The FAll of Pharmacy
It has become a little obvious that almost every pharmacy is overwhelmed, to put it nicely. Chain stores are criminally understaffed; and independents suffer such poor reimbursements that they are paying your insurance company for the privilege of serving you while slowly going out of business. Completing all the work piled up at the pharmacy has been impossible for about a decade but there was a time long ago when closing the store would involve finishing almost every prescription that had come in. Today that is physically impossible and pharmacies falling thousands of orders behind are putting both patient health and employee sanity at risk. To understand how we got here you must realize where the pharmacy is located, directly at the corner of where crap hits the fan.
It has become a little obvious that almost every pharmacy is overwhelmed, to put it nicely. Chain stores are criminally understaffed; and independents suffer such poor reimbursements that they are paying your insurance company for the privilege of serving you while slowly going out of business. Completing all the work piled up at the pharmacy has been impossible for about a decade but there was a time long ago when closing the store would involve finishing almost every prescription that had come in. Today that is physically impossible and pharmacies falling thousands of orders behind are putting both patient health and employee sanity at risk. To understand how we got here you must realize where the pharmacy is located, directly at the corner of where crap hits the fan.
If the healthcare industry is the behemoth that the size and state of the insurance cartels would suggest then directly at the bottom of that mountain from which all things roll down sits the pharmacy. The counter has become a source of frustration for patients as they often receive bad news that they are out of refills, the drug is on backorder, or the insurance company wants to pay for something else but not what was prescribed. It is a messy juxtaposition of the healthcare system coming together at once to set the pharmacy up for failure. As a greater and angrier pharmacist than I once pointed out
“Pharmacies are the human shields of the industry taking the bulk of abuse for things that they have little to no control over”
Conditions have become so bad that organized walkouts have occurred at both CVS and Walgreens. Staff insist that working conditions have deteriorated to such a point that they cannot safely run the pharmacy. Corporate counters with if you can’t get the job done there is another student loan debt slave who will. These are both true statements.
I’m reminded of the Seinfeld episode in which Newman describes why postal workers go crazy "The mail never stops". Physician reliance on the prescription pad and a system that cannot acknowledge patient agency have created a similar predicament with the pharmacy unable to hold up its end. Walgreens and CVS are happy to build the pharmacy, but they are not willing to staff the pharmacy and unfortunately that’s kind of the whole point. Despite creating a vertically controlled monopoly funneling prescriptions directly into their stores, causing a wave of demand a blind man could see coming, they still were not willing to make the investment needed in their personnel. How could such blatant mistakes be made?
The answer lies in the assumption that “you” the patient is the customer that the pharmacy is serving. It is an easy mistake to make from the patient’s perspective. The reality is the pharmacy serves a three headed monster: the patient, insurance company, and providers. So even if CVS were to hire more staff, they would not be helping at the register, they would be processing insurance claims and catering to the customer they do care about (the one that pays, rarely the patient). It may seem like you are getting very poor service. You are in fact getting the level of service that the insurance companies are paying for which is not much and may be a negative amount. Pharmacy is no longer a functioning business in its current form and so it will slowly cease to exist.
The big chains are not immune to this fact either although they may be diversified enough to survive the path ahead looks treacherous. Rite aid has filed for bankruptcy and plans to close around 200 locations. Walgreens recent earnings report crapped the bed worse than a dementia patient resulting in a 25% stock price reduction while CNBC anchors lament how the company cannot compete without owning one of the parasitic Pharmacy Benefit Managers that have decimated the sector. The brutal earnings are resulting in 450 locations shuttering their doors by the end of August as they seek to stop the bleeding. CVS has just completed a reduction in their number of Target locations. Fewer unprofitable stores and less employees may help improve efficiency, but the writing is on the wall. The National Pharmacy Association has reported that pharmacy closures are up 50% in 2024 for the year compared to 2023 at this time.
One of the reasons why the pharmacy keeps getting pushed around is the fact that pharmacists are the rarest of healthcare Pokémon. Their small numbers help explain why the world is so Pharmacoconuts.
Licensed Healthcare Professionals in the U.S.
Nurses – 3,900,000 Physicians – 1,077,115 Pharmacists – 270,137
Pharmacy itself is a house divided between those on the frontlines taking care directly of patients and everyone else who has a chair and a regular job where they are treated like human beings. Hospitals, insurance companies, long term care facilities, pharmacy lobbying organizations, academia, pharmaceutical sales or the holiest grail of all a remote work from home position, these are examples of what frontline employees would refer to as the golden ticket out of retail hell. They are being fought over desperately and it's not uncommon to see a remote position have a thousand applicants for one spot while CVS and Walgreens will have a dozen open spots and few takers.
The future does not look very bright for staffing either as most pharmacy schools have been reducing their class size, less applicants overall and a struggle to find quality candidates is the story everywhere. Pharmacy is a profession where strong math skills are a prerequisite and anybody who is good at math may balk at going a quarter of a million dollars in student loan debt for a position that pays not much more than many trades that you can get into directly out of school and be paid to learn on the job. Lack of Pharmacists will result in more duties being performed by technicians and a variety of other corners being cut to keep the doors open for a little while longer. My favorite cost saving measure recently deployed by CVS is the use of AI to answer phone calls because let’s be honest, they are getting paid 7 cents to fill your prescription and that does not cover the cost of an actual human answering your calls.
Things have become so apparently rigged that even the government has figured out the scam. The Federal Trade Commission chair Lina Khan recently released an interim report on the unfair business practices of the PBMs.
While some may view this report with optimistic hope the truth is that the FTC is trying to solve a crime, not prevent one. The murder already happened, and it was so blatant that even a bunch of government bureaucrats were able to figure it out. Most of the problems in this report will never be addressed and to be honest if they were the insurance companies would simply bring them back in six months under a different name. Your DIR fees that have bankrupted you will have a new name, but the same old song and dance and the FTC can begin a new multi-year investigation.
The endgame to me seems a little obvious by the insurance cartels but when you control so much of the narrative why bother with subterfuge. Step one drives pharmacies to the brink of bankruptcy. Step two is to buy them dirt cheap and further integrate their “healthcare” monopoly. Ultimately the real losers are the patients who relied on the pharmacy for all the services it used to provide like answering the phone. So, if you see an independent pharmacy still open stop in to take a look; you can tell your grandchildren what it was like to pick up your medicine from a local business the same day you needed it as opposed to waiting for it to be mailed out to you in the July heat from a company with a sadly ironic name like Caremark.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
@Hyattjn
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Further reading and references
https://www.wsj.com/health/healthcare/medicare-health-insurance-diagnosis-payments-b4d99a5d
https://www.cnn.com/2023/10/30/business/cvs-walgreen-pharmacy-walkout/index.html
https://www.sciencedirect.com/science/article/pii/S1544319122001315
https://www.newsweek.com/why-your-drugstore-closing-cvs-walgreens-rite-aid-1861542
https://zenopa.com/news/pharmacy-closures-increased-by-nearly-50-in-2024/
https://www.hostmerchantservices.com/2024/03/cvs-store-closure-strategy/
https://www.bu.edu/articles/2024/walgreens-and-cvs-closures-can-exacerbate-health-inequities/
https://www.pitt.edu/pittwire/features-articles/2024-pharmacy-closure-map-apha-berenbrok
https://upriseri.com/pharmacy-benefit-managers/
Once more into the breach….
Pharmacoconuts Safety Review Board
Attempting that fantastical Unicorn known as informed consent in an age that has already moved on to a one size fits all approach the P.S.R.B (Pharmacoconuts Safety Review Board) met recently to review the latest round of covid shots. These versions are relying on the success of former campaigns to justify going back to the well. Like the last set of boosters, the realization that the virus evolves faster than our development process has resulted in an almost instantaneous pipeline from pharmaceutical companies straight into the bloodstreams of a beleaguered public.
The FDA has approved new shots from both Pfizer and Moderna and a CDC panel voted 13-1 to recommend them for anyone 6 months of age and up. The lone dissenter and guy least likely to get a lucrative job offer from either company in the future was Dr. Pablo J. Sanchez MD. His reasoning for hesitation about a blanket recommendation for all.
“We have extremely limited data on children and infants and other individuals, and I think that needs to be made available to the parents. I also think that in certain circumstances, we do have to be concerned about potential side effects, especially in young adults and in young adult males. And so, I think all of that needs to be weighed. And so, that’s why I hesitate to make it just a universal recommendation.”
Dr. Sanchez graduated from the University of Pittsburgh School of Medicine and has forty years of experience. He is currently a practicing neonatologist at the Nationwide Children’s Hospital Center for Perinatal Research. His concerns have mostly been downplayed or ignored completely by the media and his cohorts who disagree while arguing the benefits outweigh safety concerns.
Dr. Ashish Jha is the former White House Covid Czar and was also the Dean of Brown University School of Public Health. Prior to these he was the faculty director of the Harvard Global Health Institute and a Senior Adviser with the Albright Stonebridge Group (Madeline Albright’s DC consulting firm). He has been the lead salesman for the White House making the media rounds promoting these new products in interviews that sound more like commercials. Dr. Jha does have a conflict of interest here in his most updated financial disclosure for the White House he reports 477,000 dollars of income from covid speaking fees and covid consulting.
Joining Dr. Jha on the pharmaceutical promotion tour is Xavier Becerra, the US Health & Human Services Secretary. He just recently pointed out that the greatest piece of data in favor of the covid vaccines is that we are all standing here alive today because of the vaccinations. This seems an insane take until you realize Mr. Becerra is not a physician or even a healthcare worker but instead is a career lawyer and politician who became the Attorney General of California in 2017. He is a very powerful man in Washington; the HHS department receives more funding than the Pentagon. That is a large amount of money, for reference the Pentagon recently failed their 6th straight audit with about 4 trillion unaccounted for.
Thanks to some tricky advertising, Pfizer has been promoting their new shot with television commercials while avoiding that long list of side effects we see at the end of every other drug commercial. If they were required to list them, it would look something like this.
Myocarditis, pericarditis, tinnitus, stroke, pulmonary embolism, anaphylaxis, muscle spasms, dysmenorrhea, guillain-barre syndrome, and thrombocytopenia just to name a few. These potential adverse reactions may be rare, but they are still real, particularly when the law of large numbers applies. Pfizer conversely uses this as a defense as their own analysis of adverse events is 38 pages long. After all we gave this shot to everyone so of course every side effect in existence is going to be reported but that should in no way cast doubt about the products themselves.
Full link - https://phmpt.org/wp-content/uploads/2021/11/5.3.6-postmarketing-experience.pdf
Stats vary on this but about 8000 people die in the US daily from a variety of causes. At the height of the pandemic, we were giving almost half a million doses a day. Statistically some overlap of those two numbers is to be expected even if the shots were completely benign. Someone somewhere is going to know someone who passed away soon after vaccination. If that did occur to a friend, loved one, or God forbid a child no number of studies published in Nature or JAMA repeating the scarcity of these incidents will assuage them.
The fly in the ointment may not be any of those known and now agreed upon adverse events, but instead something else that must not be acknowledged. Problems with manufacturing have plagued the pharmaceutical industry for its entire existence and concerns about adulterated products and contamination are not hypothetical concerns but instead historic facts that resulted in significant regulations to prevent them from happening again. Vaccines are not exempt from this history.
In April of 1995 about 200,000 children were given a defective polio vaccine that gave them polio instead of protecting them from it. Reports of paralysis would start rolling in a week later and within a month the first mass vaccination attempt against polio was an abysmal failure causing 40,000 cases of polio, 200 of which resulted in some level of paralysis and 10 deaths. The cause was poor manufacturing and quality control at Cutter Laboratories, one of four companies producing the vaccine created by Jonas Salk. Government regulators reported no issues with Cutter Labs production process but Salk himself would investigate and discover that they had deviated from his procedure leaving DNA contamination in the product. This was a horrifying turn for a product that had just received approval after the successful March of Dimes trial showed the vaccine 80-90% effective without harming a single child.
With no bad press to drag it down and an easier route of administration (by mouth with a lump of sugar) Dr. Albert Sable’s oral polio vaccine would become the product of choice. It was so popular it inspired part of the lyrics to the 1964 musical Mary Poppins “Just a spoonful of sugar helps the medicine go down in a most delightful way.” Unfortunately, the oral version would also have its problems because by absorbing the “live” vaccine through the gut there was a very small risk of virus reactivation causing polio instead of preventing it and a handful of children would be paralyzed every year. So, manufacturing difficulties ironically resulted in the commercial success of a more dangerous vaccine. The oral vaccine would also have its own contamination issues. SV40 a virus endemic in the rhesus monkeys that were used to create the vaccine was discovered in about 30% of the early doses. In 1961 new regulations would be implemented to help prevent SV40 contamination in the Polio vaccines moving forward.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/
Salk’s version of the vaccine when manufactured properly was the superior product but after the Cutter Labs incident he was persona non grata in the scientific community. Sabin did not have kind words to say about his competition and was overhead making the following comment.
“Salk was a kitchen chemist, he never had an original idea in his life....You could go into the kitchen and do what he did”
Salk experienced a great deal of animosity from the scientific community, historian Aaron Klein argues this was due to him being a prominent popular public figure. You could use the term media darling to describe Salk at this time. TV, radio interviews and press conferences with him were frequent, Life magazine would do a full spread about the good doctor. Dr. Salk believed in reaching out to the common man and speaking to him in a manner that was understandable, for this he was loved by the public but shunned by fellow academics who viewed this behavior as unseemly. Salk would sum this up very well with a statement that holds true to this day.
