Podcasts about ppis

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 Evan S. Dellon, MD, and Elizabeth T. Jensen, PhD, about a paper they published on predictors of patients receiving no medication for treatment of eosinophilic esophagitis. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship 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: [:52] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, predictors of not using medication for EoE, and today's guests, Dr. Evan Dellon and Dr. Elizabeth Jensen.   [1:29] Dr. Dellon is an Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He is also the Director of the UNC Center for Esophageal Diseases and Swallowing.   [1:42] Dr. Dellon's main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and eosinophilic GI diseases (EGIDs).   [1:55] Dr. Jensen is a Professor of Epidemiology with a specific expertise in reproductive, perinatal, and pediatric epidemiology. She has appointments at both Wake Forest University School of Medicine and the University of North Carolina at Chapel Hill.   [2:07] Her research primarily focuses on etiologic factors in the development of pediatric immune-mediated chronic diseases, including understanding factors contributing to disparities in health outcomes.   [2:19] Both Dr. Dellon and Dr. Jensen also serve on the Steering Committee for EGID Partners Registry.   [2:24] Ryan thanks Dr. Dellon and Dr. Jensen for joining the podcast today.   [2:29] Dr. Dellon was the first guest on this podcast. It is wonderful to have him back for the 50th episode! Dr. Dellon is one of Ryan's GI specialists. Ryan recently went to North Carolina to get a scope with him.   [3:03] Dr. Dellon is an adult gastroenterologist at the University of North Carolina at Chapel Hill. He directs the Center for Esophageal Diseases and Swallowing. Clinically and research-wise, he is focused on EoE and other eosinophilic GI diseases.   [3:19] His research interests span the entire field, from epidemiology, diagnosis, biomarkers, risk factors, outcomes, and a lot of work, more recently, on treatments.   [3:33] Dr. Jensen has been on the podcast before, on Episode 27. Holly invites Dr. Jensen to tell the listeners more about herself and her work with eosinophilic diseases.   [3:46] Dr. Jensen has been working on eosinophilic gastrointestinal diseases for about 15 years. She started some of the early work around understanding possible risk factors for the development of disease.   [4:04] She has gone on to support lots of other research projects, including some with Dr. Dellon, where they're looking at gene-environment interactions in relation to developing EoE.   [4:15] She is also looking at reproductive factors as they relate to EoE, disparities in diagnosis, and more. It's been an exciting research trajectory, starting with what we knew very little about and building to an increasing understanding of why EoE develops.   [5:00] Dr. Dellon explains that EoE stands for eosinophilic esophagitis, a chronic allergic condition of the esophagus.   [5:08] You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have EoE, it is a long-term condition.   [5:24] Eosinophils are a type of white blood cell, specializing in allergy responses. Normally, they are not in the esophagus. When we see them there, we worry about an allergic process. When that happens, that's EoE.   [5:40] Over time, the inflammation seen in EoE and other allergic cell activity causes swelling and irritation in the esophagus. Early on, this often leads to a range of upper GI symptoms — including poor growth or failure to thrive in young children, abdominal pain, nausea, and symptoms that can mimic reflux.   [5:58] In older kids, symptoms are more about trouble swallowing. That's because the swelling that happens initially, over time, may turn into scar tissue. So the esophagus can narrow and cause swallowing symptoms like food impaction.   [6:16] Ryan speaks of living with EoE for decades and trying the full range of treatment options: food elimination, PPIs, steroids, and, more recently, biologics.   [6:36] Dr. Dellon says Ryan's history is a good overview of how EoE is treated. There are two general approaches to treating the underlying condition: using medicines and/or eliminating foods that we think may trigger EoE from the diet.   [6:57] For a lot of people, EoE is a food-triggered allergic condition.   [7:01] The other thing that has to happen in parallel is surveying for scar tissue in the esophagus. If that's present and people have trouble swallowing, sometimes stretching the esophagus is needed through esophageal dilation.   [7:14] There are three categories of medicines used for treatment. Proton pump inhibitors are reflux meds, but they also have an anti-allergy effect in the esophagus.   [7:29] Topical steroids are used to coat the esophagus and produce an anti-inflammatory effect. The FDA has approved a budesonide oral suspension for that.   [7:39] Biologics, which are generally systemic medications, often injectable, can target different allergic factors. Dupilumab is approved now, and there are other biologics that are being researched as potential treatments.   [7:51] Even though EoE is considered an allergic condition, we don't have a test to tell people what they are allergic to. If it's a food allergy, we do an empiric elimination diet because allergy tests aren't accurate enough to tell us what the EoE triggers are.   [8:10] People will eliminate foods that we know are the most common triggers, like milk protein, dairy, wheat, egg, soy, and other top allergens. You can create a diet like that and then have a response to the diet elimination.   [8:31] Dr. Jensen and Dr. Dellon recently published an abstract in the American Journal of Gastroenterology about people with EoE who are not taking any medicine for it. Dr. Jensen calls it a real-world data study, leveraging electronic health record patient data.   [8:51] It gives you an impression of what is actually happening, in terms of treatments for patients, as opposed to a randomized control trial, which is a fairly selected patient population. This is everybody who has been diagnosed, and then what happens with them.   [9:10] Because of that, it gives you a wide spectrum of patients. Some patients are going to be relatively asymptomatic. It may be that we arrived at their diagnosis while working them up for other potential diagnoses.   [9:28] Other patients are going to have rather significant impacts from the disease. We wanted to get an idea of what is actually happening out there with the full breadth of the patient population that is getting diagnosed with EoE.   [9:45] Dr. Jensen was not surprised to learn that there are patients who had no pharmacologic treatment.   [9:58] Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are early in their disease process and still exploring dietary treatment options.   [10:28] Holly sees patients from infancy to geriatrics, and if they're not having symptoms, they wonder why bother treating it.   [10:42] Dr. Jensen says it's a point of debate on the implications of somebody who has the disease and goes untreated. What does that look like long-term? Are they going to develop more of that fibrostenotic pattern in their esophagus without treatment?   [11:07] This is a question we're still trying to answer. There is some suggestion that for some patients who don't manage their disease, we very well may be looking at a food impaction in the future.   [11:19] Dr. Dellon says we know overall for the population of EoE patients, but it's hard to know for a specific patient. We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range.   [11:39] Some people get symptoms and get diagnosed right away. Others might have symptoms for 20 or 30 years that they ignore, or don't have access to healthcare, or the diagnosis is missed.   [11:51] What we see consistently is that people who may be diagnosed within a year or two may only have a 10 or 20% chance of having that stricture and scar tissue in the esophagus, whereas people who go 20 years, it might be 80% or more.   [12:06] It's not everybody who has EoE who might end up with that scar tissue, but certainly, it's suggested that it's a large majority.   [12:16] That's before diagnosis. We have data that shows that after diagnosis, if people go a long time without treatment or without being seen in care, they also have an increasing rate of developing strictures.    [12:29] In general, the idea is yes, you should treat EoE, because on average, people are going to develop scar tissue and more symptoms. For the patient in front of you with EoE but no symptoms, what are the chances it's going to get worse? You don't know.   [13:04] There are two caveats with that. The first is what we mean by symptoms. Kids may have vomiting and growth problems. Adults can eat carefully, avoiding foods that hang up in the esophagus, like breads and overcooked meats, sticky rice, and other foods.   [13:24] Adults can eat slowly, drink a lot of liquid, and not perceive they have symptoms. When someone tells Dr. Dellon they don't have symptoms, he will quiz them about that. He'll even ask about swallowing pills.    [13:40] Often, you can pick up symptoms that maybe the person didn't even realize they were having. In that case, that can give you some impetus to treat.   [13:48] If there really are no symptoms, Dr. Dellon thinks we're at a point where we don't really know what to do.   [13:54] Dr. Dellon just saw a patient who had a lot of eosinophils in their small bowel with absolutely no GI symptoms. He said, "I can't diagnose you with eosinophilic enteritis, but you may develop symptoms." People like that, he will monitor in the clinic.   [14:14] Dr. Dellon will discuss it with them each time they come back for a clinic visit.   [14:19] Holly is a speech pathologist, but also sees people for feeding and swallowing. The local gastroenterologist refers patients who choose not to treat their EoE to her. Holly teaches them things they should be looking out for.   [14:39] If your pills get stuck or if you're downing 18 ounces during a mealtime, maybe it's time to treat it. People don't see these coping mechanisms they use that are impacting their quality of life. They've normalized it.   [15:30] Dr. Dellon says, of these people who aren't treated, there's probably a subset who appropriately are being observed and don't have a medicine treatment or are on a diet elimination.   [15:43] There's also probably a subset who are inappropriately not on treatment. It especially can happen with students who were under good control with their pediatric provider, but moved away to college and didn't transfer to adult care.   [16:08] They ultimately come back with a lot of symptoms that have progressed over six to eight years.   [16:18] Ryan meets newly diagnosed adult patients at APFED's conferences, who say they have no symptoms, but chicken gets caught in their throat. They got diagnosed when they went to the ER with a food impaction.   [16:38] Ryan says you have to wonder at what point that starts to get reflected in patient charts. Are those cases documented where someone is untreated and now has EoE?   [16:49] Ryan asks in the study, "What is the target EGID Cohort and why was it selected to study EoE? What sort of patients were captured as part of that data set?"   [16:58] Dr. Jensen said they identified patients with the ICD-10 code for a diagnosis of EoE. Then they looked to see if there was evidence of symptoms or complications in relation to EoE. This was hard; some of these are relatively non-specific symptoms.   [17:23] These patients may have been seeking care and may have been experiencing some symptoms that may or may not have made it into the chart. That's one of the challenges with real-world data analyses.   [17:38] Dr. Jensen says they are using data that was collected for documenting clinical care and for billing for clinical care, not for research, so it comes with some caveats when doing research with this data.   [18:08] Research using electronic health records gives a real-world perspective on patients who are seeking care or have a diagnosis of EoE, as opposed to a study trying to enroll a patient population that potentially isn't representative of the breadth of individuals living with EoE.   [18:39] Dr. Dellon says another advantage of real-world data is the number of patients. The largest randomized controlled trials in EoE might have 400 patients, and they are incredibly expensive to do.   [18:52] A study of electronic health records (EHR) is reporting on the analysis of just under 1,000. The cohort, combined from three different centers, has more than 1,400 people, a more representative, larger population.    [19:16] Dr. Dellon says when you read the results, understand the limitations and strengths of a study of health records, to help contextualize the information.   [19:41] Dr. Dellon says it's always easier to recognize the typical presentations. Materials about EoE and studies he has done that led to medicine approvals have focused on trouble swallowing. That can be relatively easily measured.   [20:01] Patients often come to receive care with a food impaction, which can be impactful on life, and somewhat public, if in a restaurant or at work. Typical symptoms are also the ones that get you diagnosed and may be easier to treat.   [20:26] Dr. Dellon wonders if maybe people don't treat some of the atypical symptoms because it's not appreciated that they can be related to EoE.   [20:42] Holly was diagnosed as an adult. Ryan was diagnosed as a toddler. Holly asks what are some of the challenges people face in getting an EoE diagnosis.   [20:56] Dr. Jensen says symptoms can sometimes be fairly non-specific. There's some ongoing work by the CEGIR Consortium trying to understand what happens when patients come into the emergency department with a food bolus impaction.   [21:28] Dr. Jensen explains that we see there's quite a bit of variation in how that gets managed, and if they get a biopsy. You have to have a biopsy of the esophagus to get a diagnosis of EoE.   [21:45] If you think about the steps that need to happen to get a diagnosis of EoE, that can present barriers for some groups to ultimately get that diagnosis.   [21:56] There's also been some literature around a potential assumption about which patients are more likely to be at risk. Some of that is still ongoing. We know that EoE occurs more commonly in males in roughly a two-to-one ratio. Not exclusively in males, obviously, but a little more often in males.   [22:20] We don't know anything about other groups of patients that may be at higher risk. That's ongoing work that we're still trying to understand. That in itself can also be a barrier when there are assumptions about who is or isn't likely to have EoE.   [23:02] Dr. Dellon says that in adolescents and adults, the typical symptoms are trouble swallowing and food sticking, which have many causes besides EoE, some of which are more common.   [23:18] In that population, heartburn is common. Patients may report terrible reflux that, on questioning, sounds more like trouble swallowing than GERD. Sometimes, with EoE, you may have reflux that doesn't improve. Is it EoE, reflux, or both?   [24:05] Some people will have chest discomfort. There are some reports of worsening symptoms with exercise, which brings up cardiac questions that have to be ruled out first.   [24:19] Dr. Dellon mentions some more atypical symptoms. An adult having pain in the upper abdomen could have EoE. In children, the symptoms could be anything in the GI tract. Some women might have atypical symptoms with less trouble swallowing.   [24:58] Some racial minorities may have those kinds of symptoms, as well. If you're not thinking of the condition, it's hard to make the diagnosis.   [25:08] Dr. Jensen notes that there are different cultural norms around expressing symptoms and dietary patterns, which may make it difficult to parse out a diagnosis.   [25:27] Ryan cites a past episode where access to a GI specialist played a role in diagnosing patients with EoE. Do white males have more EoE, or are their concerns just listened to more seriously?   [25:57] Ryan's parents were told when he was two that he was throwing up for attention. He believes that these days, he'd have a much easier time convincing a doctor to listen to him. From speaking to physicians, Ryan believes access is a wide issue in the field.   [26:23] Dr. Dellon tells of working with researchers at Mayo in Arizona and the Children's Hospital of Phoenix. They have a large population of Hispanic children with EoE, much larger than has been reported elsewhere. They're working on characterizing that.   [26:49] Dr. Dellon describes an experience with a visiting trainee from Mexico City, where there was not a lot of EoE reported. The trainee went back and looked at the biopsies there, and it turned out they were not performing biopsies on patients with dysphagia in Mexico City.   [27:13] When he looked at the patients who ended up getting biopsies, they found EoE in 10% of patients. That's similar to what's reported out of centers in the developed world. As people are thinking about it more, we will see more detection of it.   [27:30] Dr. Dellon believes those kinds of papers will be out in the next couple of months, to a year.   [27:36] Holly has had licensure in Arizona for about 11 years. She has had nine referrals recently of children with EoE from Arizona. Normally, it's been one or two that she met at a conference.   [28:00] Ryan asks about the research on patients not having their EoE treated pharmacologically. Some treat it with food avoidance and dietary therapy. Ryan notes that he can't have applesauce, as it is a trigger for his EoE.   [28:54] Dr. Jensen says that's one of the challenges in using the EHR data. That kind of information is only available to the researchers through free text. That's a limitation of the study, assessing the use of dietary elimination approaches.   [29:11] Holly says some of her patients have things listed as allergies that are food sensitivities. Ryan says it's helpful for the patients to have their food sensitivities listed along with their food allergies, but it makes records more difficult to parse for research.   [30:14] Dr. Dellon says they identify EoE by billing code, but the codes are not always used accurately. Natural Language Processing can train a computer system to find important phrases. Their collaborators working on the real-world data are using it.   [30:59] Dr. Dellon hopes that this will be a future direction for this research to find anything in the text related to diet elimination.   [31:32] Dr. Jensen says that older patients were less likely to seek medication therapy. She says it's probably for a couple of reasons. First, older patients may have been living with the disease for a long time and have had compensatory mechanisms in place.   [32:03] The other reason may be senescence or burnout of the disease, long-term. Patients may be less symptomatic as they get older. That's a question that remains to be answered for EoE. It has been seen in some other disease processes.   [32:32] Dr. Dellon says there's not much data specifically looking at EoE in the older population. Dr. Dellon did work years ago with another doctor, and they found that older patients had a better response to some treatments, particularly topical steroids.   [32:54] It wasn't clear whether it was a milder aspect of the disease, easier to treat, or because they were older and more responsible, taking their medicines as prescribed, and having a better response rate. It's the flip side of work in the pediatric population.   [33:16] There is an increasingly aging population with EoE. Young EoE patients will someday be over 65. Dr. Dellon hopes there will be a cure by that point, but it's an expanding population now.   [33:38] Dr. Jensen says only a few sites are contributing data, so they hope to add additional sites to the study. For some of the less common outcomes, they need a pretty large patient sample to ask some of those kinds of questions.   [33:55] They will continue to follow up on some of the work that this abstract touched on and try to understand some of these issues more deeply.   [34:06] Dr. Dellon mentions other work within the cohort. Using Natural Language Processing, they are looking at characterizing endoscopy information and reporting it without a manual review of reports and codes. You can't get that from billing data.   [34:29] Similarly, they are trying to classify patient severity by the Index of Severity with EoE, and layer that on looking at treatments and outcomes based on disease severity. Those are a couple of other directions where this cohort is going.   [34:43] Holly mentions that this is one of many research projects Dr. Jensen and Dr. Dellon have collaborated on together. They also collaborate through EGID Partners. Holly asks them to share a little bit about that.   [34:53] Dr. Jensen says EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join.   [35:07] EGID Partners also needs people who don't live with an EGID to join, as controls. That gives the ability to compare those who are experiencing an EGID relative to those who aren't.   [35:22] When you join EGID Partners, they provide you with a set of questionnaires to complete. Periodically, they push out a few more questionnaires.   [35:33] EGID Partners has provided some really great information about patient experience and answered questions that patients want to know about, like joint pain and symptoms outside the GI tract.   [36:04] To date, there are close to 900 participants in the registry from all over the world. As it continues to grow, it will give the ability to look at the patient experience in different geographical areas.   [36:26] Dr. Dellon says we try to have it be interactive, because it is a collaboration with patients. The Steering Committee works with APFED and other patient advocacy groups from around the world.    [36:41] The EGID Partners website shows general patient locations anonymously. It shows the breakdown of adults with the condition and caregivers of children with the condition, the symptom distribution, and the treatment distribution.   [37:03] As papers get published and abstracts are presented, EGID Partners puts them on the website. Once someone joins, they can suggest a research idea. Many of the studies they have done have come from patient suggestions.   [37:20] If there's an interesting idea for a survey, EGID Partners can push out a survey to everybody in the group and answer questions relatively quickly.   [37:57] Dr. Dellon says a paper came out recently about telehealth. EoE care, in particular, is a good model for telehealth because it can expand access for patients who don't have providers in their area.   [38:22] EoE is a condition where care involves a lot of discussion but not a lot of need for physical exams and direct contact, so telehealth can make things very efficient.    [38:52] EGID Partners surveyed patients about telehealth. They thought it was efficient and saved time, and they had the same kind of interactions as in person. In general, in-state insurance covered it. Patients were happy to do those kinds of visits again.   [39:27] Holly says Dr. Furuta, herself, and others were published in the Gastroenterology journal in 2019 about starting to do telehealth because patients coming to the Children's Hospital of Colorado from out of state had no local access to feeding therapy.   [39:50] Holly went to the board, and they allowed her to get licensure in different states. She started with some of the most impacted patients in Texas and Florida in 2011 and 2012. They collected data. They published in 2019 about telehealth's positive impact.   [40:13] When 2020 rolled around, Holly had trained a bunch of people on how to do feeding therapy via telehealth. You have to do all kinds of things, like make yourself disappear, to keep the kids engaged and in their chairs!   [40:25] Now it is Holly's primary practice. She has licenses in nine states. She sees people all over the country. With her diagnosis, her physicians at Mass General have telehealth licensure in Maine. She gets to do telehealth with them instead of driving two hours.   [40:53] Dr. Jensen tells of two of the things they hope to do at EGID Partners. One is trying to understand more about reproductive health for patients with an EGID diagnosis. Only a few studies have looked at this question, and with very small samples.   [41:15] As more people register for EGID Partners, Dr. Jensen is hoping to be able to ask some questions related to reproductive health outcomes.   [41:27] The second goal is a survey suggested by the Student Advisory Committee, asking questions related to the burden of disease specific to the teen population.   [41:48] This diagnosis can hit that population particularly hard, at a time when they are trying to build and sustain friendships and are transitioning to adult care and moving away from home. This patient population has a unique perspective we wanted to hear.   [42:11] Dr. Jensen and Dr. Dellon work on all kinds of other projects, too.   [42:22] Dr. Dellon says they have done a lot of work on the early-life factors that may predispose to EoE. They are working on a large epidemiologic study to get some insight into early-life factors, including factors that can be measured in baby teeth.   [42:42] That's outside of EGID Partners. It's been ongoing, and they're getting close, maybe over the next couple of years, to having some results.   [43:03] Ryan says all of those projects sound so interesting. We need to have you guys back to dive into those results when you have something finalized.   [43:15] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes below.   [43:22] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist.   [43:31] 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.   [43:41] Ryan thanks Dr. Dellon and Dr. Jensen for joining us today. This was a fantastic conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Evan S. Dellon, MD, MPH, Academic Gastroenterologist, University of North Carolina School of Medicine   Elizabeth T. Jensen, MPH, PhD, Epidemiologist, Wake Forest University School of Medicine, University of North Carolina at Chapel Hill   Predictors of Patients Receiving No Medication for Treatment of Eosinophilic Esophagitis in the United States: Data from the TARGET-EGIDS Cohort   Episode 15: Access to Specialty Care for Eosinophilic Esophagitis (EoE)   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "I've been working on eosinophilic gastrointestinal diseases for about 15 years. I started some of the early work around understanding possible risk factors for the development of disease. I've gone on to support lots of other research projects." — Elizabeth T. Jensen, MPH, PhD   "You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have it, it really is a long-term condition." — Evan S. Dellon, MD, MPH   "There are two general approaches to treating the underlying condition, … using medicines and/or eliminating foods from the diet that we think may trigger EoE. I should say, for a lot of people, EoE is a food-triggered allergic condition." — Evan S. Dellon, MD, MPH   "I didn't find it that surprising [that there are patients who had no treatment]. Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are … still exploring dietary treatment options." — Elizabeth T. Jensen, MPH, PhD   "We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. Some people get symptoms and are diagnosed right away. Other people might have symptoms for 20 or 30 years." — Evan S. Dellon, MD, MPH   "EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. EGID Partners also needs people who don't live with an EGID to join, as controls." — Elizabeth T. Jensen, MPH, PhD

