The People's Pharmacy

This week, we welcome dermatologist Dr. Chris Adigun to our studio to answer your questions about summer skin problems. You can call in your stories and questions about bites, burns and blisters between 7 and 8 am EDT on Saturday, June 21, 2025, at 888-472-3366. Or you can send us your question or story ahead of time by email: radio@peoplespharmacy.com. You could listen through your local public radio station or get the live stream at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on July 21, 2025. The Link Between Sun Exposure and Skin Cancer: Intense summer sunshine can cause sunburn and skin damage. The most worrisome consequences are skin cancers that may show up on cheeks, ears, noses, lips or other unexpected places. How can you recognize a potential skin cancer? What will the dermatologist do about it? Even more important, can you reduce your risk for basal or squamous cell carcinoma? (Those are technical terms to describe skin cancers that are not melanoma.) What are the best ways to avoid harming your skin while you are enjoying the great outdoors, whether you are at the beach or on the hiking trail? Are there criteria you can use to choose the best sunscreen without spending a fortune? How often do you need to apply it? Can you get enough vitamin D compounds if you wear a high SPF sunscreen? Are there skin conditions that might actually benefit from a bit of sun and salt water? Lowering Your Chance of Melanoma: The relationship between sun exposure and melanoma is less clear than that between sun and basal or squamous cell cancers. Find out what might make a spot suspicious. Where should you be checking your skin? What can a dermatologist do to help? Heat and Humidity Challenges: In addition to sun, heat and humidity can challenge our skin. Fungal infections may proliferate under those conditions, resulting in athlete’s foot, jock itch or under-breast rash. Can we make our sweaty skin less hospitable to fungi? Have you been troubled with heat rash? We’ll find out what it is and what to do to get rid of it. Other Summer Skin Problems: Long summer hikes can result in more trouble than sunburn or sore muscles. Unless you are very careful with your shoes, sweaty feet can develop blisters. Are there good preventive strategies? If you get a blister anyway, what can you do to ease the pain–and keep it from getting worse? Bug bites may also be the bane of your existence. Chiggers hang out in grass or brush waiting to take a bite of a tasty mammal walking by. Can you avoid or discourage them? And if you do get chigger bites, how can you manage the dreadful itch? We also want to avoid bites from ticks and mosquitoes. They may have different niches and behaviors, so avoiding them may require different tactics. What works best? How can you choose a good insect repellent for outdoor activities, and will it interact with your sunscreen? Poison Ivy and Its Cousins: Poison ivy, poison oak and poison sumac all contain the resin urushiol, which can be extremely irritating to sensitive skin. Do you know how to identify these plants so you can avoid them? If you find yourself in the middle of a poison ivy thicket, can you take quick action and reduce the chance of a rash? If you end up with a rash–it happens–we’ll find out how you can ease the suffering. Call in Your Questions About Summer Skin Problems: Dr. Chris Adigun will be in our studio to answer your questions about bug bites, blisters, burns and other summer skin problems from 7 to 8 am EDT on July 19, 2025. Give us a call to ask a question or share a story: 888-472-3366 or email us ahead of time: radio@peoplespharmacy.com This Week’s Guest: Chris G. Adigun, MD, FAAD, is a board-certified dermatologist who practices both general dermatology and cosmetic dermatology at the Dermatology and Laser Center of Chapel Hill, NC. Dr. Adigun is devoted to increasing public awareness of skin cancer and the harmful effects of UV rays—both medical and cosmetic. She specializes in both nail disorders and laser treatments. Dr. Chris Adigun, dermatologist, with People’s Pharmacy hosts Joe & Terry Graedon Listen to the Podcast: The podcast of this program will be available Monday, July 21, 2025, after broadcast on July 19. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this episode, we acknowledge the many reasons that people may be feeling anxious or depressed. It often seems that current conditions are designed to break our brains. Perhaps that’s why 60 million Americans suffer from depression or anxiety. Not everyone who might be feeling nervous or down in the dumps deserves a diagnosis. However, they can benefit from the practices we discuss in this hour. Pharmaceutical approaches such as antidepressants can be helpful for people with depression, especially in the short term. Over the long haul, though, we might want to consider whether changing our habits could help us develop the resilience we need. After all, antidepressants frequently result in side effects. Moreover, many people find it difficult to discontinue an antidepressant. Anti-anxiety agents carry similar risks. Scientific research has shown us the importance of neuroplasticity. Can we tweak our neurochemistry by embracing some simple tenets for living? We don’t really have broken brains, but we might be lacking the skills we need to pursue robust mental fitness. Where will we learn them? How You Can Listen: You could listen through your local public radio station or get the live stream on Saturday, July 12, 2025, at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on July 14, 2025. Staying Connected Protects Our Brains: Good nutrition, adequate sleep and regular exercise are all pillars of mental as well as physical health. Our guest, integrative psychiatrist Drew Ramsey, says staying connected with others is equally important. Cultivating a variety of connections is crucial for our mental health, including friends, family and even casual acquaintances. We should keep in mind that building community is different from building friendships; we need both for mental fitness. Social isolation can be damaging both for teenagers and for older individuals. Can we use social media to bolster our support systems rather than allowing them to wither? What skills can we help our teens acquire? Dr. Ramsey described a study, the AMEND trial, that combined social connection through social media with learning to cook. The young men in the study posted their cooking experiments on Instagram and bonded with each other over the experience. Adopting a more healthful diet also reduced the youths’ risk for depression. Maybe Ultra-Processed Food Breaks Our Brains: One aspect of nutrition that is important to consider is how our food affects our microbiota. Our gut microbiome has a powerful influence on inflammation in our bodies. After all, the