The Savvy Patient

Side effects. Adverse reactions. That folded-up piece of paper in your medication box with the tiny type nobody can read. That laundry list of horrible things in every drug commercial. This week, co-hosts Erin Stein and Dr. Gillian Goddard break down what all of it really means.

We start with the definitions: all side effects are adverse reactions, but not all adverse reactions are side effects. We explain how clinical trials sort side effects from coincidences with terms like “common,” “rare,” and “incidence not known.” We break down the actual numbers behind these categories and walk through a real medication’s side effect lists.

There is no medication without side effects, but side effects shouldn’t be your only consideration. We cover how to weigh benefits against the risks of doing nothing, when to stop a medication and call your doctor, and practical pharmacy tips: similar-sounding drug names, brand vs. generic, expiration dates, and why your medicine doesn’t belong in a steamy bathroom or your checked luggage.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

It's pumpkin spice season, which means it's sugar season, so co-hosts Erin Stein and Dr. Gillian Goddard are talking about why we love sweet things so much and what's really going on in the body when we eat them. We start with why humans evolved to crave sugar, then break down what "sugar" means: glucose, fructose, lactose, and the "ose" family. Does it really matter which form you eat for your health? Why do some foods spike blood sugar and send you on a craving roller coaster, while others don't? The answers may surprise you. We also cover high fructose corn syrup and why food companies love it, whether raw sugar, honey, or agave are any better, what artificial sweeteners do in the body, and how alcohol fits in. Uncover the truths behind the endless hype about the sweet stuff.

References:

A couple of great books about the history of “sugar” as a commodity.

Sugar by Elizabeth Abbott.

The World of Sugar: How the Sweet Stuff Transformed Our Politics, Health and Environment over 2,000 Years by Ulbe Bosma.

The World Corrupted: From Slavery to Obesity by James Walvin.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

This week we tell you what the Women's Health Initiative actually studied, why the hormone therapy trial was stopped, and how the headlines shaped menopause care for decades.

The Women's Health Initiative was the study that made a generation of women toss their hormone therapy in the trash. Co-hosts Erin Stein and Dr. Gillian Goddard dig into one of the largest and most comprehensive studies of women's health ever done: more than 160,000 women, multiple clinical trials, an observational study, and millions of stored specimens that researchers are still mining today. We break down what was tested (hormone therapy, low-fat diets, and calcium plus vitamin D), and why it was never about treating menopause symptoms.

We explain why the hormone therapy trial stopped, share the real numbers behind the breast cancer headlines, and talk about what the real data. We also cover the lasting fallout, including a generation of women whose menopause symptoms went untreated, and what all of this says about how we fund and study women's health.

References:

Facts about the Women’s Health Initiative: https://www.nhlbi.nih.gov/science/womens-health-initiative-whi

The Baseline Monograph for the Women’s Health Initiative explains study design and procedures, and all the components: https://www.whi.org/doc/WHI-Baseline-Monograph-All-Sections.pdf

For one critique of the study’s design: https://www.sciencedirect.com/science/article/pii/S0015028205034229

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

Co-hosts Erin Stein and Dr. Gillian Goddard tackle one of the wilder phenomena in science: The Placebo Effect. It’s real, but why and how? What’s happening in our brains and bodies when we take a medication (or a fake one)? How does it relate to things like positive thinking or mindfulness? Join us for a discussion of one of the most basic yet fascinating building blocks of medical science.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

In this episode of The Savvy Patient, cohosts Erin Stein and Dr. Gillian Goddard welcome their very first guest: Board-Certified Behavior Analyst (BCBA) Stephanie Mueller. With nearly 20 years of experience in the field, Stephanie helps break down autism spectrum disorder (ASD), clearing up common misconceptions and explaining how diagnostic criteria have evolved over time to significantly expand access to vital insurance coverage and care. Stephanie outlines the core diagnostic markers and the push within the field to distinguish profound autism for individuals requiring lifelong care. We tackle persistent myths—reaffirming that vaccines do not cause autism—and offer guidance for parents on seeking care. Plus, we discuss how teens and adults may receive a later diagnosis as life changes affect coping skills. 

