded. I didn’t have a doctor. So unfortunately, while I had been warned for several years that I had pre high blood pressure and ⁓ the doctors in Hong Kong had been, you know, monitoring my blood pressure and keeping a pretty close eye on things after arriving here in Canada, that wasn’t a case. And so you know, it would look now that I think about it, that I was having some warning signs. I was having headaches and I’d say that some of those headaches were pretty severe. ⁓ The headaches would come on like a, like a very fast, ⁓ fast onset headache. I would get very nauseated very quickly. ⁓ And then sort of, would, I’d vomit the headache. would pass. At first, I thought I was getting migraine headaches. I’d had one when I was a lot younger. But ⁓ these were coming with some visual disturbance. I was having this horrible headache. was having nausea. So all the things you might expect from a migraine, except that it was going away within minutes and all of a sudden I was back at work. you know, in hindsight, that definitely was ⁓ a warning flashes. And ⁓ had I had a proper physician, if I had somebody watching out for me, they may have caught that. I don’t know, there’s no way for us to know that. So what I would say is, if anybody’s having pretty high blood pressure, keep an eye on that. I would say my blood pressure when I had the stroke was quite high. And if I had been monitoring that, I might’ve been on top of it. So would you like to hear about the day that it happened or? Bill (10:45) Yeah, I would in a moment. So with the blood pressure in Hong Kong, were you being monitored and also medicated or was it just you were being monitored? Bill Gasiamis (10:56) We’ll get back to Jake’s story in just a moment. I want to pause for a second and ask you something important. Why do you listen to this podcast? For many people, it’s because they finally hear someone who understands what they’re going through or because they learn something that helps them make sense of their own stroke effects without feeling overwhelmed or alone. And here’s the part most listeners never really think podcast only exists because people like you help keep it There’s no big company behind it. No medical organization funding the work. It’s just me, a fellow stroke survivor doing everything I can to make sure these conversations are available for the next person who wakes up after a stroke and doesn’t know what comes One of the biggest challenges after stroke is finding reliable information without spending years searching, reading and second guessing yourself. That’s why I want to mention turn2.ai. Turn2 isn’t a sponsor, it’s a tool I personally use. If you choose to sign up using my affiliate link, you’ll get 10 % off and I’ll receive a small commission and no extra cost to you. That commission helps support the podcast and keep these conversations free. What Turn2 does is simple but powerful. It saves you time. Instead of spending years trying to track down research, discussions and updates about stroke, Turn2 brings relevant information straight to you. If you’re already dealing with fatigue, pain or cognitive overload, saving time and mental energy matters. And if you want to go deeper on your recovery journey, you can also grab my book, The Unexpected Way That a Stroke Became the Best Thing That Happened at recoveryafterstroke.com slash book. If this podcast has helped you feel understood even once, consider supporting the mission in whatever way feels right for you. All right, let’s get back to Jake. Jake (12:46) No, so I wasn’t being medicated for high blood pressure at all. was kind of these, well, it’s not quite severe enough to really do anything about it, so we’ll just keep an eye on it. ⁓ I did have pre-existing ⁓ medical issues. When I was quite a lot younger, I had suffered from ⁓ what some people might call Crohn’s disease or an inflammatory bowel issue. and I had some back pain. But other than that, I wasn’t really on any other types of medications. I wasn’t on any kinds of blood pressure medications, any kind of heart medications. ⁓ I wasn’t on any kind of antidepressants or anything like that. ⁓ I would say that I was pretty much feeling like I was in fairly good shape. haven’t gained or lost a heck of a lot of weight since the stroke. So what you see is what you get. wasn’t overweight. I wasn’t eating a lot of junk. I don’t smoke cigarettes. So. Bill (13:56) Yeah. One of those things. I know what you mean. Like I’ve been diagnosed with high blood pressure in the last six months and headaches. Jake, I’ve had headaches for years. I’m talking maybe four or five years. And at the beginning, they were intermittent. They would come and go similar to what you mentioned. And I would be able to get through the day. And I thought they were migraines, although nobody really convinced me that they were migraines. I couldn’t really say. That sounds familiar if I look up what migraine is and all the people who I’ve ever asked about a migraine, it never sounded like, I was never convinced by it. And then a little while ago, was at home, excuse me, I was at home with my wife, feeling really unwell. Did my, checked my blood pressure and it was about 170 over 110, 120, somewhere there. And that was, I knew that’s way too high, know, previously. I’ve checked my blood pressure maybe on the on perfect day and it was 120 over 80. So for me that was pretty serious. We went to the hospital because of all my history and they said your blood pressure is high. It’s probably a migraine causing you to have a migraine which is then causing your blood pressure to go high rather than the other way around. They didn’t say it’s high blood pressure is causing the migraine and or the headache. And then they put me on some migraine medication and they said, if we give you this migraine medication, it’s going to knock you out. You’re going to sleep, but you should wake up without a headache. Well, I woke up with a headache. The migraine medication didn’t do anything. So within a couple of weeks of that particular hospitalization and then going to my general practitioner, he prescribed me a blood pressure medication, came to start on it’s called to help keep the blood pressure down. Now I’m trying to get to the bottom of why do I have high blood pressure? That’s the part that’s frustrating me, because no one can tell you why you have high blood pressure unless they check your arteries and they’re half clogged or you’ve got some other issues with your heart or something like that. And I don’t have any of those issues. So now ⁓ it’s one of those things. It’s kind of like, well, you have high blood pressure. It might be something that runs in your family. When I check with my dad, my dad says that he has high blood pressure. My dad’s 84. So it’s like, you know, and he says, I started taking blood pressure medication at around 50, which is my age. But that’s still, that’s not good enough for me. Like I’m still not comfortable with, well, your dad did. So you are, and then therefore, just move on with life, take this tablet and then move on. Now I’m happy to take the tablet because I do not want to have another hemorrhagic stroke. I’m very comfortable taking a tablet to prevent that, right? No