Podcasts about nsaids

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medication options (i.e. acetaminophen, NSAIDS) but in severe pain stronger medications might be indicated. These stronger medications include options such as IV morphine, a subdissociative dose of ketamine, as well as intranasal fentanyl. Intranasal fentanyl has many advantages: Studies have shown it might be more effective early on in controlling pain, as in the first 15-20 minutes after administration, and then becomes equivalent to other pain control options Total adverse effects were also lower with IN fentanyl, including low rates of nausea and vomiting To administer, use the IV formulation with an atomizer and spray into the nose; therefore, you do not need an IV line Dose is 1-2 micrograms per kilogram, can be redosed once at 10 minutes.  Don't forget about gabapentinoids for neuropathic pain, muscle relaxants for muscle spasms, and nerve blocks when appropriate. (Disclaimer: muscle relaxers have not been well studied in children) References Alsabri M, Hafez AH, Singer E, Elhady MM, Waqar M, Gill P. Efficacy and Safety of Intranasal Fentanyl in Pediatric Emergencies: A Systematic Review and Meta-analysis. Pediatr Emerg Care. 2024 Oct 1;40(10):748-752. doi: 10.1097/PEC.0000000000003187. Epub 2024 Apr 11. PMID: 38713846. Bailey B, Trottier ED. Managing Pediatric Pain in the Emergency Department. Paediatr Drugs. 2016 Aug;18(4):287-301. doi: 10.1007/s40272-016-0181-5. PMID: 27260499. Hadland SE, Agarwal R, Raman SR, Smith MJ, Bryl A, Michel J, Kelley-Quon LI, Raval MV, Renny MH, Larson-Steckler B, Wexelblatt S, Wilder RT, Flinn SK. Opioid Prescribing for Acute Pain Management in Children and Adolescents in Outpatient Settings: Clinical Practice Guideline. Pediatrics. 2024 Sep 30:e2024068752. doi: 10.1542/peds.2024-068752. Epub ahead of print. PMID: 39344439. Summarized by Jeffrey Olson, MS4 | Edited by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the commonly used drugs in reducing pain, inflammation, and fever. And the question that rises is whether it is possible to relieve back pain without relying on NSAIDs. And, yes, it is possible to find relief from back pain without relying on NSAIDs. Alternative methods for managing back pain include physical therapy, exercise, stretching, heat or cold treatment, and mindfulness practices like yoga or meditation. In some cases, lifestyle changes such as improving posture, reducing weight, or managing stress can also help alleviate pain. Working with a healthcare practitioner can be very beneficial if the pain is persistent. Home care Home care remedies that can help relieve back pain, including heat and cold therapy, and gentle and low-impact exercises, like swimming and walking, can help strengthen the muscles supporting your spine to improve flexibility. Maintaining a straight posture while sitting and standing and a suitable sleeping position can prevent additional strain on your back. Also, gentle massage on the affected area can reduce muscle tension risks of future injury. Chiropractic Care Chiropractic care includes spinal adjustments by a professional to realign the spine, relieve nerve pressure, and reduce the pain. You can also embrace soft tissue therapy techniques such as massage to help alleviate tension and improve circulation, thus reducing back pain. In addition, chiropractors often provide activities that strengthen muscles to support the spine, enhancing flexibility and promoting better posture. Comprehensive care with movement The simple activities we engage in daily, including walking and stretching, can help with back pain without the need for NSAIDs. The comprehensive therapy combines physical activities to strengthen the core, improve flexibility, and promote proper posture. Such activities include low-impact ones like swimming, walking, and stretching regularly. However, you must be mindful of tai chi and yoga practices to alleviate back strain. ·         Decompression therapy  Using a specialized decompression table, a chiropractor will apply gentle traction to create intervertebral spaces for the compressed disks to retract and ease pressure on the surrounding nerves. Please do not lose this golden opportunity for your long-sought back pain and sciatica relief. Please book an appointment with our chiropractor for the best back pain and sciatica remedies. Long-term use of NSAIDs is not good as such drugs may lead to complications such as gastrointestinal complications, kidney issues, cardiovascular risks such as a surge in the risk of stroke and heart attack, and reduced effectiveness in treating chronic pain. Instead of using NSAIDs for back pain and sciatica relief, you can use physical therapy, proper home and work ergonomics, heat or cold therapies, and lifestyle modification. And if you need more guidance on how you can relieve back pain without NSAIDs and understanding why using NSAIDs long-term is not good, talk to Dr. Jason Jones at our Chiropractic office in Elizabeth City, NC, for assistance!

Not sure what Minimal Disease Activity or MDA is and how it relates to psoriatic arthritis and your joints? Listen as rheumatologist Dr. Arthur Mandelin explains what MDA means. Join hosts Jeff Brown and LB Herbert as they discuss minimal disease activity in psoriatic arthritis with nationally recognized rheumatologist Dr. Arthur Mandelin who identifies what it is, factors that influence achieving MDA, how long it takes to reach, and the impact on selection of treatments. Dr. Mandelin also addresses fatigue associated with inflammation, and what the future holds for minimal disease activity in psoriatic arthritis. Whether you have psoriasis or psoriatic arthritis, this episode offers information to help you understand management goals set by your doctor and the importance of attaining minimal disease activity. Timestamps: (00:00) Intro to Psound Bytes & guest welcome rheumatologist Dr. Arthur Mandelin (02:23) What is minimal disease activity (MDA) (04:32) MDA in comparison to ACR response criteria (07:36) Criteria for reaching MDA (09:20) Positive and negative factors of MDA (11:25) Importance of reaching MDA within a specific time frame (17:34) Length of time to reach MDA (18:48) Selection of treatment options and psoriatic arthritis domains (23:51) Inflammation and fatigue (26:59) A look at the future of minimal disease activity in psoriatic arthritis: Reaching ACR 90 (29:09) Advancements in psoriatic arthritis: Finding disease markers (33:40 ) If you have psoriasis, be aware of your risk for psoriatic arthritis 4 Key Takeaways: There are various ways to measure minimal disease activity in psoriatic arthritis to assess how the disease impacts quality of life.   Attaining and keeping minimal disease activity low through use of different therapy options offers a chance for better bone and joint outcomes. Advancements in psoriatic arthritis include attaining ACR90 and the potential for identifying key markers that make treatment selection more targeted and individualized. Those who have psoriasis need to realize bone and joint pain, and swelling in the joints may be related to their psoriatic skin disease and seek appropriate help.  Guest Bio: Dr. Arthur Mandelin is an Associate Professor of Medicine at Northwestern University Feinberg School of Medicine and the Department of Medicine Division of Rheumatology. Dr. Mandelin launched Northwestern University's first training program in musculoskeletal ultrasonography for rheumatology fellows. He is an active participant in the REASON Group which is a multi-center research collaboration devoted to using ultrasound guidance to obtain minimally invasive synovial tissue biopsies. Dr. Mandelin is a past member of the National Psoriasis Foundation's Medical Board where he served on consensus panels for the development of a variety of practice guidelines.  Resources Mentioned: National Psoriasis Foundation: https://www.psoriasis.org PEST Screener: https://www.psoriasis.org/psoriatic-arthritis-screening-test/ PsA Action Month 2025: https://www.psoriasis.org/psa-action-month/ NSAIDS  for Psoriatic Disease: https://www.psoriasis.org/advance/nsaids-for-psoriatic-disease-psa/ AMP (Accelerated Medicines Partnership): https://www.psoriasis.org/advance/progress-and-success- through-collaboration/  Tags: psoriasis, skin, psoriatic arthritis, minimal disease activity, ACR20, ACR50, ACR70, tender joints, bone erosion, joint swelling, enthesitis, inflammation, pain, fatigue, axial disease, spinal involvement, treatment, NSAIDS, biologics, personalized medicine, dermatology, National Psoriasis Foundation, AMP, Psound Bytes podcast, Soundbites podcast

Osteoarthritis is the most common form of arthritis in humans and in dogs, and the most common source of chronic pain in dogs. One in four dogs will be diagnosed with arthritis! And don't miss the following topics that Terry will also discuss on this show: Fix Your Swollen Feet and Ankles Can Antibiotics Cause Diabetes? Will You Be Healthy at Age 70? The Benefits of Olive Extract for Your Knees

Breast pain is common and is often managed with reassurance, education, topical NSAIDs, and stress-reduction strategies Triple test remains the gold standard for evaluating breast symptoms, with a diagnostic accuracy of over 99.6% when performed correctly Perimenopause brings breast changes, including fibrocystic changes and increased fat, which can affect cancer risk Online risk calculators like org and iPrevent are valuable tools for assessing true breast cancer risk, highlighting that lifestyle factors have more impact than family history Risk-reduction strategies include daily exercise, limiting alcohol, maintaining a healthy weight, and considering individualised approaches to menopause hormone therapy Host: Dr Marita Long | Total Time:25 mins Expert: Dr Virginia Barid, Women's Health GP Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next oneSee omnystudio.com/listener for privacy information.

In this episode, we dive into the world of rheumatology and explore how joint pain isn't always "just arthritis." From autoimmune diseases like Psoriatic arthritis to conditions like Crohn's disease, Lyme disease, and fibromyalgia, we uncover how these conditions can cause pain even before other symptoms appear. We discuss the risks of relying on long-term NSAIDs and the importance of early diagnosis to prevent permanent damage. Tune in to learn how to recognize the signs of inflammatory arthritis and other hidden causes of joint pain.

Story at-a-glance Many common medications contain hidden gluten and soy in their "inactive" ingredients, which trigger reactions in sensitive individuals A study found 44.4% of pain relievers contained gluten and 14% of NSAIDs contained soy-based additives, with poor labeling making identification difficult Solid oral medications most commonly contain gluten, while liquids and suppositories more frequently contain soy derivatives Exposure to these hidden allergens causes serious health consequences ranging from digestive issues to permanent damage in those with sensitivities Focus on leading a healthy lifestyle to reduce your reliance on medications that contain hidden allergens; this includes optimizing sun exposure, avoiding processed foods, eating enough healthy carbs and prioritizing daily movement

Dr. Nick Tiller brings his UltraRunning Magazine column, "Ask the Physiologist" to the podcast with host Scotty Sandow. Answering questions from our readers, Dr. Tiller gets to the heart of ultrarunning by offering up advice about training during an illness, what works and what doesn't when it comes to boosting your running routine, heart health, sodium intake, NSAIDs and much more.  Watch this episode on YouTube Subscribe to UltraRunning Magazine to read more from Dr. Tiller Thanks to our episode sponsor Drymax

In this episode, Dr. Kaur and Dr. Abhishek join us to discuss their recent study on acetaminophen, exploring how it compares to NSAIDs in safety and effectiveness. They break down their use of the Clinical Practice Research Datalink (CPRD), key findings—especially in arthritis patients—and what this means for clinical practice. It's an insightful look at how big data can challenge assumptions about one of the most used pain medications. 

