The People's Pharmacy

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.

In this episode, investigative journalist Gardiner Harris delves into the dark secrets of one of the country’s most admired pharmaceutical firms. Johnson & Johnson sold talcum powder–Johnson’s Baby Powder–for decades even though it contained asbestos, an acknowledged carcinogen. How did the company maintain its superb reputation for so long? You could listen through your local public radio station or get the live stream on Saturday, May 10, 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 12, 2025. Dark Secrets: Johnson’s Baby Powder was as American as apple pie. The company counted on the emotional associations with its baby products. The fragrance of its Baby Powder was linked to feelings of love and security. That was smart marketing. Continuing to sell a product contaminated with asbestos was something else, though. How did the company deal with this problem? And what did it tell the FDA? What About Tylenol? Johnson’s Baby Powder is not the only iconic product the company sells. Tylenol is another famous J&J product. Johnson & Johnson has long promoted this pain reliever as one that hospitals and doctors trust. Advertising does not feature the fact that the recommended dose and the maximum safe dose of the active ingredient, acetaminophen, are extremely close. As a result, people can inadvertently overdose, especially if they are taking several different types of medicine for symptoms of a cold or the flu, for example. Exceeding the maximum dose of acetaminophen puts a strain on the liver and, over time, may cause liver injury. This is especially worrisome if someone drinks alcohol on a regular basis. J&J’s response to a crisis in which Tylenol was deliberately adulterated with poison is held up to business students as a case study in doing the right thing. The company pulled millions of bottles off shelves and introduced tamper-proof packaging. This decision bolstered the company’s reputation. The Dark Secrets of the Opioid Crisis: Not all of the company’s business decisions are so laudable, and most are not so well-known. Few people are aware that the Johnson & Johnson company developed fentanyl, a potent opioid. It was originally invented by Dr. Paul Janssen, head of Janssen Pharmaceutica. When J&J acquired Janssen, it also acquired the rights to fentanyl, which it sold in a transdermal formulation as Duragesic. According to our guest, the company initially presented it to physicians as a non-addicting pain reliever. You are no doubt aware that is far from the case. Johnson & Johnson’s Antipsychotic Drugs: Gardiner Harris points out that Johnson & Johnson was one of the first companies to offer “atypical” antipsychotics such as Risperdal (risperidone). This drug, also developed by Janssen, was originally designed to treat the symptoms of schizophrenia. That market is relatively small, however. Later, the company started suggesting to doctors that they could prescribe it for elderly dementia patients who were agitated. Like other antipsychotic drugs, though, Risperdal increases the possibility that such patients will die prematurely from heart problems or infection. The FDA has not approved it for treating dementia-related psychosis. In 2013, J&J agreed to pay $2.2 billion in fines for its marketing of Risperdal and two other drugs. Johnson & Johnson Responds: A spokesperson for the company responded to our request for comment: “We stand behind the safety of our products and are focused on what we do best: delivering medical innovation for patients around the world.” This Week’s Guest: Gardiner Harris previously served as the public health and pharmaceutical reporter for The New York Times and is now a freelance investigative journalist. He also served as a White House, South Asia, and international diplomacy reporter for the Times. Before that, he was a reporter for The Wall Street Journal, covering the pharmaceutical industry. His investigations there led to what was then the largest fine in the history of the Securities and Exchange Commission. He won the Robert Worth Bingham Prize for investigative journalism and the George Polk Award for environmental reporting after revealing that coal companies deliberately and illegally exposed miners to toxic levels of coal dust. Harris’s novel, Hazard, draws on his experience investigating these conditions. His latest book is No More Tears, the Dark Secrets of Johnson & Johnson. 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). Gardiner Harris, author of No More Tears, the Dark Secrets of Johnson & Johnson (c) Erin Champ Listen to the Podcast: The podcast of this program will be available Monday, May 12, 2025, after broadcast on May 10. It contains some additional discussion of the relationships between drug companies and the FDA, specifically with regard to the role of user fees. We also find out about Procrit (EPO) and why it too was a source of controversy. 