trauma, no traumas. Personal Health Journey, Stroke Effects, and Challenges But ⁓ it’s a very interesting place to find myself in after going through all the three brain hemorrhages that I’ve already had since 2012, brain surgery, learning how to walk again. Now I’ve had enough. I don’t want… I don’t want to be doing this anymore, even though I am finding myself here and I’m tackling it. Part of me is going, man, this is too much. Why do we need to go through this now? Jake (17:29) Yeah, I wanted to ask you something actually, maybe if you’ve had the same, you brought something back to mind here, is that one thing I did have, again, in hindsight, I had visual disturbance. in 2018, my grandmother, bless her shit, my grandmother passed away and I was abroad and I took it pretty hard. was largely raised by my grandfather, my grandmother. And I took it, it was very emotional. And ⁓ when I was grieving, I had an episode where I had a rather bad headache. And again, I had one of these feelings, like I thought I had a migraine headache. Maybe I did, or maybe we’re reading something into it. But coming out of that, I had a visual problem. And it was one of my eyes. in my right eye, you know, again, I have my issues now with my right hand side. My right eye had gotten quite blurry. I was having ⁓ issues with my vision in my right eye. And ⁓ a doctor had decided that, well, maybe it’s a form of macular degeneration. And he decided to do a laser surgery. at the time in Hong Kong. However, it didn’t have any effect. It didn’t help me out at all. And the only thing that helped that was time. And I wonder again now if the reason why treating the eye didn’t take any effect is because he should have been treating or looking at the brain. I think that maybe the issue might have been a small stroke to begin with. and I didn’t realize it at the time. Bill (19:25) That sounds very plausible, right? That’s I think probably a very logical conclusion to get to. Sometimes, you you hear people lose their vision and the way they discovered they’ve had a stroke is they’ll go to the ophthalmologist and they’ll say, I can’t see. And the guy will go, well, your eye looks perfect. I there’s nothing wrong with your lens. There’s nothing wrong with the macula. The eye pressure is fine. Everything’s fine. And that definitely suggests that there is a ⁓ neurological issue of some kind, right? So it’s like, next step is go to the hospital, get it checked out. But ⁓ yeah, well, there’ll be no way of knowing, but I science, I had similar kind of things happen about a year and a half before my first bleed. was at our local football here, which ⁓ my team made the what we call the grand final. There’s usually a playoff series and then the last two teams get to the final game of the year and then the one that wins wins the championship. And my team made it and I was there cheering them on, screaming my head off, you know, just being a really passionate supporter and went home that weekend with a massive headache that lasted about five days and ended up in hospital. They did a lumbar puncture. They checked for a brain hemorrhage or anything along those lines and they didn’t find anything and they also didn’t find the faulty blood vessel that later would cause the first brain hemorrhage. But when I speak to people about it, everyone will say, well, we’ll never know, Bill. There’s no way of knowing whether they were linked. But in my mind, it’s pretty logical to conclude that that first massive five day headache was a sign that something wasn’t right in my brain. And although they had that suspicion of that, they didn’t know what they were looking for. So they couldn’t find the faulty blood vessel. just did a scan, a CT, sorry. Yeah, they just did a CT to actually see if there was any visible signs of a tumor or a bleed or something like that. And since there wasn’t, they weren’t able to diagnose the faulty blood vessel that would later. ⁓ bleed three times. Jake (21:55) That’s incredible, by the way, the three times thing, and that’s got to take a lot of strength to get through. ⁓ I don’t know if I had mentioned to you, how recent this has been. So ⁓ one thing that I’ve noticed with your podcast is that most of the guests who are on have had a considerable amount of time elapse in between when the event has taken place and when they’ve been able to get back lot of their capabilities, a lot of their abilities. So how long exactly did it take you to get back to the stage or the state that you’re in now? Bill (22:36) I would say that I had, ⁓ well, the first three years were tumultuous because every time I was on the road to recovery after the first bleed, then the second bleed happened, that was six weeks apart. And then after the second bleed, I was really unwell. ⁓ Memory issues, couldn’t type an email, couldn’t read, couldn’t drive, couldn’t work. Recovery Process and Emotional Impact angry, really angry. I was probably in that state for the best part of about six to nine months. And then it started to ease and settle down as the blood vessel stopped bleeding. And then the, and then the blood in my head started to dissipate and kind of dissolved, I suppose. And I think I thought everything was going fine. So between February, 2012 and November, 2014, that’s when I had the next bleed November, 2014. the third one. And then when I woke up from that, I had to learn how to walk again. So by the time I got to February 2015, I had been three years in you know, in the dungeon, you know, getting just smashed around by stroke again and again and again, and then brain surgery, then learning how to walk again. And I think personally, I turned the tide maybe at around 2018, 2019. So it took another three to four years for me to feel like even though I’m living with all these deficits, I have got enough of my cognitive function back, my physical function back to be able to go back to my painting company, which had been on pause for a number of years. yeah, so all up, you know, from first bleed, Jake (24:25) incredible. Bill (24:30) to back to the painting company, you know, it seven years. It was quite a long time. And I hear people have similar kind of stories about five, six, seven years. They’re still dealing with everything that the stroke caused, but they have some kind of a turn, like for the better, some kind of like a shift in whether it’s mindset, whether it’s emotionally or whether it’s physically, they have kind of some. Like a fork in the road moment where things change for the better. Jake (25:03) That’s incredibly inspiring for me. So yeah, you give me a lot of hope because I’ve been going through a lot and I’ve only been at this for four months now. so I had this stroke in late July and upon getting into the hospital, again, I wasn’t able to talk. I wasn’t able to use my, couldn’t move my right hand side at all. ⁓ I wasn’t able to go to the washroom, any of the things. I was basically left with kind of like ⁓ a blank slate and everything that I’ve gotten back has been pretty rapid. So I’m really extremely thankful for that, especially that, given that hemorrhagic strokes are rare, ⁓ consequences seem to be more severe and more often fatal. So, yeah, I’ve only been at this for a few