Podcasts about zetia

What is your take on DMSO?I'm taking Zetia and Crestor and have familial hypercholesterolemia. Can I eat saturated fat?I think I have demodex mite infestation. My doctor says almost everyone has it and they don't cause issues. What say you?Why do I have to stop taking my supplements before hip replacement surgery? 

Topics include: 00:40 Is Weightloss Simply Calories In and Out? 07:10 Stem Cell Injections for NBA Players?   14:60 Statins for Lowering Cholesterol 23:19 The Impact of Nature and Nurture on Longevity

This episode's Community Champion Sponsor is Ossur. To learn more about their ‘Responsible for Tomorrow' Sustainability Campaign, and how you can get involved: CLICK HERE---Episode Overview: Is it possible to revolutionize kidney disease treatment and redefine conventional care? Our next guest, John Erbey, is doing just that as the founder and CEO of Roivios. With over 25 years of pioneering experience in the medical field, John brings a unique blend of analytical rigor, physiological insight, and deep understanding of customer needs, which has driven ground-breaking advancements across the medical device and pharmaceutical sectors. Inspired by personal experiences with kidney disease in his family, John is on a mission to transform patient lives. Join us as we explore how Roivios is reshaping kidney health management, potentially saving billions in healthcare costs, and paving the way for a future where kidney function can be sustained and enhanced. Let's go!Episode Highlights:Embracing discomfort for true innovation in healthcareAddressing kidney disease's $250 billion annual cost in the USTargeting renal impairment during cardiac surgeryDeveloping JuxtaFlow technology with future wearable applicationsEnvisioning implantable devices to prevent kidney disease progressionAbout our Guest: John Erbey, a visionary with over 25 years of experience in the medical field, is the founder and CEO of Roivios. His dynamic leadership and pioneering approaches have led to substantial advancements in therapeutic development and medical devices.At Roivios, John has revolutionized the treatment of kidney disease by introducing an innovative approach that redefines conventional wisdom about kidney filtration. This led to the creation of the groundbreaking JuxtaFlow® Renal Assist Device (RAD), marking a significant evolution in kidney health management.John's leadership extends across the medical device and pharmaceutical sectors, where he has led the launch of CardioMEMS and defined the EU pricing strategy for Ezetrol (Zetia). As a strategist, his mission is to enhance patient lives by providing superior tools to healthcare providers. His unique blend of analytical rigor, physiological insight, and deep understanding of customer needs has enabled him to leverage scientific innovations, creating value for brands like CardioMEMS™, Zetia™, Vytorin™, and Avandia™.Since founding Roivios in 2015, John's personal journey has been a driving force behind his commitment to transformative healthcare solutions. Having witnessed the profound effects of kidney failure within his own family and through poignant stories shared by potential investors, John's resolve to make a positive impact on patients facing similar challenges has only strengthened over time.John holds a Ph.D. in epidemiology from the University of Pittsburgh's Graduate School of Public Health, where his groundbreaking research in this field has earned him induction into Delta Omega, the prestigious National Honor Society for Public Health.Links Supporting This Episode:Roivios Website: CLICK HEREJohn Erbey LinkedIn page: CLICK HERERoivios LinkedIn page: CLICK HERE Mike Biselli LinkedIn page:

A 65-year-old woman has hypertension, dyslipidemia, type 2 diabetes, a 50 pack-year history of cigarette smoking, currently smoking ½ PPD,  and stage 3B chronic kidney disease (CKD)  (GFR = 37 mL/min/1.73 m2). She is not currently taking any dyslipidemia therapy and her LDL= 140 mg/dL. Which of the following represents the most appropriate pharmacologic intervention for treatment of dyslipidemia?A. Owing to her age and comorbidity, no further intervention is required.B. Moderate-intensity statin therapy is the preferred treatment option.C. Niacin should be prescribed.D. The use of ezetimibe (Zetia®) will likely be sufficient to achieve dyslipidemia control.---YouTube: https://www.youtube.com/watch?v=up_iIweB9Ic&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=27Visit fhea.com to learn more!

Welcome to the 18th episode in my drug name pronunciation series!  We're talking about ezetimibe today.  In the first 4 minutes, I break ezetimibe down into syllables, explain which syllable has the emphasis, and reveal the source of the information. The last 4 minutes is a bonus.  My husband (Nathan) guest appears to say some drug names from this series.  Why? To share a fun memory!  When I was in pharmacy school, Nathan made me laugh/distracted me from the stress of studying by say drug names and medical terms badly.  It worked!  I laughed a lot, thanks to Nathan.  During this episode, Nathan shows that he can still make me laugh! Thank you for listening to episode 228 of The Pharmacist's Voice ® Podcast! Read the FULL show notes on https://www.thepharmacistsvoice.com/podcast.  Look for episode 228. Subscribe to or follow The Pharmacist's Voice ® Podcast to get each new episode delivered to your podcast player and YouTube every time a new one comes out.   Apple Podcasts   https://apple.co/42yqXOG  Google Podcasts  https://bit.ly/3J19bws  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt Ezetimibe has four syllables. ezetimibe = e ZET i mibe e, which is a short “E” sound, like the “E” in “bed.” This sounds like a schwa “E.”  (Like the second “E” in the word “elephant.”) ZET, which rhymes with “pet” I, as in “illusion” (short “I” sound, almost like a schwa “I.”  Think of the “I” in the word “president.”) mibe, which rhymes with “vibe” (“I” has the long “I” sound, like “ice cream” or “eyeball.”) I found the pronunciation of ezetimibe in the USP Dictionary Online.  The pronunciation guide is especially important for the last syllable in ezetimibe.  Thank you to the USP Legal Dept for permission to publish your written pronunciations in my podcast show notes! 5 drug names from the bonus Ezetimibe (Episode 228) Metoprolol (Episode 177, 8th episode in this series) talimogene laherparepvec or T-VEC (Episode 159, 6th in this series) Eszopiclone (Episode 134, 1st episode in this series) Carisoprodol (Episode 198, 13th in the series)    Links from this episode USP Dictionary Online (aka USAN)   USP Dictionary's (USAN) pronunciation guide (Source:  American Medical Association's  website Alice and Jack Hike the Grand Canyon by RDML Pam Schweitzer, PharmD and her daughter Amy Graves (children's book) The Pharmacist's Voice ® Podcast episode 219, pronunciation episode 17 (semaglutide) The Pharmacist's Voice ® Podcast episode 215, pronunciation episode 16 (mifepristone and misoprostol) The Pharmacist's Voice ® Podcast episode 211, pronunciation episode 15 (Humira®) The Pharmacist's Voice ® Podcast episode 202, pronunciation episode 14 (SMZ-TMP) The Pharmacist's Voice ® Podcast episode 198, pronunciation episode 13 (carisoprodol) The Pharmacist's Voice ® Podcast episode 194, pronunciation episode 12 (tianeptine) The Pharmacist's Voice ® Podcast episode 188, pronunciation episode 11 (insulin icodec)  The Pharmacist's Voice ® Podcast episode 184, pronunciation episode 10 (phenytoin and isotretinoin) The Pharmacist's Voice ® Podcast episode 180, pronunciation episode 9 Apretude® (cabotegravir) The Pharmacist's Voice ® Podcast episode 177, pronunciation episode 8 (metoprolol)  The Pharmacist's Voice ® Podcast episode 164, pronunciation episode 7 (levetiracetam) The Pharmacist's Voice ® Podcast episode 159, pronunciation episode 6 (talimogene laherparepvec or T-VEC)  The Pharmacist's Voice ® Podcast episode 155, pronunciation episode 5 Trulicity® (dulaglutide)  The Pharmacist's Voice ® Podcast episode 148, pronunciation episode 4 Besponsa® (inotuzumab ozogamicin) The Pharmacist's Voice ® Podcast episode 142, pronunciation episode 3 Zolmitriptan and Zokinvy The Pharmacist's Voice ® Podcast episode 138, pronunciation episode 2 Molnupiravir and Taltz The Pharmacist's Voice ® Podcast episode 134, pronunciation episode 1 Eszopiclone and Qulipta 