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Sean Mackey is a professor of pain medicine at Stanford University and the director of the Stanford Systems Neuroscience and Pain Lab, where his research explores the neural mechanisms of pain and the development of novel treatments for chronic pain. In this episode, Sean joins Peter for a wide-ranging discussion on the multifaceted nature of pain—as both a sensory and emotional experience—and its evolutionary purpose as a critical survival mechanism. He dives into how pain is transmitted through the nervous system, the different types of pain, and why different individuals perceive pain so differently. Sean shares insights into pain management strategies ranging from medications like NSAIDs and opioids to neuromodulation techniques such as transcutaneous electrical nerve stimulation (TENS). Additionally, this episode explores the interplay between sleep and chronic pain and the psychological and emotional dimensions of pain, and it includes a personal story from Peter about his own experience with pain and how Sean's expertise helped him more than two decades ago. We discuss: The definition of pain, and how our understanding of pain has evolved from a simplistic body-mind separation to a nuanced biopsychosocial model [2:30]; The biological mechanisms behind how we perceive pain [9:30]; The role of consciousness in the perception of pain, and how nociception functions during unconscious states [14:30]; The four types of pain [22:00]; Using fMRI to identify objective biomarkers of pain in the brain [31:30]; The evolutionary role of pain in human behavior and survival [36:00]; How the brain processes and modulates pain signals, Gate Control Theory, the variability in individuals' pain perception, and effectiveness of neuromodulation techniques like TENS [41:00]; The brain's influence on pain: the role of emotion, beliefs, sleep, and individual differences in perception and tolerance [53:45]; Peter's personal journey with chronic back pain, and how the emotional consequences of pain can be more distressing than the pain itself [1:04:30]; The pharmacology of common pain medications—NSAIDs, COX-2 inhibitors, and acetaminophen [1:09:30]; Muscle relaxants: benefits, drawbacks, and personalized strategies [1:20:30]; The definition of chronic pain [1:29:15]; The role of antidepressants in pain management [1:30:15]; Opioids: their controversial and nuanced role in pain management [1:33:45]; Alternative therapies: acupuncture and cannabis [1:54:15]; Fibromyalgia and chronic pain: clinical features, brain mechanisms, and emerging treatments like low-dose naltrexone [2:01:00]; Possible brain benefits of low-dose naltrexone (LDN) for people with mild cognitive impairment [2:15:00]; Peter's recovery from severe chronic pain—how he went from immobility and high-dose opioids to full functionality [2:20:15]; Breaking the pain cycle: how physical rehabilitation and psychological recovery work together in chronic pain treatment [2:30:45]; Sean's struggle with cluster headaches, and the value of knowledge, preparation, and empathy in both managing chronic pain and caring for patients [2:39:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

A recent study supports the use of NSAIDs to treat acute lower back pain

A recent study supports the use of NSAIDs to treat acute lower back pain

Ethan Suplee is thrilled to sit down with Dr. Stephen Gundry on the American Glutton Podcast to explore the alarming decline in America's health since the 1970s. Together, they dive into the gut microbiome's crucial role in regulating hunger and supporting weight loss, examining how antibiotics, glyphosate, and processed foods have severely disrupted this delicate system. Dr. Gundry offers practical solutions—such as incorporating prebiotic fiber and fermented foods—to help restore balance. The conversation also tackles the downsides of quick-fix drugs like Ozempic. This eye-opening episode challenges conventional health wisdom and offers real hope for sustainable change.SHOW HIGHLIGHTS00:00 - Introduction to Dr. Stephen Gundry 01:11 - The Health Decline Since the 1970s 02:25 - Ultra-Processed Foods and Their Origins 03:06 - Impact of Broad-Spectrum Antibiotics 04:22 - Glyphosate's Effect on the Microbiome 05:39 - Dangers of NSAIDs like Advil 07:34 - Obesity Trends and High Fructose Corn Syrup 08:01 - Restoring the Gut Microbiome 12:21 - Three Steps to a Healthy Microbiome 19:07 - Gut-Centric Theory of Hunger 23:35 - Challenges of Getting Enough Fiber 25:23 - Efficiency and Modern Food Access 27:47 - Weight Loss Drugs and Their Risks 33:38 - Importance of Fermented Foods 36:11 - Reintroducing Beneficial Bacteria 40:48 - Overcoming Bacteriophobia 43:20 - Final Thoughts and Takeaways Hosted on Acast. See acast.com/privacy for more information.

Are the very painkillers you rely on actually making your migraines worse? If you're stuck in an endless cycle of headaches, your meds might be the hidden culprit — and you're not alone. Up to 50% of chronic migraine sufferers fall into the trap of Medication Overuse Headaches (MOH) — also known as rebound migraines — without even realizing it.By the end of this episode, you'll discover:✨ 3 clear signs your painkillers are fueling your migraines — not fixing them✨ The science behind MOH — how common meds like NSAIDs, triptans, and opioids can rewire your brain for more pain✨ An Eastern medicine approach to break the cycle — without unbearable withdrawalsYou'll also discover how gut health, the vagus nerve, and liver detox play a surprising role in stopping rebound migraines for good.Join the conversation!Hit follow, leave a review, and let us know — have you ever suspected your migraine meds were making things worse?Download our free guide — Break Free from Rebound Migraines: Your Essential Guide — to learn how to safely stop the cycle and find real, lasting relief beyond painkillers.

Imagine your gut as a security gate, carefully controlling what enters your bloodstream. Now, picture that gate with broken locks—allowing harmful toxins, undigested food particles, and bacteria to slip through. That's leaky gut, and it could be the hidden reason behind your bloating, brain fog, autoimmune issues, skin problems, and chronic fatigue. Your gut lining is supposed to act as a protective barrier, but when it gets damaged, it no longer filters properly. This can trigger widespread inflammation, worsen allergies and asthma, contribute to autoimmune conditions like Hashimoto's and psoriasis, and throw your hormones out of balance, leading to issues like PCOS. Even your mood and mental health are deeply connected to what's happening in your gut. On this episode of Medical Disruptor, we're breaking down the truth about leaky gut—what it is, why it's causing more than just digestive issues, and how stress, antibiotics, NSAIDs like Advil and Motrin, sugar, alcohol, and processed foods could be fueling the damage. We'll also explore how gut health directly impacts your skin, hormones, and brain function, plus the foods silently making it worse—and what to eat instead. If you've been struggling with unexplained symptoms and haven't found the answers, this episode could be the breakthrough you need. Tune in and learn how to take control of your gut health once and for all.

In this Huberman Lab Essentials episode, I discuss how to build muscle strength and size (hypertrophy) and cover key training principles to enhance athletic performance and offset age-related muscle decline. I explain how the nervous system drives muscle movement, the key differences between training for hypertrophy or strength, and resistance training protocols to build muscle for performance and healthy aging. Additionally, I discuss tools for assessing recovery and the role of key nutrients—such as creatine and electrolytes—in supporting muscle development and performance. This episode provides actionable, science-backed strategies to enhance movement, preserve strength with age, and boost energy levels. Read the episode show notes at hubermanlab.com. Timestamps 00:00:00 Huberman Lab Essentials; Muscle 00:02:02 Muscle & Nervous System 00:03:24 Sponsors: Eight Sleep & LMNT 00:06:03 Strength & Aging, Henneman's Size Principle, Use Heavy Weights? 00:10:09 3 Stimuli, Muscle Strength vs Muscle Growth (Hypertrophy) 00:12:11 Tool: Resistance Training Protocol, Increase Muscle Strength 00:15:55 Sponsor: AG1 00:17:50 Tool: Advanced Resistance Training & Volume; Speed, Rest 00:21:12 Testing for Recovery, Heart Rate Variability, Grip Strength 00:24:29 Sponsor: Function 00:26:16 Testing for Recovery, Carbon Dioxide Tolerance 00:29:20 Ice Bath Timing; NSAIDs & Exercise 00:30:34 Salt & Electrolytes; Creatine; Leucine Disclaimer & Disclosures

The JournalFeed podcast for the week of March 31 to April 4, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:For pediatric ED patients, NSAIDs, ketamine, and mid-high potency opioids all reduced pain compared to placebo, with NSAIDs also reducing the need for rescue medication.Wednesday Spoon Feed:Antibiotic treatment for acute uncomplicated appendicitis in children has a significantly higher failure rate (34% vs. 7%) compared to appendectomy, but this is limited by differing definitions of failure and the chosen non-inferiority margin.

Broadcast from KSQD, Santa Cruz on 3-27-2025: Dr. Dawn comments on how inappropriate conclusions of cause and effect lead to too many drugs being prescribed and incorrect claims of drug allergies. Dr. Dawn examines the risks of ibuprofen overuse, discussing how NSAIDs can damage the gut lining, affect kidney function, and lead to various health complications when used long-term. She provides insight into Medicare reimbursement rates for common lab tests, explaining the significant price disparities between Medicare payments and commercial rates. The show explores the current H5N1 bird flu situation affecting egg and dairy production, discussing viral mutations and the promising development of a universal flu vaccine. Dr. Dawn explores the remarkable fact that among placental mammals, only humans, certain bats, elephant shrews, and one species of spiny mouse experience menstruation, leading to challenges in research models. She recounts the fascinating history of menstruation research, from 1940s scientists chasing elephant shrews in South Africa to shipping bats in takeout containers for laboratory studies. The show details modern breakthroughs in menstruation research through organoids and organs-on-chips technology, explaining how these tools are revolutionizing our understanding of women's health. Dr. Dawn addresses perimenopause and hormone replacement therapy, discussing historical misconceptions and current treatment perspectives. The show concludes with research on artemisia, explaining how this traditional herb shows promise in treating polycystic ovary syndrome through its effects on hormone regulation.

