The People's Pharmacy Radio Program Everything from home remedies to the latest breakthrough drugs are discussed on The People's Pharmacy. Pharmacologist Joe Graedon and medical anthropologist Terry Graedon talk to leading experts to discuss issues relating to drugs, herbs, home remedies, vitamins and related health topics.
The People's Pharmacy Radio Program

The People's Pharmacy Radio Program

From North Carolina Public Radio

Everything from home remedies to the latest breakthrough drugs are discussed on The People's Pharmacy. Pharmacologist Joe Graedon and medical anthropologist Terry Graedon talk to leading experts to discuss issues relating to drugs, herbs, home remedies, vitamins and related health topics.

Most Recent Episodes

Show 1241: Coronavirus Update for the Close of 2020

The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has dominated life around the world this year. Now, the FDA has granted Emergency Use Authorization for two vaccines, one from Pfizer/BioNTech and one from Moderna. How will they alter the course of the pandemic? We offer listeners a coronavirus update for the close of this pandemic year of 2020. A Coronavirus Update from the Coronavirus Hunter: Dr. Ralph Baric has been studying coronaviruses for three decades, and he has a wealth of information about SARS-2.We check in with him for the third (and last) time this year. New Vaccines Against COVID-19: We get a quick summary on how these new messenger RNA vaccines work. In animals, they stimulate a very robust immune reaction with neutralizing antibodies. They seem to do that in humans as well. In addition, they have excellent efficacy, much better than the original goal of 50 percent or higher. The AstraZeneca vaccine uses a different approach, but it also seems to provoke a strong immune response. There are a number of things we don't know yet about the new COVID-19 vaccines. For example, we know that they keep people from becoming seriously ill, but we don't know if they prevent low-level or asymptomatic infections in nasal tissue. Moreover, we do not yet have evidence on whether they can prevent transmission of the coronavirus. We will need more research to determine that in the future. Treating COVID-19 Infections: Preventing infection is only part of the story. To overcome this pandemic, we also need good treatments for people who are infected. The monoclonal antibody treatments are helpful when used appropriately, but not enough people are getting access to them. Antiviral treatments such as ivermectin, remdesivir and EIDD-2801 are promising. However, direct-acting antiviral compounds such as EIDD-2801 are most effective when given early in the course of infection. We haven't yet figured out how to administer them reliable to people who have recently become infected When Did SARS-CoV-2 Start to Circulate Globally? New research suggests that some people may have been exposed to this novel coronavirus before the first infections were reported from Wuhan, China, in December, 2019. There is a lot of travel between Asia, the US and Europe that could have helped to spread it. The focus now is on new strains with mutations that help them spread more efficiently. How will viral mutations affect vaccine efficacy? We don't yet know if SARS-CoV-2 will end up mutating so quickly that we will need a new vaccine every year or two, as we do for the flu. That doesn't seem likely right now, but we keep learning new things for the coronavirus update Herd Immunity and COVID-19: Many people have talked about achieving herd immunity, and we wonder if that is a realistic goal. There are two ways to make sure that enough people are immune to the virus that it doesn't spread through the population unchecked as it has in 2020. The first and by far the preferred way is to vaccinate a lot of people. Most experts estimate that when at least 70 percent of us have been vaccinated, SARS-CoV-2 will have trouble spreading to people who have not been vaccinated. The other way to achieve herd immunity, by letting people become infected with the coronavirus, would result in an unacceptably high death toll, not to mention disabilities among survivors with long COVID. Coronavirus Update and the Prospect for the Future: In this coronavirus update, we ask Dr. Baric for his predictions for future waves. Under worst-case scenarios, we could see many hundreds of thousands more deaths in the US. Even under the best circumstances, we may see another 200,000 or 300,000 deaths in this country before the pandemic is controlled. Dr. Baric offers his advice for safe celebrations as we bring the year to a close. He also offers an assessment for how we can use this experience to overcome the next emerging pathogen before it becomes a pandemic. This Week's Guest: Ralph Baric, PhD, is the William R. Kenan, Jr. Distinguished Professor in the Department of Epidemiology and Professor in the Department of Microbiology and Immunology of the University of North Carolina at Chapel Hill. He is a Harvey Weaver Scholar from the National Multiple Sclerosis Society and an Established Investigator Awardee from the American Heart Association. In addition, he is a World Technology Award Finalist and a fellow of the American Association for Microbiology. In this recent study by Dr. Baric and his colleagues, older adults responded well to an mRNA vaccine against SARS-2 (New England Journal of Medicine, Dec. 17, 2020). He has spent the past three decades studying coronaviruses and is responsible for UNC-Chapel Hill's world leadership in coronavirus research. For these past three decades, Dr. Baric has warned that the emerging coronaviruses represent a significant and ongoing global health threat, particularly because they can jump, without warning, from animals into the human population, and they tend to spread rapidly. Listen to the Podcast: The podcast of this program will be available Monday, December 28, 2020, after broadcast on December 26. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1240: The Link Between Vitamin D and COVID-19

