The People's Pharmacy

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.

This week, we talk with a pulmonologist–a doctor who takes care of people with lung problems. Our topics range from common respiratory infections to the hazards of breathing smoke from forest fires. We also discuss asthma and COPD. Listen to find out how you could be breathing better. 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 March 31, 2025. Breathing Better Despite Infections: We are finally emerging from an especially severe flu season. After a few years during and right after the pandemic in which there was relatively little influenza, this year was challenging. Preliminary data from the CDC suggest that between 40 million and 75 million Americans suffered from influenza or flu-like illnesses between October and March. As many as 1.2 million had to be hospitalized. The influenza viruses (there are many) are not the only pathogens that can cause coughing, fever or trouble breathing. Many others might also result in upper respiratory infections that can progress to bronchitis or lower respiratory infections and lead to wheezing or shortness of breath. A bad cold will do that for some people. Human metapneumovirus is not widely recognized and is difficult to pronounce. The infection with this virus starts like a bad cold but it produces a terrible cough that can last for weeks. How can doctors help a patient with a respiratory infection? If the problem is influenza, they could prescribe a medicine such as oseltamivir (Tamiflu) or baloxavir (Xofluza). These medicines can shorten the duration of flu symptoms and possibly make them less severe. However, they work best when taken as soon as possible (within 48 hours) of the first symptoms appearing. To learn whether that sore throat and sniffle is leading to flu, you might want to keep a test handy at home. There are several on the market that can determine if you have COVID-19 or influenza A. Then, if you have access to a patient portal, use it to communicate the results to your healthcare provider and get a prompt prescription. What About a Cold? While flu or COVID can be serious, colds are far more common. Doctors do not have much in their tool kits to help you recover from a cold, but there are a few things you can do for yourself. Spending some time in sunlight can be very useful. Dr. Seheult suspects that the benefits go beyond the amount of vitamin D you might make through that exposure. In addition, we have seen studies supporting the use of vitamin C supplements to recover from a cold more quickly. Breathing Better with Improved Ventilation: During the pandemic, air quality and ventilation got more attention than ever before. Now, although we may be less concerned about airborne pathogens, we still need to pay attention to air quality. Forest fires, whether in California, the Carolinas or any other part of the continent, can put out a lot of smoke. Wildfire smoke carries small particles that can penetrate deep in the lungs and do a lot of damage. Air conditioning may help clean indoor air. So can an inexpensive do-it-yourself air filtering system called a Corsi-Rosenthal box. Here is a link to the show in which we describe how to make one at home. Struggling to Exhale: Dr. Seheult also describes the Global Initiative for Asthma, or GINA.  Asthma is reversible airway inflammation. Sometimes this is caused by allergic reactions. Infections may also cause inflammation and lead to asthma exacerbations. In the presence of inflammation, the smooth muscle around the little airways deep in the lungs constrict. This makes it difficult to exhale and make room for the next fresh new breath. The problem is similar in chronic obstructive pulmonary disease (COPD), in that inflammation tightens those critical small airways and interferes with exhalation. That in turn can keep the patient from being able to take a good breath in. In COPD, however, the inflammation is irreversible. Both asthma and COPD may respond to drugs that activate beta receptors (“beta agonists”). The long-acting beta agonists (LABAs) are especially prominent. Inhaled steroids can calm the inflammation in both conditions so people can start breathing better. In some instances, an antibiotic like azithromycin can reduce exacerbations. We don’t know whether it is working by fighting off hidden pathogens, or whether it is also reducing inflammation. In COPD, anticholinergic drugs may be able to relax airways even beyond the effects of the beta agonists. If calming inflammation is not good enough, people may need a rescue inhaler. When Should You Get Emergency Attention? People experiencing shortness of breath, especially if they are also having fevers, chills or night sweats, should get medical attention promptly. This Week’s Guest: Dr. Roger Seheult is an Associate Clinical Professor at the University of California, Riverside School of Medicine, and an Assistant Clinical Professor at the School of Medicine and Allied Health at Loma Linda University. Dr. Seheult is quadruple board-certified in Internal