Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode we have a special guest, Dr. Spencer Nadolsky.

Dr. Nadolsky is a board-certified obesity and lipid specialist known for his straightforward approach to fitness and health, and for pioneering obesity management via telemedicine. In this episode, we'll dive into various topics, including the intricacies of Lipoprotein(a) and its impact on cardiovascular health, the balance between lifestyle changes and pharmaceutical interventions, and the challenges of research funding in lifestyle modifications.

We’ll also explore Spencer’s insights on effective weight loss strategies, sustainable diets, and his personal journey with health and fitness. So, whether you're here to glean some practical tips or to understand the latest in medical research, stay tuned—this is going to be an enlightening conversation.

04:44 Sustainable weight loss requires satiating, nutritious food.
08:55 Intermittent fasting, increased exercise caused weight loss.
10:57 Dietary composition impacts health beyond weight loss.
14:05 Appetite largely dictates body weight and thinness.
17:09 Medication and bariatric surgery enhance weight loss results.
20:55 Future obesity prevention: targeting genetic and socioeconomic risks.
22:47 Medications reduce hypertension but overlook underlying causes.
25:51 Drug trial: ~10% weight loss, possible cardiovascular benefits.
29:32 Higher LDL and APOB increase long-term plaque risk.
33:40 Advise family about LDL cholesterol management realistically.
38:48 High school glucose test fueled sports nutrition interest.
39:59 Anti-aging field's evolving, medication secondary uses explored.
45:28 Biopsychosocial model emphasizes controllable and uncontrollable factors.
47:31 Lifestyle changes are equally important as medications.
49:49 Exciting times ahead; feedback appreciated. Stay tuned.

Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we are back with our second part to the two-part series focused on the intricate world of addiction treatment.

Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, Dr. Mong and Dr. Lamba will shed light on the promise and perils of new treatment approaches, underscore the necessity of comprehensive support systems, and point to the pivotal role of social supports and stable housing in fostering sustainable recovery.

We also tackle the cultural and historical context of the opioid crisis, including the profound impact of Purdue Pharma and the Sackler family. Dispelling misconceptions about fentanyl, you'll learn about the real risks, the invaluable role of naloxone, and practical steps for overdose prevention.

This episode is not just about groundbreaking therapies; we will discuss the critical need for rigorous, high-quality data to back new treatments and reflect on the significant influence of private companies in the field. Our guests will emphasize the paramount importance of addressing the root causes of substance use, building life skills, and creating supportive networks to prevent relapses.

Lastly, this episode will feature discussions on opioid tolerance, withdrawal management, and the nuanced balance between the risks of prescribing medications versus the risks of untreated withdrawal. You’ll gain insights into how healthcare teams can shift their perceptions and practices to better support patients with substance use disorders

Stay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!

04:17 Challenges and future of addiction treatment discussed.
09:36 Understanding withdrawal challenges in hospitals with unknown dosages.
12:02 Provide proper care despite addiction-related complications.
16:20 Colleague's guarded due to personal trauma, concerns.
20:05 Conversations led hospital to adopt PICC lines.
21:54 New grads integrate social responsibility with medical care.
27:20 Risk from checking on overdose is minimal.
29:15 There can't be too much widely accessible Narcan.
34:00 Need rigorous study for psychedelics in treatment.
35:39 Concerned new treatments overshadow foundational patient support measures.
41:40 "Cured" involves functional life, stability, coping mechanisms.
42:52 Substance use disorder: Patients can achieve long-term remission.
46:01 Meet needs without substances to avoid relapse.

Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we're embarking on the first of a two-part series focused on the intricate world of addiction treatment.

Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, we'll explore the complexities of managing and treating addiction within hospital settings, the profound challenges faced by patients and healthcare providers alike, and the life-saving implications of treatments like opioid agonist therapy.
In this episode, we tackle the high relapse rates among opiate users, the effectiveness of medications for alcohol use disorders, and the importance of patient readiness in overcoming substance use. We'll also delve into the value of motivational interviewing in fostering patient cooperation and the evolving role of addiction medicine in modern healthcare.

