Weird Medicine: The Podcast - 350 - A Penny for your THOTs

Episode Date: February 22, 2019

Strokes and artificial sweeteners, should we be afraid? Accountability and weight loss, E.D. chewable tablets, fat vegans, and more! PLEASE VISIT: stuff.doctorsteve.com simplyherbals.net NOOM.doctorsteve.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

You're listening to Weird Medicine with Dr. Steve on the Riotcast Network, riotcast.com. I need to touch it. Yo-ho-ho-ho-ho-ho. In the carri-de-in. I've got diphtheria crushing my esophagus. I've got Ebola fibs dripping from my nose. I've got the leprosy of the heartbound, exacerbating my impetable woes. I want to take my brain now.

Blast with the wave, an ultrasonic, ecographic, and a pulsating shape. I want to magic pills for all my ailments, the health equivalent of citizen cane. And if I don't get it now in the tablet, I think I'm doomed, then I'll have to go insane. I want to requiem for my disease. So I'm aging Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio. I'm Dr. Steve with my little pal, Dr. Scott, the traditional Chinese. medical practitioner who keeps the alternative

medicine wackos at bay. And this is a show for people who would never listen to a medical show on the radio or the internet. If you have a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, give us a call. 347-7-4-3-23. That's 347 Pooh-Head. You're listening to us live, the number 754-227-3-6-47.

That's 754. Double-duce penis. Follow us on Twitter at Weird Medicine. at Lady Diagnosis and at D.R. Scott W.M. And visit our website at Dr. Steve.com for podcast, medical news and stuff you can buy. Go to our merchandise store at cafepress.com slash weird medicine. Most importantly, we are not your medical providers. Take everything you hear with a grain of salt. Don't act on anything you hear on this show without talking it over with your doctor,

nurse practitioner, physician, physician, physician, pharmacist, chiropractor, acupuncturist, yoga, master, physical therapist, clinical laboratory, scientist, or whatever. All right, very good. Hey, don't forget, please don't forget, go to stuff. dot, dr.steve.com for all your online shopping needs. And if you need earbuds, go to tweakeda audio.com. It's our friends from Franklin, Tennessee. They have the best earbuds for the price on the market

and the best customer service anywhere. And if you will use offer code fluid, FLUID, you will get 33% off your order. It's insane. Don't forget Dr. Scott's website at simplyerbils.net. And if you're interested in doing the Noom app, which we'll talk a little bit about later, Noom.doctrsteve.com. That's N-O-O-O-M dot, dottersteve.com.

You get two weeks free and 20% off your order. They're not actually a sponsor. It's just my referral link. But I'm a great believer. I want other people to try it. Two weeks free, 20% off at Noom. dot Dr.steve.com. And if you're interested in getting archives of this show or premium content, such as it is,

go to premium.com. You can download the app. A couple of people have been having some trouble with the app lately, but Libson is working on it. They will have it fixed. In the meantime, you can use your premium membership at Dr.steve.com. It works just fine. And let me know how that's doing if you're having any problems at all. All right.

Very good. A big deal in the news, Dr. Scott. This, another assault on the artificial sweetener consortium. This is from a very prestigious journal called Stroke. And the title is artificially sweetened beverages and stroke, coronary artery disease and all-cause-mortality in the Women's Health Initiative. So now when you read the article in the medical journalism literature, it says artificially sweetened drinks are linked to stroke and heart disease. So you go, oh, my God, if I'm drinking artificially sweetened drinks, I'm going to have a heart attack or a stroke. So I'm just going to read to you from this abstract from the journal stroke.

It's that we examine the association between self-reported concerns. consumption of artificially sweetened beverages and stroke and its subtypes, coronary a heart disease and all-cause mortality. All-cause mortality just means you just died from whatever you could die. You could be included in that if you died from getting run over by a truck. Okay. So this analytic cohort included 81,714 women from the Women's Health Initiative observational study.

First off, this is an observational study. So it's not a double-blind placebo-controlled study, which would be difficult to do, but they looked at 93,000, the whole study, looked at 93,000 post-menopausal women of ages 50 to 79 years at baseline, and they enrolled from 93 to 98. So it was a prospective study in that they identified people and then followed them over time. so the results of this study most participants these were 64% of people were in frequent consumers which meant they never drank an artificially sweetened drink or less than one a week that's me the only time i drink um a diet coke or anything similar is if i go to the movies i'll get a large diet raspberry coke which i don't know why i just it's something about going to the movie i love it

And I love that. I was an organic chemist, so it has this sort of what we call an ester smell. It's a chemical smell. And I guess it reminds me of a better age when I was working in an organic chemistry lab. But it smells like organic chemistry to me. That should be the first red sign. Of course. It smells like some kind of chemical thing.

Yeah, I love it. It smells good. It tastes like nothing that could be natural. Nothing in nature. No, it doesn't taste like raspberries. It tastes like chemicals. But I like the taste. So I like that one.

