Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Is Leg-Length Discrepancy Genetic?

Episode Date: February 28, 2023

It's another Sawbones: Medical Questions, and we're gonna go full Galaxy Brain on these listener-submitted queries. What is methalated B-12? Can my appendix grow back and give me appendicitis ad infinitum? Does sugar help tongue burns or is it just tasty? And most importantly, how do I tell my friend to stop listening to TikTok for medical advice?Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk to you about some books. One, two, one, two, three, four. We came across a pharmacy with a door and that's lost it out. We pushed on through the broken glass and had ourselves a look around.

The medicines, the medicines that escalate my cop for the mouth. Wow. Hello, everybody, and welcome to Saul Bones, a marital tour of Miss Guy and Medicine. I'm a co-host Justin McRoy. I'm Sydney McRoy. Oh, my God. Oh, my God. I don't. I don't.

You had to resolve the melody. I know, but I chose not to. And that was really up to me. That is your choice. That is your choice. You didn't ask me if I wanted our intro to be a song. You could tell from my eyes though. Couldn't you? No, you could tell from my eye. I mean, I could tell from the way that you

you just like made it a song. Like you just went right into it. Yeah. I mean, from the singing you guitar wanted to sing. You mean, yes, correct. I got you started singing. So I assumed that your heart was overflowing with song. Why are we in such a spill that of your mouth? Why are we in such a, that's how all singing works. Why are we in such a joyous mood? Well, friends, it's one of our funnest episodes that we get to do. Or most fun.

This is untenable. This tenor is untenable. It's an untenable tenor. I can't. It's an untenable tenor. It was 80 degrees yesterday, Justin. That was so good for my mood. Full summer, they call it, Sinea. Full spring.

Then it was 37 this morning. I know, it's unthinkable. Okay. Okay, well, that's the price you pay for living in a place that's four seasons. I don't think it's that simple. You think there's other complicating factors? I think there might be. Impossible to say.

No, it's possible to say, and to predict, and to address. But we're not doing a podcast about climate change right now. No, we're doing a podcast about your medical questions. Here's your first one. Are you ready to expand your mind, say, go full galaxy brain on all these and answer them? Okay, I will do my best. I will do my best.

Hello, Sydney and Justin. Hello. Hi. I have a weird medical question for you. There's been a lot of coverage lately about lots of popular chocolate brands having high levels of lead and cadmium in them. I ate a lot of chocolate and now I'm worried I'm going to get lead poisoning. Is there a way to test to find out if I have lead or cadmium and high

levels? I've heard there's this thing called chelation therapy for getting heavy metals out of the body. Does everyone want the sweet tooth? Need to go get this now. Thanks Katie. forgetting heavy metals out of the body. Does everyone want the sweet tooth need to go get this now? Thanks, Katie. You know what? This is one of those questions where I thought, oh, I bet there was a news report that sort of sensationalized some sort of study and the study was taken out of context and extrapolated to an extent that it really wasn't, you know, that like the conclusions of the media maybe outpaced the conclusions of the authors. That's usually the case, right, with a lot of this stuff. And then I went and read the study and some of the reviews and some of the like thoughts about it. And there is some truth here. So they- I wish you all had been next to City on the couch and see your true story.

So I just heard a series of like increasingly distressed. of like increasingly distressed. Mm, mm. Mm. Yeah. I like dark chocolate a lot, and I wouldn't say I'm a very regular. I don't have as much of a sweet tooth. The salty is my problem, not sweet. But not a problem, you preference.

You're right. You're right. The salty is the thing that I will just keep eating, because I love it so much. I can, you know, the sweet, I don't always crave. So anyway, there is, there was a study that was done, I think originally released in December of last year and then there've been some more articles written

about it in the last couple months. So this is pretty recent stuff that showed specifically dark chocolate had higher than what we consider preferable levels of cadmium and lead. I try not to think too much about the fact that there are totally copacetic levels of cadmium and lead. Well, there aren't with lead.

That's part of the thing. No, let us. Like how much lead is okay? Well, none. No, let's think. So I mean part of it is like we don't want you exposed to that, but I mean, because they're like they're heavy metals. And obviously if they accumulate in levels that are high enough, they can cause you health problems. They can they can make sick. So the the process by which it gets into the chocolate is different

for each one. Cadmium is being absorbed into the beans from the soil, so this probably has more to do with overall pollution that cadmium is seeping into the cocoa. The lead is actually probably a little easier to troubleshoot. What they found is that lead was on the outside of the beans and probably was from lead dust, well dust that was settling on the cocoa beans while they're drying, and lead was in that dust. So there are probably some manufacturing processes that could be trouble shot. Trouble shot in order to fix that.