immune system is in part anchored in the gut, especially in the gut microbiome. When the microbiome gets disrupted and inflammation rises, our mood and mental health can suffer. What should we be eating to feed our microbes and keep them happy? Dr. Ramsey offers a little rhyme as a mnemonic: “Seafood, greens, nuts & beans…and a little dark chocolate.” We admit the last line breaks the rhyme, but it isn’t too hard to remember! When we asked what foods to focus on for healthy gut microbes, he suggested lentils. Although they are not technically beans, as in the rhyme, they are legumes and contain lots of fiber that helps gut microbes flourish. Dr. Ramsey also extolls the benefits of microgreens, another food that gut microbes love. The microbiome acts as a master dial on our immune system and inflammation levels. Beyond Diet and Activity: Dr. Ramsey provides nine tenets for reclaiming robust mental health, even when we may feel like our situation breaks our brains. In addition to thoughtful nutrition, adequate sleep and reliable physical activity, he also stresses the importance of unburdening yourself of past trauma. This need not have been anything as major as a traffic accident or losing a parent, though such experiences are certainly traumatic and deserve attention. Even minor traumas like being picked on as a child can affect our sense of well-being. Unburdening is the process of acknowledging those and trying to understand where our past is tripping us and blocking our efforts to be mentally healthy in our present. Unburdening yourself can leave you feeling freer to pursue your goals. It helps ground you so that you can pursue your purpose. Journaling, therapy or creative pursuits could all help with unburdening. How Can You Find Your Purpose? Finding your purpose might not sound like a step towards better mental fitness, but it is. How do you know when you have found your purpose? Focusing on a sense of identity and of fulfillment will help you with this. Finding a sense of purpose is important at every stage of life, but it may be especially important for older individuals. A job is not synonymous with purpose, although at times they may overlap. Sometimes, people who have relied on work to provide their sense of purpose find themselves at loose ends when they retire. This Week’s Guest: Drew Ramsey, MD, is a leading board-certified integrative psychiatrist, best-selling author and leading proponent of Nutritional Psychiatry and Mental Fitness. He served as an Assistant Clinical Professor of Psychiatry at Columbia University in the Vagelos College of Physicians and Surgeons for twenty years. Dr. Ramsey is founder of the Brain Food Clinic in New York City and Spruce Mental Health in Jackson, WY. He is the author of several books, including his latest book, Healing the Modern Brain: Nine Tenets to Build Mental Fitness and Revitalize Your Mind. The People’s Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you). Drew Ramsey, MD, author of Healing the Modern Brain Listen to the Podcast: The podcast of this program will be available Monday, July 14, 2025, after broadcast on July 12. In this week’s podcast, Dr. Ramsey offers further discussion of the idea of finding your purpose and how to do that even after retirement. You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this week’s episode, our guest explains why treating hypothyroidism isn’t always as simple as it seems. He is a leading researcher on questions relating to thyroid hormones. What Is Hypothyroidism? Hypothyroidism, a condition in which the thyroid gland doesn’t make enough thyroid hormone, is one of the most common hormonal disorders. It was first identified near the end of the 19th century but is far more widely recognized now. More than 20 million Americans produce too little thyroid hormone for their needs, either because their thyroid glands have been removed or because they are under attack from the immune system. Inadequate thyroid hormone has an impact on every cell in the body. As a result, the symptoms are wide-ranging, from lethargy and cognitive troubles to hair loss and constipation. Why Should We Be Rethinking Hypothyroidism? Most medical students learn that this is a simple straightforward condition to diagnose and treat. For decades, doctors used a single test–the TSH, or thyroid-stimulating hormone–for diagnosis. In addition, they learn that a single medication, the hormone called levothyroxine, is the sole treatment. People may know levothyroxine by its brand names, such as Synthroid or Levoxyl. Doctors often refer to it as T4, because the molecule contains four atoms of iodine. Not everyone knows that T4 itself is not biologically active. Enzymes within the cells must remove one of those iodine atoms to create the active hormone, T3. You might recognize it by its generic name, liothyronine, or by the brand name Cytomel. What’s Wrong with Levothyroxine Only? Back in 1970, researchers discovered the enzymes that convert T4 to T3. That’s when doctors decided that patients would do well on a simple synthetic form of T4. In fact, 80 to 85 percent of patients with hypothyroidism have no great difficulties with this treatment. However, about 15 to 20 percent continue to suffer despite treatment. Some feel infuriated when the doctor tells them that their normal TSH levels mean they are fine. They don’t feel fine. They still feel exhausted, confused and miserable. Researchers, including our guest, have begun to recognize that people who do not convert T4 to T3 efficiently may suffer from residual symptoms of hypothyroidism. How Should We Be Rethinking Hypothyroidism? Lingering symptoms of hypothyroidism, such as fatigue or brain fog, are not very specific. As a result, doctors may need to utilize more sophisticated testing techniques. Moreover, rethinking hypothyroidism means considering different forms of treatment. A person who has residual symptoms despite a normal TSH level might need a trial of combination therapy. This might be in the form of desiccated thyroid extract such as Armour or Westhroid. An alternative would be a prescription for both T4 (levothyroxine) and T3 (liothyronine) as combination therapy. Doctors making such a change to their prescription need to adjust the dose carefully so that the patient does not end up with too much thyroid hormone. They also need to make sure during the diagnostic workup that the problem truly is hypothyroidism. Symptoms such as low energy don’t go away with thyroid hormone treatment unless that is the underlying problem. What Should Patients Do? For too long, patients have heard that their residual symptoms are psychological in nature. A doctor might have insisted that a normalized TSH on treatment means nothing is wrong with the thyroid gland. People who still feel bad despite such treatment may need to hunt for a clinician willing to explore ways to address those residual symptoms. This Week’s Guest: Antonio C. Bianco, MD, PhD, was professor of medicine and a member of the Committee on Molecular Metabolism and Nutrition at the University of Chicago at the time this episode first aired. He ran a laboratory funded by the National Institutes of Health to study thyroid hormones. Dr. Bianco is a former president of the American Thyroid Association and author of Rethinking Hypothyroidism: Why Treatment Must Change and What Patients Can Do. Twitter handle is @Bianco_Lab. The People’s Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you). Antonio Bianco, MD, PhD, is now The Nelda C and H.J Lutcher Stark Professor in internal medicine. VP, Vice-Provost for research and Chief research officer university of Texas Medical Branch, Galveston, Texas. Antonio Bianco, MD, PhD, University of Chicago Listen to the Podcast: The podcast of this program will be available Monday, July 7, 2025, after re-broadcast on July 5. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this episode, Joe & Terry speak with two scientists studying mosquito preferences. Why are some people mosquito magnets while others barely get bitten? A range of factors influences mosquito behavior and may explain why mosquitoes bite you and leave your neighbor alone. Learn how to outsmart them. You could listen through your local public radio station or get the live stream on Saturday, June 28, 2025, at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 30, 2025. Why We Worry About Mosquito Bites: You may think of mosquitoes as annoying insects with itchy bites. That’s certainly a reasonable summary in many places and times. But there are large swaths of the globe where mosquitoes carry deadly diseases. Malaria, for instance, kills an estimated 600,000 people a year. The majority of these victims are children under 5 years old living in sub-Saharan Africa. Even in the US, where malaria was eradicated in the mid-20th century, mosquitoes transmit some dangerous diseases, including dengue in some southern regions, West Nile virus, and in the northeast and the Gulf Coast, eastern equine encephalitis (EEE). The best prevention for these serious infections is to outsmart mosquitoes and avoid getting bitten. Depriving Mosquitoes of Breeding Grounds: One problem is that a few species of mosquito have evolved to live in close proximity to humans. They have adapted to breeding in standing water, but it doesn’t take much. An upturned bottle cap, a saucer under a potted plant or leaves lying on the ground can all offer mosquito breeding opportunities. Emptying those saucers and raking away the leaves should be a priority to reduce the risk of mosquito bites. Do You Smell Delicious? Both our guests have been studying what makes some people more appealing than others. To that end, Dr. Conor McMeniman and his team have set up the world’s largest multiple-choice smell test for mosquitoes in Zambia. They constructed a mesh greenhouse the size of two tennis courts that could be surrounded by eight single-person tents. A person sleeps in each tent and that person’s scent is wafted into the enclosure where mosquitoes are given a chance to congregate where the preferred scent appears. This scent buffet for mosquitoes demonstrated that microbial metabolites from our skin microbiome have a significant impact on insect behavior. Mosquitoes seem to home in on short chain carboxylic acids as well as acetoin. How Can We Outsmart Mosquitoes? One simple and obvious step to avoid mosquito bites is to use window screens on our homes. That helps protect us inside. Air conditioning and ceiling fans also help. We asked Dr. McMeniman how he protects himself when he is outside and what we should do. He recommends repellents. DEET is the gold standard, but some people find it unpleasant. An effective alternative repellent is derived from plants. Whether you use oil of lemon eucalyptus or DEET, it is important to read the instructions for applying the product properly. How Do Mosquitoes Change Their Behavior? In addition to smell, mosquitoes also use vision and temperature sensing to find humans to bite. (Did you know mosquitoes sing to each other? It is part of their courtship behavior.) Dr. Clément Vinauger studies how mosquito brains react during different activities. They also pay attention to people who swat them and seem to avoid those individuals who come close to killing them. Mosquitoes can also change their behavior to adapt to human behavior. For example, a species of Anopheles mosquito that was nocturnal shifted to early morning biting over a period of a few years. That happened after the human population started using effective bed nets that protected them during sleep. More on How to Outsmart Mosquitoes: Dr. Vinauger made a casual observation that some soaps seemed to attract mosquitoes while others repel them. In a study, he found that most of the soaps his team examined appealed to mosquitoes. On the other hand, coconut scented soap (Native brand tested) kept them away. We asked him about Listerine. He has not studied it, nor has he studied some remedies that our listeners like such as eating garlic. However, he suggested consulting the local gardening center or nursery in selecting plantings around the home that are not attractive to mosquitoes. This Week’s Guests: Conor McMeniman, PhD, is Associate Professor of Molecular Microbiology & Immunology at the Johns Hopkins Malaria Research Institute. Dr. McMeniman studies the molecular and cellular basis of mosquito attraction to humans. Conor McMeniman, PhD, Johns Hopkins Malaria Research Institute Clément Vinauger, PhD, is Associate Professor at Virginia Tech in the Department of Biochemistry. His research area is the molecular genetics of host-seeking behavior in insects. His website is:  https://www.vinaugerlab.com/ Clément Vinauger, PhD, Virginia Tech Listen to the Podcast: The podcast of this program will be available Monday, June 30, 2025, after broadcast on June 28. This week’s episode features bonus material, including exclusive content we couldn’t fit into the radio broadcast. In this week’s podcast bonus material, Dr. McMeniman explains why it would be really difficult to conduct a scientific study on whether taking vitamin B1 reduces your attractiveness to mosquitoes. We also discuss how climate change is likely to put Americans at greater risk for mosquito-borne diseases. Could malaria become a problem in the US once again? And we talk about “skeeter syndrome” in people who get nasty allergic reactions to mosquito bites. You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

