Weird Medicine: The Podcast - 555 - Tasting Blood

Episode Date: July 3, 2023

NOTE TO LISTENERS: Please forgive the recent delays in episodes. We are in the process of transferring to another RSS feed and having some serious technical difficulties. When we get this done, all will be explained. Thank you for your patience! =============================================== On the Ol' "Triple Nickel" Episode, Dr Steve, Dr Scott, Tacie and Dr Jeff discuss: Mom Swipes Left: weird mouth thing Tacie's Time of Topics Dementia Drug Magic Mushrooms and Color Blindness Puffy Face Syndrome Viral v. Bacterial Infections Antibiotics and Tonsillitis NSAIDs and Blood Thinners Fatty Liver, or Fatty Tumor (lipoma...they're benign)? Is thyroid resurrection possible after supplementation? Colonoscopy without anesthesia (again) And nothing about integrated circuit timers ;-) Maybe two engineers will get the reference (if that, and it's not even a funny one) Please visit: stuff.doctorsteve.com (for all your online shopping needs!) ed.doctorsteve.com (for your discount on the Phoenix device for erectile dysfunction) simplyherbals.net/cbd-sinus-rinse (the best he's ever made. Seriously.) RIGHT NOW GET A NEW DISCOUNT ON THE ROADIE 3 ROBOTIC TUNER! roadie.doctorsteve.com (the greatest gift for a guitarist or bassist! The robotic tuner!) see it here: stuff.doctorsteve.com/#roadie Also don't forget: Cameo.com/weirdmedicine (Book your old pal right now while he’s still cheap! "FLUID!") Most importantly! CHECK US OUT ON PATREON!  ALL NEW CONTENT! Robert Kelly, Mark Normand, the O&A Troika, Joe DeRosa, Pete Davidson, Geno Bisconte. Stuff you will never hear on the main show ;-) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Did you hear about the contest to win a ton of cow manure? To the victor, go the soils. Why did the dad cross the road? He saw another dad, working on a car. Why'd the cat cross the road? Because the chicken had a laser pointer. And if you like that, I can add my cat's sound. If you just read the bio for Dr. Steve,

host of Weird Medicine on Sirius XM103, and made popular by two really comedy shows, Opie and Anthony and Ron and Fez, you would have thought that this guy was a bit of, you know, a clown. Why can't you give me the run? Respect that I'm entitled to! I've got diphtheria crushing my esophagus. I've got Tobolivir, stripping from my nose.

I've got the leprosy of the heartbells, exacerbating my impetable woes. I want to take my brain out and blast it with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. 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 a requiem for my disease. So I'm paging Dr. Steve. From the world famous Carter Electric Network Studios, it's weird medicine, the first and still only on censored medical show and the history of broadcast radio, now a podcast.

I'm Dr. Steve with my little pal, Dr. Scott, the traditional Chinese medicine provider, gives me street cred the wacko alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. and my partner in all things. Tacey, hello, Tacey. Hello. Do you have topic time today? I'm mine.

Okay, awesome. And in the studio for the first time, Dr. Jeff, an osteopathic physician of great renown. Hello, Dr. Jeff. Hello, Dr. Steve. Thank you for having me. This is a show for people who would never listen to a medical show on the radio or the Internet. If you've got a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, it was a call 347-7-7-7.

66433.23. That's 347. Pooh-Hill. Follow us on Twitter at Weird Medicine or at D.R. Scott W.M. You like how I accentuated that. Visit our website at Dr. Steve.com for podcasts, medical news and stuff you can buy. 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 health care provider. All right. Very good.

Please don't forget stuff.com.com. Stuff.com.com for all your online shopping. needs. I understand that people with iOS were having trouble accessing that site. I'm going to, Dr. Jeff and I are going to figure that shit out because that works fine for me, but that may be a problem for some people. If you're having trouble with that, let me know. Stuff. Dot, Dr.steve.com. And you can have ad blockers on. It's fine. You just click through to Amazon, then they're all, you know, but you won't see the rest of the page. And then if you're interested at all in non-pharmacologic treatment for your erectile dysfunction.

Check out the Phoenix acoustic shockwave therapy. Same stuff you would get if you go to a med spa and have a stranger holding your junk in your hands and running this probe up and down for multiple visits for thousands of dollars. You go to ed. Dottersteve.com, like echo delta. you know, E.D. for erectile dysfunction. No shit. And you can get a discount for that thing.

They have a payment plan. It ain't cheap, but it's a lot cheaper than going to a med spa and having this done. And it really has some decent data behind it. So I don't like to plug things that I don't think work or that I wouldn't use myself. So I'm in my second phase of doing that. And Tasey'll let you know how that's working. later, I guess. I guess we have plans. Or whoever. Okay. Tweakeda Audio.com offer code fluid, FLUID for the best

for the best earbuds on the market for the price and the best customer service anywhere. Use offer code fluid to get 33% off your order. And simply herbals.net, Dr. Scott's website with the best CBD nasal spray ever made, maybe the only CBD nasal spray ever made. Do you know? Yeah, it's the only good one. We've been, okay. I don't think there's any other ones at all.

I have not seen any. No, I don't think so. You're the number one CBD nasal spray in the country, I believe. So that's just my personal belief. And we've been running some of your ads at the beginning. Have you noticed anything? Very good. Oh, yeah?

Okay, good. Patreon.com slash Weird Medicine. That's TaceyB. We're going to record tomorrow a new show. And, you know, Tim Dillon has agreed to be on. But then when I follow up, then, you know, I get crickets. So we'll see. Tim and I are sort of buddies.

So I think we'll be able to get him on at some point. But it's fun. We've had a bunch of lunatics on there. We had Chad Zumach. We had Gino Bisconti. We had the Troika of Opium Anthony, Mark Norman, Pete Davidson, other folks. It's worth getting in there just listening to the old stuff. And then there's classic weird medicine episodes that are no longer available

on the internet. And then I swear I'm going to start doing these live streams. It's coming. I just want it to be right when I do it. And I just right now don't have time because of my job to sit down and do it right the way I want to do it. But it's coming. I promise it's coming. So check that out. Patreon.com slash weird medicine. And if you just want me to say fluid to your mama or whatever, Oh, and you know who else got a Patreon from, or a cameo for me the other day? Dr. Scott, your favorite person. Give yourself a bill. It was Cassidy's birthday, and her dad got her a cameo from me, and I didn't realize who it was.