months, Bill (26:10) Yeah, I was gonna ask what was it what happened on the day of the strike? What was it like? Jake (26:16) Yeah, so on the day of the stroke, let me get back there for just a second. Right, so on the day of, it was a pretty regular day and I had got up, it was a beautiful day, it was July. ⁓ My family had been on a trip recently, they’d gone to the nation’s capital and visited my family and I was happy to have them back. I just bought my wife a new bike and ⁓ I tuned it up. The dog had been out and I was starting work at 2 p.m. So I was about to go in for 2 p.m. and see the drivers for the whole second part of their day until the closing. ⁓ And I ⁓ was biking into work. again, I was incredibly active. ⁓ So I was biking to work and it would be generally about a 15 minute bike ride and it’s a lot of uphill, et cetera. And some of the route is through some residential areas and even some pathways that go through the woods. Again, I live in Canada and in particular in Northern Ontario in quite a small town named Kirkland called Kirkland Lake, which is a gold mining town. we’re in a gold mining boom right now. And so yeah, I was biking to work, feeling pretty good. ⁓ When I got to work, or when I was just getting to work, I was pretty close to being late ⁓ after messing around with the kids a little bit. And so I pushed myself a little bit harder than I usually do. ⁓ I got to work right on time. I got in a little bit winded. And I started getting my equipment together, got all of my equipment and headed to my office and headed to the window where I’d be greeting all of the drivers as they come into the station. And I started to feel a little bit dizzy. So my thinking was though, I probably just pushed it a little too hard and I probably should have had a drink of water. So I grabbed a drink of water. And ⁓ I sat back down at my desk and the first drivers started to come in. And as they started to come in, I started to feel like it was hard ⁓ to keep track of what they were saying. I was having a hard time concentrating and that’s really not like me. Usually I’m able to concentrate on four children, a wife, a pet, myself. And when I’m at work, I’m able to deal with the whole station full of FedEx workers, drivers, et cetera. So I started asking the drivers, can you just leave your things with me? I’m going to put them aside for a few minutes until I’m back in the game here. I think I’ve winded myself a bit. I’m just going to chill. And the equipment started to pile up, because it was one driver, two drivers. three drivers. And as this was starting to go on, I was looking over at a lady who was working next to me in the office. ⁓ And ⁓ I’m very lucky that she was there. And ⁓ I’ll let you know why in a second. But ⁓ I started to look at her and I started to look at the drivers. And I think at that point, she looked at me and ⁓ it struck her there’s something really not right with Jake. So she came over and started to ask me some questions and she started to try and direct the drivers away from me so that maybe they’d stop asking questions. And it became pretty apparent to her real quick ⁓ that I was having a stroke. Now, thankfully, this lady’s not usually sitting in the office next to me. It was one of those things where she just happened to be there this day and she happens to work with the fire brigade here. and she works with first responders and she’s incredibly well educated as far as first aid and strokes and heart attacks, et cetera. So she was able to recognize what was going on with me right away. ⁓ She had management and she had everybody ⁓ take a look at me and they had the first responders coming right away. The emergency crew showed up within minutes. and they started asking me all the appropriate questions and they started lifting me out of there and driving me away. So I got to work, I guess, at about 2 p.m. That was when my shift started. And ⁓ by 2.25, ⁓ my wife was walking home from the neighborhood park with our kids and heard an ambulance. go by here, not realizing it was me. I’d been taken off in the ambulance. They brought me to a nearby town and then they airlifted me to Sudbury, Ontario. I guess in our nearby town, they determined that yes, I was having a stroke. They did a very quick preliminary scan. They sent me to Sudbury, Ontario, where they started doing more scans and figured out exactly what was going on. Although the medical system had failed me and I didn’t have a doctor going into it, when the rubber hit the road there, they had it together and they got me the appropriate help as fast as possible. That’s probably what helped me to get my recovery online so quick. Bill (32:18) definitely does the time that you take to get to hospital makes a massive difference. That was a good outcome considering everything that was going wrong at the time. So then how does the hospital stay go? How long are you in the hospital and how does it play out? Jake (32:37) Yeah, so I arrived in in the hospital in in Sudbury and I was there for for a few days so ⁓ yeah, I was there for a few days and in that time my My ⁓ my wife and ⁓ one of my good friends one of our children there They managed to come and see me and from what they say I was incoherent at the time So I guess I was still able to talk ⁓ but what was coming out of me was a lot of garbled nonsense. I’ve seen some of your guests say, I thought I was saying, can you please hand me my bag and I need you to bring, and all that was coming out was sort of, blah, blah, blah, blah, like it wasn’t making any sense at all. ⁓ So I was in there for days. And once they had me stabilized in ⁓ Sudbury, Ontario, they decided to transfer me and I had my choice between a couple of different towns. So I would say that by the 25th, 24th, 25th, I was stabilized and I was heading to Sudbury on the 25th. ⁓ Once I arrived in Sudbury, I think I was visited, ⁓ by my folks and my wife and kids. And then I was sent to Timmins, Ontario for my actual recovery. So it was pretty fast. I had the stroke on the 21st and by the 26th, I was in Timmins where I’d spend the rest of my ⁓ recovery time. Bill (34:27) How did they deal with leaking blood vessel? Jake (34:30) ⁓ They didn’t. So they had determined that they were going to probably do a surgery. When they were taking me into the hospital, they had told me that there was a ⁓ brain hemorrhage, ⁓ that it was leaking, that they were going to be monitoring it, that it would be likely there would be a surgery, and that I should probably be be prepared not to make it through. ⁓ So I guess, you know, they gave me some hope. I mean, they told me that we can hope for the best, but they were quite honest with me at the time in saying you might be going for the rest of your life ⁓ wearing diapers or unable to talk. ⁓ And it’s quite probable that you might not make it out of this. Uh, so they monitored it and they continued to bring me while I was in the Sudbury for scans and they continued to monitor the situation. Um, but they didn’t do any surgery. So, uh, I was put on medications to bring the blood pressure down, to keep the blood pressure down. And, uh, and I was placed on those while I was in, in hospital. And I continued to. recover all the way