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Summary:  The balance of the flora in the gut is essential to maintaining a healthy barrier between what’s in your GI tract and what’s in your bloodstream.  This episode addresses how broad-spectrum antibiotics can cause C. Diff, the dramatic effects of this and how it is treated.  Also discussed is how diet, alcohol and some drugs may affect the balance and diversity of the microbiome in your, thereby causing Leaky Gut (allowing contents of gut into the body), which in turn may cause or aggravate a variety of conditions, from autoimmune disorders to diabetes to Alzheimer’s.   

 Topics:

·       Gut-Brain Connection 01:30

·       Finding the Mother Tree 03:00

·       Antibiotics & C. Diff 04:40

·       C. Diff Treatment with Drugs 06:15

·       C. Diff Treatment with Fecal Transplant 07:50

·       Prebiotics 08:45

·       Antibiotic Stewardship 09:25

·       Leaky Gut 09:50

·       Leaky Gut Causes – Diet & Alcohol 15:10

·       Leaky Gut Causes – Laxatives, Proton Pump Inhibitors, NSAIDS, Statins? 17:90

·       Gut Serotonin Production 21:30

·       Journal & Participate 23:30

·       Conditions Caused by Leaky Gut 26:00

·       Heart Disease? 

·       Autoimmune Diseases 

·       Alzheimer’s

·       Dietician & Nutritionist Resources 30:00

·       Diet & Med-Gut Connections – Pay Attention & Participate 32:40

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 Summary:  Headlines are meant to grab your attention, whether it’s about politics or sports or medicine. And so it goes for Semaglutide (Ozempic and Wegovy) and Liraglutide (Victoza and Saxenda), whose attributes have been trumpeted for weight loss, and whose possible serious side effects have recently been noted in the press.  This episode attempts to take some of the sensationalism out of the headlines and advertisements by examining Relative Risk and what it means for your actual and Absolute Risk. 

Topics:

·       Incretins 03:20

·       Gliptins 04:30

·       Ozempic Headlines 05:10

·       Absolute & Relative Risk 05:45

·       Lighting Strike Risk 06:30

·       Risk-Benefit 09:00

·       Convert to Absolute Risk 10:30

·       Pancreatitis, Stomach Paralysis, Bowel Obstruction 11:00

·       Relative Risk to Absolute Risk 16:25

·       What We Don’t Know 19:30

·       Monitor & Participate 20:30

·       Post-Marketing Monitoring/Medwatch 21:00

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Summary:  Like it’s never happened before, the FDA approval of a new weight loss drug grabbed the headlines, but here’s another headline:  Same Stuff, Different Packaging – Zepbound.  This episode is a review of this very effective and very popular group of new drugs:  the Ozempic-like drugs, the Incretin Mimetics, which act like the gut hormones secreted in response to food.  The idea here is to provide a broader perspective on this group of drugs, so you might understand what is happening now, and perhaps you will not be surprised by what may happen in the future.  Whether it's coincidence or a subtle nod to Zepbound's intended use, it will be available shortly after Thanksgiving.

 Topics:

·       Diabetes – Weight Loss 03:00

·       Hormones 04:00

·       Incretins 04:30

·       New Drugs in Same Class 08:00

·       Zepbound Mechanisms of Action 10:50

·       Zepbound Side Effects 12:00

·       Zepbound Indications – BMI 13:30

·       Zepbound Effective? Yes 14:30

·       Semaglutide: Ozempic-Wegovy 16:30

        Liraglutide: Victoza – Saxenda 

        Terzepatide:  Mounjaro – Zepbound

·       With Exercise & Diet 18:30

·       Rybelsus (Semaglutide) - Oral 19:30

·       Document-Monitor-Participate 20:00

·       Post-Marketing Monitoring – MedWatch (FDA) 20:45

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Summary:  Do Echinacea, Vitamin C and Zinc have a place in the prevention and treatment of viral infections such as the common cold or the flu?  What should be a straightforward discussion about risks and benefits is complicated by the lack of regulation by the FDA, and therefore the uncertain content of some herbal supplements.   