This week, our guest in the studio is veterinarian Dr. Chuck Miller. You can call in your stories and questions about the animals in your life between 7 and 8 am EDT on Saturday, June 21, 2025, at 888-472-3366. Or you can send us email: radio@peoplespharmacy.com. We’ll be focusing on transforming relationships between humans and animals. Have you ever had to euthanize a beloved pet? We would like to hear your story. What was it like to lose such a close companion? You could listen through your local public radio station or get the live stream at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 23, 2025. One Health: You may have already thought about One Health without realizing it has a name. This is an interdisciplinary approach to promoting the health of animals as well as humans that share an environment. If you have companion animals that move between inside and outside, your already know that protecting them from ticks and fleas also offers you a measure of protection. Another example of the importance of this approach would be control of bird flu. So far, we have paid it relatively little attention as it spread through cattle herds and to cats and other animals. If we learned more about its behavior in other animals, might we be able to reduce the impact on humans? How Do Pets Promote Human Health? Not long ago, a friend shared a blog post she had written about the death of her chicken. The bird had reached the end of its natural lifespan, and the memorial essay was an appreciation of its special spunky personality. Probably few people who interact with animals on a regular basis can keep from noticing that each one, whether it is a chicken, a cat, a mouse or a hedgehog, has its own particular take on the business of living. That observation in itself helps make our lives richer. Quite a bit of research has shown that having a pet present can help alleviate anxiety and lower blood pressure. One study examined the impact of therapy dogs on children’s anxiety in the emergency department (JAMA Network Open, March 3, 2025). Children interacting with a therapy dog and its handler for 10 minutes in the ER had less anxiety than those whose emergency visits were dogless. Young children aren’t the only ones to respond well to dogs. A study in Thailand introduced well-socialized dogs to 122 university students feeling stressed out (PLoS One, March 12, 2025). Students’ self-reported stress, pulse rate and salivary cortisol (a stress hormone) all dropped during and after interacting with the dogs for 15 minutes. Does Lifespan Difference Cause Trouble? A dear friend just sent us a very sad email. His golden retriever Abby just died after 13 joyful years together with him and his wife. Moreover, he noted, there will not be another dog in their family because they are both getting on in years. Adopting a dog that outlives you doesn’t seem fair to the dog. When a pet dies first, the owner grieves. But if an owner dies first, someone must find the animal a new home. How do we do that? How many people make contingency plans for a surviving pet? Should we? What about grieving animals? Here we’d like to put in a recommendation for a beautiful movie, The Friend. The dog star is magnificent, and the humans are pretty great, too. Call in Your Stories about Relationships Between Humans and Animals: Dr. Chuck Miller will be in our studio to answer your questions and hear your stories about transforming relationships between humans and animals from 7 to 8 am EDT on Saturday, June 21, 2025. Give us a call to share your story or learn what you can about that bond: 888-472-3366 or email us: radio@peoplespharmacy.com This Week’s Guest: Charles Miller, DVT is the owner of Triangle Veterinary Hospital in Durham, North. Carolina. Dr. Miller has been serving the pets and animal owners of the area for 32 years. You may wish to listen to our previous episode with Dr. Miller. It was Show 1379: The Healing Power of Pets. https://trianglevet.com/ Charles Miller, DVM Listen to the Podcast: The podcast of this program will be available Monday, June 23, 2025, after broadcast on June 21. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this episode, Joe & Terry speak with two physicians who have examined ways that artificial intelligence might contribute to patient care. Can AI help with better diagnoses? Is robotic surgery better? Could AI save lives or is it more likely to cause trouble? You could listen through your local public radio station or get the live stream on Saturday, June 14, 2025, at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 16, 2025. Digital Doctoring: We begin our conversation with Dr. Jonathan Chen, who has found that chatting with a robot made him a better doctor. (He challenged ChatGPT with an ethically difficult conversation and was surprised at the sensitivity of the observations it offered.) When researchers studied diagnostic acumen pitting human doctors against AI, the results were surprising. Some doctors did the diagnosis without help, while others used ChatGPT-4 to help them. The investigators also had the AI do the diagnosis unaided (or unhindered) by humans. Doctors got a score of 74 percent on their own and 76 percent when using AI. But ChatGPT by itself scored 90 percent. (JAMA Network Open, Oct. 28, 2024). AI is certainly not perfect, and there are times when it is not the appropriate tool to use. But results like this suggest that we should be learning more about when it might be an indispensable technology for improving patient care. After all, human doctors are not perfect, either. Paging Doctor Google: Health care professionals are not the only ones who are putting artificial intelligence to use in health care settings. Many physicians dread the patient who arrives with a large stack of papers printed off the internet. Our guests suggest that doctors should welcome these patients and collaborate with them. Pointing them to more reliable sites and better search strategies, if the healthcare provider is able to do so, could yield better results overall. Who is more motivated to spend time researching the details of an unusual syndrome or its treatment? It may well be the patient. There are, of course, some cautions that people should keep in mind. One is privacy. You may not want to disclose your medical history to the internet at large. Most sites are not constrained by HIPAA, which protects patient privacy in medical settings. Another consideration is the reliability of the information you find. Robots are designed to produce answers that will please the humans asking the questions. That might mean that they make things up. If the question is how to connect your camera to your computer, an invented (“hallucinated”) answer is inconvenient. When it concerns your health, a fabricated answer could be dangerous. Could AI Save Lives in Dermatology? Our second guest, Dr. Art Papier, has been involved in developing large libraries of images of skin problems. With artificial intelligence powering it, VisualDx helps doctors recognize dermatological