So I would have said, you know, give yourself a bell to her or something. But instead, I just told a bunch of dad jokes. She's a good kid, and her dad is a cool guy. so anyway there's that so yeah she did a cameo so cameo.com slash weird medicine it's unbelievably cheap

I mean I do it just for fun but they won't let me charge zero I would charge zero if they would let me he would absolutely would it's so much fun to do anyway all right anything else nope

well welcome to the studio Dr. Jeff we're going to be talking about all kinds of stuff today including osteopathic medicine but we're basically just going to be talking about dicks and nuts and stuff like that if that's okay. Yeah, osteopathic medicine

includes dicks and nuts. Excellent. Okay, well, very good. Well, that's good to know. Check out Dr. Scott's website at simplyherbils.net. That's simplyherbales.net. And I really didn't do a whole lot of show prep today

and I'm sorry. I apologize for that. unlike normally when I play you know put in all kinds of time and I forgot to take my medicine today so this is going to be an interesting show I try to make it halfway interesting Tacey has topics let's do Jen and Carol's question first I'm doing it blind I haven't listened to it

and people were complaining that my bumper music sucked so I'm just going to play their question didn't you create that music yes fuck off Dr. Steve I have a question. We have a question. Okay.

We have a question. My entire life, I have played sports. I have not. When I exercise rigorously, I have always tasted blood in my mouth. Have you never had that? No. I also have never exercised vigorously. I mean, you had to have exerted yourself at some point.

I mean, you know what happens to me? I don't taste blood, but I get a very weird pain in my throat. and neck, which probably means I'm having a heart attack or something. When was the last time you had that? I have it frequently. Probably have a stroke. That's what I'm thinking. So I will actually taste, I'm not coughing,

but my mouth and my throat will have a metallic taste, and I'm convinced when I spit is going to be blood. It's never blood. Oh, that's weird. What is that? Is that something that I should be concerned with? Thank you. And God bless.

That's Jen and Carol from the mom's Swipes Left podcast. Check them out at mom swipes left, I think.com. And I have no effing idea on this one. Dr. Jeff. Yeah, this is a new one to me too. I'm wondering how vigorous of an exercise are we talking about? Are they bearing down? Are they clinching down? Yeah. Well, the thing is, is that we can't ask follow-up questions. So we have to deal with what we've got. Now, she said that she exercises vigorously and has for years. And then one of them said, well, maybe you're having a stroke. No, that's not it.

Stroke is characterized by one-sided weakness of the body, not a metallic thing or, you know, taste in your mouth. Tacey, what did you come up with? Some of the excess hemoglobin released from the leaky red blood cells in the lungs is transported through the bronch to the mouth. Oh, harken to thine inner voice and give myself a bell. No task shall be denied if thy will is strong and is true. It carries with it the sound of courage that gives strength to even the meekest of hearts.

All right, enough of that. So ring thine own bell. Okay. Okay, so read further taste. That's awesome. Well, there's just a couple of different things. Another thing, that was by Ohio State University. Another thing says the effort exerted on top of the existing irritation might cause the mucous membranes to bleed just ever so slightly.

Right. And then you could actually, I think the sensors and the tongue are sensitive enough to taste blood that you actually could not. Can't see. Can't see. But it's the hemoglobin that makes the metallic taste because it's bound with iron. It also says that from the Marathon Handbook, tasting blood in your mouth while running is a bipolar. product of breathing hard. Yeah, but that doesn't answer the question, though.

You know, I know that stuff from the top of your airway can sometimes, you know, if you've got an infection or something, can smell or taste metallic. But I think the metallic thing is blood. She's saying it. It tastes like blood, not just like metal. Yeah, with that much exertion, maybe it's a little sinusy thing, maybe a little post-nasal kind of drip. Yeah, yeah, yeah, but... I like Tacey's answers.

I do, too. That's why she got the full Monty on the... Give yourself a bell. Anyway, there's all kinds of stuff about it on the internet. Okay, well, can you... Tell us about the hemoglobe and leaking from... Well, you know about leaky junctions. Yes.

So, was there something else in there about the leaky junctions? No, because I'm not even on that. Because it makes sense that if you're huffing and puffing and really exerting yourself, that the junctions between the epithelial cells, which are the cells that line, you know, cavities like the lungs, would open up some, and there could be some just, you know, a blood,

you know, a red blood cell or something leaking in there, and then the lung has got to transport that out. I mean, it talks all through, I mean, about hemoglobin molecules in here. But, I mean, as it pertains to your question, yeah, I don't know. Yeah, okay. Interesting. Yeah, you know, proper breathing technique and exercise is super important, right?

Sure. And if you're not breathing during strain, you're increasing intratheracic pressure. And that could certainly, you know, cause some damage to those blood vessels. I'm wondering also, too, about reflux. Yes. There might be a little reflux involved there. That was the other thing I was wondering about. I'll give you a bell for that one.

of myself a bell. Well, just because... I don't know if you figure this out, but I give people bells when they say something that internally I was agreeing with. But yeah, I wondered about

reflux as well, but that usually gives you a metallic taste, but not blood. I've had reflux before, and you get this sour kind of almost metallic taste, but I wouldn't characterize it as tasting blood, but that

could be it. I sent you the article that talks about it. Okay. Cool. Yeah. That's pretty awesome taste. I've got to give it to you. Yeah. Red blood cells can leak into your alveoli during hard effort. It's temporary.

Nothing to worry about. If you always taste blood, you should see your doctor to rule out underlying health issues like infections, but this has been going on for years. Yeah, forever. So I think she just worked. out. I would like for I'm starting to get

their voices. I think that was Jen. I would like for her to check her resting and maximum heart rate because I wonder if she's overdoing it. You know, there is a formula for that which we can talk about. Let's see what she says

and then we could walk through the formula to figure out what your safe heart rate is and what your target heart rate is. What about the pain in neck. Did she say she was having pain in the neck too? Oh yeah.

That was the other one, yeah. She does an exercise and she gets like a pain in her neck, the back of her throat or something like the back of her throat. That would sound like that's coming from breathing.

They live in Maine. I don't know how humid it is up there, but if she's working out in the winter it's probably due to dry air, be my guess. Now, having said that we've talked about this case before on this show but this would be something

more recent where we had a patient at a university center that came in and was triaged to the non-acute side of the emergency room because he complained of sore throat and when they went in to go see him he was dead now the reason for that was after the autopsy they figured it out. He was having a heart attack, aka. Myocardial infarction. And in those situations, you have chest pain radiating to the left arm, but sometimes people will have pain that radiates to the neck.

And instead of saying, you know, because not everybody's a textbook, you know, I have left-sided chest pain radiating to my left neck, accompanied by shortness of breath, sweating, and nausea, and palpitations, which would be sort of a classic presentation, he went in and said, I'm having throat pain. And they interpreted that as, oh, this guy's got a viral URI, he's got sore throat, or something, stuck him over there, and then he had an arrhythmian died. So, yeah, when you, and caveat for the providers out there, take a complete history while you're triaging somebody, but also for us as patients, make sure we tell them the whole story. It probably wasn't the only thing.

