Copper Coil (IUD)
I’m wondering / hoping you can help shed some light on IUD contraceptive as there is very little out there beyond the unhelpful, mainstream (NHS philosophy) medical guidance. The essence of my question is - What are the pros and cons of the copper IUD copper coil as a means of contraceptive for a young (early 30s) female? I am keen to find out more about the impact on a) fundamental health, b) energy, c) hormones (and neurofunction), d) long term fertility? I have never wanted to have children and do not know whether I do but am conscious that having anything in your body is not ideal and that actually fertility is a good metric of all round health. Though the chances of me being fertile are slim, I do not want to risk it and am vehemently anti the pill and not keen on condoms. I am on 3rd 5 year copper coil (12 years of having them in total). By way of context - I am 33 year old female who has suffered numerous health issues since mid teens, have struggled with borderline anorexia / restrictive eating since I was ~13yrs and have been amenorrheric since ~13yr. Despite being in a mentally better state now, I am still thin, ~100pounds at 5ft 6in. I have always eaten what has now become known as kept just through subconsciously eating the stuff that makes me feel good (able to digest and energy). I tend to have black coffee, a2 dairy, lettuce and a few other salad items, plenty of oils and fish (as I don’t digest meat well). Medically - I had a sever knee problem at 22 and took ~5 years to get back to walking after significant steroid, opiods, surgical, daily physio and neurological treatment. We discovered my neurological system is abnormal and the surgery leaving me with keloid scaring on a main nerve caused massive issues. I’ve had a few fractures and over the years notably - I broke one calcium in 2018, found out I have osteoporosis (unsurprising really given I was about 90pounds) and refused the recommended hormone treatment in favour of gaining weight and improving bone density & hormone levels. Bone density is now improved to osteopenia levels, hormones still low. I smashed both calcaniums in 2020. I’ve had recurring warts on one elbow, have always suffered headaches often linked to shoulder tightness and get bouts of migraines, often when stress is bad. I’m hypermobile. I work out daily - low impact stuff - weights, reformer & barre plus cycling and walking. Any insight on this subject would be hugely hugely welcomed
The Starch Solution
Hola, Doc, I've done intermittent fasting with bouts of keto to combat obesity for 15 years now. I went from well over 400 pounds to around 220 back in 2008, put over a hundred pounds back on, and by Thanksgiving 2020 I was easly in the mid-300's. Today I'm under 250lb through fasting, carb cycling, and consistent exercise. I tried to explain my progress to an obese friend who discounted my approach and told me they were on a vegan "Starch Solution" diet and directed me to a Dr. John McDougall. Is approach frankly freaks me the hell out, as it espouses starchy carbs and sugar for people with metabolic disorders like T2D. I'd love to hear your thoughts on this approach, because it sure feels like a dangerous road to put a diabetic on. Cheers!
COVID-19 Vaccine Safety
I have not been vaccinated for covid-19 because I ended up infected with the disease back in April—2 days before I was supposed to get vaccinated. I had a mild case and completely recovered after about 7 days. I haven’t gotten vaccinated yet because of the immunity that seems to come from infection (as demonstrated by the Cleveland Clinic study for example). I don’t expect you to tell me whether I should get vaccinated or not, but can you help break down some of the safety data on the vaccines? Based on what I heard from the media and public health officials, the vaccines are extremely safe, but I’ve also listened to some doctors and scientists on other podcasts who seem more concerned. So I found this paper that seemed very concerning: https://res.mdpi.com/d_attachment/vaccines/vaccines-09-00693/article_deploy/vaccines-09-00693-v2.pdf 4.11 fatalities per 100,000 vaccinations sounds shocking based on everything I typically hear about the vaccines. I want to believe that they’re wrong, but with work and my family, I don’t have the time or know-how to break down whether this study is flawed or not. I listened to your podcast with Peter Hotez who’s extremely pro-covid vaccination and he seems very knowledgeable, but it seems like there are rational scientists/doctors who are far more concerned about vaccine safety. It’s extremely frustrating to hear what seems to be rational thinkers on both sides and I want to see a discussion where they hash out their differences. Can you help me understand how I should be looking at these studies and the debate around covid vaccine safety?
Current assessment of immune check point inhibitors and antibody drug conjugates effectiveness.
Please, please, devote an episode about the above approach to (urothelial) cancer versus standard platinum-based chemo. I have been dealing with bladder Ca for 12 years via BCG. It escaped my bladder via an urethral reimplanation (long story), and I was fortunate to qualify for a Seattle Pharmaceutical trial using both pemro (Keytruda) and padcev (enfortumab vedotin). After 5 months with an initial diagnosis of pulmonary mets, I have a 90% complete response. The trial lasts for a minimum of 2 years, and I have not been able to find out the prognosis of trial members of earlier cohorts who have already finished their first 2 years. I am a ChemE who doesn't have much spare time to dig deeper at the moment and will very much appreciate what you have to say.
Thyroid deep dive
I was listening to an old AMA where Bob and Peter begin to answer a question about thyroid hormones and deficiencies and then mostly punted as the discussion was more amenable to a members only whiteboard video product. Was that ever made and released? I’ve been hypothyroid most of my life and other than monitoring my TSH my doc and I don’t do much. The other ways the thyroid impacts health and the specific things I should look out for or be aware of would be great to know.