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, Joe and Terry discuss liver health with two specialists. You may not have spent much time thinking about your liver. It is, however, an absolutely essential organ. When the liver is working properly, every part of the body gets the nutrients it needs and no parts are exposed to damaging toxins. These are among its superpowers. Find out why you should love your liver. You could listen through your local public radio station or get the live stream on Saturday, May 3, 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 5, 2025. Love Your Liver: Nutrients don’t go directly from the intestines to the rest of the body. Instead, they pass through the liver first. There, this master organ breaks them down into compounds that can be recognized and utilized by individual tissues and cells. Moreover, if it finds nasty chemicals that shouldn’t be there, it utilizes its superpowers to transform them into less damaging compounds that can be more readily excreted. You should also love your liver because it can store nutrients for unanticipated periods of fasting and hold off starvation. This was a tremendous benefit during earlier periods of human evolution. These days, we have less need for a hedge against starvation. In fact, when we overload our livers with alcohol or sugar, even its superpowers may not be adequate. The liver’s response to this kind of insult is fibrosis, a condition in which it stiffens and stores fat. Liver Disease: One of the liver’s superpowers is that it can regenerate itself so long as we remove the source of injury. That’s pretty remarkable! But what if we keep on eating ultra-processed foods (Nutrients, May 10, 2023) and drinking soda or alcohol?  In that case, the liver continues to try to repair itself. That can change the architecture of the tiny blood vessels that run through the liver, raising the pressure within them and ultimately leading to serious complications. Fatty liver disease, correctly termed metabolic-associated steatohepatitis (MASH), is the first step; cirrhosis and ultimately liver failure might follow. How Do You Know If Your Liver Is Healthy? The liver is so effective at maintaining the body in balance that most people don’t develop symptoms of trouble until liver disease is quite advanced. As a result, the best way to keep tabs on liver health is through blood tests. Tests for the liver enzymes called ALT and AST are common and often used to assess liver health. Agents That Can Help or Harm the Liver: If you love your liver, consider drinking a cup or two of black coffee daily. This has been shown to help the liver fight inflammation and overcome early-stage liver fibrosis (Redox Biology, March 2025). Another precaution to take: avoid excess acetaminophen. This is the pain-relieving ingredient in Tylenol and hundreds of other over-the-counter medications. Doctors consider it safe for occasional use at doses under 4,000 mg in a day. Chronic use might call for lower doses yet. Because it is so widespread, people may mistakenly take several different medicines containing acetaminophen (paracetamol in the rest of the world) and end up exceeding the maximum dose by accident. Liver experts like our guest Dr. Ahmad treat such emergencies with a medicine called N-acetylcysteine. Other pain relievers, such as NSAIDs, are less likely than acetaminophen to damage the liver. Dangerous reactions to such drugs are unpredictable, however, which can make them harder to manage. Fluoroquinolone antibiotics such as Levaquin and corticosteroids like methylprednisolone also fall into this category. Oral antifungal drugs can also be very hard on the liver. Herbs That Can Challenge the Liver: Pharmaceuticals are not the only compounds that may test the liver’s detoxifying superpowers. Botanical medicines can also cause challenges. Dr. Ahmad has treated people whose liver injuries were caused by green tea extract, turmeric, kratom or ashwagandha. Most people taking such supplements are attempting to improve their health, so discovering that instead they have developed liver damage is a nasty surprise. If you love your liver, stick with drinking green tea and eating curry rather than taking pills with concentrated extracts. This Week’s Guests: Meena Bansal, MD, is Professor of Medicine, specializing in liver diseases, at the Icahn School of Medicine at Mount Sinai. She is System Chief of the Division of Liver Diseases and Director of the MASH/NASH Center of Excellence at Mount Sinai. Meena Bansal, MD, Professor of Medicine Mt. Sinai, photo courtesy of Mt. Sinai Jawad Ahmad, MD, is a professor of liver diseases at the Mount Sinai School of Medicine. He is co Primary Investigator on the NIH/NIDDK research initiative to study cases of severe liver injury caused by prescription drugs, over-the-counter drugs, and alternative medicines, such as herbal products and supplements. For more information on the Drug-Induced Liver Injury Network (DILIN) visit: https://researchfunding.duke.edu/drug-induced-liver-injury-network-dilin-clinical-centers-u01-clinical-trial-optional Jawad Ahmad, MD, Professor of Medicine at Mount Sinai, photo courtesy of Mt. Sinai Listen to the Podcast: The podcast of this program will be available Monday, May 5, 2025, after broadcast on May 3. 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.