Drugs known as statins are the first-choice treatment for high cholesterol but millions of people who can't or won't take those pills because of side effects may have another option. In a major study, a different kind of cholesterol-lowering drug named Nexletol reduced the risk of heart attacks and some other cardiovascular problems in people who can't tolerate statins, researchers reported. Doctors already prescribe the drug, known chemically as bempedoic acid, to be used together with a statin to help certain high-risk patients further lower their cholesterol. The new study tested Nexletol without the statin combination -- and offers the first evidence that it also reduces the risk of cholesterol-caused health problems. Statins remain “the cornerstone of cholesterol-lowering therapies,” stressed Dr. Steven Nissen of the Cleveland Clinic, who led the study. But people who can't take those proven pills “are very needy patients, they're extremely difficult to treat,” he said. This option “will have a huge impact on public health.” Too much so-called LDL or “bad” cholesterol can clog arteries and lead to heart attacks and strokes. Statin pills like Lipitor and Crestor – or their cheap generic equivalents – are the mainstay for lowering LDL cholesterol and preventing heart disease or treating those who already have it. They work by blocking some of the liver's cholesterol production. But some people suffer serious muscle pain from statins. While it's not clear exactly how often that occurs, by some estimates 10% of people who'd otherwise qualify for the pills can't or won't take them. They have limited options, including pricey cholesterol-lowering shots and another kind of pill sold as Zetia. Nexletol also blocks cholesterol production in the liver but in a different way than statins and without that muscle side effect.  This article was provided by The Associated Press.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Mitochondria are discussed in antiaging advertising like they are understood by the common man.  Even TV discussions and podcasts discuss mitochondria like we are all biology majors, but to most people mitochondria is a word but most people don't know really what they are.  Most people think Mitochondria are “good”, but what are they? Some examples of ads that use the word Mitochondria, reads “Take these Anti-oxidants every day and you will heal your mitochondria, and live longer…” “Your mitochondria are sick and need to be treated with BLANK to bring you back to health, just buy….” In reality, most students of biology and medical doctors are the only people who understand what they are and how they work, what can make them “sick”, and how to make them operate normally within each cell of our body. Simply mitochondria are organelles that take BS and Oxygen and make energy.  You can think of it as “breathing for the cell” , by taking blood sugar and O2 and creating energy, CO2 (carbon dioxide) and water H2O.  Mitochondria are the tiny determiners of our ability to metabolize food and make the energy the cell needs to do its job effectively. I bet you never thought anything about the fact that when you breath oxygen it goes into your blood stream on your red blood cells, and delivered to your tissues by diffusion through capillaries and enters the cells within your tissues…but what does it do then to sustain us?  That is where Mitochondria come in…as they work as I described in the previous paragraph. Another important piece of information about the mitochondria is that they are passed from mother to child, which means your metabolism is secondary to the genes only your mother gave you!  We call this genetic communicator that tells cells how to function metabolically, mitochondrial DNA! To locate our mitochondria, we must take a microscope to the human body, and successively dissect her into smaller and smaller parts:  A whole human body, divided into organ systems eg. Skin, Gastrointestinal system, then divided into smaller parts called tissues such as muscles and neuro-tissue.  Smaller still are the specialized cells that make up the tissues, call cells.  Smaller still are the mitochondria that are located within each cell in the body, providing energy to the cell, to make the whole-body work! Mitochondria are small, oval, sub-cellular “ energy packs” located inside every cell in our bodies.  These small oranelles within our cells turn sugar (glucose) from our food, into ATP (energy) and Carbon Dioxide (CO2).  They act like miniature lungs, taking in sugar which is made of oxygen and carbon, and returning CO2 as a by-product.   Scientists say that mitochondria's activity is “respiration”!  The CO2 passes out of the cell and is excreted by the lungs. So why do we use Mitochondria as a catchword for a way to sway lay people to buy a product to keep them healthy?  It is a way to explain complicated physiology to people who aren't trained in a particular science like medicine or biology, and a way to sell products.  The word mitochondria is associated with sickness and how to get better and it becomes a catch word everyone knows and wants to “fix”. However, if it is a fad or an advertising method to sell something, knowledge of what mitochondria need to make energy, is a valid pursuit.  In short, your cells need plenty of oxygen, healthy foods, exercise and a clean environment to make energy effectively in your mitochondria. Because our food sources do not have adequate nutrition for us and our mitochondria, we must eat foods that are particularly packed with nutrients and or add supplements such as resveratrol, Alpha-Lipoic Acid, L-carnitine and omega 3 oils to heal our “sick mitochondria”. All the while we are trying to “help our mitochondria” with nutritious food and supplements, many of us are inactivating our mitochondria just when we need them most!  How you ask? Those of the many people who take statins are inactivating their mitochondria 24-7.  That is how a statin works!  Statins inactivate mitochondria to decrease the production of cholesterol in the cells.  So why are we killing our ability to make energy and to be healthy, just to decrease our chance of getting heart disease later? Statins are only worth the risk if you have already had a heart attack or are about to have one and have narrowed atherosclerotic arteries.  Statins don't treat anything, but your cholesterol lab values, and only prevent additional buildup of more plaque. Some of my patients think statins are cleaning up the arteries, but they do not do that!  The risk for a heart attack includes blocked arteries, inflammation, smoking and a high Homocysteine level and Family history.  To clean up blood vessels, Zetia is the atherosclerotic cleaner-upper without the risks of a statin!  Zetia leaves your mitochondria alone! To know if you actually have atherosclerotic plaque, you should have a cardiac calcium scan to see if you do or not!  I have high cholesterol, and no plaque (I had one test in 2002, and one in 2019. High cholesterol doesn't necessarily lead to heart disease, but it does definitely stop your mitochondria from working! Since the mitochondria are so important to health, we will talk about How mitochondria can get sick and cause us to be sick in many ways throughout our body.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ When I started practicing medicine, I realized that there were many medical problems and patient symptoms which had no treatment approved by the FDA.  This was frustrating and I realized I had a talent for finding alternate treatments that were compounded by a compounding pharmacy for my patients.  I followed research, basic science, and the advice of a compounding pharmacist to find these treatments, and miraculously they worked!  Many of those treatments are now accepted by the mainstream medical establishment and even the FDA. That was over 35 years ago… I have continued to research treatments to address the problems of my patients. Many times, I have read research novel uses for an old drug or research that finally documents the treatments I have been successfully employing in my practice for years. My husband is a really entertaining guy and when I tell my husband that mainstream medicine has finally accepted and now endorses a treatment I have been using for 10-20 years, he has a pat response:   He sings an old Mac Davis song,, “Oh Lord it's hard to be humble when you're perfect in every way……your medical discovery is finally endorsed!”.  He is making sure I don't get full of myself because I found a treatment long before the “other guys”. It is one of my two favorite things…finding the answer for a patient's pain or illness! It is hard to wait for the huge leviathan of medical knowledge to finally endorse what I have been seeing and using for years!  The practice of medicine was and is supposed to be using what a doctor knows, has learned and what she has read in the form of research, to deductively find a solution for individual patients, instead of following a well-worn algorithm that rarely works.  What most patients experience in the doctor's office is a watered-down treatment, orchestrated by the insurance companies to save them money and to pay doctors very little for their work. They only pay for 5 minutes of a doctor's visit and decrease what they pay every year, so that doctors are expected to treat one thing at a time, and never has time to look at the whole patient picture.  It is one of the reasons I left the practice of insurance run medicine…I wanted to be able to put the pieces together for each patient and create a treatment plan to make each patient healthier so they could enjoy a quality life.  That is what I do now...I live the dream of most doctors. I have enough time to look over every part of a patient's life and create a workable plan that involves not only hormones but treatment of pre-diabetes and Pre-heart disease and other diseases of aging. Making people healthy has always been my goal and in the last 20 years I have been able to do so!  This situation came up recently when I read a research article in the Journal of the AMA (JAMA) that stated that Statins, such as Rosuvastatin, atorvastatin, simvastatin, and pravastatin, frequently make patients' diabetes worse.  The title stated, “Association of Statin Therapy Initiation with Diabetes Progression”. This is something I discovered in private practice, and from reading research a long time ago, but the majority of the doctors in my community contradicted my advice to my patients to stop statins, if they had not had a heart attack, so their diabetes would improve, and it always did.  Some of my patients were no longer diabetic when they were taken off their statin.   If they had a lot of plaque on their arteries, I put them on Zetia, a non-statin lipid lowering drug, which did not affect their AODM.  I was ecstatic when I read in JAMA that now the majority of the doctors will treat patients like I have for the last decade.  Think this through logically. Why would you take a medication to lower your chance of heart disease if you weren't at risk for it anyway.  A high cholesterol doesn't mean you have arterial plaque.  Many patients have high cholesterol and have no plaque in their vessels.  If that is you, you could be taking a drug to prevent a problem you'll never have, and develop type 2 diabetes, a disease that can cause heart disease and damage to your arteries.  My advice is to take statins only if you have had a heart attack, had stents placed, or a stroke from arteriosclerosis.  If you have a cardia calcium scan of zero-50, and have not had any of the previously mentioned heart problems, then statins aren't doing you any good, and they might cause you to have type II diabetes, which in itself can cause heart disease and strokes. So, for all the times I have been criticized for treatments that work, don't cause complications and make people well, I am now tooting my own horn like Mac Davis did in his song.  The proof is in the current medical articles that appeared years after I already treated patients with this “new discovery”.  I am just thankful that I can have the time and motivation to practice like am able to do now.   More importantly take a statin only if you need it, in other words, only if you already have proven arteriosclerosis.

Zetia (Ezetimibe) Antitrust v. Merck & Company, Inc.

XALATAN? ZETIA? XYZAL? Where do the drug makers come up with these names for the medications they sell? Do they feel X and Z have been ignored too long in the English language and are trying to make up for it in their brand names? Shouldn’t the names have a connection to the condition they are treating? Well, the Bucks think so. Dave and Del discuss this bizarre naming  scheme and offer some sensible alternatives. Del does pretty well on the drug quiz. First it was the Lantern Fly, now it’s Brood X of the 17-year cicada about to burst on the scene again in many eastern states in May. The Bucks review an article in the Smithsonian Magazine, 14 Fun Facts About Cicadas.. Fun fact: Cicadas are not locusts. Check it out for more details. A wave of the antlers to Hideki Matsuyama on his Masters victory. Dave recounts his love of golf-or lack thereof. Del assures everyone that Dave is as bad as he proclaims; he’s not just negotiating a handicap. The Bucks get a letter from Russia inquiring about The Drinking Contest and Old Buck Jim, the most spectacular contestant, responds in a letter from afar. Old Buck John, a college buddy of Dave’s and the best pitcher in the history of the school, tells about his 2.5 year stint in Lithuania. Welcome home to John.  Del recognizes some fine folks the Bucks  have met along the way.

