Podcasts about ppis

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Melanie Ruffner, an Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Dr. Ruffner describes her work in clinic and the paper she co-authored about pediatric and adult eosinophilic esophagitis (EoE). She covers the questions they considered in the paper and the conclusions they reached. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, pediatric and adult eosinophilic esophagitis (EoE), and introduces today's guest, Dr. Melanie Ruffner.   [1:23] Dr. Melanie Ruffner is an attending physician with the Division of Allergy and Immunology in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Holly welcomes Dr. Ruffner to Real Talk.   [1:50] As an attending physician in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia, Dr. Ruffner sees patients who have eosinophilic esophagitis and other eosinophilic disorders, including eosinophilic GI tract disorders.   [2:09] Dr. Ruffner also leads a research group that studies how the immune system causes inflammation in response to certain foods, leading to EoE.   [2:20] Inflammation in the esophagus is tied to other diseases like epithelial barrier dysfunction and fibrosis.   [2:28] Our bodies use many different proteins that allow cells to communicate with one another. One type of signaling protein that causes inflammation is called cytokines.   [2:41] Dr. Ruffner's group is interested in how these signaling proteins called cytokines interact with epithelial cells and how that impacts the oral function of the esophagus in patients with EoE.   [3:02] In training, Dr. Ruffner became interested in eosinophilic esophagitis and other non-IgE-mediated food allergies because we don't have a lot of clear treatments or clear mechanisms that cause them.   [3:21] Dr. Ruffner felt there was a lot of work to be done in that area. It was rewarding to be in clinical encounters with those patients. Often, patients had spent a long time trying to find out what was happening and to find a treatment plan that worked for them.   [4:31] Dr. Ruffner's group sees some patients who have eosinophilic gastroenteritis and patients who are referred for hypereosinophilia with impacts of inflammation in other organ systems.   [5:06] Dr. Ruffner co-authored a paper about pediatric and adult EoE published in the Journal of Allergy and Clinical Immunology. It explored if EoE in pediatric patients and adult patients is a spectrum or distinct diseases.   [5:29] EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to foods and causes inflammation in the esophagus.   [5:47] Eosinophils are a type of white blood cell. Eosinophils infiltrate the tissue in the esophagus of people with EoE. Doctors look for eosinophils in the tissue of the esophagus as a sign that inflammation in the esophagus is EoE.   [6:04] The symptoms of EoE can vary in children and adults. That was one of the things the doctors were interested in when they were thinking about this paper. There are no blood or allergy tests that make it easy to diagnose EoE, which requires an endoscopy.   [6:31] An endoscopy is performed by a gastroenterologist. The gastroenterologists look at the appearance of the esophagus and take biopsies.   [6:49] A pathologist counts the eosinophils in the tissue to determine if there are eosinophils present. If there are more than 15 eosinophils in the high-powered field of the microscope and symptoms and clinical conditions are present, EoE is diagnosed.   [7:25] One of the variables Dr. Ruffner considers is that symptoms can be different in children versus adults. In older adolescents and adults, the classic symptom is difficulty swallowing or dysphagia. That is often caused by fibrosis in the esophagus.   [7:54] In younger children this is often not how EoE presents. They may vomit or refuse food. They may experience more weight loss. Symptoms vary over the lifespan. Pediatric EoE symptoms of nausea and abdominal pain can also show up in adults.   [9:54] Atopy refers to allergic conditions. In the paper, a history of atopy means a history of allergic conditions, like atopic dermatitis, IgE-mediated food allergy, allergic rhinitis, or asthma.   [10:37] These disorders tend to cluster together, over time, because they share many common genetic risks. They cluster in families because some of the genetic risks are the same. Not every family member will have the same atopic or allergic conditions.   [11:07] In families, perhaps one person will have atopic dermatitis and allergic rhinitis while another will have atopic dermatitis, allergic rhinitis, asthma, and EoE. They may have inherited different genetics or had different environmental exposures.   [11:50] Ryan says that describes his family. They each have different atopic conditions. Ryan got them all! Dr. Ruffner says it describes her family, as well.   [12:26] Dr. Ruffner says it's understandable for families to stress about atopic conditions. Unfortunately, right now, there's no way to predict who will develop which atopic conditions. It's on the minds of the medical and research communities.   [13:10] IgE is an antibody that binds to food allergens and mediates anaphylaxis, usually within 30 minutes, with hives, vomiting, and difficulty breathing. Not everyone with a diagnosed food allergy will be given an epinephrine auto-injector.   [13:44] IgE-mediated food allergies are influenced by type 2 cytokines. Cytokines are immune system signaling proteins that have been labeled as groups. The group that is involved in allergy most heavily is under the label type 2.   [14:15] These type 2 cytokines are responsible for influencing B cells to make IgE. In the tissue in EoE, we find that there is a large amount of these type 2 cytokines present.   [14:37] This is quite relevant because dupilumab, the monoclonal antibody that has been approved to treat EoE, targets type 2 inflammation by blocking type 2 cytokines.   [16:04] Dr. Ruffner says one of the biggest challenges in the field of EoE is we don't have a way to stratify who should get which treatment for EoE. Patients have to choose between diet and pharmacologic therapy.   [16:48] We don't know enough about the inflammatory profiles to give any patient the specific guided information that one therapy would be better than another.   [17:11] Pediatric and adult patients are given the same treatment options. Some dosing, such as proton pump inhibitors and dupilumab, is weight-based so different doses are needed.   [17:36] Over time, people's needs change. From early school age to when people leave home, they may have very different needs. They may do well on diet therapy when their diet is controlled by parents, but, on their own, that may not be the best option for them.   [18:20] Therapy may change over time to support each patient's individual goals. It can be challenging because therapies are imperfect. Each therapy has a percentage probability of success. Not every therapy is guaranteed to work for every individual.   [19:01] There is some flexibility and possibility of switching between therapies to support people. Ryan shares one of his experiences in changing treatments.   [20:03] Some patients are stable on a therapy for a time but then see symptoms creep back up. Dr. Ruffner strongly suggests they talk to their care team for an endoscopy and biopsy to see if they need to switch therapy and if their diet has changed.   [21:31] In young children, Dr. Ruffner sees a much higher incidence of feeding refusal. The child may have a preferred food or a preferred texture like puree, long past when that would be appropriate for the age.   [22:41] It can be very difficult to move past this learned behavior even if remission is achieved through therapy. The child may need feeding therapy to help with that. [22:59] Feeding behaviors in older individuals may be much more subtle. Talk about them with your care team. Needing water to eat, cutting food very small, and fearing to eat around people are common eating behaviors to discuss in older patients.   [23:53] These eating behaviors affect people's well-being deeply because they affect how social they feel when they are around people. Ideally, you want to be around people and share in social times.   [24:16] Holly has used these eating behaviors herself and notices them in other people. When adults come to her for therapy, she asks how many times they refill their water when they eat, and if food ever gets stuck. They are surprised that those are symptoms.   [26:01] Dr. Ruffner says it's important to recognize the difference in symptoms in diagnosing EoE. The main risk factor of EoE is fibrosis, over time. The thought is that early in EoE there is an inflammatory phenotype, but later, there is a fibrotic phenotype.   [26:51] The phenotype refers to the presentation or characteristic of disease. What is the appearance at endoscopy? What do we see in the biopsied tissue? Is there fibrosis or not?   [27:15] This is the crux of the paper: Is this on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to this fibrosis over time.   [27:40] One thing that is missing is following a group of patients from the start and having that evidence. There is mechanistic evidence from studies to show that inflammation can contribute to fibrosis. That was one of the discussions in the paper.   [28:29] In endoscopies, something that can be seen with fibrosis or fibrostenotic features is more of an appearance of rings and narrowing of the esophagus. A proportion of patients with strictures or narrowing need to have them dilated.   [29:11] For patients who have dilation, it can help with symptoms significantly. When pathologists look at the tissue with fibrosis, they can see changes in the protein structure. There is more collagen and other changes in the tissue, causing fibrosis.   [30:03] Some patients use adaptive eating behaviors to adapt to significant changes in their esophagus and go for many years without being diagnosed until they present with an impaction when food becomes stuck in their esophagus.   [30:46] This makes EoE a challenging disorder for many because it can be very difficult to diagnose. The journey to a diagnosis is very individual. As a group, adults are much more likely to have fibrosis, leading to dysphagia, strictures, or impaction.   [31:25] Statistically, across all patients, you see fibrosis more in adults than in children.   [32:42] In the paper, Th1 cells are mentioned. Th1 is an immune system term referring to a cell that produces interferon-gamma. Studies show there may be differences in interferon signaling in different age groups but it needs to be studied further.   [33:57] Dr. Ruffner's team had looked at a small group and saw that interferon signaling seemed to be relatively similar between children and adults. Both CD4 and CD8 T cells (types of immune system cells) are potentially producing interferon in the esophagus.   [34:32] More study needs to be done around those immune system cells and their potential significance in EoE, if any.   [35:33] The paper suggests that EoE in children and adults is essentially a spectrum of the same disorder rather than distinct diseases.   [35:42] Aspects of immunology, responses to different treatments across children and adults, the similar responses to diet and different medications, and over time in the same individuals, indicate these are changes and complications over time.   [36:41] Dr. Ruffner suggests that medical researchers need to understand which patients are at the highest risk of complications and work to identify the best treatments to prevent those.   [37:14] Dr. Ruffner is thinking about the response to proton pump inhibitor therapy. One of the things she is looking at is whether or not proton pump inhibitors affect how eosinophils migrate into the tissue.   [37:33] They are finding that it seems that PPIs can decrease the degree of migration of eosinophils into the tissue. They are very interested in looking at that. Ryan says when Dr. Ruffner gets that paper published, she'll have to come back on the show!   [38:06] Ryan thanks Dr. Ruffner. For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes.   [38:15] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [38:24] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [38:33] Ryan thanks Dr. Ruffner for participating in the podcast episode. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Dr. Melanie Ruffner, MD, PhD, Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia “Pediatric and adult EoE: A spectrum or distinct diseases?” by Stanislaw J. Gabryszewski, Melanie A. Ruffner, and Jonathan M. Spergel   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   “EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to food allergens and causes inflammation in the esophagus.” — Dr. Melanie Ruffner   “In EoE, there are no blood or allergy tests that make it easy to diagnose EoE without an endoscopy.” — Dr. Melanie Ruffner   “Is EoE on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to fibrosis over time.” — Dr. Melanie Ruffner   “When pathologists look at the tissue with fibrosis, they can see the changes in the protein structure.” — Dr. Melanie Ruffner   “There are some folks who have adapted their eating behavior quite significantly and may have quite a number of chronic changes in their esophagus that they have adapted around, and they go for many years without being diagnosed.” — Dr. Melanie Ruffner

Do you or a loved one suffer from heartburn, acid reflux, or a hiatal hernia? In this episode, I welcome Lisa Robbins for a discussion on the homeopathic approach to chronic digestive discomfort. Lisa breaks down the distinctions between occasional heartburn and the more serious gastroesophageal reflux disease (GERD), as well as the complications of hiatal hernia. She contrasts the conventional use of antacids and proton pump inhibitors (PPIs) with the holistic, long-term healing potential of homeopathy. You'll hear why homeopathy addresses the root causes of imbalance—whether it's poor diet, stress, pregnancy, medications, or even inherited tendencies—and how it helps the body restore balance from the inside out. In this episode, we discuss: What makes homeopathy different from conventional treatment for digestive issues The body's warning signs: reflux, ulcers, and other gut-related symptoms How food allergies and emotional triggers impact your digestive health Why listening to your symptoms—rather than silencing them—is the first step to healing The role of constitutional remedies in treating GERD and hiatus hernia naturally   ✨ Explore More or Book a Chat:

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.  