Trouble blast. Either way, you can look like consumer reports that a breakdown of like which different chocolate brands had the highest levels of cadmium and lead and which ones were actually okay. So there's a wide variety. Fun list to look at by the way like, oh, where have that? Oh, we have that. Oh, we have that. Oh, we have that. I have that. I have that. Oh, no. I think right now it's in that sort of realm of like, I'm not going to tell one, you don't need to avoid all chocolate based on these reports. Nobody's recommending that at least as far as I can tell. They do recommend that you eat dark chocolate and moderation, that it shouldn't be...

What did a cookie monster talk about? A sometimes food. Yeah, dark chocolate is a reason. I don't find a food. Yeah, and like, I think that they are recommending that you eat it in moderation, especially right now while we're still figuring all this out. Certainly if you choose to avoid it, I know it's supposed to be good for you. And there are still good things about our chocolate.

There are healthy properties, but- That you have to now balance with the presence of lead and chameleon. But the problem is we don't know. And so like there were questions like about people who are pregnant or people who are breastfeeding, what could the implications be? We have no idea. I would say you don't need to go get chelation therapy or go get lead or cadmium levels drawn

just because you eat dark chocolate. If you are ill and you go to your doctor and they evaluate you for a variety of things and they suggest, hmm, this might be consistent with heavy metal toxicity and here's some tests or whatever. And then they recommend that, hmm, this might be consistent with heavy metal toxicity and here's some tests or whatever. And then they recommend that, sure. But I would not get that test just because we eat dark chocolate

and I certainly wouldn't go get chelation therapy. There's a lot of pseudoscience around chelation therapy. It's a real thing. Some people need it. There are a lot of people who use it who absolutely do not need it. It is not necessary. So I wouldn't go do that, especially if somebody's doing it

for like profit. There are people who will just do that. And I necessary. So I wouldn't go do that, especially if somebody's doing it for like profit. There are people who will just do that. And I will. So I imagine my surprise. So the science is that I don't have a hard and fast answer for you right now because this is all pretty new. I would say that for me personally, as a lover of dark chocolate, I'm going to moderate my dark chocolate intake. I'm not going to avoid it completely, but I'm also going to be a little more rate my dark chocolate intake. I'm not going to avoid it completely, but I'm also going to be a little more picky about which brands I eat and how often I eat it for now until there's more data. And start looking for dark chocolate to advertise itself as being 100%

lead free, guarantee, lead and cadmium free. Yeah. And then you're going to have missed this story. And then you're going to think, why are they, why are they saying that it's lead in cat? Well, of course it's lead in cadmium free. Why are they saying that it's lead in cadmium free? Then you'll go down the rabbit hole. Here's another question for you, Sid.

Good day. I was listening to the appendicitis episode and had a weird medical question. When I was a, I'm going to try to pet Amelia. Hold on. No, no dice. and had a weird medical question. When I was a, I'm gonna try to pet Amelia, hold on. No, no dice. I had a weird medical question. When I was 11 or 12, I had my appendix removed.

I was told that it could grow back. Is this real and could I get appendicitis again? Thanks. Valerie. So your appendix cannot grow back. Do not worry about that. That is not something. I look to see like, have there ever been even a single case of this? And I couldn't find any evidence that this is ever

this. It doesn't make sense to me that it would happen. And I can't I couldn't find a case where that would happen. What can happen if you ever read of a case of a recurrent appendicitis? What is actually occurring is aniceal stump inflammation, meaning where they made the cut to remove the appendix, they may be left a little bit of tissue there. And that can get stumpitis. Stumpitis. So there have been documented cases of just now,

of just where they removed it, there's still a little bit of that tissue left. And then you can get another, a recurrent appendicitis there. But it is not because your appendix has regrown that is not something that happens. Hi, Justin and Sydney. I burned my tongue on a spoon that had been in the brownie that just came out of the oven. Look, I have ADHD and cannot defend my choices. And my roommate said that they heard from someone that eating straight table sugar is good for tongue burns, but they couldn't think of a scientific reason

for that to be true. They also said that some other people talk about putting butter on burns, but that would probably make it worse, not better, because the layer of fat would prevent it from breathing. Is this legit? Either of these, why do people think these things? That's from AJ.

So I don't know. I tried to find a lot of, like, other references for the eating sugar for a burn or putting sugar on a burn. I couldn't find a ton of that sugar, or I should say specifically honey as a sort of form of sugar has been put on all sorts of wounds and burns and skin problems for as long as we've known about it, right? So the idea that people might use that doesn't shock me When it comes to the butter that one I've heard and that one I can tell you is not a good idea wherever your burn is do not put butter on it I've heard that one too. Yes. There is a concern that it would actually like sort of create a coating over it and allow it to continue to burn,

allow damage to continue to occur. And so you should not put butter over a burn. Best case scenario, it does nothing. So I wouldn't, I don't do that. Don't put butter or sugar. There would be no reason to put sugar on a burn. I don't know why people would think to do that, but you shouldn't. There would be no reason to put sugar on a burn. I don't know why people would think to do that, but you shouldn't. The reason people think these things, I think, is because if- It's fun to eat sugar.

