Continuity of care saves lives. There is evidence that outcomes are improved and it

used to be a core part of medicine. In recent years for many reasons continuity has been 

slightly eroded. In this episode I make the case for it and give examples of why it can be

of critical importance.

Links:

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Study on continuity and outcomes: https://bjgp.org/content/72/715/e84

How seeing the same doctor has changed in the UK: https://www.bmj.com/content/389/bmj.r833

Patient examples of the benefits: https://www.nuffieldtrust.org.uk/news-item/the-importance-of-continuity-four-personal-viewpoints

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PCOS is a growing global issue. Its prevalence has increased in recent years and the reasons behind it are complex.

In this episode I look at its roots, causes and impact plus what we can do about it in terms of lifestyle and treatments.

Links: 

Depression and PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC10607337/

LH (luteinziing hormone): https://my.clevelandclinic.org/health/body/22255-luteinizing-hormone

LH:FSH ratio in PCOS: https://gpnotebook.com/en-GB/pages/gynaecology/polycystic-ovarian-syndrome-hormonal-measurements-in

Pancreatic function in PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC9962893/

The gut microbiome and PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC9998696/

The steroid synthesis pathway starting with cholesterol: https://www.researchgate.net/figure/Biosynthesis-of-steroid-hormones-from-the-cholesterol-pathway_fig1_258055538

Angelique Panagos book on hormonal balance: https://www.amazon.co.uk/Balance-Plan-Optimize-Hormonal-Health/dp/1844039447

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In this episode I look at metabolic health which is one of the most important aspects of our long term health. I look at the mechanisms and measures of metabolic health and what we can do to improve ours.

Continuous Glucose Monitoring: https://my.clevelandclinic.org/health/articles/continuous-glucose-monitoring-cgm

Hba1c: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/hba1c#

American metabolic health stats: https://www.liebertpub.com/doi/10.1089/met.2018.0105

High fructose corn syrup; https://www.healthline.com/nutrition/why-high-fructose-corn-syrup-is-bad

Fibre in your diet: https://www.healthline.com/nutrition/why-is-fiber-good-for-you

Exercise and metabolic health: https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1365761/full

Metabolic health and Alzheimer's risk: https://pmc.ncbi.nlm.nih.gov/articles/PMC10001958/

Non-communicable diseases: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

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In this episode I cover my own personal tips from the view point of a GP and lifestyle medicine doctor. Gut symptoms Around 86% of us in the UK have experienced gut symptoms at some point. My tips are simple, for everyone and hopefully make sense.

Parasympathetic drive for digestion: https://www.livescience.com/parasympathetic-nervous-system-rest-and-digest

Digestive enzymes: https://www.webmd.com/diet/what-are-digestive-enzymes

Blue Zones eating habits: https://www.bluezones.com/2020/07/blue-zones-diet-food-secrets-of-the-worlds-longest-lived-people/

Mediterranean Diet: https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet

Late night eating: https://hms.harvard.edu/news/late-night-eating-impact

Time restricted eating: https://www.healthline.com/nutrition/time-restricted-eating

Ileo-caecal valve issues: https://www.carygastro.com/blog/what-are-the-symptoms-of-a-faulty-ileocecal-valve

Hydration and the gut (an academic paper): https://www.sciencedirect.com/science/article/pii/S2589004224011258

Buy my book The Health Fix now: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0

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Chronic inflammation is a key process which is linked to almost all non-communicable disease. In this episode I look at how it arises and why it is so harmful.

Links: 

Age-related end glycation products: https://www.healthline.com/nutrition/advanced-glycation-end-products#what-they-are

'Leaky gut’ syndrome: https://pmc.ncbi.nlm.nih.gov/articles/PMC8305009/

Depression as an inflammatory condition: https://www.sciencedirect.com/science/article/pii/S1043661824002676

Probitoics after antibiotics?: https://www.bbc.com/future/article/20190124-is-it-worth-taking-probiotics-after-antibiotics

Diabetes and inflammation: https://www.webmd.com/diabetes/inflammation-and-diabetes

Inflammation from toxins (metals and brain inflammation): https://www.sciencedirect.com/science/article/abs/pii/S2468202021000127

Anti-inflammatory diet: https://www.hopkinsmedicine.org/health/wellness-and-prevention/anti-inflammatory-diet

Fibre: https://dremilyleeming.substack.com/p/is-fibre-the-missing-link-to-true

Omega-3 and inflammation: https://pubmed.ncbi.nlm.nih.gov/37606147/

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What do surgery and psychiatry have in common? They are both demanding specialties, occasionally of last resort, that save lives acutely and help people back to better health.

