Episode 4 provides

- A refresher on how red blood cells are formed, their lifecycle and inputs

- An overview of the major types of anemia classified by pathophysiology and histology (how the red blood cells look under a slide)

- Some simple physical symptoms that pharmacists can look for in practice and what they might indicate

- A refresher on the major guidelines for iron deficiency anemia including a recent update

- Some excellent case studies detailing the complexity of dealing with patients who have chronic inflammation AND anemia

- New this episode: some semi-useful notes in pdf form from me to you. Merry Christmas ya bunch of hooligans!

Links:

Find all the links to all the things here: https://ringsabellpod.kit.com/allthethings

Find Jenny at: https://www.linkedin.com/in/jenny-hsieh-435828177/

References:

See all the links above.

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Keywords:

insulin sensitivity, metformin, blood sugar management, dietary approaches, microbiome, GLP-1 agonists, functional medicine, probiotics, metabolic health, clinical signs

Summary:

Episode 3 part 1 covers general metabolic health as it relates to pharmaceuticals, the microbiome and nutrition. My guest is Dr. Alex Nataros, a family doctor practicing in Port Hardy, BC.

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To become a guest on the show email ringsabellpodcast@gmail.com

References:

Weight Gain Drugs

https://pmc.ncbi.nlm.nih.gov/articles/PMC6109660/

Weight loss drugs

https://mobile.fpnotebook.com/Endo/Pharm/MdctnsAsctdWthUntntnlWghtLs.htm

Insulin Sensitivity Drugs

Giglio RV, Papanas N, Rizvi AA, Ciaccio M, Patti AM, Ilias I, Pantea Stoian A, Sahebkar A, Janez A, Rizzo M. An Update on the Current and Emerging Use of Thiazolidinediones for Type 2 Diabetes. Medicina. 2022; 58(10):1475. https://doi.org/10.3390/medicina58101475

Laurindo LF, Barbalho SM, Guiguer EL, da Silva Soares de Souza M, de Souza GA, Fidalgo TM, Araújo AC, de Souza Gonzaga HF, de Bortoli Teixeira D, de Oliveira Silva Ullmann T, et al. GLP-1a: Going beyond Traditional Use. International Journal of Molecular Sciences. 2022; 23(2):739. https://doi.org/10.3390/ijms23020739

https://doi.org/10.1016/j.redox.2020.101517 (Mechanisms of Action of metformin in type 2 diabetes: effects on mitochondria and leukocyte endothelium interactions.

Microbiome and obesity:

https://doi.org/10.1016/j.biopha.2022.112678

Sohail MU, Althani A, Anwar H, Rizzi R, Marei HE. Role of the Gastrointestinal Tract Microbiome in the Pathophysiology of Diabetes Mellitus. J Diabetes Res. 2017;2017:9631435. doi:10.1155/2017/9631435

HMF Metabolic:

Michael DR, Jack AA, Masetti G, et al. A randomised controlled study shows supplementation of overweight and obese adults with lactobacilli and bifidobacteria reduces bodyweight and improves well-being. Sci Rep. 2020;10(1):4183. Published 2020 Mar 6. doi:10.1038/s41598-020-60991-7

UltraFlora Control:

Stenman LK, Lehtinen MJ, Meland N, et al. Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial. EBioMedicine. 2016;13:190-200. doi:10.1016/j.ebiom.2016.10.036

Super intense study on personalized nutrition published in cell that I talked too long about :)

Zeevi D, Korem T, Zmora N, et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015;163(5):1079-1094. doi:10.1016/j.cell.2015.11.001

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- UpToDate as referenced summer 2025

- RxFiles 2023 edition

- Bristol Stool Chart

- probioticchart.ca

- Why you should be careful with psyllium husk fiber supplement. YouTube:

https://youtu.be/mPHXldh4_H4?si=wtAMhpP2QDCxPlr6

- Cascara Sagrada withdrawal in USA https://www.fda.gov/about-fda/fda-history-exhibits/drug-therapeutics-regulation-us#

- Phenothalein withdrawal from market

https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/phenolphthalein#

- Bisacodyl

Neurogastroenterol Motil. 2021 Mar 9;33(10):e14123. doi: 10.1111/nmo.14123

Bisacodyl: A review of pharmacology and clinical evidence to guide use in clinical practice in patients with constipation

Maura Corsetti 1,2,, Sabine Landes 3, Robert Lange 4

PMCID: PMC8596401 PMID: 33751780

https://pmc.ncbi.nlm.nih.gov/articles/PMC8596401/

- Stimulant laxatives

First published online June 16, 2024

Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge

Peter Whorwell https://orcid.org/0000-0002-5220-8474 peter.whorwell@mft.nhs.uk, Robert Lange, and Carmelo Scarpignato

https://doi.org/10.1177/17562848241249664

- Rhubarb

https://pmc.ncbi.nlm.nih.gov/articles/PMC8321582/#

- Demulcents

https://www.sciencedirect.com/topics/neuroscience/demulcent#

Lexicomp drug information for: podophyllum, wheat dextrin, phenolpthalein, polyethylene glycol 3350

https://time.com/archive/6617019/medicine-cut-out-the-liver/

• Pharmacology, toxicology, clinical efficacy, and adverse effects of calcium polycarbophil, an enteral hydrosorptive agent. PMID: 6765389

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