And that's, you know, maybe once a month, if that. Yeah. And then every once in a while, if I'm in the physician's or the provider's lounge and they don't have anything else, I'll drink a Diet Coke. But otherwise, I drink unsweetened tea. Can't stand. Oh, gosh, no. For those of you who are not from the South, you don't know what we're talking about when we talk about sweet tea. When they make sweet tea, we're not talking about you get.

you know, unsweet tea like you get everywhere else in the world and then add a little bit of sugar to it. They will get a gallon of, look up a recipe. I'm looking at it. I know where you're going with this. I'm looking at it right now. It's ridiculous how much sugar they'll put in. But in a gallon, I don't know if it's one or two cups of sugar

and they make simple syrup and then pour that in there. And it's so sickeningly, disgustingly sweet. You got a recipe for Southern sweet tea? I'm looking for, you know, our favorite. your little quick sudden service restaurant. Yeah, but don't, no, don't use their recipe. Do they have their recipe? It does.

It gives us a nutritional value. Oh, okay. Yeah, yeah, yeah, yeah, I do want that. Thank you. I know where you're going with that. Yeah, I mean, because we love this place, but that's the sweetest damn tea on the face of the... Okay, so here it is, a pinch of baking soda, just to buffer it. Two cups of boiling water, six tea bags, three quarters a cup of white sugar and six

cups of cool water. So one third of it is going to be simple syrup. Yep. You know? Yep. It's crazy, isn't it? I'm interested that they put the baking soda in there. I wonder why they're buffering the solution.

Yeah. Yeah. Anyway. It's crazy. But, yeah, Dr. Scott will look and see if he can get the nutritional information as far as calories per serving on that. Okay. So in a...

Okay. Okay, and a 32-ounce cup of sweet tea. Which is the minimum at the restaurant we're talking about you can get. 52 sugar grams. Oh, 52 grams of sugar. How many calories is that? That would be 187. So 200 calories right there.

That is two Yazzo, Greek yogurt, chocolate with chocolate chip. ice cream bars while they're frozen yogurt bars but it's two of those yeah wait you said 200 and how much that was 200 200 200 calories just 200 52 yeah grams of sugar per serving yeah well that's just two teaspoons though right and wait how many grams I'm looking them I'm looking at grams of sugar in one teaspoon okay so that this will give us an idea oh my goodness four grams of sugar is equal to one teaspoon and he said it's 52 yeah uh Alexa what's 52 divided by four two divided by four equals 13 so it's 13 teaspoons I guarantee it in one glass it's so sweet you almost have to you almost have to drink it like with a spoon it's so I got some in my

mouth not too long ago I had to spit it out that's that's how horrible it is to me but Anyway, so why were we talking about it? So certainly to goodness, drinking an artificially sweetened drink every once in a while has got to be better than that. You would think. But they were looking at people who were infrequent consumers, so that's me. Only 5.1% of people consumed greater than two artificially sweetened beverages per day. And what they found was those consuming the highest level of artificially sweetened beverages compared to never or rarely, in other words, people like me, had significantly greater likelihood of all endpoints except hemorrhagic stroke after controlling for multiple, you know, covariates. Like they controlled for people who had diabetes and people who had already had a history of heart disease and stuff like that.

sure. But I'm very unimpressed by these numbers. So for coronary heart disease, the hazard ratio was 1.16, which means a 16% increase in heart disease. Now, this is one of those. This is a relative risk. The absolute risk is very small. But the range on that went from 1.07 to 1.26, which means that it went from 7% to 7%. 26% and you figure it's somewhere between that. If you look at all stroke, it starts at 1.02, so maybe a 2% increase. And for a schemic stroke, 1.06. That's sort of your normal stroke. So anyway, so I drilled down into this and found that most of the things that they found

were not statistically significant. So when they look at outcomes with exclusions where they're excluding people who already had disease and stuff like that. Eschemic stroke, that's just your normal stroke where the brain doesn't get enough oxygen. The people,

and this is compared to people who never drink them or less than one a week, was never statistically significant. As a matter of fact, in the group that drank greater than two drinks, per day. That was the only one that was slightly significant, and that was, it had a hazard ratio of 1.38. So they had a 38% increase in stroke, but that ranged from 1.05 to 1.81. So there seems to be an effect there. But when you looked at 5 to 7 per week, it was actually

slightly protective. It didn't sound right. No. No. Their hazard ratio was 0.96, so they had 4% less. ischemic stroke if you drank 5 to 7 per week and it was slightly more in the group that drank 1 to 4 so if you drank 1 to 4 a week

it was 99% risk so they had a 1% protection whereas if it was 5 to 7 it was lower than that there was 4% protection so these numbers are kind of all over the place hemorrhagic stroke these are people who bleed into the

drinking one to four a week was protective to the tune of 0.88. So, 22% less hemorrhagic stroke in the group of people that drank some artificially sweetened beverages compared to those that didn't drink any at all. Now, this was not statistically significant. In other words, it didn't rise to the level where you could say, yes, this is a real effect. so very many of these can all cause mortality none of those were statistically significant if you drank one to four per week there was a 3% protection so if you if if you took this all the way to the bank you could say well you know drinking one to four seems to be beneficial

for people you know what they're you know this is the problem with statistics you know The journalists are just showing this sort of, and they're not showing a causation. Right. They're showing a correlation. They're not saying that this caused it. They're saying it's correlated with it. So people who drink a lot more, artificial beverages, maybe people who are trying to lose weight and then they're binge eating because you and I have talked about this, that when you drink

artificially sweetened beverages, the one argument against them that I buy that I think is, makes total sense is that the body's expecting, you know, it gets that sweet flavor. So it's expecting calories. When it doesn't get them, it starts to crave them. And then you start eating more. So there's more to this. Obviously drink shit in moderation.