Subscribe to the video podcast: https://www.youtube.com/@LiveHolPlus/Cardiovascular disease is still the number one killer, yet guidelines keep pushing cholesterol lower and more people are put on statins for life. In this hol+ episode, Dr. Taz sits down with worlds leading nitric oxide researcher Dr. Nathan S. Bryan to ask hard questions about statin risk versus benefit, why cholesterol alone does not explain heart disease, and what is nitric oxide actually doing inside the body long before a heart attack or stroke. Together, they explore why low or no nitric oxide may be the missing piece behind rising blood pressure, plaque, and dementia, even in people who “follow the rules.”From the benefits of nitric oxide for blood flow, blood pressure, diabetes, and brain health to the surprising impact of antiseptic mouthwash and antacid medications, this conversation reframes cardiovascular and metabolic disease as problems of cell signaling, not just lab numbers. You will learn what nitric oxide is, what does nitric oxide do for the body, why nitric oxide importance is often ignored in standard care, and how to raise nitric oxide through lifestyle, targeted support, and emerging restorative therapies based on decades of nitric oxide research.Dr. Taz and Dr. Bryan discuss:New cholesterol guidelines, statins, and rethinking risk vs benefitWhat is nitric oxide and what does nitric oxide do for the bodyWhy low or no nitric oxide shows up decades before heart attacks and strokeThe benefits of nitric oxide for blood flow, blood pressure, and sexual functionNitric oxide diabetes link and why insulin resistance is often a nitric oxide problemMouthwash and nitric oxide, antacids, fluoride, and the oral microbiomeHow lifestyle, diet, movement, and nasal breathing raise nitric oxide naturallyWhy standard biomarkers are late and vascular function should be tested soonerNitric oxide importance in Alzheimer's, dementia, and brain blood flowHow to raise nitric oxide safely and what to know about supplements vs “dead beets”About Dr. Nathan S. Bryan Dr. Nathan S. Bryan is a pioneering nitric oxide researcher, molecular medicine scientist, and biotech entrepreneur whose discoveries helped create a billion dollar nitric oxide market. His work has reshaped how we understand cardiovascular disease, metabolic health, nitric oxide diabetes links, and how lifestyle, mouthwash and nitric oxide, and common drugs impact long term health. He is the author of The Secret of Nitric Oxide, where he breaks down what nitric oxide is, what nitric oxide does for the body, and how to raise nitric oxide safely at home using science based tools and lifestyle shifts. Stay Connected:Connect further to Hol+ at https://holplus.co/- Don't forget to like, subscribe, and hit the notification bell to stay updated on future episodes of hol+.Follow Dr. Nathan S. Bryan:  YouTube: https://www.youtube.com/@DrNathanSBryanNitricOxideInstagram: https://www.instagram.com/drnathansbryan/ Website: https://www.bryantherapeutics.com/ Product: https://n1o1.com/Get The Secret of Nitric Oxide Book here.Follow Dr. Taz on Instagram: https://www.instagram.com/drtazmd/https://www.instagram.com/liveholplus/Subscribe to the audio podcast: https://holplus.transistor.fm/subscribeSubscribe to the video podcast: https://www.youtube.com/@DrTazMD/podcastsGet your copy of The Hormone Shift: Balance Your Body and Thrive Through Midlife and MenopauseHost & Production TeamHost: Dr. Taz; Produced by ClipGrowth.com (Producer: Pat Gostek)00:00 New cholesterol rules, statins, and nitric oxide importance01:00 Mouthwash and nitric oxide, blood pressure, and the oral microbiome01:46 What is nitric oxide and what does nitric oxide do for the body03:06 Why nitric oxide matters for longevity, inflammation, and aging cells04:32 Nobel Prize history and early nitric oxide research06:06 Fingerprint of nitric oxide biology and early disease markers08:13 No nitric oxide before you see plaque, blood pressure, or ED09:26 The American lifestyle and nitric oxide diabetes link10:45 Mouthwash and nitric oxide, fluoride, PPIs, and hidden blockers12:26 Statins, cholesterol guidelines, and questioning “everyone needs a statin”16:11 Cholesterol numbers, Framingham data, and what actually predicts risk19:27 Better heart screening, vascular function, and nitric oxide benefits22:28 First symptoms of low nitric oxide: ED, libido, and rising blood pressure25:04 Mouthwash and nitric oxide causation study, exercise benefits lost27:23 Antacids, reflux meds, and how they shut down nitric oxide27:58 How to raise nitric oxide naturally with food, movement, and sunlight30:19 Nasal breathing, mouth breathing, and nitric oxide delivery to the lungs31:02 Nitric oxide as a hormone and whole body signaling molecule33:18 How to measure, how to replace, and what nitric oxide testing really shows36:45 Inflammation, triglycerides, and tracking nitric oxide benefits in labs38:38 Restorative physiology vs applied pharmacology42:01 Can nitric oxide help heart failure, liver disease, and ascites44:13 Nitric oxide diabetes connection and insulin resistance46:52 Nitric oxide and Alzheimer's, brain blood flow, and “type 3 diabetes”47:57 Kids, ADHD, diet, and low nitric oxide as a blood flow problem49:08 5G, toxins, and electron flow in biochemistry51:00 Glutathione, nitric oxide transport, and why most supplements miss the mark52:18 Why arginine, citrulline, and most beet products do not fix nitric oxide55:40 Nitruticals, rebuilding nitric oxide and the oral microbiome57:32 Nitric oxide for wounds, skin, and regenerative healing59:19 Reversing disease vs managing decline, and what nitric oxide might change1:00:07 Optimizing human performance with nitric oxide as a foundation1:01:18 Where to learn more from Dr. Nathan Bryan1:01:55 Closing thoughts from Dr. Taz and hol+

“Study” that's not even a study spreads panic about dubious melatonin-heart failure link; Should you ignore dr's advice to take powerful acid-blocking drugs? Novel implantable electrical pacemakers may bring relief to sufferers of severe constipation; Benefits of cocoa flavanols for heart, brain, athletic performance. Give the gift of healthy chocolate! Go to FlavaNaturals.com and use coupon code HOFFMAN20 for 20% off site-wide. Plus get free shipping on all orders over $30. 