“I was neither a politician nor a performer. Those remarks were simply made by colleagues who at that time were reacting as is perfectly natural in professional circles, particularly in the field of science where the coin of the realm is recognition. I was being recognized; they were not.”
Salk would spend the rest of his life arguing for his vaccine over Sabin’s oral version and condemning reckless political decisions that endangered children. He would pass away before a government panel would eventually agree with him due to the slight risk of virus reactivation in Sabin’s product (1 in 750,000). Despite the bumps along the way the Polio vaccines were a resounding success resulting in the eradication of one the worst diseases mankind has ever faced. It is important to note that despite their differences both men agreed not to commercially patent their vaccines, a far cry from our pharmaceutical overlords of today.
Fast forward and we find ourselves with another case of poor manufacturing potentially leaving DNA contamination in the covid shots. Kevin McKernan was the first researcher to report these disturbing findings, which have now been duplicated. At the University of South Carolina, Professor Phillip Buckhaults repeated Kevin’s analysis with the goal of debunking it only to confirm it. He shared his concerns and what this means at a South Carolina Senate Hearing. These claims were at first ignored, then acknowledged that there may be some DNA present, but it is not enough to cause any problems. The hypothetical concern here is that this would be the first time DNA contamination was introduced directly into the cell nucleus with lipid nanoparticles so saying the amount of DNA discovered is under the limit for toxicity is disingenuous.
For the vaccine injured this has created a ray of hope to penetrate the legal liability for the manufacturers. It’s like the shield generator on the Death Star has been brought down and if it can be proven that these products were adulterated, they may have some legal ground to stand on. Investors have clearly been spooked away as Pfizer and Moderna stock have had a very rough six months. I currently view these companies as dangerous cornered wild animals, extreme caution and preventative safety measures should be implemented by anyone who dares publicly challenge their interest.
In Texas things have come to a head as the attorney general Ken Paxton fresh off surviving a political assassination attempt with sixteen impeachment charges has filed a lawsuit against Pfizer for attempting to mislead the public about the effectiveness of their product. It is 54 pages long so you may want to make a large pot of coffee. Full link - https://docs.reclaimthenet.org/Pfizer-Vaccine-Petition-Filed.pdf
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://airtable.com/appGIUGnttjzscdJF/shrAqtpTOTkoOgrbx/tblfVuObLpclbtF0W (Contact lists for Legal Representation for Vaccine Injured)
Nationwide Children's Hospital (nationwidechildrens.org)
Xavier Becerra nomination – here's why Senate should reject culture warrior for HHS post
https://www.texastribune.org/series/ken-paxton-impeachment-texas-attorney-general/
https://blog.ons.gov.uk/2021/10/04/how-many-people-have-died-as-a-result-of-a-covid-19-vaccine/
https://patents.google.com/patent/US20190240317A1/en
https://patents.google.com/patent/US10077439B2/en
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452662/
https://www.nature.com/articles/1207877
https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/sv40
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/
https://slate.com/technology/2021/02/cutter-incident-polio-vaccine-drive-history.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888238/
https://www.who.int/news-room/fact-sheets/detail/poliomyelitis
The Modern Environmental Hazards of Tyrannical Technology
Advancement always brings with it a few new curveballs for our species; coal mining provides affordable electricity for many while exposing an unfortunate few to dangerous working conditions and unheard-of ailments such as black lung. X rays allowed us to see and diagnose medical conditions like never before, it also gave early users radiation poisoning. Nuclear power has the potential for clean, near unlimited energy, but then again, we have incidents like Fukushima, Three Mile Island, and Chernobyl. As technology blazes its path into the future unfortunate humans are left drowning in its wake sometimes. This article is about the unknown dangers that presently surround and affect us whether we realize it or not.
Havana Syndrome has been in and out of the news over the past few years as inexplicable symptoms began affecting US diplomats all over the world. Currently it is considered a non-specific neurological illness from unidentified causative factors. The mysterious nature of the symptoms and the population experiencing it has led to a variety of theories including espionage, political machinations, and directed energy weapons. The debate over what is happening has gone back and forth like a ping pong ball in medical society since the syndrome was first described in Cuba.
Beginning in November of 2016 and lasting through June 2018 twenty-five US diplomats would experience a vague and unusual laundry list of symptoms, headache, nausea, fatigue, confusion, memory loss, insomnia, tinnitus, and other brain abnormalities that were described as "concussion like". Suspiciously a strange sound was also reported at the same time, and this caused talk of a new "sonic" weapon of some sort. After publicly releasing information about the attacks a few dozen tourists would come forward and claim to have experienced the same symptoms while traveling through the area.
The government viewed this as an active threat and began evacuating embassy employees who showed symptoms, this included consulates in Uzbekistan, Guangzhou, Shanghai and Beijing. Canadian diplomats would go so far as to sue their own government for 28 million citing neglect for exposing them to such dangers.
Ear specialists who examined the patients would blame inner ear vestibular damage for the symptoms, meanwhile head trauma specialists described it as a "concussion without a concussion". Imaging studies like MRI's were inconclusive. Another study performed on these patients found that all the subjects had damage to the otolith organs which help regulate balance and perceive gravity.
While the cause does remain a mystery some have argued that the entire thing could be an outbreak of a psychogenic illness. In other words, perhaps it was simply due to the high stress of being a government agent in a foreign land. Comparing it to shell shock they have asked what is more likely, an unknown super weapon or overworked weak minded government employees?
Meanwhile in not unrelated news the military has released to the public videos and even a Frequently Asked Questions page about one of their latest and greatest toys known as “Active Denial Technology”. Here is a link to their fact sheet on the fancy new directed energy weapon platform.
This non-lethal weapon technology is indeed a breakthrough and very effective. The weapon uses a gyrotron to generate a focused and directed electromagnetic energy beam at a frequency of 95 gigahertz. This very short wavelength energy beam, when pointed at humans, will penetrate 1/64th of an inch under the skin and creates a reversible sensation of burning intense enough to stop the enemy in their tracks. They tested it on over 13,000 volunteers and documented only two sustained injuries, both second degree burns. While developed as a non-lethal weapon the military is a little coy in their admission that of course if you continued pointing it at the enemy long enough death could occur but they do not specify if that is 2 seconds or 2 minutes to fry a human to a crisp. Either way it’s supposed use is as a deterrent for controlling crowds in urban environments. So, coming soon to a protest near you.
Now this is not the culprit behind Havana Syndrome, but it does add some weight to the strange weapon argument. Making me even more curious about unusual weapons platforms Eric Hecker, a whistleblower and former Raytheon contractor who worked at the South Pole Neutrino Observatory provided testimony at a recent national press club event. He alleges that the observatory serves a dual purpose as some type directed energy weapon capable of causing earthquakes and a communications array for all the strange things flying through our skies with impunity. This is tame compared to some of the other extreme claims that have percolated into the public consciousness recently, but Hecker strikes me as the sanest of the bunch which make his claims even more fascinating. In addition to his story of directed energy weapons he also describes technology that can implant voices in your head that are not yours. These are referred to as the “Voice of God” weapons capable of creating havoc and confusion behind enemy lines or inspiring extreme violence by the target which lashes out at those around him.
Our minds are essentially biological computing machines and thus they are susceptible to hacking in the same manner that your personal computer is. We receive inputs and signals constantly from the world around us and it is quite possible for some of that information to be damaging. In Japan a documented case of this occurred with an animated episode of Pokémon causing seizures in over seven hundred children who watched the show. These kids’ minds were inadvertently hacked by a signal that caused a seizure. Imagine this technology being weaponized by state powers! A seizure at the inopportune time such as behind the wheel of a car or flying a plane could be catastrophic. Political assassinations could be pulled off without the messiness or lingering questions that bullets leave behind.
Don’t worry though the odds of these technologies being used in a method to directly harm you are unlikely. Using it to manipulate you however is damn near a certainty. Massaging the public opinion and pushing preferred narratives is what state propaganda is all about and it is no secret that propagandizing the American public was made legal in 2013. Here is an article from 2012 warning about this by Michael Hastings, a journalist who would meet a mysterious and untimely demise after his reporting led to the resignation of General Stanley McChrystal. The story has been dramatized into a film called “War Machine” starring Brad Pitt.
https://www.buzzfeednews.com/article/mhastings/congressmen-seek-to-lift-propaganda-ban
So, what is the big deal with a little bit of propaganda anyway, the government deserves free speech just like the rest of us after all, but they have taken it a little further than just speaking their mind. A recent report entitled “The Weaponization of CISA” (full link below in additional reading) details much of the nefarious efforts by this government agency to censor Americans and most importantly gives us the reason why they do it. In a quote directly from Jen Easterly, the CISA Director, she sums it all up succinctly.
“One could argue that we’re in the business of critical infrastructure, and the most critical infrastructure is our cognitive infrastructure…”
Much like our roads, bridges, airports, tunnels and other sources of critical infrastructure, your personal opinions and thoughts must be safeguarded and protected by the government lest they fall prey to disinformation and misinformation. Her quote is from 2021 but unfortunately this dystopian nightmare likely stretches back much further in our history. After all I’m confident that the government didn’t just up and decide to start protecting us from ourselves in 2021, they have likely been conducting experiments like this for as long as you or I have been alive.
Historically many of the worst abuses committed by our government against the public were documented by the Church Committee in the seventies. Crimes conducted by the CIA, NSA, FBI, and IRS were displayed publicly for the first time including the MKULTRA project which helped create such gems as Charles Manson and Ted Kaczynski. The full extent and crimes of these projects will never be known since the CIA director Richard Helms ordered all files destroyed in 1973. The director of MKULTRA was Dr. Sidney Gottlieb who like many of the evilest people in history would never be held accountable for his actions and retired to an agricultural lifestyle in Culpeper Virginia. As far as I can tell he is of no relation to Dr. Scott Gottlieb the former FDA commissioner most notably known for being a cancerous polyp straight from Pfizer’s’ rectum. I bring up the Church committee not to rehash the past but as an example that these organizations have been doing these things for a very long time and what they were caught doing is likely only the tip of the iceberg.
Like many people I look at our society and its strange recent permutations and wonder what has caused such drastic changes. Is it some yet unknown chemical exposure? Endocrine disruptors, aspartame, lead in the drinking water, too many vaccines, not enough vaccines, prescription medications, illegal street drugs or our modern sex hormone roulette that is so popular, the chemical soup that we all swim in has no shortage of potential suspects. Others like to blame the moral decay on a decade long losing culture war resulting in an unstoppable social contagion. While I like this theory, I do worry that something more nefarious may be at play. Researching this piece, I stumbled across a book called Project Soulcatcher by Robert Duncan, a former CIA operative and was blown away by this paragraph from his book written over a decade ago.
“Governments spend enormous resources in unifying the populous. Religion has traditionally been used to unify cultures. However, a more intrusive form of unification has begun which develops children and adult brains within a very constrictive box, dream and thought entrainment. Brain entrainments over the population is being tested to see if they can restrict and induce a limited set of thoughts thereby controlling popular opinion, coercing human perception to a common reality, and in essence stealing their souls from self-determination without their knowing consent. Governments find it easier to govern when everyone thinks the same. Personality implantation using electromagnetic entrainments helps this agenda. Think of this as a virus that copies itself to every human being, effectively taking over the natural order of society.”
While this may seem far-fetched it’s probably been going on for a while, so long in fact that advertisers are starting to become aware of the commercial potential for this type of technology to increase sales. Targeted dream implantation is the latest and greatest idea for advertisers to shove their product down your throat even while you are sleeping. Here is where we get into some ugly truths, companies advertise because it is effective, and advertisers would not be contemplating dream commercials on just a wing and a prayer. They know this technology is effective because it has been used on humans previously. The only question is to what extent and for what purpose?
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
Bitcoin GtjoZgxE7WpTkWRE6JiEiXfUpqbWKxH4g
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Further reading and references
https://www.science.org/content/article/are-advertisers-coming-your-dreams
https://www.popularmechanics.com/technology/a36719140/sleep-ads-dream-implantation/
https://caselaw.findlaw.com/court/us-2nd-circuit/1364923.html
https://pubmed.ncbi.nlm.nih.gov/35962646/
https://www.cia.gov/readingroom/document/06760269
Asadi-Pooya AA. Havana syndrome: a scoping review of the existing literature. Rev Environ Health. 2022 Aug 15. doi: 10.1515/reveh-2021-0182. Epub ahead of print. PMID: 35962646.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961165/
Bartholomew RE, Baloh RW. Challenging the diagnosis of 'Havana Syndrome' as a novel clinical entity. J R Soc Med. 2020 Jan;113(1):7-11. doi: 10.1177/0141076819877553. Epub 2019 Oct 31. PMID: 31672089; PMCID: PMC6961165.
Sleep on the Spectrum
There are several cornerstones to health that are frequently overlooked by our modern healthcare system because they are dependent upon patient agency. Diet and Exercise are the two twin pillars that come to mind most frequently but equally important is your quality of sleep. Evolutionarily our sleep patterns have been regulated by the environmental factors of this world which were rather consistent for hundreds of thousands of years. The past century has dragged us violently into the future where our circadian rhythms are under a constant onslaught of artificial light, commercially available stimulants, and the otherwise general FOMO our 24/7 lifestyles create.
There are several cornerstones to health that are frequently overlooked by our modern healthcare system because they are dependent upon patient agency. Diet and Exercise are the two twin pillars that come to mind most frequently but equally important is your quality of sleep. Evolutionarily our sleep patterns have been regulated by the environmental factors of this world which were rather consistent for hundreds of thousands of years. The past century has dragged us violently into the future where our circadian rhythms are under a constant onslaught of artificial light, commercially available stimulants, and the otherwise general FOMO our 24/7 lifestyles create.