Why does everything have to be sweet? That's the thing. Can you drink water? Yeah. You know, your coffee should not taste like your tea, which should not taste like your peanut butter, which should not taste like your cereal or whatever. I mean, all these things.

You know, coffee should taste like coffee and tea should taste like tea. Oh, there you go. You know, peanut butter should taste like peanut butter. Hey, but you know what that reminds me of? And just kind of a segue there, it sounds like, you know, the study that came out years ago about people who consume alcohol and how abstainers have the shortest lifespan and people who drink moderately, kind of what you're describing now, have the most protection and tend to live longer.

healthier lives. Well, maybe just moderation in general. It's moderation, exactly. A little bit of this is probably not so bad. Yeah, it's not so much that the artificially sweetened drinks in moderate amounts are actually protective. Because remember, this is correlation, not causation.

I think Dr. Scott, I'm going to give you one of these for that. Uh-oh. Oh, shit. A dinger. Well, well, you son of a bitch. Give yourself a bill! There we go.

Is that it, those people may be people that embark on a lifestyle of moderation in general. And what my sort of tome or trope on moderation is everything in moderation, including everything in moderation, which means if you're a slave to moderation, you're going to be causing yourself stress. So every once in a while, you need to blow it out your ass. Right, right. You can only stay in the middle of the road so long. Yes. Every once in a while, you've got to speed up a little bit.

Or slow down. This may be all this article is telling us. The moderation is a good thing. We will have to, and that's just our interpretation of it. But I am unimpressed by a lot of these numbers, and they're not really trying to make any claims. They said, in this study of well-characterized post-menopausal women in the United States, self-reported consumption of ASBs was associated with increased risk of ischemic stroke, coronary heart disease, and all-cause mortality, a novel finding of this study is that higher risk was associated with the schemic stroke.

Okay, blah, blah, blah. Because of the observational nature of this study, however, the possibility of residual confounding cannot be excluded. In other words, this is an observational study. This isn't how we make conclusions about stuff. No matter what they put in the newspaper that your artificially sweetened beverages are causing heart attack and stroke. They are not saying that. And the authors specifically say that, but you won't read that in a lot of the journalistic medical journalism articles that you read. You know, they love stuff like this to say, well, this is bad.

And then this is bad. The next week, you'll see that, well, the same thing is good. And I'm not a huge fan of artificially sweetened beverages, but I am a fan of the truth. And we still don't know the truth. It seems to be a correlation between drinking a shitload of this stuff. and some bad outcomes in a very small number of people. Right, and some people are right. Yeah, but anyway.

Cool. You know, it just, it's, we need to do these studies, but now, so how would you determine whether these things actually caused? You would have to do a study where you did a prospective, and we'll define all these, double-blind placebo-controlled study of artificially sweetened beverages. And you could, it wouldn't even have to be beverages. What you could do is put them, if you think it's the sweetener,

because what else could it be? The rest is just water, right? Water and carbonation. So you give people water and carbonation if you want to control for that. And then you give them a pill that's got either the sweetener in it or it's got sugar in it or it could have an inert substance. I would do all three. Right.

So you'd have three arms to the study, a true placebo, a sugar arm, and then an artificially, artificial sweetener. And, of course, let's use a spartame because that's the one everybody loves to shit on. And then you have to control for everything else, smoking, diabetes, heart disease. If you've got a diabetic over here, you better have a diabetic over here. You've got to cancel them out. and you and I if we were doing this study would do a survey there are I'm sure that there are surveys on moderate lifestyle that have been that have been validated so that you can control for that too these are people that kind of practice a moderate lifestyle or they're extreme you know vegans they're extreme in the sense of that they're not in the in the mainstream right the uh crazy keto people that only eat mayonnaise steak and bacon for that's another extreme and and for the keto people out there we i'm in favor of a ketogenic diet um just not that one so you have

to control for all that and then we would follow these people for 10 you'd have the fewer people you have the longer you got to follow them so let's get 10,000 people and then follow them over the space of 10 years. That should give us some numbers. And then at the end of it, we can decode everything and see if there was a correlation between taking artificially sweetened.

And you've got to control their diet, too. You see how difficult the study would be because you can't have these people going out and they're in the plesimo arm and they're drinking a bunch of, you know, a spartame sweetened drinks. Mixed drinks. Fucking the whole thing.