Merck's History of Crimes and Misdemeanors   Richard Gale and Gary Null Progressive Radio Network, March 18, 2021     As the Covid-19 pandemic wears on past a full year, several of the world’s top pharmaceutical companies have dominated the world headlines, notably Pfizer, Johnson & Johnson and AstraZeneca, along with the smaller start-ups such Moderna and Novavax. Each is now vying to usurp the coveted Covid-19 vaccine market. Prior to the pandemic, the vaccine market worldwide was only a small slice of the overall $1 trillion pharmaceutical market at about $24 billion annually. Now sales of the new generation of vaccines to fight the pandemic are poised to exceed global vaccine sales exponentially. Ronny Gal at the market analysis firm Bernstein estimates that Covid vaccine sales will reach $40 billion this year. We believe this is a very conservative estimate as newer vaccines come on line and with companies making efforts to outdo each other on its efficacy and safety profile. Moderna and Pfizer together are expected to earn $32 billion this year and we are not taking into account Russia’s Sputnik-V vaccine and now five approved in China. The frenetic race is underway to vaccinate billions of human beings naively standing in line after drinking from the government health agencies’ and the mainstream media’s cattle trowels of vaccine hype and propaganda. What is certain is that a new era of drug discovery has begun and all will be driven by the surge in vaccines’ new celebrity status. The very definition of a vaccine is now being redefined and it is clearly predictable that we will be witnessing prophylactic and therapeutic drugs being reevaluated as vaccines to leap-frog regulatory hurdles and to escape legal actions for product injury and death.    It may be surprising that the world’s second largest vaccine maker Merck is missing from the Covid vaccine cash cow. Along with the other two of the top three global vaccine makers, Glaxo and Sanofi, Merck exited the Covid vaccine arena after its candidates flopped in generating sufficient neutralizing antibodies in Phase 1 trials. Instead the company has shuffled its resources to develop two new novel drugs that will target serious risks of the body’s over-reactive immune response to SARS-CoV2 infection. Although we will not likely see a Merck Covid vaccine any time in the coming years, it has nevertheless lucratively reaped rewards after selling its Moderna stock late last year when the price went out the roof. Merck has also partnered with J&J to increase production of the latter’s vaccine in order to meet demand.   Merck's legacy of lawsuits for crimes and misdemeanors goes back at least to the 1960s. In 1975, it was busted by the SEC for illegal payments to foreign government officials from "approximately" 36 nations. The scam was orchestrated through personal bank accounts with the sole purpose of advancing drug approvals through foreign nations' regulatory medical agencies.     One of the largest scandals in modern medical history was the company's anti-inflammatory drug Vioxx that resulted in fines above $4.8 billion for causing over a minimum 60,000 deathsfrom sudden heart attacks and over 120,000 serious medical injuries. At its height, Vioxx was earning over $2 billion in revenues annually and it is estimated that 25 million patients were prescribed the medication. The securities class action suit against Merck alone reached $1 billion, placing it in the top 15 securities lawsuits in US corporate history. The main criminal charge was Merck's intentional withholding of scientific data about the drug's adverse cardiovascular side effects.    Years after the settlement, Ron Unz, the publisher of The American Conservative, undertook his own investigation to validate Vioxx's death toll. Analyzing the drug's adverse effects over a longer time period, Unz estimated Merck may have been responsible for nearly half a million premature deaths in elderly patients, the drug's primary target group. That is roughly the same number of total civilian, military and terrorist deaths from the US's military escapades in Afghanistan, Iraq and Pakistan combined.    Merck's settlement of 47,000 pending lawsuits for personal injuries and 265 class action cases was a small pittance for the harm Vioxx left in its wake. Merck executives were never properly punished for willingly concealing the drug's dangers in order to assure FDA approval.    In Australia, Merck's efforts to increase Vioxx profits employed other forms of malfeasance. The Australian government launched a class action suit against the drug maker on charges that employees allegedly schemed a fake scientific paper that was ghostwritten for a medical journal in order to put Vioxx into a positive light. Testimonies during the trial stated data was completely based upon "wishful thinking." Merck also founded the peer-reviewed journal Australasian Journal of Bone and Joint Medicine. The journal was a fraud; it was not properly peer-reviewed and its primary purpose was to promote Vioxx on the Australian continent.    Moreover, the class action lawsuit contained Merck emails accessed by Australian officials. The company's internal communications allegedly ordered select employees to draft up a hit list of physicians who were critical of Vioxx. According to the documents, these physicians were targeted to be "neutralized" or "discredited." Some, including Dr. James Fries at Sanford University's medical school, were clinical investigators who happened to speak out about the drug's shortcomings. One email stated, "We may need to seek them out and destroy them where they live..."     But Merck's troubles with the dangers of its products, falsifying data about drugs' efficacy and safety and exaggeration of medical claims go back sixty years. In the 1960s, the FDA discovered that the drug maker's arthritis medication Indocin had not been properly tested for efficacy and its adverse effects were being completely ignored.  In the 1970s, Merck's drug dietheylstilbestrol (DES) prescribed for the prevention of miscarriages caused a flurry of vaginal cancer cases and other gynecological disorders. Merck had all along known that DES was carcinogenic based upon its own animal clinical trials. In 2007, its cholesterol drug Zetiawas shown to increase liver disease. Again Merck had known about Zetia's liver risks but withheld the clinical trial's damning results.    It would also appear that Merck has managed to hijack US courts. This includes an early 2019 ruling by Trump's corporate-friendly US Supreme Court to side with the drug maker and squash hundreds of lawsuits for failing to issue warnings that its osteoporosis drug Fosamax's may contribute to debilitating bone fractures. A federal court in California found that Merck committed perjury for lying in a patent infringement case against Gilead Sciences over the latter's blockbuster Hepatitis C drug Sovaldi. The judge ruled that Merck carried out a "systematic and outrageous deception in conjunction with unethical business practices and litigation misconduct."  It turned out that Merck's patent claims were a sham and orchestrated by its legal division.   Besides pushing through the FDA dangerous medications onto the market, the company has also found itself in the courtroom on many occasions for allegedly price-fixing, routinely defrauding and overbilling states' Medicare and Medicaid programs, and violating the Anti-Kickback Statute. In 2006, the IRS went after Merck for owing almost $2 billion in back taxes. According to the Wall Street Journal, Merck partnered with a British bank to create an offshore subsidiary in tax-friendly Bermuda to divert taxable revenue on its bestselling cholesterol drugs Zocor and Mevacor through a patent scheme. The company ran the operation for ten years before the FDA uncovered the racket.    Merck is America's leading vaccine manufacturer. Despite public perception and the ruse that vaccines are somehow safer and more effective than pharmaceutical drugs in general, it is the same industry and corporate culture that manufactures both. Currently Merck markets vaccines for Haemophilus B, Hepatitis A and Hepatitis B (individually and in combination), human papilomavirus (Gardasil), Measles, Mumps and Rubella (MMR), pneumococcal, rotavirus, varicella (chickenpox) and Zoster virus (for shingles). In 2010, Merck obtained exclusive rights to MassBiologics’ vaccine portfolio. The consequence is that Merck's Adult Vaccine Portfolio expanded to include 9 of the 10 vaccines on the CDC's adult immunization schedule. The company now holds almost a full monopoly on the government's recommended vaccines   On its website, the FDA assures the public that "Vaccines, as with all products regulated by the FDA, undergo a rigorous review of laboratory and clinical data to ensure the safety, efficacy, purity and potency of these products."  However, not a single one of Merck's vaccines has ever been tested in a scientifically viable double-blinded placebo controlled trial. In each case, the placebo in the control group was not inert, such as the use of sterile saline. Rather Merck only tested its vaccines with the viral component against a faux placebo containing the same ingredients, including aluminum, but minus the virus. Known as a "carrier solution," the standard scientific protocol does not designate it as a proper placebo for measuring the efficacy and disease risks of a drug. And in the case of Gardasil, the trial was statistical trickery to mask Gardasil's adverse effects. One placebo group received the company’s proprietary adjuvant amorphous aluminum hydroxyphospate sulfate (AAHS), a known neurotoxin. The adjuvant has yet to be properly tested for safety. One of the more serious risks of aluminum adjuvants is the triggering of an extreme autoimmune response, what Israeli immunologist Yehuda Schoenfeld has called “autoimmue/inflammatory syndrome induced by adjuvants.”   In the Cochrane Database Collaboration’s 2016 analysis of Merck's Gardasil, the investigators were so alarmed they filed a complaint against the European Medical Agency for failing to adequately assess the vaccine's neurological harms. More recently, a meta-analysis published in Systemic Reviews journal concluded “HPV vaccines increased serious nervous system disorders and general harms.”   Robert Kennedy Jr is currently taking steps to sue Merck over the Gardasil deception. Kennedy's in-depth investigations through his Children's Health Defense organization has uncovered evidence that the vaccine increases birth defects in children conceived of HPV-vaccinated moms; miscarriages have increased 2000 percent above normal, and girls are experiencing serious reproductive complications, including infertility, at approximately ten-fold above the normal rate. During an interview on the Progressive Radio Network, Kennedy noted that there was 10 times greater risk of dying from cervical cancer among Gardasil trial participants compared to the general public. There is a 10-fold increase for ovarian failure, and 1 in 37 girls who receive the vaccine will experience an autoimmune disease after 6 months of receiving the series of injections. When we consider that 1 in 37,000 women have a chance of dying from cervical cancer, it puts HPV vaccines into a completely different light. Sadly, across the nation, politicians from both sides of the aisle in state legislatures, notably Governor Andrew Cuomo in New York, are seemingly doing Merck's bidding to mandate Gardasil for all girls and boys upon entering school.    