Lower back pain is something most of us have experienced at some point. Whether it's from sitting too long, lifting something heavy, or just the wear and tear of daily life, it's a common issue. But with so many treatments available, which ones actually work? A team of researchers set out to answer this question in a massive study published in BMJ Evidence-Based Medicine. Gathering data from hundreds of previous studies, the researchers analysed 301 randomized controlled trials, covering 56 different treatments for low back pain. These treatments ranged from exercise and spinal manipulations to medications like NSAIDs (non-steroidal anti-inflammatory drugs) and antidepressants. To make the study even more precise, they divided the results into two categories: Acute low back pain (pain lasting less than 12 weeks). Chronic low back pain (pain lasting 12 weeks or more). Then, they compared each treatment to a placebo to see if it actually provided pain relief. The good news is that some non-surgical treatments do work, though not as dramatically as you might hope. For acute low back pain, NSAIDs (like ibuprofen) were the only treatment found to be effective, with a small but measurable pain reduction. For chronic low back pain, five treatments stood out: Exercise: Physical movement tailored to strengthen the back and improve flexibility. Spinal manipulative therapy: Techniques often used by chiropractors to adjust the spine. Taping: Using supportive tape to stabilize muscles and joints. Antidepressants: Certain medications that seem to reduce pain perception. TRPV1 agonists: A class of treatments that target pain receptors. Each of these treatments provided modest pain relief, meaning they worked better than a placebo, but not by much. What Doesn't Work? Some common treatments, surprisingly, did not provide significant pain relief. For acute low back pain, these treatments were found not to be effective: Exercise (which works better for chronic pain but not short-term pain). Glucocorticoid injections (steroid shots that are sometimes used for inflammation). Paracetamol (acetaminophen) (commonly recommended but found to be ineffective in this study). For chronic low back pain, these treatments failed to provide significant benefits: Antibiotics (sometimes prescribed for infections that might cause pain, but no clear benefit). Anaesthetics (numbing agents that didn't prove effective for long-term relief). Many treatments had inconclusive results, meaning there wasn't enough strong evidence to say whether they truly help. These included: Acupuncture Massage Heat therapy Laser therapy Electromagnetic therapy This doesn't necessarily mean they don't work, just that more high-quality research is needed. So, if you have low back pain and are looking for non-surgical options, the research suggests: If your pain is short-term, NSAIDs may help. If your pain is chronic, consider exercise, spinal manipulative therapy, taping, antidepressants, or TRPV1 agonists. Some treatments commonly recommended (like paracetamol and steroids) might not be as effective as previously thought. Many alternative treatments show promise but need better studies to confirm their benefits. See omnystudio.com/listener for privacy information.

Today we're continuing on with our discussion around micronutrients and their impact on endo and period pain In this episode, we're beginning with the first of the B vitamins, B1, otherwise known as thiamine. Read more. Show notes B1 properties https://www.biorxiv.org/content/10.1101/2025.02.21.639433v1.full https://pmc.ncbi.nlm.nih.gov/articles/PMC5625949/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4825494/pdf/GJHS-6-144.pdf Period pain and low B1 levels https://www.jpagonline.org/article/S1083-3188(06)00186-0/abstract https://go.gale.com/ps/anonymous?id=GALE|A123709137 https://journals.sagepub.com/doi/10.1177/17455057231185624?icid=int.sj-full-text.similar-articles.9 Endo and low B1 levels https://www.biorxiv.org/content/10.1101/2025.02.21.639433v1.full https://pmc.ncbi.nlm.nih.gov/articles/PMC11536846/ B1 and period, endo and musculoskeletal pain relief https://pmc.ncbi.nlm.nih.gov/articles/PMC7146731/pdf/jcs-9-47.pdf https://academicjournals.org/journal/AJPP/article-full-text-pdf/71051DE28902 https://www.isca.me/IJBS/Archive/v1i1/9.ISCA-JBS-2012-022.pdf https://pubmed.ncbi.nlm.nih.gov/25363189/ https://www.researchgate.net/profile/Hussain-Alharbi/publication/389210700_Efficacy_and_safety_of_combining_NSAIDs_with_vitamin_B_for_musculoskeletal_pain_a_systematic_review_and_meta-analysis/links/67b8dab7461fb56424e4fd2a/Efficacy-and-safety-of-combining-NSAIDs-with-vitamin-B-for-musculoskeletal-pain-a-systematic-review-and-meta-analysis.pdf https://poliklinika-harni.hr/images/uploads/2743/nutricijski-protokol-endometiozra.pdf B1 doses https://pubmed.ncbi.nlm.nih.gov/25363189/ https://academicjournals.org/journal/AJPP/article-full-text-pdf/71051DE28902 https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/ B1 food intake https://www.biorxiv.org/content/10.1101/2025.02.21.639433v1.full https://www.sciencedirect.com/science/article/pii/S0002916523022773?via=ihub https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/ https://www.myfooddata.com/articles/thiamin-b1-foods.php https://nutritionsource.hsph.harvard.edu/vitamin-b1/ Need more help or want to learn how to work with me? Free resources: This podcast!  Endometriosis Net Column Endometriosis News Column Newsletter Instagram Ways to work with me: This EndoLife, It Starts with Breakfast digital cookbook Masterclasses in endo nutrition, surgery prep and recovery and pain relief Live and Thrive with Endo: The Foundations DIY course One to one coaching info and application This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works Produced by Chris Robson