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

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. 

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Wayne Shreffler, Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital. Dr. Shreffler is also an investigator at The Center for Immunology and Inflammatory Disease and The Food Allergy Science Initiative. His research is focused on understanding how adaptive immunity to dietary antigens is both naturally regulated and modulated by therapy in the context of food allergy. This interview covers the results of a research paper on The Intersection of Food Allergy and Eosinophilic Esophagitis, co-authored by Dr. Shreffler. 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, GSK, Sanofi, and Regeneron. Ryan introduces co-host, Holly Knotowicz.   [1:15] Holly introduces today's topic, the intersection of food allergy and eosinophilic esophagitis.   [1:26] Holly introduces today's guest, Dr. Wayne Shreffler, Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital and an investigator at The Center for Immunology and Inflammatory Disease and The Food Allergy Science Initiative.   [1:43] Dr. Shreffler's research is focused on understanding how adaptive immunity to dietary antigens is both naturally regulated and modulated by therapy in the context of food allergy.   [1:54] Holly welcomes Dr. Shreffler to Real Talk. When Holly moved to Maine, she sent her patients to Dr. Shreffler at Mass General.   [2:25] Dr. Shreffler trained in New York on a Ph.D. track. He was interested in parasitic diseases and the Th2 immune response. Jane Curtis, a program director at Albert Einstein College of Medicine, encouraged him to consider MD/PhD programs. He did.   [3:31] Jane Curtis connected him to Hugh Sampson, who was working with others to help understand the clinical prevalence of food allergy and allergens.   [3:51] As a pediatric resident, Dr. Shreffler had seen the burden of allergic disease, caring for kids in the Bronx with asthma. His interest in Th2 immunity, the clear and compelling unmet clinical need, and the problem of food allergy guided his career.   [4:31] Dr. Shreffler's wife has food allergies and they were concerned for their children. Fortunately, neither of them developed food allergies.   [5:21] Dr. Shreffler thinks the food allergy field has a lot of people who gravitate toward it for personal reasons.   [5:53] Food allergy is an adverse response to food that is immune-mediated. There is still uncertainty about this but Dr. Shreffler believes that a large percentage of patients with EoE have some triggers that are food antigens.   [6:27] The broad definition of food allergy would include things like food protein-induced enterocolitis syndrome (FPIES).   [6:47] The way we use the term food allergy in the clinic, there are two forms: IgE-mediated allergies and non-IgE-mediated allergies, including EoE.   [7:40] Some patients have food-triggered eczema, some have FPIES.   [8:04] In 2024, Dr. Shreffler and Dr. Caitlin Burk released a paper that looked at the triggers of EoE, particularly the intersection of IgE-mediated food allergy and EoE.   [8:41] Dr. Caitlin Burk joined the group as they were publishing papers on IG food allergy and EoE. It was a moment where things unexpectedly came together.   [9:17] Adaptive immunity to food proteins comes from antibodies that cause milk allergy, egg allergy, peanut allergy, or multiple allergies. The IgE has specificity.   [9:40] T cells also are specific to proteins. They express a host of receptors that recognize almost anything the immune system might encounter. They have a long memory like B-cells.   [10:09] The overlap in these two threads of research was regarding a population of T cells that are important for mediating chronic inflammation at epithelial sites, including the gut.   [10:36] These T cells have been described in the airways in asthma, in the skin in eczema, and the GI tract. Researchers years ago had also described them as being associated with IgE food allergy. People with IgE food allergies avoid allergens.   [11:13] T cells, being associated with chronic allergic inflammation, now being associated with food allergies which are not having chronic exposures to the allergen, was interesting and surprising.   [11:30] Dr. Shreffler and his group found the T cell subset in patients who don't do well with Oral Immunotherapy (OIT) and patients who have EoE with immediate symptoms.   [12:01] Dr. Shreffler notes differences. There are immediate symptoms of IgE food allergy. There is a subset of patients with EoE who have immediate symptoms that are not fully understood. Maybe IgE plays a role there.   [12:28] There are different mechanisms for how symptoms are caused and so different ways of making a diagnosis. A food allergy with an IgE antibody can be measured through skin tests and blood tests. This can help identify which foods are the trigger.   [12:57] This common T cell subset that we see in EoE and food allergy, helps to explain why IgE alone is not always a very specific marker for identifying people who will have immediate reactions when they're exposed to the food.   [13:17] For patients who react at low levels, it's not just that they have more or better IgE but they also have an expansion of these T cells that are common between EoE and other chronic forms of allergy and IgE food allergy.   [13:41] There's a lot to learn that might be relevant for patients about this T cell subset.   [14:23] These T cells are a specific subset of the group of Th2 T cells, which are a subset of all CD4 T cells. Some CD4 T cells are important for responding to viruses and tumors. Others are important for responding to outside allergens.   [15:01] In an allergy or a parasite infection, Th2 T cells are important. There is a subset of T cells that is driven by repetitive and chronic exposure to the triggering protein, antigen, or allergen.   [15:47] Most antigens are proteins that trigger an immune response. An antigen that elicits an allergic response is an allergen. [16:30] A food trigger is a protein antigen that is an allergen. In IgE, food allergies, milk, and eggs are prevalent triggers early in life. For reasons not well understood, a lot of people outgrow them. In older patients, peanut and tree nut allergies are prevalent.   [17:01] In EoE, milk is one of the most common dietary triggers into adulthood. Some patients with IgE allergy to milk can tolerate it if it's well cooked. Patients with EoE are less likely to be able to get away with regular and ongoing exposure to milk protein.   [17:54] Milk, eggs, and nuts are common triggers in both conditions. There can also be rare food allergy triggers. That's part of the early evidence that the adaptive immune response was likely to be involved. It can be so specific for some people to rare things.   [18:20] Hallmarks of something being immune-mediated are that it is reproducibly demonstrable as a trigger. It's going to be long-lived. It's going to be generally relatively small amounts. The immune system is good at detecting small exposures.   [19:07] EoE is tricky because there's not that clear and easy temporal association between an offending allergen exposure for most people and their symptoms. People don't associate the symptoms with the triggers.   [20:14] A history of having blood in the stools can be milk-allergen-driven and was associated with a diagnosis of EoE in those kids when they're older.   [20:26] There are a lot of commonalities in the allergens but it's not always obvious clinically.   [22:40] A challenge in diagnosing EoE is that providers have to be on guard against their biases. They have to give a patient good advice. In EoE there is no test to identify triggers, except rigorous introduction, elimination, reintroduction, and endoscopies.   [24:18] For some of Dr, Shreffler's patients, it becomes less important to know their dietary triggers. They gravitate toward an approved form of treatment that may, if successful, allow them to have a more normal diet because of effective medication.   [24:50] Dr. Shreffler thinks there are other triggers, including pollens. There is evidence of seasonality of active EoE in patients shown to have allergic sensitization to pollens. That's indirect evidence. If the body is making IgE, it's likely making other responses.   [25:32] There are questions about how large the population of patients is who have EoE that may be more intrinsically than extrinsically driven because of genetic variations.   [25:54] Dr. Shreffler believes that EoE in some patients is allergen-driven and in some patients EoE is food-driven. Food is a trigger for the majority of pediatric patients and a large percentage of adult patients but not necessarily the exclusive trigger.   [27:04] If a patient is motivated to learn what dietary triggers may be at play, Dr. Shreffler often makes assessments outside of pollen season for allergens to which the patient has demonstrated positivity.   [28:09] Looking at the epidemiology, both EoE and food allergy are atopic disorders. You see an increased prevalence of asthma, hay fever, eczema, and even allergic proctocolitis in infancy. You see an enrichment of one disorder to another.   [28:29] The overlap of food allergy to EoE is stronger than you might expect. About 30 to 40% of patients with EoE will also have IgE food allergy. A higher rate will have IgE positivity, whether or not that food is a trigger of immediate symptoms.   [28:48] Patients with food allergies are about four times more likely to have EoE than the general population. That's a stronger association than the risk of eczema or other atopic conditions to EoE.   [30:09] There are differences between IgE food allergy and EoE. The presence of IgE gives a useful tool for identifying the food trigger in food allergy, but not in EoE. Identifying rare triggers in EoE patients is done by clinical observation.   [31:46] Epinephrine and antihistamines are not useful in treating EoE. Blocking IgE with Omalizumab has not been effective in trials in treating EoE. PPIs, topical steroids, and dupilumab are helpful for many EoE patients.   [32:38] Dupilumab has been evaluated a bit in food allergy in combination with OIT, and there was no statistically significant benefit from dupilumab in food allergy.   [33:25] A group in Pennsylvania has been evaluating epicutaneous immunotherapy as a modality to treat EoE. It's also being evaluated for IgE food allergy. Dr. Shreffler thinks it's something to keep an eye on.   [33:40] The oral route for immunotherapy can drive EoE for patients. As they become less sensitive from an immediate reactivity viewpoint, a significant percentage of patients develop GI symptoms. This has also been observed with sublingual therapy.   [34:14] Iatrogenic EoE, caused by the treatment, may resolve on the cessation of the immunotherapy treatment.   [36:25] Dr. Shreffler says in some cases, the shared decision is a decision where he has a strong evidence-based opinion. In some cases, there's a lot more room for a range of clinical decisions that could be equally supported by what we know right now.   [36:57] We've said that EoE is a contraindication for OIT. There is a shift happening. Dr. Shreffler sits with families and has a conversation about restricting diet or trying chronic therapy and keeping an ad-lib diet.   [37:38] What about doing the same thing by treating the immediate-type food allergy with chronic allergen exposure and then ameliorating the effects of EoE if it emerges, with another therapy? A hundred providers would have a diversity of responses.   [38:19] When there is a history of EoE in a family, Dr. Shreffler advocates for getting a baseline scope. It becomes an important “ground zero.”   [38:28] The goal is to have less invasive ways to monitor these conditions.   [39:32] Chronic inflammation, which is the hallmark of EoE, is well-targeted by therapies like PPIs and steroids. Steroids don't help with IgE-related food allergies. They're not effective at blocking the IgE-driven immediate response.   [41:13] Until recently, IgE food allergy has only been managed with avoidance. We have some other tools now. Xolair is not effective in EoE but is effective in two-thirds to three-quarters of patients with immediate-type food allergies for preventing anaphylaxis.   [41:45] Dr. Shreffler refers to an upcoming study on the effectiveness of Xolair in treating people with food allergies. Those who were able to tolerate a minimum amount were allowed to begin consuming allergen. We'll get insight into how those patients did.   [43:08] Food-induced immediate response of the esophagus (FIRE) is immediate discomfort with exposure to some allergens. Dr. Shreffler explains it. Data supports that these patients are experiencing an IgE-mediated but local response to those triggers.   [44:59] If FIRE is IgE-mediated, it may be that Xolair would help suppress it in these patients. It's worth looking at Xolair for this subset of EoE patients.   [45:20] Ryan invites any listeners who want to learn more about FIRE to check out episode #34 with Dr. Nirmala Gonsalvez.   [45:37] In the paper, Dr. Shreffler wrote about what he hopes will be the practical usefulness of the finding, the intersection between IgE food allergy and EoE.   [45:56] A subset of Th2 T cells express a protein called GPR15. It appears to be a marker for the subset of cells that are playing a role in the EoE.   [46:36] Caitlin Burk's work now is looking at their activation status in active disease and post-diet elimination and remission. She is developing a data set that is leading us toward the possibility of focusing on that cell subset and techniques to adopt in clinics.   [47:12] She is also working out more advanced techniques to look at the receptors. Dr. David Hill at CHOP is working on similar research. This research has the potential to lead to the development of better tests for EoE.   [47:44] Holly tells Dr. Shreffler this has been such an informative episode with so many tidbits of things to help patients advocate for themselves. Holly thanks him for sharing all of that.   [48:12] Dr. Shreffler is trying to see what can be utilized from their research to make non-invasive tests to identify food allergen triggers for patients so they don't have to go through so many endoscopies. He sees it as a huge unmet need.   [48:31] Ryan thanks Dr. Shreffler for joining us. For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes.   [48:41] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [48:50] 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.   [49:00] Ryan thanks Dr. Shreffler for joining us today for this interesting conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode.   Mentioned in This Episode: Dr. Wayne Shreffler, MD, Ph.D., Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital “Triggers for eosinophilic esophagitis (EoE): The intersection of food allergy and EoE” Dr. Caitlin Burk Dr. David A. Hill   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron.   Tweetables:   “This fascinating problem of food allergy: why does the immune system do that for some people — recognize what should be nutritive and innocuous sources of energy as an immunological trigger? ” — Dr. Wayne Shreffler   “A food allergy; because there is this IgE antibody, we can do skin tests. We can measure that in the blood. It's a useful marker for helping to identify which foods are the trigger.” — Dr. Wayne Shreffler   “EoE is tricky because there's not that clear and easy temporal association between an offending allergen exposure for most people and their symptoms. People don't associate the symptoms with the triggers.” — Dr. Wayne Shreffler   “Everything is shared decision-making. In some cases, it's a shared decision where I have a strong evidence-based opinion. In some cases, there's a lot more room for a range of clinical decisions that could be equally justified.” — Dr. Wayne Shreffler   “Steroids don't help with IgE-related food allergy. They're not effective at blocking that IgE-driven immediate response.” — Dr. Wayne Shreffler   “I'm trying to see what we can utilize from our research to make non-invasive tests to identify food allergen triggers for patients so they don't have to go through so many endoscopies. I think that's a huge unmet need.” — Dr. Wayne Shreffler  