Based upon Kennedy's research and documents received from Freedom of Information Act filings, during Merck's own Gardasil clinical trials, 2.3 percent of girls and women between the ages of 9 through 26 developed a serious autoimmune disease and crippling neurological disorders within seven months of vaccination. The most frequent adverse effects were arthritis and anthropathy, autoimmune thyroiditis, celiac disease, hyperthyroidism and hypothyroidism, inflammatory bowel disease, psoriasis, Raynaud's Phenomenon, rheumatoid arthritis and uveitis. In other words, it was the aluminum adjuvant responsible for this enormous suffering. He stated that according to Merck's own statistics, girls are one hundred times more likely to experience a serious adverse effect from the vaccine than to be protected from cervical cancer.    In a 2012 article published in the Journal of Law and Medical Ethics, researchers at the University of British Columbia wrote that ever since Gardasil was approved in 2006, Merck has engaged in an "overly aggressive marketing strategies and lobbying campaigns aimed at promoting Gardasil as a mandatory vaccine."  One strategy Merck has employed is to take advantage of FDA loopholes to fast track its drugs. In the case of its expanded Gardasil-9 for adults between the ages of 27 to 45, the company applied for fast tracking two days after the Journal of Toxicological and Environmental Health published a study that the HPV vaccine was lowering the probability of pregnancy for women in their 20s.   Unfortunately, the media has indiscriminately colluded with Merck. Drug companies, according to Kennedy, pay $4.5 billion to the major media networks and publications to promote their drugs. And none of the media outlets are willing to sacrifice their profits for advertising drugs on moral and ethical grounds.    Another scandal erupted within Merck's vaccine business in 2010 after two whistleblowers gave testimony that the mumps' component in its Measles-Mumps-Rubella (MMR) vaccine was based on fraudulent data about it's efficacy, and the company knowingly proceeded in order to corner the mumps vaccine market. Merck had been defrauding the US government, which purchases the MMR, for over a decade. The government and two Merck whistleblowers, virologists Stephen Krahling and Joan Wlochowski, filed a lawsuit against Merck for being in violation of the False Claims Act. According to the charges, Merck had "falsified its mumps vaccine test results to hit an efficacy rate of 95 percent. The company achieved this by adding "animal antibodies to a blood sample to give the impression of increased antibodies." This would certainly explain why mumps outbreaks in summer camps and on college campuses are found to occur among those vaccinated.    Merck has gained enormous political and social influence over the national perception about vaccines.  One example is Merck's behind the scenes aggression against the flim Vaxxed.  When the documentary film was officially selected to screen during the 2016 Tribeca Film Festival in Manhattan, we discovered in an earlier report that Merck left its fingerprints on the film's removal and censorship. The Alfred Sloan Foundation is the festival's largest sponsor; pro-vaccine advocate Bill Gates is also a notable contributor. One of the leading persons on the Foundation's board of trustees was Dr. Peter Kim.  Kim happens to be the former president of Merck's Research Laboratories who was directly responsible for the launch of Gardasil and Merck's other vaccines for the Zoster virus and rotavirus. The film presents a harsh indictment against Dr Julie Gerberding, the former head of the CDC who allegedly coordinated the cover up of data that confirmed thimerosal's role in the onset of autism. After managing the agency's operations to mine sweep the data and generate new studies with public funds to suggest thimerosal's safety, Gerberding accepted her reward from the pharmaceutical industry by becoming the head of Merck's vaccine division. In addition, according to the whistleblowing of a senior CDC scientist, Dr. William Thompson, Gerberding was allegedly responsible for destroying the CDC's research that showed African American boys were at a substantially higher risk of becoming autistic from Merck's MMR vaccine. Fortunately, Dr. Thompson, who was present during the order to shred documents, saved copies which he subsequently turned over to Congressman Bill Posy and an independent biologist Prof. Brian Hooker. Since then, Congress has refused to hold hearings thereby supporting the cover-up.    All told, these examples of Merck's culture of greed, deception, political maneuvering and aggression has collectively injured countless people. Its prime directive is selling drugs; its history of crimes and misdemeanors should indicate the company holds little integrity in its commitment to prevent and treat disease. The full extent of the casualties from Merck's drugs and vaccines may never be properly calculated. For firms such as Merck, Pfizer and Johnson and Johnson, injuries and deaths are the necessary collateral damage of getting poorly tested products on the market and as fast as possible.    Can we really trust such a company with such a criminal reputation to be forthright about its product’s safety records? Therefore we recommend people to support the efforts of Bobby Kennedy and the Children's Health Defense in its lawsuit against Merck's Gardasil. A victory may well weaken the entire edifice of vaccine pseudoscience and the public will realize that for decades it has been little more than a house of cards.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Three recent studies have shown a new light on treatments for diabetes. This group of research discoveries teaches us how to improve the severity of diabetes through several changes in diet and medication choices. One study discovered that a simple food addition to your diet can lower the risk of complicating illnesses and death from diabetes. The second study reveals the fact that statins increase the risk of getting Type II Diabetes just by taking a particular cholesterol lowering medication.  The third study found that select diabetic medications are effective at preventing heart disease in diabetics.  Join us to learn what you can do to help you, or someone you love, avoid diabetes and the complications from diabetes. Diabetes is a disease that is rapidly becoming the most common and dangerous disease of aging Americans.  The increase in obesity, the switch from whole food to junk food and fast-food and lack of active lifestyles, has contributed to the development of Adult-Onset Diabetes in almost half of all Americans.  Now that our society is flooded with citizens who have high blood sugars that cause heart disease, stroke, infections and increase the risk of cancer, what are we to do?  The first medical study recommends a simple diet change to those MEN (and possibly women) who already have diabetes, to prevent Adult-Onset Diabetes.  A study done at Stratton Veterans Affairs (VA) Medical Center in Albany, NY revealed that just one cup of blueberries daily, fresh, frozen or freeze-dried, significantly decreased triglycerides in the men tested who followed this recommendation.  It is widely known that elevated triglycerides increase the risk of cardiovascular disease in diabetic men, and one cup of blueberries daily lowered triglycerides and the risk of cardiovascular disease.  I believe that this diet recommendation can work for women as well, but they only tested men. The previous research gave Diabetics a simple way to lower their risk of getting heart disease by eating one readily available food!   Our next study reveals how doctors can prevent their patients from developing diabetes in the first place, beyond the strategies of achieving ideal weight, exercise, and eating a low carbohydrate diet?  A study done recently revealed the fact that taking statins for high cholesterol increased the risk for elevated blood sugars, HBA1C and triglycerides in patients who weren't diabetic and could cause Type II Diabetes!  As with most meds, all statins are not the same. The cholesterol medication, Crestor ®, is the least likely to have this side effect, however it is better to take an alternate drug that lowers cholesterol called Zetia® if it is strong enough to lower these blood fats enough. Zetia® is not a statin, and It doesn't cause any of the side effects that statins do, including raising your blood sugar, because it works in a completely different way than statins. If you have gotten diabetes since starting your statin then ask your doctor to switch your medication to Crestor®, Zetia®, or try normalizing your sex hormones and triglycerides through diet or by taking diabetic medications like Metformin®., which will lower your LDL cholesterol as well, without a statin! At BioBalance Health® we are able to get patients off statins all the time by replacing testosterone with pellets, lowering body fat, treating patient's AODM with Metformin, and normalizing thyroid hormones.  This is Dr. Maupin's secret weapon for treating patients with a high risk for vascular disease, who have high LDL cholesterol and or Triglycerides…Testosterone pellet therapy! Last but not least is a study from the June 2020 Endocrine News that gives us hope for a new classification of diabetic drug that lowers cardiac risk and all vascular causes of morbidity!  This class of drug is called SGLT2 Inhibitors, specifically Invocana® and Farxiga®.  These two drugs lower glucose by increasing sugar in the urine to get it out of your system.  This is how it works to treat the intended disease of Adult-onset Diabetes, but recently it has been found to prevent a common outcome of diabetes, cardiovascular disease!  Specifically, it lowered the rate of heart failure by 35% in diabetics.   Dr. Maupin has always started AODM patients on Metformin® for the past 18 years to lower blood sugar, sensitize diabetics to insulin which helps them lose weight and lower their blood sugar, and to make the other diabetic drugs they are taking, more effective.  It is inexpensive, generic, very effective, and has few side effects if a patient follows a low carbohydrate diet. The Endocrine Society guidelines, that rule the actions of Endocrinologists, changed this year: Pre-diabetes and early noncomplicated diabetes first with Metformin®. Patients with established AODM and atherosclerotic heart disease and kidney disease should be placed on SGLT2 Inhibitor like Invokana®, or the drugs like Victoza®, a GLP-1 receptor agonist. The experts in treating Adult-Onset Diabetes, Endocrinologists, are considering the use of Metformin ® for diabetic and non-diabetic patients alike, who have kidney disease, and heart disease without diabetes to improve these diseases as well.  If you have these complications to diabetes, or have these diseases but do not have AODM, ask your doctor about these new uses for this old drug. The most important part of this message is for individuals to prevent diabetes if at all possible, with lifestyle changes low carbohydrate diet and daily exercise, however some people get diabetes anyway because of their genetic makeup.  You can easily have a cup of blueberries every day to prevent heart disease if you do have diabetes, and then change your statin to Crestor® or Zetia®, and yes to the appropriate diabetic medications plus Metformin® to save you from having a heart attack, heart failure or stroke.   All of these recommendations for medications should be discussed with your doctor, who knows you best.  If they have not read these new studies or find that this research is not going to help you then always follow the advice of your diabetes doctor.