Medicine, Pulmonary Diseases, Critical Care Medicine, and Sleep Medicine through the American Board of Internal Medicine. HIs current practice is in Beaumont, California where he is a critical care physician, pulmonologist, and sleep physician at Optum California. He lectures routinely across the country at conferences and for medical, PA, and RT societies, is the director of a sleep lab, and is the Medical Director for the Crafton Hills College Respiratory Care Program. Roger Seheult, MD, MedCram, Loma Linda, UC-Riverside MedCram In 2012 he and Kyle Allred founded MedCram L.L.C., a medical education company with CME-accredited videos that are utilized by hospitals, medical schools, and hundreds of thousands of medical professionals from all over the world (and over 1 million YouTube Subscribers). His passion is “demystifying” medical concepts and offering people the tools for staying healthy. We have found Dr. Seheult’s MedCram videos amazing. He makes many complex medical topics understandable. This is a skill that few of Joe’s professors in the University of Michigan’s Department of Pharmacology could claim. Dr. Seheult was the recipient of the 2021 San Bernardino County Medical Society’s William L. Cover MD Award for Outstanding Contribution to Medicine and the 2022 UnitedHealth Group’s The Sages of Clinical Service Award. In 2022 both Roger Seheult and Kyle Allred received the HRH Prince Salmon bin Hamad Al Khalifa Medical Merit Medal from the Kingdom of Bahrain for their contribution to health policy in the Kingdom of Bahrain. Listen to the Podcast: The podcast of this program will be available Monday, March 31, 2025, after broadcast on March 29. You can stream the show from this site and download the podcast for free. In addition to what you hear on the broadcast, the podcast also contains information about TRP channels and home remedies for coughs. We also discuss the heart drug amiodarone and its effects on the lung, along with the nature of interstitial lung disease and how to treat it. You’ll also learn about the pros and cons of OTC inhalers. Can they get you breathing better? Download the mp3.

This week, Dr. Jane Andersen joins Joe and Terry in the studio to answer listeners’ questions about foot problems. Do you have bunions or plantar fasciitis? Dr. Andersen has tips on how to fix your foot pain. We invite you to call and tell us about it. You can call 888-472-3366 between 7 and 8 am EDT. Or email us: radio@PeoplesPharmacy.com. You could listen through your local public radio station or get the live stream at 7 am EST 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 March 24, 2025. How Can You Fix Your Foot Pain? If your feet don’t feel good, you won’t either. Just imagine stubbing your toe. Ouch, that hurt! But stubbed toes generally recover fairly quickly. Some other common foot problems are likely to cause more long-lasting pain. Some of these may result from participation in sports, such as sprained ankles or stress fractures. What is the best way to handle these injuries so they won’t cause persistent problems? Preventing Foot Pain: Are your feet flat? Find out what exercises may help and which shoes you should choose to fix your foot pain from flat feet. Heel pain is another common problem. Inflammation of the Achilles tendon is one possible cause. Perhaps more often, plantar fasciitis triggers heel pain. That is an inflammation of the tissue connecting the heel and the ball of the foot, and special stretches can often help. If you have wondered about heel spurs or neuromas, tell us what you would like to know. Restoring feet to good health can cover a lot of different areas. Toes and Toenails: How about toes? Find out what to do about hammertoes, mallet toes or claw toes, as well as bunions. Are you worried about gout? It may affect the toes first, before causing pain in other parts of the body. With warmer weather on the way, you may be interested in learning how to prevent athletes foot or eliminate toenail fungus. Do you have corns or calluses on your feet? What is the difference between them, and do the treatments differ? The questions listeners ask drive the topics we discuss in this show. You can email questions ahead of time to: radio@peoplespharmacy.com. This Week’s Guest: Dr. Jane Andersen, Board Certified, American Board of Foot and Ankle Surgery, is in practice at Chapel Hill Foot and Ankle, part of FASMA, Foot and Ankle specialists of the Mid Atlantic, in Chapel Hill, North Carolina. Dr. Andersen specializes in Foot and ankle care for Children, Adults, Athletes and Geriatric Patients including surgery and conservative care. She is a Trustee of the American Podiatric Medical Association. January 18, 2025, Jane Andersen, DPM, was awarded the Edwin B. Martin, Jr., Award for Podiatrist of the Year. Dr. Jane Andersen can help you manage your foot problems. Listen to the Podcast: The podcast of this program will be available Monday, March 24, 2025, after broadcast on March 22. You can stream the show from this site and download the podcast for free. Download the mp3.