through August. And by the end of August, I had come back home. ⁓ while I was in hospital, I was only visited twice because it was far away from, from my home. And, ⁓ I’m honestly, Bill, I’m glad. ⁓ I was really happy. I was able to see my, my, my wife and kids by phone, obviously, you know, the wonders of modern technology. ⁓ but I was left with a lot of time on my own to reflect and I was left with a lot of time on my own to get better. you know, one of the things I decided once I got to the hospital was I’m not going to spend any time in the lounge. I’m not going to spend any of the time with the other patients who are ⁓ in here, nothing against them or anything like that. But the very first thing I did, was I started to try and find more information about what exactly happened to me and ⁓ what are my chances of getting better and what gives me the best chances. And what I came up with was I had better start working on my recovery immediately. yeah, so one of the very first things that I did is I got my notebook into me. notebook, got pencils, I got a pencil sharpener, I got one of those, ⁓ you know, hand gripper ⁓ exercise, you know, for your hands. ⁓ And I got a razor blade, and I got my wife and kids to bring in a hair trimmer. And I decided that no matter how long it was going to take me to shave, I was going to do that on my own. no matter how long I thought I’m in here, I don’t have anything else to do today. If it’s going to take me all day to cut my hair and shave my face, I’m going to do that. ⁓ If it takes me all day to do the, write the alphabet down, I’m going to get through that. And I went from again, ⁓ scribbles from just scribbles and barely being able to hold onto the pencil to, ⁓ by the time I left the hospital, I was writing in perfect cursive. Attitude Towards Recovery Bill (38:22) Yeah, that’s brilliant. I love that attitude. That attitude is probably ⁓ something that holds people in very, like creates a great outcomes for people, regardless of how much the stroke has affected them, regardless of how bad their deficits are, you know, regardless of what version of stroke they caught, they, they had to experience. And this is what I was doing when I was in rehab as well. So I did the same thing when I came back from hospital. So My first stay, I came back and we were on the internet checking, you know, is a blade in the brain? What is all this stuff? What does it all mean? Trying to get some answers. The second time, ⁓ six weeks later, I was searching for what kind of food should I be eating? If I’ve had a stroke, what should I be avoiding, et cetera? That was pretty cool to find out and learn, wow, there is actually a protocol that you can ⁓ take that supports your brain health instead of one. that doesn’t support your brain health. So that was pretty awesome. And then ⁓ in rehab, I was searching YouTube for videos about neuroplasticity. was searching videos for ⁓ anything that had to do with recovery of a neurological challenge, et cetera. And it was just way better than being ⁓ sort of worrying about my own situation and focusing on me like. internalizing it, you know, I was externalizing it and becoming proactive and I found, ⁓ and I found some great meditations. So I’m lying there. I can’t walk. I’m very sleepy. I need to sleep most of the time because I’m exhausted from all of the rehab. I’ll put on a meditation and just let it do its thing in the background while I was healing, resting, you know, recuperating. ⁓ so I think that approach just changes the way that your body responds as well because your body wants to step up to the plate. If you set an intention, we’re going through the healing process, this is the path that we’re gonna take, the body follows. If you go through the other part, if you take the different path and go, well, things are not going good for us, we’re doing it really tough, we’re feeling sorry for ourselves, we’re not gonna put any extra effort in. the body’s going to go, no, I’m listening. I’ll do exactly what you want. And you get the results that, that your intention has set. Right. So I think that’s brilliant. The way that you went about that and not interacting with other people. kind of get that too, because it can bring you down. Like seeing other people doing it hard can bring you down. And also ⁓ sometimes other people’s attitudes can rub off as well. And they can bring you down if They’re feeling bad about this situation and you don’t want to be around people who are going to ruin your vibe. Doesn’t matter who they are or where they are. Jake (41:27) Right. And one thing that where I think the hospitals and doctors and therapy where I think they really let us down is something that I believe it was on one of your podcasts and someone talking about neuroplasticity is that when we do something for therapy, we should be doing it thousands of times. We shouldn’t be doing it a few times. I think where we’re let down is like, ⁓ for instance, I went for my physiotherapy today and I find it helpful and I definitely do go, I would recommend it to anybody. But we will do each of these exercises 10 times. Do this 10 times, do this 10 times, do this 10 times. But what we’re failing to see is that, you know, To really make those connections, need to do things hundreds or thousands of times. ⁓ I have a, know, a, for instance, for you, you know, I mentioned the writing. So a place where I have an incredible block is, ⁓ I will go to try and begin something, particularly where I’m going to write something down and I’ll have the intention of writing one thing and something different will come. So, I would try and begin a word with the letter T and instead of beginning by going up and then straight down and crossing my T, instead I’m doing a loop like it’s an L. So in order to, you know, retrain, sort of get that, get that connection made, to go and start doing words that begin with the letter T. Bill (43:17) I have Jake (43:24) and a lot of times, mean like thousands of times before I could sit down and write a letter T. if people are feeling like they’re not getting anywhere or it’s not coming along for them and they are doing the exercises, I would say don’t give up and do them more. Don’t give up and do them less, do them more. Bill (43:33) Wow. Jake (43:53) ⁓ If you’re going to be doing something like walking, if you’re finding that difficult, then I think maybe if you walked around the block on Tuesday, go another 10 steps further and do that for the following week and always just keep adding to it because it does get better. And I don’t know about you, do you find Bill like I know one of your recent guests mentioned that it was a challenge for him to deal with how non-linear the recovery is. And I think that only hearing that from other people allowed me to accept that. Because a lot of the time I’ll feel like I’m doing great and things are incredibly better. And then maybe I have a week where I’m doing in respects, I’m doing worse than I was when I was in hospital. And I think that that’s really hard to deal with. you have that too, or did you find that? The non-linear kind of feeling? Yeah. Bill (44:55) Indeed, and then what happens four months, five months, six months, 10 months, is you start