Or some ice cream that's got some sweeteners. Yes. That's why this is so difficult. That's why we don't know the answer to this because, number one, who's got the money to do that study? Who gives enough of a shit about it to do that study and who's going to administer it? I mean, this is a huge undertaking. That's why they love to do these observational studies because they can just take a whole shitload of people. They're coming to the clinic anyway and then enroll them in the study and just follow them and then data mine. And you get a publication out of it and you get, you know, newspaper articles written about you. Or they'll do preliminary studies on mice or something like that. Well, that's true. Something they can control. That's true. Could do that, too.

It could do it on mice. Yeah, it would be a little easier to manage. But then you can't generalize it to humans because mice aren't humans. So it's difficult. That's why we don't know. That's why we're still arguing about this shit decades later, you know? Yep. Anyway, all right.

Love it. So there you go. Did you have one you wanted to talk about? Yeah, I thought real quickly. I thought it was interesting. I saw a little thing on the Google News that was talking about how females tend to die of heart attacks. When they have them. When they have them.

Because their symptoms are different, right? Okay. And this is. Well, you just ruin the whole. That's a spoiler. Oh, well, I just pulled it. Hey. Well, that was my point.

Now, see, you did it right. See, the medical journalistic, not all of them. There's some really good ones out there, but very many of those folks would say, women die more often of heart attacks. And that would you start to imply that maybe women don't get quality health care or, you know, what are, but the spoiler is they actually present differently. They present differently. But now.

So tell us about it. Yeah, a little bit further. Well, and we'll get to that. that in two seconds. But the bottom line is when females, you know, we think the classic heart attack signs and symptoms, you know, chest pain, an elephant sitting on a chest, shortness of breast, you know. Shortness of breast. Breast. Breast. Breast. What are you thinking about? You know. Oh. Oh. That's a double boo. Shortness of breath. I'm sorry. And, you know, sweating,

you know, diaphrases, right? And, but those are classic. male signs of heart attacks, sometimes pain shooting in left arm, sometimes shooting into the face. But women can be, their signs can be a little bit different. They can have similar signs and symptoms, but also they can have signs that are not necessarily related to this, like fatigue, abdominal pain, pain in their neck. And remember, you tell the story, you told the story a number of times of the gentleman that came into the emergency room.

He was talking about having, you know, his throat harding. He got triaged to the ambulatory side of the emergency room because he said he had a sore throat. Right, which the ambulatory side of thinking he's not as serious. Well, they thought he had, you know, a cold or something. And what he was really trying to say is, I have chest pain and it's radiating to my neck. If he had said that, he may be still alive today. Well, that's that, and that's what this article was just pointing out. And that was my key to this is recognizing the fact that the famous.

females do have some different signs than males. But now, interestingly, it was talking a little bit lower. They also die within a year of heart attack more often than men as well. So they have the heart attack if they survive it, then within a year, they're more likely to be dead than a male. You know, and that's what I was just reading on this further down articles, they do not females, which, now this shock me, I'll have to do some more research on this. They don't follow through on cardiac rehab as much. and they don't follow the post heart attack indications or plans that sit by their dogs. Yeah, and it may be.

This is very strange. This could be an issue of health care in the sense that women may have different expectations when they, after a heart attack, than men. This is, you know, this isn't, now these people are saying this in Germany that they're expected to start functioning. again sooner, which means they're subject to bigger stresses. Now, this is a German study and a German author. Oh, look who's calling. What a coincidence. Quinky.

Tacey, you're on weird medicine. Uh-oh. She's pissed. She wasn't feeling very... No. Like being interviewed, I guess. But yeah, but that's... You know, Dr. Steve, the reason I say this is

because typically we think, you know, female's been much more proactive when it comes through health, paying attention, getting into doctors more often, as far as, you know, as far as normal routine medical visits, right? Typically, men push things up and push things up until they're just train wrecks. Yeah. And that's a broad generalization, too. This October study was done in Germany, and there could be some cultural things.

I don't know. I mean, you know, I would like to see if this has been reproduced in the United States, because this guy says in everyday life, women often face different expectations. after a heart attack than men. This is from Technical University of Munich. They're expected to start functioning sooner, which means that they are subject to bigger stresses. Our study shows it's important to pay close attention to female patients,

especially in the first year after the event. So let's try that in the United States. Let's see if women in the U.S. die from myocardial. We could have probably done this research ahead of time. heart disease is the leading cause of death for women in the United States killing, God, 300,000 women in 2013. That's one in every four female deaths.

It says here around the same number of women and men die each year of heart disease in the United States. Okay, so I'm looking at this map. Holy moly. Boy, the southeast, particularly Louisiana, Mississippi, Alabama. Pretty rough on the women having heart attacks. Wow.