This week, our guests take two different approaches to the sense of smell. We talk with a surgeon who treats people having difficulties with that sense. In addition, a nurse describes utilizing the sense of smell for aromatherapy in integrative healing. Learn about the fascinating science of smell. 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 March 17, 2025. The Science of Smell: Of all our senses, the sense of smell often gets short shrift. Aside from Marcel Proust’s evocative description of the link between odor and memory, we don’t think much about smell. Scientists have discovered, however, that much of our social interaction relies on olfaction at a subconscious level. It plays a largely unconscious role in our choice of mates as well as in the timing of sexual activity. It is also important for the bonding between mothers and their infants. Consequently, the sense of smell is crucial for the survival of our species, even when we aren’t paying attention. Losing our sense of smell can be devastating, as too many people learned by experience during the COVID-19 pandemic. Not only did they miss out on pleasant aromas like fresh-brewed coffee or newly mown grass, but they also were at a disadvantage in detecting if there might be gas leaking in the kitchen or a fire smoldering somewhere in the house. Although some of those who lost their sense of smell during an acute infection subsequently regained it, others did not. Too many people are still suffering from anosmia. Is there anything that can be done to help them? Regenerating Nerves in the Nose: Many viruses can cause inflammation in nasal tissue and potentially damage the sense of smell. During COVID-19, the SARS-CoV-2 virus attacked ACE receptors on cells in the olfactory epithelium of the nose. These cells are not the nerve cells themselves, but support cells (called, if you must know, sustentacular cells). Fortunately, these cells can regenerate, although it takes time. The Science of Smell Recovery–Olfactory Training: The first step in recovering the sense of smell is olfactory training. It could be considered something like physical therapy for the nose. In this structured smelling protocol, people are exposed to one of four distinctive aromas from essential oils: lemon, rose, eucalyptus or clove. As they attempt to discern the scent, they remember how they used to experience those odors. As part of the protocol, they also irrigate their nasal passages with high-dose steroids in saline solution (International Forum of Allergy & Rhinology, Sep. 2018).  Over many months, this concerted effort is able to help 30 to 50 percent of patients recover their sense of smell to a satisfactory degree. The Science of Smell Recovery–Platelet-Rich Plasma: To help people who are not successful enough with olfactory training, Dr. Zara Patel has pioneered the use of platelet-rich plasma. PRP injections have been used to help athletes recover from injury. Since it can be helpful in situations where inflammation is high, she tried PRP injections for people with difficulty smelling. A randomized controlled trial showed that the injection is safe and may be effective in helping people recover their sense of smell after COVID-19 (International Forum of Allergy & Rhinology, June 2023).  She hopes to conduct a larger study that would be more conclusive. Harnessing the Sense of Smell with Aromatherapy: Dr. Patel was careful to point out the distinction between olfactory training, based on the science of smell, and aromatherapy. Our other guest, an integrative care nurse, utilizes aromatherapy to help people in post-anesthesia care units. There is some evidence, for example, that the aroma of lavender essential oil can help anxious patients relax and get to sleep, but better studies are necessary (Phytomedicine, Dec. 2019). Plants use the volatile compounds in their essential oils for communication. In addition, some terpenes in juniper or pine have antiviral activity, while components in clary sage or bergamot have antifungal properties. Nurses in some cancer hospitals utilize aromatherapy to help patients overcome nausea and pain associated with chemotherapy. This is an area of the science of smell in which our guest Kathy Fritze has special expertise. This Week’s Guests: Zara M. Patel, MD, is Professor of Otolaryngology-Head and Neck Surgery at the Stanford School of Medicine. Her website is https://profiles.stanford.edu/zara-patel Zara Patel, MD, Stanford School of Medicine Kathy Fritze, RN, BSN, is a holistic and integrative care nurse in the Wellness & Support Center at the University of Maryland St. Joseph Medical Center. Kathryn Fritze RN, BSN Listen to the Podcast: The podcast of this program will be available Monday, March 17, 2025, after broadcast on March 15. You can stream the show from this site and download the podcast for free. In addition to what you heard in the broadcast, the podcast includes additional information on why people sometimes detect strange odors that others don’t perceive. We also discuss people who have strong reactions to odors in perfume or detergent, such that they become physically ill when they smell them. Download the mp3.