seeing the pattern and the pattern is, okay, I’ve made some inroads, okay, here’s the quiet time or the downtime coming and then you feel better about it because it’s not a big deal. You see the pattern and you notice it and it’s less frustrating because that’s actually, it appears as though you’re doing nothing to your head. Your head might be going, oh, I’m not doing anything. Long-Term Recovery and Reflection sitting on my butt, I’m not able to get through a day of physical exertion or anything like that. I must be going backwards. Well, in fact, your body’s just doing a different version of recovery and it looks different. It looks still and it looks silent and it looks fatigued, but it isn’t going backwards. It’s just a different phase and it needs all of it. You need to do that silent, still, quiet, fatigued resting one. And then you need to do the one which is to whatever extent you can, full on, full out, doing too much, going too far, ⁓ over-exerting yourself. And they kind of, you can’t have one without the other. You have to have them both. And ⁓ if you understand that, then you don’t get anxious or upset about it or bothered about it. And you start playing the long game. You stop focusing on today, I didn’t have a lot of effort, but… If I reflect on my last six months or nine months, there was maybe only seven days that I was really low or didn’t feel great. The rest were better days or I felt okay or whatever it was. if you start playing when you’re only four months out, it’s hard to play the long game. But when you get to a year or 12 months out, you look back and reflect, you can see that majority of what you were doing was getting. outcomes that were favorable and therefore, you know, and therefore you can sort of be okay with the quiet days, rest, the rest of all those. I used to go to loud events, whether they were a concert, a family event, a party, wedding, whatever. If they were long drawn out days, I would have to plan for the next day to be completely a write off, nothing on the calendar. No going anywhere, seeing anybody, doing anything so that I could rest properly and get my brain back online so that I could have a good day, the third day, you know? And that’s how we did it for many, many years. And I remember one time when the shift came, when I said to my wife, I am not doing anything tomorrow. You make sure that whatever you do, you do without me. You’re going to go and do your thing, but I’m not going to be involved. And then waking up in the morning and going, hey, I feel fantastic. What are we doing today? And she’s like, I didn’t plan for you, but okay. ⁓ let’s get the ball rolling on something. So we did something minor, but it was more than nothing. And that was my, okay. My moment of things are shifting and I’m able to recover overnight with a good night’s sleep quicker than I was. doing previously. Jake (48:19) That’s great. That’s great. Yeah. A lot of this, I really appreciate talking to you and I appreciate hearing your guests who have been at this a lot longer than I have. ⁓ I’m incredibly encouraged by how well I’ve done so far, but it’s also, there’s a lot of questions. ⁓ For instance, I’m in this stage where I don’t know, Bill, if I’m going to make it back to the same job as I was doing before, don’t know whether it’s reasonable to think that. Right now I’m doing, you know, going through all the steps that I need to go through and doing all the evaluations that I need to do. ⁓ But I’m not sure what the outcome is going to be. And that’s a little bit hard because I’m, you know, like most people who are entrepreneurs or, you know, have large families, we like to have an element of control, you know, with things. So it’s been hard to just sort of sit back here and not know what’s coming along. As far as work goes, I don’t know. Luckily, you know, I have a building here where I do own the building and I do have commercial space downstairs. So maybe I have the option to now use that space for myself. And ⁓ maybe I’ll have to be, maybe I’ll be forced to go back into. entrepreneurship and open my own business. Maybe going back to work ⁓ is not the path for me. We’ll have to wait and see. Bill (49:56) It will emerge. You’ll get a sense of it. I had ⁓ three years where I worked for another organization and it was a completely different field and they were, the role was a very entry level administrative role. Very, we’re talking a role that would probably be replaced by AI now. ⁓ So we, I was doing that for three years and what was good about planning and trying to get back to that level of effort and work was that it served a purpose. And part of the purpose was talking to people, traveling, ⁓ doing work on the computer. It was retraining me as I was getting comfortable with the role, getting used to traveling, getting back to being in loud environments, et cetera. So it was difficult, was tiresome, it was challenging, but it was… kind of like its own therapy. And when it served its purpose after three years, I was done. I just said, okay, I’m out of here. going back to running my own business again. And I’ll be, I’ll do that as slowly or at my own pace in any other way that I can so that ⁓ I create the whole, all the rules around the amount of hours that I attend, the type of work that I take on. You know, so if I was too tired to work the following week, I would just tell my clients I’m busy for a week and I can book you in two weeks down the road, you know. So that was what was good about going back to my business. And also what was good about going back to a job for somebody else because their expectations, you know, working for a corporation, the expectations are far lower than the ones that we put on ourselves when we’re working. for ourselves. So I know some people think working for a corporation is really stressful and all that kind of stuff. And it probably is. No. But I mean, I was barely working six hours a day. Whereas working for myself six hours a day that the day’s just starting, you six hours. You haven’t even hit lunchtime yet. So it’s interesting to think about work and how ⁓ and how you can use it as a therapy. Jake (52:23) It is well, I mean the difference for me is that I was actually in that role that you’re explaining right now when I had the stroke so I I’d gone through a whole bunch of very difficult things in Hong Kong and upon coming back here to Canada, I was almost feeling like I I had a lot of stress going on and I had a lot of things that I needed to sort out and ⁓ there was a lot of things that we need to settle with the kids. There was all sorts of stuff that needed to be done. So the job that I was working was actually, it was already fulfilling that role that you explained. I was having that less responsibility. was going in for a specific amount of hours that they were letting me know. So that was exactly it. was an administration job, but it was really not close to the amount of responsibility that I was used to having. ironically, now that this has happened to me, it might be the amount of control that I have over the amount of worked that might be an advantage after going to stroke. I’d be interested to see or to hear more about ⁓ how people deal with the change that