Specifically with butter, my best guess is that it probably feels soothing in the moment. And so I think like if you look at stuff that stuck around through history, if it, we always say if it makes you, if it makes something happen, if it has an effect,

people will keep doing it, because I think, well, it did something, you know, and a lot of, a lot of old fake medicine did nothing. So this did something. If you, if your butter is cold and you put it on your burn, it probably felt nice. And so I think something that felt soothing was probably the best case at the time. You also see a lot of these like kitchen staples, I think used in these sorts of like first unconventional first aid treatments just because you had a parent in the kitchen and the kid was burned. It's like it would be nice if this was like, what do we have on hand? What is readily available that we can try to put on it?

I don't think that that doesn't. It doesn't hurt. That's a common thing that you have on hand. You want to feel like you're doing something. Well, I mean, think about like a piece of raw meat on a bruise or something. Like if you're trying to bring down swelling and so you want to put something cold

on something that is swollen, that is legit. So you grab a steak because it's what you have, I guess. I don't know, these are very fancy people who all have steak sline around. For us, it's usually a bag of peas. But no, please don't put butter or sugar on burns. These will not be helpful and could be harmful. High-sitting, Justin, I went to a chiropractor

a few years ago, and when they took X-rays, it showed that one of my legs is slightly shorter than the other. The chiropractor explained that this is likely genetic and passed down from my mother. It made sense to me at the same time my mother and her sister both have hip slash knee issues on the right side. My mom's about to get a hip replacement. However, I'm curious that this type of leg length discrepancies actually genetic. If so is there anything I can do to prevent the issues

my mom is having later in life. Thanks love the show. Francis in ATX, which is Austin, I believe, right? Is that ATX? I think. I think. Yeah, I think that feels like it also, right? I scoff a little bit there because I didn't understand why one would need an X-ray to see if one leg is longer than the other. It seems like that wouldn't require any sort of imaging technology.

No, I mean, I guess it depends on how obvious the discrepancy is. Yeah, it is something that can just happen. You can just be born with a limb length discrepancy. That is, that is, you know, congenital, meaning it, it occurs at birth. Um, that can either be because one bone is actually shorter on one side than the other. And so they are genuinely two different lengths. Sometimes it's like a functional limb length discrepancy,

and it has to do with the way that the joint itself, like your hip, is functioning. It's like something can be contracted, the muscles that pull on the bones, the various things that connect, the tissues that connect to the bones can pull it so that it is actually, it is functionally shorter, even if you took the two bones and laid them side-by-side,

they'd be the same length. Does that make sense? It's being pulled in such a way that it's functionally shorter, even if you took the two bones and laid them side by side, they'd be the same length. Does that make sense? It's being pulled in such a way that it's functionally shorter. That can also be part of the problem. I looked up to see if we know for sure that it runs in families, that it has that genetic predisposition. I couldn't find a lot of evidence of that. I'm not saying it doesn't, certainly it could.

But it is just something that sometimes randomly happens. What I would say is that, you know, one, I would actually go see, your primary care provider would be a great place to start, but a referral to an orthopedist, who especially one who specializes in that area, would be something I would recommend over a chiropractor in this case, who would not be trained in treating or appropriately evaluating these sorts of situations, especially if it is something you've referenced there might be family members who need surgery down the road. If that is something that you are concerned about or if you are having significant symptoms

as a result of this, you need to see somebody who is qualified to assess you and make those sorts of decisions as to whether or not you might need a surgery. And that would really be, I mean, I am a family doctor. I can do lots of things. I would send you to an orthopedist to evaluate those sorts of issues. So if it's causing you problems, I would ask your primary care provider about it. Maybe they have some more imaging or studies they'd like to do and they could send you to an appropriate referral would be my, my thought.

This is from Hannah, Hannah says some nice things about the show. And then says, every day after work, I meet up with my kind and well-meaning neighbor to walk our dogs together. Anytime I bring up anything to do with health or well in the show, some often has an at-home remedy to recommend, like putting on wet socks to bring them out at down my daughter's fever. Now usually I just ignore them.

Recently she started mentioning stuff she's, this is wild, like putting her whole family on a weekend long, parasitic cleanse. How do you purchase a subject for what she's talking about is completely made up? Do you have any techniques for combating this kind of misinformation? I consider just sitting here the solbona's episode about it, but I feel like that might be too straightforward. Any help you can give would be great. Sign Hannah, the nosy neighbor.