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. John Accarino, an allergist and immunologist at Massachusetts General Hospital and Mass General for Children, on the topic of immunology support for eosinophilic esophagitis (EoE). Dr. Accarino shares his experiences as a person living with food allergies, allergic asthma, peanut allergy, and eosinophilic esophagitis. He tells how his experiences help him in his work with patients. Dr. Accarino shares some education on a variety of allergy mechanisms and the treatments that mitigate them. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, immunology support for eosinophilic esophagitis (EoE), and introduces today's guest, Dr. John Accarino, an allergist and immunologist at Massachusetts General Hospital. Holly welcomes Dr. Accarino to Real Talk.   [1:49] Holly notes that Dr. Accarino is her allergist and immunologist.   [2:03] Dr. Accarino works at Massachusetts General Hospital and Mass General for Children. Allergy and Immunology is a field where he can see pediatrics and adults. Originally trained in pediatrics, now Dr. Accarino sees patients of all ages.   [2:23] Dr. Accarino grew up with allergies. He has experienced food allergies since he was young, along with allergic asthma, and some eczema, which he grew out of. Later in life, he was diagnosed with eosinophilic esophagitis. He talks with his patients about his experiences.   [2:47] Dr. Accarino also does research on drug allergies in the context of certain drug interactions that involve eosinophils.    [3:06] When Holly was referred to Dr. Accarino, it was for multiple sclerosis (MS). He told her, “It looks like you have EoE. I have EoE.” It was a huge relief to Holly not to have to explain EoE to her doctor.   [3:41] Some patients start to explain their EoE to Dr. Accarino, and he assures them he understands where they're coming from. Sometimes, he has to be careful not to think everyone has his symptoms, as there is a large spectrum of presentations.   [4:26] Dr. Accarino wasn't diagnosed with EoE until he was in his allergy fellowship, after he suspected it when he had a food impaction at a steakhouse at a graduation party from his pediatric residency. He tried to manage the EoE with lifestyle changes.   [5:39] Dr. Accarino didn't often go to see a doctor during residency, but he realized it was probably a good time to get an endoscopy.   [5:52] Holly shares how she was also diagnosed as a clinical fellow. She was subbing for someone on the GEDP team at Children's Hospital in Colorado. Listening to all the patients, she realized, “This sounds a little bit like me … What is going on?”   [6:23] Even with his medical background, it took Dr. Accarino some time to decide to get the endoscopy and biopsies. You or your doctor have to have a high level of suspicion to realize this isn't just reflux. Food doesn't get stuck in every person's throat.   [7:01] Thinking back, Dr. Accarino remembers an instance as a child when a dry muffin got stuck in his throat. He stayed calm and waited for it to pass. He thought it was normal.   [7:39] He drank a lot of water and chewed his food a lot. Those are markers of potential esophageal inflammation.   [8:20] Different groups have different management strategies for EoE. Dietary management, topical steroids, biologics. A subgroup of people with EoE are responsive to proton pump inhibitors (PPIs). Finding the best management strategy is a work in progress.   [8:53] With pediatric patients, the parents control the diet, and the children eat what is prepared. He notes that with adult patients, sometimes they let foods slip through.   [9:10] If you want to do a single-food elimination diet with dairy, there's a lot of dairy in the American diet. Dr. Accarino tried eliminating dairy and wheat, but he still had persistent eosinophils with dietary elimination.   [9:24] Dr. Accarino then tried PPIs. To know if you have PPI-responsive EoE, you might do twice-daily omeprazole at a significant dose. Have the endoscopy after a few weeks pass and see if the eosinophils are still present in the biopsy.   [9:59] Dr. Accarino did that recently and still has the eosinophils. He plans to talk to his gastroenterologist about considering dupilumab, but he feels that he can mitigate his subjective day-to-day experience of symptoms with dietary elimination and PPIs.    [10:24] If you still have the presence of eosinophils on biopsy, there's still inflammation happening. In the long term, you still have to worry about fibrosis and narrowing.    [10:34] The last treatment Dr. Accarino tried was as a research participant in a study for dissolvable fluticasone. He received either the medication or a placebo; he doesn't know which.   [11:01] To stay in the study, he had to journal and report his symptoms regularly. He didn't have enough symptoms to stay in the study. They were looking for a baseline to see how it changed with either the placebo or the medication.   [11:20] In research, you have to have a baseline to start, and then you want to see improvement, plus or minus. With EoE, it's difficult. You have the biopsy and eosinophils, but there's a large spectrum of symptoms that people may experience.   [12:40] Holly appreciates Dr. Accarino's unique perspective as a doctor with EoE who has experienced various treatments and diets. He understands the concerns of his patients.   [12:43] Dr. Accarino says even taking a twice-daily PPI or other medication is difficult for a lot of people, and that's the most simple of these therapies.   [13:06] Dr. Accarino wants to validate everyone's experience in terms of how difficult it is to treat this disorder, how it may present in different ways, and how there may be a delay in diagnosis.   [13:16] This isn't IgE-mediated immediate food allergy, where you eat a food and may have swelling within minutes; you may have flushing or hives. That's very clear. With EoE, it's a different mechanism; in many cases, there is a delay.   [14:37] Allergy, in general, is under the purview of clinical immunology. Dr. Accarino is allergic to peanuts and has an  IgE-mediated immediate reaction to them. If he eats a peanut, he has symptoms within minutes. He could have anaphylaxis. As a result, he carries an epinephrine auto-injector.   [15:01] If Dr. Accarino has a skin test, it will be positive for peanut. He has IgE antibodies to peanuts. He also has oral allergy syndrome where the body mistakes certain fruits, vegetables, or nuts with certain tree pollens or grass pollens.   [15:23] Oral allergy syndrome is usually a lower-risk condition where it's a less-stable protein that once cooked might not produce any symptoms. If it's raw when you consume it, you may have oral itching, a bit of throat discomfort, or tongue itching. [15:54] Your stomach acid breaks it down so it doesn't get into your bloodstream and you shouldn't have a systemic reaction.   [16:01] If Dr. Accarino eats a peanut, his stomach acid doesn't break down the high-risk, stable peanut protein, it gets into his bloodstream, and he can have a systemic anaphylactic reaction.   [16:20] Chronic EoE symptoms can present with something like a food impaction, or bad reflux or belly pain, and nausea. The reaction may not be immediate. It may be progressive over days or weeks.   [16:38] FIRE is an interesting condition that takes some time to narrow down. It's an immediate response of the esophagus, but we don't think it's histamine-mediated.   [16:56] We don't know, exactly, the mechanism but it's in people with eosinophilic esophagitis. They feel differently, and there would be different specific food triggers.   [17:11]  It took some time to figure out what was going on. Dr. Accarino felt like he had a lump in his throat, then a lump in his chest, nausea, and belly pain. It felt like a slow progression of EoE symptoms, and it was from specific food triggers, in his case.   [17:30] In some of the FIRE literature, they looked at banana and avocado. For Dr. Accarino, it took a couple of exposures to protein bars and milk protein whey isolate, specific to protein bars he had multiple times, until he figured out that was the trigger.   [17:50] Another protein whey isolate that Dr. Accarino scooped as a powder and made into a shake also led to FIRE.   [17:55] It took that event for Dr. Accarino to figure out it wasn't just a flareup of EoE or reflux but some trigger that caused this response that wasn't anaphylaxis but may be due to the recruitment of eosinophils or some immediate process not well understood.   [18:18] FIRE is going to be very hard to research. How would we figure this out? Would we bring someone in and do an endoscopy immediately and see what happens? There's a lot of descriptive data and case series.   [18:32] Dr. Accarino has had experiences when he knew it wasn't an immediate anaphylactic reaction, oral allergy, or reflux. He asked what else it could be in the context of EoE. When he looked at different case series, that's the presentation he had.   [19:17] Dr. Accarino acknowledges that having personal experience with FIRE, oral allergies, and IgE-mediated allergies, on top of EoE, has influenced his work as a medical professional. He can share anecdotes with patients as he explains the available testing.   [19:39] Dr. Accarino says a lot of immunology and allergy is explaining the diagnostic tools and management strategies we have and what we think is going on.   [19:50] The immune system is infinitely complex, and a lot of the practice is making a digestible analogy, not just in the context of allergic conditions but also everything with the immune system. There are so many cells doing so many different things.   [20:04] Dr. Accarino explains false positives in testing. He has positive scratch tests for peanuts, cashews, and almonds, which shows he has IgE for each of them. He is allergic to peanuts, but he can eat cashews and almonds. Those are false positives.    [20:56] When a scratch test is negative for immediate food allergy, it's a powerful predictive tool. But you may get false positives. How positive is it? There might be room for more discussion.   [21:10] There may be more hesitation for people who do large panels of food testing without any history of reacting to any foods.   [21:31] Some people have EoE triggered by milk or wheat but have negative skin tests. That doesn't mean they aren't triggered by these foods. The skin test is an IgE histamine mast cell mechanism, not for eosinophils, which are other immune cells.   [21:58] We go down these steps of thinking about diagnostic triggers and eventually treatment for those immediate symptoms mentioned for EoE.   [22:09] Dr. Accarino doesn't expect FIRE to be responsive to epinephrine. He doesn't have to stabilize the mast cells. It's a chronic disease that's flaring up. You treat it with a chronic type of treatment.   [24:10] Dr. Accarino says that for a doctor, immunology is rewarding, interesting, and complex, but it's intimidating until you get your foothold and see patients and clinical experiences.   [25:14] A lot of medical students and residents are a little fearful of immunology. They might not think about it too much. Dr. Accarino loves to talk about it and think about it. He can't think of anything more complex in terms of systems within our body.   [25:37] Ryan comments on his experiences with IgE-mediated food allergies, some environmental allergies that he has no idea how they work, and EoE, which he believes he has a good grasp on.   [25:55] Ryan imagines that having a physician with a good understanding of the immune system and also personal experience would be helpful for a patient with multiple allergic conditions.   [26:13] Dr. Accarino sees a large overlap of seasonal or year-round environmental allergies and EoE. There are some studies that show that endoscopies on patients with EoE may change at different times of the year if they have underlying seasonal allergies.   [26:33] Some people who have food allergies also have EoE or other eosinophilic disorders. Some discussions with them may be about blood tests that detect eosinophils in the bloodstream versus biopsies of the esophagus, stomach, or colon.   [27:15] It's thinking about what tests are available, what they tell us, and how to use them to predict the next steps, things like dietary changes or for immediate food allergy, considering challenges versus full avoidance. Each test has its pluses and minuses.   [27:35] People like a clear test, and they like an easy fix, but sometimes there's a lot of nuanced conversation of shared decision-making and trying things in a supervised setting.   [27:57] Holly speaks as a patient of the investigative testing Dr. Acarino is doing with her immune system trying to figure it out along with her MS and EoE.   [28:14] Dr. Accarino says the words immune system, immunity, and inflammation are used a lot in talking about foods. Dr. Accarino uses the framework of the immune system trying to help you.   [28:42] Sometimes, instead of making helpful antibodies to things like vaccines or viruses, that give you protection, the immune system makes antibodies that attack a certain organ or your joints.   [29:02] Dr. Accarino thinks of treatments that suppress the immune system in certain ways. Some treatments cool down the populations of many different immune cells. Oral steroids and prednisone are used for many conditions for autoimmune flares.    [29:29] Oral steroids, in the long term, may lead to weight gain, bone density changes, and diabetes. The big push for many diseases is toward non-steroidal biologics to target specific cells that cause disease.   [29:59] For Crohn's disease, a specific monoclonal antibody is used to target TNF-alpha molecules and blocks that inflammation pathway.   [30:14] For EoE, dupilumab, a specifically designed antibody, blocks a specific receptor in a specific pathway so the immune system doesn't have to be shut down and the patient doesn't have the side effects of steroids. It's a targeted therapy.   [30:32] What you see in commercials for injectable medications are large, designed antibodies that, if you took them in a pill form, your stomach acid would break down and digest. So they are injections and infusions that go directly into the bloodstream.   [31:22] Medications that end in -mab are monoclonal antibodies. They are very large molecules that would not be stable in stomach acid.   [32:09] Dr. Accarino talks of eosinophil normal function and aberrant function. IgE-mediated reactions are usually related to mast cells, a type of immune cell that shouldn't be in the bloodstream.   [32:54] Dr. Accarino can do a CBC with differential to see the number of white blood cells and the number of red blood cells. The differential of white blood cells will include neutrophils, lymphocytes, and eosinophils. It shouldn't show mast cells.   [33:19] If you have mast cells in your bloodstream, that's mastocytosis, a different problem. Mast cells live in your skin, in your gut, and around your blood vessels. They're full of granules like histamine and tryptase.   [33:38] Dr. Accarino explains how mast cells release their contents and how he would treat the resulting swelling or itch with an antihistamine or epinephrine. Epinephrine treats systemic reactions and stabilizes the mast cells.   [34:16] Mast cells have many receptors and may be triggered by many things other than IgE. This is a conversation Dr. Accarino has with patients who have chronic hives unrelated to any foods.   [34:29] Some people get hives from non-steroidal anti-inflammatory drugs NSAIDs. Some get hives from vancomycin. Some get hives when the temperature changes, from tight clothing, or from IV contrast. It's not an IgE-mediated mechanism, but it's still mast cells being degranulated.   [35:45] Dr. Accarino says people see hives and they think allergy. But, like EoE, it doesn't involve histamine. There can be hives that aren't related to allergies. This can be idiopathic urticaria or spontaneous urticaria.   [36:04] Sometimes, when switching from a day shift to a night shift, hormonal changes will trigger hives. Sometimes, the stress of having a family member in the hospital will cause hives. An accumulation of triggers can lead to mast cell degranulation.   [36:38] There are many ways that allergy can have different mechanisms and treatments, with different cells involved. There are different molecules that cause symptoms and manifestations.   [36:50] Navigating that and understanding what might be going on can give people a sense of reassurance. The biggest fear is a life-threatening allergic reaction. People will read about fatal anaphylaxis and wonder if it will happen to them with their condition.   [37:16] Sometimes, thinking of the cells involved and the pathways may give a level of reassurance that this may not be the same thing that they read about.   [37:28] Ryan thanks Dr. Accarino for joining us today.   [37:37] Dr. Accarino says it was nice to reflect on things and to go through different scenarios and experiences he has gone through. It was nice to have the opportunity to share them with Ryan, Holly, and all the listeners.   [37:57] For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes.   [38:06] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [38:15] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [38:25] Ryan thanks Dr. Accarino for joining us today for this fun conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode.   Mentioned in This Episode: Dr. John Accarino, MD, Allergist and Immunologist at Massachusetts General Hospital and Mass General for Children Episode 034: Food-Induced Response and Eosinophilic Esophagitis   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron.   Tweetables:   “Allergy and immunology is a field where I can see pediatrics and adults. I was originally trained in pediatrics, but now I see all ages, from infants up until older adults.” — Dr. John Accarino   “Part of the conversation sometimes is trying not to overly bias myself, where I say, ‘Oh, this is my experience.' … Like many diseases, there's a large spectrum of presentations, … different symptoms that people have.” — Dr. John Accarino   “We don't think [Food-Induced Response in Eosinophilic Esophagitis is] histamine-mediated. We don't know exactly the mechanism, but it's in people with eosinophilic esophagitis. They feel differently, and there would be different specific food triggers. It took some time to figure out that was going on.” — Dr. John Accarino   “When a scratch test is negative for immediate food allergy, it's a very powerful predictive tool. But there are times that you may get false positives. How positive is it? There might be room for more discussion.” — Dr. John Accarino   “There are a lot of ways that allergy can have different mechanisms and different treatments, with different cells involved.” — Dr. John Accarino

Joyce talks about media headlines, the Democratic party, COVID-19, a North Carolina family allowed to sue after 14-year-old was given the COVID shot without parental consistent, NSAIDs could help with Dementia, military strikes in Yemen and a possible accidental information leak, AG Pam Bondi warning Jasmine Crockett about her remarks on Elon Musk, people leaving Democratic states, and the Canadian actress claiming she was detained by ICE. Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Joyce talks about media headlines, the Democratic party, COVID-19, a North Carolina family allowed to sue after 14-year-old was given the COVID shot without parental consistent, NSAIDs could help with Dementia, military strikes in Yemen and a possible accidental information leak, AG Pam Bondi warning Jasmine Crockett about her remarks on Elon Musk, people leaving Democratic states, and the Canadian actress claiming she was detained by ICE. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! New ACP Guidelines Recommend Adding Triptan to NSAID or Acetaminophen for Migraines The American College of Physicians now recommends adding a triptan to NSAIDs or acetaminophen for moderate to severe acute migraines and urges clinicians to initiate combination therapy early. Automated Insulin Delivery Effectively Lowers HbA1c in Type 2 Diabetes  Tandem Diabetes Care's Control-IQ+ automated insulin delivery system led to greater HbA1c reduction than continuous glucose monitoring alone in adults with insulin-requiring type 2 diabetes. FDA Approves Guselkumab (Tremfya) For Crohn's Disease  The FDA approved guselkumab for moderately to severely active Crohn's disease based on phase 3 trial data demonstrating superior efficacy over ustekinumab on endoscopic endpoints. FDA Approves Oral Iptacopan (Fabhalta) as First C3 Glomerulopathy Therapy  The FDA approved iptacopan as the first therapy for C3 glomerulopathy, with phase 3 data showing significant proteinuria reduction and sustained efficacy at 12 months. FDA Approves Vutrisiran (AMVUTTRA) for ATTR-CM  The FDA expanded vutrisiran's approval for cardiomyopathy in transthyretin-mediated amyloidosis, making it the first RNAi therapeutic to reduce cardiovascular mortality and hospitalizations in ATTR-CM.