comes with the different type of work they might be forced into, forced out of, and how they deal with that. Because I think that a lot of people deal with, ⁓ they think of their employment or they deal with their life in this sort of way, like people often ask, especially in Asia. What do you do? The first thing that people do if you’re in Hong Kong is they hand you a business card. They call it a name card there. And the very first thing that you do when you meet somebody before you even speak is you hand them the card and you each examine each other’s cards. So this idea of like, what I do is who I am. And I, and I think that when you have something like this happen to you often what you do must change. when you’re identifying with what you do, you’re sort of declaring that as your title, who you are, I would imagine that’s pretty tough. Luckily, I wasn’t tied to Federal Express, thankfully. Work and Identity Post-Stroke Bill (55:00) Yeah, I hear you. is, people will work as a lawyer for 20 years or 30 years, have a stroke, and then it’s like, well, who am I now? What am I now? And that’s the challenge with working and identifying as the work that you do. know, those days are gone in theory. You know, you don’t get named John lawyer anymore. You don’t get named John banker. anymore, you you don’t get the your surname from the occupation that you do back in the day, you know, Baker, carpenter, plumber, you know, all those people, they were their entire job, they did it for 3040 5060 years, that was what they did. And then when they couldn’t work anymore, well, they still identified as john plumber, because they had the name, the name was given to them or John Carpenter or whomever. The thing about it is now with jobs being so ⁓ not long term anymore, you get a job or you go to a particular employer and then two, three years you’re in another role or another title, et cetera, ⁓ or you’ve moved up the corporate ladder, et cetera. Well, if you’ve never even done that, if you’ve only ever worked and you haven’t explored your interests, ⁓ hiking, walking, running, playing ball, ⁓ becoming a poker player, ⁓ whatever, whatever it is other than my job, you’re very, it’s understandable that it’s very narrow how you can explain to somebody how you occupy your time. Like what do you do? Well, I do plumbing, but I also do poker. ⁓ I do this, but I also do that. I’m that guy. Like when you ask me, sometimes I will literally be in a painting outfit, not so often now, but my painting clothes, and then I’ll take them off and I’ll sit in front of the computer and I’ll record a podcast episode. And then at the end of the day, I’ll be doing a presentation somewhere, speaking publicly on a particular topic at the moment. My favorite topic is post-traumatic growth. When somebody asks me, what do you do? If they know me, they know I do podcasting. They know I do painting. They know I do speaking. They know I’ve written a book. ⁓ they know all these things about me. If they don’t know me, depending on which room I’m in, I’m a podcaster. If I’m in one room, I’m an author. If I’m in another room, if I’m in another room, I’m a painter and so on. And what that allows me to do is. not be tied down to my entire existence being about only one thing, because I think that would be boring as, and I would hate to be the guy that only knows something about painting, how to paint the wall fantastically. mean, great, maybe, but not really rewarding, and not a lot of ⁓ spiritual and existential growth in painting a wall. I solve a problem for you, but I haven’t gained anything. other than money for me. It’s not really, you know, it’s not my cup of tea anymore. Now I get to have a podcast, I get to make way less money out of a podcast episode and yet reach hundreds and thousands of people and feel really amazing about that. And what that does is that fills up my cup. That allows me to fill up my cup on the down days where I’m not earning a living. And then it allows me to go earn a living. and then not feel like all I’m doing is working and going through the maze all day every day and just being on the constant cycle of the boredom and the sameness and all that kind of stuff. So I sprinkle a little bit of this and that into my life so that I don’t have ⁓ the same day twice because I can’t cope with the same day three times. Twice is a real bad sign for me. If there’s a third day coming, that’s gonna be the same as yesterday. I’m not up for that, I don’t want to know about it. Jake (59:21) Right. Well, that also helps with your recovery. I think like, as you say, you do a lot of different things and that helps a lot. Right. So, you know, one, for instance, is, know, the, of the first things I started to think of when I was in the hospital in Sudbury and thinking of getting home is my gosh, it’s going to start getting cold soon. Winter’s going to hit. And I really have to start getting that wood all stacked. Right. So So, you know, here I am, I’m benefiting from it now. I burn wood all winter, but, ⁓ you know, I spent a lot of my rehab ⁓ stacking wood. And I mean, that’s incredibly great physiotherapy, right? Whether you’re stacking wood or like you said, you made me think when you’re talking about painting, I’m thinking about like the karate kid, right? Like with wax on wax on paint on, this is the kind of stuff that gets you out of one particular mold. And with your brain sort of like focused on recovering in one single area, you can recover in all these different areas. And I think they contribute to like a big picture of your recovery. Bill (1:00:34) I agree with that. It’s exactly right. It’s you know standing on the ladder which I do less of these days because I Felt off about a year and a half ago. So standing on the ladder and Getting down the ladder holding a paint can and applying paint ⁓ Putting drop shades down and picking up tubs of paint, you know ⁓ That whole every part of that physical activity is using a different part of the brain. Writing a book, even if it’s only 10 minutes a day, writing half a page or 10 paragraphs or whatever it is, that uses a different part of the brain. ⁓ Public speaking, that trains and uses a different part of the brain. Everything that I do definitely kind of helps to rewire the brain in many, different ways and supports my ongoing recovery and… ⁓ is and the idea behind it amongst other things, the idea behind it from a neurological kind of perspective is that it activates more of the brain. The more of the brain that’s activated, the more chance you are of creating new neuronal pathways and having ⁓ more options for healing or recovery. And then it works emotionally for me, it works mentally for me. Do you know, so I get… the emotional fitness and the mental fitness out of it. Speaking on the podcast, meeting people gives back. you know, that serves my, I need to serve other people purpose. Do you know, like, it’s just so much, everyone ⁓ who knows me kind of knows that I wear a lot of hats. I kind of. I kind of like, I do it. I show people like when they’re saying, what are you up to today? I’ve been wearing a lot of hats today. And if I’m not wearing a hat, like I pretend that I put another one off or just took one off when I’m sitting