Welcome back to our weekend Cabral HouseCall shows!   This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!   Check out today's questions:    Lauren: Hi Dr Cabral, I want to start by thanking you for all you do! I love listening to your podcasts and have learned so much. I had surgery 15 years ago to fix a labrum tear and within the last year I started experiencing pain again. I had a scope done and found out the suture rubbed the cartilage off my shoulder joint (this probably isn't the correct medical terminology) and now I'm experiencing bone-on-bone pain. I was told there wasn't anything I could do unless I replaced my shoulder. I'm working on fixing my gut and will then do a liver detox. Other than working on inflammation, what else can you recommend?                                                                                                                                                         Ann: quick question - what are your thoughts on banding internal hemroids? I recently had a colonoscopy for gut issues and in their report mentioned the hemroids i knew I had but also that they band them at their clinic. I never heard of this - I'd love to get rid of them as they are uncomfortable and messy. They say it's uninvasive and low risk but I don't always trust what the medical field has to say - just wondering what your thoughts are. Thank you for your time! :) and for all the help you give your followers.                                                                                                                                                            Audrey: Hi Dr Cabral, I know to get adequate morning sunlight I shouldn't be wearing glasses, but what about contacts? Am I still getting the healthy benefits of sunlight with wearing contact lenses? Thanks so much                                                   Anonymous: I was diagnosed with Barrett's Esophagus a year ago after getting an EDG through my GI doctor. He told me I'd need to be on PPIs for the rest of my life. This terrifies me...but I've tried to come off of them before and it's really uncomfortable. I generally understand how PPIs work and now acid will flood the body when you come off of them, and that it takes time but I've tried and can't make it past several weeks...what would you recommend?                                               Bettina: Hello Dr. Cabral, I'm curious to know your thoughts on this product. Brottrunk, a trusted German product for 36 years, is made from 100% organic, freshly baked sourdough bread (spring water, whole grain bread (WHOLE RYE FLOUR, water, WHOLE WHEAT FLOUR, natural sourdough (WHOLE RYE FLOUR, water), salt, WHOLE OAT FLOUR)). The bread is sliced, soaked in spring water, and fermented for six months. This process produces lactic acid and beneficial lactic acid bacteria, creating a drink rich in enzymes, vitamin B12, minerals, and amino acids. Brottrunk supposedly supports a normal immune system and energy metabolism, and helps reduce tiredness and fatigue. It may also have cleansing, detoxifying, and antifungal effects, making it an excellent probiotic supplement for digestion.         Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3564 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

GPs Rebecca and Sarah are joined by Dr. Jonathan Hoare, gastroenterologist at St Mary's Hospital in London, to unpack the risk factors for upper GI cancers, including lifestyle, diet, and Helicobacter infection. Together, they share clinical stories highlighting alarm symptoms such as dysphagia, approaches to history taking, and discuss best practice for investigating new indigestion. The episode covers the long-term safety of PPIs, Barrett's oesophagus management, and how empowering patients plays a vital role in cancer diagnosis and care.If you loved this episode and would like to hear more like this, please send your review to the-christie.gatewayc@nhs.net and share the series with a colleague.GPs Talk Cancer is the podcast series from GatewayC. GatewayC is the free early cancer diagnosis resource funded by the NHS and is part of The Christie NHS Foundation Trust. View the full shownotes for this episode at Podcast - GatewayCProduced by Louise Harbord from GatewayC and Listening Dog Media.DISCLAIMER: We know this podcast might be of interest to anybody, however it is aimed at primary care health professionals. All patient cases are based on real stories from our clinical practice as GPs. They are fully anonymised with no identifiable patient data. All featured statistics are accurate at the time of recording. All views expressed by guest speakers are their own. Hosted on Acast. See acast.com/privacy for more information.

Common medications like Tylenol, statins, and diabetes drugs quietly deplete essential nutrients and stress your liver. Learn which five medications cause nutritional deficiencies, what nutrients they deplete, and actionable steps to restore balance while protecting your liver health through targeted supplementation and lifestyle changes. FEATURED SUPPLEMENT Liver Boost – Every medication you take passes through and stresses your liver, depleting essential nutrients like glutathione, CoQ10, and B vitamins. Liver Boost is specifically formulated to support your liver's detoxification pathways and help regenerate liver function.  Learn more: https://mswnutrition.com/products/liver-boost 5 KEY TAKEAWAYS Acetaminophen Destroys Glutathione – Every dose of Tylenol depletes your liver's master antioxidant (glutathione), reducing your body's ability to detoxify and fight inflammation, which can lead to liver toxicity with long-term use. Statins Lower CoQ10 Levels – Cholesterol medications deplete CoQ10, a critical nutrient for heart and liver function that supports mitochondrial energy production. Anyone on statins should supplement with CoQ10 to prevent deficiency. Metformin Causes B12 Deficiency – This common diabetes medication depletes vitamin B12, leading to fatigue, nerve damage, and digestive issues. Long-term metformin users need regular B12 monitoring and supplementation. Birth Control Depletes Multiple Nutrients – Oral contraceptives reduce B6, B9 (folate), and magnesium levels, affecting liver function, hormone regulation, and overall health, especially problematic for women on long-term birth control. PPIs Create Dangerous Deficiencies – Acid-reducing medications like Nexium deplete B12, magnesium, and zinc, impairing digestion, liver health, and nutrient absorption, creating a vicious cycle of deficiency. TIMESTAMPS 00:00 – START – Welcome and episode overview 02:15 – Understanding how medications affect your liver 04:30 – Acetaminophen depletes glutathione and damages liver function 08:45 – Why glutathione is the master antioxidant your body needs 12:20 – NAC supplementation and liver regeneration strategies 16:40 – Statins lower CoQ10 and impact mitochondrial energy production 21:10 – Metformin causes B12 deficiency in diabetic patients 25:30 – How vitamin B12 supports energy, nerves, and digestion 28:45 – Birth control pills deplete B6, B9, and magnesium 32:20 – Estrogen regulation and liver health connection 35:50 – PPIs and antacids cause multiple nutrient deficiencies 39:15 – FDA warning about magnesium depletion from long-term PPI use 42:30 – Action steps for protecting your liver while on medications 45:00 – Supplementation recommendations and lab testing guidance RESOURCES PubMed – Research database for glutathione, medication-induced nutrient depletion, and liver function studies: https://pubmed.ncbi.nlm.nih.gov/ Book a Consultation with Nurse Doza – Schedule your personalized medication and liver health consultation: https://www.nursedoza.com/ MSW Nutrition Liver Boost – Targeted liver support supplement: https://mswnutrition.com/products/liver-boost MSW Nutrition Boost – Daily vitamin supplement with B12, B6, B9, and magnesium: https://www.mswnutrition.com/products/boost MSW Nutrition NAC Plus – N-Acetylcysteine supplement for glutathione production: https://www.mswnutrition.com/products/nac-plus Free Liver Detox Course – Available at School of Doza website CONNECT

In this episode of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and long-time surgical partner Deidre Schodroski dive deep into the real-world challenges bariatric patients face after surgery. From the surge in heartburn after gastric sleeve procedures to long-term PPI use, iron deficiencies, protein shake intolerance, hypoglycemia, and muscle loss—this episode delivers practical, science-backed solutions for every stage of the journey.They also discuss the synergistic benefits of combining GLP-1 medications with bariatric surgery, how to manage complications, and why technology like the Pound of Cure app and Sage, the AI dietitian, is transforming personalized weight loss care. If you've ever felt lost in the complexity of postop life or medications, this conversation offers clarity, direction, and support.- Discover why PPIs aren't always the enemy- Learn how to build muscle after surgery- Understand how meds + surgery = better results- Get protein shake tips that actually work for your gut- Start using our free app to optimize your careLearn more about how POC can help you: https://poundofcureweightloss.com/

Die Schweizer Autorin Olga Lakritz im Gespräch über ihren ersten Roman auf Mundart. «ich ha dir nie verzellt, dass du e abweseheit i mir gfüllt häsch» - die namenlose Ich-Erzählerin kann ihrem Freund nicht mehr sagen, was er ihr bedeutet hat. Er ist tot – gestorben an einer Demonstration. Im links-politischen Milieu verdächtigt man die Polizei, es kommt zu Unruhen und Untersuchungen und mittendrin: die junge Freundin des toten Aktivisten. Ohne ihn fühlt sie sich völlig allein. Sie zieht sich zurück und lässt ihre Freundinnen, ihre Eltern und selbst ihre Therapeutin im Ungewissen, was sie über das Geschehen weiss. In ihrem Mundartroman zeigt Olga Lakritz, wie sehr das Private und das Politische miteinander verschränkt sind. «so öppis wie d wahrheit» ist ein eindringlicher Bericht über Polizeigewalt, über die Trauer einer jungen Frau und die Schwierigkeit, über schmerzhafte Wahrheiten zu erzählen. Das chaotische, düstere Innenleben ihrer jungen Ich-Erzählerin schildert die Autorin in einer rhythmischen Zürcher Mundart. Dabei hat Olga Lakritz Schweizerdeutsch lange gar nie in Betracht gezogen als literarische Sprache. Warum das so ist und wieso ein Mundartroman gar nicht so klingen muss, wie gesprochene Mundart, erzählt Olga Lakritz im Gespräch. Im zweiten Teil der Sendung erklären wir den Flurnamen «Hinterofe» und den Familiennamen Bregy und wir schauen auf die verschiedenen Bedeutungen des Wortes «Schlumpf». Ausserdem zeigen wir, wie sich im Wort-und-Musik-Programm «es nachtet» von EIGETS Tänze, Lieder, Jutze und Rufe mit berndeutschen Texten verbinden.

Most people assume that if a drug sits on the shelf at Costco or Walgreens, it must be pretty safe. But what if some of the most common over-the-counter (OTC) medications are among the riskiest drugs in America? On this episode of Vitality Radio, Jared exposes the hidden dangers behind everyday pain relievers, sleep aids, and heartburn drugs—medicines that cause thousands of deaths every year when misused or taken long-term. You'll learn how a drug becomes “OTC,” what happens when pharmaceutical companies push for that switch, and why the FDA's approval process might not tell the whole story. Jared dives into the startling realities of PPIs like Prilosec, NSAIDs like ibuprofen, and acetaminophen (Tylenol)—uncovering their risks to the liver, kidneys, bones, and brain. He also discusses how marketing convinces consumers these drugs are harmless. Finally, Jared offers a resource for safe, natural alternatives for reflux, pain, inflammation, sleep, and immune support—options that nourish the body instead of depleting it. This episode will change the way you look at “harmless” OTC drugs and help you take real control of your health.Just Ingredients Lemon Swish Protein Powder Vitality Radio POW! Product of the Week $29.99 per bag (regular price $59.99) with PROMO CODE: POW15Additional Information:#341: Your Digestive Health Supplement User's Guide. From IBS to Acid Reflux - Learn How to Balance Your Gut Health With Natural Products. #522: Q&A Show #5 - Jared Answers Your Questions About Energy and Sleep!#471: Boosting Your Immune System Ahead of Winter #553: Boswellia & Curcumin: Nature's Dream Team for Pain & Inflammation with Dr. Lexi LochVisit the podcast website here: VitalityRadio.comYou can follow @vitalitynutritionbountiful and @vitalityradio on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

Root Canals, Dental Infections & Chronic Illness with Dr. Michelle Jorgensen Could your teeth be the hidden root cause of your health struggles? In this episode of The Coach Debbie Potts Show, I sit down with Dr. Michelle Jorgensen—biological dentist, functional health expert, and author—to uncover the surprising ways oral health impacts your immune system, hormones, brain, and even your longevity. We discuss: ✅ What really happens in a root canal and why they can fail over time ✅ How hidden dental infections and bacteria in root canals can spread endotoxins through the body ✅ The connection between mercury fillings, acetylcholine, and vagus nerve dysfunction ✅ Why nasal breathing—not mouth breathing—is essential for oxygen, nitric oxide, and sleep quality ✅ CPAP machines: why they aren't always the root cause solution for sleep apnea ✅ How gut health, PPIs, and mineral balance affect your teeth and bones ✅ Holistic options for safer dentistry—ozone therapy, implants, and myofunctional therapy ✅ Practical steps to identify if your dental health is draining your energy or fueling chronic illness If you've wondered about the link between root canals, CIRS (Chronic Inflammatory Response Syndrome), mold, and biotoxin illness, this conversation will give you new insights and hope for root-cause healing.

chwuler geht's nicht - Folge 273! Von geplatzten Dates, Schüssen und Wohnungsbränden in der Nachbarschaft, sowie zu lang angemeldeten Menschen auf Datingplattformen und der Frage: Warum verheilt man Schlüpfer im GYM?