That's the highest rate, up to 931 per 100,000 in that lowest part near the Gulf. Let's see what they say here. Almost two-thirds of women who die suddenly of coronary artery disease have no previous symptoms. And so even if you have no symptoms, you may still be at risk for heart disease. So it says, while some women have no symptoms, others experience dull, heavy, sharp chest pain, these may occur during rest, begin during physical activity or be triggered by mental stress. So let's just talk about the classic symptoms of a heart attack first. The classic symptoms, the elephant on your chest, shortness of breath, maybe palpitations, meaning, you know, a thumping in your chest, skip beats, sweating, nausea, nausea, vomiting, those kinds of things, shortness of breath.

Classically, this will occur. You may have these, when you're not having a heart attack, but you're having angina, which is, you know, the pain that comes before a heart attack. When you have activity, you go upstairs. And all of a sudden you have a little chest pain. Maybe it goes away and you don't think about it. And then you go upstairs again, you have it again. My dad had shoulder pain.

And so when he had his treadmill test, when my brother was giving him his treadmill test, because we lived in the middle of nowhere, and my brother was the only doctor in town at the time. So he was my dad's doctor. He gave him a treadmill, and he started to see the classic signs of ischemia. In other words, lack of blood going to the heart. And in the lower leads, 2, 3 in AVF, doesn't matter what that is, but there's 12 leads. There were three of them. that lets you think that the ischemia is in the bottom part of the heart.

Well, he saw that, and my brother said, are you having any symptoms? He's like, well, I'm having that shoulder pain. And then that's when he realized his shoulder pain was actually heart pain. And just to clarify, just to make sure that everybody that doesn't know anatomy of the heart may be so much as we do, when we're talking about the blood getting to the heart, we're not talking inside the heart chambers. We're talking to the little, we're talking to the little blood vessels that are on outside of coronary arteries that feed the muscles that cause the heart because you know typically

they'll get they'll be still have blood in the heart chambers themselves yeah you would think that that would that would the blood is full and the heart is full of blood why wouldn't it just feed itself but it really doesn't work that doesn't work that way yeah and I think that's important to remember those are those are the arteries on the outside of the heart to feed the muscles right carrying oxygen that's where you see the ischemia typically yeah so you'll you have um a couple of so you've got your aorta and the aorta is the big vessel coming out of the heart and just as it comes out of the heart it will have a couple of outlets there's a left main coronary artery and then a right coronary artery and the right corner artery kind of goes around the right side of the heart

to the bottom and then the left main splits into a left anterior descending artery which is the artery that goes down the front of the heart and then another one called the circumflex which circumflexes the heart. It goes around the back of the heart. And from there, all these little branches will come out of those main arteries. And those are the ones that will get clogged. And when they get clogged, the part of the heart that they feed will not get enough blood supply. And then you can see that on this cardiogram or other things that we can do. We can do a thallium stress test and you'll see that there's less oxygen being used in one part of the heart. It kind of shows up as a dark hole in the blood distribution to the heart,

and that gives you an idea that there's a blockage there. The gold standard, of course, is doing a catheterization. So now, because there's three main coronary arteries, but that left main artery, the one that we talked about is it comes out of the aorta and then splits into two. If you get a clog there, you're getting two-thirds of the heart, or more, is no longer getting oxygen. And that's the so-called widow maker.

Yeah, that's the bad one. And with that one, we take personally because that's what GVAC has. And so if you're interested, if you have any risk factors at all, first-degree relative with early heart attack, in other words, heart attack before the age of 65, if you have high cholesterol, high blood pressure, if you're a smoker, you can go get a cardiac test that costs about 50 bucks. and it's a calcium score.

It's a CT. You lay down in between cycles. They'll do these between cases because it really only takes about 30 seconds to do. You lay down, they do this scan, and then they'll read it, and they can tell you what your risk of having a heart attack in the next 10 years is. I want to tell you a really quick story if you've got two things. Of course. We have 20 minutes and 25 seconds to kill.

Great story. Blues Traveler, one of my favorite bands, John Popper, used to be morbidly obese. The guy who just noodles on that harmonica? He doesn't wear it out. He just noodles out of it. He just plays a bunch of notes. He blows it out. He's the best. He's the best I've ever heard.

But anyway, so he was, like I said, morbidly obese, he had a heart attack. Well, how he figured he was having a heart attack. Now, this is a true story. He tells us he was laying in bed. He was watching him porno. He was giving himself some pleasure, masturbating. Well, about the time he'd start getting. and really into it, he noticed he started having chest pain.

Uh-huh. And so he stopped, and he thought, when chest pain went away, then he did it again. There he is. It's about the third time he blew into the, or got ready to really get excited. He started having severe chest pains. He thought, maybe I should stop this and go to the hospital. Yeah. Went and found his blockage.

I guess my assumption is they did a stint on him. He's lost probably 100 pounds, and it sounds great. Wow. That is a true story. Yeah. Good for him. Dang. Well, anyway, I'm not a fan of his harmonica playing. Oh, I love it.

Let me see. Here he's playing it on Covino and Rich. Let's see what he did here. If he would just do something melodic with it, but he just plays a shitload of notes. Oh, it's a ton of notes, yeah. It's like, um... He's got a big old breath. I don't know what the hell he's doing there.