Scientists have long suspected that vitamin D is crucial for the immune system to function properly. Presumably, that is why cod liver oil was utilized as a tonic to ward off colds and flu in northern climes. After all, as you get farther from the equator, you get less sunshine during the winter. Consequently, you make less vitamin D. How does this simple fact connect vitamin D and COVID-19? Vitamin D and Infection: Several studies have suggested that people whose stores of vitamin D are low may be more vulnerable to COVID-19. Dr. David Meltzer of the University of Chicago compared pre-existing vitamin D measurements with the risk of COVID-19 infection. The results of his study show a clear link between low vitamin D and COVID-19 infection risk. Susceptibility to infection is not the only possible link between vitamin D and COVID-19. Through its impact on the immune system, vitamin D may also affect the likelihood of cytokine storm. This is a potentially deadly immune system over-reaction. Cytokine storm may occur as a consequence of many different conditions, but it appears to be one of the dangerous consequences of severe COVID-19. People with adequate levels of vitamin D seem less vulnerable to this complication. What Vitamin D Does in Your Body: Scientists have long associated vitamin D with strong bones. In fact, when the Institute of Medicine revised the RDA in 2010, it focused almost completely on bone health. That's how they concluded that 600 IU daily is plenty for adults through age 70. Older people are encouraged to get 800 IU through food or supplements each day. However, vitamin D is actually a hormone and affects many tissues in addition to bone. Find out what else it does, and why pregnant women should pay attention to getting an adequate amount. We consider why so many physicians are skeptical about the potential benefits of vitamin D supplements. Should you be taking vitamin D? If so, what form is best? How much do you need? Dr. Bruce Hollis answers these questions. In addition, he describes why African-Americans may be at higher risk for vitamin D insufficiency. What Dose of Vitamin D Is Too High? Many doctors worry that people taking supplements will get too much vitamin D and experience toxicity. While toxicity is possible, Dr. Hollis explains, it is uncommon. Not long ago, Dr. Anthony Fauci admitted that he takes a supplement providing 6,000 IU a day. That is the same dose Dr. Hollis takes himself. This dose is above the upper limit of 4,000 IU daily set by the Institute of Medicine, so be sure to check with your personal health care provider before starting to supplement. As Dr. Hollis describes, regular blood tests can reveal if you are getting an appropriate amount of vitamin D. Lack of Evidence That Vitamin D Supplements Prevent COVID-19: An expert panel in England reported this week that they don't recommend vitamin D supplements to prevent infection. The scientists on the panel would like to see more randomized placebo-controlled trials to demonstrate the effectiveness of supplements. A study in Brazil that tested a single enormous dose of vitamin D (200,000 IU) as a treatment for COVID-19 concluded that it was not effective (MedRxiv, Nov. 17, 2020). We don't know if well-designed studies will demonstrate a protective connection between vitamin D and COVID-19. This Week's Guests: David O. Meltzer, MD, PhD, is Chief of the Section of Hospital Medicine, Director of the Center for Health and the Social Sciences (CHeSS) and the UChicago Urban Labs Health Lab, and the Fanny L. Pritzker Professor in the Department of Medicine, Department of Economics and the Harris School of Public Policy Studies at the University of Chicago. His article, "Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results," was published in JAMA Network Open on Sept. 3, 2020. Bruce W. Hollis, PhD, is Professor of Pediatrics, Biochemistry and Molecular Biology and Director of Pediatric Nutritional Sciences at the Medical University of South Carolina in Charleston, SC. The photo is of Dr. Hollis. Listen to the Podcast: The podcast of this program will be available Monday, December 21, 2020, after broadcast on December 19. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1239: How Can We Prevent Diagnostic Disasters?