Since Pfizer has no vaccine for insomnia and brand name sleeping drugs are now off patent the constant marketing for these products has receded with the industry viewing it as an already tapped vein of resources. It is still an incredibly common complaint from patients, however. The initial symptoms of sleep deprivation are irritability, fatigue and difficulty focusing. As it progresses further it impairs communications, causes poor judgement, and stimulates an increase in the appetite. Ultimately this will lead to lethargy, apathy, and social withdrawal. It should come as no surprise that the symptoms of sleep deprivation mirror the troubles of our modern society so well.
Ethically studying sleep deprivation any further becomes an issue, but animal studies have confirmed that without sleep animals can and will die from a cascade of physiological failures. We do have some human trials though thanks to the work of the CIA who used tax dollars to incorporate sleep deprivation into their "enhanced interrogation techniques" which are now known by the more accurate but legally dubious term "torture". Perhaps it is the worst kind of torture since any information it produces should be immediately suspect due to the cognitive impairment of the subject.
If you step back and look at it many of the most common complaints faced by patients may have their root cause in a lack of sleep. It can be a difficult thing to diagnose since doctors tend to see patients while they are awake and the patient themselves being unconscious makes it a hard thing to measure. Many people are stuck relying on their significant other to inform them of their poor sleep, how many times a night have you been woken up with a pillow to the face? Single patients may struggle with vague symptoms and issues for an extended period or may never figure it out. Their sleep may even be negatively impacting their love life since snoring and other nighttime disruptions have been called "deal breakers" by those who provide relationship advice.
So many of us are torturing ourselves with a lack of sleep even if we don't realize it. Even if all else is well and our diet and exercise are what they should be, a lack of sleep can hurt any chance of improving your health. All sleep is not the same and the healthy restorative version that we need for our bodies to recover has become more and more elusive. Simply being unconscious is no replacement for proper rest.
Humans will chase sleep or self-medicate in a variety of ways. Depressants like alcohol will eventually render you unconscious if you consume enough. Antihistamines and other sedating over the counter medicines like diphenhydramine and doxylamine succinate are marketed for sleep under brand names like Unisom or ZZZquil but it’s essentially the same old Benadryl that has been around forever just in a different box (and much more expensive). The over-the-counter options for sleep are rather limited and can cause a hangover that lasts into the morning, a sure-fire sign that your sleep was not as restorative as it needs to be.
Supplements for improving sleep can be found everywhere, ranging from melatonin, CBD products, magnesium glycinate or herbal combinations like the “Sleep Perfect Formula” which includes almost everything that has ever been rumored to help with sleep (valerian root, GABA, L-Theanine, 5-HTP, chamomile, hops extract, passionflower, and the melatonin/magnesium for good measure). A tall glass of milk before bed has been a common suggestion to aid in sleep long enough to be called an old wives’ tale but studies have shown that impaired calcium homeostasis is linked to anxiety, insomnia and sleep disturbances. So, a tall glass full of liquid protein that has melatonin, calcium, and vitamin D is far from a bad idea.
Everything mentioned above may or may not improve your sleep but at least you won’t wake up with your car inside someone else’s living room. Using medication for sleep has always struck me as a risky proposition especially in an outpatient setting. Instead of addressing the underlying cause we attempt to ameliorate the symptoms with a prescription. While this may be necessary in some cases generalized overuse has caused its own set of problems. Nobody is interested in paying their office copay for just advice, so the prescription pad usually winds up getting involved.
The most benign options are antidepressants that have sedating properties like trazodone and mirtazapine. Since depression and difficulty sleeping usually come hand in hand these are appealing cost-effective drugs that can address both problems. Getting a little riskier benzodiazepines like diazepam became famous under the brand name Valium. The drug was so popular in the 70’s that it wound up as a punchline in the Burt Reynolds film Starting Over when the main character has a heart attack in a public place and his friend screams for a valium every lady in the store pulls a prescription bottle out of their purse. Hypnotic drugs like zaleplon, eszopiclone and zolpidem are the next tier up, but they come with dependency concerns and zolpidem has become notorious for side effects like sleep walking, sleep eating, sleep cooking to full on sleep driving and the most disturbing or awesome of all sleep sex. Memory impairment, abnormal thoughts and behaviors, hallucinations, and the very real risk of withdrawal make the safety profile something to be concerned about.
Michael Jackson is perhaps the best public example of how far someone will go to sleep and if you have unlimited resources just what that can get you. Our healthcare system is built around customer satisfaction, and he had the money to go all the way down the rabbit hole to a drug that has no place outside of a surgical setting, propofol. Michael had enough money to get access to this drug, but he didn’t know he also needed someone competent to administer it properly without killing him. Of course, anyone competent would likely respond with WTF are you doing. So, Michael was left with Dr. Write for anything drawing up his dose and then killing him. He may have even drawn up the proper dose, but the rate of administration is crucial when giving propofol and easy to mess up.
Goodnight and sleep tight, if you can!
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://www.psychologytoday.com/us/blog/dreaming-in-the-digital-age/201412/why-sleep-deprivation-is-torture
https://www.apa.org/monitor/2017/10/cover-sleep
https://pubmed.ncbi.nlm.nih.gov/28993837/
Wisden W, Yu X, Franks NP. GABA Receptors and the Pharmacology of Sleep. Handb Exp Pharmacol. 2019;253:279-304. doi: 10.1007/164_2017_56. PMID: 28993837.
https://pubmed.ncbi.nlm.nih.gov/37123350/
Boisgontier J, Beccaria K, Saitovitch A, Blauwblomme T, Guida L, Fillon L, Dufour C, Grill J, Lemaitre H, Puget S, Vinçon-Leite A, Dangouloff-Ros V, Charpy S, Benichi S, Levy R, Roux CJ, Grévent D, Bourgeois M, Saidoun L, Gaillard R, Zilbovicius M, Boddaert N. Case Report: Zolpidem's paradoxical restorative action: A case report of functional brain imaging. Front Neurosci. 2023 Apr 14;17:1127542. doi: 10.3389/fnins.2023.1127542. PMID: 37123350; PMCID: PMC10140395.
https://pubmed.ncbi.nlm.nih.gov/37069546/
Bonomo N, Huang H, Schoenbachler B. Rapid resolution of catatonia secondary to post traumatic stress disorder with secondary psychotic features through scheduled zolpidem tartrate. BMC Psychiatry. 2023 Apr 17;23(1):258. doi: 10.1186/s12888-023-04769-x. PMID: 37069546; PMCID: PMC10111647.
https://pubmed.ncbi.nlm.nih.gov/37047843/
Squitti R, Reale G, Tondolo V, Crescenti D, Bellini S, Moci M, Caliandro P, Padua L, Rongioletti M. Imbalance of Essential Metals in Traumatic Brain Injury and Its Possible Link with Disorders of Consciousness. Int J Mol Sci. 2023 Apr 6;24(7):6867. doi: 10.3390/ijms24076867. PMID: 37047843; PMCID: PMC10095508.
https://pubmed.ncbi.nlm.nih.gov/36749030/
Aquizerate A, Laforgue EJ, Istvan M, Rousselet M, Gerardin M, Jouanjus E, Libert F; French Addictovigilance Network; Guerlais M, Victorri-Vigneau C. French national addictovigilance follow-up of zolpidem between 2014 and 2020: evolution of drug abuse, misuse and dependence before and after the regulatory change. Eur J Public Health. 2023 Apr 1;33(2):169-175. doi: 10.1093/eurpub/ckad003. PMID: 36749030; PMCID: PMC10066475.
https://pubmed.ncbi.nlm.nih.gov/36901441/
Carbone EA, Menculini G, de Filippis R, D'Angelo M, De Fazio P, Tortorella A, Steardo L Jr. Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. Int J Environ Res Public Health. 2023 Mar 1;20(5):4431. doi: 10.3390/ijerph20054431. PMID: 36901441; PMCID: PMC10002427.
https://pubmed.ncbi.nlm.nih.gov/36674498/
Dhillon VS, Deo P, Thomas P, Fenech M. Low Magnesium in Conjunction with High Homocysteine and Less Sleep Accelerates Telomere Attrition in Healthy Elderly Australian. Int J Mol Sci. 2023 Jan 4;24(2):982. doi: 10.3390/ijms24020982. PMID: 36674498; PMCID: PMC9866301.
https://pubmed.ncbi.nlm.nih.gov/32536366/
Ekholm B, Spulber S, Adler M. A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders. J Clin Sleep Med. 2020 Sep 15;16(9):1567-1577. doi: 10.5664/jcsm.8636. PMID: 32536366; PMCID: PMC7970589.
https://pubmed.ncbi.nlm.nih.gov/30248967/
Cao Y, Zhen S, Taylor AW, Appleton S, Atlantis E, Shi Z. Magnesium Intake and Sleep Disorder Symptoms: Findings from the Jiangsu Nutrition Study of Chinese Adults at Five-Year Follow-Up. Nutrients. 2018 Sep 21;10(10):1354. doi: 10.3390/nu10101354. PMID: 30248967; PMCID: PMC6212970.
https://pubmed.ncbi.nlm.nih.gov/35893875/
Jeon YS, Yu S, Kim C, Lee HJ, Yoon IY, Kim T. Lower Serum Calcium Levels Associated with Disrupted Sleep and Rest-Activity Rhythm in Shift Workers. Nutrients. 2022 Jul 22;14(15):3021. doi: 10.3390/nu14153021. PMID: 35893875; PMCID: PMC9331058.
https://pubmed.ncbi.nlm.nih.gov/22860241/
Dolder CR, Nelson MH, Iler CA. The effects of mirtazapine on sleep in patients with major depressive disorder. Ann Clin Psychiatry. 2012 Aug;24(3):215-24. PMID: 22860241.
https://pubmed.ncbi.nlm.nih.gov/36168907/
Li Y, Wu F, Mu Q, Xu K, Yang S, Wang P, Wu Y, Wu J, Wang W, Li H, Chen L, Wang F, Liu Y. Metal ions in cerebrospinal fluid: Associations with anxiety, depression, and insomnia among cigarette smokers. CNS Neurosci Ther. 2022 Dec;28(12):2141-2147. doi: 10.1111/cns.13955. Epub 2022 Sep 28. PMID: 36168907; PMCID: PMC9627395.
https://pubmed.ncbi.nlm.nih.gov/33186550/
Blum ID, Keleş MF, Baz ES, Han E, Park K, Luu S, Issa H, Brown M, Ho MCW, Tabuchi M, Liu S, Wu MN. Astroglial Calcium Signaling Encodes Sleep Need in Drosophila. Curr Biol. 2021 Jan 11;31(1):150-162.e7. doi: 10.1016/j.cub.2020.10.012. Epub 2020 Nov 12. PMID: 33186550; PMCID: PMC8442851.
https://pubmed.ncbi.nlm.nih.gov/30729219/
Parmalee NL, Aschner M. Metals and Circadian Rhythms. Adv Neurotoxicol. 2017;1:119-130. doi: 10.1016/bs.ant.2017.07.003. Epub 2017 Sep 1. PMID: 30729219; PMCID: PMC6361389.
https://pubmed.ncbi.nlm.nih.gov/29113075/
Cherasse Y, Urade Y. Dietary Zinc Acts as a Sleep Modulator. Int J Mol Sci. 2017 Nov 5;18(11):2334. doi: 10.3390/ijms18112334. PMID: 29113075; PMCID: PMC5713303.
Mushroom Round up - Cordyceps, Psilocybin, and Lion’s Mane. Riding down the Three Musketeers of the Mushroom Kingdom.
Cordyceps mushrooms have emerged into the mainstream recently thanks to The Last of Us on HBO. The show has its proponents and detractors but the science fiction angle of a fungus causing zombie-like aggression does have some grounding in reality. Cordyceps reproduce in ants by infecting them and hijacking their nervous system causing what are known as zombie ants. The ants slowly lose control of their motor functions as the new fungal operators force the ant to climb as high as possible in order to spread their spores in the wind.
Cordyceps mushrooms have emerged into the mainstream recently thanks to The Last of Us on HBO. The show has its proponents and detractors but the science fiction angle of a fungus causing zombie-like aggression does have some grounding in reality. Cordyceps reproduce in ants by infecting them and hijacking their nervous system causing what are known as zombie ants. The ants slowly lose control of their motor functions as the new fungal operators force the ant to climb as high as possible in order to spread their spores in the wind.
Fungal spores are mother nature’s answer to spreading life through even extreme adverse conditions. There are spores that can survive the vacuum of space and tolerate radiation that would kill most other forms of life. They can be stored forever and are produced in copious amounts which can be easily harvested by any amateur Egon Spangler out there who wants to catch them all. Mushrooms have a wide range of properties, a simple source of protein, an herbal medicine, food supplement, and potent psychedelic.
The literature supports the use of Cordyceps as a pre workout supplement and I have used it myself for that purpose. Cordyceps extracts work by stimulating ATP (adenosine triphosphate) generation in the mitochondria. ATP is the key energy producing molecule of the body, we break it down into ADP (adenosine diphosphate) to release energy. In our skeletal muscle we have precious little ATP maybe only a few seconds worth, which is why we can sprint but not forever. We must refresh this system to continue using it, converting ADP back to ATP only to break it down again. Creatine kinase is the enzyme which cleaves creatine phosphate apart giving us a free phosphate to turn ADP—>ATP. This is why creatine supplements are popular amongst bodybuilders. They result in more ATP which means more repetitions/weight which stimulates muscle growth.