Merck’s History of Crimes and Misdemeanors Merck’s History of Crimes and Misdemeanors   Richard Gale and Gary Null Progressive Radio Network, Which private corporation has likely been responsible for the deaths of more innocent people than any terrorist organization or military regime change in Afghanistan, Iraq, Libya, Syria and elsewhere?  For us, the answer is evident:  Merck and Company. Iatraogenic medicine, or medical error, is now the third leading cause of death in the US after cardiovascular disease and cancer. The majority of these deaths are caused by FDA approved drugs’ adverse effects and from patients taking multiple medications without thorough clinical research to determine the safety of their synergistic effects.  Consequently our health agencies’ oversight and monitoring of drugs on the market is dismal.   One of the worst corporate deals the US government may have ever made in modern history was to acquire the American subsidiary of the German pharmaceutical firm Merck and Company during the first world war. Later in 1953, Merck acquired a competitive drug maker Sharp and Dohme, thereby establishing itself as America’s largest drug developer and manufacturer. Since then this corporate Medusa has ensnared thirteen other drug firms, including Scherring Plough, which it acquired for $41 billion. The two pharmaceutical giants had earned $47 billion in combined sales at the time the merger was finalized in 2009.   Merck’s life of criminal behavior was observed back in the 1970s. In 1975, it was busted by the SEC for illegal payments to foreign government officials from “approximately” 36 nations. The scam was orchestrated through personal bank accounts with the sole purpose of advancing drug approvals through foreign nations’ regulatory medical agencies.   One of the largest frauds in recent medical history was the company’s anti-inflammatory drug Vioxx that resulted in fines above $4.8 billion for causing over a minimum 60,000 deaths from sudden heart attacks and over 120,000 serious medical injuries. At its height, Vioxx was earning over $2 billion in revenues annually and it is estimated that 25 million patients were prescribed the medication. The securities class action suit against the company alone reached $1 billion, placing it in the top 15 securities lawsuits in US corporate history. The centerpiece of the crime was Merck’s intentional withholding of scientific data about the drug’s adverse cardiovascular side effects.   Years after the settlement, Ron Unz, the publisher of The American Conservative, undertook his own investigation to validate Vioxx’s death toll. Analyzing the drug’s adverse effects over a longer time period, Unz estimated Merck may have been responsible for nearly half a million premature deaths in elderly patients, the drug’s primary target group. That is roughly the same number of total civilian, military and terrorist deaths from the US’s military escapades in Afghanistan, Iraq and Pakistan combined.   Merck’s settlement of 47,000 pending lawsuits for personal injuries and 265 class action cases was a small pittance for the harm Vioxx left in its wake. Merck executives were never properly punished for willingly concealing the drug’s dangers in order to assure FDA approval.   In Australia, Merck’s efforts to increase Vioxx profits employed other forms of malfeasance. The Australian government launched a class action suit against the drug maker on charges that employees schemed a fake scientific paper that was ghostwritten for a medical journal in order to put Vioxx into a positive light. Testimonies during the trial stated data was completely based upon “wishful thinking.” Merck also founded the peer-reviewed journal Australasian Journal of Bone and Joint Medicine. The journal was a fraud; it was not properly peer-reviewed and its primary purpose was to promote Vioxx on the Australian continent.   Moreover, the class action lawsuit contained Merck emails accessed by Australian officials. The company’s internal communications ordered select employees to draft up a hit list of physicians who were critical of Vioxx. According to the documents, these physicians were targeted to be “neutralized” or “discredited.” Some, including Dr. James Fries at Sanford University’s medical school, were clinical investigators who happened to speak out about the drug’s shortcomings. One email said, “We may need to seek them out and destroy them where they live…”   Efforts to target critics for harassment is not limited to Merck. Earlier, Monsanto earned a similar reputation. The Monsanto’s parent company Bayer had to release a public apology for the discovery of a Monsanto hit list of 200 French journalists and politicians who opposed glyphosate and its GMO crops. It has acted similarly in other countries including the US, according to veteran journalist Carey Gillam.  The list originated from the multinational public relations firm Fleishman Hillard. Merck has also employed Fleishman Hillard as well as Monsanto’s other notorious PR firm Ketchum. One of Merck’s Executive Directors, Ian McConnell, earlier served as a vice president at Fleishman. The PR firm’s senior adviser on healthcare Dr. Lukas Pfister, was at Merck for 25 years in its government affairs unit. Merck’s revolving door is not limited to our federal health agencies, but also fully infiltrates some of the world’s most shadowy international PR firms that specialize in whitewashing the public images of executive elites, corporations and in the case of the PR firm Burson-Marsteller even dictators. Following the Vioxx case, Merck had hired B-Marsteller to clean up its public image. MSNBC reported back in 2009, “When evil needs public relations, evil has Burson-Marsteller on speed dial.”   But Merck’s efforts to conceal the dangers of its products, falsify data about drugs’ efficacy and safety and exaggeration of medical claims go back sixty years. In the 1960s, the FDA discovered that the drug maker’s arthritis medication Indocin had not been properly tested for efficacy and its adverse effects were being completely ignored.  In the 1970s, Merck’s drug dietheylstilbestrol (DES) prescribed for the prevention of miscarriages caused a flurry of vaginal cancer cases and other gynecological disorders. Merck had all along known that DES was carcinogenic based upon its own animal clinical trials. In 2007, its cholesterol drug Zetia was shown to increase liver disease. Again Merck had known about Zetia’s liver risks but withheld the clinical trial’s damning results.   It would also appear that Merck has managed to hijack US courts as well. This includes an early 2019 ruling by Trump’s corporate-friendly US Supreme Court to side with the drug maker and squash hundreds of lawsuits for failing to issue warnings that its osteoporosis drug Fosamax’s may contribute to debilitating bone breaks. A federal court in California found that Merck committed perjury for lying in a patent infringement case against Gilead Sciences over the latter’s blockbuster Hepatitis C drug Sovaldi. The judge ruled that Merck carried out a “systematic and outrageous deception in conjunction with unethical business practices and litigation misconduct.”  It turned out that Merck’s patent claims were a sham and orchestrated by its legal division.   Besides pushing through the FDA dangerous medications onto the market, the company has also found itself in the courtroom on many occasions for price-fixing, routinely defrauding and overbilling states’ Medicare and Medicaid programs, and violating the Anti-Kickback Statute. In 2006, the IRS went after Merck for owing almost $2 billion in back taxes. According to the Wall Street Journal, Merck partnered with a British bank to create an offshore subsidiary in tax-friendly Bermuda to divert taxable revenue on its bestselling cholesterol drugs Zocor and Mevacor through a patent scheme. The company ran the operation for ten years before the FDA uncovered the racket.   Merck is America’s leading vaccine manufacturer. Despite public perception and the ruse that vaccines are somehow safer and more effective than pharmaceutical drugs in general, it is the same industry and corporate culture that manufactures both them. Currently Merck markets vaccines for Haemophilus B, Hepatitis A and Hepatitis B (individually and in combination), human papilomavirus (Gardasil), Measles, Mumps and Rubella (MMR), pneumococcal, rotavirus, varicella (chickenpox) and Zoster virus (for shingles). More recently it has jumped into the coronavirus vaccine race. In 2010, Merck obtained exclusive rights to MassBiologics vaccine portfolio. The consequence is that Merck’s Adult Vaccine Portfolio expanded to include 9 of the 10 vaccines on the CDC’s adult immunization schedule. The company now holds almost a full monopoly on the government’s vaccines   On its website, the FDA assures the public that “Vaccines, as with all products regulated by the FDA, undergo a rigorous review of laboratory and clinical data to ensure the safety, efficacy, purity and potency of these products.”  However, except for Gardasil, not a single one of Merck’s vaccines has ever been tested in a scientifically viable double-blinded placebo controlled trial. In each case, the placebo in the control group was not inert, such as the use of sterile saline. Rather Merck only tested the vaccine with the viral component against a faux placebo containing the same ingredients, including aluminum, but minus the virus. Known as a “carrier solution,” the standard scientific protocol does not designate it as a proper placebo for measuring the efficacy and disease risks of a drug. And in the case of Gardasil, the trial was statistical trickery to mask Gardasil’s adverse effects. Therefore the FDA’s claim is patently false. None of Merck’s vaccines have ever undergone a “rigorous review” prior to regulatory approval.   Although not completely innocent from internal unfairness and conflicts of interest, the Cochrane Database Collaboration arguably remains the most reliable resource for analysis of drugs, vaccines and medical devices in the evidence-based medical establishment. In its 2016 analysis of Merck’s human papillomavirus vaccine Gardasil, the investigators were so alarmed they filed a complaint against the European Medical Agency for failing to adequately assess the vaccine’s neurological harms.   As we have recently witnessed with Monsanto’s Roundup and Bayer’s settlement of $10 billion to cover 80,000 lawsuits, Gardasil may very well become the company’s Achilles heel. The Gardasil scandal may very well begin to topple the vaccine regime and raise the public’s already increasing awareness and distrust in the official mantra that vaccines are safe and effective. The development, scientific rationale, fraudulent clinical trials and data reporting, and inside negotiations with federal health officials to market the vaccine to pre-teen and teen girls and boys, is a story riddled with misconduct. Today it is Merck’s third largest revenue-generating drug after its cancer drug Keytruda and diabetes drug Januvia, earning $3.1 billion in 2018. Its MMR vaccine is fifth having earned $1.8 billion. Gardasil’s success has nothing to do with the prevention of an urgent national health need. Instead it was a business strategy through Merck’s influence over our nation’s regulatory agencies and state politicians whose election campaigns it funds.   In 2018, a French oncologist, Dr. Gerard Delepine, stumbled upon a correlation between the increase of cervical cancer rates with the rising rates of Gardasil vaccinations. Delepine also compared France, which was deliberating on whether to mandate HPV vaccination, with other countries that relied upon pap smears as a preventative measure against cervical cancer. He observed that in all countries that prioritized pap smears, cervical cancer rates were decreasing; whereas, in those countries with higher HPV vaccination compliance, the rates increased. In his letter to the French government in defiance of Merck’s lobbying efforts, Delephine stated:   “A compulsory health measure should not be based on faith in vaccination or hidden conflicts of interest, but on proven facts, verifiable by every citizen. However, the facts established by the official records of cancer registries show that HPV vaccination does not protect against invasive cancer of the cervix, but seems rather to maintain its frequency at a high level and sometimes even increase it.”   An article published in the French journal Agoravox noted that other national health ministries are coming around to acknowledge that Gardasil is an extremely unsafe vaccine. Japan, Austria and Denmark no longer promote it due to is trail of injuries with fatal consequences. Public demonstrations against Merck’s Gardasil have occurred in Japan, Colombia, and Ireland.   Yet none of these efforts to warn the public about Gardasil’s risks have reached the American media. Hopefully this may change. Medical researchers at the University of South Alabama presented their paper at the Society of Gynecologic Oncology’s annual conference. There is great disparity between HPV vaccine compliance across Alabama counties, which range anywhere between 33 and 66 percent. Yet the epidemiological data suggests there is no evidence that Gardasil lowered cancer rates in counties with higher vaccine uptake. Moreover, there is zero chance of pre-teens and teens getting cervical cancer. The average age for the onset of the cancer is 50 years. Nor has the vaccine been on the market long enough to determine whether it protects a woman when she reaches even close to that age. Its product insert for physicians states the vaccine “may not result in protection in all vaccine recipients” and it “has not been demonstrated to prevent HPV-related CIN 2/3 [abnormal pre-cancerous cervical cells] or worse in women older than 26 years of age.” Consequently, there is no scientific rationale for states to mandate the HPV vaccine for schoolchildren let alone even vaccinating them in the first place. In addition, the federal agencies and Merck market the vaccine under a false pretext that HPV infection is the leading cause of cervical cancer; correctly, only a third of cervical cancer cases are caused by the virus.   Robert Kennedy Jr is currently taking steps to sue Merck over the Gardasil deception. Merck’s first effort to have the class action suit dismissed was overturned by the court. Kennedy’s in-depth investigations through his Children’s Health Defense organization has uncovered evidence that the vaccine increases birth defects in children conceived of HPV-vaccinated moms; miscarriages have increased 2000 percent above normal, and girls are experiencing serious reproductive complications, including infertility, at approximately ten-fold above the normal rate. During an interview on the Progressive Radio Network, he noted that there was 10 times greater risk of dying from cervical cancer among Gardasil trial participants compared to the general public. There is a 10-fold increase for ovarian failure, and 1 in 37 girls who receive the vaccine will experience an autoimmune disease after 6 months of receiving the series of injections. When we consider that 1 in 37,000 women have a chance of dying from cervical cancer, it puts HPV vaccines into a completely different light. Sadly, across the nation, politicians from both sides of the aisle in state legislatures, notably Governor Andrew Cuomo in New York, are doing Merck’s bidding to mandate Gardasil for all girls and boys upon entering school.   Based upon Kennedy’s research and documents received from Freedom of Information Act filings, during Merck’s own Gardasil clinical trials, 2.3 percent of girls and women between the ages of 9 through 26 developed a serious autoimmune disease and crippling neurological disorders within seven months of vaccination. Among the 10,700 who received the actual vaccine, 245 (2.3%) had an autoimmune disorder; among the 9,412 who received either an “AAHS Control” — the aluminum hydrophosphate sulfate adjuvant solution with other ingredients minus the HPV virus vectors, there were 218 (2.3%) life-threatening injuries. The most frequent adverse effects were arthritis and anthropathy, autoimmune thyroiditis, celiac disease, hyperthyroidism and hypothyroidism, inflammatory bowel disease, psoriasis, Raynaud’s Phenomenon, rheumatoid arthritis and uveitis. In other words, it was the aluminum adjuvant responsible for this enormous suffering. He stated during the Progressive Radio Network broadcast that according to Merck’s own statistics, girls are one hundred times more likely to experience a serious adverse effect from the vaccine than to be protected from cervical cancer.   In a 2012 article published in the Journal of Law and Medical Ethics, researchers at the University of British Columbia wrote that ever since Gardasil was approved in 2006, Merck has engaged in an “overly aggressive marketing strategies and lobbying campaigns aimed at promoting Gardasil as a mandatory vaccine.”  One strategy Merck has employed is to take advantage of FDA loopholes to fast track its drugs. In the case of its expanded Gardasil-9 for adults between the ages of 27 to 45, the company applied for fast tracking two days after the Journal of Toxicological and Environmental Health published a study that the HPV vaccine was lowering the probability of pregnancy for women in their 20s.   Unfortunately, the media has indiscriminately colluded with Merck’s scam. Drug companies, according to Kennedy, pay $4.5 billion to the major media networks and publications to promote their drugs. And none of the media outlets are willing to sacrifice their profits for advertising drugs on moral and ethical grounds.   Another scandal erupted within Merck’s vaccine business in 2010 after two whistleblowers gave testimony that the mumps’ component in its Measles-Mumps-Rubella (MMR) vaccine was based on fraudulent data about it’s efficacy, and the company knowingly proceeded in order to corner the mumps vaccine market. Merck had been defrauding According to the charges, Merck had “falsified its mumps vaccine test results to hit an efficacy rate of 95 percent. The company achieved this by adding “animal antibodies to a blood sample to give the impression of increased antibodies.” This would certainly explain why mumps outbreaks in summer camps and on college campuses are found to occur among those vaccinated.   Merck’s has gained enormous political and social influence over the national perception about vaccines.  One example is Merck’s behind the scenes aggression against the flim Vaxxed.  When the documentary film was officially selected to screen during the 2016 Tribeca Film Festival in Manhattan, we discovered in an earlier report that Merck left its fingerprints on the film’s removal and censorship. The Alfred Sloan Foundation is the festival’s largest sponsor; pro-vaccine advocate Bill Gates is also a notable contributor. One of the leading persons on the Foundation’s board of trustees was Dr. Peter Kim.  Kim happens to be the former president of Merck’s Research Laboratories who was directly responsible for the launch of Gardasil and Merck’s other vaccines for the Zoster virus and rotavirus. The film presents a harsh indictment against Dr Julie Gerberding, the former head of the CDC who coordinated the cover up of data that confirmed thimerosal’s role in the onset of autism. After managing the agency’s operations to mine sweep the data and generate new manipulated studies with public funds to suggest thimerosal’s safety, Gerberding accepted her reward from the pharmaceutical industry by becoming the head of Merck’s vaccine division. In addition, according to the whistleblowing of a senior CDC scientist, Dr. William Thompson, Gerberding was responsible for destroying the CDC’s research that showed African American boys were at a substantially higher risk of becoming autistic from Merck’s MMR vaccine. Fortunately, Dr. Thompson, who was present during the order to shred documents, saved copies which he subsequently turned over to Congressman Bill Posy and an independent biologist Prof. Brian Hooker. Since then, Congress has failed to hold hearings.   All told, these examples of Merck’s culture of greed, deception, political maneuvering and illegal aggression has collectively injured countless people. Merck is a global corporation. Its products, like Monsanto’s glyphoste, are marketed globally. To better understand Merck, the company should be perceived foremost as a cash cow for Wall Street. Its prime directive is selling drugs; its history of misdemeanors and criminal activities should indicate the company holds little integrity in its commitment to prevent and treat disease. The full extent of the casualties from Merck’s drugs and vaccines may never be properly calculated. For firms such as Merck and Monsanto, injuries and deaths are the necessary collateral damage of getting poorly tested products on the market and as fast as possible. A black box should be slapped on the Merck logo.   What is important at this moment is that many corporations are fast-tracking, without sufficient long-term animal and human clinical trials, Merck is now aggressively making efforts to beat out its competition with a Covid-19 vaccine.  Do we really want to trust such a company with this reputation with a Covid vaccine? Therefore we recommend people to support the efforts of Bobby Kennedy and the Children’s Health Defense in its lawsuit against Merck’s Gardasil. A victory may well weaken the entire edifice of vaccine pseudoscience and the public will realize that for decades it has been little more than a house of cards.