And it may have been I was pushing my lawnmower when this started or I was running up the stairs or something like that, you know. So we've got to give people context. A little bit more info, yeah. Yeah, it didn't even sound like she was exercising when it happened to her, though. Do I need to play it again? Was that? I thought she said when she...

Okay, when we... Yeah, it's right there. It's right. pain in my throat and neck which probably means I'm having a heart attack or something when was the last time you had that I have it frequently probably have a stroke that's what I'm thinking so I will actually taste I'm not okay so that was Carol saying that and then this is coughing but my mouth and my throat will have a metallic taste and I'm convinced when I spit it's going to be blood now that yeah again the metallic taste could be reflux that could be yeah

if it's just happening, you know, when you're not exercising. Now, the pain in the second throat, I'd like to hear more about that because, of course, Carol throws that in, and then Jen just, you know, takes over the conversation again. Yeah, the pain in the throat is a little concerning. Yeah, let's hear more about that. Maybe some more information. Yes. Be helpful on that.

Yes. Carol, you can just send that in by yourself, and then we will pay attention to you. Quickly, quickly. Send it in quickly, please. All right. Let's move on. Oh, well, of course we have something that we can do right now. It's Tacey's Time of Topics, a time for Tacey to discuss topics of the day.

Not to be confused with Topic Time with Harrison Young, which is copyrighted by Harrison Young and Area 58 Public Access. And now, here's Tacey. Well, hello, everyone. Hello. Hi, Tacey. Okay, topic number one Okay I can't read because my microphone is in the way

I've never noticed that before Anyway, new Alzheimer's drug slows disease by a third We are on the cusp of drugs being available for this It seems previously impossible Because I know it's coming Eli, Lily Okay, don't know how to pronounce this Donanamab

Oh, okay, it's a monocle antibody Slows it by about a third What? Yeah, antibody made to attack viruses but engineered to clear a sticky gunk from the brain called beta amyloid. Amyloid builds up between brain cells and forms plaques, which is a hallmark of the disease. Full details are yet to be published, but, number one, 1,734 people in early stages took part. Number two, given as a monthly infusion until plaques and the brain were gone. Number three, disease pace slowed 29% overall.

And number four, those given the drugs were able to retain their day-to-day lives. Really? Okay. Brain swelling happened in one-third of patients. One point six got dangerously swollen and two deaths. Maybe a third occurred. Ooh. Eli Lilly will begin the process of having its drug approved for hospital use soon. That's from BBC.

Hospital use. Yes. They said hospital use. I don't know. That's strange. So anyway. Big deal, though. Okay, drug slowed the disease progression by 35%.

Yeah. Wow. Okay. Well, there were some pretty serious adverse effects on this. And there was another one, Lachanamab, which was, you know, touted as a new Alzheimer's drug. And it didn't quite make the cuff. because it had so many adverse effects. This one, some people, you know, this Robert Howard,

he's a psychiatrist at University College of London, says this one looks just as dangerous as Lekanamab. So, but we think that this has got to be, you know, at least a glimmer of hope for a safe treatment in the future. If this one doesn't make it, which it may not, maybe they're on the right path anyway Eli Lilly's going to hype it up of course but you know if you've got people dying

of brain swelling when they when they have grade one dementia you know there's seven stages of dementia we use a score called the fast scale and one through seven

well the first five are just you know you start off as being slightly eccentric and then you can't plan a party and then you can't do your checkbook and then as you descend down that scale then you start losing some real cognitive ability and by the time you get to 7c the you know seven is divided up into a bunch of different segments people at 7c can't walk and can't talk and they have trouble eating so you know it goes all the way down if you are at class one

or stage one and you just have some memory trouble and then you take this and then you get brain swelling and you die that wasn't worth it. No. If it works for you and it slows progression

so that you get an extra year of being able to do stuff before things get really bad, that's great. So what they need to do, if they can, is figure out what is common in the people that have the brain swelling

and then you can subtract those people out. It could be a genetic marker, who knows, but they got to figure this out, because these drugs are not going to get approved like this if they continue to have such serious adverse effect. I had an Alzheimer's patient, excuse me, once, and I had to remove her teeth and clean them every day. But she liked to bite me. With their gums or with the teeth? No, with her teeth. So I had to try to get in there and get her teeth out without being bitten. How do you do that? Well, Well, it was, I mean, I don't remember. It's been so long ago, but, I mean, it was, it was like, hell, I've never been so scared.

Because you're an idiot. I mean, it was terrifying. She was like, go ahead. Oh, really? Yeah. Oh, she would invite you to do it, and then you'd get your finger in them. Yeah, no, she was me. It's a trap.

Good for her. It's awful. Oh, my gosh. Wow. That's awful. That is an awful story. It was, did it for like a year. So what did you do, just start smacking in the back of the head.

Yeah, I just smacked around a little bit. We know taste pretty well. You ready for topic number two? Yes. That's a good one, Tase. We should have a sound effect for these different topics. Can Magic Mushrooms cure color blindness? What?

No. This is from interesting engineering. And they used a test called the Shihara test, Steve. Okay. Which is the most common color vision test. Before ingestion, a subject self... Okay, so this is a study of one, okay? Some guy took magic mouthwash, magic mushrooms.

Yeah. And I saw colors. Maybe they're having trouble finding participants that are both colorblind and connoisseurs of magic mushrooms. That would not be hard. So I almost didn't do it, but I thought it was pretty interesting. No, that's funny. The subject self-administered this test and scored a 14. Now, if you get a 17 or above, your vision is considered normal, but a 13 or below, you have color vision deficiency.

So 12 hours post ingestion, he scored a 15. 24 hours post ingestion, he had an 18. He peaked at 19 on day 8 after his mushroom experience. After a year, he scored a 16. So in conclusion, a single use of, how do you say it? Scylla Simon may produce partial improvements, well, I started to say, ask the hippie, may improve partial improvements in CVD extending beyond the period of acute effect. Okay, so this is pretty interesting. I've thought this was kind of BS, and then I'm looking at this, the Isha, so this guy did this on his own, and then he reported it to his doctors, and then they said,

by God, we're going to do a test and just by God, see. So the Ishihara test has these plates of colored dots and they have these patterns and they would be either invisible to someone with color blindness or they would be only visible to someone

with color blindness. And it's a pretty cool test and it's a good test for determining color blindness. But the problem with color blindness is you actually don't have the rods or the cones

that you need to detect those colors so I don't know or the chemistry in them is distorted so that they don't work and I don't know how this would work. That is pretty bizarre

isn't it? Yeah so he reported 14 then a 15 and then an 18 and normal's 21 Unless you've got normal, you know, normal rods in your, and cones in your eyes, but it's your visual cortex. It didn't. Oh, okay.