Have you ever wondered how to get OFF your PPI safely - without hurting your body in the process? This is one of the most common questions I get from my clients who are struggling with acid reflux. And I get it. I've worked with clients on 1 PPI a day… 2 PPIs a day… even 3 PPIs a day PLUS tums and antacids stacked on top. I've worked with a client told by doctors at the University of Michigan that there was nothing left they could do for her. And I've gotten clients like her all the way down to ZERO PPIs. Here's the thing: if you're on a PPI, your acid reflux is probably pretty severe. Stopping cold turkey can leave you in pain, afraid to eat, and stuck in fear. So - how do you get off PPIs safely? That is exactly what we're covering today. On today's episode, we're diving into: The #1 thing stopping you from getting off PPIsHow to taper off PPIs without painStories of clients who've ended 20+ and even 40+ years of acid reflux with this approach If you're ready to finally end your reflux for good - this episode is for you. TIMESTAMPS:00:00 - Introduction: Safely Getting Off PPIs 01:14 - Welcome to the Better Belly Podcast 02:24 - Understanding the Fear of Stopping PPIs 05:28 - Steps to Safely Taper Off PPIs 06:53 - The Better Belly Blueprint Program 10:01 - Monitoring Symptoms and Adjusting PPIs 17:37 - Client Success Stories 19:03 - Conclusion and Next Steps EPISODES MENTIONED:285// Two Steps to Reversing Your Acid Reflux (for good!)Acid reflux testimonials:Andrea - 200// How to End 20+ Years of Constipation and Acid Reflux in 3 MonthsDon - 242// How He Ended 40+ Years of Diarrhea, Bloating, and Acid Reflux (Don's Testimonial)Jamie - 249// She Beat Her Bloat, Constipation, and Acid Reflux in One Month HEAL YOUR GUT TODAY!Option #1)

Have you ever wondered how to get OFF your PPI safely - without hurting your body in the process? This is one of the most common questions I get from my clients who are struggling with acid reflux. And I get it. I've worked with clients on 1 PPI a day… 2 PPIs a day… even 3 PPIs a day PLUS tums and antacids stacked on top. I've worked with a client told by doctors at the University of Michigan that there was nothing left they could do for her. And I've gotten clients like her all the way down to ZERO PPIs. Here's the thing: if you're on a PPI, your acid reflux is probably pretty severe. Stopping cold turkey can leave you in pain, afraid to eat, and stuck in fear. So - how do you get off PPIs safely? That is exactly what we're covering today. On today's episode, we're diving into: The #1 thing stopping you from getting off PPIsHow to taper off PPIs without painStories of clients who've ended 20+ and even 40+ years of acid reflux with this approach If you're ready to finally end your reflux for good - this episode is for you. TIMESTAMPS:00:00 - Introduction: Safely Getting Off PPIs 01:14 - Welcome to the Better Belly Podcast 02:24 - Understanding the Fear of Stopping PPIs 05:28 - Steps to Safely Taper Off PPIs 06:53 - The Better Belly Blueprint Program 10:01 - Monitoring Symptoms and Adjusting PPIs 17:37 - Client Success Stories 19:03 - Conclusion and Next Steps EPISODES MENTIONED:285// Two Steps to Reversing Your Acid Reflux (for good!)Acid reflux testimonials:Andrea - 200// How to End 20+ Years of Constipation and Acid Reflux in 3 MonthsDon - 242// How He Ended 40+ Years of Diarrhea, Bloating, and Acid Reflux (Don's Testimonial)Jamie - 249// She Beat Her Bloat, Constipation, and Acid Reflux in One Month HEAL YOUR GUT TODAY!Option #1)

In this conversation, The doctors discusses the implications of long-term use of Proton Pump Inhibitors (PPIs), their efficacy, risks, and the importance of tapering off these medications. The discussion covers the physiological effects of PPIs, the necessity of addressing underlying causes of reflux, and the potential for natural and herbal alternatives to support patients in tapering off PPIs. The conversation emphasizes the importance of patient education and the need for a gradual approach to discontinuing PPIs to avoid rebound symptoms.TakeawaysPPIs are effective for short-term use but not for long-term.Tapering off PPIs should take three to six months.Natural alternatives can help manage reflux symptoms.Melatonin can improve lower esophageal sphincter function.Nutrient deficiencies are a risk with long-term PPI use.DGL has been shown to improve quality of life in patients.Patient education is crucial in managing PPI use.Underlying causes of reflux should be addressed.Herbal remedies can provide additional support during tapering.A gradual tapering process is essential to avoid rebound symptoms.

Are you tired of chasing your acid reflux symptoms with PPI's, annoying food restrictions like the GERD diet, or hyper-vigilance about when and how much food you eat? When you ask your doctor if there's ANYTHING else you can do to help your acid reflux, do they tell you that you just need to pop another antacid, avoid trigger foods, or sleep on a wedge pillow? Do you wish there was a solution to acid reflux that was permanent, so you could eat late at night without worrying about a reflux flare, or that you could eat your favorite foods again without feeling punished for it later? If you said yes to any of these questions, then this episode is for you. On today's episode, my goal is to lay out acid reflux in one MASTER episode so that, by the end of it, you can have a map for exactly how to find, and deal with, the root cause(s) of your acid reflux. In this episode, I'm talking about: The real causes of acid reflux and GERD symptoms (and why it's not “too much acid”)The difference between acid reflux, GERD, LPR, and silent reflux — and why this episode can help ALL of these diagnosesWhy standard acid reflux drugs (PPIs, acid reducers) give quick relief but cause long-term problemsHow the acid reflux diet and GERD diet miss the root causeAnd, most importantly, 2 steps to reversing your acid reflux (for good!) If you're tired of relying on medication to manage your acid reflux and want freedom from your stomach terror - then this episode is for you. TIMESTAMPS:00:00 - Introduction to Acid Reflux Struggles 00:56 - Understanding Acid Reflux and GERD 01:44 - Welcome to the Better Belly Podcast 04:27 - The Anatomy and Symptoms of Acid Reflux 08:16 - Diagnosing Acid Reflux 10:24 - Causes of Acid Reflux 13:00 - Pressure Systems and Acid Reflux 25:49 - Conventional Treatments for Acid Reflux 28:25 - The Impact of Low Stomach Acid on Nutrient Absorption 29:32 - The Vicious Cycle of PPIs and Acid Reflux 31:29 - Steps to Reverse Acid Reflux 33:37 - Identifying Pathogens and Their Effects 40:09 - The Role of Histamine in Acid Reflux 40:49 - Fascial Restrictions and Their Impact 44:53 - Testing for Low Stomach Acid 48:05 - Comprehensive Testing and Treatment Plan 51:22 - Client Success Stories and Testimonials 53:08 - Conclusion and Next Steps EPISODES MENTIONED:47// The Gut-Sinus Connection233// H. Pylori: Symptoms of H. Pylori, How to Interpret H. Pylori Test Results, and Why H. Pylori Treatments Fail40// Reduce Acid Reflux with the Magic Power of Zinc68// 10 Markers on Your Bloodwork Linked to Acid Reflux

Are you tired of chasing your acid reflux symptoms with PPI's, annoying food restrictions like the GERD diet, or hyper-vigilance about when and how much food you eat? When you ask your doctor if there's ANYTHING else you can do to help your acid reflux, do they tell you that you just need to pop another antacid, avoid trigger foods, or sleep on a wedge pillow? Do you wish there was a solution to acid reflux that was permanent, so you could eat late at night without worrying about a reflux flare, or that you could eat your favorite foods again without feeling punished for it later? If you said yes to any of these questions, then this episode is for you. On today's episode, my goal is to lay out acid reflux in one MASTER episode so that, by the end of it, you can have a map for exactly how to find, and deal with, the root cause(s) of your acid reflux. In this episode, I'm talking about: The real causes of acid reflux and GERD symptoms (and why it's not “too much acid”)The difference between acid reflux, GERD, LPR, and silent reflux — and why this episode can help ALL of these diagnosesWhy standard acid reflux drugs (PPIs, acid reducers) give quick relief but cause long-term problemsHow the acid reflux diet and GERD diet miss the root causeAnd, most importantly, 2 steps to reversing your acid reflux (for good!) If you're tired of relying on medication to manage your acid reflux and want freedom from your stomach terror - then this episode is for you. TIMESTAMPS:00:00 - Introduction to Acid Reflux Struggles 00:56 - Understanding Acid Reflux and GERD 01:44 - Welcome to the Better Belly Podcast 04:27 - The Anatomy and Symptoms of Acid Reflux 08:16 - Diagnosing Acid Reflux 10:24 - Causes of Acid Reflux 13:00 - Pressure Systems and Acid Reflux 25:49 - Conventional Treatments for Acid Reflux 28:25 - The Impact of Low Stomach Acid on Nutrient Absorption 29:32 - The Vicious Cycle of PPIs and Acid Reflux 31:29 - Steps to Reverse Acid Reflux 33:37 - Identifying Pathogens and Their Effects 40:09 - The Role of Histamine in Acid Reflux 40:49 - Fascial Restrictions and Their Impact 44:53 - Testing for Low Stomach Acid 48:05 - Comprehensive Testing and Treatment Plan 51:22 - Client Success Stories and Testimonials 53:08 - Conclusion and Next Steps EPISODES MENTIONED:47// The Gut-Sinus Connection233// H. Pylori: Symptoms of H. Pylori, How to Interpret H. Pylori Test Results, and Why H. Pylori Treatments Fail40// Reduce Acid Reflux with the Magic Power of Zinc68// 10 Markers on Your Bloodwork Linked to Acid Reflux

Will and Derek just got back from rallying through the Blue Ridge and Smoky Mountains before spending the weekend at Luftgekühlt 11 in Durham, North Carolina. From secret back-road routes around Blowing Rock to running laps at Bristol Motor Speedway, it was two days of incredible driving followed by the most artfully curated Porsche event on the planet — courtesy of Patrick Long and Jeff Zwart at the historic Lucky Strike factory.In the intro, Derek gives a full recap of the week: Then we roll into one of our favorite classic episodes — “The Big Lie: Making Money on Every Porsche.” We dig deep into:The myth of always profiting on Porsche ownershipThe hidden costs (taxes, insurance, PPIs, must-dos vs. nice-to-dos)Why ceramic and PPF are often sunk costsThe ethics of selling and what it means to be a good stewardWhy breaking even might actually mean you're winningSo grab your coffee, settle in, and enjoy a mix of mountain-road storytelling and Porsche ownership truth-talk.Related videos: • Will's new 993 video → @Rennthusiast • Derek's Luft Shorts + Boxster first drive → @ElevenAfterNine #Porsche #Porsche911 #Luftgekühlt #PorscheLife #CarPodcast #RennthusiastRadio #PorscheOwnership #PorscheCulture #CarTalk #BlueRidgeParkway #PorscheCommunity #AirCooledPorsche #WaterCooledPorsche Hosted on Acast. See acast.com/privacy for more information.

Molecular-medicine expert Dr. Nathan Bryan explains how nitric oxide (NO) protects the endothelium, drives vasodilation, and influences energy, immunity, hormones, and longevity. He links stubborn hypertension and poor exercise tolerance to the microbiome–NO axis and outlines common NO killers—antiseptic mouthwashes and fluoride overuse, chronic PPIs, ultra-processed diets, and inactivity. We cover practical restores (movement, nutrient-dense food, targeted micronutrients, careful PPI weaning, ditching antiseptic rinses) and preview clinical work on NO-releasing lozenges for ischemic heart disease, approaches to improve cerebral blood flow and insulin signaling in cognitive decline, and topical NO for chronic wounds. Bryan also touches on food quality (glyphosate, soil health), hormone synergy with NO, and NO-based skincare that supports perfusion and collagen. Bottom line: rebuild NO, and the body's own repair systems can finally do their job.(Educational only; not personal medical advice.)Guest BioNathan S. Bryan, PhD is a molecular medicine researcher and leading authority on nitric oxide (NO) biochemistry. Over two decades, he has mapped how the body generates and uses NO—and what happens when it doesn't—publishing widely, authoring multiple books, and translating discoveries into products and late-stage drug trials. His work spans cardiovascular health, metabolism, neurocognition, wound healing, and skin biology, with a focus on restoring NO as a foundation for repair. Dr. Bryan speaks globally on NO and leads development of NO-based therapeutics targeting ischemic heart disease, Alzheimer's disease, and non-healing ulcers. GET SOCIAL WITH US!

Emma – Schlaf, auf den Du zählen kannst: https://shorturl.at/2sGJo SATTESACHE | 5% on Top auf alles in der gesamten DACH-Region. Du bist ständig heiser, räusperst dich dauernd oder hast einen Kloß im Hals – aber niemand findet eine Ursache? Dann solltest du diese Episode nicht verpassen. Denn genau das kann auf stillen Reflux (LPR) hinweisen – eine Form von Reflux, die ganz ohne Sodbrennen verläuft und trotzdem weitreichende Beschwerden verursacht.