Host Daniel Bauer provides weekday motivation for the modern educator. Listeners can expect tools and tricks from a variety of sources: inspirational books, stories from the mastermind, and weekly challenges. Learn more and listen to the category defining leadership conversation for school leaders, Better Leaders Better Schools at https://betterleadersbetterschools.com   Copyright © 2020 Better Leaders Better Schools

Merck's History of Crimes and Misdemeanors   Richard Gale and Gary Null Progressive Radio Network, June 1, 2020 Which private corporation has likely been responsible for the deaths of more innocent people than any terrorist organization or military regime change in Afghanistan, Iraq, Libya, Syria and elsewhere?  For us, the answer is evident:  Merck and Company. Iatraogenic medicine, or medical error, is now the third leading cause of death in the US after cardiovascular disease and cancer. The majority of these deaths are caused by FDA approved drugs' adverse effects and from patients taking multiple medications without thorough clinical research to determine the safety of their synergistic effects.  Consequently our health agencies' oversight and monitoring of drugs on the market is dismal.    One of the worst corporate deals the US government may have ever made in modern history was to acquire the American subsidiary of the German pharmaceutical firm Merck and Company during the first world war. Later in 1953, Merck acquired a competitive drug maker Sharp and Dohme, thereby establishing itself as America's largest drug developer and manufacturer. Since then this corporate Medusa has ensnared thirteen other drug firms, including Scherring Plough, which it acquired for $41 billion. The two pharmaceutical giants had earned $47 billion in combined sales at the time the merger was finalized in 2009.   Merck's life of criminal behavior was observed back in the 1970s. In 1975, it was busted by the SEC for illegal payments to foreign government officials from "approximately" 36 nations. The scam was orchestrated through personal bank accounts with the sole purpose of advancing drug approvals through foreign nations' regulatory medical agencies.     One of the largest frauds in recent medical history was the company's anti-inflammatory drug Vioxx that resulted in fines above $4.8 billion for causing over a minimum 60,000 deaths from sudden heart attacks and over 120,000 serious medical injuries. At its height, Vioxx was earning over $2 billion in revenues annually and it is estimated that 25 million patients were prescribed the medication. The securities class action suit against the company alone reached $1 billion, placing it in the top 15 securities lawsuits in US corporate history. The centerpiece of the crime was Merck's intentional withholding of scientific data about the drug's adverse cardiovascular side effects.    Years after the settlement, Ron Unz, the publisher of The American Conservative, undertook his own investigation to validate Vioxx's death toll. Analyzing the drug's adverse effects over a longer time period, Unz estimated Merck may have been responsible for nearly half a million premature deaths in elderly patients, the drug's primary target group. That is roughly the same number of total civilian, military and terrorist deaths from the US's military escapades in Afghanistan, Iraq and Pakistan combined.    Merck's settlement of 47,000 pending lawsuits for personal injuries and 265 class action cases was a small pittance for the harm Vioxx left in its wake. Merck executives were never properly punished for willingly concealing the drug's dangers in order to assure FDA approval.    In Australia, Merck's efforts to increase Vioxx profits employed other forms of malfeasance. The Australian government launched a class action suit against the drug maker on charges that employees schemed a fake scientific paper that was ghostwritten for a medical journal in order to put Vioxx into a positive light. Testimonies during the trial stated data was completely based upon "wishful thinking." Merck also founded the peer-reviewed journal Australasian Journal of Bone and Joint Medicine. The journal was a fraud; it was not properly peer-reviewed and its primary purpose was to promote Vioxx on the Australian continent.    Moreover, the class action lawsuit contained Merck emails accessed by Australian officials. The company's internal communications ordered select employees to draft up a hit list of physicians who were critical of Vioxx. According to the documents, these physicians were targeted to be "neutralized" or "discredited." Some, including Dr. James Fries at Sanford University's medical school, were clinical investigators who happened to speak out about the drug's shortcomings. One email said, "We may need to seek them out and destroy them where they live..."     Efforts to target critics for harassment is not limited to Merck. Earlier, Monsanto earned a similar reputation. The Monsanto's parent company Bayer had to release a public apology for the discovery of a Monsanto hit list of 200 French journalists and politicians who opposed glyphosate and its GMO crops. It has acted similarly in other countries including the US, according to veteran journalist Carey Gillam.  The list originated from the multinational public relations firm Fleishman Hillard. Merck has also employed Fleishman Hillard as well as Monsanto's other notorious PR firm Ketchum. One of Merck's Executive Directors, Ian McConnell, earlier served as a vice president at Fleishman. The PR firm's senior adviser on healthcare Dr. Lukas Pfister, was at Merck for 25 years in its government affairs unit. Merck's revolving door is not limited to our federal health agencies, but also fully infiltrates some of the world's most shadowy international PR firms that specialize in whitewashing the public images of executive elites, corporations and in the case of the PR firm Burson-Marsteller even dictators. Following the Vioxx case, Merck had hired B-Marsteller to clean up its public image. MSNBC reported back in 2009, "When evil needs public relations, evil has Burson-Marsteller on speed dial."   But Merck's efforts to conceal the dangers of its products, falsify data about drugs' efficacy and safety and exaggeration of medical claims go back sixty years. In the 1960s, the FDA discovered that the drug maker's arthritis medication Indocin had not been properly tested for efficacy and its adverse effects were being completely ignored.  In the 1970s, Merck's drug dietheylstilbestrol (DES) prescribed for the prevention of miscarriages caused a flurry of vaginal cancer cases and other gynecological disorders. Merck had all along known that DES was carcinogenic based upon its own animal clinical trials. In 2007, its cholesterol drug Zetia was shown to increase liver disease. Again Merck had known about Zetia's liver risks but withheld the clinical trial's damning results.    It would also appear that Merck has managed to hijack US courts as well. This includes an early 2019 ruling by Trump's corporate-friendly US Supreme Court to side with the drug maker and squash hundreds of lawsuits for failing to issue warnings that its osteoporosis drug Fosamax's may contribute to debilitating bone breaks. A federal court in California found that Merck committed perjury for lying in a patent infringement case against Gilead Sciences over the latter's blockbuster Hepatitis C drug Sovaldi. The judge ruled that Merck carried out a "systematic and outrageous deception in conjunction with unethical business practices and litigation misconduct."  It turned out that Merck's patent claims were a sham and orchestrated by its legal division.   Besides pushing through the FDA dangerous medications onto the market, the company has also found itself in the courtroom on many occasions for price-fixing, routinely defrauding and overbilling states' Medicare and Medicaid programs, and violating the Anti-Kickback Statute. In 2006, the IRS went after Merck for owing almost $2 billion in back taxes. According to the Wall Street Journal, Merck partnered with a British bank to create an offshore subsidiary in tax-friendly Bermuda to divert taxable revenue on its bestselling cholesterol drugs Zocor and Mevacor through a patent scheme. The company ran the operation for ten years before the FDA uncovered the racket.    Merck is America's leading vaccine manufacturer. Despite public perception and the ruse that vaccines are somehow safer and more effective than pharmaceutical drugs in general, it is the same industry and corporate culture that manufactures both them. Currently Merck markets vaccines for Haemophilus B, Hepatitis A and Hepatitis B (individually and in combination), human papilomavirus (Gardasil), Measles, Mumps and Rubella (MMR), pneumococcal, rotavirus, varicella (chickenpox) and Zoster virus (for shingles). More recently it has jumped into the coronavirus vaccine race. In 2010, Merck obtained exclusive rights to MassBiologics vaccine portfolio. The consequence is that Merck's Adult Vaccine Portfolio expanded to include 9 of the 10 vaccines on the CDC's adult immunization schedule. The company now holds almost a full monopoly on the government's vaccines    On its website, the FDA assures the public that "Vaccines, as with all products regulated by the FDA, undergo a rigorous review of laboratory and clinical data to ensure the safety, efficacy, purity and potency of these products."  However, except for Gardasil, not a single one of Merck's vaccines has ever been tested in a scientifically viable double-blinded placebo controlled trial. In each case, the placebo in the control group was not inert, such as the use of sterile saline. Rather Merck only tested the vaccine with the viral component against a faux placebo containing the same ingredients, including aluminum, but minus the virus. Known as a "carrier solution," the standard scientific protocol does not designate it as a proper placebo for measuring the efficacy and disease risks of a drug. And in the case of Gardasil, the trial was statistical trickery to mask Gardasil's adverse effects. Therefore the FDA's claim is patently false. None of Merck's vaccines have ever undergone a "rigorous review" prior to regulatory approval.    Although not completely innocent from internal unfairness and conflicts of interest, the Cochrane Database Collaboration arguably remains the most reliable resource for analysis of drugs, vaccines and medical devices in the evidence-based medical establishment. In its 2016 analysis of Merck's human papillomavirus vaccine Gardasil, the investigators were so alarmed they filed a complaint against the European Medical Agency for failing to adequately assess the vaccine's neurological harms.    As we have recently witnessed with Monsanto's Roundup and Bayer's settlement of $10 billion to cover 80,000 lawsuits, Gardasil may very well become the company's Achilles heel. The Gardasil scandal may very well begin to topple the vaccine regime and raise the public's already increasing awareness and distrust in the official mantra that vaccines are safe and effective. The development, scientific rationale, fraudulent clinical trials and data reporting, and inside negotiations with federal health officials to market the vaccine to pre-teen and teen girls and boys, is a story riddled with misconduct. Today it is Merck's third largest revenue-generating drug after its cancer drug Keytruda and diabetes drug Januvia, earning $3.1 billion in 2018. Its MMR vaccine is fifth having earned $1.8 billion. Gardasil's success has nothing to do with the prevention of an urgent national health need. Instead it was a business strategy through Merck's influence over our nation's regulatory agencies and state politicians whose election campaigns it funds.    In 2018, a French oncologist, Dr. Gerard Delepine, stumbled upon a correlation between the increase of cervical cancer rates with the rising rates of Gardasil vaccinations. Delepine also compared France, which was deliberating on whether to mandate HPV vaccination, with other countries that relied upon pap smears as a preventative measure against cervical cancer. He observed that in all countries that prioritized pap smears, cervical cancer rates were decreasing; whereas, in those countries with higher HPV vaccination compliance, the rates increased. In his letter to the French government in defiance of Merck's lobbying efforts, Delephine stated:   "A compulsory health measure should not be based on faith in vaccination or hidden conflicts of interest, but on proven facts, verifiable by every citizen. However, the facts established by the official records of cancer registries show that HPV vaccination does not protect against invasive cancer of the cervix, but seems rather to maintain its frequency at a high level and sometimes even increase it."   An article published in the French journal Agoravox noted that other national health ministries are coming around to acknowledge that Gardasil is an extremely unsafe vaccine. Japan, Austria and Denmark no longer promote it due to is trail of injuries with fatal consequences. Public demonstrations against Merck's Gardasil have occurred in Japan, Colombia, and Ireland.    Yet none of these efforts to warn the public about Gardasil's risks have reached the American media. Hopefully this may change. Medical researchers at the University of South Alabama presented their paper at the Society of Gynecologic Oncology's annual conference. There is great disparity between HPV vaccine compliance across Alabama counties, which range anywhere between 33 and 66 percent. Yet the epidemiological data suggests there is no evidence that Gardasil lowered cancer rates in counties with higher vaccine uptake. Moreover, there is zero chance of pre-teens and teens getting cervical cancer. The average age for the onset of the cancer is 50 years. Nor has the vaccine been on the market long enough to determine whether it protects a woman when she reaches even close to that age. Its product insert for physicians states the vaccine "may not result in protection in all vaccine recipients" and it "has not been demonstrated to prevent HPV-related CIN 2/3 [abnormal pre-cancerous cervical cells] or worse in women older than 26 years of age." Consequently, there is no scientific rationale for states to mandate the HPV vaccine for schoolchildren let alone even vaccinating them in the first place. In addition, the federal agencies and Merck market the vaccine under a false pretext that HPV infection is the leading cause of cervical cancer; correctly, only a third of cervical cancer cases are caused by the virus.    Robert Kennedy Jr is currently taking steps to sue Merck over the Gardasil deception. Merck's first effort to have the class action suit dismissed was overturned by the court. Kennedy's in-depth investigations through his Children's Health Defense organization has uncovered evidence that the vaccine increases birth defects in children conceived of HPV-vaccinated moms; miscarriages have increased 2000 percent above normal, and girls are experiencing serious reproductive complications, including infertility, at approximately ten-fold above the normal rate. During an interview on the Progressive Radio Network, he noted that there was 10 times greater risk of dying from cervical cancer among Gardasil trial participants compared to the general public. There is a 10-fold increase for ovarian failure, and 1 in 37 girls who receive the vaccine will experience an autoimmune disease after 6 months of receiving the series of injections. When we consider that 1 in 37,000 women have a chance of dying from cervical cancer, it puts HPV vaccines into a completely different light. Sadly, across the nation, politicians from both sides of the aisle in state legislatures, notably Governor Andrew Cuomo in New York, are doing Merck's bidding to mandate Gardasil for all girls and boys upon entering school.    Based upon Kennedy's research and documents received from Freedom of Information Act filings, during Merck's own Gardasil clinical trials, 2.3 percent of girls and women between the ages of 9 through 26 developed a serious autoimmune disease and crippling neurological disorders within seven months of vaccination. Among the 10,700 who received the actual vaccine, 245 (2.3%) had an autoimmune disorder; among the 9,412 who received either an "AAHS Control" -- the aluminum hydrophosphate sulfate adjuvant solution with other ingredients minus the HPV virus vectors, there were 218 (2.3%) life-threatening injuries. The most frequent adverse effects were arthritis and anthropathy, autoimmune thyroiditis, celiac disease, hyperthyroidism and hypothyroidism, inflammatory bowel disease, psoriasis, Raynaud's Phenomenon, rheumatoid arthritis and uveitis. In other words, it was the aluminum adjuvant responsible for this enormous suffering. He stated during the Progressive Radio Network broadcast that according to Merck's own statistics, girls are one hundred times more likely to experience a serious adverse effect from the vaccine than to be protected from cervical cancer.    In a 2012 article published in the Journal of Law and Medical Ethics, researchers at the University of British Columbia wrote that ever since Gardasil was approved in 2006, Merck has engaged in an "overly aggressive marketing strategies and lobbying campaigns aimed at promoting Gardasil as a mandatory vaccine."  One strategy Merck has employed is to take advantage of FDA loopholes to fast track its drugs. In the case of its expanded Gardasil-9 for adults between the ages of 27 to 45, the company applied for fast tracking two days after the Journal of Toxicological and Environmental Health published a study that the HPV vaccine was lowering the probability of pregnancy for women in their 20s.   Unfortunately, the media has indiscriminately colluded with Merck's scam. Drug companies, according to Kennedy, pay $4.5 billion to the major media networks and publications to promote their drugs. And none of the media outlets are willing to sacrifice their profits for advertising drugs on moral and ethical grounds.    Another scandal erupted within Merck's vaccine business in 2010 after two whistleblowers gave testimony that the mumps' component in its Measles-Mumps-Rubella (MMR) vaccine was based on fraudulent data about it's efficacy, and the company knowingly proceeded in order to corner the mumps vaccine market. Merck had been defrauding the US government, which purchases the MMR, for a decade. The government and the two Merck whistleblowers, virologists Stephen Krahling and Joan Wlochowski, filed a lawsuit against Merck for being in violation of the False Claims Act. According to the charges, Merck had "falsified its mumps vaccine test results to hit an efficacy rate of 95 percent. The company achieved this by adding "animal antibodies to a blood sample to give the impression of increased antibodies." This would certainly explain why mumps outbreaks in summer camps and on college campuses are found to occur among those vaccinated.    Merck's has gained enormous political and social influence over the national perception about vaccines.  One example is Merck's behind the scenes aggression against the flim Vaxxed.  When the documentary film was officially selected to screen during the 2016 Tribeca Film Festival in Manhattan, we discovered in an earlier report that Merck left its fingerprints on the film's removal and censorship. The Alfred Sloan Foundation is the festival's largest sponsor; pro-vaccine advocate Bill Gates is also a notable contributor. One of the leading persons on the Foundation's board of trustees was Dr. Peter Kim.  Kim happens to be the former president of Merck's Research Laboratories who was directly responsible for the launch of Gardasil and Merck's other vaccines for the Zoster virus and rotavirus. The film presents a harsh indictment against Dr Julie Gerberding, the former head of the CDC who coordinated the cover up of data that confirmed thimerosal's role in the onset of autism. After managing the agency's operations to mine sweep the data and generate new manipulated studies with public funds to suggest thimerosal's safety, Gerberding accepted her reward from the pharmaceutical industry by becoming the head of Merck's vaccine division. In addition, according to the whistleblowing of a senior CDC scientist, Dr. William Thompson, Gerberding was responsible for destroying the CDC's research that showed African American boys were at a substantially higher risk of becoming autistic from Merck's MMR vaccine. Fortunately, Dr. Thompson, who was present during the order to shred documents, saved copies which he subsequently turned over to Congressman Bill Posy and an independent biologist Prof. Brian Hooker. Since then, Congress has failed to hold hearings.    All told, these examples of Merck's culture of greed, deception, political maneuvering and illegal aggression has collectively injured countless people. Merck is a global corporation. Its products, like Monsanto's glyphoste, are marketed globally. To better understand Merck, the company should be perceived foremost as a cash cow for Wall Street. Its prime directive is selling drugs; its history of misdemeanors and criminal activities should indicate the company holds little integrity in its commitment to prevent and treat disease. The full extent of the casualties from Merck's drugs and vaccines may never be properly calculated. For firms such as Merck and Monsanto, injuries and deaths are the necessary collateral damage of getting poorly tested products on the market and as fast as possible. A black box should be slapped on the Merck logo.    What is important at this moment is that many corporations are fast-tracking, without sufficient long-term animal and human clinical trials, Merck is now aggressively making efforts to beat out its competition with a Covid-19 vaccine.  Do we really want to trust such a company with this reputation with a Covid vaccine? Therefore we recommend people to support the efforts of Bobby Kennedy and the Children's Health Defense in its lawsuit against Merck's Gardasil. A victory may well weaken the entire edifice of vaccine pseudoscience and the public will realize that for decades it has been little more than a house of cards.