More than 60 million Americans experience heartburn on a regular basis, but the recommended treatment does nothing to address the root cause - and totally messes up your digestion. The most important thing that I want you to know is that acid reflux has absolutely nothing to do with overproduction of acid. These symptoms are caused by inappropriate opening of the lower esophageal sphincter, and on today's show, I'm going to tell you about the three most common factors that cause that lower esophageal sphincter to open, and how to treat them without blocking stomach acid. We'd love to hear from you - send us a text!Thank you for being a part of our community! For the latest in digestive wellness go to https://gutbliss.com and follow us on https://www.instagram.com/gutbliss/ for more gut health info. Dr. Robynne Chutkan

Hosted by Dr. Sarah Hensley, Specialized Social Psychologist, Attachment Theory Expert, and Founder & CEO of The Dating Decoder with Co-host Raina Butcher, Owner/CEO of Joyful Consulting, LLC. Welcome to "The Love Doc Podcast" where Host Dr. Sarah Hensley and her co-host Raina Butcher dive deep into the intricacies of love, attraction, attachment, relationships, and self-awareness. Dr. Hensley brings a wealth of knowledge and experience to help listeners navigate the complexities of modern romance. In each episode, Dr. Hensley tackles burning questions about love, relationships, and the mind's complexities, drawing from her psychological research, real-life experiences, and her own individual expertise, to provide insightful perspectives and practical advice.The Love Doc Podcast – Episode 40: "The Bright Side of Suffering." In this transformative episode of The Love Doc Podcast, Dr. Hensley explores one of the most difficult yet essential aspects of the human experience—suffering. Rather than something to fear or avoid, she reframes suffering as a necessary force for growth, resilience, and transformation—but only if we allow it to serve that purpose.Why Do Some People Break While Others Rise? The Science of SufferingDr. Hensley begins the episode by addressing a fundamental question: Why do some people experience post-traumatic stress while others experience post-traumatic growth? She discusses the psychological and neurological factors that determine whether suffering will lead to breakdown or breakthrough.She highlights a study that examined two different therapeutic approaches for trauma survivors:Cognitive Behavioral Therapy (CBT): A structured, problem-focused therapy that helps individuals change negative thought patterns.Positive Psychological Interventions (PPI): A strengths-based approach that focuses on resilience, finding meaning in suffering, and reframing challenges in a positive light.The study revealed that individuals who underwent PPI showed greater post-traumatic growth compared to those who only engaged in CBT. This is because PPIs encourage individuals to see their pain as part of a bigger picture, whereas CBT primarily focuses on managing symptoms.Faith and the Power of Redemption in SufferingAs the episode progresses, Dr. Hensley shares a deeply personal perspective on suffering—one rooted in faith. She explains how her own hardships have been catalysts for spiritual growth, helping her develop deeper trust and surrender.She reflects on the suffering of Christ, emphasizing that His sacrifice was the ultimate example of how pain can lead to redemption. Through faith, suffering can take on a greater purpose, allowing people to transcend their pain rather than be defined by it.The Role of Community in HealingDr. Hensley stresses that healing from suffering is not meant to be done alone. She explores the importance of community and connection, explaining how isolation often prolongs suffering while healthy relationships create a safe space for healing and transformation. Whether through friendships, support groups, or spiritual communities, surrounding oneself with understanding and uplifting people can make all the difference.Attachment Styles and How They Influence HealingAt the midpoint of the episode, Dr. Hensley shifts the discussion to attachment theory, explaining how different attachment styles process and cope with suffering:Anxious Attachment: Those with an anxious attachment style often get stuck in victimhood, replaying their pain and seeking validation to soothe their wounds. They struggle with letting go and moving forward.Avoidant Attachment: On the other hand, avoidant individuals tend to suppress and dismiss their suffering, refusing to acknowledge their pain. They may appear strong on the outside but often struggle with deep emotional disconnect.Dr. Hensley shares specific strategies for each attachment style to help them move through suffering in a healthier way.Somatic Healing: Moving Through Suffering with the BodyOne of the most crucial parts of healing, Dr. Hensley explains, is not just feeling emotions, but actually processing them through the body. She introduces somatic healing techniques—practices that help release stored trauma and emotions physically, since emotions are "energy in motion."She shares different methods to create safety in the body, including:Breathwork to regulate the nervous systemGrounding exercises to reconnect with the present momentMovement-based practices like yoga, shaking, or dance to release stored emotional energyDr. Hensley emphasizes that growth from suffering requires more than intellectual processing—it requires physical release and transformation.The Difference Between Therapy and Coaching in HealingAs the episode nears its conclusion, Dr. Hensley breaks down the key differences between therapy and coaching when it comes to healing from suffering:Therapy: Primarily focuses on processing past trauma, offering a safe space to understand and work through emotions.Coaching: Takes a prescriptive and action-oriented approach, providing concrete tools to change behavior and rewire neural pathways for long-term transformation.Dr. Hensley explains that while therapy is invaluable for understanding pain, coaching is essential for creating real, lasting change—helping individuals take proactive steps toward rewiring their mindset, behaviors, and emotional responses.Final Takeaway: Growth is a ChoiceDr. Hensley wraps up the episode with a powerful message:"Suffering is inevitable, but what you do with it is up to you. Will you let it break you, or will you let it build you into the highest version of yourself?" This episode is both deeply personal and profoundly practical, providing listeners with the tools, insights, and inspiration to embrace suffering as a stepping stone to greatness.Tune in to "The Love Doc Podcast" every Tuesday morning for candid conversations, expert guidance, and a deeper understanding of love and relationships in the modern world. To see all of Dr. Hensley's services please visit the links below and follow her on social media. PROMO CODE FOR OUR LISTNERS: Use LOVEDOC27 to receive 27% off any of Dr. Hensley's courses or her Hybrid Group Coaching Program. Dr. Hensley's Hybrid Group Coaching: https://www.thedatingdecoder.com/group-coaching/Book one on one with Dr. Hensley or one of her certified coaches: https://www.thedatingdecoder.com/book-appointment/Purchase Dr. Hensley's online course: https://dating-decoder.mykajabi.com/offers/PpEPKnsM/checkoutTik-Tok: @drsarahhensleyInstagram: @the_dating_decoderFacebook: The Dating DecoderYoutube: @Dr.SarahHensleyBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-love-doc-podcast--6390558/support.

Did you know that PPIs are one of the most commonly prescribed medications in Australia according to PBS data? Join Kristin for a deep dive into proton pump inhibitors as she chats with Gastroenterologist, Hepatologist and Gastrointestinal endoscopist, Dr Kostas Brooks. What dose PPIs should patients actually be taking? How do you manage rebound symptoms? Listen in to find out.

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.

Acid Reflux Medicine May Cause Osteoporosis Stomach acid–blocking proton pump inhibitor drugs—PPIs with brand names like Prilosec, Prevacid, Nexium, Protonix, and AcipHex—appear to significantly increase the risk of bone fractures. Listen to today's episode to learn about the written by Dr. Michael Greger at @NutritionFacts.org #vegan #plantbased #plantbasedbriefing #acidreflux #GERD #osteoporosis #ppi #protonpumpinhibitors #Prilosec #prevacid #Nexium #protonix #acipHex ============================ Original post: https://nutritionfacts.org/video/acid-reflux-medicine-may-cause-osteoporosis/  Related Episodes: Acid Reflux 943: How to Prevent and Treat Heartburn Without Medication https://plantbasedbriefing.libsyn.com/943-how-to-prevent-and-treat-heartburn-without-medication-according-to-gastro-docs-by-dana-hudepohl-at-forksoverknivescom 174: [Part 1] Dining by Traffic Light: Green is for Go, Red is for Stop https://plantbasedbriefing.libsyn.com/174-part-1-dining-by-traffic-light-green-is-for-go-red-is-for-stop-by-dr-michael-greger-at-nutritionfactsorg 133: Treating Reflux in Babies with Diet https://plantbasedbriefing.libsyn.com/133-treating-reflux-in-babies-with-diet-by-dr-michael-greger-at-nutritionfactsorg 90: 'Plant Based Diet Healed My Gut and Made Me a Better Doctor' and '5 Ways to Reduce Food Waste at Home' https://plantbasedbriefing.libsyn.com/90-plant-based-diet-healed-my-gut-and-made-me-a-better-doctor-and-5-ways-to-reduce-food-waste-at-home   Osteoporosis 822: Calcium and Strong Bones https://plantbasedbriefing.libsyn.com/822-calcium-and-strong-bones-by-physicians-committee-for-responsible-medicine-at-pcrmorg  760: Fall Prevention Is the Most Important Thing for Preventing Osteoporosis Bone Fractures https://plantbasedbriefing.libsyn.com/760-fall-prevention-is-the-most-important-thing-for-preventing-osteoporosis-bone-fractures-by-dr-michael-greger-at-nutritionfactsorg  695: Is a Plant-Based Diet the Best for Senior Health? https://plantbasedbriefing.libsyn.com/695-is-a-plant-based-diet-the-best-for-senior-health-by-charlotte-pointing-at-vegnewscom 612: 5 Tips To Maintain Strong Bones And Prevent Osteoporosis https://plantbasedbriefing.libsyn.com/612-5-tips-to-maintain-strong-bones-and-prevent-osteoporosis-from-switch4goodorg  489: [Part 2] Calcium for Vegans https://plantbasedbriefing.libsyn.com/489-part-2-calcium-for-vegans-by-brigitte-gemme-at-veganfamilykitchencom 488: [Part 1] Calcium for Vegans https://plantbasedbriefing.libsyn.com/488-part-1-calcium-for-vegans-by-brigitte-gemme-at-veganfamilykitchencom 340: Milk and Osteoporosis: The Calcium Myth https://plantbasedbriefing.libsyn.com/340-milk-and-osteoporosis-the-calcium-myth-by-rick-scott-at-switch4goodorg   ============================ Dr. Michael Greger is a physician, New York Times bestselling author, and internationally recognized speaker on nutrition, food safety, and public health issues. A founding member and Fellow of the American College of Lifestyle Medicine, Dr. Greger is licensed as a general practitioner specializing in clinical nutrition. He is a graduate of the Cornell University School of Agriculture and Tufts University School of Medicine. He founded NUTRITIONFACTS.ORG is a non-profit, non-commercial, science-based public service provided by Dr. Michael Greger, providing free updates on the latest in nutrition research via bite-sized videos. There are more than a thousand videos on nearly every aspect of healthy eating, with new videos and articles uploaded every day.   His latest books —How Not to Die, the How Not to Die Cookbook, and How Not to Diet — became instant New York Times Best Sellers. His two latest books, How to Survive a Pandemic and the How Not to Diet Cookbook were released in 2020.  100% of all proceeds he has ever received from his books, DVDs, and speaking engagements have always and will always be donated to charity. ============================== FOLLOW THE SHOW ON: YouTube: https://www.youtube.com/@plantbasedbriefing     Spotify: https://open.spotify.com/show/2GONW0q2EDJMzqhuwuxdCF?si=2a20c247461d4ad7 Apple Podcasts: https://podcasts.apple.com/us/podcast/plant-based-briefing/id1562925866 Your podcast app of choice: https://pod.link/1562925866 Facebook: https://www.facebook.com/PlantBasedBriefing   LinkedIn: https://www.linkedin.com/company/plant-based-briefing/   Instagram: https://www.instagram.com/plantbasedbriefing/   