problems such as skin cancers. He describes one situation in which misdiagnosis is common and can cause harm. Cellulitis is a dangerous inflammation due to bacterial infection that can lead to sepsis. Red skin can be a signal of cellulitis, but sometimes it is caused by other problems. Misdiagnosis can lead to hospitalization and inappropriate antibiotics being administered. Utilizing a clinical decision tool like VisualDx reduced unnecessary hospital admission and antibiotic use (Journal of the American College of Emergency Physicians Open, June 8, 2023). Another strength of the system Dr. Papier has helped build is that it offers doctors views of atypical presentations of common problems. Hopefully, this keeps them from focusing on a single feature of an illness, such as a bulls-eye rash, as the only defining characteristic. The builders of VisualDx have deliberately included many images of skin of many different shades, as rashes sometimes look different depending upon the background coloration. Both our guests emphasize that AI is a tool. To get the best results, it must be used intelligently, not indiscriminately. This Week’s Guests: Jonathan Chen, MD, PhD, assistant professor of medicine at Stanford Medicine, works at the intersection of artificial intelligence and medicine in the hopes that combining human knowledge with AI will deliver better care than either can alone. His expertise lies in developing innovative AI-driven solutions that enhance diagnostic accuracy, treatment efficiency, and patient outcomes. Dr. Chen focuses on integrating machine learning algorithms and predictive modeling into clinical practice, revolutionizing the way healthcare is delivered. His goal is to use real-world clinical data, such as electronic medical records, with machine learning and data analytics to reveal new clinical insights that will inform patient care. Jonathan Chen, MD, PhD, Stanford Medicine Art Papier, MD, is a dermatologist and medical informatics expert and the co-founder and CEO of VisualDx. He has led the development of VisualDx, a professional, point of care decision support system as well as Aysa, a freely available consumer and patient facing AI app for dermatology (www.askaysa.com). A thought leader in clinical informatics, Dr. Papier maintains the overall vision for the company with a keen focus on product integration and impacting costs in healthcare through clinical accuracy. https://www.visualdx.com/blog/our-team/art-papier/ Dr. Art Papier is founder & CEO of VisualDx Listen to the Podcast: The podcast of this program will be available Monday, June 16, 2025, after broadcast on June 14. In this week’s podcast, Dr. Chen describes the effort by Dr. David Fajgenbaum to use AI to search the medical literature and find potential treatments for rare diseases. Dr. Papier discusses the use of AI to reduce the chance of misdiagnosis. How should patients and doctors negotiate the use of AI? You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this episode, our guest, award-winning science journalist Carl Zimmer, describes the hidden dangers in the air we breathe. He begins with the concept of the aerobiome–the collection of living things from ground level to the stratosphere. While that includes eagles and dragonflies, the most insidious inhabitants are those we can’t see. Often, we are totally unaware of their presence. Yet bacteria like the one that causes tuberculosis or viruses like those that cause COVID or flu have the power to make us ill even if we don’t know they are there. You could listen through your local public radio station or get the live stream on Saturday, June 7, 2025, at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 9, 2025. Hidden Dangers in the Air We Breathe: You have surely heard of the microbiome, but perhaps you thought it only applied to the microscopic beings living in our digestive tract. Lately, scientists have learned that humans have a microbiome for every different part of our bodies, including our eyes, ears, mouth and lungs. The air around us is also full of microorganisms. And even though we can’t see them and we may not be able to smell or taste them, they can still have a big impact on our health. What are the hidden dangers in the air we breathe? Florence Nightingale and the Science of Ventilation: Back in the mid-19th century, Florence Nightingale insisted that fresh air and sunlight were essential for patients to recover. Even though she didn’t know the scientific reason for this, her observation was correct. Good ventilation can help lessen the risk of disease transmission. But infectious disease specialists were not paying much attention to air quality until COVID-19 came along. At the beginning of the pandemic, health experts actually resisted the idea that SARS-CoV-2, the virus that causes COVID, could be airborne. Public health authorities stressed the importance of hand washing, social distancing and disinfecting doorknobs, groceries or other items that someone else might have touched. Those turned out to be of much less significance than the dangers in the air we breathe. The Skagit Valley Chorale Superspreader Event: In the spring of 2020, the Skagit Valley Chorale got together to rehearse for an upcoming concert. There were about 60 singers who took the advised precautions: social distancing and hand sanitizing. The room in which they rehearsed was poorly ventilated, and no one was wearing a mask. This was at a time when the CDC was urging Americans NOT to wear masks, for fear there wouldn’t be enough for healthcare workers. Within a few days, six of the singers were sick. Eventually, 52 of them came down with COVID from this single exposure. Two women died. The Skagit Valley Chorale provided an irrefutable example that the virus could be airborne. Have We Learned the Lessons of COVID-19? If we learned the lessons we should take from the pandemic, we will be on the lookout for other hidden dangers in the air we breathe. We know that measles is incredibly transmissible and that the measles virus is airborne. In areas where measles is spreading, people would be smart to wear effective masks, such as N95, in public. Unfortunately, masks have been politicized, although viruses do not care. Another pathogen that spreads through the air is tuberculosis. Americans don’t think of this as an important problem, but drug-resistant TB is a world-wide threat. Approximately one-fourth of humans carry this pathogen. It can become active whenever stress or other problems knock the immune system down. Many other countries responded differently to the pandemic. Perhaps some will improve the ventilation and filtration in public spaces. That is unlikely in most parts of the US, due to cost. Perhaps we should take to carrying carbon dioxide monitors wherever we go. That will not tell us if there are hidden