Dr. Bonta reflects on his experiences and frustrations with addiction treatment, emphasizing the need for evidence-based approaches and reducing harm. We'll discuss the broader implications of addiction treatments, including societal perceptions and the importance of treating addiction as a complex, multifaceted issue.

Stay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!

06:28 Biopsychosocial overview and social determinants of health.
08:33 Addiction perception varies; harm reduction prioritizes context.
12:42 Substance use disorder defined by the four C's.
15:24 Challenges of informing patients about health impacts succinctly.
20:11 Enjoyed working with you; motivational interviewing technique.
21:40 Promote cooperation and autonomy in medical interactions.
24:38 Brief interventions reveal deeper patient issues for treatment.
30:23 Support for treating illness without moral judgment.
31:43 Understanding treatments can improve patient prognosis discussions.
34:59 Medication modulates neurotransmitters for alcohol use disorder.
39:44 Four reasons to start opioid agonist therapy.
42:14 Discharged patients risk fatal overdose; opioid therapy saves.
46:42 Patients generally agree with treatment but resist lifestyle changes.
49:00 Importance of discussing addiction and enabling behaviors.

Welcome to "Ditch the Lab Coat," where we bring you insightful conversations that peel back the layers of medicine and health. In this episode, Dr. Mark Bonta sits down with Dr. Samira Jeimy, a leading expert in allergies and immunology. Together, we'll dive deep into the complexities of managing allergies in today's world.

In this episode, we explore the dangers of relying on inaccurate allergy tests and supplements, the limitations of "may contain" labels, and the critical need for precise allergy management. We'll also examine the disconnect between school allergy policies and allergist recommendations, emphasizing the need for standardized forms and comprehensive staff training.

Dr. Jeimy will share practical advice on treating anaphylaxis, from recognizing symptoms to the correct use of EpiPens and the importance of proper positioning during a reaction. We’ll also discuss the prevalence of milk allergies, the challenges of reintroducing allergens, and the various risks associated with milk consumption.

Lastly, we’ll address the broader implications of labeling children as allergic, the effectiveness of nut-free school policies, and the vital need for education and communication in managing allergies in school settings.

Join us for an insightful journey into the world of allergies and immunology. Remember, this podcast is here to inform, not replace professional medical advice. So, let’s ditch the lab coat and get started!

04:04 Summer camps bring challenges and rule flexibility.
08:34 Allergists advocate standardized school anaphylaxis protocols.
11:07 Practical approaches to reduce anaphylaxis complications.
16:11 Correct epiPen placement crucial for immediate effect.
18:00 Expired food debated, decisions made to keep.
23:09 Adverse effects of milk consumption explored briefly.
24:03 Dairy worsens eczema, but avoiding it promotes allergies.
27:18 Processing milk alters protein, making it tolerable.
31:05 Alarming focus on nut-free schools after tragedy.
34:17 Be prepared for allergy symptoms on subway.
36:55 Parent's emotional response to children's safety concerns.
42:11 Blood tests, oral challenge, and immunotherapy options.
43:20 Maintain exposure to build immune tolerance, spectrum conditions.
49:31 Engaging discussion on allergies with medical expert.
50:39 Correctly administer expired EpiPen to save lives.

Welcome to "Ditch the Lab Coat," where we bring you insightful conversations that peel back the layers of medicine and health. In this episode, Dr. Mark Bonta sits down with the esteemed Dr. Roy Eappen, an adult clinical endocrinologist with over three decades of experience. Together, they dive into a myriad of crucial, and sometimes controversial, topics in endocrinology.

From the risks associated with anabolic steroids to the complexities of thyroid hormone replacement therapy, we explore the delicate balance of hormonal health. Dr. Eappen also shares his expert perspective on the current approaches to gender-affirming care, expressing concerns about the medicalization of children and the long-term consequences of treatments like puberty blockers and cross-sex hormones.