This system refresh buys us a short boost of energy, but it is still finite lasting seconds not minutes. If the stress continues the next source of ATP is glycolysis, a chemical process that occurs under anaerobic conditions and generates ATP but also lactic acid which results in muscle soreness and fatigue. This can be continued until the lactic acid buildup becomes the rate limiting step. Last but not least is aerobic respiration to generate ATP from whatever is available, carbohydrates first, then fats, and finally protein can be broken down. This is the process you will find most adapted in endurance athletes because you can continue it indefinitely, as long as you have oxygen and some type of fuel.
Psilocybin could be called the bad boy of the group, or maybe it’s just misunderstood. Either way the powers at be have relegated it to schedule one status which is a little silly for something that will spring up after a rain shower. Despite the mushrooms taboo, interest in psilocybin’s therapeutic uses continued to grow. The same mushrooms that they warned would kill our brain cells are now being promoted by institutions like John Hopkins for their potential benefits not harms.
https://www.hopkinsmedicine.org/psychiatry/research/psychedelics-research.html
Since the therapeutic benefits for major depression are now an acceptable avenue of treatment it may be a good time to reflect on the decades spent criminalizing it and learn from those mistakes. Psilocybin’s medical benefits appear to lie with its neurogenesis potential. Neuroplasticity is the fancy word used to describe how our nervous system can grow and conform to its environment, it is essential to our memory and ability to learn and adapt. One way to measure it is a chemical known as BDNF (Brain Derived Neurotrophic Factor) which regulates neuron growth and synaptic connections. Psilocybin is believed to make epigenetic changes (changing your gene expression) that result in improved neuroplasticity measured by the density of synapses, growth of dendrites, and an increase in BDNF.
Animal studies have helped show that the effect is dependent upon (5-HT2a) a serotonin receptor. Blocking this receptor partially will cause a partial decrease in neuroplasticity, meanwhile by eliminating the receptor completely in genetically modified mice the benefit vanishes entirely. Stimulating these receptors results in the release of glutamate which stimulates AMPA receptors. It is only a theory at this point, but it is thought that activation of the AMPA receptors creates a feedback loop by increasing BDNF secretion, that causes activation of two receptors mTor & TrkB which produces more BDNF further stimulating the AMPA receptors.
Depending upon your location you may have legal access to psilocybin. In Oregon for example the EPIC (Eugene Psychedelic Integrative Center) has begun offering guided group or individual sessions. It can get a little expensive at the top end where a high dose journey will cost you 3500 bucks a session. You can find their pricing plan here if you are curious about costs.
It can very easily cross the line into a world of “woo” though. The Church of Psilomethoxin for example is a religious organization that distributes their own special psilocybin mushrooms to its members. The church believes that they can create psilomethoxin by mixing 5-MeO-DMT (another potent psychedelic) into their psilocybin cultures. It is of course found in Austin Texas and if you can find a referral code the cost of their blessed sacrament is rumored to be about 55 bucks. Buyers should beware however because samples of the churches’ so-called special shrooms have been shown to not be that special. A chemical analysis showed them to be just regular old psilocybin mushrooms. From an organic chemistry perspective this makes sense, just chucking some other substances in with the mushroom cultures does not cause a chemical reaction resulting in a new designer drug. Full analysis can be found here.
Lion’s Mane Mushrooms are a rare fungus that will grow very large under the proper conditions. It can be rather beautiful when seen growing naturally and its appearance gives us its name with long wispy extensions of the fruiting body (picture below).
This mushroom is certainly a gift from the heavens because it is an edible source of protein with medicinal benefits. If you were in a foraging or survival situation stumbling across the above specimen would be like hitting the lottery. As a supplement or extract it is often marketed for improving mental focus or stimulating brain health in the west. In eastern medicine it is commonly used to treat digestive issues like acid reflux and stomach ulcers. Studies have shown that they cause an increase in peptide levels which are vital to brain cells. This discovery is causing optimism for its therapeutic potential to treat or prevent Alzheimer’s disease.
If you know the Alexander Dumas tale you should be expecting a fourth and final fungus, our D’Artagnan if it were, is the Turkey Tail mushroom. It gets the name from its appearance which does look like fanned out turkey feathers. Can you guess which is the shroom?
As far as its medical uses go, studies have shown that it has the potential to modulate our immune system. Polysaccharide peptide (PSP) is an ingredient found in the mushroom that is currently in animal studies for its potential anti-tumor properties. Polysaccharide krestin (PSK) is another ingredient that is being studied for the prevention of cognitive deficits and Alzheimer’s.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
Bitcoin GtjoZgxE7WpTkWRE6JiEiXfUpqbWKxH4g
Litecoin ML1N31UVz6sRfo2m2oLaorXgPexUtv3Q3t
Further reading and references
https://www.space.com/fungi-survive-high-dosage-radiation-iss.html
https://worldmushroomsociety.com/lions-mane-mushroom-guide/
https://www.uclahealth.org/news/turkey-tail-mushrooms-act-as-nonspecific-immune-modulators
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700802/
Calder AE, Hasler G. Towards an understanding of psychedelic-induced neuroplasticity. Neuropsychopharmacology. 2023 Jan;48(1):104-112. doi: 10.1038/s41386-022-01389-z. Epub 2022 Sep 19. PMID: 36123427; PMCID: PMC9700802.
https://pubmed.ncbi.nlm.nih.gov/18230170/
Herda TJ, Ryan ED, Stout JR, Cramer JT. Effects of a supplement designed to increase ATP levels on muscle strength, power output, and endurance. J Int Soc Sports Nutr. 2008 Jan 29;5:3. doi: 10.1186/1550-2783-5-3. PMID: 18230170; PMCID: PMC2253504.
https://pubmed.ncbi.nlm.nih.gov/27162767/
Lee SH, Ko IG, Kim SE, Hwang L, Jin JJ, Choi HH, Kim CJ. Aqueous extract of Cordyceps alleviates cerebral ischemia-induced short-term memory impairment in gerbils. J Exerc Rehabil. 2016 Apr 26;12(2):69-78. doi: 10.12965/jer.1632586.293. PMID: 27162767; PMCID: PMC4849494.
https://pubmed.ncbi.nlm.nih.gov/20804368/
Chen S, Li Z, Krochmal R, Abrazado M, Kim W, Cooper CB. Effect of Cs-4 (Cordyceps sinensis) on exercise performance in healthy older subjects: a double-blind, placebo-controlled trial. J Altern Complement Med. 2010 May;16(5):585-90. doi: 10.1089/acm.2009.0226. PMID: 20804368; PMCID: PMC3110835.
https://pubmed.ncbi.nlm.nih.gov/33312018/
Choi E, Oh J, Sung GH. Beneficial Effect of Cordyceps militaris on Exercise Performance via Promoting Cellular Energy Production. Mycobiology. 2020 Nov 9;48(6):512-517. doi: 10.1080/12298093.2020.1831135. PMID: 33312018; PMCID: PMC7717596.
https://pubmed.ncbi.nlm.nih.gov/29568244/
Sellami M, Slimeni O, Pokrywka A, Kuvačić G, D Hayes L, Milic M, Padulo J. Herbal medicine for sports: a review. J Int Soc Sports Nutr. 2018 Mar 15;15:14. doi: 10.1186/s12970-018-0218-y. PMID: 29568244; PMCID: PMC5856322.
https://pubmed.ncbi.nlm.nih.gov/25230212/
Park JM, Lee JS, Lee KR, Ha SJ, Hong EK. Cordyceps militaris extract protects human dermal fibroblasts against oxidative stress-induced apoptosis and premature senescence. Nutrients. 2014 Sep 16;6(9):3711-26. doi: 10.3390/nu6093711. PMID: 25230212; PMCID: PMC4179184.
https://pubmed.ncbi.nlm.nih.gov/27408987/
Hirsch KR, Smith-Ryan AE, Roelofs EJ, Trexler ET, Mock MG. Cordyceps militaris Improves Tolerance to High-Intensity Exercise After Acute and Chronic Supplementation. J Diet Suppl. 2017 Jan 2;14(1):42-53. doi: 10.1080/19390211.2016.1203386. Epub 2016 Jul 13. PMID: 27408987; PMCID: PMC5236007.
https://pubmed.ncbi.nlm.nih.gov/29736181/
Yuan G, An L, Sun Y, Xu G, Du P. Improvement of Learning and Memory Induced by Cordyceps Polypeptide Treatment and the Underlying Mechanism. Evid Based Complement Alternat Med. 2018 Mar 15;2018:9419264. doi: 10.1155/2018/9419264. PMID: 29736181; PMCID: PMC5874985.
https://pubmed.ncbi.nlm.nih.gov/18095756/
Illana Esteban C. Cordyceps sinensis, un hongo usado en la medicina tradicional china [Cordyceps sinensis, a fungi used in the Chinese traditional medicine]. Rev Iberoam Micol. 2007 Dec 31;24(4):259-62. Spanish. doi: 10.1016/s1130-1406(07)70052-9. PMID: 18095756.
https://pubmed.ncbi.nlm.nih.gov/31388403/
He MT, Lee AY, Park CH, Cho EJ. Protective effect of Cordyceps militaris against hydrogen peroxide-induced oxidative stress in vitro. Nutr Res Pract. 2019 Aug;13(4):279-285. doi: 10.4162/nrp.2019.13.4.279. Epub 2019 Jul 10. PMID: 31388403; PMCID: PMC6669067.
https://pubmed.ncbi.nlm.nih.gov/31623349/
Liao YH, Chao YC, Sim BY, Lin HM, Chen MT, Chen CY. Rhodiola/Cordyceps-Based Herbal Supplement Promotes Endurance Training-Improved Body Composition But Not Oxidative Stress and Metabolic Biomarkers: A Preliminary Randomized Controlled Study. Nutrients. 2019 Oct 3;11(10):2357. doi: 10.3390/nu11102357. PMID: 31623349; PMCID: PMC6835767.
https://pubmed.ncbi.nlm.nih.gov/31978767/
Bai X, Tan TY, Li YX, Li Y, Chen YF, Ma R, Wang SY, Li Q, Liu ZQ. The protective effect of cordyceps sinensis extract on cerebral ischemic injury via modulating the mitochondrial respiratory chain and inhibiting the mitochondrial apoptotic pathway. Biomed Pharmacother. 2020 Apr;124:109834. doi: 10.1016/j.biopha.2020.109834. Epub 2020 Jan 21. PMID: 31978767.
https://pubmed.ncbi.nlm.nih.gov/32748587/
Zhao X, Li Q, Liu W, Guan H, Li C, Wang J, Wang L. [Advances in biosynthesis of cordycepin from Cordyceps militaris]. Sheng Wu Gong Cheng Xue Bao. 2020 Jul 25;36(7):1293-1304. Chinese. doi: 10.13345/j.cjb.190500. PMID: 32748587.
https://pubmed.ncbi.nlm.nih.gov/36212977/
Lan L, Wang S, Duan S, Zhou X, Li Y. Cordyceps militaris Carotenoids Protect Human Retinal Endothelial Cells against the Oxidative Injury and Apoptosis Resulting from H2O2. Evid Based Complement Alternat Med. 2022 Sep 30;2022:1259093. doi: 10.1155/2022/1259093. PMID: 36212977; PMCID: PMC9546680.
https://pubmed.ncbi.nlm.nih.gov/31791317/
Benson KF, Stamets P, Davis R, Nally R, Taylor A, Slater S, Jensen GS. The mycelium of the Trametes versicolor (Turkey tail) mushroom and its fermented substrate each show potent and complementary immune activating properties in vitro. BMC Complement Altern Med. 2019 Dec 2;19(1):342. doi: 10.1186/s12906-019-2681-7. PMID: 31791317; PMCID: PMC6889544.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975919/
Chen SH, He CY, Shen YY, Zeng GH, Tian DY, Cheng Y, Xu MY, Fan DY, Tan CR, Shi AY, Bu XL, Wang YJ. Polysaccharide Krestin Prevents Alzheimer's Disease-type Pathology and Cognitive Deficits by Enhancing Monocyte Amyloid-β Processing. Neurosci Bull. 2022 Mar;38(3):290-302. doi: 10.1007/s12264-021-00779-5. Epub 2021 Oct 6. PMID: 34611829; PMCID: PMC8975919.
Pathways to Weight Loss
Pathways to weight loss
Wegovy JanuviaMetformin Pharmacologic Pathway
Eat BetterWalkingExercise Lifestyle Pathway
Wegovy —>Januvia—>Metformin Pharmacologic Pathway
Eat Better—>Walking—>Exercise Lifestyle Pathway
Injectable GLP-1 drugs like Wegovy (semaglutide), Saxenda (liraglutide), and Mounjaro (tirzepatide) are becoming almost universally known in society for their potential weight loss properties. Off label use of some of these drugs has practically gone viral. Elon Musk himself gives the drug Wegovy credit for his improved health and slimmer figure. The demand has been so high for these products that availability has become a serious issue. This is more than just a manufacturing backlog that has slowed international roll out; these are expensive products with sometimes subpar reimbursements from insurance companies. The margins have become so tight on dispensing some of these more expensive drugs that for smaller independent pharmacies it means potentially filling the prescription at a loss.
