This is the second show featuring Mira Achilles, a UCSC graduate working on her masters in epidemiology. Dr. Dawn and Mira open with a Harvard study showing OpenAI's o1 reasoning model reached correct diagnoses 67% of the time versus 50-55% for physicians, and scored 89% versus 34% on treatment plans. The AI advantage shrinks when doctors get more data and time, suggesting its greatest value is in fast-moving triage. Dr. Dawn cautions that over-reliance on AI during residency could undermine the clinical reasoning neurologic pathways doctors must develop, and emphasizes the "zebra paradox"— rare diseases remain rare even when symptoms match the textbook.

Dr. Dawn shares a personal case of a patient with throat shingles, leading her to use a medical AI (OpenEvidence) to investigate Shingrix risks. An Australian study found an elevenfold increase in shingles within 21 days of the first Shingrix dose in adults over 65, though dose two reduced overall risk by 73%. She explains this could be one of several things such as immune reconstitution inflammatory syndrome (IRIS), or that the AS01B vaccine adjuvant's strong activation may transiently reactivate latent virus, and recommends valacyclovir prophylaxis for high-risk patients for their first Shringrex shot..

Mira discusses AI in education, noting the shift from professors threatening plagiarism charges to teaching students how to critique AI output, emphasizing taking summaries "with a grain of salt."

Dr. Dawn describes Chinese research scanning 1,154 children that identified a third ADHD subtype—severe emotional dysregulation—showing 45 abnormal brain regions versus 26 in the inattentive and hyperactive-impulsive types, with standard stimulants working poorly for this group. She connects this to traditional psychiatric personality disorder classifications and

A discussion of vagus nerve stimulation's emerging applications for autoimmune conditions.

Dr. Dawn and Mira discuss menstruation and bodily autonomy, then describe the Somedays period pain simulator that uses electrical impulses to let men experience menstrual cramps, highlighting differing pain thresholds.

An emailer references a Radiolab episode about deliberate hookworm infection to treat asthma and allergies. Dr. Dawn explains parasites release immunosuppressants to survive, including anti-inflammatory protein-2 (AIP) now in drug development, which stimulates T-regulatory cells and IL-10 while "alarmins" inhibit lung inflammation—though this increases vulnerability to new infections.

A caller with H. pylori and frequent viral infections asks whether S. boulardii and reuteri probiotics are safe given her low immunity. Dr. Dawn explains immunosuppression warnings target transplant-level drug suppression, not a tendency toward viruses like hers. Dr. Dawn thinks that her near-zero natural killer cells explain frequent infections, and suggests that the H. pylori test given her absence of symptoms, may be an incidental bystander rather than the cause of her low ferritin, which suggests bleeding.

In medical news of the weird, Dr. Dawn describes Baby Cassian, diagnosed in utero with congenital high airway obstruction syndrome (CHAOS), who was partially removed from the womb at 25 weeks for airway surgery, returned, and born again at 31 weeks—leading to a discussion of microsurgery and how specialties partition by the physical scale of the surgery rather the location or type of structure.

An emailer from Switzerland follows up on the case of neurological symptoms, warning about the fox tapeworm Echinococcus multilocularis from unwashed garden vegetables and tick-borne encephalitis requiring the FSME vaccine available in Europe. Dr. Dawn adds that cysticercosis from undercooked pork leaves calcified brain lesions detectable on CT scans.

Dr. Dawn covers the Andes hantavirus outbreak that sickened at least eleven people on a cruise ship, with the virus spreading person-to-person unlike other hantaviruses. She explains that Andes virus grows to unusually high levels in blood and resists antimicrobial compounds in human saliva, with super-spreaders driving transmission chains. British paratroopers had to parachute medical supplies to an infected passenger on remote Tristan da Cunha island.

Dr. Dawn reviews brain health supplements with UCLA longevity expert Gary Small. Both recommend curcumin (500-1,000mg) for anti-inflammatory effects and CoQ10 for statin users. She endorses multivitamins and high-quality fish oil but considers creatine, phosphatidylserine, and nicotinamide riboside insufficiently proven for cognitive enhancement.