He's just playing. I just hear a shitload of notes. No, that's one of this. I know I feel like the emperor in Amadius, Amadeus. Amadius. By the way, that was his song called, oh, shit. I would defy you if I isolated all of his harmonica. fellows if you could tell one from the other.

There's one that was a song called Run Around. Okay. All right. Well, I may have to stand corrected on this, but the emperor listened to the magic flute in Amadeus. And he said, Mozart, it has too many notes. And, of course, Mozart looks at the emperor and says, well, just tell me which ones to remove. You know, I'll do that when people come to me and say, well, my mom is on too much medicine. It's like, well, tell me which ones to take her off.

I'll be happy to take her off. all that. So, anyway. All right. Where are we at? Where are we at with all this? Next question. All right.

Well, that didn't play. Hey, Dr. Steve. I know I keep leaving messages about weird stuff you suggest on the podcast. But, um, not yesterday, but I think it was day. before yesterday, say Thursday. So like, Monday or Tuesday, anyway. Anyway. I signed up for the noon app that you were talking about.

And so far, like yesterday was the first day that I fully logged my, you know, entire day. And the accountability really helps. Yes. I've tried, you know, my fitness pal. Okay, what she's talking about is I'm doing that thing. They're not a sponsor called Noom. It's an app.

And I talked about it in the show. I've lost 21, 22 pounds on it now. And one of the aspects of it is accountability. I have to report every single thing I put in my mouth to my counselor. And she listens to the show. So I, you know, she got a little frustrated with me because I said, you know, she's so hot that I didn't want to. well the feminist part of me doesn't like that it's about my looks but it's like no that's a dude thing you know I have no shot with her it's not that it's just that she's attractive she's attractive

and I don't want to admit to her that I ate a whole bag of freaking snickers so I don't do it so that's what she's talking about so let's see what she had to say tried you know like a quote-unquote accountability through like gyms and friends going to the gym with me and all this other kind of stuff and it never worked but it did work for me going to the gym when I had a friend that I went with every single time um and that was in medical school I had a friend who was a ham radio operator and we that's where we knew each other and and we would meet at the gym three times a week and encourage each other. That made a difference, and that was the one time when I was actually buff was because he and I would compete against each other, who can curl the most on the, you know, on the Nautilus curling machine. We got to the point where, you know, we could curl the max on the Nautilus machine. And, you know, I was in really good shape. But you got to have somebody like that. They've got to go with you every single time. So I agree with her on that.

You have somebody like, you know, actually holding you. you accountable for oh anyway yes I agree accountability is huge um that's what for me that's what I needed because before that I could say

well I'll just have four snickers because they don't bother my stomach so they must be good for me because everything else seems to bother my stomach anymore and then well I'd go back well I'll just have a handful this time and the next thing I knew I'd eat in a whole bag and I was just going up and up and up and wait And since I've had this accountability, it's not just that, but that was a big part of it, just the ability to have to tell somebody, uh-oh, I screwed up. And I don't want to tell them I screwed up so I don't screw up.

Now, it'll be interesting when I'm no longer in the program. But I've forged new habits. It's been 100 days. And I'm eating differently without even thinking about it now, you know? Good. So, but anyway. So, yeah, accountability is a big deal. How much have you lost?

21, 22. I'm going for 33 total. So that'll be at my ideal body weight. My BMI is below 25, which I'm not a big fan of BMI, but is below 12. It's all we got. Below 25, so I'm no longer considered overweight by medical standards, which is the first time in my adult life. But the kids, how do you feel? A million.

I feel like a million bucks. Yeah. people notice that's the first thing people notice way you look pretty good um i i've lost so much weight i can no longer fit in my expensive uh hospital clothes so uh brooks brothers is losing a bunch of money because i was like i can either buy a shitload more brooks brothers pants and shirts or i can just switch to scrub so i decided to switch to scrubs and i feel better in these it's a hell of a lot more comfortable I always look you know I never I don't fit I just look but it's crappy anyway I got a stupid body it's too straight and when it's not straight and I got a gut then it's disgusting so I just feel better about myself I've got more energy just you know yeah better yeah just better yeah I'm actually now for the first time in my life I'm motivated to actually work out and stuff too which I've of course have not done, but I'm motivated to do it.

Well, don't start jogging. That's how you blew up your... I know. No, I'm not... Your leg last time. I did. I don't know what was wrong with me thinking I was going to... Oh, I know what it was.

My kid. You're running with your... No, my son was doing cross-country and it looked like that. That looks like fun. And I didn't realize that he was a semi-elite athlete when I would see him come around the corner in front of everybody and I'd be cheering. That wasn't going to be me. So, and then I just, yeah, I tore my gastronomias muscle, which for those of you who are lay people,

which is most everybody that's listening to this, hopefully, that was my calf muscle. I ripped it in two, and talk about pain. And then I look stupid. I'm in the middle of this track at the middle school, and I'm just laying down, holding my leg like a big baby. And I had to limp home. Terrible. Jogging sucks. It's terrible I do.