dangers in the air, but it will indicate how many people have been breathing it. This Week’s Guest: Carl Zimmer writes the “Origins” column for the New York Times and has frequently contributed to the Atlantic, National Geographic, Time, and Scientific American. His journalism has earned numerous awards, including ones from the American Association for the Advancement of Science and the National Academies of Science, Medicine, and Engineering. Carl Zimmer is an adjunct professor at Yale, where he teaches writing. He is the author of fourteen books about science, including Life’s Edge. His most recent book is Air-Borne: The Hidden History of the Life We Breathe. The People’s Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you). Car Zimmer. Photo credit Mistina Hanscom Listen to the Podcast: The podcast of this program will be available Monday, June 9, 2025, after broadcast on June 7. In this week’s podcast, we discuss the value of CO2 monitors as well as the potential effectiveness of ultraviolet light for purifying the air. Could UV be a helpful part of our toolchest? Might there actually be benefits to breathing in certain microorganisms, similar to the probiotics you might take for gut health? You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

This week, the topic is lead. A hundred years ago, chemists discovered that adding lead to gasoline decreased engine knock and gave the cars of the day more power. It remained a popular additive for decades. At the same time, companies were adding lead to house paint to help it last longer. We know now that lead exposure harms children, but what about adults? Could lead in our environment have contributed to the horrific toll of heart disease over the past century? Find out about the chemical roots of chronic disease on this week’s nationally syndicated radio show! You could listen through your local public radio station or get the live stream on Saturday, May 31, 2025, at 7 am EDT on your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 2, 2025. The Chemical Roots of Chronic Disease: When the nascent automotive industry began adding tetraethyl lead to gasoline early in the 20th century, scientists did not fully understand the potential health impacts of this compound. They knew by 1889 that lead poisoning could result in saturnine (ie, lead-induced) gout, an inflammatory condition accompanied by atherosclerosis. And at first, public health officials worried that adding it to gasoline might not be safe, especially after large numbers of refinery workers suffered lead poisoning in 1924. According to chemical warfare expert Yandell Henderson, “The use of tetraethyl lead will cause vast numbers of the population to suffer from slow lead poisoning with hardening of the arteries.” (New England Journal of Medicine, Oct. 30, 2024). He made that statement at a meeting in 1925. Why didn’t regulators pay attention? The Kehoe Problem: One reason there wasn’t more regulatory attention is that the industry was new and the government hadn’t figured out how to regulate it to make it safer. Another reason is a persuasive individual named Robert Kehoe. As the chief medical officer of the Ethyl Corporation, he had a substantial conflict of interest. But he argued that no one had the right to ban the use of lead in gasoline until someone had proven that it was dangerous. Mind you, not whether lead was dangerous, which scientists knew, “but whether a certain concentration of lead is dangerous.” Unfortunately, the Kehoe rule held sway and has helped shape the American approach to chemical regulation ever since. Lead was used very widely during the 20th century. People put it in insecticide and in jet fuel. We already mentioned its use in paint. The 21st-century water disaster in Flint, Michigan, reminded the country that many cities still contain lead pipes as part of their plumbing infrastructure. In the 1960s, lead levels in the most recent layers of glacial core samples were 1000 times higher than those in more ancient pre-industrial cores. Moreover, people were also carrying around 1000 times more lead in their bones than skeletons from pre-industrial times. Even now, the total amount of lead in our bodies is 10 to 100 times higher than that of pre-industrial people. How Does Lead Affect Health? We asked our guest, Dr. Bruce Lanphear, whether public health improved when we got lead out of gasoline late in the 20th century. The answer is yes; blood lead levels have dropped dramatically. Consequently, many fewer children are dying of acute lead poisoning. But we are still underestimating the overall health effects of chronic low-level lead exposure. Lead exposure, even at low levels, is linked to hypertension and heart disease. People who are exposed to lead have higher blood pressure. In addition, they are more likely to have damage to the endothelium of the blood vessels. This can result in plaques that cause heart attacks. Scientific assessments show that people with blood level levels at the 90th percentile have double the risk of death from cardiovascular disease as those at the 10th percentile. The conclusion is that chronic low-level lead exposure is a leading cause of heart disease. Worldwide, there are about 5.5 million deaths a year due to low-level lead poisoning. How Do We Learn About the Chemical Roots of Chronic Disease? Some critics have objected that association is not causation. That is certainly true. When we have the opportunity to use randomized placebo-controlled trials, we can have more confidence in the conclusions. Yet when there is an overwhelming amount of evidence, we should pay attention. Just as no one now doubts that tobacco harms health, we do not need to doubt the lasting harm caused by lead exposure. We can learn from the lead saga and apply those lessons to other toxic chemicals. First off, lead poisoning is preventable. Cutting lead exposure reduces the harms. In general, chronic disease risk rises with environmental exposure. To prevent disease, we need to clean up the environment. Just as Robert Kehoe objected to eliminating lead from gasoline, current manufacturers defend their own toxic chemicals, whether those are PFAS, cadmium, arsenic, phthalates or the herbicide glyphosate. If we want a cleaner environment, resulting in less chronic disease, we need to demand action. This radio show is a wake-up call to all those politicians calling for less regulation. This Week’s Guest: Bruce Lanphear, MD, MPH, is Professor of Health Sciences at Simon Fraser University in Burnaby, British Columbia. Professor Lanphear’s research, at the intersection of preventive medicine, pediatrics, public health, toxicology, and infectious disease, is driven by a commitment to prevent death, disease, and disability. He has published over 350 peer-reviewed studies about the impact of toxic chemicals on