It seems obvious that to provide the proper treatment, a doctor first needs to know what is wrong. However, although medical experts have been focusing on improving diagnosis in medicine for more than a decade, people still suffer from delayed or incorrect diagnoses. In some cases, these result in diagnostic disasters. We hear from a retired specialist about his own experience as a patient. If the problem had not been in his own specialty, he might not have realized how serious the consequences could have been. Fortunately, a second opinion was correct and led to appropriate treatment that prevented bad outcomes. Unfortunately, though, when he offered to tell his story to the hospital where the misdiagnosis occurred, they declined. Health care systems will have trouble preventing diagnostic disasters if they don't know what went wrong. How Common Are Diagnostic Disasters? Although researchers don't have a good way of collecting accurate statistics on misdiagnoses, delayed or missed diagnoses pose a serious safety problem. Experts with the Society to Improve Diagnosis in Medicine note that 10% to 20% of autopsies reveal serious diagnostic errors. This suggests that 40,000 to 80,000 people die in the US each year as a result of diagnostic disasters. The Institute of Medicine drew attention to the problem in 2015 with its publication, Improving Diagnosis in Health Care. How much progress has been made? Dr. David Newman-Toker, past president of the Society to Improve Diagnosis in Medicine, describes the efforts to reduce serious diagnostic mistakes. When Telemedicine Can Help Prevent Diagnostic Disasters: With the COVID-19 pandemic, many people have been avoiding face-to-face encounters with health care providers. As a result, some people who had strokes or other serious health conditions did not receive timely attention. While telemedicine provides a possible alternative, we need to look at the pros and cons of using such video technology. Dr. Newman-Toker describes how neurologists can use telemedicine to arrive at a provisional diagnosis. In addition, certain modifications can be particularly helpful. Specifically, he and his colleagues have developed a way for dizzy patients to use their smartphones to record a video of their eye movements and send it to the neurologist for diagnostic assessment. What lessons can we learn from the difficulties imposed by the pandemic that can help prevent diagnostic disasters? In summary, Dr. Newman-Toker recommends targeted questions patients can ask to help health professionals consider the diagnosis carefully. This Week's Guests: Steven Horowitz, MD, is a retired academic neurologist who continues to teach medical students as an adjunct clinical professor of neurology at the Tufts University School of Medicine. He is also on the teaching faculty of the Maine Medical Center. His story was published in The Washington Post on Oct. 4, 2020. The photo is of Dr. Horowitz. David Newman-Toker, MD, is Professor of Neurology and Director of the Division of Neuro-Visual & Vestibular Disorders in the Department of Neurology at Johns Hopkins University School of Medicine. Dr. Newman-Toker is the Director of the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence, as well as the immediate past president of the Society to Improve Diagnosis in Medicine (SIDM). Listen to the Podcast: The podcast of this program will be available Monday, December 14, 2020, after broadcast on December 12. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3 Learn More: You may find our book, Top Screwups Doctors Make and How to Avoid Them, of interest. In it we discuss a variety of medical errors, including diagnostic mistakes. We also provide detailed recommendations on how you can prevent such complications.