This week, a renowned neurosurgeon shares what he has learned in decades of working to restore ailing brains. His new book covers a vast range of neuroscience. Our dilemma was what to pay attention to in all those options. In a sense, that is always the human situation. We are capable of conscious processing of approximately 200 bits per second (bps) of information. Our unconscious brain deals with as much as 11 million bps. You could listen through your local public radio station or get the live stream Saturday, April 26, 2025, at 7 am EDT on your computer or smart phone (wvtf.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 April 28, 2025. The Power of the Unconscious Brain: Our senses feed us a tremendous amount of information all the time, but we don’t have the bandwidth to pay attention to more than a small fraction of it. That’s where the unconscious brain is so valuable, juggling millions of bits of information while we focus our conscious attention on what seems important. One surprising outcome of the research on how our brains function is a re-assessment of what is going on when people are unconscious. For centuries, doctors thought there was really no brain activity while a person was comatose. Then, a few decades ago, a scientist was recording the brain waves of a patient in a coma. The activity was very peculiar, as if the person were watching a ball being lobbed back and forth across a tennis court. In actuality, a television set in the room was broadcasting a world championship match between Roger Federer and Rafael Nadal. The neuroscientist recognized that this individual was following the match and was not nearly as deeply unconscious as had been thought. Further research showed that this kind of unconscious brain activity is not uncommon. It may hold keys to determining who has the best potential for recovering from their coma. Freud and the Unconscious Brain: If you hear the term the unconscious mind, you may think of Sigmund Freud. He really popularized the concept that some very important brain activity takes place outside of our conscious awareness. It still has a powerful influence on our behavior. By the way, if we recognize that our conscious attention is indeed a limited resource (200 bps, remember), we won’t try to multitask. Humans actually aren’t very good at multitasking; instead, we switch our attention from one thing to another. Some people can do that fairly easily, but for most of us, it is less effective than staying focused. Three Stages of Brain Development: Evolution likes to build on what it’s already got in place, so it shouldn’t surprise us that we can track three different evolutionary stages to our human brains. The reptilian brain came first, of course, and is there as a base, operating mostly on reflex. It’s definitely an important part of the unconscious brain. The mammalian brain brings in emotions. The hormone oxytocin is relevant for this discussion. It is critical for birthing and nursing young. As it turns out, oxytocin can also be put to other uses, such as bonding mates together and creating friends. Finally, we have the primate part of our brain. We humans, like other primates, can exercise empathy because our mirror neurons allow us to relate to another creature’s experience. In fact, mirror neurons were discovered by scientists studying macaques and eating gelato. Listen for a great story! Speaking of empathy, we wondered about empathy fatigue. We started hearing about empathy fatigue during the COVID pandemic, when healthcare providers were overwhelmed by extreme demands with inadequate support. Research shows that “constant, repetitive exposure to the pain of others leads to empathy fatigue.” Lack of empathy can lead people to do terrible things. Wonders of the Unconscious Brain: Our brains are full of clocks. To some extent, these are shaped by how we use them. Musicians who play percussion instruments can perceive time differences of just a few hundredths of a second. All of us are entrained to a 24-hour a day cycle, whether we observe sunrise and sunset or not. But if we are deprived of connection with that cycle, our internal clocks can’t keep good time, and our brains may get far off track. What About Premonitions? Some people think premonitions are a fantasy. Yet this is another area where our unconscious brain may be more capable than we imagine. Dr. Hamilton describes an experience in the Swiss Alps where he and his wife had a choice of which path to take down from the summit. One appeared to be a shortcut, and they did have some time constraints. But as soon as they had taken a few steps that direction, he had a premonition of something terrible. They took the other path and learned later that there had been a landslide on the shortcut that would have swept them helplessly down the mountain. According to Dr. Hamilton, some people have the ability to influence the output of random number generators. Those of us who can’t may wish to reject that idea, but it has been documented. The Princeton Engineering Anomalies Research lab has run many studies demonstrating an impact on random number generations, not to mention remote viewing. In this way, some of the hidden power of the unconscious brain appear as cerebral entanglements, analogous to quantum entanglements at the sub-atomic level of matter. This Week’s Guest: Dr. Allan Hamilton, MD, FACS, is a neurosurgeon who has specialized in treating brain tumors. His extraordinary journey from janitor to Harvard-trained neurosurgeon is just the beginning of his remarkable story. A decorated Army veteran, he now holds four professorships at the University of Arizona and has been recognized as “One of the Leading Intellects of the Twenty-First Century.” As the only American honored with the Lars Leksell Award for pioneering scientific discovery in stereotactic neurosurgery, Dr. Hamilton’s groundbreaking work has revolutionized the field. He has had a life-long interest in the application of computer technologies to enhance surgical care and reduce avoidable medical adverse events. In addition, he has served on two White House Advisory Committees under two presidential administrations. Allan Hamilton, MD, FACS His expertise extends beyond medicine, having studied creative writing under Rod Serling and serving as a senior medical consultant for Grey’s Anatomy for nearly two decades. Dr. Hamilton’s seven non-fiction books have garnered numerous awards and international translations, offering insights that have inspired leaders across various fields. Dr. Hamilton’s 7th non-fiction book is Cerebral Entanglements: How the Brain Shapes Our Public and Private Lives. 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). Listen to the Podcast: The podcast of this program will be available Monday, April 28, 2025, after broadcast on April 26. 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 engaging conversation with Dr. Mark Hyman, a leading functional medicine expert, listeners learn how to measure biological age versus chronological age. He shares vital insights on nutrition, advocating for the Mediterranean diet and its role in preventing chronic diseases. Hyman discusses the transformative power of functional medicine, emphasizing the need to address root causes of health issues. Practical tips on dietary strategies, including the importance of a nutritious breakfast and innovative recipes, make health both achievable and delicious.

