What Your GP Doesn’t Tell You

Should You Take A Weight Loss Drug?

Dr Barbara Mintzes and Dr Joel Lexchin, have recently published a review paper on the weight loss drug Wegovy (generic name semaglutide). They discuss it and the new generation of similar obesity medications.
The hype surrounding this new class of drugs has been huge, but is it justified?
These pharmaceuticals are called glucagon-like peptide 1 agonists or GLP-1 for short. They work by stimulating cells in your intestines to release a natural hormone called GLP-1 that tricks your stomach and your brain into thinking you’ve just eaten a large meal.
Clearly, obesity is major problem in countries across the world, but as Barbara and Joel reveal although these drugs do achieve a significant weight loss, weight gain is common once the medication is stopped.
And like any drug there are side effects, common ones include headache, vomiting, diarrhoea, and constipation. Rare reported side effects include pancreatitis and increased heart rate.  Currently, the European drug regulator, the EMA is reviewing data on the risks of thoughts of suicide and self-harm associated with GLP1 medicine. It is analysing around 150 reports. It expects to report on its findings this year.
So exactly what are the risks and the benefits of these drugs, and who should take them?
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Deprescribing from Psychiatric Drugs: The Problems and the Solutions

Dr Mark Horowitz discusses why psychiatric medication has turned out to be far harder to stop than any one expected.
For Mark, this is as much a personal as well as a professional interest. For as a patient, at one point he was taking five different psychiatric drugs. Ironically, although Mark was working in London at the Institute of Psychiatry, he found the mostly useful information about deprescribing came -  not from the medical profession - but from peer support websites.
This experience has driven his research and interest in safely stopping psychiatric medication. He, along with Professor David Taylor, has just written a new handbook The Maudsley Deprescribing Guidelines, providing step-by-step instructions on how to effectively stop all commonly used antidepressants, benzodiazepines, gabapentinoids and z-drugs.
One of the key findings from this work, is that it is essential to taper off the drugs much more slowly than patients have previously been advised. And perhaps most surprising of all, is  how a small amount of medication can have a completely disproportionate effect. In some cases, a 1mg dose can have nearly half the effect of a 20 mg dose, which means patients may have to taper far more gradually as they move down to smaller and smaller amounts of a drug. A process that may need to take months or even years.
The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs (The Maudsley Prescribing Guidelines Series) by Mark Horowitz and David Taylor, published by Wiley-Blackwell will be available from 15 February 2024.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Could Changing Your Diet Improve Your Mental Health?

Psychiatrist Dr Georgia Ede argues that the medical profession has completely underestimated the huge impact of diet on our mental health.
In her new book, Change Your Diet, Change Your Mind,  Georgia reveals improvements we can all make to our diet, and in particular, three different dietary approaches for those looking to improve their mental health.
She suggests that early results from a range of trials using this approach to treat conditions from bipolar disorder to schizophrenia, show a much great effect, in fact 6 to 10 times  that seen in any comparative drug trial.
Georgia believes a metabolic evaluation should be standard practice for every patient seeking psychiatric help.
In her own practice, this approach has enabled her to reduce the medication many of her patients take and in some cases allowed them to come off all medication all together.
Ironically, the psychiatric drugs used to treat many of these mental health conditions, which Georgia argues can also be useful, can at the same time actually worsen metabolic health, which can then negatively impact brain health.
So just how does a psychiatrist -  or indeed any doctor  - balance the benefits and risks of treatment?
Change Your Diet, Change Your Mind by Georgia Ede is due to be published by Yellow Kite books on 30th January 2024.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Treating Long Covid

Dr Lisa Sanders, writes a column called Diagnosis in the New York Times magazine, which was the inspiration for the Fox medical drama House, M.D. .The show in which Hugh Laurie, playing Dr Gregory House, regularly managed to diagnose the most obscure of medical conditions.
But today Lisa has arguably a rather tougher challenge than Hugh Laurie ever faced, she’s recently become the Medical Director of Yale's Long Covid Multidisciplinary Care Center.   Long Covid  can affect multiple systems and organs in the body, and finding effective treatments so far has proved extremely difficult.
However, Lisa reveals several approaches that it does appear can help at least some patients.
She argues that we need to see long covid not as entirely new phenomenon, but in the context of many other post-acute infection syndromes such as ME/CFS or flu. Controversially,  Lisa suggests that it needed enough doctors to get sick from long covid for the profession to start taking these syndromes more seriously.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