Protein Myths Debunked: What Really Damages Your Kidneys | Podcast #463

In this episode, I sat down with Lucas Aoun, Australia's leading expert in biohacking, nootropics, and human optimisation. Known online for his deep dives into energy, hormones, and supplements, Lucas has built a powerful personal brand helping thousands of people around the world take back control of their health.With nearly 100,000 followers on Instagram, a booming supplement funnel, and years of experience researching the science behind performance, he's become the go-to voice for people who want more energy, better sleep, sharper focus, and stronger results - both in business and in life.After years of trial and error, he stopped relying on traditional medicine, turned his back on caffeine, and began building the ultimate entrepreneur's supplement stack. What started as a way to heal himself soon became a growing business — one that now helps people optimise their health, think clearer, and perform better than ever.Get ready to rethink your health, your habits, and what's actually possible.In this episode:How Lucas hit rock bottom with gut issues and energy crashes — and the radical steps he took to rebuild his health from scratch.Quitting caffeine cold turkey after years of addiction and the surprising way it changed his brain, focus and mood.The real reason you wake up tired and crash at 3PM, and the daily habits Lucas changed to feel superhuman without stimulants.Why most supplement stacks don't work (and how Lucas built a custom stack that actually delivers results).The shocking truth about PPIs, antacids and how they destroy your gut health — even when doctors say they're safe.Lucas's $97 supplement funnel and how he built a scalable health business using personalisation.How he bounced back from being shadowbanned for years during COVID and rebuilt his online brand from scratch.What testosterone, DHT and hair loss actually mean for your energy, confidence and drive (and what you can do about it).—Get Shopify for $1

Buying a Porsche is the fun part—selling it? Not so much. In this episode of Rennthusiast Radio, Derek and Will break down the right way to sell your Porsche without wasting time, money, or sanity. From prepping your car for sale, to pricing it correctly, to knowing whether PCA classifieds, Rennlist, Bring a Trailer, or Cars & Bids is the right platform—we've got you covered.We'll share the mistakes we've seen sellers make (“testing the waters,” anyone?), how to present your Porsche with pro-level photos and videos, and the insider details buyers look for: PPIs, DME reports, binders of receipts, and even paint-meter readings.Whether you're moving on from your first 911 or your tenth Cayenne, this episode is your playbook for selling smarter.Topics Covered:Why “testing the waters” turns buyers offWhere to list: PCA, Rennlist, BaT, Cars & Bids, Facebook MarketplacePricing strategies that actually workPhotos, videos, and presentation tips that sell carsReceipts, PPIs, and Porsche “nerd catnip” buyers loveWhen to pull the trigger and get the deal doneSubscribe to Rennthusiast Radio and ElevenAfterNine for real Porsche ownership talk, no fluff. #Porsche #RennthusiastRadio #Porsche911 #PorscheBoxster #PorscheCayman #PorscheLife #PorscheForSale #BringATrailer #CarsAndBids #Rennlist #PorscheCommunity Hosted on Acast. See acast.com/privacy for more information.

Omar The Pharmacist and Earl Ingram dive into the surprising risks of long-term medication use. They reveal how common drugs can deplete essential nutrients, leading to fatigue, muscle pain, and cognitive fog. Rph Omar highlights the importance of supplements, like magnesium with PPIs and CoQ10 with statins, to counteract these effects. They stress the necessity of building a relationship with a knowledgeable pharmacist, especially as insurance and big pharmacy chains often overlook patient education. As health costs rise, investing in quality supplements becomes crucial for maintaining vitality and combating the systemic challenges of modern healthcare.This conversation is all about empowering listeners with real tools to take charge of their health — physically, mentally, and emotionally. Stay tuned for more insightful health segments with Omar The Pharmacist on What's Goin' On with Earl Ingram

Ever wondered how a single molecule can regulate blood flow, support neurotransmission, and boost immune defense? Dr. Bryan unravels these mysteries and cuts through the confusion with nitrous oxide, sharing invaluable insights from his collaborations with Nobel Prize winners. Join us as we explore why nitric oxide is pivotal to our health and longevity, and why it deserves more attention in medical circles.We also probe into the darker side of proton pump inhibitors (PPIs) and their detrimental effects on nitric oxide production. Through Dr. Bryan's expert lens, we examine the serious health risks tied to long-term PPI use, such as heart disease and cognitive decline, and highlight the hidden dangers of fructose metabolism in suppressing nitric oxide synthase. Our discussion underscores the importance of understanding these complex interactions and the need for increased awareness among both medical professionals and patients.Not stopping there, we venture into the fascinating interplay between erectile dysfunction drugs and nitric oxide. Dr. Bryan explains how maintaining optimal nitric oxide levels can enhance the effectiveness of medications like Viagra and Cialis, with potential benefits for overall vascular health and longevity. We wrap up with practical advice for boosting nitric oxide naturally, including simple lifestyle changes and mindfulness around oral health products. Don't miss out on this opportunity to enrich your understanding and take proactive steps toward better health!https://n1o1.comLies I Taught In Medical School : Free sample chapter- https://www.robertlufkinmd.com/lies/Complete Metabolic Heart Scan (LUFKIN20 for 20% off) https://www.innerscopic.com/Fasting Mimicking Diet (20% off) https://prolonlife.com/Lufkin At home blood testing (20% off) https://siphoxhealth.com/lufkinMimio Health (LUFKIN for 15% off) https://mimiohealth.sjv.io/c/5810114/2745519/30611 Web: https://robertlufkinmd.com/X: https://x.com/robertlufkinmdYoutube: https://www.youtube.com/robertLufkinmdInstagram: https://www.instagram.com/robertlufkinmd/LinkedIn: https://www.linkedin.com/in/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinThreads: https://www.threads.net/@robertlufkinmdFacebook: ...

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net. Today on the emDOCs cast with Brit Long, MD (@long_brit), we're back with Part 2 on upper GI bleeding.  Today we cover endoscopy, other interventions for bleeding cessation, intubation, and risk scores.  Please see Part 1 for some background, NG tube lavage, blood product transfusion, proton pump inhibitors (PPIs), prokinetic agents, somatostatin analogues, and antibiotics. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play 

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long, MD (@long_brit), we cover part 1 on upper GI bleeding, specifically some background, NG tube lavage, blood product transfusion, proton pump inhibitors (PPIs), prokinetic agents, somatostatin analogues, and antibiotics. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Sarah: Hello! Back with another question.. Im 28 female from scotland, and have had hair growing in places I shouldn't since age 24. The hair under my chin and a bit on my neck/cheeks is what gets me down the most. My doctor has checked me for PCOS through bloodwork and said everything was fine. I've recently did your hormone test. Testosterone was great, estrogen good, progesterone was low and cortisol was low. I've been on progesterone support, adrenal energy aswell as DNS, greens, omegas etc for some time now. I also take pumpkin seed oil and saw palmetto. The hair just keeps growing. What else can I do? I've tried countless rounds of laser but it just returns. Is hair in this area always related to PCOS/hormones? Can it just be genetics? Thank you!!                                                            Larissa: Hello! I was exposed to black mold for 6 yrs about 5yrs ago. Although my most severe symptoms went away, some longer. I've been working with a naturopath whom recommended a protocol with cholestyramine, charcoal, and minerals for about 1M. However, I've read Andrew Campbell mold protocol and he recommends itraconazole for 7 days. I did my urine mycotoxin testing FYI which still shows a high load of most all strains. Which do you recommend? I want to get rid of all the mold with the least side effects and avoiding constipation (I already have to take daily magnesium citrate to have daily bowel movements). Thank you!!!                                                                                                          Sabrina: Hi doctor Cabral. I'm hoping you can help me with something that is super frustrating. My stomach craves large meals for satisfaction, yet they cause bloating. Conversely, small-volume meals, despite being calorie-dense, just don't register as filling, leaving me wanting more. Is there a way to solve this, meaning training your stomach to be satisfied with smaller meals? Thanks so much for your help!                     Lisa: I am a 48yr old female and have elevated kidney function. 1.1.  have been told not to take creatine. I have heard multiple times that to much protein can have an effect on kidney function also. I love to workout and fir my age high protein and creatine is suppose to be good for someone who works out. Will these things truly hinder or further hinder my kidney function.                                                                                   Cassi: Just completed your book, The Rain Barrel Effect, and was wondering if you have worked with anyone with EOE (Eosinophilic esophagitis) to successfully get them off of PPIs? I've also dealt with histamine intolerance, that I've actually been able to reverse through a lot of what you teach in the book, and I have also gotten down from 20mg of omeprazole twice a day to 20mg once every other day but if I go longer than that I find myself choking on food again no matter how little I eat at a time or how well I chew it.      Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3487 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

In this episode, Dr. David Jockers dives into the dangers of proton pump inhibitors (PPIs), one of the most commonly prescribed medications worldwide. You'll learn why PPIs, though effective for acid reflux, can lead to serious health issues like heart disease, cancer, and nutrient deficiencies. Dr. Jockers explains how these medications only mask symptoms without addressing the root cause.   Discover how low stomach acid, not high acid, is often behind acid reflux and how PPIs can worsen digestion and overall health. Dr. Jockers shares practical strategies to naturally manage acid reflux, focusing on lifestyle and dietary changes rather than relying on medication.   Find out how long-term use of PPIs can increase your risk of early death, as well as the alternative solutions that actually promote better digestion and overall health. Tune in to understand why healing your gut should be the priority over simply masking symptoms.     In This Episode:  00:00 Introduction to Proton Pump Inhibitors (PPIs) 00:17 The Dangers of Blood Sugar Imbalances 02:27 Podcast Introduction and Overview 04:24 The Most Dangerous Medication: PPIs 05:16 How PPIs Affect Your Body 14:21 Natural Remedies and Lifestyle Changes 17:06 Conclusion and Final Thoughts   If you're dealing with blood sugar swings, stubborn fat, or constant cravings, Berberine Breakthrough by BiOptimizers could be the game-changer your body needs. This advanced formula goes beyond standard berberine by combining it with 12 synergistic ingredients like alpha-lipoic acid, chromium, and cinnamon to supercharge your metabolism, stabilize insulin levels, and fuel mitochondrial health. Users report better energy, fewer cravings, and noticeable fat loss — all backed by science. Plus, it comes with a 365-day money-back guarantee, so there's zero risk. Use code JOCKERS at bioptimizers.com/jockers to save 10% and start transforming your health today.     “PPIs don't fix acid reflux—they silence the symptoms while the damage continues.”  ~ Dr. Jockers     Subscribe to the podcast on: Apple Podcast Stitcher Spotify PodBean TuneIn Radio     Resources: Use code JOCKERS at bioptimizers.com/jockers to save 10%     Connect with Dr. Jockers: Instagram – https://www.instagram.com/drjockers/ Facebook – https://www.facebook.com/DrDavidJockers YouTube – https://www.youtube.com/user/djockers Website – https://drjockers.com/ If you are interested in being a guest on the show, we would love to hear from you! Please contact us here! - https://drjockers.com/join-us-dr-jockers-functional-nutrition-podcast/ 

If you care about longevity, brain optimization, sexual performance, or metabolism, this molecule changes everything. Host Dave Asprey sits down with nitric oxide pioneer Dr. Nathan Bryan to reveal why this overlooked molecule controls your blood flow, mitochondrial energy, neuroplasticity, insulin response, and even your libido. You'll learn how nitric oxide acts as a master switch for human performance and why the medical system has ignored it for decades. Watch this episode on YouTube for the full video experience: https://www.youtube.com/@DaveAspreyBPR Dr. Nathan Bryan is a world-renowned expert in nitric oxide biochemistry with over 20 years of clinical research, multiple patents, and collaborations with Nobel Prize-winning scientists. His groundbreaking work forms the foundation for modern functional medicine protocols targeting blood flow, metabolism, cognitive enhancement, and mitochondrial upgrades. You'll learn: • How nitric oxide drives mitochondria, metabolism, and human performance • Why most nitric oxide supplements fail and how to spot real ones • The critical role nitric oxide plays in brain optimization, libido, and insulin signaling • How poor oral health, statins, and PPIs can kill nitric oxide production • What nitric oxide has to do with sleep optimization, aging, and disease prevention • How to stack nitric oxide with fasting, ketosis, nootropics, red light, and supplements • Why “Smarter Not Harder” starts with nitric oxide fueled upgrades This episode is essential listening for anyone into biohacking, cold therapy, functional medicine, or RFK-style medical freedom. You'll walk away with practical tools to boost nitric oxide naturally, prevent dysfunction, and optimize your biology whether you're on a carnivore diet or just looking for an edge. Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade is the top podcast for people who want to take control of their biology, extend their longevity, and optimize every system in the body and mind. Each episode features cutting-edge insights in health, performance, neuroscience, supplements, nutrition, hacking, emotional intelligence, and conscious living. Episodes are released every Tuesday and Thursday, where Dave asks the questions no one else dares, and brings you real tools to become more resilient, aware, and high performing. Get Nitric Oxide products for 10% off with code ‘Dave': https://bit.ly/Nitric-Oxide-Product SPONSORS: Leela Quantum Tech | Head to https://leelaq.com/DAVE for 10% off. Timeline | Head to https://www.timeline.com/dave to get 10% off your first order. Resources: • Nathan's Website: https://www.n1o1.com • Nathan's YouTube: https://www.youtube.com/channel/UCtftGy8e0r9DO8ActcyGi4w • Dave Asprey's Website: https://daveasprey.com • Danger Coffee: https://dangercoffee.com/DAVE15 • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Upgrade Collective: https://www.ourupgradecollective.com • Upgrade Labs: https://upgradelabs.com • 40 Years of Zen: https://40yearsofzen.com Timestamps: • 00:00 Trailer • 01:03 Intro • 01:15 Why Medicine Ignores Nitric Oxide • 01:59 What Nitric Oxide Does in the Body • 04:46 How the Body Makes Nitric Oxide • 07:12 Diet's Impact on NO Levels • 13:28 Why Most NO Supplements Fail • 19:32 Personalized Biohacking with NO • 22:33 How Medicine Misses the Mark • 30:40 Oral Health and Nitric Oxide • 31:30 Mouthwash Kills Your Microbiome • 32:28 The Problem with Fluoride • 33:25 Better Toothpaste for NO • 33:49 NO's Role in Energy and Healing • 34:17 Blood Pressure and NO • 35:29 NO and Sexual Performance • 37:09 NO and COVID Recovery • 40:50 Brain Fog and NO Deficiency • 49:01 Carnivore, Sugar, and NO • 50:11 Why You Still Need NO Supplements • 54:19 Final Takeaways See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

fWotD Episode 2991: Heartburn Welcome to featured Wiki of the Day, your daily dose of knowledge from Wikipedia's finest articles.The featured article for Sunday, 13 July 2025, is Heartburn.Heartburn is a burning sensation felt behind the breastbone. It is a symptom that is commonly linked to acid reflux and is often triggered by food, particularly fatty, sugary, spicy, chocolate, citrus, onion-based and tomato-based products. Lying down, bending, lifting, and performing certain exercises can exacerbate heartburn. Causes include acid reflux, gastroesophageal reflux disease (GERD), damage to the esophageal lining, bile acid, mechanical stimulation to the esophagus, and esophageal hypersensitivity. Heartburn affects 25% of the population at least once a month.Endoscopy and esophageal pH monitoring can be used to evaluate heartburn. Some causes of heartburn, such as GERD, may be diagnosed based on symptoms alone. Potential differential diagnoses for heartburn include motility disorders, ulcers, inflammation of the esophagus, and medication side effects. Lifestyle changes, such as losing weight and avoiding fatty foods, can improve heartburn. Over-the-counter alginates or antacids can help with mild or occasional heartburn. Heartburn treatment primarily involves antisecretory medications like H2 receptor antagonists (H2RAs) and proton-pump inhibitors (PPIs).This recording reflects the Wikipedia text as of 00:30 UTC on Sunday, 13 July 2025.For the full current version of the article, see Heartburn on Wikipedia.This podcast uses content from Wikipedia under the Creative Commons Attribution-ShareAlike License.Visit our archives at wikioftheday.com and subscribe to stay updated on new episodes.Follow us on Mastodon at @wikioftheday@masto.ai.Also check out Curmudgeon's Corner, a current events podcast.Until next time, I'm neural Ayanda.