Yeah. So. Oh, my gosh. And I almost fell, I almost bought one of those $2,500 elliptico things because I thought that would be fun. It's an elliptical bicycle where you stand on it, you don't sit, because I don't want to sit on a bike because I don't want to get pedendal neuropathy. It's your prostate all pissed off. Yeah, and your dick, too. Your dick can go numb if you don't sit on that thing, right? If you're going to be a bike rider, by the way, look for seats that support the back.

part of your ass and don't make your taint put a bunch of weight on a real narrow thing. So I didn't want to do that. But I have found a virtual reality thing, exercise workout, and I'm going to try that. See, because that's what I really want is an exercise bike that's hooked up to a virtual reality. And then, like, you run away from aliens or something, and the faster you pedal, the less you get killed. or, you know, that you may have a spaceship or something, you're going through an asteroid field. Like, that would be, that I would do.

Yeah, that would be cool. It would be cool if you could be like, it'd be cool if you could put yourself into like one of those, those virtual-arranted games, the shoot-em-up games where you could be like the person trying to avoid getting shot. Yes, but it's all dependent on how fast you're going on the bike and maybe it would change, like if you're going uphill, it would change the resistance and stuff like that.

I would love that. I found one online, but it's not quite ready for prime time yet. But if anybody knows anything like that that would work with the Oculus go, let me know. All right. Let's try. Oh, here's one for you. Let's see. I thought it was.

Oh, yeah, here you go. This is a question for Dr. Scott. Hey, Dr. Steve, got a question for you. 43 years old. I go to the gym five days a week. and I have a yearly fiscal and before my last fiscal I decided to try something different

so for six months we went vegan so I cut out all meat, chicken eggs, dairy if it had a mother I didn't need it no honey and no gelatin

and to boot I also cut out alcohol and carbonated drinks so so Oh, wait, I think I just booed over the important part. It consisted mainly of fruits, vegetables, and bread, and I made sure the bread didn't have any eggs or milk in it either. And that also left me with a protein and soy-based diet.

And we did that for six months. So when I get my labs back from the doctor, my total cholesterol has went from 196 to 228. and my triglycerize went from 264 to a whopping 554 and I gained 14 pounds. So my question to you is, what the hell. Thank you very much. I fucked that up.

I hit all the wrong buttons, but anyway. Well, so. We know what to tell you. He went on a totally plant-based diet. Right, big and based diet. And he gained weight in his cholesterol and his triglycerides went up. So what did he do wrong, if anything? Well, you know, it sounds like.

to me and Dr. Steve, he fell in that same habit. A lot of people get into, they read these things that say healthy or organic or are all good for you and they don't read in there. And look at the ingredients where there's a lot of hidden sugars. Well, sugar itself is vegan. That's correct. That's correct. And I think that's probably...

Table sugar is vegan. Yeah, because you think about money is not. No, but still yet it's the hidden sugars. If you notice the one interesting thing, you said, is trachlyceride shot up. So his liver is being over-stimulated with these sugars. kicks that up and that kicks up the production of the cholesterol too. So, you know, what you want to... Carbohydrates are the enemy, not fats.

Right, that's correct. So, you know what it looks like to me is that he was trying to do the right thing, but he wound up eating the foods that were absolutely categorically wrong. If you want to be a true vegan and not gain any weight, you have to eat kind of like an ape and a wild, you know, and eat 16 pounds of spinach and kale and, stuff daily and then that won't happen you'll get all your proteins can you get enough protein

you know what they found is that one of the reasons that animals in a wall specifically and I can speak specifically to apes that eat these they get a very small amount of animal protein and the bugs and stuff that they are on the leaves right right and they they found that in captivity actually and but so what he was

well that's interesting because they'd wash their food they wash it clean right and took all the bugs took all the bugs off but that's exactly right So this gentleman had a good idea, but the bottom line is he, you know, if he's eating a bunch of rice, if he's eating a bunch of bread, if he's eating these things, the grains that convert in your bloodstream almost instantly to sugar, spiking your serum glucose, it's spiking triglycerides that spikes your cholesterol. He had it close, but I would say stop the sugar, you know, the fruit drinks, stop the fruit, I hate to say it. Well, cut down on the fruit. Or at least cut down the fruit and absolutely cut down on all the brains and the rice, et cetera.

Go back to the green leafy vegetables if you want to be vegan. But I'm a huge fan of, again, moderation. I think a little bit of meat. You know, we talk about a lot of times on here the pescatarian diets. Yeah. Based mostly on veggies and fish. And that's kind of the diet that I go to. So he was close.

He just had a bunch. You know, I think in retrospect, he can look back and see there were a bunch of hidden sugars in there. And that's what derailed him. Sure. I see a lot of vegans who get fat, and their indices don't do well because they're eating a lot of pasta and potatoes. And then, as you said, other things. And so starches are just sugars that are chained together.