This week, we get in-depth information on Lp(a), the heart risk no one talks about. You have heard of cholesterol, and you may even know what your cholesterol level is. The compound lipoprotein a may be equally dangerous when it is elevated, but you have probably heard very little about it. 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 March 10, 2025. What Is Lp(a)? Lipoprotein a, or L-P-little a for short, circulates in the bloodstream, where it picks up and carries cholesterol and oxidized phospholipids. Scientists believe that blood levels are determined mostly by genetics and change very little over the course of our lives. Roughly 20 percent of people have high levels of Lp(a), above 30 ng/dL or 75 nmol/L. The two different figures are because tests use different units to measure the blood concentration, either nanograms per deciliter or nanomols per liter. While we don’t know if Lp(a) has or perhaps once had some important functions, we do know that elevated levels of this chemical is associated with heart disease. People with higher levels are more likely to suffer blood clots and inflammation. That puts them at risk for heart attacks or even strokes. So why hasn’t your doctor ordered a blood test to learn your level? Is Lp(a) the Heart Risk Doctors Can’t Treat? Perhaps doctors have been reluctant to measure or discuss lipoprotein a because they don’t have good interventions. That is beginning to change with the development of antisense oligonucleotides, a new category of prescription drugs that can cut levels sharply. The FDA has not yet approved any of these new medications, though. The first of these, pelacarsen, is still in Phase 3 trials needed before the agency can consider the evidence. However, it can bring down lipoprotein a by an estimated 80 percent. Cardiologists’ favorite drugs, statins, do not help Lp(a) levels. In fact, Lp(a) the heart risk rises when people are taking statins to lower their cholesterol. Other cholesterol-lowering drugs such as evolocumab (Repatha) and alirocumab (Praluent) can bring Lp(a) levels down modestly. One really old cholesterol-lowering drug, high-dose niacin, also helps moderate Lp(a). Some people do not tolerate it, however, as it can cause very uncomfortable flushing. So far as we know, no scientists have run studies to see whether niacin reduces the risk of heart attacks and other complications because of its effects on Lp(a). Other Complications of Lp(a): Our guest, Dr. Sam Tsimikas, is among the country’s leading experts on lipoprotein a. We asked him whether Lp(a) the heart risk factor causes other problems as well. Dr. Tsimikas described heart failure, potentially resulting from a heart attack, as well as peripheral artery disease (PAD), which can make it painful to walk. Lp(a) seems to cause plaque in arteries throughout the body. As a result, it can increase the chance of a stroke. In addition, it contributes to calcification of the heart valves. This condition interferes with their ability to function properly. What Can We Do If Lp(a) Is Too High? Dr. Tsimikas runs a unique clinic for cardiology patients with high levels of Lp(a). We asked him how he helps them. One approach is to collect additional information about their level of risk. A coronary calcium score can be a useful indicator. If it is high, he and his patients work to control all the potential risk factors that they can. He discusses the potential benefit of aspirin with them. Because Lp(a) the heart risk factor increases the chance of dangerous blood clots, the anti-clotting activity of aspirin can sometimes be helpful. Offering dietary advice can be tricky if a patient has high cholesterol as well as elevated Lp(a), since the ideal diets for each are nearly opposite each other. A ketogenic diet tends to raise LDL cholesterol, for example, while it may modestly lower Lp(a). We think by the end of this episode, you’ll join us in hoping that scientists can learn a lot more about Lp(a) in the next few years. This Week’s Guest: Sotirios (Sam) Tsimikas, MD, FACC, FAHA, FSCAI, is Professor of Medicine/Cardiology and Director of Vascular Medicine at the Sulpizio Cardiovascular Center. That is part of the Division of Cardiovascular Medicine at the University of California, San Diego. His website is https://profiles.ucsd.edu/sotirios.tsimikas Sotirios (Sam) Tsimikas, MD, FACC, FAHA, FSCAI, UCSD Listen to the Podcast: The podcast of this program will be available Monday, March 10, 2025, after broadcast on March 8. You can stream the show from this site and download the podcast for free. In addition to what you heard in the broadcast, the podcast includes additional information on calcium scores and the benefits and risks of statins to lower cholesterol. Download the mp3.