In this Live Friday CME Series recap, Dr. Todd Holcomb, an Internist and hospitalist with Lakeview Clinic and Ridgeview Medical Center, presents an interesting Internal Medicine case that is sure to scratch some heads, and remind us of the need to go back to the beginning, if it's not making sense after several attempts. Dr. Holcomb is accompanied by cardiologist Dr. Joshua Buckler, with Minneapolis Heart Institute, Dr. Jonathan Larson, family physician at Lakeview Clinic, Dr. Carl Dean, nephrologist with Kidney Specialists of Minnesota, and Dr. David Gross, radiologist with Consulting Radiologists.  So put on your thinking caps, listen closely and ask yourself what you would do as Dr. Holcomb guides us through this interesting case. Enjoy the podcast! OBJECTIVES:    Upon completion of this podcast, participants should be able to: Identify secondary causes of hypertension. Identify when further testing is warranted. Discuss newer treatments available for cholesterol related conditions. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2 weeks.  You may contact the accredited provider with questions regarding this program at  rmccredentialing@ridgeviewmedical.org.   CLICK ON THE FOLLOWING LINK FOR YOUR CME CREDIT: CME Evaluation: "2019 Internal Medicine Case Conference" (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.   FACULTY DISCLOSURE ANNOUNCEMENT  It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. SHOW NOTES: PART 1: Alright, let's break down the first portion of this case discussion. This is a 60 yo male with chest pain for over a year. Intermittent aching and burning in right anterior chest, worse with activity and lately has worsened overall with a stressful job and strong family hx of heart disease. General exam ins unremarkable. ECG normal. HDL is 60 and LDL slightly up at 137. PFTs and CXR are normal.  Stress echo is normal.  Cardiology referral results in a low Ca++ score but some plaque in the LAD. Dr. Buckler, the cardiologist, feels this is ischemic heart disease until proven otherwise. Therefore, a coronary angiogram is necessary. Imaging has its limitations, as do stress tests. When the history still doesn't point in another explicable direction, we must follow the logic and most likely etiology, which is till coronary artery disease and ACS. One of the problems with stress tests in general, is there are limitations inherent. It's hard to miss the big stuff, but the more minor findings can be missed. With a high pretest probability, he could have perhaps gone straight to angio. In this case, though, he was started on a statin and aspirin. Per Dr. Buckler, Imdur could also have been given. Two year later, he comes in with headaches in the same area of the head since his wife recently passed away. He takes Advil for this. BP has been elevated at home. Dr. Jonathan Larson, family physician, questions the type of headache, it's location and possible etiologies. Is the Advil causing rebound headaches or contributing to the headaches? The elevated home blood pressures also need further investigation. His kidney function is temporarily normal. NSAIDs are d/c'd and Lisinopril is started. A month later, the headaches have improved. BP improved, but not tremendously. In addition, his chest pain has gone away. A new antihypertensive, a combo HCTZ/Lisinopril regimen is started. Although Amlodipine would have been a reasonable choice. A year later, he returns with the same chest pain on exertion. Normal ECG. Normal renal function too. He now goes back to a CT angiogram showing multi-vessel disease. Per Dr. Buckler, one of the reasons he has worsened on a statin is that we may have limited understanding of his pathology, or potentially the CTA was not accurate the first time. Virtual FFT now can show the flow and how significant the lesion is, which is an advancement in this technology. Unfortunately, despite aggressive lipid therapy, sometimes people progress. A few days after the CTA, his Creatinine goes up a bit and GFR goes to 43. This is also after years of Lisinopril. Dr. Carl Dean comments on this alteration in renal function. He feels this is not entirely unexpected, but the data doesn't really reflect CIN (contrast induced nephropathy). Yet intuitively and experientially, we sometimes see this. The amount of contrast used is significantly more on a CTA than on an invasive angio. At this point, the ACE inhibitor is held and Amlodipine is started. Renal function now has improved. The angiogram demonstrates significant 3 vessel disease, with good downstream targets. The SYNTAX surgical risk score directs the cardiologist toward CABG instead of PCI. Post angio, he develops some lower extremity edema, and he is discontinues on Amlodipine, resumed on the HCTZ, Lisinopril. The creatinine is now 2.4. Did he receive enough fluids for the angiogram? Or was the few hundred cc's he obtained during the angio okay? Again, hindsight is 20/20, but the data doesn't support a causality for AKI due to CIN, nor is there a true preventable measure, including n-acetylcysteine or bicarbonate. Perhaps, in this case, CIN as a possibility in the past as discussed, that many would not argue with overhydrating. Ultimately it was felt the ACE and contrast contributed to his creatinine elevation. The ACE combo is now stopped and he is started on Hydralazine and Metoprolol. Creatinine improves, and he goes into CABG surgery. He is discharged and he continues on aspirin and Plavix for 3 months, and Carvedilol and Hydralazine. Atorvastatin is increased to 80 mg daily, a more aggressive dose. EF is normal on echo.  Do statins affect kidney function positively or negatively? According to Dr. Dean, there is no trial that supports either. His BP starts to increase, and Lisinopril is once again added, along with an increase of creatinine, and the ACE is again d/c'd. HCTZ was added. Then spironolactone for ongoing HTN. He's still running high though. Labetalol is replacing carvedilol now. And the pressure is still running high. What is happening here? What to do next? Do we try Lisinopril again? It is attempted, and he once again fails the creatinine test. It goes up again. PART 2: What we do now for this patient? It seems he can only improve on Lisinopril for blood pressure, but his creatinine continues to go up. According to Dr. Dean, in this patient, Lisinopril may not be a great option going forward, not only due to creatinine increase, but it will not help him in terms of mortality outcome. renal artery stenosis is a concern in this case. Dr. Tara McMichael interjects the question, could a loop diuretic have been tried? With a creatinine of 2.3, a loop diuretic could have been an option, since volume and sodium retention could be contributing to the hypertension. Isosorbide with hydralazine is also an option if more meds were to be added. Per Dr. Buckler, however, a four drug regimen that is poorly controlling blood pressure doesn't necessarily indicate adding a fifth drug. We need to know if there is a secondary cause of HTN. Sometimes, even in the setting of renal artery stenosis, patients still require significant anti-HTN drug regimens. Also, per Dr. Dean, the pretest probability in this type of patient for renal artery disease is high. And will an intervention be desirable if it is found? The ASTRAL trial demonstrated no improvement in outcomes. The CORAL trial was also done and considered to be a negative trial. One of the trial criticisms though was that it didn't include patients with severe enough disease. According to Dr. Dean, refractory hypertension should cause screening for this and an intervention should be done if it is seen.  Our patient has a renal u/s that shows bilateral RAS. Dr. David Gross, radiologist discussed the results of the MRA. The aorta, SMA and celiac trunk show atherosclerosis. The renal arteries are paired bilaterally. They have moderate to high grade narrowing of the arteries. Dr. Buckler asks the question of the safety of gadolinium in renal disease. In the setting of low GFR, in other words, less than 30, the risk for nephrogenic systemic fibrosis exists, although very rare. This is usually fatal, though. Basically, he has 4 out of 4 arteries occluded. Dr. Dean feels referral to a center of excellence for this unique issue is best for the patient. He undergoes transaortic endarterectomy, as his creatinine is rapidly going up. A significant plaque is resected from the aorta which was extending into the renal arteries. Post-procedure, he is placed on metoprolol, requiring nothing further. Rosuvastatin, Zetia and baby aspirin is started. Basically, unclogging the pipes resulted in a cure. And a while later, he's no longer on any antihypertensives. Blood pressures are great now. LDL now 57 on the new cholesterol meds. Zetia has limited data, but the PcsK9 inhibitor and his LDL is now 1. Dr. Buckler states there is a lot of unknowns about the LDL levels and whether there is a point of diminishing returns, but the science is not there yet. In this case, Dr. Buckler feels that stopping the Zetia and continuing the pcksk9 inhibitor makes sense. PART 3: Renovascular HTN is more commonly found in the setting of acute, severe, refractory, very high blood pressure. Work-up is needed when there is a strong possibility of secondary cause, and in the absence of another secondary cause, like pheochromocytoma or hyperaldosteronism. Also in an acute rise in BP, a young age, elevated Cr after starting an ace inhibitor, etc. Renal asymmetry on imaging and flash pulmonary edema are other clues. If Cr and BP are stable in the setting of stenosis, no intervention is indicated. Testing can potentially worsen function, as can the interventions performed to treat the disease. Who benefits most? People with short term hx of HTN, people who fail optimal medical therapy, not tolerating medical therapy and progressive renal failure. Ultrasound and CTA or MRA are the options for work-up. US is cheaper, but time consuming and operator dependent, with modest sensitivity/specificity. CTA is accurate for atherosclerosis. Highly sensitive and better if GFR below 30. MRA is highly sens/spec. Gadolinium complications can ensue in low GFR situations. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9) will lower LDL up to 60%. 50% decease in stroke and MI risk. The PCSK9 enzyme binds to liver LDL receptors and thereby increases plasma LDL levels. so inhibiting this enzyme leads to a lower LDL level. These inhibitors also can decrease triglycerides, increase HDL somewhat and decrease the volume of atheroma. Low adverse effects are noted with the med as well. Regarding renovascular HTN, Dr. Dean also reminds us that someone who is significantly older with chronic renal ischemia in the setting of this disease, may not have improvement in renal function even after intervention. Therefore, some of these patients who suddenly reperfuse a chronically ischemic kidney may actually worsen. Renal artery stenosis is also not an absolute contraindication for ACE. Such as in low EF heart failure. If the creatinine markedly rises, it can be discontinued again. Fibromuscular dysplasia patients, unlike atherosclerosis patients, should all receive an intervention. This is more commonly found in younger patients. Dr. Buckler addresses the ease of use and cost of the PCSK9 inhibitors. It turns out the cost is high at this point, up to $14k/year. But coverage has shown promise in FH and refractory high LDL. As it was alluded to by Dr. Holcomb, the patient really doesn't exercise and has a very stressful job, as it turns out. His dies wasn't discussed. Was he managing his risk factors very well? What does that mean nowadays? We have potent medications and skillful intervention options for reacting to this sort of pathology nowadays, but where are we at with prevention? Hopefully a conversation for another day.

Pharmaceutical drugs, especially statins, tend to get a bad rap, but the world of heart drugs goes well beyond statins. In fact, one of the best known heart drugs called Zetia, is used as a therapy for people who hyper absorb cholesterol as well as plant sterol. At Gene Food we are interested in both cholesterol and sterol absorption as the tendency to hyper absorb is tied heavily to genetics. In this episode of the podcast, John shares his experience taking Zetia as a "biohack" experiment to see what the drug would do to his lipid numbers. As we see in the episode, the experiment didn't quite go as planned. Later in the episode both John and Dr. Aaron discuss how different diets have impacted their blood work, specifically C reactive protein, a marker of inflammation in the body, and LDL-C. 