Insurance companies are not exactly happy to see all these expensive claims coming through either. So, they throw up every roadblock they legally can in order to avoid paying for these products. Prior authorizations, step therapy, and outright claim rejections are their first line of defense. Next are audits of the pharmacy for any reason possible to later claw back those claims. Further complicating the payment issue are drug coupons handed out by the manufacturers. Mounjaro has become notorious for coupons that appear to work initially but can be taken back later for a variety of reasons in the fine print that void the coupon, off label prescribing for one. Wegovy is the only drug in the class that currently has an FDA approved indication for weight loss, others have approval for diabetes so using them for weight loss is technically off label prescribing. You can see why it happens after all Wegovy is the same drug as Rybelsus they are both semaglutide except one is injectable and the other is an oral tablet, one has approval for weight loss the other diabetes despite being the same drug. They are both very expensive, so what are the options for the financially or insurance challenged?
Januvia (sitagliptin) is the first drug that comes to mind when I think of less expensive alternative products to the GLP-1 drugs because it causes an increase in GLP-1 by inhibition of DPP-4. A study comparing the drugs showed sitagliptin to be comparable with lower doses of semaglutide. The beneficial effect is provided by the same mechanism, an increase in GLP-1 either by preventing its metabolism with DPP-4 inhibitors or injecting it directly once a week. Januvia is brand only until 2027 and costs about 500 bucks a month which is not cheap but is better than 2000. It also provides a real bang for its buck. Januvia can lower A1C by up to a point which is significant. Regarding weight loss, the results seem mixed. A recent study comparing the two drugs showed substantially more weight loss with the higher dose semaglutide. With Januvia we are politely nudging the system towards where we want to go. By directly injecting GLP-1 we are kicking the door down and forcefully dragging the system where we want it. Because it is more of a brute force approach the GLP-1 drugs do cause gastrointestinal issues (despite being injectable) and have more potential for hypoglycemia. I do have theoretical concerns about the abuse of these products causing acute hypoglycemia which could precipitate a cardiovascular event. (1)
Sitagliptin has received attention as a potential covid therapy also. Molecular modeling has confirmed that the drug has the potential to bind and interact with two proteases 3CL and PL. Both proteases play a role in viral reproduction and inhibition of them has been proposed as a beneficial mechanism for the treatment of covid. Another study looking at diabetic patients with covid did show improved outcomes when sitagliptin was given in addition to metformin. A retrospective cohort study of 220 patients looked at DPP-4 inhibitors in diabetic patients with covid and there was a significant decrease in hospitalization duration but no statistical significance for survival.
Metformin has been the gold standard for treating diabetes and is so widely used that its weight reduction benefits, and safety profile are well documented. The best thing about it is the price, since it is such an old generic medication it is as cost effective as it gets. Titrate the dose up slowly over a week or two to prevent gastrointestinal distress. Other generic drugs with weight loss credentials using different mechanisms include Topamax (topiramate) a migraine medication and Wellbutrin (bupropion) an antidepressant and smoking cessation drug that has its own potential for abuse.
At their best all these products discussed are hyped to be exercise in a bottle. The reason they say that is because there are studies showing that exercise increases GLP-1. Animal studies have shown that GLP-1 is involved in exercise endurance and remodeling of skeletal muscle. So instead of paying for GLP-1 you can go farm it the old-fashioned way, building more muscle and moving that muscle to burn fat.
Wegovy $2,000
Rybelsus $1,000
Januvia $500
Gym $50
Metformin $10
Walking $0
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649367/ (1)
Sanon VP, Sanon S, Kanakia R, Yu H, Araj F, Oliveros R, Chilton R. Hypoglycemia from a cardiologist's perspective. Clin Cardiol. 2014 Aug;37(8):499-504. doi: 10.1002/clc.22288. Epub 2014 Jun 4. PMID: 24895268; PMCID: PMC6649367.
https://pubmed.ncbi.nlm.nih.gov/36738369/
Zong Y, Wang X, Zhang Y, Tan N, Zhang Y, Li L, Liu L. Sitagliptin Ameliorates Creb5/lncRNA ENSMUST00000213271-Mediated Vascular Endothelial Dysfunction in Obese Mice. Cardiovasc Drugs Ther. 2023 Feb 4. doi: 10.1007/s10557-023-07436-1. Epub ahead of print. PMID: 36738369.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145895/
Gilbert MP, Pratley RE. GLP-1 Analogs and DPP-4 Inhibitors in Type 2 Diabetes Therapy: Review of Head-to-Head Clinical Trials. Front Endocrinol (Lausanne). 2020 Apr 3;11:178. doi: 10.3389/fendo.2020.00178. PMID: 32308645; PMCID: PMC7145895.
https://pubmed.ncbi.nlm.nih.gov/36874737/
Benido Silva V, Pereira MT. Six-Year Complete Remission of Type-1 Diabetes Mellitus in an Adult Treated With Sitagliptin. Cureus. 2023 Jan 30;15(1):e34376. doi: 10.7759/cureus.34376. PMID: 36874737; PMCID: PMC9976506.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484814/
Rosenstock J, Allison D, Birkenfeld AL, Blicher TM, Deenadayalan S, Jacobsen JB, Serusclat P, Violante R, Watada H, Davies M; PIONEER 3 Investigators. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. JAMA. 2019 Apr 16;321(15):1466-1480. doi: 10.1001/jama.2019.2942. PMID: 30903796; PMCID: PMC6484814.
https://pubmed.ncbi.nlm.nih.gov/36724745/
Sun X, Xu Y, Zhou J. DPP4 Inhibitor Sitagliptin Reduces Inflammatory Responses and Mast Cell Activation in Allergic Rhinitis. Pharmacology. 2023;108(2):166-175. doi: 10.1159/000528634. Epub 2023 Feb 1. PMID: 36724745.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524728/
Alomair BM, Al-Kuraishy HM, Al-Buhadily AK, Al-Gareeb AI, De Waard M, Elekhnawy E, Batiha GE. Is sitagliptin effective for SARS-CoV-2 infection: false or true prophecy? Inflammopharmacology. 2022 Dec;30(6):2411-2415. doi: 10.1007/s10787-022-01078-9. Epub 2022 Sep 30. PMID: 36180664; PMCID: PMC9524728.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9639723/
Sadidi M, Zare A, Nasrollahzadehsabet M, Dastan F, Mosadegh Khah A, Jafari Asheyani M. The roles of dipeptidyl peptidase-4 inhibitors in prognosis of COVID-19 infection in patients with type 2 diabetes mellitus. J Res Med Sci. 2022 Aug 27;27:62. doi: 10.4103/jrms.jrms_71_22. PMID: 36353337; PMCID: PMC9639723.
https://pubmed.ncbi.nlm.nih.gov/36382241/
da Cruz Freire JE, Júnior JEM, Pinheiro DP, da Cruz Paiva Lima GE, do Amaral CL, Veras VR, Madeira MP, Freire EBL, Ozório RG, Fernandes VO, Montenegro APDR, Montenegro RC, Colares JKB, Júnior RMM. Evaluation of the anti-diabetic drug sitagliptin as a novel attenuate to SARS-CoV-2 evidence-based in silico: molecular docking and molecular dynamics. 3 Biotech. 2022 Dec;12(12):344. doi: 10.1007/s13205-022-03406-w. Epub 2022 Nov 7. PMID: 36382241; PMCID: PMC9640538.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699540/
Al-Kuraishy HM, Al-Gareeb AI, Albogami SM, Jean-Marc S, Nadwa EH, Hafiz AA, A Negm W, Kamal M, Al-Jouboury M, Elekhnawy E, Batiha GE, Waard M. Potential Therapeutic Benefits of Metformin Alone and in Combination with Sitagliptin in the Management of Type 2 Diabetes Patients with COVID-19. Pharmaceuticals (Basel). 2022 Nov 7;15(11):1361. doi: 10.3390/ph15111361. PMID: 36355535; PMCID: PMC9699540.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121144/
Mikhael EM, Ong SC, Sheikh Ghadzi SM. Efficacy and Safety of Sitagliptin in the Treatment of COVID-19. J Pharm Pract. 2022 May 17:8971900221102119. doi: 10.1177/08971900221102119. Epub ahead of print. PMID: 35581701; PMCID: PMC9121144.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294388/
Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. doi: 10.3389/fendo.2021.645563. Erratum in: Front Endocrinol (Lausanne). 2021 Nov 10;12:786732. PMID: 34305810; PMCID: PMC8294388.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393509/
Domecq JP, Prutsky G, Leppin A, Sonbol MB, Altayar O, Undavalli C, Wang Z, Elraiyah T, Brito JP, Mauck KF, Lababidi MH, Prokop LJ, Asi N, Wei J, Fidahussein S, Montori VM, Murad MH. Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015 Feb;100(2):363-70. doi: 10.1210/jc.2014-3421. Epub 2015 Jan 15. PMID: 25590213; PMCID: PMC5393509.
https://pubmed.ncbi.nlm.nih.gov/35636559/
Wu L, Zhou M, Li T, Dong N, Yi L, Zhang Q, Mi M. GLP-1 regulates exercise endurance and skeletal muscle remodeling via GLP-1R/AMPK pathway. Biochim Biophys Acta Mol Cell Res. 2022 Sep;1869(9):119300. doi: 10.1016/j.bbamcr.2022.119300. Epub 2022 May 27. PMID: 35636559.
Tainted Drops
Although it is rare the eye can be a portal for systemic infections to invade. It is a long hard road through the tear ducts and nasal cavity, but it is possible. This is why all eye drops must be sterile. Occasionally a mistake gets made where a patient places ear drops in their eyes which can lead to issues because ear drops are not sterile. Eye drops can be placed in the ear, but ear drops should not be put in the eye. Sometimes this allows for cost saving alternatives when some antibiotic ear drops can be expensive brand names while their ophthalmic equivalent may be an affordable generic. There is no issue using a sterile product in an unsterile environment but flip that situation around and you can get burned.
Although it is rare the eye can be a portal for systemic infections to invade. It is a long hard road through the tear ducts and nasal cavity, but it is possible. This is why all eye drops must be sterile. Occasionally a mistake gets made where a patient places ear drops in their eyes which can lead to issues because ear drops are not sterile. Eye drops can be placed in the ear, but ear drops should not be put in the eye. Sometimes this allows for cost saving alternatives when some antibiotic ear drops can be expensive brand names while their ophthalmic equivalent may be an affordable generic. There is no issue using a sterile product in an unsterile environment but flip that situation around and you can get burned.
Recent failures in quality control for Globe Pharma, a large Indian pharmaceutical manufacturer have done just that, and it has resulted in patient harm across the country. Ophthalmic products from the company are distributed by a New Jersey based company Ezricare. Unfortunately, their artificial tears eye drops, a common over the counter product showed contamination with a strain of multi drug resistant Pseudomonas Aeruginosa. This bacterium has been a deadly enemy for some time killing about 2500 in the United States annually. It can be a difficult infection to treat and many of the drugs that once worked against it like Zosyn (Piperacillin & Tazobactam) are now ineffective. This troublesome strain from India has resulted in at least one death and five patients with permanent vision loss.
Some credit is due to the work of the CDC and FDA for tracking down and identifying the culprit quickly as infections in long term care facilities across thirteen states were genetically analyzed to confirm they were the exact same strain of Pseudomonas despite varying clinical presentations of the disease. Then they grabbed some of the suspected Ezricare drops off the shelf and sure enough the same strain was found in the drops. This was enough for the CDC to issue a full recall of the product. Indian investigators have halted Globe’s production of ophthalmic products pending an investigation. There may have already been some suspicion towards the quality because a month prior to the recall the FDA would ban the import of Global Pharma products due to an inadequate response by the company and concerns about their manufacturing process.
The hero riding to the rescue for those patients who contracted this infection is called Fetroja (cefiderocol). Retail cash price for a course of treatment is over two thousand dollars just for the drug. It must be administered IV so there will certainly be some administration costs involved. The high price is justified here though because Fetroja is one of a kind at the moment. Its novel mechanism of action puts it in a class all by itself as a siderophore cephalosporin.
Siderophore may be a new term to many people, essentially, they are small chemicals that bacteria and fungi use to obtain iron. They need iron to survive just like we do, and they obtain it by sending out siderophores which then bind iron creating a complex that travels back into the cell through small porin tunnels. Think of gram-negative bacteria such as pseudomonas like the death star, we need to penetrate the surface to do damage. This is the small thermal exhaust point we are shooting for and Fetroja is designed to sneak in by binding iron and catching a ride inside the cell. Binding the antibiotic to a siderophore compound also provided other benefits like increased stability against beta lactamases making future siderophore antibiotics vital weapons in our fight against drug resistant infections.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://apnews.com/article/new-york-city-business-health-4572be6da44f4fab4e0f691f5e37e3ed
Placebo & NOcebo
The history of placebo likely goes as far back in history as we do but the first documented medical placebo occurred in 1796 when a Dr. Elisha Perkins began marketing a new healthcare product called the "Perkins Tractor". Heralded as a medical breakthrough the tractor was nothing other than two metal sticks one made of iron and the other brass. Simply touching these sticks to the patient was rumored to cure all sorts of health problems. As people tend to do, they deferred to the science at the time and Dr. Perkins would become very wealthy selling overpriced metal rods to many physicians, even George Washington would pick up a pair. According to Dr. Perkins the unique metal composition of the tractor yielded the medical benefits.