Show 1238: How Is COVID-19 Affecting Mental Health?

These are stressful times. Many people are grieving the death of a loved one, while others are struggling with working or studying from home. Being separated from loved ones can be emotionally draining. How are you dealing with the mental health challenges of the COVID-19 pandemic? Trauma and Kids' Mental Health: Trauma, like that experienced on 9/11, can have a profound impact on children's mental health. That depends largely on how the adults in their lives are able to support them. This pandemic may be traumatic for many youngsters. How do their parents evaluate whether kids are coping well enough? Our expert guest, Dr. Robin Gurwitch, describes resources where parents can get help for their children. School and Holidays: Perhaps when schools first sent students home to learn online, some kids would have welcomed the reprieve from routine. By now, however, many if not most are so over it. How can parents help children having a hard time learning over Zoom? We'll also discuss how families may want to observe winter holidays unlike any others. The Pandemic Reveals Societal Stresses: Difficulties with employment, housing, even putting food on the table, reveal ways in which we have not been taking care of everyone in our society. The constant stress over the course of this pandemic year is causing mental health challenges for a lot of people (JAMA, Nov. 23, 2020). How can you tell if you are appropriately bummed out by the circumstances or if you are really becoming depressed? Dealing With Depression: If you find you are indeed depressed, what are your options? Many mental health professionals are offering telehealth counseling (JAMA Psychiatry, Dec. 1, 2020). Our guest expert Dr. Timothy Strauman also has tips for dealing with burnout. We should all be practicing kindness and acknowledging the frontline workers, including those in the supermarket, post office and other positions outside of healthcare. If you are not on the front lines yourself, you may be working from home. While that helps protect you from infection, it can also be frustrating. How can you get your work done and also take care of your mental health? Self-care is extremely important. Dr. Strauman has recommendations for the unpredictability of the coming months. This Week's Guests: Robin Gurwitch, PhD, is a professor in psychiatry and behavioral sciences at the Duke University Medical Center and the Center for Child & Family Health. She is a recognized expert in understanding and supporting children in the aftermath of trauma and disasters. Dr. Gurwitch has been involved in direct services, research, consultation, and material development following national and international disasters and terrorist events. She has been an active member of the National Child Traumatic Stress Network since it began in 2001. The photo is of Dr. Gurwitch. Timothy Strauman, PhD, is a professor of psychology and neuroscience at Duke University. He studies the psychological and neurobiological aspects of self-regulation, or how people pursue goals in the face of inevitable challenges and how problems in self-regulation can lead to disorders such as depression. He also studies how treatments for depression work. Listen to the Podcast: The podcast of this program will be available Monday, December 7, 2020, after broadcast on December 5. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1237: Improving Your Mood With Food