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter’s head analyst, asks the questions. This also marks the first video release of the podcast. You can find it on YouTube (https://youtu.be/kzs7GgxR_FQ) and the website (peterattiamd.com/ama03). If you have any questions for the next AMA, please submit them to the AMA section on the website (peterattiamd.com). We discuss: What references ranges does Peter consider too broad on lab tests? [5:30]; What aspect of women’s health is the least studied/understood? [21:15]; What are your thoughts on fasting and ketosis for females? [31:30]; Advice for medical students and residents, how to get through it, and optimize their time while in med school [38:00]; What is Peter’s opinion on the best way to monetize a podcast to make it sustainable? [47:45]; What are you looking to achieve and monitor with your blood glucose monitor? [57:15]; Thoughts on lithium supplementation? [1:08:15]; Insights about berberine? [1:16:00]; Why does Peter take a baby aspirin? What does the science say? [1:19:20]; How do you use HR variability as a metric in your practice and/or in your own personal use? Sleep, pre/post exercise, pre/post eating, every morning readiness? [1:23:25]; With the emergence of “the coconut oil is pure poison” article, can you shed some light on saturated fat in the literature and the types of studies done specifically on coconut oil? [1:38:45]; Would you discuss the recent meta studies that claim that moderate carbohydrate intake may be best for health? [1:40:45]; What is the number one recommendation/habit you would suggest every person add to their daily regimen (besides physical activity) for wholesome health? [1:42:45]; What does it mean if your body has a harder time getting into ketosis via fasting than it used to (testing using a Precision Xtra)? [1:44:15]; Why are you taking Zetia and Lipitor? Are you mitigating risk based on your APOE4? Or is there something else going on? [1:46:10]; What will your book be about and what is the expected release date? [1:47:45]; What are your thoughts on nicotinamide riboside supplementation for longevity? [1:49:30]; Which brand of supplements have you found to be effective? [1:54:30]; Are you currently accepting new patients? And how do I find a ‘Peter Attia clone’ in my area? [1:56:20]; Bob’s personal experience with Peter as a doctor [1:58:45]; Can you tell us more about the latest and best of APOE4? [2:06:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook| Twitter| Instagram.

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!  Check out today's questions: Ruben: Hello Dr. Cabral, First of all THANK YOU for putting in the time to put out the podcast on a regular basis. I wasn't sure what address to reach out with my question, so I figured I would start with this one. The question is actually for my wife. She had a annual exam yesterday and the Cholesterol test came back high. The doctor prescribed her a low dose Statin. My wife has been really sad since then because she really watches what she eats and is active. here is a brief overview: Height: 5'8 Weight: 134 lbs Age: 38 - Does not eat beef/pork - Eats chicken ( once a week) - eats fish ( once a week) - drinks a green drink 98% of the time, daily ( spinach, banana, apple, ginger, tumeric, spirulina, water) - when she doesn't pull her back ( she has few back issues), she works out about 4 times a week. - workouts consist: 10 minutes cardio fast pace, 20-30 minutes strength and conditioning. - Prior to the blood test she hasn't really worked out for about 2 weeks here are the numbers ( fasted test) Chol: 280 Trigly: 173 HDL: 51 Chol/HDL rate: 5.49 LDL: 194 Non HDL Chol : 229 Rest of the numbers look good. She has a history of high cholesterol even though she doesn't eat bad at all 2012 : Chol 169 | Tri 62 | HDL 40 | Ratio: 4.23 | LDL 117 2015: Chol 246 | Tri 139 | HDL 46 | Ratio: 5.35 | LDL 172 2017: Chol 226 | Tri 186 | HDL 47 | Ratio: 4.81 | LDL 142 2018: Chol 280 | Tri 173 | HDL 51 | Ratio: 5.49 | LDL 194 She does not want to start taking a statin but she really feels defeated, so I am reaching out to see if there are any other tests that she could do to make sure there aren't other things that are actually causing the high cholesterol. Also, if she can do any of your protocols or any of the daily support products. Any info that could give us some hope or something to try in the near future would be really really appreciated! Kind Regards, Ruben Breanna: Hi Dr. Cabral. Thank you so much for providing us with such amazing content, and inspiring many to live happier, healthier and happier lifestyles. I listen to your podcast daily and have providing me with the knowledge I've always wanted to know growing up. I have a little story for you. For as long as I can remember I would be in excruciating pain 24/7, especially in the morning. I was diagnosed with lactose intolerance as a baby, but it wasn't until I was 11 years old that the doctors diagnosed me with Celiac Disease... then depression, then anxiety, then acid reflux, then anemia... my symptoms never went away, my intestines never fully recuperated and I was taking 5 different pills daily at 12 years old, despite eliminating gluten. I stopped taking all medication a year ago because I was fed up and I am now 18. Through your podcast I now realize why all these extra symptoms occurred and how they were going against me.. the health system failed me. My intestines still aren't fully recuperated but this isn't part of my question. I just believe my health background may play a part in my current situation. I was always super active growing up as I was a competitive dancer. A year ago I decided to start going to the gym and got approached by a coach who offered her services to help prepare me for a bodybuilding competition. I did my first competition in april and won 2nd place. That diet wasn't bad and didn't have to do too much cardio as I was only 17 and she didn't want anything bad to happen. 3 months later I started prepping for my second show, at 18 years old. My "diet" lasted 12 weeks. She started me off at 1800 calories, lowered weekly and by the end I struggled to loose weight. For the last 4 weeks I was doing 2 hours of cardio + 1 hour weight training, and my diet composed of 5 chicken breasts and 2 tbsp ground flaxseed (+ 1/4 cup oats ONCE a week on leg day, and cut out those carbs 2 weeks out). How did I survive? Barely. I realize that this is extremely unhealthy, but I was too far in to give up. I had 0 days off the gym in 4 months. Also, I was extremely constipated. There was a period where I went 4 weeks only pooping 3 times and had to use diuretics each time to force myself to go!!! I started taking probiotics as another coach had told me this helped her use the bathroom, and it did for a while. My body toxicity was so high. She also advised me to use "estro control" to help get rid of that toxicity and loose my last pounds on my legs. I won first place by the way :). But here is my question.. what exactly did I do to my body? And what could I do differently next time? From listening to your podcasts, (especially your low carb diet ones), I realize I lowered my metabolism dramatically, lowered my thyroid, increased cortisol, burned a lot of muscle and increases levels of disease from purely eating chicken. To put in perspective, I'm 18, 5ft, mesomorph body type, was 95 pounds before going to the gym, gained a lot of muscle and started my diet at 112 lbs but cut down to 98 lbs for my competition. To reverse diet, she advised me to eat 200g carbs, 100g protein and 45g fat, and 0 cardio.I had very minimal "cheats", meaning I only eat whole clean foods such as sweet potato, rice, berries, gluten free oats, veggies, protein powder, eggs, chicken, extra lean ground turkey, rarely red meat, nuts, peanut butter and coconut oil (literally all I eat). Following this diet I am 5 weeks post show and 120 lbs!!! I went from being 10% body fat to having the most fat on my body I've ever had. So what do I do now? Do I just follow this new diet and wait for my metabolism to reset? I know that lowering my calories and doing cardio is only going to hurt me more in the long run (metabolism, thyroid, cortisol)... so I'm just confused and extremely unhappy. On top of that, I haven't gotten my period in months (and no I'm not pregnant). I now go to the gym 5 times a week to weight train and I take multivitamins, omega 3, potassium, digestive enzymes and probiotic5, but no more estro control... should I still be taking these supplements? I have recently started implementing your morning routine (water, yoga, smoothie) and definitely feeling better, but not looking better. Can you help me? I'm sooooo lost. And I know you are the best of the best, and the only person I would trust answering this properly, as you always look at all perspectives. Amanda: Hi Dr. Cabral, I have been listening to your show for over a year and absolutely love it. I receive more knowledge from you to help my clients than most other sources. My question is about a current private client I am working with. She is about 65, has had 2 heart attacks in the last 8 years (the last one about 2 years ago) and she is on about 12 different medicines (metformin, wellbutrin, Spironolactone, Zetia, *Metoprolol ER, *Crestor, *Aspirin, Cymbalta, Levothyroxine, Plavix, Avapro) progesterona along with 2 topical hormones estrogen and testosterone. My question is, what would be your order of operations for this client. She is open and ready to change her diet and lifestyle and ideally, one day she would love to not be taking any medications or the least amount possible. I've got her on your daily support shake and doing berry smoothies daily. We are working on increasing her stomach acid and next I would like to help her get rid of heavy metals (is there something you recommend for this that won't interfere with her medications?) She is on so many medications and I can see that they are crossing to cause many of her symptoms, I also want to be sure to take things really slow and respect her doctor decisions (although she has tried to come off medications many times and they almost always resist her requests). Any advice would be great, thanks for all that you do   Judy: Hi Dr. Cabral! I just finished your podcast (713) on body types and Inhave a follow up question. I am currently on week 2 of your detox and I have suffered for over a decade with adrenal fatigue and hypothyroidism. Therefore, I have metabolism issues that I didn’t always have at a young age. When determining my body type, should I consider my current state or when I aas a kid with no health issues? Judy: Hi Dr. Cabral, In your podcasts, you mentioned the importance of a cheat meal once a week for grehlin and leptin levels. I have a hard time resisting cravings once I cheat. I am on week 2 of your detox and no linger crave all the bad foods. I worry I will go downhill again once I allow myself the bad foods. What do you recommend I do to prevent a relapse? Are the better cheat foods to stick with that still address grehlin and leptin and avoid a relapse? What about portion sizes for cheat meals?   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community’s questions! - - - Show Notes & Resources: http://StephenCabral.com/771 - - - Get Your Question Answered: http://StephenCabral.com/askcabral  

You'll see more top-selling drugs go generic in 2016. But don't expect drastic price drops initially...the first generic usually has 180-day exclusivity before other generics come out. Prepare patients for these switches. Explain these are best-guess release dates...they can change due to legal maneuverings, etc. OxyContin (oxycodone ER)...available now. But advise patients generics are only out for the 10, 20, 40, and 80 mg tabs so far. Gleevec (imatinib)...February. This could be a game changer for certain leukemias...since the brand costs about $10,000/month. Crestor (rosuvastatin)...May. This is big...it's the only high-intensity statin besides atorvastatin. Consider rosuvastatin if interactions or muscle problems are an issue with atorvastatin. Nuvigil (armodafinil)...June. Explain armodafinil may last longer than modafinil...but there's no proof it's better or safer. Suggest either option for shift workers if nondrug treatments (sleep hygiene, etc) and caffeine aren't enough. Benicar (olmesartan)...October. It will join a handful of other generic ARBs. Pick one based on payer preference. ProAir HFA (albuterol)...December. Explain this generic will NOT be equivalent to Ventolin HFA, Proventil HFA, or ProAir RespiClick. Encourage prescribers to write "albuterol HFA" to give you flexibility. Zetia (ezetimibe)...December or early 2017. Suggest saving ezetimibe as an add-on for high-risk patients who can't tolerate a high-intensity statin. For patients on Vytorin, consider suggesting generic ezetimibe plus a generic statin instead...at least until Vytorin goes generic. Also look for Basaglar in late 2016. It's a new BRAND of insulin glargine that will be similar to Lantus...NOT a generic or biosimilar.

Today in FirstWord:

Over and over again we still have tendency of believing that we are going to be able to muck up what Mother Nature has given us, this body, and we are going to continue to put in bad molecules, molecules that were never existed in nature before, and somehow we are going to get away with it. Tune in to Eve Plews, L.N.C, and the truth about many conventional drugs.

The ENHANCE (Effect of Combination Ezetimibe and High-Dose Simvastatin vs. Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia) trial results were released on Jan. 14, 2008.  Dr. Tedd Mitchell, president of Cooper Clinic, discusses results of the ENHANCE trial (which compared Vytorin to Zetia), and gives Cooper Clinic's recommendation of what to do if someone currently takes either of these medications.