This week, we dig into the cooking oil controversy. For decades, we’ve heard that we should be using vegetable oils rather than butter, lard or other fats (possibly even olive oil). Oils from corn, soybeans, sunflower or safflower seeds are rich in polyunsaturated fatty acids. Consequently, people consuming them may have lower cholesterol levels than those primarily using saturated fats. But could there be a downside? We hear from scientists who have found these seed oils may be linked to certain cancers. 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 March 3, 2025. The Cooking Oil Controversy: The more we learn about fats, the more it seems that focusing on just one aspect may be too simplistic. In the 1990s, health experts told Americans to avoid all fat. When it became clear that low-fat diets were not necessarily making everyone healthy, we got the message that we needed to stick with polyunsaturated fatty acids (PUFAs) like those in corn or canola oil. There are, however, different types of PUFA. Chemists classify them as omega-3, omega-6 and omega-9 fatty acids. Only omega-3 and omega-6 are considered essential fatty acids. Current cooking oils have a preponderance of omega-6 fatty acids. As a result, the ratio of omega-6 to omega-3 in our blood has risen from a pre-industrial average of an estimated 4:1 to our current ratios of 20:1 (Missouri Medicine, Sep-Oct. 2021).  This could have biological consequences. Dietary Fat and Cancer: Dr. William Aronson has asked how different types of dietary fat affect the progression of prostate cancer. Laboratory studies show that a diet high in corn oil accelerates the growth of human prostate cancer tumors implanted under the skin of mice. That inspired him and his colleagues to conduct a randomized controlled trial (Journal of Clinical Oncology, Dec. 13, 2024). Fish Oil vs. Prostate Cancer: For their trial, they recruited 100 men diagnosed with prostate cancer who opted for active surveillance rather than immediate surgery or radiation. They assigned these volunteers to different diets for one year. One group followed their usual diet and did not take fish oil. The researchers instructed the other group in avoiding omega-6 fats in their diet, increasing the amount of omega-3 rich fish and taking fish oil supplements. Minimizing omega-6 fats meant staying away from fried foods, cooking oils, bottled salad dressing and mayonnaise. At the end of the year, there was a significant difference in an important prostate cancer biomarker called Ki-67. Does the Cooking Oil Controversy Extend to Other Cancers? We spoke with Dr. Timothy Yeatman about his research on colorectal tumors. His research was published in Gut, a leading journal for gastroenterologists (Dec. 20, 2024). He and his colleagues used a technique called lipidomics for their analysis. They found that the lipid profile of the tumors and their micro-environments is pro-inflammatory. They seem to lack the resolving mediators (“resolvins”) that should normally accompany healing. The balance has been disrupted. Dr. Yeatman suspects that some of this disruption may be due to changes in the microbiome that constitutes a lot of the immediate environment for colorectal tumors. He suggests that extensive use of seed oils high in pro-inflammatory omega-6 fatty acids may contribute to the imbalance. You can find soybean oil, for example, in many foods where you might not expect it, such as breads, cakes, cookies, crackers, chips and even hummus. Cooking at home allows people to avoid seed oils, but it takes time, skills and resources that are not available to everyone. Can We Resolve the Cooking Oil Controversy? Neither of the studies we discuss during this episode is definitive. Scientists need more research to be able to make solidly evidence-based recommendations. However, both our guests would suggest we need not wait for the final word to reduce the inflammatory potential of our diets. Reading labels carefully is a good first step to avoiding some of the seed oils that provide excess omega-6 fats and gravitate more toward omega-3 fats. This Week’s Guests: William Aronson, MD, is Professor in the Department of Urology of the David Geffen School of Medicine at the University of California, Los Angeles. He is also Chief of Urologic Oncology at the West Los Angeles Veterans Affairs Medical Center and Chief of Urology at the Olive View-UCLA Medical Center. Dr. William Aronson, UCLA Timothy Yeatman, MD, FACS, is Professor in the Dept of Surgery at the University of South Florida. He is also Associate Center Director for Translational Science and Innovation Tampa General Hospital Cancer Institute. His website is https://phenomehealth.org/c-suite/tim-yeatman-md-facs Timothy Yeatman, MD, University of South Florida Debora Melo vanLent, PhD, is Assistant Professor at the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health in San Antonio, TX. Her interview is part of the podcast. Listen to the Podcast: The podcast of this program will be available Monday, March 3, 2025, after broadcast on March 1. You can stream the show from this site and download the podcast for free. In addition to what you heard in the broadcast, the podcast also includes our discussion with Dr. Melo vanLent on her research into the link between dietary inflammation and dementia. Download the mp3.