I really appreciated this question because I feel like it's a lot of what we try to do on the show, right? But in all honesty, as much as I can provide information and I have training and schooling that gives me expertise, a personal relationship with somebody is often going to be much more persuasive or beneficial to changing someone's mind or helping correct misinformation. That honestly, leveraging the relationship you already have with this person, any trust or closeness that you have is going to be the best tool you have in that effort. Because people don't change their minds about stuff because you give them a stack of data or even a link to a podcast. And I know I realize I'm saying don't share

my podcast. I'm not saying don't. I'm saying I don't think sending them a link to a podcast, and I know I realize I'm saying don't share my podcast. I'm not saying don't. I'm saying I don't think sending them a link to our show would make a difference as much as I would love to say it would. Yeah. If you want, if that's a, if that is a helpful support to say, let's listen to something together and then you can and make an unbroken, have picked one. Let's listen to one together and make unbroken eye contact for 30 minutes. No, no. But like if you have secretly chosen an episode that you think would be, like would be directly.

But I mean, honestly, the best thing to do is to recognize that a lot of people who sort of fall into these traps, and I mean, there are wellness traps. There are crunchy traps. There are lots of different versions of what this looks like. They, you need to acknowledge that they probably have their family's best interests at heart, right? They're probably not trying to harm anyone.

I'm not saying no one is, but for the most part, no one's trying to harm themselves or their families. Nobody is trying to do something that is dangerous. They genuinely are trying to do the best they can for their whoever is their family, kids or whatever. And they have been misled and they are misguided, but that doesn't mean that you're not going to be able to redirect that aggressively. You can't beat them into doing the right thing. I mean verbally beat them, I guess, is what I mean.

You know, you're not gonna talk them out of it. You're not gonna debate them. You're not going to argue them into doing something different. What you do. Gaslighting, nagging is huge. You find common ground. Ha, ha, ha, ha. You find common ground.

What you do is you find the things you agree on. You both want the best for your families, I'm sure. You find common ground. What you do is you find the things you agree on. You both want the best for your families, I'm sure. You both are trying to sort through all the information that we're inundated with all the time to make the best decisions we can. Here's some things that you found that work for you and your family. Here's some things that are some sources that you have found reliable that you think are good. Here's some ways that you have found

to address those issues. Oh, I can see why you would think that. That makes sense to me. And I know you're always trying to look for the best, you know, the healthiest food to feed your kids or the healthiest way to address that issue. I can totally understand, you know, I've tried this and this has worked for me.

Those sorts of emotional connections, aligning yourself with someone and saying, we're on the same team, but we've come to different conclusions. And maybe if I show you why I came to my conclusions in a kind way, in an open understanding way, you'll start to come to those same conclusions as well. That is a much more powerful tool to change minds and help lead people away from dangerous misinformation than cold hard facts or data is ever going to be. That's a lot harder to do. It's lots of small conversations that ease people in that direction with no judgment,

and no anger, and no no laughing and no mocking. And that's hard. You're going to have to bite your tongue a lot. That sounds too hard actually and I don't think I would be able to do that. I'm actually thinking about it definitely because I don't have the patience. I can barely do it with our children. I don't think I can take the time to share for the stranger away from crystals. You got to, you have to build trust with them. It takes, it does. It takes a long time, but you could slowly do that. If it's something that you, and I mean, this is not your job, you don't have to do this. But if it is something that you feel passionately about, and if it's

someone who you want to have a genuine relationship with. If you really value this person's friendship and you want to share the things you know with them, it might be worth the effort. You think we take a bag of it? Yeah, yeah, yeah. And then we'll be back with more questions. Okay, Sidney, give me the line. Let's go to the Millenipartment. Let's go.

The medicines, the medicines that I skill make my cards for the mouth. If you have trouble falling asleep, try sleeping with celebrities. Tell me about your view of succulents. I'm not a huge fan. It's a different kind of sleep podcast. There are some real benefits to parking legally. Featuring remarkable guests and unremarkable topics. There's two Orlando airports.