Story at-a-glance PPI heartburn drugs have been linked to a 16% higher risk of heart attacks and double the risk of dying from cardiovascular events, even in people with no history of heart disease Contrary to common belief, most reflux is caused by too little stomach acid, not too much, and PPIs worsen this problem by further suppressing acid production Long-term PPI use damages kidneys, weakens bones, impairs nutrient absorption and increases infection risk, as stomach acid is essential for pathogen defense If you're using PPIs, taper off slowly and switch to famotidine (Pepcid), a safer option that not only avoids heart risks but also helps block excess serotonin that disrupts energy and drives inflammation Full recovery of stomach acid production and digestive function after long-term PPI use takes several months up to two years, requiring targeted nutritional support

Did you know that low stomach acid could be silently harming your bones? In this episode, I'm joined by Andrea Nakayama, a functional medicine nutritionist, who dives deep into the surprising connection between stomach acid and osteoporosis. We discuss why so many people with osteoporosis have low stomach acid and don't even know it, and how proton pump inhibitors (PPIs), commonly used to treat heartburn, may be making the problem worse. Andrea explains how stomach acid plays a vital role in absorbing key nutrients essential for bone health, such as calcium, magnesium, and vitamin B12, and how a lack of stomach acid can prevent the body from fully utilizing these nutrients. She also shares practical tips on how to increase stomach acid naturally and how to address heartburn without relying on harmful medications. If you're struggling with bone health or heartburn, this episode offers valuable insights into supporting your digestion and bone strength. “I always wanna remind people: Do what you can do to support your body, really take care of yourself first, and then raise your hand when you need extra help, when you can't figure it out." ~ Andrea Nakayama, FNLP MSN CNC CNE CHHC   In this episode: - [02:23] - The reason we're discussing stomach acid  - [06:12] - Low stomach acid and osteoporosis connection - [08:18] - Why it's important to have enough stomach acid - [15:44] - Heartburn: a symptom of too little stomach acid - [18:50] - Essential nutrients that impact stomach acid levels - [25:26] - PPIs: How they reduce stomach acid and increase bone loss - [27:40] - Tips for tracking issues and lifestyle strategies to aid digestion - [36:00] - Long-term effects of low stomach acid on health   Resources mentioned - Andrea's contact information - https://www.andreanakayama.com/ and https://www.fxnutrition.com/ - Osteoporosis Exercises Handout - tinyurl.com/osteoporosisexercises   More about Margie - Website - https://margiebissinger.com/  - Facebook - https://www.facebook.com/p/Margie-Bissinger-MS-PT-CHC-100063542905332/  - Instagram - https://www.instagram.com/margiebissinger/?hl=en    DISCLAIMER – The information presented on this podcast should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider. The ideas shared on this podcast are the expressed opinions of the guests and do not always reflect those of Margie Bissinger and Happy Bones, Happy Life Podcast.   *In compliance with the FTC guidelines, please assume the following about links on this site: Some of the links going to products are affiliate links of which I receive a small commission from sales of certain items, but the price is the same for you (sometimes, I even get to share a unique discount with you). If I post an affiliate link to a product, it is something that I personally use, support, and would recommend. I personally vet each and every product. My first priority is providing valuable information and resources to help you create positive changes in your health and bring more happiness into your life. I will only ever link to products or resources (affiliate or otherwise) that fit within this purpose.

Herzlich Willkommen zur 139. Ausgabe des BiketourGlobal Podcast Season 2!Das Taunus Bikepacking Event gilt seit Jahren als Geheimtipp, auch und vor allem wegen der Community und der immer wieder großartigen Strecke. Ich spreche mit Marina und Lukas über ihre Fahrt durch den Taunus und was sie daran so begeistert hat. Viel Spaß!ShownotesMarina auf Instagram https://www.instagram.com/runningmarina/Lukas auf Instagram https://www.instagram.com/bikepacking_luke/Taunus Bikepacking auf Instagram https://www.instagram.com/taunusbikepacking/Quelle MusikTropic Fuse - French Fuse aus dem YT Creator StudioQuelle Bilder Marina & Lukas

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 Anna Henderson, MD, a pediatric gastroenterologist at Northern Light Health in Maine, about bone mineral density in EoE patients. They discuss a paper she co-authored on the subject. 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: [:50] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, eosinophilic esophagitis (EoE), and bone density.   [1:22] Holly introduces today's guest, Dr. Anna Henderson, a pediatric gastroenterologist at Northern Light Health in Maine.   [1:29] During her pediatric and pediatric gastroenterology training at Cincinnati Children's Hospital, she took a special interest in eosinophilic esophagitis. In 2019, Dr. Henderson received APFED's NASPGHAN Outstanding EGID Abstract Award.   [1:45] Holly, a feeding therapist in Maine, has referred many patients to Dr. Henderson and is excited to have her on the show.   [2:29] Dr. Henderson is a wife and mother. She loves to swim and loves the outdoors. She practices general pediatric GI in Bangor, Maine, at a community-based academic center.   [2:52] Her patient population is the northern two-thirds of Maine. Dr. Henderson feels it is rewarding to bring her expertise from Cincinnati to a community that may not otherwise have access to specialized care.   [3:13] Dr. Henderson's interest in EoE grew as a GI fellow at Cincinnati Children's. Her research focused on biomarkers for disease response to dietary therapies and EoE's relationship to bone health.   [3:36] As a fellow, Dr. Henderson rotated through different specialized clinics. She saw there were many unanswered questions about the disease process, areas to improve treatment options, and quality of life for the patients suffering from these diseases.   [4:00] Dr. Henderson saw many patients going through endoscopies. She saw the social barriers for patients following strict diets. She saw a huge need in EoE and jumped on it.   [4:20] Ryan grew up with EoE. He remembers the struggles of constant scopes, different treatment options, and dietary therapy. Many people struggled to find what was best for them before there was a good approved treatment.   [4:38] As part of Ryan's journey, he learned he has osteoporosis. He was diagnosed at age 18 or 19. His DEXA scan had such a low Z-score that they thought the machine was broken. He was retested.   [5:12] Dr. Henderson explains that bone mineral density is a key measure of bone health and strength. Denser bones contain more minerals and are stronger. A low bone mineral density means weaker bones. Weaker bones increase the risk of fracture.   [5:36] DEXA scan stands for Dual Energy X-ray Absorptiometry scan. It's a type of X-ray that takes 10 to 30 minutes. A machine scans over their bones. Typically, we're most interested in the lumbar spine and hip bones.   [5:56] The results are standardized to the patient's height and weight, with 0 being the average. A negative number means weaker bones than average for that patient's height and weight. Anything positive means stronger bones for that patient's height and weight.   [6:34] A lot of things can affect a patient's bone mineral density: genetics, dietary history, calcium and Vitamin D intake, and medications, including steroid use. Prednisone is a big risk factor for bone disease.   [7:07] Other risk factors are medical and auto-immune conditions, like celiac disease, and age. Any patient will have their highest bone density in their 20s to 30s. Females typically have lower bone mineral density than males.   [7:26] The last factor is lifestyle. Patients who are more active and do weight-bearing exercises will have higher bone mineral density than patients who have more of a sedentary lifestyle.   [7:56] Ryan was told his bone mineral density issues were probably a side-effect of the long-term steroids he was on for his EoE. Ryan is now on benralizumab for eosinophilic asthma. He is off steroids.   [8:36] Dr. Henderson says the research is needed to find causes of bone mineral density loss besides glucocorticoids.   [8:45] EoE patients are on swallowed steroids, fluticasone, budesonide, etc. Other patients are on steroids for asthma, eczema, and allergic rhinitis. These may be intranasal steroids or topical steroids.   [9:01] Dr. Henderson says we wondered whether or not all of those steroids and those combined risks put the EoE population at risk for low bone mineral density. There's not a lot published in that area.   [9:14] We know that proton pump inhibitors can increase the risk of low bone mineral density. A lot of EoE patients are on proton pump inhibitors.   [9:23] That was where Dr. Henderson's interest started. She didn't have a great way to screen for bone mineral density issues or even know if it was a problem in her patients more than was expected in a typical patient population.   [9:57] Holly wasn't diagnosed with EoE until she was in her late 20s. She was undiagnosed but was given prednisone for her problems. Now she wonders if she should get a DEXA scan.   [10:15] Holly hopes the listeners will learn something and advocate for themselves or for their children.   [10:52] If a patient is concerned about their bone mineral density, talking to your PCP is a perfect place to start. They can discuss the risk factors and order a DEXA scan and interpret it, if needed.   [11:11] If osteoporosis is diagnosed, you should see an endocrinologist, specifically to discuss therapy, including medications called bisphosphonates.   [11:36] From an EoE perspective, patients can talk to their gastroenterologist about what bone mineral density risk factors may be and if multiple risk factors exist. Gastroenterologists are also more than capable of ordering DEXA scans and helping their patients along that journey.   [11:53] A DEXA scan is typically the way to measure bone mineral density. It's low radiation, it's easy, it's fast, and relatively inexpensive.   [12:10] It's also useful in following up over time in response to different interventions, whether or not that's stopping medications or starting medications.   [12:30] Dr. Henderson co-authored a paper in the Journal of Pediatric Gastroenterology and Nutrition, called “Prevalence and Predictors of Compromised Bone Mineral Density in Pediatric Eosinophilic Esophagitis.” The study looked at potential variables.   [12:59] The researchers were looking at chronic systemic steroid use. They thought it was an issue in their patients, especially patients with multiple atopic diseases like asthma, eczema, and allergic rhinitis. That's where the study started.   [13:22] Over the years, proton pump inhibitors have become more ubiquitous, and more research has come out. The study tried to find out if this was an issue or not. There weren't any guidelines for following these patients, as it was a retrospective study.    [13:42] At the time, Dr. Henderson was at a large institution with a huge EoE population. She saw that she could do a study and gather a lot of information on a large population of patients. Studies like this are the start of figuring out the guidelines for the future.   [14:34] Dr. Henderson wanted to determine whether pediatric patients with EoE had a lower-than-expected bone mineral density, compared to their peers. [14:44] Then, if there were deficits, she wanted to determine where they were more pronounced. Were they more pronounced in certain subgroups of patients with EoE?   [14:59] Were they patients with an elemental diet? Patients with an elimination diet? Were they patients on steroids or PPIs? Were they patients with multiple atopic diseases? Is low bone mineral density just a manifestation of their disease processes?   [15:14] Do patients with active EoE have a greater propensity to have low bone mineral density? The study was diving into see what the potential risk factors are for this patient population.   [15:45] The study was a retrospective chart review. They looked at patients aged 3 to 21. You can't do a DEXA scan on a younger patient, and 21 is when people leave pediatrics.   [16:03] These were all patients who had the diagnosis of EoE and were seen at Cincinnati Children's in the period between 2014 and 2017. That period enabled full ability for chart review. Then they looked at the patients who had DEXA scans.   [16:20] They did a manual chart review of all of the patients and tried to tease out what the potential exposures were. They looked at demographics, age, sex, the age of the diagnosis of EoE, medications used, such as PPIs, and all different swallowed steroids.   [16:44] They got as complete a dietary history as they could: whether or not patients were on an elemental diet, whether that was a full elemental diet, whether they were on a five-food, six-food, or cow's milk elimination diet.   [16:58] They teased out as much as they could. One of the limitations of a retrospective chart review is that you can't get some of the details, compared to doing a prospective study. For example, they couldn't tease out the dosing or length of therapy, as they would have liked.   [17:19] They classified those exposures as whether or not the patient was ever exposed to those medications, whether or not they were taking them at the time of the DEXA scan, or if they had been exposed within the year before the DEXA scan.   [17:40] They also looked at whether the patients had other comorbid atopic disorders, to see if those played a role, as well.   [18:03] The study found that there was a slightly lower-than-expected bone mineral density in the patients. The score was -0.55, lower than average but not diagnostic of a low bone mineral density, which would be -2 or below.   [18:27] There were 23 patients with low bone mineral density scores of -2 or below. That was 8.6% of the study patients. Typically, only 2.5% of the population would have that score. It was hard to tease out the specific risk factors in a small population of 23.   [18:57] They looked at what the specific risk factors were that were associated with low bone mineral density, or bone mineral density in general.   [19:12] After moving from Colorado, Holly has transferred to a new care team, and doctors wanted her baseline Vitamin D and Calcium levels. No one had ever tested that on her before. Dr. Henderson says it's hard because there's nothing published on what to do.   [19:58] The biggest surprise in the study was that swallowed steroids, or even combined steroid exposure, didn't have any effect on bone mineral density. That was reassuring, in light of what is known about glucocorticoid use.   [20:16] The impact of PPI use was interesting. The study found that any lifetime use of PPIs did seem to decrease bone mineral density. It was difficult to tease out the dosing and the time that a patient was on PPIs.   [20:34] Dr. Henderson thinks that any lifetime use of PPIs is more of a representation of their cumulative use of PPIs. At the time of the study, from 2014 to 2017, PPIs were still very much first-line therapy for EoE; 97% of the study patients had taken PPIs at some time.   [21:02] There are so many more options now for therapy when a patient has a new diagnosis of EoE, especially with dupilumab now being an option.   [21:11] Dr. Henderson speaks of patients who started on PPIs and have stayed on them for years. This study allows her to question whether we need to continue patients on PPIs. When do we discuss weaning patients off PPIs, if appropriate?   [22:05] Ryan says these podcasts are a great opportunity for the community at large and also for the hosts. He just wrote himself a note to ask his endocrinologist about coming off PPIs.   [22:43] Dr. Henderson says that glucocorticoid use is a known risk factor for low bone mineral density and osteoporosis. In the asthma population, inhaled steroids can slightly decrease someone's growth potential while the patient is taking them.   [23:10] From those two facts, it was thought that swallowed steroids would have a similar effect. But since they're swallowed and not systemic, maybe things are different.   [23:23] It was reassuring to Dr. Henderson that what her study found was that the swallowed steroid didn't affect bone mineral density. There was one other study that found that swallowed steroids for EoE did not affect someone's height.   [23:51] Dr. Henderson clarifies that glucocorticoids include systemic steroids like prednisone and hydrocortisone.     [23:57] Based on Dr. Henderson's retrospective study, fluticasone as a swallowed steroid did not affect bone mineral density. It was hard to tease out the dosing, but the cumulative use did not seem to result in a deficit for bone mineral density.   [24:16] Holly shared that when she tells a family of a child she works with that the child's gastroenterologist will likely recommend steroids, she will now give them the two papers Dr. Henderson mentioned. There are different types of steroids. The average person doesn't know the difference.   [25:15] Dr. Henderson thinks that for patients who have multiple risk factors for low bone mineral density, it is reasonable to have a conversation about bone health with their gastroenterologist to see whether or not a DEXA scan would be worth it.   [25:56] If low bone mineral density is found, that needs to be followed up on.   [26:03] There are no great guidelines, but this study is a good start on what these potential risk factors are. We need some more prospective studies to look at these risk factors in more detail than Dr. Henderson's team teased out in this retrospective study.   [26:23] Dr. Henderson tells how important it is for patients to participate in prospective longitudinal studies for developing future guidelines.   [26:34] Holly points out that a lot of patients are on restrictive diets. It's important to think about the whole picture if you are starting a medication or an elimination, or a restricted diet. You have to think about the impact on your body, overall.   [27:11] People don't think of dietary therapy as medication, but it has risks and benefits involved, like a medication.   [27:50] Dr. Henderson says, in general, lifestyle management is the best strategy for managing bone health. Stay as active as you can with weight-bearing exercises and eating a well-balanced diet. If you are on a restrictive diet, make sure it's well-balanced.   [28:12] Dr. Henderson says a lot of our patients have feeding disorders, so they see feeding specialists like Holly. A balanced diet is hard when kids are very selective in their eating habits.   [29:10] Dr. Henderson says calcium and Vitamin D are the first steps in how we treat patients with low bone mineral density. A patient who is struggling with osteoporosis needs to discuss it with their endocrinologist for medications beyond supplementation.   [29:31] Ryan reminds listeners who are patients always to consult with their medical team. Don't go changing anything up just because of what we're talking about here. Ask your care team some good questions.   [29:47] Dr. Henderson would like families to be aware, first, that some patients with EoE will have bone mineral density loss, especially if they are on PPIs and restrictive diets. They should start having those discussions with their providers.   [30:04] Second, Dr. Henderson would like families to be reassured that swallowed steroids and combined steroid exposure didn't have an impact on bone mineral density. Everyone can take that away from today's chat.   [30:18] Lastly, Dr. Henderson gives another plug for patient participation in prospective studies, if they're presented with the opportunity. It's super important to be able to gather more information and make guidelines better for our patients. [30:35] Holly thanks Dr. Henderson for coming on Real Talk — Eosinophilic Diseases and sharing her insights on bone mineral density, and supporting patients in Maine.   [30:57] Dr. Henderson will continue to focus on the clinical side. She loves doing outreach clinics in rural Maine. It's rewarding, getting to meet all of these patients and taking care of patients who would otherwise have to travel hours to see a provider.   [32:01] Ryan thinks the listeners got a lot out of this. For our listeners who would like to learn more about eosinophilic disorders, please visit APFED.org and check out the links in the show notes.   [32:11] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [32:19] 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.   [32:28] Ryan thanks Dr. Henderson for joining us today for this great conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Anna Henderson, MD, a pediatric gastroenterologist at Northern Light Health in Maine Cincinnati Children's “Prevalence and Predictors of Compromised Bone Mineral Density in Pediatric Eosinophilic Esophagitis.” Journal of Pediatric Gastroenterology and Nutrition   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, Sanofi, Regeneron, and Takeda.   Tweetables:   “DEXA scan stands for dual-energy X-ray absorptiometry scan. It's a type of X-ray where a patient lies down for 10 to 30 minutes. A machine scans over their bones. Typically, we're most interested in the lumbar spine and hip bones.” — Anna Henderson, MD   “We wondered whether or not all of those steroids and those combined risks even put our EoE population at risk for low bone mineral density. There's not a lot published in that area.” — Anna Henderson, MD   “If a patient is worried [about their bone mineral density], their PCP is a perfect place to start for that. They're more than capable of discussing the risk factors specific for that patient, ordering a DEXA scan, and interpreting it if need be.” — Anna Henderson, MD   “I think we need some more prospective studies to look at these risk factors in a little bit more detail than we were able to tease out in our retrospective review.” — Anna Henderson, MD   “Just another plug for the participation in prospective studies, if you're presented with the opportunity. It's super important to be able to gather more information and to be able to make guidelines better for our patients about these risks.” — Anna Henderson, MD