The history of placebo likely goes as far back in history as we do but the first documented medical placebo occurred in 1796 when a Dr. Elisha Perkins began marketing a new healthcare product called the "Perkins Tractor". Heralded as a medical breakthrough the tractor was nothing other than two metal sticks one made of iron and the other brass. Simply touching these sticks to the patient was rumored to cure all sorts of health problems. As people tend to do, they deferred to the science at the time and Dr. Perkins would become very wealthy selling overpriced metal rods to many physicians, even George Washington would pick up a pair. According to Dr. Perkins the unique metal composition of the tractor yielded the medical benefits.
Not everyone was a believer however, the Connecticut Medical Society to which Dr. Perkins belonged would give him the boot and many other skeptical physicians would begin experimenting with the tractors. A Dr. John Haygarth was treating patients with rheumatic disorders and decided to try and use a wooden stick in place of the metal tractor. He observed similar results no matter what substance the stick was constructed of and determined that Dr. Perkins' product was a sham. This would become the first documented case of the placebo effect. Dr. Haygarth would publish a book on the subject entitled On the Imagination as a Cause & as a Cure of Disorders of the Body.
Haygarth would go on to become a celebrated physician, Perkins on the other hand would be run over directly by a karma train when he traveled to New York city during a smallpox outbreak hoping to test his new antiseptic, a combination of vinegar and salt water. The antiseptic was a failure and Perkins himself would catch smallpox and die a month later.
Pacemaker studies provide an interesting view of the phenomenon. Proving that pacemakers worked would require studies comparing it to placebo. That is easy to do with say a drug when you never know what is in the pill provided, gets tougher when you need to surgically implant something. The solution is everyone is getting a pacemaker but we're only going to turn on half of them. Eyebrows were raised when improvements were seen across both groups. As late as 2012 a Cochrane review would be ambivalent calling for larger higher quality trials to be conducted. Recent studies have shown a small to moderate benefit over placebo but it's still closer than you would expect.
Perhaps the best documentation for the power of the placebo effect comes from the eighties when 74 patients after dental surgery were randomly assigned to receive either morphine or normal saline. It yielded some surprising results like the average pain being independent of the morphine dose administered. The placebo was as effective as 4 to 6 milligrams of morphine. With higher doses the morphine would prove to be the superior analgesic as you would expect, but the placebo put up a good fight.
For a short time, doctors were able to prescribe placebo or sugar pills for patients. Physicians had the option of prescribing something completely inert and safe for their patients who demanded medication. While it may have been more to placate the patient than treat a disease there is no way to prescribe an inert substance like that today. Instead, doctors tend to use actual drugs going off label for instance or simply prescribing medications they know are safe even if they think them unnecessary. They do this because patient expectations matter and having a positive attitude about a potential treatment can make it that much more effective.
The placebo effect is very real and for that reason most in medicine are careful to use it as a tailwind instead of fighting against it. Cautious optimism is always preferred to pessimistic nihilism. When the placebo effect works in reverse, we call it a nocebo. While we try to harness the placebo for our benefit the nocebo should be avoided at all costs. Nocebo does not get the attention of its more positive counterpart because ethically it should never happen but there are two good reasons for the nocebo to break into the mainstream consciousness sometime soon. The first is the movie Nocebo a decent psychological horror flick starring Eva Green, the former Bond girl from Casino Royale. It is worth a watch and strangely enough popped in my shudder watch list a few hours after finishing this piece. The second reason is because the nocebo effect is the perfect scapegoat.
The mRNA vaccines have hit a speed bump in their PR campaign, between VAERS, VSAFE, a recent Rasmussen poll and increasingly vocal vaccine injured patients, people suspect there is something going on. Since the government must start from the conclusion that their products are not the problem, the next best argument for them is the nocebo effect. Studies are already coming out concluding that adverse events from vaccination can be reduced with what they call “positive information framing”. In Canada “Altruism-Eliciting video intervention” is being studied to make young people more amenable to vaccination. A recent paper on vaccine anaphylaxis argues that the mRNA shots have a similar rate of anaphylaxis as other vaccines but offers stress related and nocebo effects as potential sources of the public misconception.
Providing positive propaganda to people before giving them their injection is not exactly what I would call informed consent, but it is at least keeping the placebo effect pointed in the right direction. The effect is real enough to make sure it is in your favor and the nocebo effect is good enough to blame the vaccines shortcomings on. The problems were not unexpected side effects and suspicious quality control. You see the problem was your lack of faith, which the government finds disturbing. Framing it in this light freedom of speech and bodily autonomy stood no chance against certain forces' determination to prevent a nocebo effect on their precious.
At the same time, they were also coordinating the greatest nocebo campaign in history against off label treatments like ivermectin, hydroxychloroquine, fluvoxamine, famotidine, and even vitamin D. The FDA would go so far as to openly mock sick people for seeking a cure that their doctor prescribed. Physicians wishing to share their success with the medications were silenced and shunned. Only profitable meds whose name rhymes with covid are the acceptable forms of treatment. Even if all the potential benefits of ivermectin were due to nothing more than the placebo effect this still makes their actions asinine and lacking common decency.
If you wanted a little more insight into the ivermectin debate Sharyl Attkisson has an interesting interview with patients who after failing to get their prescription filled downed the actual horse paste and recovered. She also speaks with a pharmacist who argues that the doses being prescribed are unsafe, not the pharmacologic hill I want to make a stand on but a good job by Sharyl to find someone to argue the other side. Ivermectin is weight based so higher doses should be no surprise especially when the patient population most are concerned with are not skinny sallies.
https://sharylattkisson.com/2023/02/after-hours-dr-vs-pharmacist-the-power-to-prescribe-podcast/
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further Reading and References
https://archive.org/details/b21514859 (Haygarth's book)
https://archive.org/details/2566066R.nlm.nih.gov/page/n15/mode/2up (Perkins original study)
https://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol26_no2/dnb_vol26_no2_100.pdf
https://countway.harvard.edu/news/backblog-elisha-perkins-metallic-tractors
https://www.founderoftheday.com/founder-of-the-day/perkins
https://sitn.hms.harvard.edu/flash/2016/just-sugar-pill-placebo-effect-real/
https://pubmed.ncbi.nlm.nih.gov/7279424/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094451/
https://pubmed.ncbi.nlm.nih.gov/10190407/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360382/
https://www.webmd.com/pain-management/news/20081023/50percent-of-doctors-give-fake-prescriptions
https://pubmed.ncbi.nlm.nih.gov/34041973/
https://pubmed.ncbi.nlm.nih.gov/36789412/
https://pubmed.ncbi.nlm.nih.gov/36780276/
https://pubmed.ncbi.nlm.nih.gov/35544437/
Pfizer’s no good very bad date
The internet went crazy after an insane display by a young doctor employed by Pfizer. Despite his youth Dr. Jordan Walker was the Director of Research, Development, and Strategic Operations for Pfizer. Undercover video provided by Project Veritas shows Dr. Walker over the course of several dates discussing things his employer would prefer to stay in the office. The video passed 20 million views before YouTube managed to pull it down. Upon realizing what was going on, Dr. Walker became violent and turned the restaurant into a Jerry Springer show.
The internet went crazy after an insane display by a young doctor employed by Pfizer. Despite his youth Dr. Jordan Walker was the Director of Research, Development, and Strategic Operations for Pfizer. Undercover video provided by Project Veritas shows Dr. Walker over the course of several dates discussing things his employer would prefer to stay in the office. The video passed 20 million views before YouTube managed to pull it down. Upon realizing what was going on, Dr. Walker became violent and turned the restaurant into a Jerry Springer show.
The implications of the video are troubling, but to Pfizer the bad press is far more concerning than any adverse events that may have already occurred. In the video Dr. Walker admits that they are studying the virus and uses the term directed evolution. He also brazenly brags about how the vaccines are a profit windfall for the company. As embarrassing as the video is the idea that Pfizer was studying covid, which should not be a surprise to anyone. It would be absurd to imagine that the company tasked with coming up with a cure for the virus would not be studying and manipulating it in a variety of ways. The conspiracy theory takeaway from these dinner dates is the insinuation that Pfizer may have played a part in creating the virus itself. While I rule nothing out, there is plenty of evidence circulating that raises questions about the pedigree of the virus and implicates American companies. Pfizer certainly robbed the bank once the door was open, but I don't see any evidence that they were involved in the initial setup.
Pfizer would respond a few days later with a public statement right before the weekend so everyone would have time to read it. The statement is little more than legal fluff managing to both confirm and deny the worst of the claims at the same time. More interestingly though is that the company took a moment to cover their ass by publishing a list of side effects and adverse events that you see at the end of every drug commercial. Normal statements that you could not even say on the internet a few years ago about the vaccine are now published by Pfizer openly.
1. The vaccine may not protect everyone
2. There is a remote chance that these vaccines may cause a severe allergic reaction
3. Side Effects listed below
• Severe allergic reactions
• Non-severe allergic reactions such as rash, itching, hives, or swelling of the face (cute that angioedema is considered non-severe)
• Myocarditis (inflammation of the heart muscle)
• Pericarditis (inflammation of the lining outside the heart)
• Injection site pain
• Tiredness
• Headache
• Muscle pain
• Chills
• Joint pain
• Fever
• Injection site swelling
• Injection site redness
• Nausea
• Feeling unwell
• Swollen lymph nodes (lymphadenopathy)
• Decreased appetite
• Diarrhea
• Vomiting
• Arm pain
• Fainting in association with injection of the vaccine
• Unusual and persistent irritability
• Unusual and persistent poor feeding
• Unusual and persistent fatigue or lack of energy
• Unusual and persistent cool, pale skin
• Dizziness
4. These may not be all the possible side effects of these vaccines
That last one is my favorite, talk about covering your bases. It’s a good thing they did too because Veritas, like any good poker player, slow played their hand and on the heels of Pfizer's statement, released more footage. In these videos Dr. Walker said that the vaccines could affect menstrual cycles by some type of hormone disruption. These are more troubling statements because they allude to the possibility that Pfizer failed to report material adverse events. At this point there is nothing that the loquacious Dr. Walker stated that has not crossed my own mind when I think of all the ways this thing could potentially backfire. Hormone disruption would be one of the worst-case scenarios because if it can affect the menstrual cycle, it could also affect pregnancy. If you think proving what caused a heart attack was a tough case to make, try getting to the bottom of a miscarriage.
In an internal communication Pfizer would confirm that Dr. Walker is an employee and warned other employees to be aware of potential sting operations from outlets like Veritas. The memo was then quickly leaked to Veritas who would publish it. It is a good thing that there are a few Pfizer employees willing to spill the beans, but Veritas may have bitten off more than it can chew here. Turnabout is fair play and James O’Keefe the founder of Veritas just took a knife in the back from his own board who is attempting to boot him from his own company after multiple employees openly accused him of being a “power hungry tyrant”.
The narrative that all the world has been playing “find a cure” since this mess started thanks to a passionate bat/pangolin wet market tryst. The overwhelming reality of a lab leak has now become impossible to ignore and with it the realization that the “find a cure story” is a gigantic game of “hide the liability”. The clear and obvious winner of this game is the Chinese government who has made sure that despite their obvious participation in the virus's development there is little evidence. The losers however are their American counterparts who despite their best illegal efforts simply have too long of a paper trail to ever cover up completely. A guilty conscience really does explain some of the worst behavior we have seen from health officials.
If you would like an inside look at this whole situation, I recommend Dr. Andrew Huff’s recent book The truth about Wuhan: How I uncovered the biggest lie in history. It is a very entertaining read and Dr. Huff has done a marvelous job of breaking down gain of function research for all to understand as he walks us through his time spent working for EcoHealth Alliance. As he tells the tale the company was a bit of a fly by night operation that had little corporate governance, seemingly on purpose to allow Peter Daszak the company’s founder the flexibility to do whatever he wanted. Daszak is described as an excellent writer and Huff provides examples of government funded research proposals for gain of function research that use other euphemisms like reverse genetics to skirt around former President Obama's ban on the research. Despite the evidence linking them to the dangerous research that put us here EcoHealth alliance continues to receive government funding.