intellectual deficits, behavioral problems, and brain structure in children. He is ranked among the top 1% of most-cited scientists globally. Bruce and his brother, Bob, co-founded Little Things Matter to make the science on toxic chemicals publicly accessible. They produce videos to show how human health is inextricably connected with exposures to toxic chemicals and to elevate efforts to prevent disease. Professor Lanphear’s new video, Toxic Hearts, will soon be released. May 20th, 2025, was the 100th anniversary of the US Surgeon General’s report on the safety of tetraethyl lead. Follow Dr. Lanphear on Substack at https://blanphear.substack.com/ Bruce Lanphear, a health sciences professor at Simon Fraser University and an expert on lead toxicity. Listen to the Podcast: The podcast of this program will be available Monday, June 2, 2025, after broadcast on May 31. This week’s podcast has a more extended discussion of how industry tries to blame the victim. What is Dr. Lanphear doing to upset that dynamic? You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. You may also want to listen to a prior interview with Dr. Lanphear: Show 1418: More About the Pros and Cons of Water Fluoridation (Part 2). You can download the mp3 file at this link. There is also Show 1417: Examining the Pros and Cons of Water Fluoridation (Part 1). We try to bring you a variety of perspectives on The People’s Pharmacy. If you find this kind of balanced approach worthwhile, please consider a donation at this link. It will help us keep moving forward with our radio show, podcast, newsletter and this website. Thank you for your support. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

This week, two scientists discuss the evidence on using vitamin C to treat colds and as part of the treatment for cancer. For years, the medical establishment has maintained that such claims could not be considered seriously. But new studies vindicate Linus Pauling, the Nobel Prize winner who postulated that vitamin C would help. You could listen through your local public radio station or get the live stream on Saturday, May 24, 2025, at 7 am EDT on your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on May 26, 2025. Studies That Vindicate Linus Pauling: In 1970 the Nobel Prize-winning chemist, Dr. Linus Pauling, published a paperback book titled Vitamin C and the Common Cold. Although this idea captured the public imagination, it got a lot of pushback from scientists. Most of the American medical establishment rejected Pauling’s claims that vitamin C could help people recover from the common cold. They were especially dismissive of the idea that vitamin C might be helpful in treating cancer. However, there have been a number of studies conducted over the decades since then. The weight of the evidence now seems to vindicate Linus Pauling. Does Vitamin C Help Recovery from the Common Cold? Our first guest, Dr. Harri Hemilä of Helsinki, Finland, has done several meticulous systematic reviews of the research. Although some people expect supplemental vitamin C to prevent colds, it does not appear to prevent colds except among people doing extreme physical activity (Polish Archives of Internal Medicine, Jan. 30, 2025). Instead, however, studies show that at doses considerably higher than the RDA vitamin C can reduce the duration and severity of these upper respiratory tract viral infections (BMC Public Health, Dec. 11, 2023). To achieve this, people take a dose of 6 to 8 grams per day. That is a lot more vitamin C than you would get from a morning glass of orange juice. Of course, we worry about the potential harms of consuming an excessive dose of vitamin C. According to Dr. Hemilä, taking this amount for as long as a cold might last does not produce serious side effects. If one were to take it for a lot longer, that might not be the case. Some reports suggest that long-term high-dose vitamin C supplementation might trigger kidney stones. Cancer Studies Vindicate Linus Pauling on Vitamin C: We turn our attention next to a surgeon who treats patients with pancreatic cancer. This type of cancer usually has a grim prognosis. Dr. Joseph Cullen was intrigued by a report that high-dose vitamin C could inhibit the growth of cancer cells, so he and his team tested that possibility in tissue culture. They were impressed at the excellent results they achieved at this first step of the research. However, the benefits were only seen at extremely high doses of vitamin C. This is consistent with preliminary research conducted by Linus Pauling and a colleague testing intravenous (IV) administration of vitamin C in cancer patients. To get exposure to that level of vitamin C (ascorbate) requires IV dosing. The next step in Dr. Cullen’s research was to test vitamin C in mice with experimentally induced cancer. His team administered vitamin C in conjunction with radiation. Once again, the results were promising. How Does Vitamin C Affect Cancer Cells? At low doses, such as those we can get by eating strawberries, bell peppers or oranges, vitamin C is an antioxidant. At the very high doses achieved only by IV administration of 75 grams of ascorbate, this compound acts as a pro-oxidant. It generates hydrogen peroxide that attacks cancer cells. Dr. Cullen’s team continued their research with a preliminary clinical trial (Redox Biology, Nov. 2024). By administering IV vitamin C together with the usual chemotherapy drugs for pancreatic cancer, they were able to help those patients survive twice as long as those getting chemotherapy alone. Of course we asked about side effects; Dr. Cullen reports that people become very thirsty during the infusion. The scientists did not observe any serious adverse reactions. Using IV Vitamin C for Other Cancers: In addition to pancreatic cancer, Dr. Cullen and his collaborators have tested the effects of this treatment in another cancer that is notoriously difficult to treat. They found that cells of the brain cancer glioblastoma were far more vulnerable to radiation In the presence of high-dose ascorbate. On the other hand, normal cells suffered less radiation damage. With such success, Dr. Cullen’s team and some others are conducting pre-clinical research on some other cancers. Not all types of cancer appear to respond to high-dose IV vitamin C. Apparently, a trial of prostate cancer was disappointing. However, there is now adequate evidence of the potential benefits of vitamin C when used properly to vindicate Linus Pauling and his conviction that this remarkable compound could contribute enormously to human health. This Week’s Guests: Harri Hemilä, MD, PhD, is an adjunct professor at the University of Helsinki in Finland. His research has focused on vitamin C, vitamin E, and zinc lozenges for respiratory infections, and he has also analyzed the effects of vitamin E on mortality. Dr. Harri Hemilä Joseph J. Cullen, MD, is Professor of Surgery, Gastrointestinal Surgery and Radiation Oncology at the University of Iowa College of Medicine. His website is https://surgery.medicine.uiowa.edu/profile/joseph-cullen Listen to the Podcast: The podcast of this program will be available Monday, May 26, 2025, after broadcast on May 24. This week’s podcast contains additional discussion with Dr. Hemilä about the use of zinc in treating the common cold. What type of zinc is best? Should you take tablets or suck on lozenges? Are there any worrisome side effects? We explore briefly the possibility of using both zinc and vitamin C to reduce the duration of a cold. You can stream the show from this site and download the podcast for free, or you can find it on your favorite platform. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