Spring means one thing– the reemergence of snot slugs on the faces of marathoners. Just like this podcast, running ain't pretty, but we're good about putting lipstick on a pig, so we try to do it here by throwing in some talk about the LA Marathon and NYC Half Marathon. Also, let's say it for the record: don't take NSAIDs before or during a race. But DO take Zbiotics* afterwards.*Does not consitute as medical advice, consult your doctor before and after listening to The Drop or celebrating St. Paddy's with KarlSupport our sponsors!SAYSKY X PUMAExperience the premium quality and unique design of the PUMA x SAYSKY collection. Check it out now at saysky.com and use code DROP15 to save. WAHOO FITNESS We've got a new series on YouTube that follows Thomas' training to London using the Wahoo Kickr Run Treadmill. Follow along every Frida, and watch episode 2 ⁠here⁠. You can learn more about the runner-focused treadmill (including seamless elevation and pace changes) and purchase one ⁠here⁠.LMNTIt's warming up, which means you're sweating more, which means you need more salt. Like, a lot more. Luckily, LMNT has 1000 mg of the stuff, as well as potassium and magnesium. Get your free 8-count LMNT Sample Pack with any purchase: http://drinklmnt.com/thedropINDEX00:00 - Intro5:08 - Streaking, Movie Talk, Looney Tunes15:23 - NYC Half Marathon 20:48 - LA Marathon 202528:03 - ZBiotics 31:42 - Advil + Influencer Campaign45:10 - Training Talk 1:08:47 - Gym Talk1:12:28 - Shoe Talk (Diadora Atomo Star)

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the MSK section.Follow⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

NSAIDs might be the go-to for pain relief, but they come with some gnarly gut side effects. The Turds unravel how these common meds can lead to gastritis, ulcers, and even long-term digestive issues—sometimes in as little as a week. From topical alternatives to protective strategies like H2 blockers and mucilaginous herbs, they weigh the pros, cons, and sneaky risks of these over-the-counter staples. If you've ever popped an ibuprofen without a second thought, this episode might just change your approach to pain management.

Non-Steroidal Anti-inflammatory drugs (NSAIDS) stop inflammation on the COX pathway but do NOTHING for the 5-LOX pathway! And don't miss the following topics that Terry will also discuss on this show: The Health Costs of Sugar-Sweetened Beverages When an Adults is Diagnosed with ADHD Red Dye #3 Finally Banned in the US Number 1 on the “Health Wants” List: More Energy

20% of all adults suffer from chronic pain, while up to 80% will experience acute pain from injury or surgery.   $600 billion is spent annually in health care costs and loss of productivity due to pain.  In this episode, you'll discover:—Dr. Prather's theory that pain comes from a blockage of energy in one or more of The 5 Pathways Of Pain.  And how each pathway needs to be treated in a different way. —Why Dr. Prather says his patients will first feel an increase in their energy level before they feel a decrease in their pain level.—How 80% of chronic Headache patients have actually given up on finding a solution, but Dr. Prather says that his office is "pretty much 100% successful" with Headaches.—The difference between the medical approach of pain management that masks the symptoms versus the Structure-Function approach of actually fixing the underlying cause of the pain.—Why Opioids and NSAIDs actually "make the pain problem worse" long-term by damaging the body.  And the long list of natural, safe, non-pharmaceutical alternatives Dr. Prather uses in his office that produce better results than the drugs.—How the treatments offered by Holistic Integration are exactly what an independent government commission recommended as the best approach to pain…until the pharmaceutical companies interfered.—Why Dr. Prather says that "Chiropractic is one of the best things you can do" when you're talking about pain relief.  And the reason why Holistic Integration begins with making sure the Atlas is in its proper position.—How Acupuncture "can actually reverse" Opioid addiction by stimulating the body's own natural Opioid production.  And how "everybody" has some issues with a blockage of their Electromagnetic pathway, which makes the biggest difference for Chronic Pain patients.—The link between the Lymphatic pathway of pain and Fibromyalgia, for which Dr. Prather's office gets "remarkable results".  And how the B Vitamins are particularly effective for Nerve Pain. —The Cerebrospinal Fluid blockage that is "easy to diagnose" and is "a different type of pain" which responds well to Craniosacral Therapy at Holistic Integration.  And how Dr. Prather considers a lot of the deep joint pain as a blockage of the Circulatory pathway, which can be treated by "pumping" the joint.http://www.TheVoiceOfHealthRadio.com

Did you know that over 70% of your immune system is located in your gut? Your gut health affects digestion, immunity, metabolism, hormone balance, and even mood. Yet, millions suffer from bloating, food sensitivities, autoimmune diseases, and fatigue. The good news is that you can start healing your gut in just 30 days with the right approach. In this episode, Dr. Axe breaks down a step-by-step plan to restore gut health naturally. From hidden culprits that damage your microbiome to the best foods, supplements, and peptides for healing, you'll get a complete guide to repairing your gut and improving your overall health. You'll Learn: The biggest gut-damaging mistakes and how to fix them How antibiotics, NSAIDs, and birth control disrupt gut health The three-phase gut healing protocol: remove, repair, rebuild Top gut-healing foods, supplements, and peptides The link between gut health, autoimmune conditions, and mental health How to detox from toxins like glyphosate and heavy metals Tune in to learn practical, science-backed strategies to heal your gut, reduce inflammation, and take control of your health. #guthealth #leakygut #draxe Want more of The Dr. Josh Axe Show? Subscribe to the YouTube channel. ------  00:00 Introduction 04:55 About Your Gut  07:18 Biggest Signs of Poor Gut Health 10:38 What is Damaging Your Gut  29:00 Tips to Heal Your Gut  ------  Follow Dr. Josh Axe Instagram Twitter Facebook TikTok Website ------  Staying healthy in today's world is an upstream battle. Subscribe to Wellness Weekly, your 5-minute dose of sound health advice to help you grow physically, mentally, and spiritually. Every Wednesday, you'll get:  Holistic health news & life-hacks from a biblical world view Powerful free resources including classes, Q&As, and guides from Dr. Axe The latest episodes of The Dr. Josh Axe Show Sign up here → https://forms.thehealthinstitute.com/l-77  Submit your questions via voice memo to be featured on the show → speakpipe.com/drjoshaxe  ------  Links:  https://pmc.ncbi.nlm.nih.gov/articles/PMC4542385/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9862683/ https://www.pnas.org/doi/10.1073/pnas.2411919121 https://pubmed.ncbi.nlm.nih.gov/27865294/ https://pubmed.ncbi.nlm.nih.gov/35452382/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11635378/#:~:text=MPs%20not%20only%20alter%20the,liver%20function%20and%20overall%20metabolism. https://pubmed.ncbi.nlm.nih.gov/22314561/ https://www.sciencedirect.com/science/article/abs/pii/S1382668923000911?via%3Dihub https://www.medpagetoday.com/popmedicine/celebritydiagnosis/102478 https://pmc.ncbi.nlm.nih.gov/articles/PMC5440529/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6748614/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10989710/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10835098/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6528490/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3949258/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10906476/ https://pubmed.ncbi.nlm.nih.gov/37638043/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6770155/ https://pubmed.ncbi.nlm.nih.gov/37952360/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10224484/ https://pubmed.ncbi.nlm.nih.gov/22074294/ https://pubmed.ncbi.nlm.nih.gov/18061177/  ------  Ads:  Even if your bloodwork looks "normal," your symptoms could point to Cell Danger Response (CDR). Discover how to break free from CDR and unlock your full potential at https://beyondbloodwork.com/.

We discuss the evaluation of and treatment options for acute back pain. Hosts: Benjamin Friedman, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Acute_Back_Pain.mp3 Download Leave a Comment Tags: Musculoskeletal, Orthopaedics Show Notes **Please fill out this quick survey to help us develop additional resources for our listeners: Core EM Survey** Clinical Evaluation: Primary Goal: Distinguish benign musculoskeletal pain from serious pathology. Red Flags: Look for indicators of spinal infection, spinal bleed, or space-occupying lesions (e.g., tumors, large herniated discs). Assessment: A thorough history and neurological exam (strength testing, gait) is essential. Additional Tools: Use bedside ultrasound for post-void residual assessment in suspected cauda equina syndrome Imaging Guidelines: Routine Imaging: Generally not indicated for young, healthy patients without red flags. ACEP Recommendations: Avoid lumbar X-rays in patients under 50 without risk factors, as they do not change management and may increase costs and ED time. Advanced Imaging: Reserve MRI for patients with red flags, neurological deficits, or suspected cauda equina syndrome; CRP may be a part of your calculus when evaluating for infectious causes of back pain Treatment Options: Evidence-Based First-Line: NSAIDs offer modest benefit.

According to published estimates, the prevalence of an NSAID allergy (hypersensitivity) in the general population is estimated to be between 0.5% and 2%, with some studies reporting a range of 1-3% of people experiencing a reaction to NSAIDs; however, this rate can be significantly higher in individuals with conditions like asthma, nasal polyps, or chronic urticaria, where it may reach up to 20-30%. Genetic and epigenetic backgrounds are implicated in various processes of NSAID-induced hypersensitivity reactions. Aspirin is a type of NSAID and may result in some cross sensitivity in NSAID allergic people. Well, as low dose aspirin is currently the only pharmacological recommended prophylactic agent for HDP, what can we do for these patients? In a new publication (ahead of print, 2/17/2025), clinicians from Singapore provide helpful insights- and an easy to adopt protocol- for aspirin desensitization in pregnancy. Listen in for details.