From the creator of the Presh mode with John Moe, it's sleeping with celebrities every week on Maximum Fun. Nighty night sleepyheads. every week on Maximum Fun. 99 Sleepy Heads. Hi, I'm Jesse Thorne, the founder of Maximum Fun, and I have a special announcement. I'm no longer embarrassed by my brother and my brother in me. You know, for years, each new episode of this supposed advice show was a fresh insult that depraved Jumbo of erection jokes

ghost humor and frankly this is for the best very little actionable advice. But now as they enter their twilight years I'm as surprised as anyone to admit that it's gotten kind of good. Just in Travis and Griffin's witticisms are more refined, like a humor column, in a fancy magazine, and they hardly ever say Bazinga anymore. So, after you've completely finished listening to every single one of all of our other shows, why not join the McElroy Brothers every week for my brother and my brother in May? brother and mate. Dear Dr. and Mr. McElroy, how do I get a good primary care doctor? I grew up poor and my parents were a bit off-grid, so I haven't had a regular doctor since

I was a baby. In college, I could always go to the campus health center, but that was only for urgent issues. I have my first actual adult job with insurance and everything, and I'm not sure how to go about finding the medical care I need. I'm sure I could just call up the doctor's office and ask, but I'm afraid they're going to be annoyed

that I don't know what I'm doing. Worst, I'm scared that I won't be able to find someone who's gender affirming and won't be judgmental about my weight. Is it just a process of trial and error? Do I just have to go with whatever my insurance covers and call it a day? Any advice is appreciated. Much love. Milo, Milo, Roxas, they've been pronouns and that sounds hard. That's a tough question. It is hard and it's harder than any of us.

Wait, no, this is actually easy. Asked me. That is my solution. Well, I mean, my answer is not going to be incredibly satisfying because I don't, and I'm not asking you to tell me this, Milo, I don't know where you live. And so I don't know all the resources available. You can't help me with that. Your social security number Milo. Just send it all away. No, I, if you, if you live in Huntington, I have lots of answers for you. But if you don't, I probably don't have direct answers to this question.

Generally speaking, this is, first of all, let me acknowledge this is a really challenging process for a lot of people. You're not alone. You're not silly for not knowing how to do this. Most people don't. Hey, y'all, can I tell the story for my own life? I have a carpal tunnel pretty bad in my wrists, and I have to get shots in my wrists, like steroid shots to make it so I can still use my hands. And I didn't know, like, and I have had these before, I went to a doctor. I called the office that I had gone to previously

and I didn't know, but I had put it off for so long because I didn't know what to say, right? I didn't know if I needed to talk to my primary care doctor first and I didn't know if I needed to call their office. And I mean, obviously you told me what to do, but like, had you not been there? Like, I put it off for quite a while. And then when I finally called there,

like, you put it off for so long, it's gonna be six months before we can get you into the shots. My hands hurt right then. So it's, it's even if you're married to a doctor, it's like really intimidating. I don't know why it's so confusing. It is. And the steroid shots gave you hiccups for a couple of days.

Oh man, she's a whole other thing. Yeah, do an episode about this calamity. Yeah. That's a whole other weird thing you can have. I had really, really bad hiccups for days. Two days, but yeah. I didn't sleep, days is plural, plural, two days, days, plural. Two days, but yeah. I didn't sleep. Days is plural, plural. Two days, days, plural.

So, yes, it is. In nights where I didn't sleep, because it hiccups. And in this country, unfortunately, one of the first places you do have to start is to figure out who is in your network, who your insurance carrier will pay for you to go see. Because obviously you can see who you have, whoever you want, but if you see someone who is outside your network, who your insurance doesn't cover, you're going to end up paying out a pocket, and that can be very expensive. It can be a few hundred bucks just to see the doctor before you have gotten any studies done or paid for a medicine you might need or whatever else you might need.

So a good place to start, your insurance provider should give you a list of doctors and network. It may be available online, which would be an easy way so you don't have to make a phone call because I hate making phone calls personally. But that would be a good place to start, and then you have a list that you know at least is going to get paid for. When you call a doctor's office, nobody is going to be annoyed that you don't know what you're doing. They're just sitting there doing their job.

Nobody's annoyed. Nobody knows what they're doing. I don't know what I'm doing. Half the time when I doing their job. Nobody's annoyed. Nobody knows what they're doing. I don't know what I'm doing. Have the time when I call my own office to do stuff for like our family or my kids or whatever. Nobody's annoyed. They're gonna ask you some information you might not know and that's okay.

If they ask you immediately about insurance stuff, I would have your insurance card handy. They might ask you who your carrier is. Although normally they just ask, are you insured? I mean, they're probably gonna wanna know your name, your birthday, your phone number. And then they might ask you if you have a preferences to like, I know at our office they'll say,

do you care what gender your provider is? And then they'll give you an appointment. So, that phone call is probably gonna be very low stress when you actually do it. In terms of finding specific. Oh, I'm already pretty stressed with the what gender provider do you want. I will stare blankly at you.

There is no correct answer to this question. I have no idea. Most, I will say most people don't care, but when they do care, they want a female. When they care of a girl. When they care, they want a female. I mean, almost. Oh, well, that makes sense.