Interpreting the. All right. I got to give you that one. That's possible, but I don't think that's how colorblindness works, but maybe in his case it does. I don't either, but I think that could be. We don't go in and biopsy people's retinas and go, oh, well, you don't have your colorblind, sorry. Green, you know, thing. So absolutely, there's anything.

in that circuit could be screwed up That's interesting Isn't it wild? Yeah, see if you can find neurologic or neurogenic color blindness Because if that's a thing And I don't know, I'm not

One thing we don't learn about In medical school too much Is a whole lot of ophthalology And a whole lot of dental stuff Or magic mushrooms Or magic mushrooms Although we did do pharmaceutical cocaine In medical school

I've told you that story. Oh, yeah. So, yeah, if we can find anything on neurogenic, because if he had that, then that makes total sense to me. Because maybe it was altering the visual processing centers in the brain. Right. Well, again, kind of the same thing that he said. Give thyself a bell. But yeah, I give you a bell for that. Appreciate that. It says, here, we would not expect psilocybin to repair his genetic defect, so it could never fully restore his color vision. Instead, we hypothesize

psilocybin. There you go. Improved processing of the limited visual sensory input entering the brain of this individual. So, yeah, it was doing it at the level of the cortex, just like Scott and Dr. Jeff said. So that is fucking fascinating. That sure is.

That's a good one, Tase. I'm going to give you a bell. Oh, no. Well, this next one sucks, so get ready. Okay. I did this for myself because I often have a puffy face, and I always thought it was Hashimoto's, whatever. But it is a puffy face, a sign of a serious health problem.

This is from the scientific, um, are you, did you just seriously put that on me? Oh, did you turn it so it wasn't on you? No, I don't, I did not shower today, and I do not want to be on, this is a radio show. But she brushed her teeth, she did brush her teeth. I did brush my teeth. Do you use deodor? I did. Do you rub a clear, a clean rock under your armpits?

No, I used her. True style. I believe it was a secret. You can use bacon, soda. You are such a... All right, anyway. So anyway, this comes from the scientific magazine Good Housekeeping. Chronic facial swelling is often an early warning that something serious is going on.

Now, we're not talking about just a little bit, like, ooh, I had a little wine last night. We're talking about if you look like a blowfish. Oh, yeah. Or a dog after a bee sting. Well, yes. Which, yes, like if you had that, so you need to go to the doctor. So I told you it wasn't good. It could be a sign of inflammation in your body.

Inflammation, hormones, or allergens can all contribute to it. If it comes out of nowhere, like not after wine the night before, and you have difficulty breathing or swallowing, have a pain or numbness, fever or can't move part of your face, visit the ER. Yeah, no shit. Or call your doctor. Now, treatment for mild facial swelling. cold compresses, stay hydrated, sleep upright, take an OTC and a histamine.

This is for a hangover. Yes, I believe so. Don't drink alcohol or eat salty foods, and don't sleep in your makeup, ladies. Oh, really? Yes. So, yeah, so the kinds of facial swelling that we see that are really pathologic, the one that can come up suddenly is a thing called Superior Vena Kava syndrome, which is where you actually have a tumor that is blocking

the egress of blood from the head and the whole head face will swell up and maybe even turn purply kind of color and that is a medical slash surgical emergency. Often they'll give you a dose of radiation to the tumor and a lot of times people who have that didn't even know they had cancer. That's how they find out about it.

And that's what fucking sucks about cancer. I'm going to stick my neck out and say cancer sucks and give me, you know, what a hot take. But instead of knocking the door, you know, knocking on your front door and say, can I come ahead? Which if it did, you could just shoot it with a double barrel on your porch, right? And what's that called? Castle rules or what I know? But instead of doing that, it waits until you're asleep. and sneaks in the back window and knocks you over the head with a lead pipe like a, like a bitch.

So cancer can kiss my ass, no use for it whatsoever. There's no benefit from it. It needs to die. And we are very close, my friends. You remember a long time ago we talked about the lady, and if you're interested in this, go to dr.steve.com and click on the menu and look for non-sudoscience cancer cures. but there was a lady literally dying of stage 4 cervical cancer and they said well do you want to try this new treatment

and she was like do I you know what have I got to lose so what they did was they took some of her tumor cells out mixed them up with her white blood cells and then sent them back and it was sort of like taking a sock and and you know letting a dog sniff it and go go find Scotty's you know he's out in the woods some worse and then the dog goes and finds him. Right? It was just like that.

And that woman, to my understanding, is walking around cancer-free today. Wow. So they are now selling this as a thing called CAR T-cell therapy. So it's chimeric antigen receptor T-cell therapy. And it's actually on the market. Fabulously expensive, of course. And you have to get into a lottery, most places, to even get it if they have one that's based on your cancer, but

this is just the first step and it will become commonplace over the next, I think, 10 years. And I used to say this shit was 100 years away. It's here now. So yeah, pretty amazing shit.

So there you go. That concludes our topic. Ah, very good, Tacey. Let me see. Thank you, Tacey. I've got to have an outro too. All right. Good stuff.

You got you brought some stuff, didn't you? Yeah. Okay. Yeah, we've got two questions from the Fluid Family. All right, let's do it. Fluid Family is our YouTube channel while we, this is a radio show, but we do have a YouTube presence just for the five or ten people who want to hang out with us while we're recording. Scott and I said from the day we started doing this that it gives it a little bit of different vibe because we at least. aren't just in here masturbating with ourselves.

Circle jerk where we have a group of people that we're actually talking to live. Even if it's one person, it changes things. It does help. It sure it does. But anyway, but you can hang out with us. Check my Twitter at Weird Medicine or check our YouTube channel, which is YouTube.com slash at Weird Medicine, all one word. and then you can subscribe and like and all those things,

and then you'll get notifications whenever we go live. Usually Saturday around 1 p.m. Eastern time. So anyway, what you got there? Yeah, so Love it. First question, very good. It kind of feeds into the second question. Okay. How can you tell the difference between a bacterial and viral infection? Of the what, though?

Well, she just says in general. Okay. So let's just pick one. Well, it's pretty easy. Let's do bacterial versus viral of the eye. Okay. Or of the nose. Usually, well, Dr. Jeff, you take this.

Shit, I'm doing all the talking. Sure. This is primary care, you know, bread and butter topic. Yep, yep. So, you know, somebody comes in with conjunctivitis, let's say, right? Yeah. They describe. Which is infection of the clear part of the eye, or the whites of the eye.