In this week’s episode, find out what everyone gets wrong about weight loss. Why don’t diet and exercise work very well? Do official guidelines and weight loss drugs offer a clearer path to success? Health Consequences of Excess Weight: With nearly three-fourths of American adults either overweight or obese, we can’t ignore the problem any longer. For decades, people have acted as though packing on extra pounds was simply a matter of poor willpower. “Eat less and exercise more” is the standard mantra. But that is just one of the things we get wrong about weight loss. In truth, obesity is far more complex than we may imagine. In fact, neuroendocrinologist Robert Lustig has spent decades studying obesity and diabetes in children. During the past 25 years, the weight of newborn babies has risen by about 200 grams. No reasonable person could imagine this is the babies’ fault! As a result, he says we need to grapple with the concept of different obesities with different causes and diverse consequences. When we come to terms with what we get wrong about weight loss, we may be able to start helping people achieve it. One Thing We Get Wrong About Weight Loss–Not Distinguishing Different Fat Depots: Dr. Lustig points out that not all fat is identical. In fact, the most visible fat depot, the subcutaneous fat, may be the least dangerous. Many people could handle as much as 20 pounds of subcutaneous fat visible on the arms, legs or butt without serious health consequences. Visceral fat, wrapped around the internal organs, is associated with high cortisol levels much more than with overeating. As little as 2 pounds of visceral fat could make trouble. However, the deadliest fat depot is the liver. As little as ½ pound of fat in the liver can damage health. Dr. Lustig traces fatty liver to overconsumption of alcohol or sugar. Fructose, an important component of sugar, is one of the bad actors driving the epidemic of non-alcoholic fatty liver disease among children (Nature Reviews. Gastroenterology & Hepatology, May, 2010). Consequences of Obesity: The obesities can increase our risk for a number of serious conditions, including hypertension and diabetes as well as metabolic syndrome and heart disease. Fatty liver disease, whether associated with fructose or alcohol consumption, can damage the liver and lead to cirrhosis. It also triggers severe inflammation and is linked to a greater chance of kidney disease. The Impact on Mitochondria: Every cell in our body relies on mitochondria to produce its energy. These tiny organelles take the energy from food and turn it into ATP, the form of chemical energy that our cells need to function. Unfortunately, the fructose in sugar or high-fructose corn syrup can mess mitochondria up in the context of a high-fat diet (Cell Metabolism, Oct. 1, 2019). High-Powered Weight Loss Drugs: Recently, people have gotten excited about the potential for drugs originally designed to treat type 2 diabetes to help people with significant weight loss. Medications like semaglutide, sold as Ozempic or Wegovy, have become so popular that there have been shortages. Dr. Lustig discusses their use and the symptoms that may be associated with them. Importantly, such drugs can lead to weight loss, up to 16% of total body weight in some studies. However, many people report nausea, sometimes vomiting, lack of appetite and diarrhea. Perhaps we should not consider these side effects; they may be contributing to the effectiveness of the drugs. (Dr. Lustig points out that if people are provided with a healthier diet of real food, they can reduce their risk of metabolic disorders by 29 to 45 %.) Earlier versions of these GLP-1 analogs such as exanetide (Byetta) may increase the risk for pancreatic cancer or certain types of thyroid cancer. We don’t yet know if Wegovy will have similar risks. But we do know that when people stop taking one of these pricey pills, they often gain the weight back. You can read more about this “boomerang” effect at this link. How to Correct What We Get Wrong About Weight Loss: Dr. Lustig points out that the subsidies that the US provides to major food companies mean that ultra-processed foods containing corn syrup or sugar are cheap. As a result, many Americans rely on these inexpensive sources of calories instead of paying more for real food. But they are paying a price far beyond dollars and cents, because the cheap and easy foods are making Americans fat. Can we get food companies to do the right thing? Promoting Good Health in Children with Real Food: School cafeterias across the nation serve kids a tremendous amount of junk food, like pizza or potato chips. But they don’t have to. Dr. Lustig and his colleagues operate a pilot program with schools that serve real food instead. Happily, they do not have to increase their budgets to do so. Providing youngsters with tasty real food can set them up for success in resisting weight gain as they grow older. Finally, we ask Dr. Lustig what people can do to help themselves with healthful, lasting weight loss. This Week’s Guest: Dr. Robert Lustig Robert H. Lustig, MD, MSL, is Professor emeritus of Pediatrics in the Division of Endocrinology at the University of California, San Francisco (UCSF). He specializes in the field of neuroendocrinology, with an emphasis on the regulation of energy balance by the central nervous system. His research and clinical practice has focused on childhood obesity and diabetes. Dr. Lustig is the author of several books, including his most recent, Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine.  You may also be interested in his previous books, Fat Chance and The Fat Chance Cookbook as well as The Hacking of the American Mind. His website is https://robertlustig.com/ The nonprofit organization improving food in schools is https://eatreal.org/ Listen to the Podcast: The podcast of this program will be available Monday, May 19, 2025, after re-broadcast on May 17. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.