What do you get when you mix a surgeon, a scientist, and a self-proclaimed “tinkerer” who also happens to struggle with reflux? You get Dr. James Daniero—and you get this conversation about RefluxRaft. In this episode, Theresa Richard chats with Dr. Daniero, an ENT who's not just treating voice, airway, and swallowing disorders—he's innovating them. From basement experiments to biomaterials backed by NIH grants, Dr. Daniero walks us through how his personal journey with reflux turned into RefluxRaft, a barrier-based solution designed to help patients (and clinicians) think beyond PPIs. We dive into the science behind alginates, the "physics problem" behind reflux, and the collaborative power between ENTs, SLPs, and GIs. This one's for the med SLPs who want to understand the why behind the symptoms—and the potential tools to help. https://RefluxRaft.com Download show notes and references here: https://syppodcast.com/372 The post 372 – What If Reflux Isn't Just an Acid Problem? A New Way to Think About It with RefluxRaft appeared first on Swallow Your Pride Podcast.

Story at-a-glance Pepcid (famotidine) uniquely blocks serotonin activity unlike other H2 blockers, helping interrupt chronic pain, inflammation and fatigue caused by elevated serotonin levels A 70-year-old patient's life-threatening serotonin syndrome was rapidly reversed within 15 minutes using intravenous famotidine, demonstrating its powerful anti-serotonin effects Elevated serotonin impairs mitochondrial energy production and drives chronic inflammation, depression and pain, contrary to the popular "feel-good chemical" misconception Pepcid is safer than recalled Zantac (ranitidine) and more potent than older H2 blockers, with fewer drug interactions and decades of proven safety Unlike proton pump inhibitors (PPIs) with serious long-term risks, Pepcid offers a safer approach by targeting serotonin overload while providing effective heartburn relief

Send us a textGut issues are incredibly common in scleroderma — but they also show up across many autoimmune diseases. In this episode, I'm diving deep into how scleroderma affects the gut, why gut motility and vagal tone matter so much, and what you can actually do to support digestion and resilience — whether or not you have a scleroderma diagnosis.If you're dealing with bloating, reflux, constipation, food sensitivities, SIBO, or nutrient deficiencies — this one is for you.I'll cover:How excess collagen and nervous system changes affect gut functionWhy so many people end up on PPIs — and what to do alongside themHow to safely support motility and nutrient absorptionMy go-to foods and supplements for gut repair and resilienceThe critical role of vagal tone — and simple ways to improve itPractical steps to address stubborn constipationPlus I'll share how I use Nurosym for vagus nerve support (discount code VH5 for 5% off here), and how our Gut Health Testing Package can help you get to the root of your gut symptoms. Learn more here. And don't miss our upcoming live Q&A on Foods to Eat for Autoimmune Disease inside The Autoimmune Forum — happening 18th June. Link in show notes.Your gut can heal — and this episode will give you the tools to start.Thanks for listening! You can join The Autoimmune Forum on Facebook or find me on Instagram @theautoimmunitynutritionist.

In this episode of Renthusiast Radio, Will and Derek crack open the shady side of the Porsche marketplace—the half-truths, strategic omissions, and full-on scams that buyers need to watch out for. From odometer fraud and blurry listing photos to cleverly staged “cold starts” and flippers pretending they're not, they share real experiences and the psychological games sellers play to close the deal.Will reveals what finally pushed him over the edge into doing this episode—hint: it involves a mysteriously “perfect” car that showed up dripping oil. Derek adds tales of deceit, missing paperwork, and how sellers weaponize your excitement against you. But it's not just venting—they'll arm you with the best ways to protect yourself, from smarter PPIs to reading between the lines of sketchy seller stories.If you've ever bought a car remotely, been ghosted after asking tough questions, or heard “I've got a guy flying in tomorrow,” this one's for you.Enjoying the show? Don't forget to:Subscribe to the Renthusiast YouTube channel for Porsche deep dives, ownership stories, and more.Check out Derek's channel ElevenAfterNine for raw sound tests, driving reviews, and real-world Porsche content.Drop your wildest seller horror stories in the YouTube comments—we might read yours in a future episode!And remember: Buy the seller, not just the car. Hosted on Acast. See acast.com/privacy for more information.

Obwohl Pam sich sofort auf den Weg gemacht hat, kommt die Feuerwehrschnecke zu spät zum Brand. Er ist gelöscht. Aber es gibt ein anderes Problem: Püppis Nest! Kann Pam helfen? Aus der OHRENBÄR-Hörgeschichte: Feuerwehrschnecke Pam (Folge 2 von 7) von Ariane Grundies. Es liest: Antje von der Ahe. ▶ Mehr Infos unter https://www.ohrenbaer.de & ohrenbaer@rbb-online.de

In this episode of The Real GI Doc Show, Dr. Fred Gandolfo reviews current concerns surrounding heartburn drugs called proton pump inhibitors (PPIs) and their potential risks with a focus on the risk of dementia. Key discussions include: - An in-depth look at PPIs, including their mechanism of action, common uses, and the historical context of their development. - The array of misconceptions surrounding PPIs, especially concerning their association with serious side effects, including dementia risk. - A breakdown of the scientific method and how to critically evaluate research studies, illustrating the importance of understanding study design and evidence quality. - The definition of pseudoscience and how it contrasts with legitimate scientific inquiry, emphasizing the dangers of starting with conclusions rather than evidence. - The challenges of conducting long-term studies on PPIs and dementia, highlighting the need for rigorous, well-designed research. As the episode wraps up, Dr. Gandolfo emphasizes the importance of discerning credible medical information from pseudoscience and encourages listeners to engage with their healthcare providers about any concerns regarding medications. Stay tuned for part two, where Dr. Gandolfo will delve deeper into the existing studies on PPIs and dementia, providing insights on how to approach treatment decisions. Referenced in this episode: Episode 3: Stomach Acidity Episode 5: Understanding GERD: Diagnosis, Treatment, and Prevention Watch The Real GI Doc Show on YouTube! Click here! Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here. Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Support your health journey with our private practice! Explore comprehensive lab testing, functional assessments, and expert guidance for your wellness journey. Find exclusive offers for podcast listeners at nutritionwithjudy.com/podcast. _____Dr. Neil and I dive into the complexity of the gut microbiome, challenging the notion that a single probiotic strain can fix everything. We explore how diversity—not one 'superbug'—may be the real key to gut health. We also unpack how fecal transplants work, why antibiotics often do more harm than good, and if fermented foods are necessary or ideal.Dr. Neil Stollman is a practicing gastroenterologist based in Oakland, California, and serves as voluntary faculty at UCSF. A pioneer in the field of fecal microbiota transplantation (FMT), he has been involved in gut microbiome research and treatment for over two decades. Known for his work with Clostridium difficile infection (CDI) and broader gut health issues, Dr. Stollman brings a balanced and often humorous perspective to microbiome science.We discuss the following:All about Dr. Neil StollmanThe importance of gut healthAll about AkkermansiaGlyphosate and other antimicrobial foodsFMT (Fecal Microbiota Transplantation)Getting sick from C. diff (Clostridioides difficile)Strengthening the MicrobiomeDo we need FermentsThoughts on giving antibiotics to people with C. diffSymptoms of H. pyloriThoughts on long-term PPI useWhy gut doctors prescribe PPIsThoughts on colon testsWhere to find Dr. Neil Stollman_____EPISODE RESOURCESWebsiteTwitterThe Sonnenburgs Fermented Food StudyOpenBiome (Stool Bank)NwJ Complete Wellness PanelComplete GI Map Stool Test_____WEEKLY NEWSLETTER 