with them or talking with them. It’s crazy how many things I do. And about the only hat I would prefer not to wear right now is I prefer to put the painting hat down. and just hand that over to somebody else and just go, I think that part of my life’s done and I’ll move on to other things. Jake (1:02:57) If you don’t mind, have one, there’s one more thing that right now that I’d like to mention just before I forget. Is that all right? All right. All right. So the only other thing, the thing that I’ve been dealing with myself and I don’t know how many people deal with it or don’t deal with it. I know that not everybody does. don’t, I deal with a lot of post, uh, post stroke pain. So while I don’t have Bill (1:03:04) Yeah, of course. Jake (1:03:25) ⁓ the misfortune of losing use of my feet or losing use of my hand. I mean, it’s limited. do therapy, but I’m able to use my hands. I’m able to write and all this. But coming along with that is an incredible amount of ⁓ burning, tingling ⁓ sort of ⁓ feelings like there is ⁓ almost like the, know, if you can think of newspapers when they’re delivered in a bundle and they’ve got this kind of plastic strapping around it. ⁓ It’s usually it’s yellow, you know, this sort of plastic strapping. I feel often like that is wrapped around my arms, like it’s wrapped around my leg. I deal with a lot of this kind of stuff, unfortunately. So again, I mean, I’m not going to sit here and whine about it because again, ⁓ I can walk, I can do all the things that I need to do and I’d rather have that than what I do. But I’m wondering if it’s really common for a lot of people to have this, you know, post stroke pain. Bill (1:04:44) If 10 was the worst pain you’ve ever experienced in your life, that’s like we’re talking about 10 is somebody’s cut your limb off ⁓ and one is no pain at all. Like where would the pain be for you? Jake (1:05:00) Well, thankfully, again, thankfully ⁓ I’ve had some progress in this. So when I first came to, when I was first starting to get all the feeling back, ⁓ I started to notice that some feeling wasn’t coming back. But while I was in the hospital, I was on quite a lot of medication. So I was on some pretty heavy painkillers. ⁓ I think hydro-morphone, things like this. And I came off of those when I was coming home and a lot of the feelings started coming back. I would say that some days and at some times that pain can be what I would say maybe it’s a 12 out of 10. Like it’s bad. at some points I’ve been left doing nothing but be able to just really just sit there and cry. I’m going to be honest with you. And the pain could be quite severe. Now luckily those days are few and far between. It’s not all the time. ⁓ And here’s the deal. The thing that’s very strange with the post stroke pain or the intensity of it is that it’s like going to sleep or it’s like the start of a new day, the beginning of a new day is like a reset button’s been hit. So for instance, I could wake up on a Monday and I could be hit with the worst pain that I’ve ever had in my life. It feels literally like I’m being hit with a taser gun on the right side of my body and that while somebody’s hitting it with the taser gun, they’ve lit my hand on fire. And, ⁓ And then the very next day after I’ve gone to sleep, I woke up and I’ve had the rest. I wake up almost scared to move because for me, sort of when I wake up and I haven’t moved yet, it’s almost like nothing’s happened to me. It’s like I wake up and I don’t know that I’m numb. don’t know that I’m in pain. don’t know that all this is going on. And then I start to move and sometimes I can sit there and feel a relief. Think, wow. There’s nothing severe going on. This is pretty good and it’s going to be a great day. Or sometimes I can be struck with a type of debilitating pain that I can’t even describe. Yeah. Pain Management and Coping Strategies Bill (1:07:34) Well, what you’re describing is very common. I know a lot of people going through post stroke pain. ⁓ It is a thing. I have a very minor version of exactly the thing that you described about how the tightness and things wrapped around ⁓ your hand, like the newspaper. that’s kind of what I feel on my left side, the whole left side all the time and the burning and tingling sensation all the time. And okay, on my worst days, these days, like it’s probably, you know, I know, it’s probably a four and a terrible one would be a five, but it doesn’t get there much. And what I’ve noticed is that the, either I’ve become more tolerant of it or my my pain has decreased in my awareness. Like I’m aware of the fact that my limb is in the state that it’s in. And sometimes I’ll go to get a massage to get the muscles loo
No BS Newshour Episode #401Media: May Cause Heartache, Hysteria & NauseaMainstream News is NOT independent. (0:04) How the press, the politicians and the pollsters conspire to manipulate.Which paper goes down first - The Detroit Free Press or the Detroit News?(24:06) City Hall puts out a press release. They've fixed Detroit's Dirt scandal. How this is not true says the demo contractor Mr. XAnd then there are the good reporters. (46:09) Tresa Baldas (Free Press) on Karen McDonald's Crumbly Case scandal.(53:35) Ross Jones (WXYZ) and George Hunter (Detroit News) exposé on the ex-con Detroit Police commissioner.Social Media is not the new media. Look no further than (57:30) Don Lemon and (1:02:18) Benny Johnson. NBN on YouTube: https://www.youtube.com/@NoBSNewshourNBN on iTunes: https://podcasts.apple.com/us/podcast/no-bs-newshour-with-charlie-leduff/id1754976617NBN on Spotify: https://open.spotify.com/show/0qMLWg6goiLQCRom8QNndCLike NBN on Facebook: https://www.facebook.com/LeDuffCharlieFollow to NBN on Twitter : https://x.com/charlieleduff Sponsored by American Coney Island, Pinnacle Wealth Strategies, and XG Service Group
If you're pregnant right now, chances are your mornings—or really, your entire day—feel like a constant battle with nausea.
This hypnosis session was for a pregnant client to help ease nausea, to reduce the intensity, and help them feel better able to manage any feelings of sickness. To access a subscriber-only version with no intro, outro, explanation, or ad breaks and 24 hours earlier than everyone else, tap 'Subscribe' nearby or click the following link.https://creators.spotify.com/pod/profile/adam-cox858/subscribe
On this episode of Vitality Radio, we revisit the Grandma Was Right series to explore the therapeutic use of cayenne pepper and ginger root—two traditional remedies used for centuries to support circulation, digestion, and recovery. Jared explains why these warming herbs were historically used during illness rather than avoided, how they help restore blood flow, support digestive function, and ease aches and stiffness, and what modern research reveals about compounds like capsaicin and gingerols. You'll also learn how to use cayenne and ginger safely, how they complement each other, and why simple, time-tested remedies still matter today.Cayenne and Ginger Products DiscussedBuy KAL Think Magnesium L-Threonate AND Lifeseasons Lion's Mane Mushroom together and save $28! Vitality Radio POW! Product of the Week with PROMO CODE: POW22Visit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.