A caller asks about supplements and testosterone for a 77-year-old. Dr. Dawn recommends topical testosterone (patches, creams, gels) over injections to avoid testicular shrinkage and elevated sex hormone-binding globulin. She emphasizes protein intake matching one's age in grams, branched-chain amino acids during exercise, and warns against fasted training after age 65.

An emailer shares news that PCOS is being renamed to polyendocrine metabolic ovarian syndrome (PMOS) because many patients lack ovarian cysts, and genetic males can also have the condition. Dr. Dawn explains it's fundamentally an endocrine and metabolic disorder involving insulin resistance, elevated testosterone, and DHEA dysregulation.

A study found that infrasound—low-frequency sound below human hearing range—elevated cortisol and worsened mood in subjects who didn't know and couldn't detect it was playing. Old buildings generate infrasound through aging boilers, ventilation ducts, and metal pipes, potentially explaining why, beyond autosuggestion, that old "haunted" houses feel spooky.

Dr. Dawn debunks the 1971 "220 minus age" maximum heart rate formula, noting a 2025 study found individual predictions were off by up to 20 beats per minute. She recommends the Tanaka equation (208 minus age) times 0.7, but emphasizes tracking improvement trends rather than absolute numbers.

ConsumerLab testing found Safe Catch Wild Elite Pure Tuna and Wild Ahi Yellowfin Tuna had no detectable mercury, prompting Dr. Dawn to reconsider eating tuna after years of avoidance due to concerns about mercury bioaccumulation and its effects on nerve microtubules.

A meta-analysis of 115 studies involving 55,000 men found limiting ejaculation before IVF leads to increased sperm DNA damage and poorer motility. Clinical trials showed 46% IVF pregnancy rates with less than 48 hours abstinence versus 36% with longer periods.

A personalized mRNA vaccine for pancreatic cancer showed striking results: of 16 patients whose tumors were surgically removed, half produced killer T-cells targeting cancer, and seven of those eight remain alive six years later.

Pfizer and Valneva's Lyme disease vaccine reduced infection by over 70% in a trial of 9,400 people ages five and up. Nearly half a million Americans contract Lyme annually, and chronic infection can cause nervous system damage and chronic fatigue.

Dr. Dawn explores the gray-market peptide ecosystem, where compounds are sold as "research chemicals" with wink-and-nod marketing. A 2018 Belgian study found purity levels ranging from 5% to 99.9%, with some samples containing arsenic, lead, or industrial contaminants.

A study of 450 people found that blocking smartphone internet access for two weeks improved sustained attention equivalent to reversing 10 years of age-related cognitive decline, with depression symptom improvements comparable to cognitive behavioral therapy.

A multi-country study of 241 unresponsive patients found that 25% showed brain activity indicating consciousness when asked to imagine playing tennis during advanced brain scans. Scientists call this cognitive motor dissociation, and by some estimates tens of thousands of Americans may be misdiagnosed.

Chinese researchers grew functional adrenal cortex organoids that responded to pituitary hormones and produced cortisol when transplanted into mice. They also introduced genetic mutations to create organoid models of Cushing's syndrome for drug testing.

A Science paper identified the neural pathway connecting psychological stress to eczema flare-ups: sympathetic neurons from the stellate ganglion recruit eosinophils to the skin. Researchers traced the pathway using pseudo-rabies virus injected into skin.

Mouse studies showed prenatal stress causes elevated corticosterone in amniotic fluid, which activates fetal mast cells derived from the yolk sac. Offspring develop eczema-like lesions in areas receiving mechanical stimulation, but symptoms resolve around 24 weeks when bone marrow-derived mast cells replace the activated ones.

Callers ask about CBN side effects. Dr. Dawn explains cannabinoids prolong anandamide's calming effects by slowing its breakdown, and considers 30-45mg over a night reasonable, but cautions against escalating doses given limited research.

Dr. Dawn opens with a bike safety public service message, noting a 34% increase in bicycle use in Santa Cruz alongside rising e-bike accidents. She urges drivers to stay vigilant and calls for education and enforcement of helmet laws, particularly for riders under 18.

A University of Michigan researcher discovered that standard nitrile, latex, and vinyl gloves shed stearate particles indistinguishable from polyethylene under spectroscopy, contaminating microplastics research with approximately 2,000 false positives per square millimeter. Only clean-room gloves avoided this problem, throwing years of microplastics studies into question.