So pasta, even, you know, whole grain pasta, even potatoes, any of that stuff. and they're filling and they taste good and it's like well I can't have all these other things but I can eat all the damn potatoes I want and then that's the problem I'm just reading yeah vegan diets a lot of times just rely too heavily on carbs

and there's a report in the American Journal of Clinical Nutrition and says 99% of our genes were formed before the development of agriculture and the consumption of grains like wheat around 10,000 years ago which you and I have been talking about

for a long time. Right. Our ancestors didn't have gluten and a lot of wheat in their diet because they hadn't developed agriculture yet. And these things are a mismatch with our genes for a lot of people. And then you refine it and you hybridize stuff and you spray stuff and genetic modification, whether it's through GMO-type stuff or just Mendelian genetic modification. You know, we're eating things that are.

bodies didn't evolve to process very well. Exactly. So, but anyway. So, yeah, that's probably what's going on there. And I'm with Scott. I think green leafy vegetables applies in another place, too, these people that are eating ketogenic diets. If they're just eating meat, they're malnourished.

They will lose weight, but they're losing weight because they're malnourished. You know, there's as much protein in a head of broccoli as there isn't a flamenon. Is that right? Yep. And you think about it. Those, you know, rhinoceros. This is, you're right, you're right. Giraffes, et cetera.

Herbivores must be getting protein from plants. They get protein from plants. But the reason they do is because they eat such massive amounts, right? They're not protein dense, but there's adequate protein if you eat enough of it, which is, you know, what you and I, you and I, we have to eat at certain times because we have jobs and families and blah, blah, blah, blah. But, you know, if we're living in the out in the jungle and, you know, we're going to eat and sleep most of the time, you can kind of eat at your leisure throughout the day and get those calories. but we just can't do that. Okay, so let me, I'll give you some vegetables,

and you tell me, oh, we don't have enough time for this stupid game. Okay. Weirdly, and this one surprises me, one of the vegetables highest in protein is watercress. Yeah. Cuciferous plant grows in water as a high protein content. One cup of chopped watercress contains 0.8 grams of protein, 100% of vitamin K. and B vitamins.

Okay, let's see here. How about spinach? Protein accounts for 30% of its calories. I love spinach. Raw spinach is my favorite thing as far as vegetables are concerned. Cale and Swiss chard and things of that nature. Yeah, Chinese cabbage, bok choy, asparagus, and also you can piss and stink up the bathroom.

One cup contains 2.9 grams of protein, mustard greens. broccoli. One cup serving of raw chopped broccoli has 2.6 grams of protein. And all the essential amino acids also contains folate, manganese, potassium, phosphorus, and vitamin C. So people who are on a ketogenic diet, if they will skew highly toward the green leafy vegetables and lean animal protein, that's a reasonably safe and effective diet for people. I'm not a big fan of diets per se, but it's a lifestyle, it's reasonable. And particularly if you're gluten-sensitive like I am, you know, and don't want to eat a bunch of potatoes

because that's what gained, where I gained a lot of weight. So anyway, all right. I'm looking to see if we have any dick or nut questions. Well, I have a Cialis question. I'll say I had a masturbation. Oh, you did? Yeah, well, no. Hey, Dr. Steve.

This is the, you want to do it? No, no, that was the John Popper thing. Oh, that had called a while about. about the projectile ability of ejaculation and also about Viagra versus Cialis. I have a question relating to the Viagra versus Cialis. Blue Chew, is it safe? Does it actually use the ingredients? Okay, so I don't know anything about blue chew, but if they're FDA, you know,

approved and they are selling what they say is the same ingredient as Viagra, then that's sildenafil, then yes, that would be safe as long as there's no contraindications. The deal with these, we only got 30 seconds, is that

compounding pharmacies can make a chewable Viagra because there isn't one commercially on the market. So they can make anything that's not commercially on the market and you can go to any compounding pharmacy and get Viagra lozenges and, you know, and chewables and stuff like that. And those are perfectly legal

and they're just as safe as the regular. So anyway, you can even get your local compounding pharmacy to make some of those for you. Just talk to them and let us know if you try it. Make sure you don't have any contraindications. You're not taking nitrates or alpha blockers or you have other reasons not to take these medications. They will drop your blood pressure in the presence of other medications, and there have been known to be some serious adverse effects in people who are taking them not as prescribed or for whom they shouldn't have been prescribed in the first place. All right.

Have a great week. Thanks always go to Dr. Scott. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teft, Lewis Johnson, Paul Offcharski, Eric Nagel, Roland Campos, Eton Twads. Happy birthday, Eton, my good man. Willie Fistigash, Lou Stool, Eileen Eulick, Sifonda Cox, and none other than the inimitable,

Hugh Jasshole, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, and Fes Wattley, whose early support of this show has never gone unappreciated. Listen to our SiriusXM show on the Faction Talk channel, SiriusXM, Channel 103,

Saturdays at 8 p.m. Eastern, Sundays at 5 p.m. Eastern on demand, and other times at Jim McClure's pleasure. Many thanks to our listeners, whose voicemail and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps, quick smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine.

You know,