David Nichols, an authority on hallucinogens from UNC Chapel Hill, and Matthew Johnson, a psychiatric researcher at Johns Hopkins, discuss the evolving landscape of psychedelic therapy. They explore how psychedelics like LSD, traditionally stigmatized, are now being researched for mental health treatment, including addiction and cancer-related distress. Notably, they highlight a modified LSD that lacks hallucinogenic effects but may enhance neuroplasticity. Their insights shed light on the potential revolution in mental health care through these once-taboo substances.

David Kaylie, a neuro-otologist at Duke Health, dives into the intricacies of dizziness and balance disorders. He explains the differences between vertigo and lightheadedness, exploring conditions like Menière disease and BPPV. Listeners learn about potential treatment options, including the Epley Maneuver and beta histine for Menière's. Personal stories from callers enrich the discussion, emphasizing the impact of these conditions on daily life. Kaylie also shares insights on managing symptoms and navigating communication with healthcare providers.

This week, two pharmacists describe why you should check with a pharmacist about possible problems when you combine supplements, herbs and medicines. In some cases, a supplement might interfere with your prescription drug. In other situations, an herb might slow metabolism of the medicine and increase the possibility of side effects. It’s better to know which pills don’t get along well. 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 April 7, 2025. Getting Information on Supplements & Herbs: When you have a question about supplements or herbs, you probably go to the web for answers. But while there is plenty of information out there, not all of it is reliable. We start this episode by talking with a pharmacist who does research for one of the sites we use as a favorite resource, Examine.com. The site has long provided information on what a product is supposed to do and how well it might do that thing. It also offers information on dosing and on quality. For example, if you look up turmeric, you’ll learn that Meriva and BCM95 are standardized extracts that have been used in a number of randomized controlled trials. Now, Examine is going beyond efficacy and looking at safety. Because there is less information available about safety, even for medications, this has been more challenging. We especially appreciate that the summaries are succinct and easy to understand and that the statements are supported by peer-reviewed research. Checking Examine.com is a good place to start learning about potential incompatibilities among supplements, herbs and medicines you are taking. What Does Grapefruit Have to Do with It? We recognize that grapefruit is not an herb or a supplement. It is certainly not a medication, although it is a great source of vitamin C and regular consumption of grapefruit can help control cholesterol (Metabolism, July 2012).  Nonetheless, it is important to our topic, because scientists discovered a potent interaction between grapefruit juice and certain prescription drug many decades ago (Lancet, Feb. 2, 1991). Although grapefruit inhibits the CYP3A4 enzyme that metabolizes many medicines, it is not the only plant product that can affect them. This was a wake-up call for us and for many health professionals to pay attention to interactions among supplements, herbs and medicines. Like grapefruit, both ginger and berberine inhibit CYP3A4. St. John’s wort, on the other hand, induces the enzyme, which means that the target medication may be less effective. If it is an oral contraceptive or a drug to prevent transplant rejection, you need to know that! How Pharmacists Can Help: Pharmacists stand ready to help people review their supplements, herbs and medicines to see if there are potential interactions, redundancies, adverse reactions or other problems. Technically, everyone on Medicare is entitled to a comprehensive medication review annually. Some pharmacists like to conduct that as a “brown bag review,” in which the patient brings in everything they are taking–OTC med, prescription drugs, herbs, vitamins and other dietary supplements–so the pharmacist gets a complete picture. Sometimes, it may even be helpful to talk about food and drink. We already mentioned grapefruit. During this interview, we also bring up research showing that hibiscus tea (which can lower blood pressure) could interact with the cholesterol-lowering drug simvastatin (Journal of Clinical Pharmacy and Therapeutics, Dec. 2017).  Hibiscus tea itself lowers cholesterol well. However, it interacts with simvastatin and reduces the drug’s effectiveness. The authors of the study advise against co-administration. This Week’s Guests: Katie Jantz, MS, RPh is a researcher on the staff for Examine.com. Katie Jantz, MS, RPh Stefanie Ferreri, PharmD, is the Henry L. Smith and James L. Olsen, Ph.D., Distinguished Professor in Pharmacy Practice. She has served as the Chair of the Division of Practice Advancement and Clinical Education at the UNC Eshelman School of Pharmacy. Her main research interests include advancing clinical practice in the community-pharmacy setting.
https://pharmacy.unc.edu/directory/ferreri/ Stefanie Ferreri, PharmD Listen to the Podcast: The podcast of this program will be available Monday, April 7, 2025, after broadcast on April 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.