We'll touch on the variability of hormonal levels, the rigid societal stereotypes around gender, and the evolving landscape of transgender medicine. Throughout the episode, Dr. Bonta and Dr. Eappen emphasize the importance of scientific evidence and thoughtful care in addressing these deeply personal and sensitive issues.

Don't miss this thought-provoking discussion that challenges conventional wisdom and sheds light on the ever-changing world of endocrinology. Stay curious, stay informed, and let's ditch the lab coat together!

02:00 Renowned endocrinologist Dr. Roy Epin's impactful career.
05:25 Importance of thyroid gland for health and treatment.
07:30 Thyroid hormone levels and controversies explained briefly.
10:24 TSH levels determine thyroid function, cutoff varies.
13:31 Early detection of hypothyroidism prevents severe developmental effects.
17:16 Steroids can build muscle but cause harm.
20:01 Psychologists affirm care without thorough evaluation.
23:40 Dutch protocol overlooks psychological work with children.
29:17 Sticking to evidence-based practice in healthcare.
32:20 WPATH lawsuits reveal controversial practices and ethical concerns.
36:18 Rita's research on children's suicide risk.
39:21 Caution urged before altering physical appearance.
41:02 Health initiative led to reconsideration of estrogen therapy.
46:41 Complex modern life overwhelms parents, kids. Simplify.
51:11 Limited education in gender affirming care history.
52:12 Understanding historical context in gender affirming care.

Welcome to another episode of "Ditch the Labcoat," where we step outside the confines of conventional science and into the transformative world of behavioral insights.

Today, we're thrilled to have Dr. Hasan Merali, an esteemed emergency medicine pediatric doctor, join our host, Dr. Mark Bonta, to explore the magical world of toddlers and their surprisingly transformative behaviors for adults.
In this episode, Dr. Merali dives into how the natural tendencies of toddlers—such as laughter, play, risk-taking, and confident self-expression—can be integrated into adult behavior to enhance success and well-being. From the morning routine of waking up happy to the benefits of deep reading and consistent bedtimes, Dr. Merali offers a refreshing perspective on how adults can benefit from behavior typically exhibited by toddlers.

We'll also delve into the science of self-talk, the significance of play for creativity and cognitive flexibility, and the profound impact of direct communication in personal and professional relationships. Dr. Bonta shares his journey of overcoming discomfort with kids and applying these insights both as a father of four and a professional.

Expect practical tips, scientific evidence, and inspiring anecdotes that highlight the importance of adopting toddler-like behaviors for a more successful and fulfilling life. Plus, you'll get a sneak peek into Dr. Merali's book, designed to equip you with actionable strategies to incorporate these playful and inquisitive behaviors into your daily routine. So, get ready to ditch your lab coat and embrace the wisdom of our smallest humans for a happier, healthier you!

07:57 Understanding toddler behavior and its application to work.
13:42 Childlike mindset fosters new perspectives and learning.
16:49 Prefrontal cortex acts as CEO of brain.
24:21 Common sense actions for physical and mental well-being.
26:50 Deep reading is undistracted absorption, disconnect from phone.
36:02 Quality sleep, morning routine, and health benefits.
41:27 Mindful eating, movement, and standing meetings are beneficial.
46:36 Remind yourself of childhood or a hero.
49:41 Preview: Podcast to discuss neuroscience lab opening in 2025.
54:33 Direct communication is key in all relationships.
59:15 Meta-analyses clump research for more powerful study.

Welcome to another enlightening episode of "Ditch the Lab Coat," the podcast where we critically examine health issues through a lens of scientific skepticism and practical wisdom.

I'm your host, Dr. Mark Bonta, and today, we have a special guest, Dr. Shawn Gill, a clinical pharmacist and founder of Deprescribed Solutions.