Dr. Dawn explains skin's three-layer structure and the stratum corneum's ceramide-based moisture barrier. She warns against stripping natural oils with astringents and hot showers, notes that UV disrupts proteins holding skin cells together, and cites a 2019 study showing moisturing treatment reduced circulating inflammatory cytokines in older adults.

Making music coordinates sound, vision, motor control, and imagination across the brain. Studies show musicians have more gray matter, better executive function, sharper memory, and even reduced pain sensitivity. A 2010 paper found musicians who began before age seven have a larger corpus callosum, and a 2024 study showed pianists had better working memory while woodwind players did best at executive function.

Stanford researcher Pascal Geldsetzer analyzed populations in Australia, New Zealand, Wales, and Ontario, finding the Shingrix vaccine reduces dementia risk by up to 20%. Dr. Dawn hypothesizes that even "dormant" varicella triggers low-level inflammation affecting brain microglia, and recommends spacing Shingrix three months apart from the second dose rather than one month to avoid side effects.

A Nature study of 175 people watching movies found that observing someone being touched activates the same brain regions as being touched yourself—your brain experiences sensations in corresponding body parts. This vision-touch link could enable less invasive sensory testing for autistic individuals.

Princeton and Flatiron Institute researchers identified four distinct autism phenotypes: broadly affected (10%), mixed with developmental delay (19%), moderate challenges (33%), and social/behavioral (37%). A second Nature study confirmed genetically distinct forms unfold on different timelines, with post-age-six diagnoses showing different genetic profiles than early childhood cases.

Dr. Dawn highlights ARPA-H-funded breakthroughs: Duke researchers created injections enabling cartilage cells to divide and remodel bone, UC Boulder developed intermittent-burst delivery of a repurposed drug that reversed rabbit arthritis in 4-8 weeks, and Columbia printed a living 3D knee using stem cells on biodegradable scaffolding. She notes the agency's budget was cut by $945 million despite requiring human trials within 18 months of funding.

A cord blood study across 200 countries links phthalates—found in food packaging, vinyl flooring, shampoos, and toys—to placental disruption and premature birth. Dr. Dawn warns that removing specific chemicals just leads to untested replacements, and urges avoiding microwaving in plastic.

An emailer asks about microbiome and exercise motivation. Dr. Dawn describes research showing Veillonella atypica bacteria eat lactate produced during exercise and trigger dopamine production via the vagus nerve, creating a reward loop. Bred "super-runner" mice ran three times longer than average, but antibiotics reduced their running by 21%, implicating microbiome involvement.

Dr. Dawn expands on cortisol dynamics: levels should rise gradually from 3 a.m., spike threefold at waking to synchronize hormones, then decline throughout the day. Chronic stress keeps cortisol elevated, while burnout from sustained overproduction eventually exhausts the adrenals and disrupts circadian rhythm, requiring 6-12 months to restore.

An emailer asks about food-based detoxification for skin and inflammation. Dr. Dawn explains that plant bioflavonoids—originally insecticides—trigger enzyme production that also breaks down synthetic pollutants, with sulfur-containing vegetables (crucifers, onions, garlic) particularly important. Colorful fruits and vegetables scavenge free radicals that damage DNA and collagen.

Dr. Dawn explores red and near-infrared light therapy (600-1100nm), which boosts ATP production by energizing cytochrome c oxidase in mitochondria. The FDA approved a device for dry macular degeneration, and red light is recommended for chemotherapy-induced oral mucositis. She notes modern buildings filter these wavelengths, potentially starving us of light our bodies evolved to need.

Dr. Dawn shares research on unsupervised childhood play, citing psychologist Peter Gray's finding that independent play develops internal locus of control—the belief you can influence outcomes. such as youth anxiety and depression, as children no longer learn to self-soothe through tolerating boredom.