At the Martin Clinic, we've come up with our own alphabet when it comes to naming vitamins. The real vitamin C is actually coffee, vitamin S is steak. The real vitamin E is exercise and it turns out that exercise is actually a better treatment for pre-diabetes than Metformin! Join Dr. Martin as he reviews this study and shares an updated article about the dangers of the long-term use of PPIs, proton pump inhibitors.  

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Margaret Collins, a professor of pathology at the University of Cincinnati and a staff pathologist at Cincinnati Children's Hospital Medical Center. Dr. Collins was a member of the task force that produced the Guidelines on Childhood EGIDs Beyond EoE. In this interview, Dr. Collins discusses the guidelines and how they were created and shares some of the results, including an algorithm for diagnosing non-EoE EGIDs. She shares why she specialized in EGIDs and what her hopes are for the future development of the guidelines. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron, and co-host, Holly Knotowicz.   [1:13] Holly introduces today's topic, guidelines for childhood eosinophilic gastrointestinal disorders (EGIDs) beyond eosinophilic esophagitis (EoE).   [1:27] Holly introduces today's guest, Dr. Margaret Collins, a professor of pathology at the University of Cincinnati and a staff pathologist at Cincinnati Children's Hospital Medical Center.   [1:38] Dr. Collins specializes in the pathology of pediatric gastrointestinal disease, especially EGIDs, and is a central pathology reviewer for the Consortium of Eosinophilic Gastrointestinal Researchers (CEGIR), as well as a member of APFED's Health Sciences Advisory Council.   [2:11] As a pathologist, Dr. Collins examines biopsies microscopically. For EGIDs, she determines the peak count of eosinophils per high-power field, or reports the numbers of eosinophils in multiple high-power fields, and analyzes the tissue for additional abnormalities.   [2:33] Dr. Collins then issues a report that becomes part of the patient's medical record and is provided to the patient's doctor.   [2:41] The biopsies Dr. Collins examines may be the first biopsies for a diagnosis, or follow-up biopsies to determine response to therapy, or as part of ongoing monitoring to determine if inflammation has returned even if the patient has no symptoms.   [3:07] Dr. Collins was inspired to specialize in EGIDs after speaking with patients with EGIDs. She used to give tours of the pathology lab at Cincinnati Children's Hospital. She met affected children and their caregivers. Their courage and gratitude moved her.   [3:43] Ryan mentions the wonderful patients and their families in the APFED community. Holly says that as a patient, it's fascinating to meet a pathologist. Pathologists are generally behind the scenes.   [4:42] Dr. Collins specializes in GI pathology, including eosinophilic-related conditions in the GI tract. EoE, eosinophilic gastritis, eosinophilic enteritis, and eosinophilic colitis.   [5:16] In January 2024, “Guidelines on Childhood EGIDs Beyond EoE” were published in the Journal of Pediatric Gastroenterology and Nutrition. Dr. Collins served on the task force that prepared the guidelines.   [5:35] Non-EoE EGIDs affect all sites of the GI tract except the esophagus. All sites of the GI tract except the esophagus normally have eosinophils in the mucosa, which complicates the diagnosis.   [6:03] Like EoE, the diagnosis of non-EoE EGIDs is made after known causes of tissue eosinophilia are excluded.   [6:28] Consensus guidelines help bring attention to best practices and encourage uniformity of practices.    [6:50] This is especially important for rare diseases and for centers that see fewer patients with rare diseases than the more specialized centers. Guidelines based on the best information available help these centers.   [8:03] The best distribution of guidelines is to publish them in the medical literature and sometimes in multiple journals to target audiences of allergists, gastroenterologists, and pathologists. Guidelines may be presented at national meetings to increase awareness.   [8:36] Several specialties are involved in the care of patients who have EGIDs. If patients or caregivers learn of published guidelines, they can also inform their providers.   [9:23] Insurance is a big issue for so many patients. Getting coverage for both diagnostic and treatment options can be complex.    [9:50] The guidelines may be helpful to insurance companies to accept that a certain drug is needed by a patient with a certain condition. However, if the sequence suggested in the guidelines is not followed, there may be difficulty getting coverage in the U.S.   [11:11] Patients can advocate for themselves with insurance companies by explaining that the order of testing is not important but getting the recommended tests done is important.    [11:55] The greatest challenge the task force faced was the lack of large clinical studies and quality research reports. We're making progress in this field but we're at the beginning. Dr. Collins is hopeful that progress will be made in the next two to three years.   [12:24] When there were knowledge gaps, the task force filled them in with their published research and their own experiences. It's always reassuring to have a well-conducted clinical study that verifies that your thinking is correct.   [13:29] How long did it take the task force to create these guidelines? Longer than they wanted it to take! The years they put into composing these guidelines were greater due to the interruption caused by the [COVID] pandemic. They all felt good when they finished.   [14:18] The guidelines were written by 26 authors from five continents. These are international guidelines.   [14:44] Dr. Collins highlights the pathology. The guidelines state that non-EoE EGIDs should be considered clinicopathologic diagnoses, as EoE is, meaning that biopsies from the affected site in the bowel must show excess eosinophils.   [15:10] The guidelines, for the first time, recommend threshold eosinophil values for a diagnosis in the parts of the GI tract other than the esophagus. For a diagnosis of EoE, a threshold value of greater than or equal to 15 eosinophils per high-power field.    [15:36] The guidelines now recommend that for a diagnosis of eosinophilic gastritis, a threshold value of greater than or equal to 30 eosinophils per high-power field is present.   [15:48] For a diagnosis of eosinophilic duodenitis, a threshold value of greater than or equal to 50 eosinophils per high-power field. For a diagnosis of eosinophilic ileitis, a threshold value of greater than or equal to 60 eosinophils per high-power field.   [16:03] For a diagnosis of eosinophilic colitis in the right colon, a threshold value of greater than or equal to 100 eosinophils per high-power field. For a diagnosis of eosinophilic colitis in the transverse and descending colon, a threshold value of greater than or equal to 80 eosinophils per high-power field. [16:12] For a diagnosis in the rectosigmoid, a threshold of greater than or equal to 60 eosinophils per high-power field.   [16:18] These numbers may change over time. One or more thresholds will likely change as we gain more experience with these diseases. The pattern won't change.   [16:29] Several studies have shown that the normal pattern of eosinophil presence in the mucosa in the GI tract is that the number increases from the stomach to the right colon and then decreases throughout the colon to the rectosigmoid.   [17:40] When giving tours of the hospital, Dr. Collins found that people understood better when they knew the numbers and could see the slides of their biopsies.   [18:48] Dr. Collins found literature reviews that suggested that the GI mucosa was often normal in non-EoE EGIDs. She believes that in the next few years, as we publish more and gain more experience, we will realize that is not the case.   [19:14] There is already a method for scoring the mucosa in the stomach in eosinophilic gastritis (EoG) and there are abnormalities found in a majority of patients. We have to work on the rest of the GI tract.   [19:35] Dr. Collins was surprised that there's not very good information about the use of proton pump inhibitors (PPIs) in eosinophilic gastritis and eosinophilic duodenitis. There haven't been studies about that. We need to work on that, too.   [20:47] Dr. Collins isn't sure we can recognize misconceptions about non-EoE EGIDs at this point. It might be premature to label any belief as a misconception. We thought that eosinophils were responsible for all symptoms in EoE, but we know now that is not true.   [21:10] Dr. Collins thinks we need to wait a bit before we decide that we know for sure all about non-EoE EGIDs. Ryan is excited to learn what the research will show us next.   [21:44] Holly loved learning about the algorithm in the guidelines.   [22:01] Dr. Collins says this is the first effort to create uniformity in the way in which non-EoE EGIDs are diagnosed. This algorithm can change over time. It provides signposts for the diagnosis, based on the information we have currently.   [22:20] The diagnosis of non-EoE EGIDs should rest on symptoms and the detection of dense eosinophilic inflammation in the mucosa by biopsy and the absence of evidence of other diseases, such as parasitic and other diseases, that might cause dense eosinophilic inflammation in the GI tract.   [22:46] The algorithm suggests that the particular anatomic site or sites in the GI tract responsible for the symptoms should be determined, for example, eosinophilic gastritis or eosinophilic colitis.   [23:03] The algorithm also suggests that the involved part of the wall in the involved anatomic site should be identified.   [23:13] For example, if the symptoms are suggestive of mucosal disease, without deeper mural or wall involvement, the clinical investigation can proceed directly to endoscopy.   [23:26] However, if symptoms suggest partial or complete bowel obstruction, which is typical of deep muscular involvement, then imaging studies should be considered before proceeding to endoscopy, to confirm or refute that there is a bowel obstruction.   [23:47] If the obstruction is identified, a full-thickness biopsy of the bowel wall may be indicated, possibly requiring a non-endoscopic surgical procedure. If obstruction is not identified, then the investigation can proceed to endoscopy.   [24:05] If there is abdominal distension, suggestive of fluid accumulation, consideration should be given to sampling the fluid, using a needle to pull some fluid out to determine if there are numerous eosinophils in the fluid that would indicate eosinophilic ascites, with the eosinophilic inflammation involving the outer lining of the bowel wall.   [24:41] The signposts are a little involved. They are a reasonable way to approach working up a diagnosis of non-EoE EGIDs.   [25:34] How is EoE ruled out before using this algorithm? It's sometimes difficult to distinguish symptoms that are relevant only to the esophagus and symptoms that are relevant only to the stomach.   [26:26] Someone with upper tract symptoms only will have an upper tract endoscopy, especially if that person has mucosal symptoms that seem to be relevant to the mucosa only. The best thing is to take biopsies of the esophagus, stomach, and duodenum to be sure where the eosinophil infiltrate is.   [27:06] If the person has lower tract involvement only, such as diarrhea and lower abdominal pain, and no upper tract symptoms, a transnasal endoscopy could be used to determine if there is EoE in addition to the non-EoE EGIDs. Each case is different.   [29:12] As a pathologist, Dr. Collins has seen the guidelines for treating eosinophilic conditions evolve. They've become more specific as our knowledge of the data concerning the disease has increased. PPIs are now considered a treatment for EoE.   [30:12] Dr. Collins says we need clinical trials testing therapies in children and adults with non-EoE EGIDs. We need to determine which patients have single-site disease and will only have single-site disease, and which patients may develop multi-site EGIDs.   [30:42] Those aspects will be addressed in the next version of CEGIR, if it's funded.   [30:49] Ryan tells Dr. Collins it's been fantastic having her on the show. This has been a good overview of non-EoE EGIDs and the new methods clinicians are looking into to help people get a better diagnosis and treatment.   [31:11] Dr. Collins says we don't have validated instruments yet to measure symptoms, evaluate the mucosa, and evaluate the biopsies under the microscopes. We need to create those validated tools to help us determine the significance of our findings.   [31:31] Some data strongly suggest that eosinophilic colitis is different from the rest of the EGIDs; certainly from the upper tract EGIDs. We need to move more deeply into what eosinophilic colitis actually is.   [32:05] For our listeners, feel free to check out the article we've been mentioning in the show notes. We'll include a link to it.   [32:11] For those of you who would like to learn more about eosinophilic disorders, please visit APFED.org and check out the links in the show notes.   [32:18] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [32:27] 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.   [32:36] Ryan thanks Dr. Collins for joining us today for this great conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode.   Mentioned in This Episode: Margaret H. Collins, M.D., A.G.A.F., Director, Gastrointestinal Pathology Division of Pathology ML 1035 Cincinnati Children's Hospital Medical Center “Guidelines on Childhood EGIDs Beyond EoE,” 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, GSK, Sanofi, and Regeneron.   Tweetables:   “The best distribution of guidelines is accomplished by publishing them in the medical literature; sometimes in multiple journals to target audiences of allergists, gastroenterologists, and pathologists.” — Dr. Margaret H. Collins    “Guidelines may be helpful to insurance companies to accept that a certain drug is needed by a patient with a certain condition.” — Dr. Margaret H. Collins    “It's always reassuring to have a well-conducted clinical study that verifies that your thinking is correct.” — Dr. Margaret H. Collins    “This is the first effort to create uniformity in the way in which non-EoE EGIDs are diagnosed. This algorithm can change over time. It provides signposts for the diagnosis, based on the information we have currently.” — Dr. Margaret H. Collins   “We don't have validated instruments yet to measure symptoms [for non-EoE EGIDs], evaluate the mucosa, and evaluate the biopsies under the microscopes. We need to create those validated tools to help us determine the significance of our findings.” — Dr. Margaret H. Collins  