And, you know, they describe if they describe a dry sensation with kind of feels like sand and grit in the eye. and they talk about it being isolated to one side, not crossing the midline. Then they talk about how they take a nap and they wake up, and when they do, their eyelid is matted down, just crusted over with all this goop and crud. That really speaks to that being a bacterial infection. And how would you tell the difference between the two if you wanted to laboratory-wise? So, you know, we don't culture eye-goop all that much. Culture it, but what could you do? I'm stumping.

It's called stumping. Well, you could swab it and look for white blood cells. Oh, sure. Yeah, so a bacterial infection, more likely to have white blood cells in great numbers than a viral infection would. Now, viral infections do stimulate the body to make white blood cells, but there's a specific kind of white blood cell that we would look for, and they're very obvious. We also can look at patient population, too. with the conjunctivitis. So your bacterial tends to be,

you're really young or you're really old, patients that can't keep their hands away from their butts and then their eyes. Yeah. To make the bacterial stuff. To where us folks... That's what's causing mine. I was trying to figure it out.

Those of us in the middle of... Oh, shit I. Oh, shit. Of the age range. We tend to get viral conjunctivitis because we get adenovirus or something like that. We get one of the calming... cold viruses. There you go. And that

spreads up to the eye. Yep. Very good. So, next question. Very good. So, and this is from Aegee, who is live with us in Germany. Oh, yeah. Wow. That's cool. Vigates. Volkimen. So, a question, my daughter started

kindergarten in January. I have been sick one week on when we got since with tonsillitis. I've had it three times in the last six weeks. At what point are too many antibiotics a problem oh yeah okay this is another primary care one once you take this as well dr jeff boy antibiotic stewardship right yeah why why do we worry about antibiotic stewardship so we have amazing

antibiotics that are very well tuned against certain bacteria based on certain specific properties bacteria though aren't just sitting idly by and just letting themselves get killed off they are adapting and they are evolving as they need to to avoid, to evade, you know, our therapies. So we take, we start taking too many antibiotics or more often we don't complete a course of antibiotics. And we induce resistance. And resistance sucks because, you know, you get a sore throat, your PCP gives you antibiotics when maybe you didn't need it.

And you only take it for three days because it was viral and it got better in three days. And now you've killed the good, you know, healthy back to the time. and you've killed the weak bacteria. And you've self-selected now for these really tough bastards. There you go. And then you start spreading. Give myself a bell. That was well-deserved.

Yeah, that was well-deserved. So, no, you're still on a roll, but I just, I want to just interject. So you have 100 bacteria. You kill 99 of them. But the one that is resistant, because you might have died if you'd taken all of your antibiotics, but you didn't, and this thing was just barely hanging on. Now it's going to multiply, and that'll be the only clone that's left is when that thing starts multiplying. And the doubling time can be, you know, a minute or two where these things are just growing like crazy if they have enough nutrients.

And next thing you know, you've got nothing but resistant population. That's right. You've eliminated your healthy flora, too. So now that that one lone, you know, assassin bacteria that you didn't kill has no competition for resources. Right. And it could just flourish. And so, you know, he says he had tonsillitis three times. I'm not doubting him.

I might be doubting the primary care provider who saw him or her, his AG. Anyway, saw them. and we're, and I don't know what the policies are in Germany, but we have real problems just throwing antibiotics at people. And tonsillitis really is characterized by enlarged tonsils, sore throat, and exudate where you see, you know, pus basically on the tonsils. And then we swab for that and see if it's actually bacteria or not, which is apropos to Lovett's question. and there are tests that you can do to see if it's group A strep, or you could, again, look at it under the microscope and see if you see a bunch of white blood cells or you can culture it. And very many sore throats, particularly brought home by kids at school, are going to be viral in nature. Absolutely.

And then we treat with antibiotics and blah, blah, blah. So I would just make sure that you're really treating bacteria before you, before you take an antibiotic. And that's easier said than done when you're the patient, particularly when the physician is trying to throw antibiotics at. Sure. And as their doc, you know, the patient comes in, they feel lousy and terrible, and they're asking you for help. And, you know, you're, you got into this line of work to do just that. Right. But you have to kind of keep the big picture in mind that the best way to help is not to overprescribe.

Yeah. Well, when people come in and it's like, well, I've got this sore throat, give me an antibiotic, and then you go, well, you know, take a little ibuprofen, do some fluids, try some, by the way. Gargling salt water. Right, and then they go, fuck, I paid $150 for that. Yeah, and they go out and call their buddies. Yeah, that son of a bitch. You got any leftover antibox?

If you, if there is no contraindication, by the way, if you have a viral sore throat or sore throat really from anything, the non-steroidals really work better than acetaminophen or paracetamol, which I think they call it in Germany, because it is an inflammatory problem. And of the anti-inflammatories, I prefer naproxin, which is napresin or, you know, just sold as generic, you know, CVS of the blue pills over ibuprofen because it lasts longer. yeah you know it's 12 hours instead of four or four to six and uh it may i correct me if i'm wrong dr jeff may have fewer cox-cox related uh cardiac issues that ibuprofen does absolutely it's safer so thank i'll give myself a bell i'm not going to no please do i'm sorry i think

it leaves the only one that doesn't have any cardiac i don't know if it's not any but uh Compared to the other ones. There are other ones like the non-acetylated solicilates also don't, but you can't hardly find those anymore. Like disalcid and salacet and stuff like that. Because those are aspirin-like. Definitely. Sparing the cardiac effects, it's easier on the kidneys.

Right. Lots of good reasons to choose it last longer, like you said. And you don't want to miss, however, strep throat. Yeah. Because if you, the only reason we treat strep throat, is not to make the syndrome go away. If we treat strep throat with penicillin, a syndrome may go down, you know, decreased by one day.

But what we're really doing is preventing rheumatic fever and rheumatic heart disease. Absolutely. And, yeah, go ahead. This is such a topic in primary care that we have, we even have a really good pre-test for this, right? So we have something called the centaur score that we use. And it's a set of criteria where someone can come in,

they present. And we can base it. Censor score is, I think it's five total age of the patient. If there's exudates or swelling on the tonsils, if they have swollen or tender anterior cervical lymphiness, right? Oh, yeah, that's a good one, yeah. That's very specific for strep. Fever.

And then cough. And it's not if you have a cough that you get points. It's if you don't have a cough. That's correct. If you have a cough, then it's probably not stress. Probably not strep. Yeah. Very interesting.