Dr. Dawn opens with a follow-up from an email from Maryland about a friend in Switzerland, who has ongoing neurological and gastrointestinal symptoms. She reviews the earlier effort to connect him with functional-medicine resources in Switzerland, then focuses on a new observation that the patient may have had multiple parasitic infections during travel in Europe. Dawn agrees that this may have left a major gap in the workup and says that, in puzzling neurologic cases, a sleep-deprived EEG can sometimes reveal a “fingerprint” of brain-based dysfunction even if the patient is not actively having symptoms during the test.

Dr. Dawn says that for people over 60 who have never had a heart attack or stroke, daily baby aspirin is no longer considered a good routine preventive measure because the bleeding risks, especially gastrointestinal bleeding, can outweigh the cardiovascular benefit. She makes the distinction that aspirin may still make sense for secondary prevention in people who already have established cardiovascular disease.

She next reviews several medications that she thinks many older adults should reconsider. She explains that phenylephrine, which replaced easier access to pseudoephedrine in many cold remedies, has been found to work no better than placebo . She also says Colace is not very effective, and she strongly advises older adults to avoid Benadryl because it accumulates with age, increases fall risk, and may be associated with cognitive decline. She adds that beta blockers are no longer preferred first-line treatment for uncomplicated hypertension in many older patients, and that medications targeting the angiotensin pathway are generally favored instead.

Dr. Dawn introduces Mira Achilles in the studio, describing her as her excellent administrative assistant. Mira explains that she gathered health questions from peers from her college world. Mira asks what best supports focus for someone with ADHD working at a desk job. Dr. Dawn says the two evidence-based pillars are cognitive behavioral therapy and exercise. She walks through practical strategies including using calendars, reminders, index cards, and to-do lists; sorting tasks by urgency and importance; breaking large projects into smaller steps; creating small reward loops by checking off progress; and deliberately reducing distractions in the work environment.. She emphasizes that movement and exercise improve attention and executive function, and that ADHD management often improves when sleep timing is stabilized.

Another of Mira’s peers asks whether women should avoid very cold showers or ice baths during the luteal phase or around menstruation. Dr. Dawn says the answer is not absolute, but she cautions that cold exposure can hit women differently depending on hormonal state. She notes that the luteal phase may make vasoconstriction and cold sensitivity more pronounced, and she raises concerns about the physiologic stress of cold immersion, including possible adverse effects on circulation and rewarming. Her overall tone is cautious rather than enthusiastic, especially for people who are already prone to feeling chilled or reactive.

Another contributor asks why some people faint when seeing needles, blood, or medical procedures. Dr. Dawn explains the vasovagal response: a reflex in which blood pressure and heart rate suddenly drop, reducing blood flow to the brain. She offers simple countermeasures such as crossing the legs, tightening muscles, squatting, or using hand-grip tension to help push blood back toward the brain and prevent passing out.

Dr. Dawn closes by asking whether cortisol is a “good” or a “bad” hormone. Dr. She answers that cortisol is essential: it helps regulate daily rhythms, energy balance, and the broader hormonal system, so it is not something to think of as inherently harmful. At the same time, she says problems arise when cortisol is chronically dysregulated or excessive, so the goal is to maintain a healthy rhythm and avoid overwhelming the adrenal system.

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Dr. Dawn shares a follow-up from an emailer in Switzerland providing seven functional medicine practitioner addresses near Zurich and Aargau, noting that Switzerland uses different terminology but is actually an "epicenter of functional medicine."

Dr. Dawn calls for support of the bipartisan Break Up Big Medicine Act, modeled on Glass-Steagall, which would prohibit common ownership of medical providers with insurers, pharmacy benefit managers, or drug wholesalers. She explains how vertical integration by companies like UnitedHealth, CVS/Aetna, and Cigna allows them to game medical loss ratio requirements through self-dealing while driving up costs.

A European clinical trial implanted 2mm x 2mm light sensors beneath the retinas of 38 people with advanced macular degeneration, with 80% gaining clinically meaningful improvement (two lines on the vision chart) after one year. The device bypasses damaged rods and cones, sending camera images from glasses directly to the optic nerve.

Dr. Dawn explains that air temperature warnings are measured in shade, but direct sunlight can add 20°C to heat exposure. Heat stroke triggers gut permeability, releasing lipopolysaccharides that cause cytokine storms and organ failure. She advises fans over air conditioning when possible, shade, hydration, and loose natural-fabric clothing.