What Doctors Don’t Get Taught

Dr Robert Lufkin argues that modern medicine hasn’t paid nearly enough attention to the underlying causes of diseases, and has tended to treat symptoms instead.
And in a controversial new book Lies I taught at Medical school, How Conventional Medicine is Making You Sicker and What You Can Do to Save Your Own Life, published by BenBella books, as evidence for his claims, he points to the epidemics of chronic disease, we are now seeing in the industrialised world.
In the US in 2010, 16-21% of adults had two or more chronic diseases. Today, shockingly, the figure is 40%.
Rob explains what needs to  change and why he believes medical teaching gets a number of pivotal facts so wrong.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Thalidomide - The Story You Don’t Know (Part Two)

This is the second episode of a  two parter about  a new investigation into the drug thalidomide, so if you haven’t listened to part one, please do go back and listen to that first.
Thalidomide is one of the greatest medical catastrophes of the 20th century. It’s now thought to have been  responsible for around 100,000 miscarriages and disabled children.
In this episode, journalist Jennifer Vanderbes reveals the second half of the story. The result of six years of research, resulting in her recent book: Wonder Drug: The Hidden Victims of America’s Secret Thalidomide Scandal.
After thalidomide’s launch in 1957 by the Germany company Chemie Grunenthal, four years on, doctors in a number of countries, are becoming increasingly concerned about the drug’s effects.
In Australia obstetrician, Dr William McBride, having delivered several disabled babies in mothers who were given thalidomide, starts to conduct animal experiments and becomes convinced the drug is linked to the disabilities he is seeing.
While in Germany, geneticist Dr Widukund Lenz's analysis of babies whose mothers  have taken thalidomide, produces what he believes is a clear evidence that the drug is very far from safe. The devastating disabilities being caused in new born babies, include a shortening or absence of limbs; hands and feet that don’t fully form; and damage to ears, eyes, brain, skeleton and internal organs.
So the pressure to take the drug off the market grows.
And in the States, further children will be harmed as unbeknownst to the FDA, the drug has been dispensed by over one thousand doctors. This is despite the fact that it has not been approved for use, a development which will add further heartbreak  to the tragedy. In total, Vanderbes estimates that five million doses of thalidomide were distributed in America.
Jennifer Vanderbes Wonder Drug: The Hidden Victims of America’s Secret Thalidomide Scandal is published by Harper Collins.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/
 

Thalidomide - The Story You Don’t Know (Part One)

It was one of the greatest medical tragedies of the 20th century.
In 1957, a new wonder drug was launched in Germany. It was marketed as an astonishingly safe sedative. Tragically, this could not have been further from the truth. For this was the drug thalidomide, and it would end up being responsible for around 100,000 miscarriages and disabled children.
This week’s guest, journalist Jennifer Vanderbes,  in a forensic six year investigation has uncovered compelling and shocking new information about warnings that went unheeded, test results that were misrepresented, and uncovered scores of potential victims who have never before been recognised as harmed by the drug.
One of the heroines of this narrative is a dogged and committed FDA reviewer Dr Frances Kelsey, who sceptical of the drug never approved it for US use. However, as Vanderbes reveals in her new book: Wonder Drug The Hidden Victims of America’s Secret Thalidomide Scandal, published by Harper Collins, although the drug was never sold in the states,  the medication was sent out to 1,200 doctors to be used in what were termed clinical trials. These physicians then passed on thalidomide to other colleagues.
But the FDA later described these not as a clinical trials - but a marketing scheme. Which as Jennifer reveals, means, tragically, there are also American babies born with birth defects likely to have been caused by thalidomide.
Had early safety signals been acted on or investigated, thousands of families and babies could have been spared unbelievable heartbreak.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