Very interesting indeed. And Centaur is not like half horse, half human. It's C-E-M-T-O-R. Stupid. Should be Centaur. Dr. Robert Centaur, who devised this. Yeah, of course, he named it after himself. His name is stupid.

I invented, well, I can't have a formula from converting from one opioid to another, and I resisted calling it by my name because I think that's stupid. stupid. Just say, just put it out there. You don't have to name it after yourself. All right. Well, let's do one. System duration. Okay. Well, anyway. Oh, okay. Okay. So, let's say you are, who was it, BG? Yeah. Okay. So BG comes in, and you're going to be BG. So how long have your symptoms? Oh, A.G. Yeah. Okay. How long have you had your symptoms? You don't have to ask them. You're role playing for them. We don't have time. six weeks so shut off that's what he said oh is that what he said six weeks a week on a week off a week off he said he's had three

three times back to back and back okay so let's say seven days and so each one is seven days right for six weeks okay the centaur rule only applies for symptoms less than are equal to three days so so we'll say three days okay and then age is great 15 to 44

yes 43 actually okay swelling or exudates on the tonsils let's say no. No. Tender swollen lymph nodes? No.

Fever? No. Cough, present? I don't know. I'm going to say yes. Okay. Okay, there's a one to two percent likelihood of group A strep pharyngitis. No testing or antibiotics required.

Hey, AG, take the centaur, C-E-N-T-O-R score and look at it and then let us know what the results were in Scott. will give us the result. And if you don't feel like doing that, take that to your primary care person who's treating you and see, because half the shit that kids bring home are viral.

It's way more than a half. And it's awful in kindergarten. It does suck. It's awful. Because all of these viruses have mutated since we were in kindergarten and all these kids get together and they're gooey and they eat each other's sandwiches and stuff. And he can't do a couple things. And this is

true. He can gargle the salt water that can help protect him from getting another infection. He can do the nasal sprays that can help, you know, keep him from getting infections too. So especially with a kid in kindergarten, you're going to catch a bunch of stuff. So maybe trying to keep from catching those in the first place. But just lavaging out your pharynx is what you're saying. Of course, he's a little far away for his simply herbal nasal spray, I think. Yeah, we can get a nabash though. I don't know that they have any data on if you use the nabage every day if you get sick less frequently

that would be a good study for them to do if people don't know what I'm talking about the Navage is the uh it would make sense automated Nettipot and if you go to our YouTube channel you can see who was it NP Melby

Melby right yeah yeah do the Navaj she hated putting anything in her note she was horrified but it worked for her long feather's got a great question too kind of a follow up he's asking you know as far as inseds folks that are on cumminsetsets non-steroidal inflammation can you take an inset if you're on cumminton

Jeff so you know on cummiden or warfarin you have to be careful with any medication there's so many interactions you have to be careful with medications and foods and so I it's not strictly contraindicated to take ensed you know taking insides in the setting of cummiden no it increases the risk of blood eating because they interfere with platelet function, so I wouldn't do it. If I was on kumaden, I would probably take acetaminophen for pain rather than... But if you're... Ask them why you're on kumidin, though, because there may be reasons that you could get off of the kumaden, which is warfarin, which is rat poison.

Yep. I mean, it's... We don't want to say, this is not like a Joe Rogan thing where they were saying, well, he took a, you know, what vermectin and he was taking horse paste. He was taking, you know, a human drug for human reason. And when we say warfarin is rat poison, don't get the wrong idea. They use warfarin in rat poison because when the rats eat it in huge amounts, then it induces bleeding in them.

So that's why it's not. It is, yes, it is also used as rat poison. But warfarin, if you're taking war, And you're not taking rat poison. No. So, you know, there are other drugs now. And some people get stuck on kumaden and don't need it anymore and they're on it, on and on it forever. And you have to do blood testing and you have to adjust it and all this stuff.

Talk to your primary about, you know, is there a compelling reason to still be on warfarin? There are still some reasons to take that over the eloquises and other things of the world. All right. Any other? Nope. Okay. All right. Let's do one. We're going to do a blind voicemail. Oh, gosh. All right. And let me see. Okay. Let's try this one. Hey, Steve. It's Evan from Wisconsin.

And I, hold on. I'm going to call back. Okay. All right. This is why we don't do blind voicemails. Let's try this one. Hey, Steve, it's Evan from Wisconsin, calling in with a take-toe. I'm in my early 30s. I drink more than I should. And I also have these weird, like, painful lumps, I guess, on my, like, both my side area and my sternum. They're pretty small about pea size, and I can manipulate them, and it won't. hurt, but if I, like, put direct pressure on it, it leaves, like, this kind of lingering pain.

It's kind of hard to describe, you know, like a kidney punch or something, but I've read it from a fatty liver and is probably tied into my alcoholism, but just wanted to see what you thought. Thank you. Love the show, fluid. Thanks, man. Well, number one, if you're drinking more than you should, you can get help. you know, go to a meeting. Dr. Jeff, you can talk a little bit about that if you're cool with it.

Yeah, the alcohol is probably one of the, you know, strongest drugs that humans have formulated in our history. It can be a lot of fun until it isn't. And then it can destroy lives and relationships and careers and families and all of the above. There's lots of help out there, especially over the Internet. listening to an amazing medical show over the internet. You can go to meetings, reach out to people all online. People have been there going through what you're going through. Helps out there, find it, my friend. Yeah, absolutely. I mean, you've identified that you have a problem. So how would you recommend someone who's actively drinking? Yeah. He's still drinking.

Yeah. How does he get started on that? So we're going to get to the lumps, but this is more important. This is more important than that. So, you know, the first thing is, doing exactly what he did, recognizing that this is a problem. We call that step one. Lots of research out there has shown that these 12-step programs are some of the best modalities we have for conquering this addiction. Find yourself a meeting. If you can't find a meeting, find somebody else who will listen,

family, friends, whoever it may be, admit that you've got a problem. And then we can start taking steps to stop the drink, Now, drinking is different than other drug use. It's different than smoking weed too much or doing coke or whatever. If you're an everyday drinker or, you know, five times a week drinker, this isn't something that you can just stop all the time. You can go into withdrawal that can be fatal. That's right. So we have to be really careful when it comes to alcohol depending on how much, you know, how much you're drinking.

And it's a process. It's a process of realizing that you got a problem, asking for help, getting a good support, system behind you and realizing that you're worth getting past this your life your happiness the happiness of your loved ones is worth it and there's there's a new day ahead you know there's a there's a better day ahead for you uh without the drinking yeah very good i yeah absolutely it's is uh please dude just take that first step and then uh get back to us we're here for you if you need you know we You can go to samsa.gov. I hate that they spell it so weird.