“Active holistic therapy” for prostate cancer with diet and fish oil helps defer need for surgery, hormone blockade, radiation; Why 70 is the new 60; Long-term harmful effects of acid-blockers; Do memory supplements pass the blood-brain barrier? Fish oil, krill oil, olive oil for cardiovascular prevention; Paxlovid aggressively promoted but overprescribed for otherwise healthy patients. 

In this episode, the hosts discuss Eosinophilic Esophagitis (EOE), a condition that has gained recognition in recent years. They explore its symptoms, including dysphagia and food impaction, and the importance of accurate diagnosis through endoscopy and biopsies. The conversation delves into risk factors, potential triggers such as food allergies, and the role of diet in managing EOE. Treatment options are discussed, including pharmaceutical interventions like Budesonide and PPIs, as well as dietary management strategies such as elimination diets. The hosts also touch on herbal remedies and the importance of monitoring for fungal overgrowth during treatment.

In Part 2 of our EoE FAQ series, Dr. Pooja Singhal answers your top questions about medications for managing Eosinophilic Esophagitis. What are proton pump inhibitors (PPIs), steroids, and biologics? How do these medications work, and how can they help alleviate EoE symptoms? Dr. Singhal also highlights the importance of a collaborative process between patients and healthcare providers in selecting the most effective treatment plan. Sponsored by Sanofi Regeneron, this episode offers a clear and insightful look into EoE medications and their role in treatment.

Heartburn is a common symptom during pregnancy, affecting up to 80% of expecting mothers. While it can be uncomfortable, the good news is that it resolves after you have your baby. In the meantime, there are many safe and effective ways to manage heartburn during pregnancy. Discover why heartburn is more prevalent during this time and the foods and behaviors that can trigger it. Learn about evidence-based interventions for relief, ranging from dietary and lifestyle adjustments to over-the-counter and prescription medications. Explore the evidence on the safety of heartburn medicines during pregnancy, including antacids, histamine 2 (H2) blockers, and proton pump inhibitors (PPIs). Plus, hear about the fascinating evidence that may link heartburn to how much hair your baby has.     Thank you to our sponsors   VTech is the most trusted choice for baby monitors and North America's leading #1 baby monitor brand. The Vtech V-Care Over the Crib Smart Nursery Baby Monitor has every feature you could want in a monitor to keep an eye on your baby and have peace of mind that they are safely sleeping. The V-Care has built-in intelligence to alert you if your baby's face is covered or has rolled over on their stomach, full high-definition video, infrared night vision technology, and even analysis of sleep patterns and quality. The V-Care Over the Crib Smart Nursery Baby Monitor is exclusively available on Amazon.   Looking for a way to share baby photos and stay connected to family who are far away? I've got the perfect gift for you! Skylight Frame is the touchscreen digital photo frame your whole family will love. Skylight has over a million happy customers and thousands of 5-star reviews. They are confident you will love this frame and offer free 120-day returns. And now, as a special, limited-time offer for our listeners, get $20 off your purchase of a Skylight Frame when you go to SkylightFrame.com/PREGNANCYPOD.   Treat yourself or surprise your loved ones this holiday season with gifts that illuminate them with Fount Society's clean, luxurious skincare and body care. During pregnancy, you are more cautious about the ingredients in your skincare. The Fount Society Water Cream uses clean and hydrating ingredients to transform dry winter skin into a healthy, dewy complexion. Plus, it is free of parabens, and phthalates, so you get to nourish your skin without the toxins. Visit Fount Society, your one-stop shop for every skincare lover on your list, and use code PREGNANCYPOD to get an exclusive 30% off!     Read the full article and resources that accompany this episode.     Join Pregnancy Podcast Premium to access the entire back catalog, listen to all episodes ad-free, get a copy of the Your Birth Plan Book, and more.     Check out the 40 Weeks podcast to learn how your baby grows each week and what is happening in your body. Plus, get a heads up on what to expect at your prenatal appointments and a tip for dads and partners.     For more evidence-based information, visit the Pregnancy Podcast website. https://pregnancypodcast.com

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

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: World Diabetes Day roundup, existing drugs examined for T1D prevention, Blue Circle Health expands its novel T1D care model, Mounjaro studied further, Canada approves a new pumps system, and tragedy in the diabetes community.  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Of course, World Diabetes Day was yesterday. November 14 marks the birthday of Sir Frederick Banting. who discovered insulin along with Charles Best in 1922. Lots of the tech companies are taking action.. I'm going to link up a great article highlighting what many of them are doing…. from Medtronics Blue Balloon challenge to Dexcom's Nick Jonas video and a lot more. https://www.drugdeliverybusiness.com/world-diabetes-day-2024/ XX A new triple combo therapy could restore insulin production in people with type 1 using existing medications. Levicure's triple-combo oral therapy is already considered very safe, because it involves two drugs approved by the U.S. Food and Drug Administration (FDA) and a well-known supplement. The therapy is a combination of: DPP4-inhibitors, a common type 2 diabetes medication Proton pump inhibitors (PPIs), a drug for severe acid reflux A proprietary version of gamma-aminobutyric acid (GABA), a supplement often used to treat anxiety Levicure says the combined effect can block beta cell destruction, suppress autoimmunity, and restore beta cell function. So far, Levicure's triple therapy has gone through only one retrospective chart review; it has not been put to the test in a randomized controlled trial https://www.diabetesdaily.com/blog/can-this-triple-combo-oral-therapy-restore-insulin-production-733261/   XX Blue Circle Health is expanding it's unique approach to type 1 care. Already active in Florida, Maine & Vermont, it will now be in Delaware and Ohio. Blue Circle Health is free and develops a personalized care plan for each participant, tailored to their unique needs, and offers comprehensive multidisciplinary support over a six-month period. It's paid for by the Helmsley Charitable Trust. The program is available to people 18 years of age and older that speak Spanish or English, regardless of insurance coverage or citizen status. We've got an upcoming podcast episode all about Blue Circle coming up soon. https://www.prnewswire.com/news-releases/blue-circle-health-expands-to-delaware-and-ohio-to-address-health-system-barriers-to-type-1-diabetes-care-and-education-302304170.html XX An international team of experts has created the world's first evidence-based guide for eating lower and low carb. The group says until now, people with type 1 diabetes and their healthcare providers have lacked comprehensive resources to help implement this approach safely and effectively. The guide provides essential information for dietitians and nutritionists and empowers them to work collaboratively with individuals and families who are interested in reducing carbohydrates. It's free and we've got the download link in the show notes. https://www.newswire.ca/news-releases/international-team-launches-first-guide-for-carbohydrate-reduction-in-type-1-diabetes-883729104.html XX A new pump system is available in Canada. mylife YpsoPump insulin pump and CamAPS FX hybrid closed-loop algorithm by Health Canada. mylife Loop consists of the mylife YpsoPump, a lightweight intuitive insulin pump, integrated with the CamAPS FX hybrid closed-loop, a mobile phone-based algorithm, and the Dexcom G6 Continuous Glucose Monitoring (CGM) System. Working together, these components provide an innovative, automated insulin delivery (AID) system designed to simplify insulin therapy and improve glycemic control for Canadians living with diabetes.   "The approval of the mylife YpsoPump and CamAPS FX marks an important milestone as we bring these advanced technologies to the Canadian market," said Sébastien Delarive, Chief Business Officer of Ypsomed Diabetes Care. "Although Ypsomed is relatively new in Canada, our established leadership in diabetes care throughout Europe provides a solid foundation for delivering innovative solutions to Canadians living with type 1 diabetes."   "We are excited to see both mylife YpsoPump and CamAPS FX approved," said Karina Schneider, General Manager at Ypsomed Canada. "This step brings us closer to offering an integrated solution that will help simplify diabetes management for Canadian patients, empowering them to take more control of their health." https://finance.yahoo.com/news/ypsomed-camdiab-receive-health-canada-205500840.html XX The FDA updates the labels for all GLP-1 receptor agonists with a warning about pulmonary aspiration during general anesthesia or deep sedation. The affected drugs are semaglutide (Ozempic, Rybelsus, Wegovy); liraglutide (Saxenda, Victoza); and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 tirzepatide (Mounjaro, Zepbound). the Medication Guide section of the label also has new additions. Patients are counseled to tell their healthcare provider if they are scheduled to have surgery or other procedures that use anesthesia or deep sleepiness (deep sedation). They are alerted that the GLP-1 RAs they are taking may cause serious side effects, including food or liquid getting into the lungs during surgery or other procedures that use anesthesia or deep sedation. Patients are advised to tell all their healthcare providers that they are taking a GLP-1 RA before they are scheduled to have surgery or other procedures. https://www.medscape.com/viewarticle/fda-updates-glp-1-label-pulmonary-aspiration-warning-2024a1000k84?form=fpf XX Following an impressive data drop this summer highlighting the potential for Eli Lilly's tirzepatide to stave off progression to Type 2 diabetes in prediabetic patients, the Indianapolis-based drugmaker is laying out full results from its longest completed study of the dual GIP/GLP-1 receptor agonist to date. In the three-year SURMOUNT-1 trial, tirzepatide curbed the risk of disease progression to Type 2 diabetes by 94% versus placebo in adult prediabetes patients who were obese or overweight, Lilly said in a release Wednesday. The number represents a pooled result from three tirzepatide doses (5 mg, 10 mg and 15 mg) studied in the trial.   Putting those results into perspective, one new case of diabetes could be prevented for every nine patients treated with tirzepatide, which is marketed in the U.S. as Mounjaro for Type 2 diabetes and as Zepbound for obesity, Lilly said. https://www.fiercepharma.com/pharma/lilly-unwraps-detailed-data-showing-tirzepatide-kept-nearly-99-pre-diabetic-patients XX Edgparke commeical? XX https://www.bloomberg.com/news/articles/2024-10-25/apple-secretly-tests-blood-sugar-app-in-sign-of-health-ambitions XX XX And finally, many of you have likely already heard but we had some incredibly tragic news in the diabetes community, especially for the Breakthrough T1D ride community. I'm going to read from the Breakthrough T1D website: The leadership, staff, and volunteers of Breakthrough T1D mourn the tragic, sudden loss of five T1D Champions on Friday, Nov. 1, 2024.  Jeff and Michelle Bauer, Josh and Tammy Stahl and Barry Sievers were all killed in a singe car crash. The group included two married couples and one single individual—all very close friends and veteran Breakthrough T1D Ride participants. Of this incredibly impactful group, I knew Michelle Bauer personally, I met her as Michelle Alswager – you may know her as Jesse's mom. Her son, Jesse died from complications of type 1 in 2010. And that year, mile 23 on the JDRF ride was created as a mile of silence in memory of Jesse.  Now all riders are asked to ride in silence for that mile not only in memory of Jesse, but all those lost to type 1 diabetes. Michelle wrote her book, Jesse Was Here and created a program that's part of Beyond Type 1 to this day, all to help other families going through grief. She called me a few years ago when she was thinking of writing her book and I'm so grateful for our conversations and that our conversations may have helped her get it out there into a world where it's so needed. But we need Michelle here to talk about grief. More about talking to Michelle about the book).   Please, write the book, ride the bike, do the ironman, follow your heart and your dreams.  All of these incredible people gone too soon. https://www.breakthrought1d.org/news-and-updates/breakthrough-t1d-mourns-tragic-sudden-loss-of-five-ride-champions/   Thanks for joining me..

Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities.Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Wednesday at 7 AM. In this episode, Leah discusses osteoporosis and its potential connection to Veterans Affairs (VA) disability benefits. She explains that osteoporosis, which weakens bones and increases fracture risk, can be linked to military service either directly or as a secondary condition caused by another service-connected disability. Leah highlights the risk factors and symptoms of osteoporosis and mentions that certain medications, such as proton pump inhibitors (PPIs), can contribute to its development. She also outlines how veterans diagnosed with osteoporosis during or after service may qualify for VA disability ratings, particularly if they experience incapacitating episodes or significant bone damage.

This week on Fat Science, we explore how popular digestive aids can interfere with your metabolism. Dr. Emily Cooper is back with co-hosts Andrea Taylor and Mark Wright. Dr. Cooper demystifies the roles of digestive enzymes and probiotics, offering a science-based approach to managing gut health. This episode sheds light on how diet impacts the microbiome plus the benefits and potential drawbacks of supplementation. Key Takeaways: Digestive enzymes help break down food, which may aid digestion, but they can backfire. Probiotics potentially improve gut microbiome health, but not all pro probiotics are alike. A varied diet rich in whole and fermented foods can naturally support gut health, often reducing the need for supplements. Caution against unnecessary food group elimination, particularly gluten, unless medically advised. Medical evaluation is crucial for identifying the root causes of gastrointestinal issues before resorting to supplements or restrictive diets. Long-term use of medications like PPIs for acid reflux has potential side effects, including disruption of the microbiome. Probiotics might help mitigate PPI-induced microbiome issues, but choosing the right one is key. Personal Stories & Practical Advice:  Andrea discusses her journey with acid reflux and surgical intervention, which resolved her need for medication. Mark shares his long-term experience with acid reducers, highlighting the importance of regular health checks and exploring alternative solutions. Resources from the episode: Connect with Dr. Emily Cooper on LinkedIn. Connect with Andrea Taylor on LinkedIn. Connect with Mark Wright on LinkedIn. Fat Science is a podcast on a mission to explain where our fat really comes from and why it won't go (and stay!) away. In each episode, we share little-known facts and personal experiences to dispel misconceptions, reduce stigma, and instill hope.  Fat Science is committed to creating a world where people are empowered with accurate information about metabolism and recognize that fat isn't a failure. This podcast is for informational purposes only and is not intended to replace professional medical advice. If you have a show idea, feedback, or just want to connect, email info@diabesityinstitute.org.

Vitamin K2 removes calcium from your arteries and other soft tissues and puts it into the bone where it belongs. In this video, we're going to discuss the health benefits of vitamin K2 and how it can be used to clean your arteries, prevent heart attacks, and keep you healthy! Vitamin K2 deficiency can lead to soft tissue calcification, bone corrosion, osteoporosis, and cavities. You can get vitamin K2 from the diet, or you can make it from vitamin K1 in the gut. Natto (fermented soybeans) is the food with the most vitamin K2. Eel, goose liver, chicken liver, and beef liver also contain a significant amount of vitamin K2. Butter and cheese from grass-fed animals, salami, pork chops, and fermented vegetables contain small amounts of vitamin K2. Vitamin K2 can clean your arteries naturally, yet it's found in fatty foods that we've been told to avoid! Because it's a fat-soluble vitamin, you may have trouble absorbing it if you don't have a gallbladder or you have a bad liver. You need plenty of healthy microbes to convert vitamin K1 to vitamin K2. B. subtilis is the primary microbe responsible for this conversion. Only 30% of the population has this microbe in their gut because it's very easily destroyed when you consume broad-spectrum antibiotics. Without B. subtilis and vitamin K2 foods, you're at risk for developing calcification in the arteries. Antibiotics, steroids, PPIs, antacids, glyphosate from GMO foods, alcohol, junk food, liver disease, high-sugar diets, and blood thinners destroy the gut's ability to make vitamin K2. Low-fat diets can also put you at risk for a vitamin K2 deficiency. Vitamin K2 is dependent on magnesium. Together, magnesium and vitamin K2 can help clean your arteries and remove calcium deposits from your soft tissues. There are two kinds of vitamin K2: MK4 (synthetic) and MK7 (natural). Try taking 100 mcg of MK7 vitamin K2 for every 10,000 IU of vitamin D3.

Join Dr. Martin in today's episode of The Doctor Is In Podcast.  

Are you taking PPIs?

Gastroesophageal Reflux Disease (GERD) aka acid reflux is one of the most prevalent gut issues in the world. And unfortunately, popping those PPIs and Tums isn't doing your body much good. This has been my most popular episode EVER, and so I'm bringing it back around -- Listen to this episode to find out: - why you aren't just suffering from TOO MUCH or NOT ENOUGH stomach acid - why you shouldn't drink tons of liquids with your meals - why proton-pump inhibitors aren't the best option for your health - which foods are common triggers for GERD - how naturally heal your system instead of just covering up symptoms ... and more! If this episode resonates with you and you're looking for more guidance, consider joining my pH Balance DIY Program to naturally heal your acid reflux. You can find it at bit.ly/phbalancegroup Show Notes: Get my Core-Gi Workout Program with the exclusive listener discount! Join the Compass Method DIY Program Schedule a 1:1 Discovery Call Coursework from the Master's of Human Nutrition & Functional Medicine program at the University of Western States Gastric acid normosecretion is not essential in the pathogenesis of mild erosive gastroesophageal reflux disease in relation to Helicobacter pylori status You can learn more about me by following on IG @imperfectlypaigewellness or by checking out my blog, freebies, and offers on my website: https://imperfectlypaigewellness.com Please share with #PaigeTalksWellness to help get the word out about the show - and join the Imperfect Health Fam over on Facebook.

In this week's episode of Red Pill Your Healthcast, Dr. Charlie Faganholz and Lauren Johnson tackle a variety of health-related questions submitted by listeners. We kick off the discussion by addressing how to improve lung health, particularly for children who frequently experience respiratory issues. Lauren emphasizes the importance of assessing the indoor air quality and suggests using air purifiers and testing for mold. Dr. Charlie adds that supporting the immune system with specific supplements like glutathione, vitamin A, and herbal tonics can be beneficial. Next, we delve into the topic of foot fungus and dry, cracked heels, highlighting the connection between systemic fungal issues and localized symptoms. We recommend a combination of antifungal herbs and dietary adjustments to address these concerns effectively. The conversation then shifts to the challenges of discontinuing proton pump inhibitors (PPIs) like Pepsin, especially for individuals with a history of H. pylori infection and gallbladder removal. We stress the importance of a gradual approach to tapering off PPIs and suggest exploring root causes, including potential food sensitivities and emotional factors. As we wrap up, we discuss preparing for a C-section, emphasizing the need for emotional support and physical preparation through supplements and red light therapy. Finally, we touch on the use of nicotine pouches and the management of gestational diabetes, advocating for home blood sugar monitoring as a practical alternative to traditional testing methods. Shop our recommended supplement and submit your questions on our website https://www.redpillyourhealthcast.com/ Time Stamps: 00:00:00 - Introduction and Question Submission 00:00:22 - Improving Lung Health for Children 00:02:39 - Supporting Lung Health: Supplements and Strategies 00:06:30 - Addressing Recurrent Lung Issues and Pneumonia 00:12:04 - Foot Fungus and Dry Cracked Heels 00:15:48 - Getting Off Proton Pump Inhibitors (PPIs) 00:29:33 - Preparing for a C-Section 00:35:04 - Opinions on Nicotine Pouches and Gestational Diabetes Testing

In this episode of the IBS Freedom Podcast, we dive into the polarizing world of conventional and holistic medicine. We discuss the extreme stances often taken by both sides and emphasize the importance of a balanced, moderate approach. Conventional medicine isn't inherently evil, and it has its place, especially in acute or emergency situations. Simultaneously, holistic approaches can be very beneficial but can often lead to fear-mongering and disordered eating if taken to the extreme. We share personal experiences and practical advice on when to consider conventional interventions, such as antibiotics or PPIs, as part of a comprehensive treatment plan while maintaining a strong foundation in holistic health practices. Join us as we aim to dispel myths and encourage a compassionate, open-minded approach to healthcare.00:00 Introduction and Episode Premise00:36 Personal Experiences with Conventional Medicine02:53 Balancing Conventional and Functional Medicine05:18 Examples of Conventional Medicine's Role10:51 Judgment in Functional Medicine12:57 Critical Thinking in Medicine23:46 Challenges in Conventional Medicine30:12 Conventional vs. Functional Medicine: A Comparison32:32 The Fear Factor in Functional Medicine34:33 The Middle Ground: Balancing Both Worlds36:18 Gratitude and Professional Support38:16 Challenges in Conventional Medicine41:51 Navigating Lab Tests and Insurance48:13 Personal Stories: Birth Experiences and Medical Choices53:48 Final Thoughts and CompassionLove this episode?Be sure to LIKE it and SUBSCRIBE :)Nikki's Info:- Youtube Channel: https://www.youtube.com/c/TriangleHolisticGutHealth- Instagram: @Gut.Microbiome.Queen- FODMAP Freedom in 90 Days: https://www.fodmapfreedom.com/enroll- Private Appts: https://infinityholistichealth.com/Amy's Info:- Practice: https://sibodiaries.com/- Instagram: @Amy_Hollenkamp_RD

On this episode of the Real Life Pharmacology podcast, I cover medications 81 through 85 on the top 200 drug list. Famotidine is an H2 blocker. H2 blockers are less potent than PPIs but can be used to manage heartburn symptoms. Aspirin is technically an NSAID but is primarily used for cardioprophylaxis purposes. Senna is a stimulant laxative. I often see this medication used with opioids to help manage opioid-induced constipation. Novolog is a rapid acting insulin used to bring down post prandial blood sugars. I discuss sliding scale insulin and other concepts with this medication. Baclofen is a skeletal muscle relaxant. It has central nervous system depressant effects which can be especially problematic in elderly patients. Support the sponsor Meded101.com by going to meded101.com/store - Study materials, books, review courses for pharmacists, pharmacy students, pharmacy technicians, nurses, physicians, prescribers, dietitians, and all others who want to learn pharmacology!