Send us a textAnesthesiologist Dr. Todd Bertoch speaks with Dr. Michael Koren in this exciting episode about the a new pain medication, Journavx (suzetrigine), which was just approved by the FDA in January, 2025. The doctors discuss this breakthrough pain management medication, its safety profile, side effects, and how it compares to NSAIDs, acetaminophen, and opioids. They also dive into the approval process, how trials were conducted and standardized, and where the medication will go from here.Koren's Key Takeaways:New options like suzetrigine for pain medication that are non-addicting are neededThis medication is another tool, not a replacement for opioidsThe clinical trials for this medication have been rigorousBe a part of advancing science by participating in clinical research.Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.comListen on SpotifyListen on AppleWatch on YouTubeShare with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.Follow us on Social Media:FacebookInstagramTwitterLinkedInWant to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.comMusic: Storyblocks - Corporate InspiredThank you for listening!

Contributor: Ricky Dhaliwal, MD Educational Pearls:  Ketorolac and ibuprofen are NSAIDs with equivalent efficacy for pain in the emergency department Oral ibuprofen provides the same relief as intramuscular ketorolac IM ketorolac is associated with the adverse effect of a painful injection IM ketorolac is slightly faster in onset but not significant Studies have assessed the two medications in head-to-head randomized-controlled trials and found no significant difference in pain scores IM ketorolac takes longer to administer and has a higher cost Ketorolac dosing Commonly given in 10 mg, 15 mg, and 30 mg doses However, higher doses are associated with more adverse effects Gastrointestinal upset, nausea, and bleeding risk Studies have demonstrated equal efficacy in pain reduction with lower doses References Motov S, Yasavolian M, Likourezos A, et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2017;70(2):177-184. doi:10.1016/j.annemergmed.2016.10.014 Neighbor ML, Puntillo KA. Intramuscular ketorolac vs oral ibuprofen in emergency department patients with acute pain. Acad Emerg Med. 1998;5(2):118-122. doi:10.1111/j.1553-2712.1998.tb02595.x Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

In 2013, The ACOG's Hypertension Task Force suggested that NSAIDS not be used in postpartum patients with hypertensive disorders of pregnancy due to theoretical concerns on BP aggravation. But “medicine moves fast”. In 2020, the ACOG “green lighted” ibuprofen use postpartum in these patients if no evidence of renal insufficiency was present. In episode, we will review a brand-new publication (soon to come out), in AJOG, released ahead of print on February 10, 2025. This study is a randomized trial also evaluating the effect of ibuprofen on blood pressure control in those with hypertensive disorders of pregnancy. Did they find something new? This highlights the importance of going through an entire study's materials and methods focusing on the years of patient recruitment to properly interpret results. Listen in for details!

Weight loss, NSAIDs, physical therapy, you've done it all and your knees are even more painful. Stefan Coombs, an orthopedic surgeon at Johns Hopkins, says when surgery seems to be the best option, so called knee replacement should be understood. … What does ‘knee replacement' really mean? Elizabeth Tracey reports Read More »

An episode from The Holistic Navigator. This is not to diagnosis or treat any disease or illness. Consult your physician before taking supplements or medications OR before you stop taking medications. This is for entertainment/informational purposes only-do your own research and talk to your doctor as needed! Chronic pain is epidemic and traditional treatments are causing health disasters in this country. The widespread use of NSAIDs (non-steroidal anti-inflammatory drugs) are wreaking havoc on the health of many worldwide and they might not even know it's happening. These are meant to be used for acute pain and short term use, but there are many people that are taking them every day for years. Long term use of these drugs can cause kidney damage, fluid retention, liver stress, create a higher risk of heart disease, and can cause damage to the gut. Are there other options? YES. It's not the norm to be walking around in pain on a daily basis. There are many habits and lifestyles that contribute to this type of pain without you even knowing it. What we eat, our activity levels, our emotions all play a role in our discomfort levels. We're here to say that there is hope and it's possible to live pain free. We'll cover natural supplements and new habits that can help you on the journey to living without pain. What is chronic pain? (1:35) What are the common side effects of NSAIDS? (3:18) What causes chronic pain? (6:42) What is the protocol for addressing chronic pain? (20:25) What is the ideal diet for chronic pain management? (37:12) What about using CBD for pain? (37:47) === THANK YOU TO OUR SPONSORS: Vascular Institute of Chattanooga: https://www.vascularinstituteofchattanooga.com/ The Barn Nursery: https://www.barnnursery.com/ Optimize U Chattanooga: https://optimizeunow.com/chattanooga/ Guardian Investment Advisors: https://giaplantoday.com/ Alchemy Medspa and Wellness Center: http://www.alchemychattanooga.com/

In this episode, Tracey Davidoff, MD and Joe Toscano, MD discuss the January 2025 Evidence-Based Urgent Care article, Management of Nephrolithiasis in the Urgent Care SettingIntroductionPathophysiology and Differential Diagnosis of Kidney StonesEvaluating Patients in Urgent CareDiagnostic Studies for Kidney StonesImaging and Case StudyTreatment and Pain ManagementRenal Precautions and NSAID UseEffectiveness of NSAIDs and AcetaminophenOpioids and Legal ConsiderationsMedical Expulsive TherapySpecial Populations and Kidney StonesControversies and Cutting-Edge TreatmentsPatient Disposition and Follow-UpFinal Points and PearlsConclusion and Next Month's Topic