This week, Terry and Joe welcome Dr. Andrew Spector to the studio to share his expertise with listeners. Restless legs syndrome (RLS) is a relatively common problem that can really wreak havoc on a good night’s sleep. Have you experienced this problem? How do you manage it? We invite you to call and tell us about it. You can call 888-472-3366 between 7 and 8 am EST. Or email us: radio@PeoplesPharmacy.com. You could listen through your local public radio station or get the live stream at 7 am EST 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 February 24, 2025. What Is Restless Legs Syndrome? This neurological condition is not new. The first description appeared late in the 17th century. However, it wasn’t until fairly recently that doctors started studying this problem so they could offer effective treatments. Usually RLS starts with an uncomfortable feeling in the legs that is relieved only by moving them. Sometimes people report a sensation similar to ants crawling on them. Others describe legs that throb or itch. Occasionally, the sensation will affect another body part, though legs pose the most common problem by far. The symptoms are noticeable when a person is resting, especially at the end of the day. However, sitting still for a long plane ride can also be very uncomfortable. Do You Have Restless Legs Syndrome? Dr. Spector will describe how he diagnoses RLS as well as other conditions that may sometimes make a diagnosis more confusing. Restless legs are not usually painful, so pain that keeps a person awake might be due to neuropathy. Another condition that often bothers a bed partner more than the patient is periodic limb movements of sleep. The name is descriptive, and because the person doesn’t wake up and isn’t troubled by unpleasant sensations, it is different from restless legs. What Can You Do About RLS? According to Dr. Spector, research points to low iron in the brain as a common contributor to RLS. Consequently, iron supplements could often be helpful. He’ll describe the testing that a doctor would use to determine the appropriate protocol for boosting iron. Medications That Make RLS Worse: If you have RLS, you may have considered taking an over-the-counter sleep aid containing diphenhydramine. Many listeners have told us that these medicines seem to make the RLS symptoms worse. Can You Manage RLS Without Drugs? We have heard from many people who have developed non-drug approaches that help them overcome their restless legs. They may avoid sugar or caffeine, which can sometimes trigger a bout of RLS. Avoiding nicotine and alcohol may also be useful. Magnesium or selenium supplements help certain individuals. Some listeners put a bar of soap under the bottom sheet near their legs and find that their symptoms are less troublesome. This home remedy is even more popular as a way to ward off nocturnal leg cramps. We have also heard from sufferers who have sought out acupuncture and found it effective. Maintaining a moderate level of exercise benefits many people with RLS. Treating RLS: In the past few decades, the FDA has approved several prescription drugs that can ease the symptoms of restless legs syndrome. It started with ropinirole (Requip), a drug that was originally developed to treat Parkinson disease. It is effective for RLS, although it has side effects that may limit its usefulness for some people. Other drugs in the same category are pramipexole (Mirapex) and rotigotine (Neupro). If a patient cannot tolerate one of these medicines, or if the doctor decides they are not appropriate, there are other options. Doctors may prescribe a medicine such as gabapentin enacarbil (Horizant). Other drugs in this category include gabapentin or pregabalin. Although the FDA has not approved them specifically for RLS, doctors sometimes find them helpful. They frequently cost less than Horizant. Opioids and benzodiazepines offer additional prescription options. If you have experience with any of these medicines, we’d love to hear about it. This Week’s Guest: Andrew Spector, MD,is an Associate Professor in the Department of Neurology at the Duke University School of Medicine. Along with his clinical practice in sleep medicine, he serves as the Program Director of the Sleep Medicine Fellowship, the Duke Athletics Sleep Optimization Consultant, and the Vice Chair for Professionalism, Inclusion, Diversity, and Empowerment. Dr. Spector is the author of Navigating Life with Restless Legs Syndrome.  His website is http://www.andrewspectormd.com Andrew Spector, MD, Duke University Department of Neurology 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, February 24, 2025, after broadcast on Feb. 22. You can stream the show from this site and download the podcast for free. Download the mp3.