History's greatest cash grab is probably a best-case scenario at this point. At worst we are in a viral Jurassic Park situation where coronaviruses have been placed on the evolutionary expressway. It's like we brought the raptors back but decided it would be cool if we gave them wings as well.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://timcast.com/news/james-okeefe-accused-of-erratic-behavior-by-16-project-veritas-employees/
https://www.projectveritas.com/
https://www.ecohealthalliance.org/2022/12/ecohealth-alliance-statement-regarding-book-by-andrew-huff
https://www.pfizer.com/news/announcements/pfizer-responds-research-claims?__cf_chl_tk=Tdyd8b.cCbVwTuFP30wDmdrUFIuYZtu.MQS834GQfnc-1675816496-0-gaNycGzNCeU (Pfizers Friday evening statement)
https://assets.ctfassets.net/syq3snmxclc9/2mVob3c1aDd8CNvVnyei6n/95af7dbfd2958d4c2b8494048b4889b5/JAG_Docs_pt1_Og_WATERMARK_OVER_Redacted.pdf (Infamous DARPA memo)
https://assets.ctfassets.net/syq3snmxclc9/oVt6gT0yBx4eQXSeuNfEp/3cbbd7ef84e90c9702c1943c55d80f75/executive-slide-hr00118s0017-ecohealth-alliance-defuse.pdf (DEFUSE proposal summary)
https://assets.ctfassets.net/syq3snmxclc9/4NFC6M83ewzKLf6DvAygb4/0cf477f75646e718afb332b7ac6c3cd1/defuse-proposal_watermark_Redacted.pdf (Full DEFUSE proposal)
https://assets.ctfassets.net/syq3snmxclc9/5OjsrkkXHfuHps6Lek1MO0/5e7a0d86d5d67e8d153555400d9dcd17/defuse-project-rejection-by-darpa.pdf (EcoHealth proposal rejected by DARPA)
https://assets.ctfassets.net/syq3snmxclc9/6K3RxB1DVf6ZhVxQLSJzxl/6be5c276bc8af7921ce6b23f0975a6c3/A_prempt-background-hr001118s0017.pdf (DARPA PREEMPT Program)
https://www.sgtreport.com/2023/02/leaked-pfizer-memo-admits-dr-jordon-walker-works-there-does-not-deny-directed-evolution-of-covid-variants/
Fancy Aspirin: All dressed up with nowhere to go
There is a brand-new aspirin in town. Vazalore is not your grandpa’s baby aspirin. Its cutting-edge drug delivery technology applied to a classic medication to solve its eternal nagging problem. Bleeding risks exist, even if it is a rare adverse event the widespread use of the drug means there will always be a few cases. In the past this issue was enough of a justification to develop all new drugs. Cox-2 Inhibitors like Bextra, Vioxx, and Celebrex all came to the market claiming to be safer alternatives. Those drugs of course wound up having some negative cardiovascular effects resulting a black box warning for one and the other two being pulled from the market. Now years later we have a fancy new liquid filled aspirin capsule that addresses those bleeding concerns, and nobody seems to care
There is a brand-new aspirin in town. Vazalore is not your grandpa’s baby aspirin. Its cutting-edge drug delivery technology applied to a classic medication to solve its eternal nagging problem. Bleeding risks exist, even if it is a rare adverse event the widespread use of the drug means there will always be a few cases. In the past this issue was enough of a justification to develop all new drugs. Cox-2 Inhibitors like Bextra, Vioxx, and Celebrex all came to the market claiming to be safer alternatives. Those drugs of course wound up having some negative cardiovascular effects resulting a black box warning for one and the other two being pulled from the market. Now years later we have a fancy new liquid filled aspirin capsule that addresses those bleeding concerns, and nobody seems to care.
Vazalore is a unique product that greatly improves absorption while reducing GI events. The liquid filled capsule contains an aspirin-phospholipid complex that is designed to be stable in low pH environments but dissolves at higher pH allowing for the drugs rapid absorption. This results in targeted drug delivery that avoids areas where it is most likely to cause damage to the mucosal lining of the stomach. This phospholipid delivery technology has the potential to be applied to many other drugs that can harm the lining of our stomachs which appears to negatively impact our microbiome and thus modulate overall immune function.
I doubt you will ever see other products using this technology because the company behind it has pretty much been smacked in the face by the market reality that nobody is interested in expensive aspirin. It might be cool and twice as safe with potentially better therapeutic effects but compared to regular aspirin it's 1000 times as expensive and nobody is interested in that. PLX Pharma is the company behind Vazalore and as you can see from the chart below things have not really gone to plan. The stock price hit an all-time high of 136 dollars in September of 2016, now you can load up for only a quarter a share.
Their mistake was going over the counter, if they had gone the prescription route where the obscene costs can be hidden behind the insurance system the drug may have been successful. I respect the drug company though for betting on their product and pursuing over the counter status. Unfortunately for them it appears to be a spectacular commercial failure. Even someone like me who takes aspirin daily and can appreciate all the things that make Vazalore awesome are yet to buy a bottle. Perhaps in a few years when my Costco sized baby aspirin runs out, then I will pick up some Vazalore, if it's still on the shelf. The harsh reality for PLX is that if you cannot sell fancy aspirin in this market with half the world freaking out about sudden cardiovascular death then you likely never will.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://pubmed.ncbi.nlm.nih.gov/36592127/
https://pubmed.ncbi.nlm.nih.gov/36601590/
https://pubmed.ncbi.nlm.nih.gov/36588714/
https://link.springer.com/article/10.1007/s40262-021-01090-2#citeas}
https://link.springer.com/article/10.1007/s11239-020-02051-5
https://link.springer.com/article/10.1007/s11239-019-01933-7
Mifepristone comes to the pharmacy
The discovery of Mifepristone goes back to the sixties and the sexual revolution when a Dr. Gregory Pincus who is ironically referred to as the father of birth control. His first book The Eggs of Mammals was published in 1936 and his most famous work The Control of Fertility was published in 1965. Collaborating with Dr. John Rock who was a practicing gynecologist and OBGYN their work with hormones would lead to the first successful oral contraceptive pill called Enovid which was licensed in 1960. It was a combination of progesterone and estrogen that would change the world for better or worse.
The discovery of Mifepristone goes back to the sixties and the sexual revolution when a Dr. Gregory Pincus who is ironically referred to as the father of birth control. His first book The Eggs of Mammals was published in 1936 and his most famous work The Control of Fertility was published in 1965. Collaborating with Dr. John Rock who was a practicing gynecologist and OBGYN their work with hormones would lead to the first successful oral contraceptive pill called Enovid which was licensed in 1960. It was a combination of progesterone and estrogen that would change the world for better or worse.
Not long after in France Roussel Uclaf a Pharmaceutical company found while experimenting with the synthetic hormone norethindrone that placing a 4-dimethyl-amino-phenyl group at a particular position resulted in the greatest affinity for the progesterone receptor without activating it. That compound which the company coded as RU38486 is now known as mifepristone. It has been in the news recently as the FDA has updated their REMS (Risk Evaluation & Mitigation Strategies) guidance to allow pharmacies to dispense it pursuant to a prescription. CVS and Walgreens, never missing an opportunity to pile a little more on their staff's plate, have already announced their intentions to carry the product.
As a progesterone blocker administering the drug during pregnancy will cause the endometrium to break down. Proper functioning of the endometrium is a necessity for the pregnancy to continue and when it is disrupted by a progesterone blockade the environment will no longer be conducive to the embryo's existence. To further assist in full expulsion the prostaglandin misoprostol is also administered which stimulates uterine contractions. Given in combination this has become the treatment of choice when removal of the embryo is necessary. It has also been shown to be safer and more cost effective compared to suction alternatives. The drug has several other uses including endometriosis, Cushing's syndrome, breast cancer, uterine fibroids and it can even be used to induce labor but none of those uses would come to define it.
Trials with the new compound would start in the eighties and by 1988 it would be approved for sale in France with a one week waiting period. One source boasted that it was used by 100 French women a day. Internationally it was not as well received and was causing serious headaches with Russel Uclaf’s parent company Hoechst. They were concerned about political blowback and a boycott by the American public. Apparently not without actual merit because several years later, they would give the drugs patent away to appease anti-abortion groups who were refusing to use their new allergy medication Allegra. Hoechst executives in private would admit that the pro-life argument that they were doing to fetuses what the Nazi’s did to the Jews hit a little close to home. Hoechst parent company IG Farber supplied the cyanide gas used by the concentration camps and would throw much of its political weight behind a young Adolf Hitler.
Importing Mifepristone to the United States was illegal and customs would go digging through your bags to confiscate it at the airport. One California woman would be caught this way and appealed her case all the way to the supreme court despite being ultimately unsuccessful. The political winds would begin to change in America with the election of Bill Clinton who would order the FDA to investigate the drug's use for abortion. By 1995 Russel Uclaf would give the American patent rights for the medication to The Population Council, an international NGO. The Population Council's goal is to help achieve a "humane, equitable, and sustainable balance between people and resources".
If you're wondering why a drug patent would be given to an NGO and not a drug company, well here lies the heart of mifepristone's problems. It was not very profitable, and no company wanted to touch it out of the very real fear of boycotts. Finding a company to manufacture and distribute it was going to require some extraordinary measures and deep pockets. Fortunately for NGOs like The Population Council the Buffett Foundation and Rockefeller Brothers Fund are big donors. That makes it a little easier to fly down to the Cayman Islands to incorporate a drug company and thus Danco Laboratories was born. Danco does not exist to make money, it exists to distribute mifepristone. That is taking the culture war bull by the horns right there. Ironically mifepristone would become a lucrative drug when another company would use a slightly higher dose to treat Cushing's syndrome and market it under the name Korlym which at 550 dollars a pill cost 180,000 annually per patient.
Roussel Uclaf has an interesting history, it was founded in 1920 by a Dr. Gaston Roussel who would make the company an international success expanding its operations into Mexico, Brazil, and Argentina. Upon his death in 1947 his son Jean-Claude would assume control of the company. If there was an equivalent to the American dream for France this is probably it, the young Jean-Claude was a successful industrialist and pharmacist. The company would continue to grow and thrive, it was said to be a source of great pride for the French people. In 1968 Jean-Claude finds himself on a vacation in the south of France where he meets with a director of Hoechst, a German chemical company. I don’t know what was discussed between the two men and perhaps that is a mystery left to history, but the result was Hoechst purchasing 43% of Roussel Uclaf and Jean-Claude had a newfound desire to “Europeanize” his company.
This was unheard of at the time, and it did not sit well with the French government who considered foreign ownership of their pharmaceutical industry a bad idea. Jean-Claude would have to make many promises to get the deal to go through. He had to agree to never sell any of his own shares and guarantee that no foreign company would ever completely take over the industry. The French government was also given control over the future sale of stock in the company.
Despite those plans an unfortunate accident would throw the company in disarray, setting the stage for a corporate takeover. Jean-Claude was flying his own helicopter to his summer home when he ran into a cable causing him to crash, killing everyone on board. Jean-Claude was a decorated pilot with over 20 years of experience flying his own helicopters. The circumstances around his death certainly raise eyebrows if nothing else. Settling his estate would prove to be a financial mess and his interest in the company would have to be sold. The French government which was already toying with the notion of nationalizing the industry would panic and attempt to convince other large French companies Rhone-Poulenc and Elf-Aquitaine to step in and buy it. They would both decline and the French government itself would wind up buying 33% while Hoechst managed to increase its holdings to 51%.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
Institute of Medicine (US) Committee to Study Decision Making; Hanna KE, editor. Biomedical Politics. Washington (DC): National Academies Press (US); 1991. A Political History of RU-486. Available from: https://www.ncbi.nlm.nih.gov/books/NBK234199/
https://www.fertstert.org/article/S0015-0282(97)00189-1/pdf
https://www.company-histories.com/Roussel-Uclaf-Company-History.html
https://www.elsevier.com/books/the-control-of-fertility/pincus/978-1-4832-3291-1
https://www.nytimes.com/1972/04/10/archives/jeanclauderoussel.html
https://journals.co.za/doi/pdf/10.10520/AJA20785135_31727
https://www.ncbi.nlm.nih.gov/books/NBK234199/
https://www.plainsite.org/dockets/21jtx15me/supreme-court-of-the-united-states/benten-v-kessler/
https://www.earlyoptionpill.com/wp-content/uploads/2023/01/DAN_Pharmacy_Agreement_1.2023.pdf
Doctor Fight to save the bus
The behemoth that is modern corporate medicine tends to turn slowly. When the pivot eventually begins it is a messy situation. Imagine a bus making a U-turn on a crowded street; that it never should have gone down in the first place. The turning is already beginning if you're paying attention. Dr. Aseem Malhotra a British cardiologists has been very vocal about his opposition to the covid vaccines, in part due to the death of his father, which he blames on the shot. He is no stranger to controversy; his book titled A Statin Free Life probably cost him his invitation to the cool kid's cardiologist club.
The behemoth that is modern corporate medicine tends to turn slowly. When the pivot eventually begins it is a messy situation. Imagine a bus making a U-turn on a crowded street; that it never should have gone down in the first place. The turning is already beginning if you're paying attention. Dr. Aseem Malhotra a British cardiologists has been very vocal about his opposition to the covid vaccines, in part due to the death of his father, which he blames on the shot. He is no stranger to controversy; his book titled A Statin Free Life probably cost him his invitation to the cool kid's cardiologist club. Prior to his father's passing and subsequent further investigation of the mRNA vaccines he was a proponent of the products. More conversion stories like his are needed because one interesting thing about medicine is it can only correct itself. If the Lancet for example publishes a bunch of false data, then only the Lancet can set the record straight. Anyone outside of the Lancet that points out that same data is spreading misinformation.
In the states Dr. Peter McCullough was also outspoken but consistent this whole time. An early advocate of hydroxychloroquine & ivermectin his head was first on the chopping block. Baylor University Medical Center where he had hung his hat since 2014 would disown him and go so far as to file suit against him to prevent him from claiming any association with the institution. Those are the actions of a teaching hospital in Texas, it illustrates the extent of institutional capture by this lunacy. His most recent published paper, a report on myocarditis adverse events, was initially approved for publication but then quickly withdrawn by the publisher. Dr. McCullough has fought back with a lawsuit against the publisher Elsevier. He has accused them of censorship for the removal of the article. His co-author Jessica Rose, an immunologist and biochemist has stated that the removal of the article is unheard of and in breach of contract.
American converts include Dr. Vinay Prasad, a physician from California whose greatest crime is advocating for a more open debate on both sides. Dr. Leana Wen CNN's medical analyst, perhaps most famous for her comments about barring the unvaccinated from polite society, just recently called for the removal of mandates. Dr. Drew of Loveline fame and still the host of a very popular YouTube show has gone from defending Dr. Fauci to interviewing Dr. Ryan Cole a forensic pathologist making waves by describing some very disturbing blood clots he believes are related to the covid vaccines. To his credit Dr. Drew has been open about his own vaccinations and adverse events associated with them.