Working from home during the pandemic has wrought havoc with a lot of healthy eating habits. It's harder to shop safely, and minimizing time in the grocery store may mean people have stocked up on shelf-stable highly processed foods. What's more, lots of us have been responding to stress by eating sweet or salty treats that are appealing in the short run but may not benefit our health over the long term. Are there ways you can improve your mood with food? Connecting Psychiatry and Nutrition: We don't usually connect nutritional wellbeing and mental health, but our guest, psychiatrist, nutrition specialist and chef Uma Naidoo, MD, thinks we should. Changing dietary habits can have a profound impact on our emotional status. How did Dr. Naidoo come to follow such an unusual career path? Foods That Help Fight Depression and Anxiety: There are intimate connections between the digestive tract and the central nervous system. What fuels this gut-brain romance, and what disrupts it? When people are eating not from hunger but from stress, how can they interrupt that behavior? It can be especially challenging in the middle of the pandemic. Dr. Naidoo discusses foods that can help reduce depression and anxiety so you can improve your mood with food. High-fiber foods, such as an easy lentil and spinach soup she describes, can be particularly helpful. Boosting Your Memory With Food: Food can impact your cognitive capacity as well as your emotional condition. Surprisingly, spices may have the power to boost memory. Dr. Naidoo offers the following recipe featuring rosemary from her new book. Southern French–Style Scallops (gluten-free, dairy-free) Scallops are delicious and easy to cook. They are a great way to impress friends with your chef skills. This gluten-free recipe highlights the memory-boosting benefits of rosemary and omega-3s. Servings: 6 Prep Time: 10 minutes Cooking Time: 15 minutes 1 pound bay scallops (or sea scallops, halved horizontally) 1 ½ teaspoons kosher salt, plus more if desired 1 teaspoon black pepper, plus more if desired 2 tablespoons organic gluten-­free flour 2 tablespoons olive oil 2 medium shallots, finely diced 1 clove garlic, finely chopped 1 ½ teaspoons fresh rosemary (or ¾ teaspoon dried) 2 tablespoons chopped fresh flat-­leaf parsley 1/3 cup white wine 1 lemon Sprinkle the scallops with salt and pepper and then toss them in the flour, shaking off the excess. Heat the olive oil in a large stainless- steel sauté pan on high heat. Add the scallops in a single layer. Lower the heat to medium and allow the scallops to brown lightly on one side. They will release from the pan when ready; turn them over and let them brown lightly on the other side. The scallops should cook for about 4 minutes in total. Remove the scallops and set aside in a medium bowl. Add the shallots, garlic, rosemary, and 1 tablespoon of the parsley to the pan and sauté for a few minutes. Return the scallops to the pan and add the wine and cook for 1 minute. Zest the lemon over the scallops and sprinkle on the remaining 1 tablespoon parsley. Season with additional salt and black pepper. Serve hot with a squeeze of lemon juice. From This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More by Uma Naidoo, MD, Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital. If you are a beginning or hesitant cook, Dr. Naidoo offers encouragement. Learn how you can improve your mood with food. This Week's Guest: Uma Naidoo, MD, MBCHB, is Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital. A board-certified psychiatrist, professional chef, and nutrition specialist, she also serves on the faculty at Harvard Medical School. Dr. Naidoo is the author of This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More. Listen to the Podcast: The podcast of this program will be available Monday, November 30, 2020, after broadcast on November 28. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1236: The Inside Story on Vaccines Against COVID-19

SARS-CoV-2, the coronavirus responsible for COVID-19, has infected many millions of people both in the United States and around the world. The death toll is horrifying, with more than a quarter of a million people in the US alone. With infections soaring as we head into winter, the news that a couple of vaccines against COVID-19 appear to be effective is especially welcome. What Do We Know About Vaccines Against COVID-19? Pharmaceutical firms around the world are working hard to develop vaccines against COVID-19. In the US, those that are farthest along are based on a new technology using messenger RNA (mRNA). Both Pfizer and Moderna are using this approach, and both have recently announced effectiveness rates approaching 95 percent. So far, what the world has seen are press releases. However, when the companies apply for approval or emergency use authorization, the FDA will examine the data carefully. How Do the Companies Test the Vaccines? To determine a vaccine's effectiveness, some volunteers in the trial must get the immunization while others get a placebo. Neither the participants nor the researchers can know who has received vaccine and who got placebo. That is the only way to be able to tell if the vaccine actually works. For the vaccines currently under development, the companies made a special effort to recruit a diverse group of volunteers. They wanted participants of various ages, genders and ethnic background so they could make sure the shot will be safe and effective for everyone. Moreover, they wanted to make sure to test it in tens of thousands of people. That way, they could be reasonably sure to detect common side effects. Even some uncommon reactions will show up if you give a shot to 20,000 individuals. Distributing Vaccines Against COVID-19: Once data on these vaccines have been closely examined by the FDA and its advisory committee, the Centers for Disease Control and Prevention will also take a look. If they are given the green light, the firms face the hardest part: producing and distributing the shots. Both of these new vaccines need to be transported and stored at cold temperatures. However, the Pfizer vaccine has some extreme requirements that are likely to pose logistical challenges. Who Should Be First to Get Their Immunizations? Public policy suggests that people at highest risk should be the first to get their shots. That would definitely include health care workers and first responders. It might also include essential workers and people with health conditions that put them at risk. It may take some time before everyone can be protected. In the meantime, we will all have to stay vigilant with distance, facial coverings, hand hygiene and avoiding gathering with others indoors. Our guest, Dr. Paul Offit, is one of the country's leading experts on vaccines. He serves on the advisory committee for Vaccines and Related Biological Products at the FDA. He shares his knowledge, his concerns about vaccine-related misinformation and his vision of how we can bring this pandemic to a close. This Week's Guest: Paul A. Offit, MD is the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Offit is the author of several books, including his most recent, Overkill: When Modern Medicine Goes Too Far. His website is http://paul-offit.com/ Listen to the Podcast: The podcast of this program will be available Monday, November 23, 2020, after broadcast on November 21. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1235: Safer Sex in the Time of COVID