Get more notes at https://podcastnotes.org ​Time Saved This Week: 13 Hours, 45 Minutes​​NEW Premium Notes​Peter Thiel | Tetragrammaton with Rick Rubin ​​Peter Thiel (@peterthiel) is an entrepreneur, investor, and philanthropist who has appeared in many Podcast Notes over the years. However, legendary producer Rick Rubin still somehow managed to peel back new layers of Peter's life, revealing how he flipped the script from ordinary Stanford law school graduate to one of the most prominent entrepreneurs of his generation. These two titans of industry also discuss the student debt crisis, the progression of AI relative to the dot-com bubble, the current state of Silicon Valley, and much more!Marc Andreessen: It's Morning Again In America | Uncommon Knowledge with Peter RobinsonIt's time for another podcast episode with the chief ideologist of the Silicon Valley elite, Marc Andreessen (@pmarca)! In this episode, Marc talks about how technology and politics have changed in Silicon Valley, his shift from left to right, and how he believes innovation can solve big issues like energy, border security, and defense​Tim Cook: What It Takes to Run Apple, the World's Largest Company | Dua Lipa: At Your Service​A wild Tim Cook appeared! The Apple CEO sat down with Dua Lipa for a rare podcast interview to answer about his daily routine, favorite national parks, and books, Apple's climate goals, leadership philosophy, and even tackling the big question: does Apple use child labor for cobalt?​​Upgrade to Premium to Get 3 Premium Notes Every Week, the Full Newsletter, Playable Timestamps, AI Powered Answers, Unlock 500+ Premium Posts, No Ads and MORE​Go PREMIUMTop Premium Takeaways Of The Week​​​Peter Thiel | Tetragrammaton with Rick Rubin ​​​Peter's Quarter Life Crisis: “I ended up at a top New York law firm. It was one of these very strange places where from the outside ....” – Peter Thiel​Student Loan Nightmare: Of 1997 graduates, almost all of them paid off their debt within XX years. Of 2009 graduates, the median student after 12 years has ,,,* “If you make the colleges even partially responsible, ...” – Peter Thiel​You Can Just Buy Users Instead of Ads: Paypal gave $10 to create an account, another $10 ...​Competition is for Losers: Capitalism and competition are opposites...​IPO's Are Awful: Taking a company public is in part a government takeover* The accountants and lawyers get...​Peak Insanity to Peak Clarity: “Maybe AI is like the internet in 1999, where ...​The Origin of the Name Palantir and Its Goal: Palantíri in Lord of the Rings were ...* Palantir = more security without...​Contrarian: A controversial idea isn't automatically correct, but ...​​Marc Andreessen: It's Morning Again In America | Uncommon Knowledge with Peter Robinson​​3 Targets of DOGE:​* Headcount (like, how many people work in the government)* ....* ...​Afuera: Did you know? There are XXX federal agencies* “There's a rumor going around that nobody actually knows the number of federal agencies.” – Marc​Abandoned Offices: A lot of these federal buildings in D.C. are empty* Occupancy is around...* Some only work ...​Techno Optimism: “We are told that technology takes our jobs, reduces our wages, increases inequality, and is ever on the verge of ruining everything. But our ...” – Marc​Trump and Systems Thinking: And when you're good at real estate, you learn what's called ...​Project Independence: The idea? Build ...* But then, Nixon created the EPA and the Nuclear Regulatory Commission, and they ...* Marc's devious plan: Bring back Project Independence and have someone like ...​Small Nuclear is a Solved Problem: The U.S. has been building small nuclear reactors for ...​Wide Open Border: Out of those, 2.5 million people were released into the U.S. while waiting for their cases* Another 2 million crossed without being caught* Total? At least 4.5 million illegal entries during Biden's term​Is Technology Bad for Jobs? Lower costs give consumers and businesses more spending power to ...* The enemy isn't technology-driven unemployment; it's ...​No Growth Stagnation: UK, Germany, and Canada have fallen into a “no growth” trap, resulting in ...​​Tim Cook: What It Takes to Run Apple, the World's Largest Company | Dua Lipa: At Your Service​​3 qualities Apple looks for in employees: ​* Collaboration: The ability to...* Curiosity: A passion for ....* ....​Tim shares 5 books that have shaped him:​* ​To Kill a Mockingbird – A formative read for young students and everyone* ​Shoe Dog by Phil Knight – A book on business and life* ...​1+1=3? Your idea + my idea is ...​Tim Cook on leadership: “I try to be a leader that deeply believes in collaboration because ...”​About that Cobalt: Tim Cook 100% guarantees that the cobalt ...​Tim's Daily Routine:​* He wakes up very early, typically around 4 to 5 a.m.* He spends the first hour of the day ...* After emails, he spends an hour ...* After that, he goes to ....​Top 5 National Parks:​* ​Yosemite (his local park)​* Grand Canyon* ....​​Upgrade to Premium to Read the Full Newsletter, Playable Timestamps, AI Powered Answers, Unlock 300+ Premium Posts, No Ads and MORE​Go PREMIUMControl Pain & Heal Faster With Your Brain | Huberman Lab Essentials​Tools to improve the function of the glymphatic system:* Sleeping on one side increases glymphatic washout and clearance efficiency* Zone 2 cardio (only if it doesn't exacerbate the injury!): Fast walking, jogging, or cycling for 30–45 minutes, 3 times a weekPlacebo effects are very real: People anticipating morphine report reduced pain even before receiving itFoundational principles for injury recovery (in consultation with Kelly Starrett):* Sleep is essential: 8 hours ideal or 8 hours immobile to support glymphatic clearance, tissue clearance, etc.* Movement: A 10-minute walk daily if possible* Ice is more of a placebo: Reduces pain for a short while but can impede healing by causing fluid sludging* Heat is quite beneficial: Improves tissue viscosity, fluid clearance, and perfusion* Anti-inflammatory medications (NSAIDs like ibuprofen) block inflammation but may interfere with early recovery stagesBreathing vs. Infection: “Things like Wim Hof breathing, ice baths, anything that releases adrenaline will counter the infection but you want to regulate the duration of that adrenaline response.” – Huberman​​Dr. Becky Kennedy: Overcoming Guilt & Building Tenacity in Kids & Adults | Huberman Lab ​Question for parents: “Who do I need in my life when things go poorly so I don't lean on my young children and give them a responsibility that's not theirs?”Don't Keep Kids in the Dark: It's not emotions that dysregulate a kid, it's the lack of a story to explain it. Kids can handle the truth when it's told to them by a loving, trusted adultHappiness is the NOT the Goal: Your job is not to make your kid happy. Your job is to help create the conditions for your kid to be a real functioning, confident adult. It's just different rolesThe concept of “not guilt”: “What I think is happening is a lot of us, especially women, when we were growing up, we learned to notice everyone's feelings around us. And we learned that our value, really, and our worth, really, and we were kind of best and good girls when we took care of everyone else's feelings except for our own.” – BeckyThe most important skill for kids to learn is to tolerate frustration: “The things that are good for humans long-term are things that involve humans to tolerate frustration.”– BeckyGet Off Your Phone: “We have so much less tolerance for our kids' tantrums because we're on our phones wanting our life to be easier.” – BeckyConfidence: “Confidence is not feeling like you're the best at something, it's feeling like it's okay to be you when you're not the best at something.” – Becky​Hetty Green – The Single Biggest Individual Financier In The World & The Richest Woman In America | Founders Podcast with David Senra #375Hetty Green's business maxims:* 1. Seek out every piece of information on an investment before deciding on it* 2. Watch your pennies and the dollars will take care of themselves* 3. Generally, in business, do not close a bargain until you have reflected on it overnight* 4. Before making a deal, if anyone is foolish enough to offer you the full amount, take it!* 5. Buy when everyone wants to sell and sell when everyone wants to buySome things on Hetty Green's list of things to NOT do in business:* 1. Do not cheat in business or you will find yourself in an early grave* 2. Do not fail to be fair in all things and do not kick a man when he is down* 3. Do not envy your neighbors* 4. Do not forget to be charitable and never falsifyA defining character trait of Hetty: She lived by her own rules and did not care what other people thought; by casting off the societal norms of her time, she freed herself to do as she pleased and to live a life on her termsHetty was self-sovereign, very frugal, and very paranoid: She did not tell other people what she owned or how much she was making, and commonly bought property and stocks under fictitious namesGreed and Envy: Greed does not drive the world, envy does; cure yourself of envy because envy is a weaknessHetty Green's wealth management principles:* 1. No debt* 2. No buying on margin* 3. Watch every penny* 4. Stack your cashChaos is a Ladder: Most humans will panic during times of economic crisis, but those who do not panic will get rich* Shrewd investors can buy assets at low prices from speculators who use margin* There are good bargains in the aftermath of the crisisFun fact: The creation of railroads led to the creation of standardized time because it required coordination between two towns, located several hundred miles away from each other​​​Mark Zuckerberg: The Dark Side of Social Media, Censorship, and AI in 2025 | Joe Rogan Experience (#2255) ​The Decade of Censorship: “It was really in the last 10 years that people started pushing for ideological-based censorship.” – Mark Zuckerberg. The 2 key triggers:* The 2016 election of Donald Trump* The 2020 COVID-19 pandemicSuppressing legitimate information about metabolic health: “High doses of Vitamin C, D3 with K2, and magnesium—they were suppressing this stuff because they didn't want people to think that you could get away with not taking a vaccine.”– JoeThe US Is Hurting it's Tech Leaders: When the U.S. government goes after its tech industry, it opens the door for other nations to do the same. The EU has fined U.S. tech companies more than $30 billion over 10–20 years* The U.S. government has the power to pressure other countries to protect American industries but has done the opposite for techThe dilemma of setting classifier thresholds:* If a classifier is set to 99% confidence, it might miss 80% of harmful content, whereas setting it to 90% confidence might catch more, but still mistakenly flag 10% of innocent content* When dealing with billions of posts from billions of users, setting classifiers with too low precision leads to millions of innocent posts being wrongly taken downThe tension between allowing anonymous accounts and the potential for abuse: “I think there's nothing wrong with that… you should be able to be anonymous… but if you're going to allow anonymous accounts, you're going to open up the door to bad actors having enormous blocks of accounts where they can use either AI or just programs.” – Joe​PREMIUM:* ​Peter Thiel | Tetragrammaton with Rick Rubin​* ​Marc Andreessen: It's Morning Again In America | Uncommon Knowledge with Peter Robinson​​* ​Tim Cook: What It Takes to Run Apple, the World's Largest Company | Dua Lipa: At Your Service​FREE:* ​Control Pain & Heal Faster With Your Brain | Huberman Lab Essentials​​* ​Dr. Becky Kennedy: Overcoming Guilt & Building Tenacity in Kids & Adults | Huberman Lab​​* ​Hetty Green – The Single Biggest Individual Financier In The World & The Richest Woman In America | Founders Podcast with David Senra #375​​* ​Mark Zuckerberg: The Dark Side of Social Media, Censorship, and AI in 2025 | Joe Rogan Experience (#2255) Thank you for subscribing. Leave a comment or share this episode.

TODAY ON THE ROBERT SCOTT BELL SHOW: Holistic Health Surge, FDA RSV Warnings, Formaldehyde Health Risks, Luna for Sleep & Hormones, 17K Doctors vs. RFK Jr., SIDS & Preterm Vaccines, NSAIDs & Kidneys, Chemical Impact on Kids, Stand with RFK Jr. and MORE! https://robertscottbell.com/holistic-health-surge-fda-rsv-warnings-formaldehyde-health-risks-luna-for-sleep-hormones-17k-doctors-vs-rfk-jr-sids-preterm-vaccines-nsaids-kidneys-chemical-impact-on-kids-stand-with-r/

Listen in as Dr. Judy chats with Dr. Alexia Tsakiris, owner of Naturopawthic Veterinary Wellness Center and a holistic veterinarian specializing in herbal treatments for behavioral issues in pets. Dr. Tsakiris emphasizes the importance of diet, gut health, and individualized herbal protocols in managing behavior problems. She discusses the limitations of traditional pharmaceutical approaches and the benefits of using herbs and flower essences to address anxiety, aggression, and other behavioral issues. She also highlights the role of the microbiome and the need for personalized treatment plans as well as her experience with successful cases and the challenges of managing behavior cases in veterinary practice. Fascinating info that could help your pet! Websites www.naturopawthicvet.com www.zoabotanicals.com Social Media URLs or Tags Instagram: www.instagram.com/naturopawthic_vet Facebook: www.facebook.com/naturopawthicvet LinkedIn: www.linkedin.com/alexiatsakiris OFFER: Use code DRJUDY on either www.naturopawthicvet.com or www.zoabotanicals.com and get 15% off of your purchased PRODUCT SPOTLIGHT #1: TREATING HEART DISEASE IN DOGS SHORT COURSE A heart disease diagnosis doesn't mean your pup has to stop living the vibrant life they deserve. There's hope. As both an integrated veterinarian of 40 years and a lover of rescue Spaniels with heart disease, Dr Judy Morgan has first hand experience dealing with heart disease holistically. She's included the essentials in her Treating Heart Disease in Dogs short one hour course. Learn how heart disease is diagnosed, how to manage medications, supplements and diet as well as how to monitor and deal with emergencies. Feel confident that you're equipped with the knowledge to advocate for the best possible care for your dog. Save 15% with code PODCAST47 when ordering on DrJudyU.com PRODUCT SPOTLIGHT #2: DR. JUDY MORGAN'S PEADoes your pet need PEA? Dr Judy is a huge fan, because PEA is a naturally occurring fatty acid compound found in plants and animals that has anti inflammatory, neuro protective and pain killing properties. An alternative to NSAIDs, opioids and steroids. She even has her own brand. Podcast listeners can take advantage of 15% off with the code PODCAST47. Get your own Dr Judy's PEA today at NaturallyHealthyPets.com And for large dogs and equines save money with the bulk sized PEA

In episode 595, Mike and James invite Jennifer Young back to talk about the use of combined oral contraceptives for heavy menstrual bleeding (benign etiology) and see if they improve patient outcomes. They do! Have a listen to get all the numbers and see how they compare to using levonorgestrel-containing intrauterine devices or NSAIDs. Show […]

In this episode, Nurse Mo breaks down the key differences between acute and chronic pain to help you navigate pain management more effectively as a nurse or nursing student. By understanding how these two types of pain differ in causes, duration, and treatment approaches, you'll be better equipped to deliver compassionate and tailored care (and crush those nursing school exams!). Highlights include: Key characteristics of acute and chronic pain - causes, duration, quality, and impact on life Pharmacologic treatments for acute and chronic pain Non-pharmacologic treatments - explore medications (from NSAIDs to botulinum toxin) and non-pharmacologic strategies (such as CBT, physical therapy, and TENS units) Links mentioned in this episode: Types of Pain - Dive deeper into the different subtypes of pain here! Corticosteroids - Learn the key things you know about this common type of medication LAST - Learn about local anesthetic systemic toxicity ___________________ Full Transcript - Read the article and view references FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!  Pharmacology Success Pack - Want to get a head start on pharmacology? Download the FREE Pharmacology Success Pack.  Fast Pharmacology - Learn pharmacology concepts in 5 minutes or less in this audio based program. Perfect for on-the-go review! Clinical Success Pack - One of the best ways to fast-track your clinical learning is having the right tools. 