Topics:

·       Cold, Flu and COVID-19 02:30

·       Virus-Living or Not? 03:20

·       Echinacea 06:45

·       Echinacea History 07:50

·       Echinacea Quality of Products 09:00

·       Germany 10:40

·       Talk With Your Doctor

·       Contraindication with Echinacea 12:50

·       Risk-Benefit 14:45

·       Side Effects 16:00

·       Caffeine-Echinacea Interaction 18:25

·       Vitamin C 19:00

·       Zinc 22:00

·       Zinc Nasal Spray – Potential Permanent Loss of Smell 26:00

·       Participate – Use Your Healthcare Team 28:00

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Summary:  For decades the FDA told us phenylephrine worked, that it was safe and effective, and now we hear that it is safe, but maybe not so effective?  This episode addresses the oral phenylephrine situation specifically, including possible options for when/if oral phenylephrine is pulled from the shelves.  We also take a look at the FDA process for establishing the status of drugs, and where concerned citizens are able to participate in this process.  

Topics:

·       Decongestant Pharmacology 01:45

·       Oral Phenylephrine 02:00

·       Phenylephrine vs. a Skittle 03:20

·       GRASE 03:40

·       Phenylephrine 10mg Dose 06:00

·       Sympathomimetic 07:30

·       FDA Advisory Committee 08:50

·       Citizen Petitions to FDA 10:10

·       Pharmacology 10:45

·       Options to Oral Phenylephrine 12:00

·       Development of New Options? 16:30

·       FDA Ruling Process 19:00

·       Placebo Effect 21:00

·       Participate-Monitor 23:00

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Summary:  I’ve forgotten how to sleep.  Try harder?  No.  Trying to sleep is like trying to forget something:  the more you try the more you lie awake, remembering what you are trying to forget.  The treasured good-night’s sleep evades so many of us, so here is a brief discussion of a relatively new group of drugs for insomnia, with a reminder to consider utilizing cognitive behavior therapy to help you on your sleepy way.

Topics:

·      Nonpharmacologic Stuff 01:55

·      Cognitive Behavior Therapy 02:00

·      Sleep Hygiene 02:15

·      Belsomra, Dayvigo, Quviviq 03:15

·      Stop the Waking Up 04:00

·      Orexin Receptor Antagonists 04:20

·      Quviviq 05:00

·      Hypnotics 05:55

·      Start Low 06:30

·      Sleep & Drug Journal 06:40

·      Transient, Short-term and Long Term Insomnia 06:55

·      Risk-Benefit 07:30

·      Warning: Worsening of Depression &/or Suicidal Ideation 08:45

·      Narcolepsy – No. 09:15

·      Monitor and Participate 11:05

·      FDA Approved – Post Marketing Data 12:00

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Summary:  The rising number of children and teens suffering with mental health issues, primarily anxiety and depression, is not a blip, but rather a real trend.  Anxiety or depression has grown by thirty percent in children aged 3 to 17, between 2016 and 2020.  The Covid-19 pandemic certainly had an effect, but prior to Covid-19 mental health disorders in children and teens was already on the rise.  According to Health and Human Services, between 2009 and 2019 high school students who reported persistent feeling of sadness or hopelessness increased by forty percent.  The “People” in this episode is a Pediatrician, who shares his experiences with mental health issues in children and teens, discussing where we were, where we are and why, and perhaps where we might go in the future.  This is Part 2 of a 2-part series.      