In the midst of a pandemic, many people feel isolated. When you are not even supposed to shake hands, much less hug or kiss, how can those who live alone meet their needs for sexual intimacy? Is it possible to date without running a high risk for COVID-19–or a sexually transmitted infection? How can people have safer sex, even in these risky times? Talking About STIs: Our guest, Dr. Ina Park, talks frankly about sexually transmitted infections (STIs) and how to reduce the risk. She describes ways people can have safer sex. In fact, the first health professionals to use public health tools such as contact tracing were striving to control conditions like syphilis and gonorrhea. Now contact tracers are on the front lines against the spread of COVID-19. It is a critical tactic in trying to figure out who may have been exposed to an infection. Many people are very reluctant to talk about STIs due to the stigma we associate with them. However, nearly every sexually active person will catch one strain or another of human papillomavirus (HPV) at some point in their lifetimes. As a result, we should drop the stigma and deal with these infections based on knowledge and compassion. Testing at Home: Although people have cut back dramatically on their visits to doctors and clinics, they can still check on their sexual health. Those who continue to be sexually active with more than one partner may need access to testing for safer sex. We discuss how to use home tests for sexual infections. Dr. Park offers this link from the Kaiser Family Foundation to learn more about online access to testing and contraception: https://www.kff.org/womens-health-policy/issue-brief/a-look-at-online-platforms-for-contraceptive-and-sti-services-during-the-covid-19-pandemic Negotiating Safer Sex: When you want to socialize safely during the pandemic, you need to negotiate. That is a lot like negotiating safer sexual practices. Embarrassing as it may be, you need to ask if your partner has been tested and what the results were, as well as whether they are interacting with others or just you. Masks and condoms are certainly vastly different. However, the practice of negotiating may be more similar than you realized. The Talk About Safer Sex: Dr. Park suggests that when parents try to fit everything they want to impart into a single big talk about birds and bees, they are putting themselves under a lot of excess pressure. Instead, she recommends having dozens of little talks instead of one big one. Then, perhaps your children will grow up comfortable discussing the risks and rewards of sexual activities in a matter-of-fact way. This Week's Guest: Ina Park, MD, MS, is an Associate Professor in the Department of Family and Community Medicine at the University of California San Francisco School of Medicine, and the Medical Director of the California Prevention Training Center. Her website is at: https://www.inapark.net Dr. Park is the author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs, (available on 2-2-2021). The photograph of Dr. Park is by Stefan Cohen. Listen to the Podcast: The podcast of this program will be available Monday, November 21, 2020, after broadcast on November 14. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3 You can find more informatioin on the special sale on CocoaVia that we mentioned during the show at this post.