The Accidental Drug Advocate

Kim Witczak's life was changed for ever one tragic day in 2003 when her husband Woody killed himself. Several weeks earlier, Woody, who did not have a history of depression or mental illness, had been prescribed the SSRI anti-depressant drug Zoloft (generic name sertraline) for his insomnia. Kim sued the drug company Pfizer for wrongful death, later settling out of court. Pfizer did not admit liability.
Since Woody’s death 20 years ago, Kim has become a committed advocate for safer medication. She campaigned for stronger safety warnings to be put on SSRI drugs. And in 2004 and 2006, labelling in the US was changed to include a black box warning on antidepressants regarding the risk of suicidality in young adults.
Today Kim, as a consumer representative, sits on the (Food and Drug Administration (FDA) psychopharmacologic advisory board committee, which recommends whether a new drug should be approved or not.
She argues that safety is not given a high enough priority by the FDA and explains why she thinks the system is failing. Kim says that for the sake of both patients and doctors it's essential this changes.
Kim is the  co-founder of Woodymatters, a non-profit dedicated to advocating for a stronger FDA and drug safety system She is on the board of directors of National Physicians Alliance and MISSD (Medication Induced Suicide Prevention in Memory of Stewart Dolin).  And Kim is also an active member of the DC-based Patient, Consumer, and Public Health Coalition that aims to ensure that the voice of non-conflicted patients and consumers is represented in healthcare and FDA related legislative issues.
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Why Knowing Your Blood Sugar Level Matters

GP Dr David Unwin has been a pioneer in the UK developing and promoting a low-carb approach for treating type 2 diabetes. In 2016, he won the NHS innovator of the year award for his work. His treatment approach has been so successful that  he has put around half his type 2 diabetic patients, who follow a low carb diet, into remission. And as a result, his practice, spends far less on diabetic medication than any of the surrounding GP surgeries. The potential cost savings if this approach was adopted nationally and internationally, would be huge for health services across the world.
We tend to think that unless we have a form of diabetes that we don’t really need to be concerned about our blood sugar levels, but nothing could be further from the truth.
As we get older, all of us unless we change our diet and lifestyle, will see our blood sugar levels rise, this causes our bodies to produce more and more insulin, which can lead to insulin resistance. If we eat a diet high in carbohydrates, this is likely to exacerbate the problem.
And that matters because insulin resistance isn't just linked to type 2 diabetes but a wide range of illnesses including high blood pressure, heart disease, Alzheimer's and some cancers too.
In the podcast, David discusses the Public Health Collaboration, a charity that he set up with colleagues, which aims to promote metabolic health and so prevent many chronic diseases. Here's a link to it:
https://phcuk.org/
And here is a link to David’s most recent paper published in BMJ nutrition, also discussed in the podcast:
https://nutrition.bmj.com/content/6/1/46
 
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so at patreon.com/whatyourgpdoesnttellyou or via PayPal at https://www.patreon.com/WhatYourGPDoesntTellYou
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

How To Keep Your Brain Healthy Into Old Age

Neuroscientist Dr Sabina Brennan argues that while we may be increasingly aware of the importance of physical health, we neglect the value of brain health.
By giving our brains the right stimulation, she believes, not only can we increase our odds of either avoiding or delaying serious diseases such as Alzheimer’s, we may actually be able to build in resilience and slow down the ageing of our brains.
Sabina discusses the research that shows how essential it is that at every stage of our lives, our brains receive the right input at the right time. And she argues that we completely fail to understand the teenage brain. Our brains are not fully formed until we are around 24, and due to this, in our adolescence we are more like to indulge in risk taking, and are also at high risk of addictive behaviour. Yet she believes that neither society nor the way parent our teenagers really takes this into account.
Sabina was responsible for running Trinity College, Dublin’s Brain Fit, a study of brain health, lifestyle, genetics and dementia.  And she has published a number of books about brain health including 100 Days to a Younger Brain and Brain Fog. Sabina also has a website Superbrain with advice on how to enhance brain health and has a particular interest in promoting the public understanding of science. 
https://superbrain.ie/
The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com
If you would like to support this podcast you can do so via Patreon at https://www.patreon.com/WhatYourGPDoesntTellYou or via PayPal at https://www.whatyourgpdoesnttellyou.com/support/
What Your GP Doesn’t Tell You has been selected by Feedspot as one of the top 20 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/