What would happen if you chewed one clove daily for 7 days? I'm sure you've heard of the benefits of clove for teeth and gums, but there's so much more to this fascinating spice. In this video, we're going to talk about the many health benefits of cloves. DATA: https://onlinelibrary.wiley.com/doi/a... https://pmc.ncbi.nlm.nih.gov/articles... https://pmc.ncbi.nlm.nih.gov/articles... https://pubmed.ncbi.nlm.nih.gov/16235... https://pmc.ncbi.nlm.nih.gov/articles... https://pmc.ncbi.nlm.nih.gov/articles... https://www.cambridge.org/core/journa... https://www.sciencedaily.com/releases... https://pubmed.ncbi.nlm.nih.gov/28524... Clove can act as a natural painkiller, especially for a toothache. Eugenol, the chemical found naturally in clove, can mimic the effects of lidocaine without any side effects. Clove doesn't just work for toothaches. It may work systematically for many other inflammatory conditions. Clove can be beneficial for arthritis, swelling, and joint pain. It mimics the effects of NSAIDs, such as ibuprofen. Cloves also have potent antimicrobial effects, even for antibiotic-resistant bacteria. It's also beneficial against fungi, viruses, Candida, and parasites like malaria. It's been shown to mimic the effects of antibiotics without harming good bacteria. Clove oil can break down biofilms so your immune system can destroy bacteria. Eugenol in clove starves pathogens of energy, preventing them from reproducing. Clove has also been shown to make insulin more sensitive, producing results similar to a mild form of Metformin. Here are a few more of the potential benefits of cloves: •Cancer-fighting properties •Detoxification of the liver •Blood-thinning effects •Boosts your mood •Eliminates gas and bloating •Higher ORAC scale (antioxidant scale) than blueberries •Decreases mucus •Improves bad breath For the benefits of cloves, chew one clove daily, use clove oil topically, or grind it and add it to a smoothie.

Emmy-winning journalist Alison Morrow was fired by Washington state authorities after she defied their orders to censor an interview with Dr. Aaron Kheriaty – an act he calls “a clear violation by a government employer of an employee's First Amendment free speech rights.” Reclaim The Net reports that with the “Silent Majority Foundation, Morrow has filed a lawsuit against the Washington State Department of Natural Resources (DNR) and its top officials, citing wrongful termination.” “I was told I could never interview Dr Kheriaty (or anyone with ideas like his) ever again if I wanted to keep my job… when I refused, I was fired,” writes Alison. “And I would do it all over again.” Alison Morrow (AKA Alison Westover) is an Emmy Award-winning journalist and media analyst with over a decade of experience in television news. A former FOX News producer and environmental reporter for NBC Seattle (KING TV), she holds a Master of Divinity from Boston University specializing in Psychology & Counseling. Morrow has earned an Associated Press Award and the Sigma Delta Chi Award for Excellence in Journalism. She currently hosts podcasts focused on environmental issues and media analysis, particularly covering endangered Southern Resident killer whales. Find more at https://alisonmorrowmedia.com and follow her at https://x.com/alisonmorrowTV Pete Serrano is Director and General Counsel for Silent Majority Foundation. Learn more at https://silentmajorityfoundation.org Dr. Stephanie Venn-Watson is a co-founder of Seraphina Therapeutics. She holds a Doctor of Veterinary Medicine from Tufts University, a Master of Public Health from Emory University, and completed a National Research Council Associateship with the Armed Forces Medical Intelligence Center. As a Technical Agent for DARPA and researcher with the U.S. Navy Marine Mammal Program, she discovered C15:0's role in preventing Cellular Fragility Syndrome. This led her to co-found Seraphina Therapeutics, developing the fatty15 supplement. Find more at https://drdrew.com/fatty15 「 SUPPORT OUR SPONSORS 」 Find out more about the brands that make this show possible and get special discounts on Dr. Drew's favorite products at https://drdrew.com/sponsors  • CAPSADYN - Get pain relief with the power of capsaicin from chili peppers – without the burning! Capsadyn's proprietary formulation for joint & muscle pain contains no NSAIDs, opioids, anesthetics, or steroids. Try it for 15% off at https://drdrew.com/capsadyn • FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at https://drdrew.com/fatty15 • CHECK GENETICS - Your DNA is the key to discovering the RIGHT medication for you. Escape the big pharma cycle and understand your genetic medication blueprint with pharmacogenetic testing. Save $200 with code DRDREW at https://drdrew.com/check • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at https://drdrew.com/paleovalley • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at https://twc.health/drew 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (https://kalebnation.com) and Susan Pinsky (https://twitter.com/firstladyoflove). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Learn more about your ad choices. Visit megaphone.fm/adchoices

After the 2024 election, NY Post reports that Georgetown University deployed ‘self-care suites' for students who were ‘stressed' by the results, while other schools encouraged students who were 'emotionally distressed' to skip class entirely. The paper also says the college students, whose tuition hovers around $61,000 per year – and who are allegedly grown adults – were given access to Legos, coloring books, milk, cookies, and other “goodies that wouldn't be out of place at a child's birthday party.” Ted Balaker is an award-winning filmmaker, former ABC Network News producer, and think tank scholar. He directed ‘The Coddling of the American Mind,' the first ‘Substack Presents' feature film, and ‘Can We Take A Joke?' which received acclaim from The Los Angeles Times and The Hollywood Reporter. Balaker produced ‘Little Pink House' starring two-time Oscar nominee Catherine Keener and is an executive producer of ‘Honor Flight,' which holds the Guinness World Record for largest film screening. He co-founded Korchula Productions and Reason TV, and his work has appeared in The New York Times, The Washington Post, and USA TODAY. Find more at https://thecoddlingmovie.com Courtney Balaker is an award-winning filmmaker and professor whose work spans features, documentaries, and theater. She directed LITTLE PINK HOUSE starring Catherine Keener, which earned a historic bipartisan congressional screening. Her documentaries include CAN WE TAKE A JOKE?, THE CODDLING OF THE AMERICAN MIND, and the PBS series AMERICA IN PRIMETIME. She directed Off-Broadway theater, including the acclaimed UNCLE BOB with Joseph Gordon-Levitt. A Royal Academy of Dramatic Art graduate, she is co-founder of Korchula Productions and is set to direct the feature adaptation of TROUBLED. Learn more at https://korchulaproductions.com Lionel is a talk radio veteran, trial lawyer, former prosecutor, author, pioneer podcaster, and multi-platform legal and media analyst. Lionel has hosted shows for Court TV, WABC, Air America, and RT. He has his own subscription video channel, free from draconian limitations of free expression. Find more at https://LionelMedia.com 「 SUPPORT OUR SPONSORS 」 Find out more about the brands that make this show possible and get special discounts on Dr. Drew's favorite products at https://drdrew.com/sponsors  • CAPSADYN - Get pain relief with the power of capsaicin from chili peppers – without the burning! Capsadyn's proprietary formulation for joint & muscle pain contains no NSAIDs, opioids, anesthetics, or steroids. Try it for 15% off at https://drdrew.com/capsadyn • FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at https://drdrew.com/fatty15 • CHECK GENETICS - Your DNA is the key to discovering the RIGHT medication for you. Escape the big pharma cycle and understand your genetic medication blueprint with pharmacogenetic testing. Save $200 with code DRDREW at https://drdrew.com/check • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at https://drdrew.com/paleovalley • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at https://twc.health/drew 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (https://kalebnation.com) and Susan Pinsky (https://twitter.com/firstladyoflove). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Learn more about your ad choices. Visit megaphone.fm/adchoices

After the COVID debacle – with its unscientific lockdowns, unreliable vaccines, and ridiculous masking mandates – how can public health systems ever regain our trust? Wilk Wilkinson hosts the ‘Derate The Hate' podcast, which focuses on civil dialogue across political differences. Wilkinson serves on the Board of Advisors at the Prohuman Foundation and is a volunteer leader with Braver Angels, a grassroots organization dedicated to reducing political polarization. Find his podcast on all major platforms and follow him at https://x.com/WilksOpinion Chef Andrew Gruel appeared as a judge on Food Network's “Food Truck Face Off”, as a host of FYI's “Say It to My Face!” and is the founder of American Gravy Restaurant Group. After the COVID-19 pandemic forced many restaurants to shut down, Gruel started a fund in December 2020 to raise money for out-of-work restaurant industry employees, raising over $230,000 in the first three weeks. His latest book “Andrew Gruel's Family Cookbook” is available soon. Follow Chef Gruel at https://x.com/ChefGruel and learn more at https://chefgruel.com 「 SUPPORT OUR SPONSORS 」 Find out more about the brands that make this show possible and get special discounts on Dr. Drew's favorite products at https://drdrew.com/sponsors  • CAPSADYN - Get pain relief with the power of capsaicin from chili peppers – without the burning! Capsadyn's proprietary formulation for joint & muscle pain contains no NSAIDs, opioids, anesthetics, or steroids. Try it for 15% off at https://drdrew.com/capsadyn • FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at https://drdrew.com/fatty15 • CHECK GENETICS - Your DNA is the key to discovering the RIGHT medication for you. Escape the big pharma cycle and understand your genetic medication blueprint with pharmacogenetic testing. Save $200 with code DRDREW at https://drdrew.com/check • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at https://drdrew.com/paleovalley • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at https://twc.health/drew 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (https://kalebnation.com) and Susan Pinsky (https://twitter.com/firstladyoflove). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Learn more about your ad choices. Visit megaphone.fm/adchoices

You can smell the excitement on this amazing episode! The main training topic was on David's favorite study of 2024, which caused major changes in his training approach. The study found some potential mechanisms for improved fatigue resistance, but we take it a step further into theories about solving for a puzzle that has flummoxed coaches and researchers forever. Could this study be the missing link connecting fatigue resistance and training interventions? Maybe. We dive into the cutting edge of endurance training to find out. We also talked about how Megan is planning to rebuild for big goals in 2025 and beyond. It's the perfect opportunity to discuss the interplay of power, speed, cross training, and strength work in an athletic journey. It's also the perfect opportunity to talk about critical internet comments. Scared money don't make money! And this one was full of awesome topics! Other topics: the perils of heat suit training and weak laundry practices, building strength and power, why people are weird on the internet, a shoe that really let us down, some reviews of "supertrainers" and why we think these shoes are so important in training, a triathlon case study on carb oxidation in long events, the controversy around NSAID use in endurance races, and Listener Corner. This one was SO MUCH FUN. Like the listener at the end of the episode, you (and we mean everything that goes into what makes you... plus what comes out of you) = awesome. We love you all! Huzzah! Follow Huzzah for science insights: https://www.instagram.com/thehuzzahhub/ Click "Claim Reward" for $80 at The Feed here: thefeed.com/swap Buy Janji's amazing gear: https://janji.com/ (code "SWAP") For weekly bonus podcasts, articles, and videos (plus hat purchases): patreon.com/swap