In this episode, I'll cover the root causes of reflux & share the most effective treatments. Tune in! Work with us! https://drruscio.com/virtual-clinic/ Product mentions:  Thiamega https://www.objectivenutrients.com/products/thiamega/ Vagustim https://vagustim.io/   Watch next

Many people are prescribed a PPI without knowing the reasons, or how long long they should be taking it.In this episode, Robin Riddle, FNP-C breaks down the issues with PPIs, who actually needs them, and the right way to taper off.What did you think of this episode of the podcast? Let us know by leaving a review!Connect with Performance Medicine!Check out our new online vitamin store:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://performancemedicine.net/shop/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Sign up for our weekly newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://performancemedicine.net/doctors-note-sign-up/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@PMedicine⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@PerformancemedicineTN⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Performance Medicine⁠

This week Kate, Gary, Mark and Henry discuss discontinuation of benzodiazepines and treatment of insomnia, the value of baseline cognitive testing of college athletes, vonoprazan vs PPI for preventing and treating ulcers, and whether herpes zoster vaccine reduces dementia risk.Show links:Essential Evidence Plus: www.essentialevidenceplus.comTapering benzos: https://pubmed.ncbi.nlm.nih.gov/39374004/ Baseline neuro eval for athletes: pubmed.ncbi.nlm.nih.gov/39741470/ David Kaufman, “We Need You in the Locker Room” https://thesagergroup.net/books/in-the-locker-room Vonoprazan vs PPIs for ulcers: https://pubmed.ncbi.nlm.nih.gov/39294424/ Zoster and dementia: https://pubmed.ncbi.nlm.nih.gov/40175543/ 

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The newest miracle drug for weight loss is changing the lives of thousands of people who have battled obesity for extended periods of time….These GLP-1 medications are also treating or preventing the diseases that go with long term obesity: Diabetes, Heart Disease, Joint replacements, Arthritis, Sleep Apnea, and Alzheimer's Disease. Researchers are finding more indications every day for patients to take these weight loss medications. But like anything else there is no perfect answer to any problem.  Among the few side effects of this drug, the most frequent side effect is reflux, also called acid indigestion, or GERD (gastroesophageal reflux disease).  Often my patients don't even know what their diagnosis is, they just tell me about their symptoms. The symptoms of GERD include: Asthma symptoms A bad taste in the mouth Difficulty swallowing Dry, hacking, cough Chest pain after meals These symptoms are worse after a big meal, at bedtime, after spicy food, or dose related.  Most of my patients don't want to discontinue the GLP-1 inhibitors because they are finally losing weight!  We manage the GLP-1 side effect of GERD by decreasing dose of the medication and slowly increase the dose back to an effective level. We also offer lifestyle and dietary treatments before we offer prescription medication. Therefore, if reflux is not constant, and is not causing any lasting damage to the patient's esophagus, we can treat it with lifestyle changes and over the counter medication, to lower the stomach acid that is refluxing into the esophagus. The lifestyle changes patients can employ on their own are described below. Lifestyle changes needed to avoid or treat Gastric Reflux caused by GLP-1 agonists. What can you do to prevent and treat this side effect: Eat smaller meals: Large meals expand your stomach and put pressure on your lower esophageal sphincter (LES). Don't go to bed less than 2 hours after eating Avoid trigger foods see below Sleep on your left side Elevate the head of your bed Avoid tight clothing: Chew your food well– chew each bite for 20 seconds. Quit smoking: Smoking weakens your LES and makes your stomach more acidic. Stop drinking alcohol Chew (non-mint) sugar-free–gum  In addition to changing your active lifestyle, changing your diet is necessary as well. There are trigger foods to avoid minimizing your reflux symptoms.  tomato sauce and other tomato-based products high fat foods, such as fast food and greasy foods fried foods citrus fruit juices soda-diet and regular Caffeine Garlic onions mint of any kind milk based products My patients ask me, “So what can I eat?” …I admit I did take away some of the most exciting foods, however my patients ask me what they can eat so the list of foods that help avoid and treat GERD are listed below. High-fiber foods: vegetables, fruit, and whole grain bread. Alkaline foods. Foods fall somewhere along the pH scale (turns litmus paper blue). Drink alkalinized water (PH > 8) Ginger—fresh sushi Ginger from Asian food stores. Apple cider vinegar on salads and a Tablespoon in water every morning Lemon water—just squeeze a slice of lemon in your water. Coconut water Honey. Lean Protein including meat Low-Fat and Nonfat Dairy Products. Non-Citrus Fruits like apples, pears, bananas, and melons Vegetables like broccoli, Carrots, Corn, Cucumbers, Green Beans, Green peppers, Potatoes and Sweet potatoes   For my patients who take herbal and other supplements, the following is a list of the supplements that may decrease your symptoms of GERD. Chamomile Tea Licorice Marshmallow Slippery Elm Tablets Probiotics-Mega Brand Prebiotics-Mega Digestive Enzymes Aloe Vera Juice Baking Soda Magnesium glycinate What happens when you have made all the lifestyle changes you can and have lowered your GLP-1 dose or changed to a different type of GLP-1 Agonist, and you still have GERD? As a physician I prescribe medications to help my patients treat their GERD, however most of the medications have been placed over the counter so I can recommend them to my patients, and they can buy the medication without a script. The class of medication that treats GERD include Antacids, H2 Blocker, and Proton Pump Inhibitor.  Antacids neutralize stomach acid, but they typically only work for short periods. They are generally made of calcium. This type of medication is best used prn for symptom relief.  Side effects of antacids may include constipation and diarrhea. The second option for treatment of GERD is an H2 blocker. These drugs reduce the amount of acid the stomach releases. Eg. Pepcid, Tagamet, Gaviscon. Proton pump inhibitors (PPIs): These drugs are available by prescription from a healthcare provider, and now some doses are over the counter. PPIs help reduce the amount of acid the stomach makes.  They should be used for a two-week period only for severe attacks and then you should change to an H2 blocker or antacid. WHY stop a PPI after 2 weeks?   Omeprazole is an example of a PPI.  Theses medication kill the good bacteria in your intestines, change your breath and can affect how you absorb your nutrients. If you must take them chronically to treat and prevent the progression of damage to the esophagus. What if I did everything and GERD is still a problem: If your condition is severe, your doctor may recommend a consultation with a GI doctor for an endoscope or other diagnostic procedure.  In addition, you may have to hold your GLP-1 Agonist for a period of time while you treat your esophageal inflammation. Just as in all medical issues there are many ways to treat side effects of drugs. Your provider will prescribe the medication that she or he is most comfortable with. What next? So if you have reflux and are on a GLP-1 inhibitor, you may be advised to decrease your dose or switch to Tirzepatide medication (Mounjaro, Zepbound). There are many steps you can take before you need prescribed medication. Your doctor may even change your GLP-1 agonist prescription or refer you to a GI doctor, but before this is necessary you should try the lifestyle and dietary changes that I recommend in this Blog first. This side effect of GLP-1 agonists doesn't affect every patient and can be managed as you see above, however the lifestyle changes and dietary changes can only be done by you, so the ball is in your court!

Dr. Fred Gandolfo dives into a rapid-fire Q&A session, addressing a backlog of listener questions that cover a variety of gastrointestinal topics. Key highlights include: - The pros and cons of capsule endoscopy versus traditional endoscopy and colonoscopy, particularly regarding the visualization of the small intestine. - A listener who appreciates Dr. Gandolfo's detailed explanations, leading to a discussion on the balance between clarity and conciseness in patient communication. - An exploration of swallowing difficulties related to a "twisty esophagus," including potential treatments and the importance of specialized care. - A review of the safety and efficacy of the supplement Preservision for patients with chronic pancreatitis and macular degeneration. - A discussion on the challenges of managing SIBO (small intestinal bacterial overgrowth) and the low FODMAP diet, with a promise of a future deep dive into this topic. - An examination of the long-term effects of proton pump inhibitors (PPIs) and the complexities of their use in clinical practice. As the episode concludes, Dr. Gandolfo shares a rant about the frustrations of navigating insurance hurdles in patient care, particularly concerning inflammatory bowel disease treatments. His reflections shed light on the often unseen struggles healthcare providers face while advocating for their patients against insurance denials of necessary treatment. Listeners are encouraged to submit their own questions for future episodes, ensuring that the conversation continues to address the topics that matter most to them. Watch The Real GI Doc Show on YouTube! Click here! Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here. Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.  

In this episode of Better Than Before Breast Cancer, we're talking about the crucial role of magnesium in breast cancer recovery, metabolic health, and overall well-being What You'll Learn in This Episode:✅ Why magnesium is vital for breast cancer survivors and how it supports healing✅ How chemotherapy, aromatase inhibitors, and stress can deplete magnesium levels✅ The best types of magnesium supplements (and which one is right for you!)✅ How to get enough magnesium through diet with whole, nutrient-dense foods✅ Signs of magnesium deficiency and how to test your levels✅ How magnesium impacts inflammation, bone density, and hormone balance Download Your Free Resources:

CT scan accidentally reveals calcium deposits where they don't belong; Dispelling the myth that hunter-gatherers get more sleep than Westerners; Blue light exposure at night impairs sleep—but morning exposure improves it; When normal B12 levels aren't enough; NT Factor vs. urolithin A (Mitopure®️) for mitochondria; Alternatives to PPIs for Barrett's Esophagus; Topical—not oral—melatonin for skin rejuvenation. 

In this episode of the Smarter Not Harder Podcast, Dr. John Kim discusses the impact of various medications on nutrient deficiency and mitochondrial dysfunction. He focuses on commonly prescribed medications such as statins, PPIs, SSRIs, and antibiotics, detailing their effects on essential nutrients like CoQ10, B vitamins, and magnesium. Dr. Kim also shares insights on the interplay between pharmaceutical and nutraceutical treatments, the importance of hormone levels, and mitochondrial health. The episode further delves into the complications of oral contraceptives, the dangers of fluoroquinolone toxicity, and the role of methylene blue and phospholipids in combating these issues. Dr. Kim rounds out the discussion with insights into managing mold toxicity and the significance of functional medicine. Join us as we delve into: + Exploring mitochondrial dysfunction caused by common drugs + The dangers of drug-induced nutrient depletion + Enhancing recovery with methylene blue and more + Mold toxicity and its hidden health impacts This episode is for you if: - You're curious about how common meds lead to nutrient deficiencies - You're keen on understanding the synergy of methylene blue & supplements - You're interested in the link between medications and mitochondrial health - You want to know how diet and lifestyle affect neurotransmitter production You can also find this episode on… YouTube: https://www.youtube.com/watch?v=8zS-1mKbrXM Find more from Dr. John Kim: Kim Wellness: https://www.kimwellness.co/ Instagram: https://www.instagram.com/john.pharmd LinkedIn: https://www.linkedin.com/in/dhjohnkimpharmd/ Find more from Smarter Not Harder: Website: https://troscriptions.com/blogs/podcast | https://homehope.org Instagram: @troscriptions | @homehopeorg Get 10% Off your purchase of the Metabolomics Module by using PODCAST10 at https://www.homehope.org Get 10% Off your Troscriptions purchase by using POD10 at https://www.troscriptions.com Get daily content from the hosts of Smarter Not Harder by following @troscriptions on Instagram.

Today, I'm going to tell you how to get rid of bloating. After you chew your food, it travels through the esophagus and into the stomach. The stomach is very acidic to break down proteins and kill microbes. Ninety percent of digestion occurs in the small intestine, where bile and secondary bile salts made by your microbes break down your food. The large intestine, small intestine, and pancreas release enzymes to aid digestion. Around 20% of these enzymes are made by your microbes. Bloating is caused by a problem with digestion. The type, amount, and diversity of your gut bacteria directly affect bloating. This often depends on if you've taken antibiotics and how much you've taken over time. Broad-spectrum antibiotics significantly reduce your microbes, and they do not come back! If you're missing any of your gut microbes, you'll experience bloating, gas, burping, constipation, and more. Other chemicals in the environment that mimic antibiotics can also cause a bloated belly. Glyphosate, birth control pills, steroids, anti-depression medications, PPIs, artificial sweeteners, fluoride, and statins can all contribute to bloating. So many people can not properly digest food anymore because they don't have all of their microbes in sufficient quantities. A high-quality probiotic is a great solution to bloating. Along with probiotics, consume fermented foods regularly, such as kefir, yogurt, sauerkraut, and pickles. Apple cider vinegar and kombucha can also help awaken dormant microbes by acidifying their environment. These microbes help support your bile and enzymes, helping you digest food, which takes stress off your organs. SUPER GUT BOOK LINK: https://amzn.to/4dIxTy2 L. Reuteri Strain: https://www.amazon.com/BioGaia-Osfort... **I am finding that using only ONE TBS of fiber in the recipe makes a better-quality product. How to Make It: https://drdavisinfinitehealth.com/201... https://www.culturedfoodlife.com/l-re... MICROBIOME MASTER CLASS WEBSITE: https://innercircle.drdavisinfinitehe... Yogurt Maker — https://lvnta.com/lv_lrJY1A8ZLtxmwUpYdX Yogurt Jars — https://lvnta.com/lv_qB2B90JNh0hQjaMoXk Yogurt Containers — https://lvnta.com/lv_SFt3wnanoNkBHrf0Rs