It's S-A-M-S-H-A. No, shit. SAMSA. Hang on. S-A-M-H-S-A. Yeah, it's pronounced SAMH-SA because the H goes in front of the S. That's why. So S-A-M-H-S-A.gov, you can find treatment programs,

but you can just go to A-A.org, too, right? Absolutely. Absolutely. Another great resource that I'll put out there is called In The Rooms.com. And this is a group of virtual meetings that are happening internationally around the world, 24 hours a day, seven days a week. You name your addiction. They have a support group for you. Alcohol and drugs, obviously, most common in these groups, but everything from gambling, addiction, sex addiction, whatever it may be. Really? And these are phenomenal because you can be as involved and as public as you want to be.

If for professional reasons, you don't want to, you know, spread the news around, that's okay. You can be anonymous. Absolutely free. Who the hell pays for this? This is an amazing website. So those of us who have recovered and found success in life outside of this, we go back and we give money. Really? Because they save lives, yeah.

Wow. Okay. Well, shit. In the Rooms.com. Okay. Check that out. I hope he's listening. Now, let's talk about the lumps.

Yeah, so anytime I hear somebody who prefaces a symptom with when I drink, I notice this or when I've been drinking a lot, I notice this, any kind of pain or, because he said they were painful, yes? Yeah. Well, they're not painful. He can manipulate them. Manipulate. But when he pushes on them, they hurt. They hurt. Okay.

First thing that pops in my head is the Hodgkin's lymphoma. No. No. Sorry. Didn't mean to get it down. Oh, I think these are superficial. Superficial? Okay.

Then I vote lightomas. That's what you get for them. I vote light on. That's what you get with a new doctor. But it's easy to find out, Jeff, we try not to just throw the C word out there, willy-nilly to people and have them shit their pants. Sorry about that. But it sounds superficial. These things sound like little fatty tumors, fatty tumors, but not malignant fatty tumors.

They are, you know, little collections of fat cells. The easiest way to know, though, is go to your primary, talk to them about these lumps, show them to them, let them poke on them. Maybe they want to take one off and biopsy it. Then they'll know. And then, while you're there, say, I want to get into recovery. Absolutely. And there are things that they can do. They can send you to an addictionologist if you need pharmacologic help.

if they're well-versed in this like most family physicians are, then they may be able to get you started with medication-assisted treatment and then get, but it's just not taking a pill. Pills are great, and there are some great new medications out there, like naltrexone and other medications to use, but it's got to be multifactorial. You can't just do that. You can't just take a pill.

to conquer this. Absolutely. All right. Absolutely. Okay, very good. Well, it was very interesting. I've got a couple of emails that were sent to me. One of them is really long, so I'm going to abbreviate it.

But I think it's kind of interesting. And y'all, you can email me stuff. Just call the voicemail. It works better. It's 347766-4-323. But this was, both of these were good enough. I really wanted to read them. So this is from.

Kai in Connecticut said I thought you might appreciate a lay person's experience trying and eventually succeeding in getting a colonoscopy done without sedation because you know I've talked about how I like doing my colonoscopies Over and over

Oh, for fuck sake For fuck sake Fuck the bright eye Lord and lady Doosh your back Oh my God Anyway Yeah so I've had a

Something about a big hairy ass on a picture. Okay, all right, right. But it says, after hearing you talk about it, apparently over and over and over again. Well, he does say several times over the years. Can you fuck off. I thought that I, too, would really prefer going without anesthesia during my first ever colonoscopy. There you go, because he's smart. I've never liked it.

I've always asked the lightest possible amount during any invasive procedure. so I figured I'd go without it here entirely. So I quickly realized, unlike your experience with sedation-free colorectal cancer screenings, it seems since I, one, am not a fellow physician, and two, don't personally know the folks who'd be doing the screening, I had much more difficult time convincing them to do it. Literally at every step of the way, let me see, I had to remind every single one of them of my wishes.

each person went right into their so do you have a ride home today and quote during your recovery from sedation you'll experience script it was unreal I can't tell if this was some kind of communication breakdown I mean obviously it was but they just have it in their brain

it's just habit or if they're legitimately convinced people don't know what's best for themselves no it's not that it's just that most people aren't aware that you can do it and it's just habit and you get into this mind drone where you just say okay do you have a ride You know, they're not even looking at it.

This was a large city hospital in Connecticut. I'm convinced no one has ever requested not to be anesthetized here. I was initially annoyed by it, but then saw the hilarity of having to start my story over with every single person. As I mentioned, they even sent the anesthesia out and I was just into the room at one point. It was the shortest communication ever. Hi, I'm Dr. So-and-so, and I'll be your anesthetized. Nope. So the good news it went right.

Now, listen, if they had a problem and they perforated your colon, they would have to anesthetize you. So it is good to still talk to the anesthesiologist, but just say, I don't need you, but they can put in an IV and have it ready in case you need it, okay? Because not everybody, some people will get into it and go, okay, I want the anesthesia because they weren't expecting it to be as uncomfortable as it. But it's just uncomfortable. It's not horrible. What's worse? That or the cystoscope, when you say worse.

Yeah, painful like. The cystoscopy Okay, someone manipulating your ass or manipulating your cock. Well, I've had one. I've not had the other, so. They were both equally just stupid.

You know, it's just stupid. I wouldn't ask for anesthesia to have a cystoscopy you're thinking you might you thinking you would? I'm thinking I would consider it. I think squirt the

numbing juice up the urethra and let it sit there for a few minutes before you just shove a damn tube in there. I've got a better idea. How about why not drinking the numbing juice and peeing it out? That would be interesting. It numbs everything on the way. I wouldn't be too bad. If they had something like that. That's my next million. They do have

pyridium, which is a pill that turns your urine orange and it is an anesthetic for the GI track. I don't think it would help for its cystoscopy, though. That's pretty horrible. It might be something to do, though. That might be an interesting clinical trial. You know, if people experience less discomfort because Dr. Jeff, you probably haven't listened

when we were talking about this, but Scott and I both had cystoscopies done, which is a little, you know, fiber optic for people who don't know, fiber optic scope, shoved up your urethra so that they can look around your bladder. And they put numbing gel on it. but they just put it on there and then just jammed the thing in there and it's really sit and wait they just that just that makes that don't think you could sit and wait long enough that makes them feel better it doesn't make us feel better and if you've ever had an STD test which I never have but they take the little swab well maybe I did before I got

married I don't know but they take a little swab and they shove it up your urethra and it's a tiny little swab and then you have to twist it around and people tell me that's just agony no thanks very uncomfortable but again it's just uncomfortable I tell people if you're going to quit smoking what's the worst that's going to happen to you

you're going to be uncomfortable who cares who gives his shit if you're a man and you smoke and you stop smoking you'll regain that erectile dysfunction that you were lost or we're going to lose but you're just going to be uncomfortable now if you just quit as Dr. Jeff

alluded to if you just quit drinking you could have serious side effects so you want to do that under someone's supervision, a medical encounter to make sure that you're not putting yourself at jeopardy. Same thing with benzodiazepines

like Valium or Xanax. Same kind of deal. Same receptor. It could be very dangerous to just stop those cold turkey. Anyway, okay, one more letter. This is from Dr. Perkins. I don't know if it's Dr. Perkins or DR. Perkins.

