May 25, 2021

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Scot: Hey, this is Scot from "Who Cares About Men's Health?" What we're trying right here is a brand new concept we're calling the "Who Cares About Men's Health Sideshow." So as the podcast is developing, we've come up with some different themes. One is our "Core Four Plus One More," which is activity, nutrition, sleep, emotional health, and then also knowing your genetics have a big impact on your current health and your health in the future and also can help prevent disease in the future as well. So we do episodes that focus around those areas and how to improve in those areas and just education in those areas.

Another concept that we have are "Who Cares About Men's Health Men's Health Essentials." These are diseases and conditions that impact men, stuff you need to know in order to remain healthy. And now, this particular concept, if you see a show called the "Sideshow," we're going to be a little bit more loose. Could talk about some of the Core Four stuff, probably going to involve a few more personal stories, and might be some articles that Troy has, or just some other interesting things we think you might find interesting. But if you're here because you want to focus on your "Core Four Plus One More," check out those episodes. That'd be a good place for you to go. If you're interested in specific men's health conditions, check out our "Men's Health Essentials." If you're interested in a little bit more free form, then that's what you're going to get right here. So pick and choose what you like and enjoy.

I need to talk about nutrition because I was a freak at one point. Like before this podcast started, I was logging and weighing all my food, and I scheduled my times to eat, and I stressed about what I ate, and I didn't want to eat any bread, and I hesitated on fruits because I was trying to keep low carbs. And I didn't want to, you know, eat too much fat and . . . I should talk about that, because I changed a lot with my nutrition. I think I feel pretty much okay.

Troy: Well, that gets to that orthorexia and . . .

Scot: What's orthorexia?

Troy: Well, do you remember . . .

Scot: Oh, that eating disorder.

Troy: Dr. [Pohl], Susan Pohl, she talked about it very briefly, buy it's not anorexia. I mean, it kind of obviously has that same root.

Scot: [inaudible 00:02:02]

Troy: But it's orthorexia where you get like a very strict diet and to the point that it becomes like a compulsion where it's just like, "Oh, I can't do that, I can't do that, I can't do that. I have to do that exactly this way," where it is classified as an eating disorder. It's a newer thing that's come out in the last 5 to 10 years I think. But that might be interesting to talk about your experience and say, "Hey, do I meet the criteria for orthorexia?" And I can dive on mine too. Like, sometimes I wonder, "Am I orthorexic?"

Scot: You know what changed all of that was, first of all, realizing that I didn't need as much protein as I thought, because I was building my life around protein. Second of all . . . Actually, the first thing was when Thunder said, "If you just alter the time that you eat. Like, if you do 8 on, or 16 off, or even 12 on, 12 off, you can eat what you want and you're going to maintain." I'm not going to go crazy with junk, but at least I'm like, "Well, I don't have to weigh my food anymore." So that was kind of good. And I kind of have an idea of how much I'm eating now anyway. That's so freeing and it's freeing to know that I can have bread. I just had some great sourdough bread. It wasn't made by Mitch this time, but . . .

Troy: It's all good.

Scot: . . . Bob and Randy Harmon made it and they did a pretty good job of it.

Troy: Nice.

Scot: Yeah. Troy, what do you got there? Looks like you got some sort of medical journal there. You want to tell us a story from that book of medicine?

Troy: Well, I have several options today, Scot. Would you like to know about the effectiveness of honey for symptomatic relief of upper respiratory infections?

Scot: Okay.

Troy: The efficacy of ginger for the treatment of migraines?

Scot: Okay.

Troy: The effect of vitamin D supplementation, omega-3 fatty acids, or strength training for older adults?

Scot: All right.

Troy: A man with a gnawing sensation under his scalp?

Scot: Eww, that sounds creepy. I bet you Mitch is going to vote for that one.

Troy: Maybe he will.

Scot: Yeah, so which one of those are you going to vote for, Mitch? What do you like?

Mitch: Oh, I don't know.

Troy: Or let me give you the last one. A pilot trial of topical capsaicin treatment for cannabinoid hyperemesis syndrome. Basically, how do you treat retching when you smoke marijuana?

Mitch: They all sound so good. I can't choose.

Troy: I know. Every one of these I could use in some form.

Mitch: All of them, please.

Scot: I don't know. Which one, Mitch?

Mitch: We can we talk about the cannabinoid one? I am interested.

Troy: Yeah, absolutely. And this is something I use in the ER.

Scot: Really?

Troy: Yeah.

Scot: Oh, this technique, if somebody . . .

Troy: Yeah.

Scot: . . . comes in with this problem. All right.

Mitch: I'm in.

Troy: I put it on myself before I go to work. It's how I get through the shift.

Scot: All right. I'm into this. So essentially, it's about people that smoke marijuana, and then they start retching, what to do about that?

Troy: Yeah. How do you treat it, yeah.

Scot: Okay. So what journal is this from?

Troy: This is from the journal "Academic Emergency Medicine."

Scot: All right. Troy reads them and finds a good story so you don't have to. So . . .

Troy: That's right.

Scot: . . . go ahead and go.