Show 1234: How Microbes Evolve to Become Enemies or Allies

The SARS-CoV-2 coronavirus behind COVID-19 is changing. This should not be a surprise, since microbes evolve by nature. What implications might this have for the infection in future months? We speak with an evolutionary biologist to see how his perspective can illuminate the pandemic. How Do Microbes Evolve? SARS-CoV-2 is a coronavirus that evolved initially in bats. How can microbes that have adapted to one species leap into a different species–say, from a bat to a pangolin or a human being? What sorts of changes will it make along the way? We consider other examples of microbes that have moved to new host species. What does this suggest about COVID-19? In addition, we'll look at the interaction with our immune systems as microbes evolve. Are Microbes the Hidden Cause of Some Chronic Diseases? A number of chronic conditions that are difficult to treat may be traced in part to infection with certain microbes. Some doctors don't believe patients suffer chronic Lyme disease. In this case, they recognize the pathogen, Borrelia burgdorferi, but no one has proven it causes the persistent health problem. On the other hand, many clinicians doubt that there are microbes behind chronic fatigue syndrome. Unfortunately, researchers have not yet identified them conclusively. Moreover, although scientists have demonstrated links between heart disease and oral microbes, few cardiologists test their patients for these germs. Initially, we consider some important questions. How would microbes evolve from agents that cause acute illness to those that cause chronic disease? What role do our immune systems play in these developments? Furthermore, what does this mean for people recovering from COVID-19? We worry that when microbes evolve, some individuals may end up suffering long-haul coronavirus symptoms. Finally, how can evolutionary biology help us understand such issues more fruitfully? This Week's Guest: Paul Ewald, PhD, is an evolutionary biologist, specializing in the evolutionary ecology of parasitism, evolutionary medicine, agonistic behavior, and pollination biology. He is Professor of Biology at the University of Louisville, in Louisville, Kentucky. His books include Plague Time: The New Germ Theory of Disease and Evolution of Infectious Disease. Listen to the Podcast: The podcast of this program will be available Monday, November 9, 2020, after broadcast on November 7. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1233: How Does Your Immune System Overcome Viruses?

One of the striking things about the COVID-19 pandemic is how differently people respond. Some people contract the virus but never really have symptoms, while others land in the hospital struggling for breath. More than a million people around the world have died from the infection, with about a quarter of those in the US. We can understand this immense variability better if we consider how does the immune system overcome viruses. How Does the Immune System Respond to Viruses? Before the immune system can overcome viruses, it has to recognize that pathogens are invading. Human immune systems have two different branches: the innate immune system that kicks in very quickly to respond to anything it perceives as a threat, and the adaptive immune system that responds very precisely to microbes it has met before. How do our bodies know that a pathogen is invading? What Is a Virus? Viruses are essentially genetic material–either DNA or RNA–that must invade a host cell and commandeer its genetic material in order to replicate. Some viruses have envelopes surrounding them, while others are "naked." All viruses can trigger signals called pathogen-associated molecular patterns (PAMPS). These in turn activate the pathogen recognition receptors that put out the alarm to the immune system. The first responders of the immune system are the cells that make up the innate immune system. Neutrophils, macrophages, monocytes and natural killer cells pick up the signals from the pathogen recognition receptors and react quickly, usually within hours. Part of their reaction is to ramp up inflammation. As a result, an infected cut gets red, swollen and painful. Certain molecules, including cytokines, draw immune cells to the site where they are needed. In the process, they create inflammation. How Does a Fever Help Your Immune System Overcome Viruses? Such inflammatory chemicals are also responsible for the fever you may experience with a systemic infection. Although many people are quick to try to bring a fever down, that might not be smart. Often a fever can help the body fight off an infection. What Happens in a Cytokine Storm? Cytokines are an important part of the innate immune response. But when the immune system overreacts, the result can be high fever, respiratory distress and lung damage. Runaway cytokines can also damage blood vessels, a common problem in COVID-19 (The Lancet Respiratory Medicine, April 27, 2020). This is called a cytokine storm. Our guest is a virologist and immunologist whose special interest is the innate immune system and how it can overcome viruses. Learn about the most promising future approaches against SARS-CoV-2, including ways to make vaccines more effective (Current Opinion in Immunology, Oct. 7, 2020). This Week's Guest: Michael Gale, Jr., PhD, is a professor of Immunology at the University of Washington School of Medicine. Dr. Gale is a formally trained immunologist and virologist whose research is focused on understanding the molecular mechanisms of innate immune response and immune programming against infection by RNA viruses, including emerging SARS-CoV-2, emerging flaviviruses, HIV, and influenza viruses. Listen to the Podcast: The podcast of this program will be available Monday, November 2, 2020, after broadcast on October 31. You can stream the show from this site and download the podcast for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