An emailer asks if low-dose oral strontium supplementation has the same problem as pharmaceutical strontium. Dr. Dawn confirms it improves bone density scores without reducing fracture risk, and recommends telopeptide testing to monitor actual bone loss after discontinuing.

An emailer's doctor wants to prescribe high-dose dexamethasone for low platelets. Dr. Dawn advises against rushing to steroids since platelets of 40 are adequate for clotting, recommending a hematology consultation and repeat testing with citrated blood.

Dr. Dawn reviews fiber types: wheat dextrin (Benefiber) is fermentable but technically gluten-free; guar fiber (Sunfiber) ferments slowly and works for low-FODMAP diets; inulin feeds bifidobacteria and produces anti-inflammatory short-chain fatty acids; methylcellulose (Citrucel) is non-fermentable; and psyllium (Metamucil) is facing a class action lawsuit over undisclosed lead contamination.

An emailer with varicose veins reports recurring superficial blood clots. Dr. Dawn explains these don't travel to lungs like deep vein clots, but repeated clotting suggests possible thrombophilia requiring workup. She recommends consulting a vascular surgeon about superficial venous ligation under local anesthesia.

Analysis of 25,000 wearable users found that three daily "exercise snacks" of just 1-2 minutes of vigorous activity (stairs, running for a bus) reduced all-cause mortality by 38-40%. Benefits plateau around 7,500 steps daily, and simply standing up every couple of hours dramatically reduces sedentary risks.

Dr. Dawn briefly responds to an emailer in Aptos, advising that her numbers don't require rushing into therapy but recommending a more thorough workup.

An emailer asks about her sister's osteoporosis treatment, including Reclast side effects and vitamin D levels of 28. Dr. Dawn recommends raising vitamin D to around 50, adding vitamin K2 (MK7-9) and calcium, and suggests weekly oral Fosamax as an alternative to annual Reclast infusions that cause week-long flu-like symptoms.

A caller reports dizziness when sitting up in bed and recent fainting episodes during hot weather. Dr. Dawn distinguishes vestibular problems from postural hypotension — spinning dizziness when legs are still in bed suggests loose otoliths in the semicircular canals rather than blood pressure issues. She recommends the Dr. Foster vestibular exercises and increased fluid and salt intake.

Cancer survival has reached a major milestone: 70% of U.S. patients now survive at least five years, up from 50% in the 1970s, thanks to reduced smoking and advances like immunotherapy and checkpoint inhibitors.

An Estonian Biobank study of 67,000 adults found men's libido peaks in their early 40s while women's peaks in their 20s-30s with sharper decline around age 50, though testosterone levels begin falling in men's early 30s.

Dr. Dawn frames perimenopause and menopause as natural transitions rather than diseases, explaining that perimenopausal hormone swings can actually be larger and more erratic than during fertile years. She recommends limiting caffeine (which is metabolized more slowly after menopause), alcohol, and spicy foods, and strongly advocates transdermal bioidentical hormones over oral synthetics—oral estrogen increases clotting risk 400% while transdermal carries no increased risk.

An emailer asks about transcranial magnetic stimulation for depression. Dr. Dawn explains that while the technology works and shows benefit in studies, targeting remains challenging because each person's brain architecture differs based on individual developmental experiences.

Researchers found that applying gamma-frequency electrical stimulation (40-90 Hz) to frontal and parietal lobes made participants more likely to choose generous money-splitting options with strangers, suggesting brain stimulation can nudge social decision-making toward altruism.

A small Indian study found that daily conch shell blowing reduced sleep apnea symptoms by 34% after six months, similar to earlier didgeridoo research—blowing against resistance strengthens airway muscles and increases resting muscle tone during sleep.

Dr. Dawn announces a UCSF study recruiting participants for psilocybin therapy to help patients cope with chronic low back pain, requiring ages 25-70 with failed prior treatments.

A caller preparing for bladder stone surgery asks about avoiding a repeat of severe post-anesthesia disorientation. Dr. Dawn recommends pharmacogenomic testing through 3x4 Genetics to identify slow acetylator status and other detoxification enzyme variants that can guide anesthesiologists toward better drug choices.