While some riders have jumped up and attempted to turn the bus before it goes over the cliff completely (maybe it already has), there are still numerous voices from the back telling them to sit down and shut up. Dr. Fauci clearly has no regrets, and his likely successor Dr. Peter Hotez continues to advocate for the covid vaccines across all age groups. Dr. Hotez even goes a little further claiming that upwards of 40,000 unvaccinated Texans are dead due to anti-vaxx grifters (excellent band name). Dr. David Gorski, a surgical oncologist, describes Dr. Prasad as "at best a useful idiot for antivax propagandists". The idea that anyone questioning medicine has no place in medicine is still a popular point of view for many.
What we have here is a good old fashioned doctor fight, these are nothing new but in the past were less public and less consequential. The stakes are higher than ever before. It's not like we are arguing over how aggressive statin therapy should be or which blood pressure medicine is most appropriate. Instead, each of these sides is accusing the other of outright harm by professional negligence to be as polite as possible. Safe and effective may be long gone but safe enough to get away with is still on the table. Things have gone off course before and history proves one thing, it takes time to resolve.
Oxycontin came to the market in December of 1995, almost a decade later Barry Meier, a journalist, would begin investigating Purdue Pharma and Oxycontin. In 2006 Purdue executives would pay 634 million in fines. Fast forward another decade and by 2015 much more of their nefarious web of marketing including 20,000 educational pain programs were revealed. Big surprise these organizations advocated and promoted more aggressive identification and treatment of pain pushing people towards their drugs. It was remarkably easy for them to saturate the conversation with their propaganda. It’s been 27 years and they are still settling lawsuits over that debacle.
There was a point when cigarettes were thought of as healthy and relaxing. You could argue that RJ Reynolds and their Medical Relations Division were pioneers when it came to controlling the medical establishment. The 1942 American Medical Association convention featured a smoking lounge for doctors to relax and socialize, by 1947 hundreds of doctors were lining up to receive a free pack of smokes. Much like today suspiciously biased studies were conducted to make the case that Camels were the healthiest cigarette. One study claimed that camels burned slower than other brands and thus exposed the smoker to less nicotine. Their most egregious marketing campaign would claim that all doctors preferred Camels, however with the FTC beginning to crack down they would change the wording from "all doctors" to "113,597 surveyed physicians". The party would finally come to an end in 1964 with the surgeon general's report on smoking and health.
There was also that other time we rushed a vaccine to market only to later have it withdrawn but I have touched on that in an older article you can find here.
https://www.pharmacoconuts.com/articles/echoes-of-76
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
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Further reading and references
https://www.health.harvard.edu/blog/surgeon-generals-1964-report-making-smoking-history-201401106970
https://beardyhistory.com/2021/02/28/healthy-cigarettes-advertising/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470496/
https://sciencebasedmedicine.org/dr-vinay-prasad-echoes-the-common-antivax-trope-of-portraying-a-desire-not-to-catch-a-deadly-disease-as-irrational-and-mental-illness/
https://www.lifesitenews.com/blogs/dr-mccullough-sues-medical-journal-for-refusing-to-publish-papers-showing-covid-shot-risks-in-children/
https://www.sciencedirect.com/science/article/pii/S0146280621002267?via%3Dihub
Echoes of 76
In the spring of 1976 at Fort Dix, a military base in New Jersey a particularly bad flu outbreak would capture the attention of health officials. The army estimated a few hundred soldiers fell ill and samples taken of the mystery flu strain would be sent to labs for analysis. They would identify it as an H1N1 influenza strain also known as the swine flu, thought to have killed over forty million in 1918. News would spread fast and the federal government's response would begin with a meeting of the Advisory Committee on Immunization Practices. A quote from one committee member at the time summed it up well.
In the spring of 1976 at Fort Dix, a military base in New Jersey a particularly bad flu outbreak would capture the attention of health officials. The army estimated a few hundred soldiers fell ill and samples taken of the mystery flu strain would be sent to labs for analysis. They would identify it as an H1N1 influenza strain also known as the swine flu, thought to have killed over forty million in 1918. News would spread fast and the federal government's response would begin with a meeting of the Advisory Committee on Immunization Practices. A quote from one committee member at the time summed it up well.
“If we believe in prevention, we have no alternative but to offer and urge the immunization of the population”
H1N1 vaccines had been made before by the military so there was confidence that it could be done. Timing was also fortuitous; they had just finished production of the normal flu vaccine and the specialized flocks of hens and roosters used in vaccine production were still alive although scheduled for destruction. Fearing a repeat of 1918 and with the 1968 Hong Kong flu fresh in recent memory the president would create the National Influenza and Immunization Program (NIIP) with the goal to produce sufficient vaccines for the entire population. This was announced in a press conference with the president that included Jonas Salk and Albert Sabin, well respected public health professionals of the time. NIIP would also create a monitoring system for adverse events dubbed the Surveillance Assessment Center (NIIP-SAC). Congress and the Senate would both write and approve legislation to fund the program appropriating 137 million dollars.
The first big problem outside of making the vaccine was acquiescing to the demands of manufacturers that they be indemnified against any adverse event that may occur. They would quickly grant their request, but many would worry that even asking for such a thing would send a subtle message that something may be wrong with the product. In August, another mystery illness would kill some attendees of a Legionnaires convention in Philadelphia, within two days influenza was ruled out as the culprit but opponents of the plan and conspiracy theorists of the time would claim it as a false flag operation to stoke fear and promote NIIP. It would be the discovery of what we now know as Legionnaire's disease, a bacterial pneumonia like infection. There would also be a cluster of three deaths in elderly patients that were vaccinated at the same clinic, an investigation would not attribute the deaths to the vaccine, but public hysteria ensued anyway. Despite these issues NIIP managed to vaccinate over forty million people.
As the vaccination campaign proceeded on however the complete absence of any other H1N1 flu transmission became evident. Public concern was beginning to mount over a rare neurological condition known as Guillain Barre Syndrome. Opinion would quickly shift as the risks of exceedingly rare side effects began to outweigh any apparent benefit. A moratorium would be declared for the shots by December, the pendulum had fully swung as was made evident by a scathing New York Times article labeling the entire incident a “debacle.”
The swine flu fiasco as it became known would hold many important lessons for public health that we never seem to learn. About a dozen years ago during the most recent swine flu outbreak Dr. Harvey Fineberg was interviewed to discuss problems with the public health response back then and how that should guide us now and in the future.
The interview is surreal to read today and includes many great insights that were ignored including avoiding overconfidence about scientific insights. His synopsis of how policy was kickstarted is just as good an explanation for our current conundrum. Political leaders wanting to do the right thing but lacking the expertise to know what that was would rely on the opinion of health experts. At the heart of the problem then and now is the inability of our health experts to effectively communicate the risk/benefit with any real accuracy. Fortunately, he points out that the health care system has a much more sophisticated approach to mass media today.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
https://substack.com/discover/pharmacoconuts
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Further reading and references
https://www.ncbi.nlm.nih.gov/books/NBK219603/
https://www.history.com/news/the-discovery-of-legionnaires-disease
https://academic.oup.com/cid/article/52/suppl_1/S4/498175
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291400/
Sencer DJ, Millar JD. Reflections on the 1976 swine flu vaccination program. Emerg Infect Dis. 2006;12(1):29-33. doi:10.3201/eid1201.051007
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686218/
Fineberg HV. Swine flu of 1976: lessons from the past. An interview with Dr Harvey V Fineberg. Bull World Health Organ. 2009;87(6):414-415. doi:10.2471/blt.09.040609
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946351/
McCullers JA, Van De Velde LA, Allison KJ, Branum KC, Webby RJ, Flynn PM. Recipients of vaccine against the 1976 "swine flu" have enhanced neutralization responses to the 2009 novel H1N1 influenza virus. Clin Infect Dis. 2010 Jun 1;50(11):1487-92. doi: 10.1086/652441. PMID: 20415539; PMCID: PMC2946351.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859467/
Kash JC, Qi L, Dugan VG, Jagger BW, Hrabal RJ, Memoli MJ, Morens DM, Taubenberger JK. Prior infection with classical swine H1N1 influenza viruses is associated with protective immunity to the 2009 pandemic H1N1 virus. Influenza Other Respir Viruses. 2010 May 1;4(3):121-7. doi: 10.1111/j.1750-2659.2010.00132.x. PMID: 20409208; PMCID: PMC2859467.
The Science of Spit
Your saliva is a fascinating multifunctional biofilm that almost nobody appreciates. It helps us break down and swallow our food acting as both a lubricant and digestive aid.
Your saliva is a fascinating multifunctional biofilm that almost nobody appreciates. It helps us break down and swallow our food acting as both a lubricant and digestive aid. At the same time its bicarbonate component acts as a buffer to protect our teeth. Antibacterial, antifungal, and antiviral properties also make it one of our immune system's first lines of defense. Multiple proteins and salivary epidermal growth factor are the reason why cuts inside your mouth heal so quickly compared to other locations, this same principle is why animals will lick their wounds. It is as close to an onboard first aid kit as mother nature provides. Analytically our saliva can provide a wealth of information about our overall health and well-being. Detailed hormone levels can be easily assayed by spitting in a cup. That is a whole panel of interesting metrics that provide great insight into your overall health that the average patient has probably never seen before.
Let’s start with your estrogen, do you know your estrogen level? A bit of a trick question because estrogen comes in several forms Estrone (E1), Estradiol (E2), Estriol (E3) are our naturally occurring versions. Ethinyl Estradiol (EE) is the most common synthetic estrogen used for contraceptive purposes. All these different types of estrogen are slightly different and produced naturally at different points. Estradiol (E2) is usually produced during the reproductive years by the ovaries. Estrone (E1) in comparison is found in excess after menopause. Estriol (E3) is the least potent by far of all three and is produced during pregnancy and is very notable for its anti-cancer effects.
As far back as the sixties medicine became aware of the connection between Estriol (E3) and breast cancer. Estriol is linked to lower incidence of breast cancer because of its weaker potency in comparison to the other estrogens. Breast cancer needs activation of the estrogen receptor to grow, when Estriol (E3) is present the receptor becomes blocked but not activated essentially. On the flip side of this the more you are activating those estrogen receptors the greater the increased risk of breast cancer. Ethinyl Estradiol (EE), our common contraceptive, is also the most potent of the bunch and this is the dark side of some birth control pills. It would take a while but eventually a 2014 article in Cancer Research would estimate you were 2.7 times more likely to develop breast cancer if you took some of the higher dose birth control pills.
That’s enough time in the lady's section, what about your testosterone level? Do you have the infamous low T the commercials warned you about? Statistically the answer is probably yes since many studies have shown a decline in testosterone across the population. The cause for this is hotly debated. Some blame smoking, diabetes, obesity and other general comorbidities of the modern age and others say the drop is too significant for these things to explain. The result is a disturbing decline in reproductive function. Testosterone and its metabolite dihydrotestosterone, which is more potent, can both be measured with saliva testing. Both activate the androgen receptor which has a wide variety of downstream effects that are not as appreciated today as they once were.
Precursors to testosterone can also be measured dehydroepiandrosterone (DHEA) and its metabolites DHEA-S and 7-Keto DHEA. DHEA gets metabolized into the two forerunners for testosterone androstenediol and androstenedione. Androstenediol has no other pathway except to be metabolized into testosterone, androstenedione though has options and can either make testosterone or estrone (E1). Testosterone itself is not the end of the line because it can then be metabolized into its more potent version dihydrotestosterone or into estradiol (E2) via the protein aromatase. Aromatase is the reason why the biggest buffest steroid users may end up growing breast tissue. Aromatase inhibitors like anastrozole (Arimidex) and letrozole (Femara) have FDA indications for breast cancer which makes sense because they are going to decrease estradiol (E2) and thereby inhibit cancer growth. This also makes them popular among men looking to increase their testosterone or negate its conversion to estradiol (E2).
One of the easiest things to measure from your saliva is pH which should range somewhere between 6.2 and 7.6. If this number drops too low down into the 5 range the acidity will begin breaking down the enamel required to protect your teeth. Studies have shown that lower saliva pH correlates with periodontal disease and gingivitis. This can be caused by the acidic things we drink such as coffee or soft drinks or rarely health conditions such as acidosis. Low saliva pH can also be an indicator of underlying mineral deficiencies.
Saliva also contains markers for that vague thing we call stress. Science usually divides your stress response into two pathways (HPA) and autonomic nervous system (ANS). The best measurement of the HPA side is cortisol which is produced in your adrenal glands and is sometimes referred to as the “fight or flight” hormone. It is the biomarker commonly correlated with stress and the most widely studied in scientific literature. Perhaps the next best thing though is salivary alpha amylase which is thought to be an indicator of overall ANS activation. Together these two salivary measurements have been used in multiple studies to measure stress. The argument has been made that they should be included as an independent marker of cardiac stress and cardiometabolic risks.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
www.pharmacoconuts.com
@Hyattjn
Bitcoin GtjoZgxE7WpTkWRE6JiEiXfUpqbWKxH4g
Litecoin ML1N31UVz6sRfo2m2oLaorXgPexUtv3Q3t
Further reading and references
https://pubmed.ncbi.nlm.nih.gov/28177057/
https://pubmed.ncbi.nlm.nih.gov/17062768/
https://www.zrtlab.com/media/2405/lcms-saliva-steroid-profile-pds.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018981/
https://pubmed.ncbi.nlm.nih.gov/9685760/
https://pubmed.ncbi.nlm.nih.gov/36458168/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737684/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720920/
https://pubmed.ncbi.nlm.nih.gov/36466209/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527714/
https://pubmed.ncbi.nlm.nih.gov/36339833/
https://pubmed.ncbi.nlm.nih.gov/36405600/