How Can You Take Control of Your Digestive Health?

The conventional view of the digestive system was that it took care of digestion and wasn't involved very much with the rest of the body's systems. Now, though, science has shown that the gut and the millions of microbes that live in it have a profound impact on other aspects of our body, from immune response to brain health and psychological well-being. How can we put that knowledge into action? To find out, we spoke with Dr. Marvin Singh. He is an integrative gastroenterologist at the forefront of delivering personalized medicine to his patients with a focus on digestive health. This is a special podcast from The People's Pharmacy, just for podcast subscribers, and it features information about one of our underwriters, Verisana. Dr. Singh shares his unique perspective as an integrative gastroenterologist who is also board certified in internal medicine. He describes how our gut health influences other aspects of our health. How Has COVID-19 Affected Our Digestive Health? The SARS-CoV-2 virus that causes COVID-19 affects the digestive tract as well as the respiratory tract. That is why some people experience diarrhea and loss of appetite among their symptoms of the disease. While we are staying out of restaurants to avoid catching ÇOVID-19, most of us have been doing more cooking at home. What are the nutritional implications? What should we be paying most attention to as we plan and shop for home-cooked meals? How Does the Gut Microbiome Shape Our Digestive Health? What is the gut microbiome? How could it modify the behavior of seemingly unrelated parts of our body. When we talk about the microbiome, we are not just describing a single species, but an entire collection. The ecological balance of bacteria, viruses and fungi that live in our intestinal tract both reflects and influences nutrition, metabolism, inflammation and hormones. How do we know whether our microbiome is healthy or out of balance? Dr. Singh describes conditions that can disrupt the microbiome as well as the consequences of dysbiosis. To improve our microbiome, it would be helpful to be able to learn more about it. You probably don't want to be spending any unnecessary time at the doctor's office during the pandemic. That's where the home health tests offered through the Verisana Health Plan can be so helpful. What Is the Verisana Health Plan? At Verisana.com, you can order home health tests for hormones, gut health and the microbiome. But which ones do you need? The advantage of the Verisana Health Club is that it provides you with the tests you need to keep track of your microbiome, hormones, and markers of inflammation and metabolism. They are offered in a rational sequence throughout the year so you don't have to stop and ponder which test you need next. With regular testing, you can detect and correct health imbalances before they lead to illness. As a special introductory offer to People's Pharmacy podcast listeners, Verisana Health Club is offering a 50% discount off the first month. To claim your discount, go to www.verisana.com/health-club/ and enter the code PEOPLE50 when you check out. Taking Control of Your Own Health: The philosophy of home testing is that patients control their own health. Monitoring our health status conscientiously with home tests is one aspect of taking control. Dr. Singh describes how we can use that information in the context of precision medicine, addressing exactly what we need when we need it. Learn what we should be doing to keep our digestive tracts healthy during the pandemic and henceforth. The Guest for This Episode: Marvin Singh, MD, is founder and CEO of Precisione Clinic. He is also director of Integrative Gastroenterology at the University of California, Irvine and a board member of the American Board of Integrative Medicine. Dr. Singh is board certified in internal medicine and gastroenterology and is also a diplomate of the American Board of Integrative Medicine.

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