A clinical trial found that 24 minutes of music with binaural beats—where slightly offset audio in each ear generates synchronized brainwaves—significantly reduced anxiety in medicated patients. Dr. Dawn encourages trying this accessible, low-risk intervention.

Chronic noise exposure triggers oxidative stress, inflammation, and endothelial dysfunction, increasing cardiovascular disease risk. Data centers and server farms are emerging noise pollution sources, and Dr. Dawn recommends affordable noise-canceling headphones as a health investment.

A Crohn's patient in Switzerland reports alarming neurological symptoms including speech arrest with preserved awareness and transient visual disturbances. He is having trouble finding any Functional Medicine trained physician and Dr. Dawn recommends emailing to [email protected]. Furthermore, Dr. Dawn suspects possible seizure activity from brain inflammation and recommends pursuing a sleep-deprived EEG and MRI through a neurology referral.

MIT researchers discovered Interlectin-2, a protein that both strengthens the mucus barrier by cross-linking mucins and directly traps and kills pathogens like Salmonella and Shigella. Imbalanced levels may contribute to inflammatory bowel disease. Synthetic versions may be an effective treatment for inflammatory bowel disease.

A 33-year-old man survived 48 hours without lungs after flu-triggered bacterial pneumonia caused ARDS and multiple organ failure. Surgeons removed both lungs treat septic shock while ECMO (extracorporeal oxygenation)sustained him until a successful double lung transplant.

A meta-analysis of 43 studies involving millions of births found no evidence that acetaminophen use during pregnancy increases autism, ADHD, or intellectual disability risk, contradicting recent political claims.

Green tea contains about 30% more L-theanine than black tea, with studies showing 200mg daily improves verbal fluency, sleep quality, and reduces anxiety. Decaffeinated green tea retains full theanine content.

Pop star Robbie Williams developed scurvy while on GLP-1 weight loss drugs, highlighting that only 2 of 40+ major GLP-1 trials assessed vitamin intake. Dr. Dawn urges anyone on these medications to take a comprehensive multivitamin.

Dr. Dawn warns that stacking multiple gummy supplements can cause GI distress from sugar alcohols like xylitol, sorbitol, and mannitol, with symptoms persisting up to three days after stopping. She recommends limiting sugar alcohol intake to 6mg daily and switching to non-gummy formulations if experiencing bloating, cramping, or diarrhea.

An emailer asks about finding treatment for abdominophrenic dyssynergia, a condition causing progressive abdominal distension after meals. Dr. Dawn recommends using AI search to locate physical therapy centers offering EMG-guided biofeedback, and suggests ruling out SIBO and low stomach acid.

Researchers at the American Chemical Society have created modified psilocybin variants designed to release the active compound more slowly, potentially reducing hallucinogenic effects while maintaining therapeutic benefits. Dr. Dawn expresses concern that such patentable alternatives could prevent legalization of natural psilocybin for addiction treatment.

Japanese researchers used PET imaging to discover that ketamine rapidly relieves treatment-resistant depression by altering the distribution of AMPAR glutamate receptors in the brain. Within two weeks, patients' receptor patterns normalized to resemble healthy controls, with enduring changes tracking symptom improvement.

A study found CBD and CBG improved fatty liver disease markers in mice by increasing phosphocreatine energy reserves and reactivating cellular recycling centers. Dr. Dawn notes the compounds were injected directly into the abdominal cavity, making the results impossible to translate to oral consumption, an example of headlines exceeding reality.

King's College London research found that root canal treatment for apical periodontitis improved blood sugar, cholesterol, and inflammation markers over two years. Dr. Dawn advises regular flossing and periodically tapping teeth with a metal instrument to detect painful teeth needing attention.

An emailer asks about Crohn's disease and the gut-brain axis. Dr. Dawn explains that the vagus nerve serves as a bidirectional highway between brain and gut, with gut bacteria producing serotonin that affects mood, while stress increases intestinal permeability and worsens inflammation.

In medical news of the weird, scientists discovered that malaria parasites contain tiny iron crystals powered by hydrogen peroxide—the same fuel used in rockets. This first-ever biological self-propelled nanoparticle could inspire new approaches to powering medical nanobots.