TODAY ON THE ROBERT SCOTT BELL SHOW: Alexis Lorenze tragedy, EMF Protection, Lisa Rooney, Ignatia Homeopathic Hit, Proton Pump Inhibitors in Children, Microplastics in the Brain, Obesity Crisis, Bee Vaccines for Pesticides, and MORE! https://robertscottbell.com/alexis-lorenze-tragedy-emf-protection-lisa-rooney-ignatia-homeopathic-hit-proton-pump-inhibitors-in-children-microplastics-in-the-brain-obesity-crisis-bee-vaccines-for-pesticides-and-more/

It's slow going for sure, but Americans seem to be catching on to "our food is poison" and "big medicine makes money off of our suffering". It can't come too soon. Some docs sound off on nutrition and docs. And more bad news about PPIs?

The Society of Critical Care Medicine just released their first set of updated stress ulcer prophylaxis (SUP) guidelines since 1999 that include groundbreaking changes. We also discuss evidence on proton pump inhibitor (PPI) use for SUP that impacts ICU practice.  The GameChangerNew guidelines for use of PPIs for stress ulcer prophylaxis will have a significant impact on ICU practice.HostJen Moulton, BSPharmPresident, CEimpactGuest Geoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthMatthew Trump, DO, FACP, FCCPPulmonologistThe Iowa ClinicReferenceGuidelinesPaperPharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the new Stress Ulcer Prophylaxis (SUP) guidelines from the Society of Critical Care Medicine (SCCM), including identifying patients at risk.2. Discuss the use of Proton Pump Inhibitors (PPI) and Histamine-2 Receptor Antagonists (H2RA) for Stress Ulcer Prophylaxis (SUP).0.05 CEU/0.5 HrUAN: 0107-0000-24-247-H01-PInitial release date: 08/26/2024Expiration date: 08/26/2025Additional CPE details can be found here.

The Society of Critical Care Medicine just released their first set of updated stress ulcer prophylaxis (SUP) guidelines since 1999 that include groundbreaking changes. We also discuss evidence on proton pump inhibitor (PPI) use for SUP that impacts ICU practice.  The GameChangerNew guidelines for use of PPIs for stress ulcer prophylaxis will have a significant impact on ICU practice. GuestGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthMatthew Trump, DO, FACP, FCCPPulmonologistThe Iowa Clinic ReferenceGuidelinesPaper Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the new Stress Ulcer Prophylaxis (SUP) guidelines from the Society of Critical Care Medicine (SCCM), including identifying patients at risk.2. Discuss the use of Proton Pump Inhibitors (PPI) and Histamine-2 Receptor Antagonists (H2RA) for Stress Ulcer Prophylaxis (SUP).0.05 CEU/0.5 HrUAN: 0107-0000-24-247-H01-PInitial release date: 08/26/2024Expiration date: 08/26/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

In this episode, Will and Derek discuss the importance of pre-purchase inspections (PPIs) when buying a used car, particularly a Porsche. Does the idea of flying your mechanic out to inspect a car sound crazy to you? After you hear a few of these horror stories you might not think so! Hosted on Acast. See acast.com/privacy for more information.

In this episode, we discuss the approach to deprescribing for several drugs such as benzodiazepine receptor agonists, cholinesterase inhibitors, memantine, antipsychotics, and antihyperglycemics. Key Concepts Medication appropriateness including indication and risk vs. benefit should be evaluated for all stages of life; however, more importantly in older individuals to address polypharmacy. There is an emerging trend of deprescribing networks that conduct research and provide evidence-based recommendations for how to deprescribe certain medications used for specific indications. Evidence-based deprescribing guidelines for PPIs, benzodiazepines, benzodiazepine receptor agonists, opioids, antipsychotics, cholinesterase inhibitors, memantine, and antihyperglycemics are available for patient-provider shared decision making.  A general deprescribing approach is gradual tapering of the drug leading to discontinuation over several weeks while monitoring patients for withdrawal symptoms or benefits of discontinuation.  References http://deprescribing.org https://www.australiandeprescribingnetwork.com.au

Dive into the complexities of heartburn and GERD (Gastroesophageal Reflux Disease), understanding why it may present itself in otherwise healthy, young individuals and the potential complications if left untreated. Discover common causes such as dietary habits and lifestyle factors as well as other culprits that may be causing your symptoms like H. pylori or low stomach acid. Gain insights into the importance of proper meal hygiene, the impact of stress on digestion and the role of various treatments, from natural remedies to prescription medications. Lindsey Parsons, your host, helps clients solve gut issues and reverse autoimmune disease naturally. Take her quiz to see which stool or functional medicine test will help you find out what's wrong. She's a Certified Health Coach at High Desert Health in Tucson, Arizona. She coaches clients locally and nationwide. You can also follow Lindsey on Facebook, Tiktok, X, Instagram or Pinterest or reach her via email at lindsey@highdeserthealthcoaching.com to set up a free 30-minute Gut Healing Breakthrough Session. Show Notes

From a young age, Dr. Tieraona Low Dog has been deeply drawn to the natural world and the field of natural medicine. Her academic journey encompasses a diverse range of disciplines including massage therapy, martial arts, midwifery, and herbal medicine, before going to earn her medical degree from the University of New Mexico School of Medicine. She is the Founding Director of the Medicine Lodge Academy, and Dr. Low Dog served as a founding member of the  American Board of Physician Specialties' American Board of Integrative Medicine.  Her leadership extends to her tenure as Director of the first Inter-professional Fellowship in Integrative Health and Medicine, Fellowship Director for the University of Arizona's Center for Integrative Medicine that was founded by Andrew Weil, MD, and Co-Founder and guiding teacher for the New York Zen Center's Fellowship in Contemplative Medicine. She currently oversees the Fellowship of Integrative and Functional Medicine at the University of California-Irvine's Susan Samueli Integrative Health Institute. Recognized as a foremost authority in integrative medicine, women's health, dietary supplements, and herbal medicine, her scholarly work encompasses over 54 peer-reviewed scientific articles, 25 chapters in medical textbooks, and numerous authoritative books on health and medicine. Dr. Low Dog's global influence is highlighted by her participation in over 600 medical and scientific conferences worldwide. Dr. Low Dog has had a great impact on my professional work and it is an absolute honor to have her on the podcast today.  Together we discuss the incredible impact that she has had on both the holistic and traditional medicine communities and how she has effectively worked to bridge the gaps between herbal medicine and traditional medicine.  She reflects on the importance of continuing her education to expand her own knowledge and effectiveness and the power that comes with admitting that, even as a lifelong learner and practitioner, she doesn't know everything.  She also shares insights into the offerings from her Foundations in Herbal Medicine program and highlights the value of using herbs in clinical practice.  Together we discuss the dismal state of nutrition in America today and consider drug-nutrient interaction and depletion, strategies for effectively weaning patients off of PPIs, and the many plants and supplements that she recommends in achieving whole health and healing.  I'm your host, Evelyne Lambrecht, thank you for designing a well world with us. Key Takeaways: [3:16] From herbalist, midwife, and martial arts instructor to medical school student, Dr. Low Dog recalls the moment she realized the limits to what she could do without a medical degree.  [7:15] The importance of training clinicians and expanding practitioners' knowledge of botanical medicine. [11:16] Encouraging healing and creating change in the US healthcare system. [15:18] Bridging the gap between herbal medicine and traditional medicinal care. [21:00] Dr. Low Dog offers insights into the offerings from her Foundations in Herbal Medicine program. [23:32] Treating anxiety with nervings starts with considering how a patient views the world. [29:20] The value of storytelling when helping patients understand the value of plants in their healthcare. [34:14] Accurate dosing based on patient information and health profile. [38:16] Recommendations for herbs that are safe during pregnancy and breastfeeding. [42:47] The current state of nutritional health in the United States and the drug-nutrient interaction and depletion. [49:02] Dr. Low Dog's recommendations for transitioning patients off PPI's, including utilizing melatonin. [53:38] Dr. Low Dog shares what she has changed her mind about over her years of practice, her favorite supplements, and the health practices that keep her balanced.   Episode Resources: Dr. Tieraona Low Dog - https://www.drlowdog.com/ Medicine Lodge Academy - https://www.medicinelodgeranch.com/ U.S. Pharmacopeia - https://www.usp.org/ Design for Health Resources: Designs for Health - https://www.designsforhealth.com/ Visit the Designs for Health Research and Education Library which houses medical journals, protocols, webinars, and our blog. https://www.designsforhealth.com/research-and-education/education

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To learn more about working with me and to get a free call and bonus digestion training, go to: www.gutpartner.com Or, call us now at 586-685-2222 To try Dr. Christine's Smart Carb-45 for $19.99, go to: www.TrySmartCarb.com