I never know. It's just like we've got a place in town called, I thought it was called Mr. Cleaners, and they will correct you every time. No, it's MR. Cleaners. Well, it looks like Mr. Cleaners. So this could be DR. Perkins or Dr. Perkins, which says, I picked up on one of your podcast discussions about the body getting too used to certain medications. Here's my question.

After being on, and Tacey, you're going to answer this. After being on thyroid supplementation for 20 years, is there's zero hope for my thyroid? And then he said, you know, are there any odds of finding a treatable blood flow problem? And that's really not the problem with low hypothyroidism. You know, you want to talk a little bit about... I mean, Steve, I really don't know.

Since I've... I mean, it's a long road to get to the correct dose of... Or to get to the right cocktail for being like Hashimoto's or thyroid. I mean, it's a long, terrible, difficult, awful experience. It took about a year for me. And, you know, now I feel good. And you start off with Hashimoto's, which is autoimmune destruction of the thyroid,

where you may have hyperthyroidism for a while when the inflammation is going on. And then you may even feel good during that. Some people, you know, if it's mild, they may feel kind of energetic and stuff. But then when it shuts down, that's when you feel like, Oh, just terrible. I've never felt so bad in my life. And that's the problem with people. Yeah, I could sleep.

Well, I can still sleep, but anyway. I have seen people come in, and when you treat them, it's so gradual, they don't realize it. I've seen people come in and they're talking like this, you know. And then you test them, and their thyroid stimulating hormone is elevated, and their thyroid is low. Thyroid hormone is low, and you start to treat them. And then they come in, they go, hey, how's it going? You know, and you go, can you tell any difference? No.

And it's like, you're bouncing around now. And you came in here looking like, you know, a sloth. That's a good question. I mean, are you on the same dose forever? Because I have been for a few years. Yeah, many people can be on the same dose forever. So, I mean. But there isn't hope for, for, it's not blood flow.

And there's not hope for just fixing. But it feels like blood flow. Yes. Yeah, it feels like. I understand that. I mean, like, I'm a little Hashimotoy today, and it kind of feels like my blood is moving kind of slow. Okay. Yeah. Well, that's how we perceive those things. You know, back in the day when we were just making up things, we talked about humors and stuff. You had melancholy humor and slow blood and all that kind of stuff. So, yeah, that's where that comes from. Yeah. So, I mean, if a person doesn't gain a bunch of weight or.

has any kind of changes like that. Yep. Do they usually stay on the same medication? Yeah. Well, what they do is they check your thyroid levels and your TSA. And they do kind of treat people as if their numbers on a piece of paper. Yes, they do. When it comes to thyroid, and that's not always correct.

No, it's not. And I really wish that there was a whole damn semester on the thyroid. Right, because they messed Tasey up pretty bad. And, well, it's like testosterone. If you're low normal testosterone, but you're symptomatic, just because your number is above the low threshold doesn't mean don't treat. And I think they should do this with thyroid, too. I feel like shit. My numbers are normal, but I still feel crappy.

I think those people, if they're in the range, you could crank up their thyroid dose a little bit, see if they feel better. Just keep them in that normal upper range. I mean, I had an endocrinologist tell me that I was just depressed and I just got up and walked out of the room. Right. Fuck that. And I'm going to give them a boo. Let's see. I mean, he was not listening to my symptoms.

And here's the thing. We shouldn't as providers, and Dr. Jeff, as you go forward, aim for the lower part of the normal range just because you get somebody. So the range is, you know, 10 to 100 of whatever disease. And their level was five. And we bring them up and now they're 12 and go, oh, you're fine. They still feel like shit. Let's bump them up until maybe they're 50 or 70.

And then it's still normal. Why can't we do that? The thyroid people will not do that. If you're in the normal range, they won't titrate you up, even if you are symptomatic. And I think that's incorrect. Yes, very incorrect. Some of this is art of medicine, but there's that science as well because you're still, if you're worried about that normal range, bump them up to the upper range.

You know, why not? And keep them in normal. but just a little bit of higher. And then there's, oh, I'm sorry. There's all this other stuff I don't understand, like T3, T4, and... Yeah, don't worry about all that. T, blah, blah, blah. Who cares?

But I want it to be good because I want to feel good. So I want my doctor to know about that. Right. That's all I was going to say. Often, we call it the curse of the low side of normal, right? And patients get stuck in it and... Yeah. He's got a name for everybody.

yeah the low side of normal patients get stuck there providers get lazy right because they're normal but the low side of normal is no place to live i agree yep i'm with you all right you got anything scott no sir all right well good deal thank you everybody i'm i'm temporizing because i don't have the right script up although after 17 years you'd think i could do it without it but uh thanks go to dr scott Thanks to Tacey, thank you. Dr. Jeff, very illuminating, and you're a great person to have in the studio, so you're welcome any time. Unfortunately, he is moving to California, is that correct? I've moved from California. Oh, no, that's right.

Yeah. You're not going back to California. I'm not. Okay. Sticking around, local, yeah. Oh, you are? Wait, local? Relatively local.

Compared to from California to where we're sitting now, it feels local. Yeah. All right. Your local like Ahmed is local. He was going to drive here and he had to get up at five in the morning to get here just to be in the studio. I said, dude, just come when you don't have to get up at five in the morning and you can hang out because we love Ahmed. He's doing very well. Get ready to become a senior resident.

Is he really? Yeah. Yeah, it's crazy. Plus. All right. All right. Well, thank you for coming and you're welcome. Thank you for us.

As long as you're still here anytime. Listen to our SiriusXM show on the Faction Talk channel. Serious XM Channel 103, Saturdays at 7 p.m. Sunday at 6 p.m. Eastern, on demand. And other times at Jim McClure's pleasure. Thank you, Jim. I mean, we're still on the air. I don't know why, but thank you. I really appreciate the fact that we are.

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, podcasts, other crap. Check out Dr. Scott's website at simplyherbils.net. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses, get some exercise. We'll see you in one week for the next edition of Weird Medicine. Hello, Holly. Thank you.