Resources and References:

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Your period is over. Congratulations! But cohosts Erin Stein and Dr. Gillian Goddard have news for you: hormonal health care isn’t over! Let us introduce health during your second act, and life after menopause. We cover what happens to your hormones, why vaginal estrogen may still matter, when to think about bone density, thyroid and blood sugar testing, and why you should keep up with cancer and cardiovascular screening. We also make the case for things that may be just as important as any lab test: using your brain, learning new things, making friends, and staying socially connected. Because menopause is not the end of the road, it’s just a new turn!

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

In this episode of The Savvy Patient, cohosts Dr. Gillian Goddard and Erin Stein debunk fad diets and explore what the science actually says about healthy eating. We discuss the problems with extreme diets, the limitations of diet studies, and why short-term weight loss doesn't necessarily lead to long-term health. For so many reasons, typical diets and fads are not sustainable. Most dieting strategies lack evidence. We highlight the DASH and Mediterranean diets as the two eating approaches with the strongest evidence, particularly for improving blood pressure, cholesterol, diabetes risk, and overall metabolic health. A healthy diet doesn't need to be extreme: eating mostly whole foods, getting enough fiber, limiting highly processed foods and excess sugar, staying hydrated, and making gradual, sustainable changes are more important than following a perfect diet. Bottom line: Forget the quick fixes. The best diet is one that supports your health and that you can realistically maintain long-term.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

Caring for both aging parents and growing children can feel like being stuck in a sandwich — squeezed from both sides. In this episode of The Savvy Patient, cohosts Dr. Gillian Goddard and Erin Stein discuss the reality of navigating midlife while stuck in the “sandwich” phase—simultaneously caring for aging parents and raising growing children or adolescents. We explore how this dual responsibility creates intense pressure from both sides, disproportionately placing an invisible load of caregiving, stress, and labor on women. The conversation dives into the emotional and physical toll of this phase, offering validation along with practical strategies to manage responsibilities, alleviate stress, and navigate the emotional strain.

References:

Gillian mentions the podcast This is So Awkward with Dr. Cara Natterson and Vanessa Kroll Bennet, https://lessawkward.com/podcast-this-is-so-awkward-2/

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

Losing hair? Don't panic—we’ve got you covered! In this episode of The Savvy Patient, cohosts Erin Stein and endocrinologist Dr. Gillian Goddard break down everything you need to know about the hair on your head—focusing on why hair falls out, how to distinguish normal shedding from true scalp hair loss, and what medical treatments actually work. Dr. Goddard explains the biology of the hair growth cycle (Anagen, Catagen, Telogen, and Exogen) and clarifies that shedding every day is completely normal. Temporary hair shedding caused by telogen effluvium is also normal—and you may be surprised by common stressors that trigger it such as pregnancy or anesthesia. We review more serious, non-reversible forms of alopecia before tackling the common androgenic (female and male pattern) hair loss, genetics, and evidence-based treatments, detailing the pros and cons of minoxidil, injections, and red-light therapy. Get the real facts, cut through the marketing noise, and keep your scalp healthy.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.

In this episode of The Savvy Patient, cohosts Erin Stein and Dr. Gillian Goddard lift the curtain on the side hustles, consulting gigs, and industry ties that many physicians take on behind the scenes. Dr. Goddard breaks down why so many doctors step outside the clinic—from writing books and hosting podcasts to working with pharmaceutical companies as "Key Opinion Leaders" or brand ambassadors. While clinical work isn't always as lucrative as people think, these side endeavors allow doctors to share their expertise on a larger scale. But as we point out, where there’s money involved, there’s always potential for bias. We dive into the subtle line between genuine medical advice and clever marketing and take a close look at the supplement aisle. We discuss why "proprietary blends" are a major red flag, and Gillian shares her own experience serving as a medical advisor. By the end of the episode, you’ll know how to spot financial conflicts of interest, and how to evaluate health recommendations with a healthy dose of smart skepticism.

We take a moment to remind you that while this is a medical discussion, it is not providing a diagnosis or treatment or any medical advice. The only way to get a diagnosis, treatment or medical advice for your particular condition is through a discussion with your doctor.

Please subscribe savvypatient.substack.com

Visit www.thesavvypatient.com/podcast for episode transcripts.

Watch full podcast episodes @TheSavvyPatient on Youtube.com.

Get your copy of The Hormone Loop by Dr. Gillian Goddard wherever books are sold.

This episode was produced and edited by Erin Stein. Music: “All We Live For (instrumental)” by Wolfclub licensed through Audiio.com. Intro and outro edited, and video created, by Ian Mayer. The Savvy Patient logo by Amanda Spielman.