I mean, that's, now I'm not saying nobody prefers male doctors. This is not, I am a cis woman And I am speaking for myself only in this moment There are people who call and ask for Female send us a woman doctor. Send us a lady doctor Anyway, the uh, the insurance is a big part of it Making the phone calls not that is not gonna be as bad as you think it is, I promise. The other piece of that,

finding someone in your area who is gender affirming or specific concerns you have, that's trickier. I know in our area, for instance, we have a resource guide that was made up as a partnership through Huntington Pride and Branches, the domestic violence shelter, that shows like LGBTQ sensitive providers. It's a good place to start.

Probably to see if there's a group like that in your area. Yeah. I mean, so looking to see if you do have Pride organizations or other LGBTQ advocacy organizations in your community, they may have lists. They usually do of people who are like, either like here are vetted resources or even just like comments. I know I went to this person and they were good at this person. So sometimes you have to do that. I wouldn't just randomly look for health reviews online because those can be all over the map. But if you look specifically to organizations like that, they usually put together, we have statewide organizations and local organizations

who have resource guides that will say, here are gender affirming providers in your area. So I would definitely look for those organizations as references and then sort of like cross-reference that with your insurance coverage list. Not bad, word of mouth too. I mean, if you know people who have similar concerns to you, just seeing, you know, what they've heard or what doctor they see might be good.

I know none of the kids use Facebook anymore, but it's a common Facebook post you'll see. So. Um, I adjusted in Dr. Sydney. I know someone who's way too into TikTok and occasionally said things that don't seem super connected to science. Recently, they said, I should stop using liquid IV in electrolyte, like, additive for water, because it has un-methylated B12, which if you have the MTHFR gene, which sounds like a social media way of saying a bad word. That's what we always said in med school, too. Really? Also, that kind of B12 may be generally bad for you as well.

I couldn't guess on this specific from them regarding what it was that was bad or what it causes or how you would find out you have the gene. I was just curious if maybe this is true, whether the difference in methylated B12, the good vitamin apparently, and un-methylated B12 is. I love the show. I really appreciate your research. Thank you so much jail

generally speaking here's what i would say so jill wants to know if jill can keep using liquid ivy in their um their the olic go i don't know in your this is for a borg isn't it no i i am not aware of any danger specific to that product. I have never heard of that issue. A lot of the times, whatever the vitamin- Fair and fair, thank them though, didn't know about the lead in the chocolate until you passed it out. When it comes to B vitamins, the nice thing is if you are taking in unnecessary B vitamins,

generally speaking, you're just going to pee it out. Now, obviously, everybody can push everything. Humans will try anything. So is there an amount of B vitamin that you could take that I would recommend again? Sure, I'm sure you could come up with that. Generally speaking, if you're taking extra B vitamin, you're just going to pee it out. You see, you have expensive pee, and that's it. It is not one that is fat stored in your body. It is water soluble soup. Just gone. Most of us, especially if you've

had like your B12 levels drawn and they're fine, you don't need any specific kind of vitamin supplement. And we do not recommend it this time, like broad testing for the MTHFR gene. That's not necessarily something that we need to do. We don't do that standardly. If people have certain problems like blood clots, that might be something we look for, but otherwise that is not something that you need to. I would not lose a lot of sleep over this,

I would not worry about it. And I don't know of any specific health concerns with using that product. I wasn't able to find anything. Hello, long time, listen, the first time we had medical question asked her, I actually have a few. Why does hair sometimes grow back curly after chemo? My mom always had straight hair, but grew back curly and fluffy after she finished chemo. I heard it was anecdotal evidence in other places, but I'm wondering if this is a real document in phenomenon. That's what Caitlin.

It is. It is a real documented phenomenon. Your hair, not just curly, it can be curly, but after chemo, your hair can grow back in different than it did previously. It can be thicker, fuller, different texture. All of those things can change. It is usually the, so chemo effects, fast dividing, fast, fast dividing, fast growing cells. So that's why you tend to have side effects like losing your hair or some diarrhea or nausea

or vomiting because it affects the GI tract and your hair cells as well. Those drugs can continue to persist in your body and impact things even after you stop taking them. It just takes a while for them to be completely out of your system basically. And so that is why those hairs that first start growing in are still being impacted by that. So they're different. Over time, the expectation is your hair will start growing in the way it used to. That is generally what happens. A lot of that can depend on exactly what chemoregiment you're on, how long you're on them.

So when your hair grows back and how it grows back, and if or when you can expect it to look like it did before, all of that is very variable. Your specific oncologist would have a lot more information because they would know about the agents you're on, but that is definitely a real documented phenomenon. Hi, Sydney. I love the show, I hope you're doing well.