Dr. Nathan Bryan earned his undergraduate Bachelor of Science degree in Biochemistry from the University of Texas at Austin and his doctoral degree from Louisiana State University School of Medicine in Shreveport where he was the recipient of the Dean's Award for Excellence in Research. He pursued his post-doctoral training as a Kirschstein Fellow at Boston University School of Medicine in the Whitaker Cardiovascular Institute. After a two year post-doctoral fellowship, in 2006 Dr. Bryan was recruited to join faculty at the University of Texas Health Science Center at Houston by Ferid Murad, M.D., Ph.D., 1998 Nobel Laureate in Medicine or Physiology.During his nine years at UT, Dr. Bryan focused on drug discovery, screening natural product libraries for active compounds. His research led to over a dozen US and international patents. Notably, he was the first to describe nitrite and nitrate as essential nutrients for cardiovascular health and demonstrated an endocrine function of nitric oxide. He discovered compositions that generate and restore nitric oxide in humans, validated by six clinical trials. In this episode, we cover:The role of nitric oxide in maintaining cardiovascular and brain health.How nitric oxide production declines with age and its impact on chronic diseases.The connection between nitric oxide and diet, highlighting the importance of vegetables.The surprising link between oral hygiene and nitric oxide levels, and how mouthwash may harm your health.The influence of nitric oxide on hormone regulation and sexual health.Myths about nitrates in cured meats and their health effects.The risks associated with proton pump inhibitors (PPIs) and their impact on nitric oxide production.The role of nitric oxide in mitochondrial function and overall energy production.Dr. Nathan Bryan's actionable tips for enhancing nitric oxide production through diet, lifestyle, and supplementation.Sign up to The Neuro Athletics Newsletter: https://bit.ly/3ewI5P0Sponsors:Momentous - Use code NEURO to get up to 32% off your first subscription order - https://www.livemomentous.com/Apollo Neuro - Use code NEURO40 and get $40 off - https://apolloneuro.com/Connect with Dr. Nathan Bryan:Twitter: https://www.instagram.com/drnathansbryan(00:00) Preview and Introduction(02:14) What is Nitric Oxide?(06:12) Impact of Nitric Oxide on Aging(08:20) Pathways of Nitric Oxide Production(14:01) Nitric Oxide and Alzheimer's Disease(19:23) Challenges in Nitric Oxide Detection(22:32) Nitric Oxide and Erectile Dysfunction(28:01) Impact of Exercise on Nitric Oxide Production(31:22) Role of Oral Microbiome in Nitric Oxide Production(36:05) Fluoride Causes Health Issues?(41:25) Nitric Oxide Production Dependency on Diet(46:15) How Does Nitric Oxide Affect Mitochondrial Function (49:05) Importance of Nitric Oxide for HealthThe Neuro Athletics Newsletter Instagram: @louisanicola_Twitter : @louisanicola_YouTube: @Louisa NicolaThe Neuro Experience Podcast is proud to have hosted: Dr Andrew Huberman, Dr Gabrielle Lyon, Dr Layne Norton, Thomas DeLauer, Shawn Stevenson, Dr. Rocio Salas-Whalen, Saad Alam, Uma Naidoo, Dr. Lanna Cheuck, Angela Lee Pucci, Jillian Turecki, Dr. Jordan Feigenbaum, Dr. Darren Candow, Dr. Sue Varma, Evy Poumpouras, Dr Casey Means, Renee Deehan, Dr Chris Palmer, Dr Charles Brenner.

"For most American adults, a strong foundation in supplementation can be built with five key nutrients: a high-quality multivitamin, magnesium, omega-3 fatty acids, probiotics, and digestive enzymes."Are you frustrated by the lack of transparency in the supplement industry?Overwhelmed by the endless options and claims on supplement labels?Unsure how to distinguish high-quality, effective products from ineffective ones?Join us as we chat with Jared St. Clair of Vitality Nutrition and host of the Vitality Radio Podcast about the often convoluted world of dietary supplements. In this episode, Jared pulls back the curtain on questionable practices by some companies and shares his 'vital five' must-have supplement recommendations.Learn how to spot trustworthy brands that prioritize your health over profit, and gain adept knowledge on supplementing wisely. Tune in to Season 3, Episode 17 of the Gutsy Health Podcast! Show Highlights: 00:00 - Episode start02:25 - Jared's background as health store manager turned owner and radio show host 12:52 - The impetus for creating his own product line of supplements17:28 - Jared shares his "vital five" supplement recommendations18:28 - Why multivitamins like Centrum are a waste of money25:41 - Praise for companies with high-quality standards and commitment to purity29:13 - Direct-to-consumer business models that allow for higher quality at lower prices33:05 - Risks of long-term use of proton pump inhibitors (PPIs) 34:14 - cGMP (current Good Manufacturing Practices) in the supplement industry36:10 - Are fillers and flow agents in supplements something to be mindful of?39:50 - Differences between synthetic and natural/food-based sources of nutrients47:59 - Why you need more magnesium and methylated B vitamins49:25 - Voting with your dollars to support ethical companies and drive real change50:33 - Jared's top picks for omega-3 supplements58:18 - How and where to start your supplement journey1:00:52 - The gut-brain connection and the link between IBS and depression1:06:19 - Guidance on selecting a high-quality probiotic supplementImportant Links: Gutsy Health Website - https://www.mygutsyhealth.com/Gutsy Health Podcast IG - https://www.instagram.com/gutsyhealthpodcast/Reach out to Provo Health and schedule a consultation with Dr. Jeff Wright by calling 801-691-1765Connect with Jared St. Clair on:Vitality Nutrition - https://vitalitynutrition.com/Vitality Radio Podcast with Jared St. Clair - https://podcasts.apple.com/us/podcast/vitality-radio-podcast-with-jared-st-clair/id1499760048Instagram - https://www.instagram.com/vitalitynutritionbountiful/Reach out to Vitality Nutrition by calling 801-292-6662 or visit the shop on 107 South 500 West, Bountiful, UT 84010Links Mentioned:Jared's Vital 5 - https://vitalitynutrition.com/collections/vital-5Just Ingredients Podcast with Karalynne Call - https://podcasts.apple.com/us/podcast/just-ingredients/id1557557205The Great Debate  in Probiotics: Human Strains vs. Spores - https:Send us a Text Message.

Today, I'm going to tell you how to reverse magnesium deficiency. It's very difficult to test for magnesium deficiency. Around 60% of your magnesium is in your bones, 39% in your soft tissue, and only 1% in your blood. A blood test is not a reliable way to determine if you have low magnesium. Magnesium deficiency can be caused by the following factors: • Diet • Gut inflammation • Diabetes • Insulin resistance • Excessive sugar consumption • Vitamin D without magnesium • Medications (antibiotics, PPIs, antacids, diuretics) Symptoms of magnesium deficiency can include: • Tetany • Tight muscles • Insomnia (sleep problems) • Anxiety • Fatigue • Nystagmus • Migraines • Kidney stones You need magnesium to make ATP, the “energy currency” of the body. Magnesium deficiency can also lead to calcium buildup. Here are some of the foods that have the most magnesium per 100 grams/3.5 ounces: 1. Sea kelp: 760 mg of magnesium 2. Almonds: 490 mg of magnesium 3. Nutritional yeast: 231 mg of magnesium 4. Pecans: 142 mg of magnesium 5. Leafy greens: 100 mg of magnesium 6. Dark chocolate: 165 mg of magnesium 7. Pumpkin seeds: 265 mg of magnesium 8. Meat and fish: 25 to 35 mg of magnesium The RDA for magnesium is 300 to 420 mg, and the average person only consumes 215 mg. If you have magnesium deficiency, increase your intake of magnesium-rich foods and supplement with 800 mg of magnesium glycinate. It can take up to a year to fix a chronic magnesium deficiency, but you might find that your low magnesium symptoms go away in a few weeks or months. After you've increased magnesium levels with supplements, you can maintain it with your diet. Always ensure you consume at least 400 mg of magnesium daily. Sun Tzu The Technology of War Book Link: https://www.amazon.com/Sun-Tzu-Techno... The Miraculous Cure for and Prevention of ALL Diseases Book Link: https://www.amazon.com/Miraculous-Pre... DATA: https://www.ncbi.nlm.nih.gov/pmc/arti... https://pubmed.ncbi.nlm.nih.gov/7786694/ https://www.nature.com/articles/s4200... https://www.mdpi.com/1422-0067/24/1/223 https://link.springer.com/article/10.... https://www.ahajournals.org/doi/full/...

On this episode, I discuss the new medication vonoprazan and where it will likely be used in practice. Vonoprazan is from a brand new class of medication called "PCAB". I discuss this medication and its pharmacology in this podcast episode. Drug interactions and cost are the two major downsides of this medication that will likely limit its use compared to the PPIs. CYP3A4 inducers like rifampin, carbamazepine, and phenytoin should not be used with vonoprazan. They will reduce the effectiveness of vonoprazan.

Key takeaways you'll learn in this episode: What most doctors get wrong about stomach acid. What is an Alkaline diet and why is your PH Balance important? What causes Acid Reflux and how can you improve it? Dr. Daryl Gioffre's two-week protocol to improve leaky gut. Get weekly tips from Gary Brecka on how to optimize your health and lifestyle routines - go to ⁠https://www.theultimatehuman.com/⁠ For more info on Gary, please click here:⁠ ⁠⁠⁠https://linktr.ee/thegarybrecka Order The 1 Genetic Test That Will Give You Results For Life Here: ⁠⁠⁠⁠https://10xhealthnetwork.com/pages/genetic-testing?utm_source=gbrecka⁠⁠⁠ Get The Supplements That Gary Recommends Here: ⁠⁠⁠⁠⁠⁠⁠⁠https://10xhealthnetwork.com/pages/supplements?utm_source=gbrecka⁠ Sign up for 10X Health Affiliate Program ⁠https://10xhealthsystem.com/GBaffiliate⁠ ECHO GO PLUS HYDROGEN WATER BOTTLE ⁠http://echowater.com⁠ BODY HEALTH - USE CODE ULTIMATE10 for 10% OFF YOUR ORDER ⁠https://bodyhealth.com/ultimate⁠ Are you struggling with acid reflux or digestive issues? Gary Brecka is sitting down with Dr. Daryl Gioffre about natural ways to improve gut health and reduce acidity. Dr. Daryl Gioffre is a functional nutritionist, board-certified chiropractor, and anti-inflammation expert. He specializes in the alkaline/acid diet and is the author of, “Get Off Your Acid.” He's also the founder of the supplement line Alkamind, and known as, “The Celebrity Nutritionist!” They're diving into food sensitivities, the best (and easiest) ways to support healthy stomach acid, and how to gradually get off dangerous PPIs. He also shares his personal story of how he became obsessed with helping people improve from the inside out with his holistic approach to restoring balance and digestive wellness through lifestyle changes! 01:00 - Who is Dr. Daryl Gioffre, “The Celebrity Nutritionist?” 03:30 - Why does he focus on eliminating sugar as a first step? 07:00 - What is an Alkaline diet and why is your PH Balance important? 14:00 - The best morning routine for treating deficiency and toxicity.  20:00 - How stomach acid works and what it takes for it to be healthy. 23:30 - What is causing food sensitivities? 25:30 - What causes Acid Reflux and how to improve it? 27:30 - Dr. Daryl's turning point, seeing acid reflux lead to cancer in his father. 33:45 - Easy first steps to improve your stomach acidity. 39:00 - Why you shouldn't quit proton-pump inhibitors cold turkey. (Tums, Prilosec, etc.) 44:30 - What supplements should people take to rebuild a healthy gut? 50:00 - When is it safe to stop taking PPIs? (Acid Reflux Medications) 58:30 - What causes a leaky? 59:00 - Dr. Daryl's two-week protocol to improve leaky gut. (Liquid Alo Vera + Bio-Active Silver Hydrosol) 01:06:00 - What is “Alkamind” and why did he create his products? Connect with Dr. Daryl Gioffre on Instagram: @drdarylgioffre ⁠https://www.instagram.com/drdarylgioffre/⁠ Get Your Ultimate Human Customized Gut Lab Package with Dr. Daryl (Discounted Rate) ⁠https://l.bttr.to/TTJSr⁠  Check Out Dr. Daryl's Supplements Here: ⁠https://www.getoffyouracid.com/?afmc=2o&utm_campaign=2o&utm_source=leaddyno&utm_medium=affiliate⁠ Gary Brecka: ⁠@garybrecka⁠ The Ultimate Human: ⁠@ultimatehumanpod⁠ Subscribe on YouTube: ⁠@ultimatehumanpodcast⁠ The Ultimate Human with Gary Brecka Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. Learn more about your ad choices. Visit megaphone.fm/adchoices