 Topics:

·      Risk-Benefit, Monitor, Participate 02:00

·      SSRI’s 02:30

·      Monitor Closely 05:00

·      Double Blind, Randomized, Placebo Controlled 05:15

·      Meds and Attitude 06:00

·      Anxiety, ADHD, Depression 09:50

·      Neurotransmitters 10:30

·      Work With the Doctor 16:00

·      Resources:  988 & Mobile Crisis (Google) 18:00

·      Emergency Room for Psych Evaluation 18:30

·      Communication 19:40

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 Summary:  The rising number of children and teens suffering with mental health issues, primarily anxiety and depression, is not a blip, but rather a real trend.  Per a Health and Human Services Study, anxiety or depression has grown by thirty percent in children aged 3 to 17, between 2016 and 2020.  The Covid-19 pandemic certainly had an effect, but prior to Covid-19 mental health disorders in children and teens was already on the rise.  According to Health and Human Services, between 2009 and 2019 high school students who reported persistent feeling of sadness or hopelessness increased by forty percent.  The “People” in this episode is a Pediatrician, who shares his experiences with mental health issues in children and teens, discussing where we were, where we are and why, and perhaps where we might go in the future.  This is Part 1 of a 2-part series.      

 Topics:

·      Mental Health Trends in Children 02:00

·      Emo 04:00

·      Anxiety and Depression 04:45

·      American Academy of Pediatrics & U.S. Surgeon General 05:00

·      U.S. Government Response 05:30

·      Cognitive Behavioral Therapy & Meds 07:20

·      Social Media 08:10

·      Family Unit Affected 13:10

·      Parents 14:45

·      Solutions? 15:40

·      Suggestions for Parents 17:00

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Summary:  A new option is coming for an often-underreported condition:  postpartum depression.  The FDA Fast Tracked the review of Zurzuvae, thereby acknowledging that this new drug may fill an unmet medical need.  We discuss how this drug works, how quickly it can have an effect, and (as usual) the importance of actively participating in the risk-benefit discussion and subsequent monitoring with your healthcare professional.

 Topics:

·      Fast-Tracked 01:05

·      Incidence of Postpartum Depression 06:00

·      Postpartum Depression 07:10

·      Previous Drug Options 08:00

·      Zulresso IV 08:30

·      Cost/Insurance? 09:00

·      Causes of Depression 09:30

·      Zurzuvae Mechanism of Action 10:30

·      Neuroactive Steroid 11:00

·      Zurzuvae Dosing 12:00

·      How Soon to See Effect 12:30

·      Zurzuvae for Major Depression? 13:45

·      Side Effects 14:30

·      988 15:15

·      Breastfeeding 15:30

·      Risk-Benefit 15:45

·      Phases of Clinical Research 17:00

·      Phase 4 of Clinical Research – Post Marketing 18:00

·      Drug Journaling 18:45

·      Drug-Drug Interactions 19:45

·      Monitor and Participate 24:45

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Summary:  Another option for treating anxiety might be laying in the bottom of your toolbox, resting beneath the handful of drug options – Xanax, Buspirone, Escitalopram, Sertraline, Propranolol…  It’s Meditation.  This episode looks at a comparison of the effectiveness of Escitalopram (an SSRI) versus Mindfulness Meditation for the treatment of anxiety, and though the results are impressive, this does not serve as a recommendation, but rather an indication that another possible option might be there for you.  As always, work with your healthcare team to determine the best course of treatment for you.  Participate in your healthcare - Monitor - Participate...    

Topics:

·      Another Tool for Anxiety 01:40

·      Drugs for Anxiety (benzo’s, buspirone, beta-blockers, Escitalopram) 02:05

·      How does Lexapro work? 03:30

·      Anxiety and Depression 04:30

·      Escitalopram 05:00

·      Risk-Benefit 06:00

·      Shared Decision Making 06:15

·      Buspirone 07:35

·      Chemistry of Anxiety 07:50

·      Participate-Monitor-Participate 08:45

·      Just Trying Stuff 09:20

·      Escitalopram Vs. Mindfulness-based Stress Reduction (Medication) 10:45

·      The Right Tool for You 11:50

·      Thirty Percent Reduction in Anxiety Symptoms 13:00

·      Escitalopram Side Effects 13:50

·      Meditation Side Effects 14:10

·      Is Meditation a Harder Pill to Swallow? 18:00

·      Resource: Mayo Clinic 22:00

·      Why Not Med & Meditation? 22:15

·      Choose the Right Tool for You 23:00

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