Troy: So Scot, so this is an interesting article. I love articles that just show you a fairly simple treatment, and maybe it's not a huge study, maybe it's not the best done study, but it shows it's effective. And then you try it at work and you treat someone with it, or maybe you try it yourself and it works. So as you know, the use of marijuana is becoming more and more prevalent. Maybe they have a prescription for it. You know, there's several states where you can use it recreationally legally. So we are seeing more and more cases in the emergency department of what's called cannabinoid hyperemesis syndrome. And what this means is that people who use marijuana frequently can sometimes just develop just retching vomiting. They just cannot stop vomiting and they feel miserable. Sometimes they treat it by taking a hot shower. For some people, that seems to work. But there was a study that was done, and this appeared in the journal "Academic Emergency Medicine." So not a big study, they had 30 patients, and 17 patients, so about half of them, they treated with capsaicin cream. Are you familiar with capsaicin cream?

Scot: No, what is that? Mitch, do you know what capsaicin cream is?

Mitch: It's like the granola version of IcyHot. What's that brand called?

Troy: Yeah. Well, actually the brand is called Capzasin, C-A-P-Z-A-S-I-N, so you may have heard of it. But yeah, something you can use to treat muscle soreness. I mean, capsaicin is a pepper. So it's actually like this pepper in this cream, and people put it on sore muscles, sore joints, things like that. Kind of like IcyHot, it relieves the pain because it just stimulates these nerves in a certain way that the nerves are then more focused on that or it just, you know, overstimulates them in a sense where then you're not so focused on the pain there. But the bottom line is that's what it's used for. It's over the counter, super easy to find this stuff in any pharmacy, any place you want to shop.

But basically, they treated 17 patients with the capsaicin cream and they treated 13 patients with the placebo, just another cream that was not a capsaicin cream. They found, in just about everything they measured, in the patient's nausea, in just their vomiting, you know, like the 30 minutes, at 60 minutes, they found that the large majority of the patients who had the capsaicin cream did better. And patients who had the capsaicin cream, 29% had complete resolution of the nausea versus none of the patients who had the placebo treatment.

Scot: Wow.

Troy: So, yeah, pretty significant improvement, and that's complete relief. But then just looking at, okay, how much did you improve? Maybe not completely. People who got the cream did a lot better. So it's something I use in the ER, because we see this surprisingly frequently, people who come in who just are having this retching vomiting and feel miserable. And I'll just order up some capsaicin cream. I'll have them apply it to their abdomen and the large majority of the time, with an hour, they feel better. And I say, "Just take this home. If this happens again, use this cream."

Mitch: You take the cream and you rub it on your belly?

Troy: Yeah, you just rub it on your belly.

Mitch: Oh wow.

Troy: It's very simple. You're not rubbing it on joints or anything like that. You're just rubbing it on your belly. Don't drink it, don't eat it, just rub it on your belly. Just use it externally. It's just a cream. You know, I don't know if this will work for any other types of nausea, I've never tried it there. Certainly there are other meds that can help with those sorts of things. But a lot of times with these patients who come in with this type of vomiting, it's like you give them other stuff and nothing seems to help, like a lot of the standard medications we use. You use some capsaicin cream, makes a difference, they feel better, I just tell them, "Use it at home."

Scot: And you have to put it on your abdomen? If you put in your arm, then it doesn't help?

Troy: Yeah, don't put it anywhere else. Just rub it right over your belly. Right over that spot that's cramping up, that's miserable.

Scot: Do we know why it works?

Troy: I don't know why. And I don't know [inaudible 00:08:48]. It's probably the same thing as the hot shower. It's one of those things, I remember seeing case reports about this, you know, a few years ago where people are like, "Hey, we tried this and it worked." And I don't know if it was the same thing as the hot shower, where some dude is just like, "Hey, I've got some of my grandmother's arthritis, while I'm in here I'm going to rub this on my belly," and then he told someone else, and then someone reported it in a medical journal, and then here's this really small study that said, "Hey, it really seemed to help." So I don't know the origin or the rationality behind it.

Scot: It's a bizarre thing to try.

Troy: It is.

Scot: You know, like any time you look at anything, sometimes I look at like foods and I'm like, "Who decided to try that first?" You know? And it's like who decided to try this first?

Troy: Who decided to do this first?

Scot: Like what was the connection that they made that they're like, "That could work."

Troy: Yeah, I don't know. And again . . .

Scot: Why ask why sometimes, right?

Troy: Why ask why? I'm sure there's someone who's come up with some sort of physiologic explanation for why it worked. But I guarantee that's not the reason someone used it in the first place. It's not like someone thought, "Well theoretically, this could make a difference." Again, the only reason this study happened, it's because of some of these case reports that were out there that I saw, you know, appearing in journals several years ago. And so someone tried it at some point, it seemed to work, and now here's a study, very small study, but says, "Yeah, it does seem to work." And my experience is that it does seem to work.

Scot: Hey, thanks for checking out "Who Cares About Men's Health The Sideshow." If you liked what you heard, we'll have more Sideshow episodes coming up. I also ask you to check out our "Men's Health Essentials" and our "Core Four" episodes to help you lead a healthier life today and in the future. Feel better now and later.

By the way, check out our migraines episode that we just recently did. It's really, really good if you know somebody that suffers from migraines. And if you know anybody that might enjoy what you just heard, do us a favor and just share this podcast with that one person. If you share that podcast with this one person, it will help us get to more people that we can help and more men who want to care about their health.

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