Dr. Gill collaborates closely with physicians and patients to create detailed taper plans for safely coming off medications like SSRIs. In this episode, we dive deep into the challenges of convincing physicians to adopt evidence-based tapering approaches, the importance of individualized patient care, and the hazards of over-relying on medication for minor ailments. Dr. Gill shares his practical, sustainable mental health-boosting practices and underscores the need to consider lifestyle interventions over long-term pharmaceutical treatments.

Listen in as we explore the complexities of medication therapy in both acute and community settings, debate the appropriateness of prescribing SSRIs, and discuss the collaborative interprofessional model in healthcare. We also touch on the systemic challenges within a fee-for-service infrastructure and the significance of managing patient expectations during the transition off medications.

Join us for an insightful discussion on how we can evolve as healthcare providers and implement holistic, non-pharmacological approaches to improve patient care. And remember, this podcast is aimed at fostering thoughtful discussion and is not a substitute for professional medical advice or treatment. Enjoy the episode, and stay tuned for more in-depth conversations on "Ditch the Lab Coat"!

06:43 Limited access to specialists leads to disjointed care.
10:31 Concern about medication adherence and deprescribing motivation.
14:21 Navigating healthcare challenges and career self-reflection.
16:53 Intervening with young patients to prevent complications.
18:58 Emphasizing patient goals and identifying severity of symptoms.
23:43 Antidepressant numbness, fear of stopping medication.
26:22 Mental health treatment lacking options due to time.
31:36 Pharmacist navigates patient dynamics without prescribing authority.
32:59 Experienced doctor focuses on patient's mental health.
37:31 Coordinate deep prescribing with physicians, share updates.
39:19 Building trust, giving feedback, and fragile egos.
42:33 Consider stopping antidepressants, it's possible and rewarding.
47:07 Discontinuing medication requires careful adjustment and support.
51:46 Reflection on medical practice, calls for diverse guests.
53:48 Mother's nursing work inspired son's medical career.

Welcome back to "Ditch the Lab Coat," the podcast where we explore the fascinating world of health and medicine with a skeptical eye. I'm Dr. Mark Bonta and In today's episode, Dr. Kaplovitch dives deep into the different types of blood clots and the importance of personalized treatment.

He explains that not all blood clots are created equal - some predominantly affect the veins, while others can travel to the lungs and become life-threatening. We discuss the various risk factors that can lead to blood clot formation, from genetic conditions to long plane rides, and Dr. Kaplovitch offers practical advice on managing this complex disorder.

We also touch on the fascinating history behind some blood thinning medications, like warfarin, which was originally used as rat poison! Dr. Kaplovitch clarifies the distinctions between its toxic properties and medical use.

Throughout our conversation, we emphasize the importance of transparently counseling patients about the risks and benefits of different treatments. Dr. Kaplovitch highlights the abundance of research in the field of thrombosis and how it informs the personalized approach he takes with his patients.

So join us as we simplify these complex medical concepts and explore the latest advancements in blood clot prevention and treatment. As always, remember that this podcast is for informational purposes only and does not substitute for professional medical advice. Let's ditch the lab coat and dive in!

04:24 Experienced medical student impresses with professionalism.
09:02 Blood clots can travel to lungs, fatal.
12:14 Prolonged sitting at desk may increase thrombosis risk.
16:01 Minority with blood clots can improve naturally.
18:45 Clot busters have significant risk of bleeding.
20:59 Treatment options for preventing blood clot complications.
25:39 Passion for vascular medicine, citing primary literature.
29:26 Newer blood thinners may have advantages.
31:37 Warfarin inhibits clotting by blocking vitamin K.
36:09 Balancing blood thinness for health benefits is crucial.
37:22 Maintain optimal blood thinness to prevent risks.
42:22 Minor bleeding from gut might not require action.
46:27 Consistent blood thinner use is crucial.
50:05 Discussing evolving thrombosis practices, specifically genetic testing controversies.
51:24 Testing for clotting disorders requires informed discussion.
57:02 Advancements in personalized medicine revolutionize treatment.
58:45 Hip hop slang reference and deep thrombosis.