My weird question is, should we reduce fevers when we are sick? It was my understanding fevers are an immune response by our bodies to fight infections more effectively. So isn't trying to reduce the fever counterintuitive? Thanks, Nick from Pittsburgh. That's a good question. I can understand why a lot of people ask this question, and there are a lot of people

who are afraid to treat fevers for this reason. What I would say is, first of all, there is no reason to think that your body is not heating up to an extent that it's eliminating germs through heat killing them. Does that make sense? It feels like boiling the water. Yeah. You know, I mean, a boil water advisory like to kill off the germs. No, that's, I mean, it's part of a whole inflammatory cytokine pathway that does lots of things.

It's doing lots of things in your body to fight off the infection. It is not just heating you up to kill off the germs. If we heated you up enough to kill off the germs, we would kill off other things. Oh, yeah, it makes sense. We have a lot of stuff in us. We need. Yeah, exactly. So it is more mainly microbes, more basically back to. We're at least equally microbes. Fair. But I would say that on the flip side of that, so it's okay to treat a fever. It's fine. You're not harming your immune response. On the flip side, we do tend to over treat fevers, I think. I think we have sort of this fear, especially in kids, if a kid gets a fever and I've been that parent,

it's scary. And it can make you feel like you need to hurry, hurry, hurry and do something. So I do think there's a tendency. I'll hear a lot of people say like, well, you got to alternate the IV profen and the Tylenol and you keep that fever down, keep that fever down. No, I mean, it is not generally necessary to eliminate all feverish. There is, of course, an extent to which we, when it gets high enough, we are concerned and we do want to treat that fever or maybe they need to go in and be seen if you're that concerned. So I think that there's a point here where you're like, yes, every time someone has a temperature of 100, we don't need to throw medicine at them, but it is fine to treat a

fever. Okay. Easy. Take the recommended dosing that's on the bottle and according to your health conditions and all those other things, of course, too. I feel like I should, is that, is that understood? Yeah. Don't just take should, is that understood? Yeah. Don't just take medicine willy-nilly.

Why do we need sunlight to get vitamin D? I feel like most minerals, vitamins to get for food, because you're actually eating the vitamin, but that sunlight is just photons. Not like there are some vitamin D molecules in there. That's from L'Orly. Justin, do you know about vitamin D? Why we have to get sun?

I do, but I'd like to test you to see if you know. Do you know? Yeah, I don't want to spoil it for you. We need, so, okay, you can get vitamin D from food, of course, or from supplements or whatever. Milk, right, milk, high vitamin D. Yeah, milk has vitamin D for sure. But you also, your body will make vitamin D

from cholesterol in your skin cells. Okay. So there's cholesterol in the skin cells, UVB rays from the sun, hit that cholesterol and change it to turn it into vitamin D. Really? Yes. It's weird. Yep.

Have we figured that one out? Yeah. I mean, there's a whole chemical pathway that it goes down where it starts as a form of cholesterol and ends up as vitamin D. I don't care what. But that is why we say you need sunlight. You're not absorbing vitamin D directly from the sun. You're absorbing UVB rays, which cause a reaction in your body that turns cholesterol

into vitamin D. I don't care if you're a religious person and a religious person, a hardcore, anything. No matter whether you believe, whatever you believe, can we all just collectively as a people take a moment to appreciate whatever force brought us to this point that one day, this force was like, I don't know, they keep dying.

Just right away. And then they're like, I got, hey, listen, I know, and I'll speak up with these means a lot. I got a wild idea. What if the sunlight turns cholesterol vitamin D? And it was like, is wild. Let's try that. That's a wild thing to happen. Should we do with other vitamins? Nope. Just this one thing where the sunlight turns cholesterol on the skin to vitamin D. What a wild play that was. What is swing? You know what is wilder, Justin,

is that the way this as a scientist, the way this happened was incredibly slowly over the course of thousands of years where creatures that had this ability to utilize the suns rays to convert cholesterol and vitamin D in their bodies had an evolutionary survival advantage over those who didn't. Probably because we need vitamin D, you know. Don't hear it as a skit, it's nothing. I mean, that's not a skit.

Mine's a skit. I know. You're a skit. I think that's it. If you cannot see the, like, it's just beyond comprehension that over time, it is. It is. I mean, it is.

I mean, I understand, I mean, it is a comprehend, I guess it we can. I just explained it, but like, it is, it is incredible mean I understand I mean it is comprehend I guess it it we can I just explained it But like it is it is incredible You can This point it is unfathomable it is it is an incredible process, but that that is why Creatures that gained this ability through evolutionary changes Where had a survival advantage over creatures who didn't.