This episode originally aired as #432 on 5/22/24 and we are bringing it to you again! Parasite cleansing has become a hot topic in the natural health world, but it can feel a little overwhelming. Are you confused about where to start or how to do a cleanse yourself? On this episode of Vitality Radio, Jared demystifies the process by sharing his experience along with his wife's, and a thorough breakdown of the entire process, the products, and what to expect. You'll learn a couple of ways to approach parasite cleansing and which one might be right for you or your family, including kids. If you never thought about parasites being a problem in America, think again! For a deeper understanding of why parasites are indeed a bigger problem than is understood by most, be sure to listen to Jared's interviews with Dr. Todd Watts and Dr. Jay Davidson - the founders of CellCore.Products:CellCore Para KitVitality Nutrition Parasite CleanseVital 5 Precision Probiotic Vital SporesMagnesium BisglycinateCellCore Bowel MoverLife Seasons Regulari-TRedmond RelyteTrace Minerals Endure Drops***Inquire for capsule-free protocol Additional Information:For information on coaching options and personalized support, please email jessica@vitalitynutrition.comVitality Wellness Community Detox & Support GroupVitality Radio Podcast Listener Community#359: Comprehensive Detoxification of Parasites, Lyme, and Other Toxins With Dr. Todd Watts of CellCore Biosciences#431: Are Parasites Part of Your Health Concerns? With Dr. Jay Davidson#385: Rebalancing and Healing the Body Through Functional Medicine Detoxification With Dr. Stephen Cabral#258: Your Magnesium User's Guide***Be sure to check out all of the Emotional Vitality Episodes, including Jen's Story mentioned in this showVisit the podcast website here: VitalityRadio.comYou can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Please also join us on the Dearly Discarded Podcast with Jared St. Clair.Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
In this episode, we review the pharmacology, indications, adverse effects, and unique drug characteristics of 5-HT3 receptor antagonists such as ondansetron (Zofran) and palonosetron (Aloxi). Key Concepts There are four 5-HT3 (serotonin subtype 3) receptor antagonists on the market: ondansetron, granisetron, dolasetron, and palonosetron. These have primarily been studied for acute chemotherapy-induced nausea and vomiting (within 24 hours of chemotherapy administration) and for post-operative nausea and vomiting. When used for chemotherapy-induced nausea/vomiting, 5-HT3 receptor antagonists are given prior to chemotherapy (usually 30-60 minutes before) on day #1. They are not given on subsequent days because they are not as effective for delayed nausea and vomiting. Palonosetron has the longest half-life, longer binding affinity to the 5-HT3 receptor, and trends towards having the best efficacy among the 5-HT3 receptor antagonists. 5-HT3 receptor antagonists are associated with QTc prolongation and may cause headache, dizziness, constipation, or diarrhea. Their association with an increased risk of serotonin syndrome is controversial and not supported from a mechanistic perspective. References Simino GP, Marra LP, Andrade EI, et al. Efficacy, safety and effectiveness of ondansetron compared to other serotonin-3 receptor antagonists (5-HT3RAs) used to control chemotherapy-induced nausea and vomiting: systematic review and meta-analysis. Expert Rev Clin Pharmacol. 2016;9(9):1183-1194. doi:10.1080/17512433.2016.1190271 Tricco AC, Soobiah C, Blondal E, et al. Comparative efficacy of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis. BMC Med. 2015;13:136. Published 2015 Jun 18. doi:10.1186/s12916-015-0371-y Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline Update. J Clin Oncol. 2020;38(24):2782-2797. doi:10.1200/JCO.20.01296 Herrstedt J, Clark-Snow R, Ruhlmann CH, et al. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open. 2024;9(2):102195. doi:10.1016/j.esmoop.2023.102195 Rojas-Fernandez CH. Can 5-HT3 Antagonists Really Contribute to Serotonin Toxicity? A Call for Clarity and Pharmacological Law and Order. Drugs Real World Outcomes. 2014;1(1):3-5. doi:10.1007/s40801-014-0004-3 Li WS, van der Velden JM, Ganesh V, et al. Prophylaxis of radiation-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trials. Ann Palliat Med. 2017;6(2):104-117. doi:10.21037/apm.2016.12.01
Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions: Michelle: Hi Dr. Cabral, I started the para Support protocol this morning. I had 16 ounces of warm, lemon & hydrogen water upon waking and a half hour later took 2 of the Proteolytic enzymes on an empty stomach and about a half hour later I drank a cup of coffee with a teaspoon on ghee (my regular routine water first and coffee 20 min later). Shortly, there after I got extremely nauseous over the next several hours. I'm in overall good health and have taken many supple Adam: Hey Dr. Cabral, I am 15 years old and weigh 160 pounds. I am 5ft 10 and a half and I have been working out for 3 years and have always tried to have a healthy lifestyle. I have recently been interested in taking supplements to support muscle building and overall health. What supplements, vitamins, and minerals do you recommend for someone of my age? Thank you for all that you do, God Bless. Taruna: I have been diagnosed with oral lichen planus for 5 years now. I have been on anti inflammatory diet but keep getting flares. Using hydroxychloroquine now, and steroids on and off for flare. Want to get your opinion Tricia: Hi Dr Cabral, I just listened to your podcast this morning with Dr. Axe and Jordan Rubin. I enjoyed it thoroughly and did purchase the book. The one thing they mentioned that I do wrong is I love shellfish. I live in MD so I do have crabs but not frequently. In general I do eat shrimp once a week and scallops once or twice a week. Can you give me your thoughts on if we need to remove scallops? I read they aren't scavengers. I do your quarterly detox. Would you recommend I do your parasite protocol and how often? Interested in your opinion and advice how to offset the toxins from shellfish. I can't give it up totally. Thank you! Kai: Hello! Thank you for all you do. I am currently finishing up my IHP Level 2 and I'm excited to help people! Im 3 months postpartum and dealing with Hidradenitis Suppurativa (HS). It's a bummer to say the least. I eat organic, lots of veggies, pasture-raised beef etc. I do occasional dairy and sourdough. I also love the Equilife DNS! I'd like to do a detox as soon as I'm done breastfeeding. What test would you reccomend to figure out whats going on with the HS- please note I am a bit on a budget! Thank you! Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions! - - - Show Notes and Resources: StephenCabral.com/3578 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!