Links

Antipsychotic drug discovery: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.903156/full

Pyrrole Disorder: https://www.healthline.com/health/pyrrole-disorder#diagnosis

Rationing in the NHS: https://www.kingsfund.org.uk/insight-and-analysis/blogs/nhs-rationing-under-the-radar

An example of risks vs benefit in surgery: https://www.neurosurgeonsofnewjersey.com/blog/spinal-fusion-surgery-risks/

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There are so many posts, papers and publications about the vagus nerve.

In this episode I look at why it’s so popular and whether it really can be a key to future treatments with advances vagus nerve stimulation.

Links: 

Quick overview: https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about/pac-20384565

Polyvagal Theory: https://www.polyvagalinstitute.org/whatispolyvagaltheory

The Great Nerve: https://www.amazon.co.uk/Great-Nerve-Science-Harness-Reflexes/dp/059371699X

Research on the vagus and rheumatoid arthritis: https://pubmed.ncbi.nlm.nih.gov/27382171/

Ear stimulation: https://medicine.ouhsc.edu/news/article/ear-clip-stimulation-of-vagus-nerve-shows-promise-as-pots-treatment-according-to-ou-college-of-medicine-study

Vasovagal attacks: https://my.clevelandclinic.org/health/diseases/23325-vasovagal-syncope

Crohn’s Disease and vagus nerve stimulation: https://pubmed.ncbi.nlm.nih.gov/32515156/

Vagus nerver and inflammation: https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-022-00100-3

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Medicine is an inexact science. My patients who are engineers find it frustrating that there is so much conjecture and educated guess work in medicine. But this episode highlights why diagnoses can take time. It’s a mix of detective work, bias and listening to the patient story.

Links:

Chilblains: https://www.mayoclinic.org/diseases-conditions/chilblains/diagnosis-treatment/drc-20351103

STI and painful knee: https://www.medicalnewstoday.com/articles/gonococcal-arthritis

Carpal tunnel syndrome: https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/

Psychodermatology (the mind-skin link): https://www.psychodermatology.co.uk/

Liver inflammation and glandular fever: https://www.healthline.com/health/mono-hepatitis

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Not a week goes by in practice where I don’t see a patient who hasn’t collapsed or had a dizzy spell.

There are so many reasons for this, some preventable, some not. I look at some of the syndromes that lead to these issues.

Links:

Fainting: https://www.healthline.com/health/fainting#causes

Pseudoseizures (non-eplieptic seizures): https://my.clevelandclinic.org/health/diseases/24517-psychogenic-nonepileptic-seizure-pnes

Absence seizures: https://www.mayoclinic.org/diseases-conditions/petit-mal-seizure/symptoms-causes/syc-20359683

Epilepsy and driving: https://www.gov.uk/epilepsy-and-driving

BPPV (a type of vertigo): https://my.clevelandclinic.org/health/diseases/11858-benign-paroxysmal-positional-vertigo-bppv

Patient perspective of Mal de Debarquement syndrome: https://www.rarediseaseday.org/heroes/a-uk-patient-perspective-on-mal-de-debarquement-syndrome/

Heartblock: https://www.nhs.uk/conditions/heart-block/

Gluten ataxia: https://www.medicalnewstoday.com/articles/320730

Proprioception: https://my.clevelandclinic.org/health/articles/proprioception

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5-15% of GP consultations are linked to tiredness. And the number is growing. In this episode I look at common and rarer reasons for tiredness. 

Hydration - if you’re feeling thirsty you’re partly dehydrated: 

https://www.nhsinform.scot/illnesses-and-conditions/nutritional/dehydration/

Sleep apnoea: https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631

Breathing to help some root causes of fatigue: https://buteykoclinic.com/blogs/buteyko-breathing-technique/buteyko-breathing-technique

Mycotoxin illness: https://www.parsleyhealth.com/blog/mold-toxicity-symptoms/

Co-enzyme Q10: https://bjcardio.co.uk/2015/10/coenzyme-q10-and-cardiovascular-disease-an-overview/

Antibiotic tiredness: https://www.medicalnewstoday.com/articles/do-antibiotics-make-you-tired

Burnout: https://mentalhealth-uk.org/burnout/

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