That's why the sun has to be involved. And of course, there's a lot that comes with that. We've done a lot of shows on sunscreen and sunburns. And the risks of overexposure to the sun were well aware of that. But there is a degree to which some sunlight is necessary. That's the other fun thing about it. That's the other twist that the spin they put on it. Well, too much vitamin D makes them super powerful. Like, okay, we'll make them burn if they get too much

sun. Well, actually, they're- Now, vitamin D, unlike vitamin B, is something you can get too much of. So don't just go out there, swallow vitamin D non stop. You can that accumulates. That's a fat soluble one. I'm sorry, big part. DEA and K, those are the ones that you can just keep accumulating in your body. I listen folks, we know I'm gonna have time to answer this last question. Big podcast says that we gotta clear out the studio, but I'm gonna, you know what?

Forget about it. Forget the man. I'm just gonna do it anyway. Okay. Hello city and Justin, why are some babies born Johnnest? I was talking about mommy other day and she mentioned I was born Johnnest It's kind of shocked that I've never come up before but she was like Don't even worry. It just happens to newborns sometimes. No big deal

But typically Johnnest is a pretty big concern, right? Seems like it'd be extra scary for a totally fresh new baby That's from KC so it's they then pronoun it, you're right that a lot of times, especially in adults, John does this a big deal. John does meaning yellowing of the skin, probably usually as the result of accumulation of Billy Rubin, which is something in your blood that can be caused from the breakdown of blood cells. That's not like a loud singer for the 70s. Billy Ruben.

I'm Billy Ruben. They love to be here in the cat's skills. Always a treat. And if you're having, especially as a sign of liver dysfunction, this is when we worry. When we see John Dess, we generally are worried about. Billy Ruben would be John Dess. Don't you feel like Billy Ruben is a hard-bought? Billy Ruben would be.

Yeah, he would be John Dess. And babies, the reason we say it can be no big deal is that early, early in a newborn's life, their liver may not be like functioning at 100% quite yet. It's still like ramping up. And they have a lot of red blood cells too that are being broken down. That combination can lead to neonatal jaundice.

So it is incredibly common that a newborn might have jaundice. It's estimated six out of every 10 babies. So that's where do you don't have jaundice? If you're born prematurely, eight out of every 10. Only about one in 20 have levels high enough that they might need some sort of treatment and the initial treatment for newborn jaundice if you need it, which is why by the way they monitor a newborn at first, both with the thing called a belly meter, which is just like an external meter that can give

them an estimate of how high the belly ribbon might be, and then they can actually draw blood and check belly ribbon levels if they're, if you're looking kind of yellow. But the treatment, if they do find that it's too high, which is again, why they monitor, so it's okay, they're watching for it, is UV lights. Because again, the UV light can help break down the Billy Rubin. Isn't that cool? It's also so cool. help break down the Billy Rubin. Man. Isn't that cool? That's also cool.

So if you've ever walked by a newborn nursery and you see a baby laying in a little baby tanning bed, and they put like little baby, like these little soft, they're not goggles because it's like a soft thing that they just sort of put over their eyes, to protect their eyes, and they just lay there in these little baby tanning beds.

But if you ever see that, that's what they're doing. They have blankets that also release this, that also have this UV lights, you can even take them home with a belly blanket. And wow for the baby man, like, so this is life, huh? This is what, okay, all right.

But if you ever hear the belly lights or the belly blanket, that's what they're talking about, it's just to reduce that. And then your liver starts functioning up to snuff and then you're fine and you don't need to, you know, continue that. But that is why, generally speaking, it is no big deal. There are cases where newborn jaundice could be indicative of some other underlying

problem, which is why we watch it closely, which is why we check levels, which is why we treat it, which is why we monitor most of the time. It is no big deal. Um, thank you so much for joining us for this episode. Uh, a couple of quick plugs. First off, the adventure zone is a graphic novel series that my brothers and dad and I wrote. The fifth book just came out last Tuesday. It's called the 11th hour, the adventure zone, the 11th hour.

If you haven't read the series, I'm really proud of it. I think it's really good. So if you would go buy that book and read it, that'd be really nice. Also, March 17th, 9 p.m. Eastern Standard. We are going to have a, my brother, my brother, me live and virtual show celebrating the kickoff of our 20 Sun and Sea year of touring. We're going to have a very cool young podcast called Solbona's opening for that show, where you've heard of it. Take us or $10. It's March 17th and 9 p.m. The video will be on demand for two weeks after the event. You'll be able to watch it or you can pick it up for two weeks after the event.

Go to bit.ly-m-b-m-b-a-m-virtual and come watch. It's going to be great. I'm certain of it, right, Ted? Absolutely. It won't be there, you know me. Yeah. Assuming you're children, go to sleep. I'm hopeful. Thanks to the taxpayers for the use of their song, Medicines is the intro and outro of our program.

And thanks to you for listening. We appreciate you very much. That's gonna do it for us until next time. My name is Justin McRoy. I'm Sydney McRoy. As always, don't drill a hole in your head. Alright!