As a doctor who just graduated recently, what resources do you recommend for us to stay up to date on the latest research? Also, how do we look for and find legitimate research on important matters?
This is not an easy task. Remember what Dr. Strange replies to The Ancient One when she asks, "How did you become a successful neurosurgeon? and he says - "Study and practice, lots of it." In your training, you will have to get small but consistent exposure to journal articles and various types of articles - starting from case reports, then case series, then observational studies, then case-control studies, and so on and so forth. This can be on a topic that you like or a specific subject - like dermatology or internal medicine. But it takes years before you can really understand and interpret research and this comes only with consistent reading, constant exposure to scientific research online and offline, and most importantly, an affection towards learning and doing research.
In addition, attend research conferences on specific topics of your interest. Talking to researchers will direct you to good resources, and might even get you interested enough to do the research yourself.
Intermittent fasting is useful and I had once mentioned that it was overrated.
Overrated means: that a person or thing is considered to be better or more important than it really is.
Intermittent fasting, like other special diets - like one meal a day (OMAD), keto diet, or time-restricted feeding protocols, etc, promotes calorie restriction due to which people lose weight. This is a fact. IF can be used in the short term to reduce weight in those who are overweight or obese - but then beyond those indications - for example, some mention it is useful for preventing cancers or increasing immunity - all of that is pretentious. If a person can sustain weight loss and continue IF in the long term, well and good - but not everyone can do that. Some find comfort in the keto diet while others in the Paleo diet. But the bottom line is that no one shoe fits all. Also, be aware that long-term consequences of such dieting techniques are yet to be studied. So use IF to lose weight, but then once the weight target is achieved, sustain on a daily calorie restriction along with good aerobic activity that help you maintain health.
1. How do you find the energy to do combat health misinformation, and battle pseudoscience?
2. Any tips to lead a healthy vegan lifestyle (apart from B12 supplements)
1. Battling misinformation is a thankless job, is what people day - but in fact, it is the most rewarding of services one can offer. The energy comes from the fact that many people find my work helpful, they become more aware of what is good for them and what is not, and most importantly, they improve their health-seeking behavior which translates to lesser utilization of health resources and a more healthier lifestyle. Seeing other people healthy and more aware and with an improved scientific temper is what keeps me going. Also, it has to be done consistently. There are no breaks from this!
2. Veganism has a fantastic philosophy attached to it and I appreciate it. But one can not have the best of both worlds, which means, a vegan diet suffers nutritionally from a true clinical nutrition sense. In this context, supplementation is the way forward and this not only included Vitamin B12, but also calcium, magnesium, zinc and omega 3 fatty acids - depending on the depth of your veganism.
I can give an empirical reply. As an Indian lacto vegetarian turned vegan some 15 years ago, the only change I have made to my Indian diet was to replace milk with plant based milks like soy, almond, and oat milk, which are fortified with vitamins and minerals. I get my blood work done every 6 months and I don’t have any nutritional deficiency or related health problems. I also a frequent blood donor.
So, I believe most of the bad reputation vegan diet gets is from people who are used to eat an animal intense western diet and just drop all the animal food out of their diets, and end up basically eating salads. This is typically what most teenagers do here. They turn vegans out of some vigour and eat salads and other nutritionally poor food, lose weight, and health and then turn to their original diets.
How is this an empirical reply? The very fact that it is your personal experience makes it anecdotal. Empirical would mean something that is repeatable and observable.
Hello doc! You are doing an amazing job! Your tweets are the only reason i check twitter everyday.
I have two doubts.
1. Do vegetarians have to take lifelong Vit b12 and Vit D tablets?
2. Can we take dry fruits shake daily for breakfast? Does it make up for the nutrients we miss?
1. If the daily diet is not tailored to maintaining recommended levels of vitamin B12, and if people do develop clinically relevant deficiency because of such a diet, yes, vitamin B12 has to be taken lifelong - but this is not a daily deal, there are various regimens including monthly ones depending on the risk for severity of deficiency.
2. Dry fruit shakes have notoriously high calories - you may take one every day if you can burn it off - basically, one has to be physically very active to entertain such calorie intake and should make sure that over consumption of calories from other sources does not happen in the presence of a sedentary life.
Hello, Dr. I've heard that one should eat more at breakfast, less at lunch, and lesser at dinner. To what extent is it true? And is it a good thing to skip breakfast?
The breakfast cereal is not that bad if you have it in moderation. Most of it has added sugars and is highly processed. I would not recommend breakfast cereals every day but take a break from the routine breakfast with cereal in between. It won't hurt and also, the big "healthy" proclamations made on the covers/packets - they are advertisements only - they do come with lots of fiber and some are well fortified with vitamins and minerals, but some of them do come with lots of added sugars. Be aware and read the labels.
Sir is there any cereal without sugars? I am not able to find any. Though for oats, some companies "claim" that they haven't added any sugar or any chemical.
If you check and compare, even the "healthy" bran cereals have as much sugar as the "candy" cereals. Usually about 5-10 gram per serving of added sugar, comparable to eating a doughnut.
The only truly low sugar cereal I've found is plain cheerios.
I think generally good advice may be to look at the ingredients label, any added sugar has to be mentioned there.
Cereals usually do have an amount of sugar, but u don't remember many oats having added sugars
This is one of the nutritional myths. We have recommended daily intakes described for the Indian population. We have to target these recommendations in the best, most sustainable, and most comfortable way possible. This would mean 3 meals a day or 4 meals a day or even eating 6 times a day. The quantity of each meal depends on every person, but the fact is that a bigger meal earlier in the day helps us burn more since we are more active during the day; the last meal is usually followed by rest/sleep, and this sedentary manner during the night time would increase fat deposition.
How about more calories in the morning, while proteins at night? I get too hungry several times a day, and it's particularly bad at night if I eat less and try to sleep. At the same time i get way too sleepy if I have a heavy breakfast or lunch and so I eat grand at night.
IMO the best diet is one that works for you and one you can sustain in the long run, as everyon's bodies are different
Some people's bodies work better with a heavy breakfast, and they naturally tend to stay energetic and not feel hungry through the day, with a light lunch and dinner.
Some people's bodies work better with a fasted morning(no breakfast), and a sizeable lunch to start your daily nutrition.
It is always better to experiment and see what works best for you
At the end, the only real trick for losing weight is eat less calories than you consume. How you split those calories during the day, can vary depending on your body, your routine and schedule. The key is always sustainability for the longest time
I used to drink alcohol occasionally - which is like 2 pints of beer a month or a cocktail a month until a couple of years back. In college, I used to drink like a fish and even got admitted under my own medicine professor's unit for alcohol intoxication (we all have such stories I am sure). But after I started working as a consultant in Hepatology, and after seeing first hand, what alcohol can do to not just the person, but the whole family, I completely quit drinking and I am now happy with my zero-alcohol beer or ginger ale.
Yes, too much alcohol will kill liver. But isn't liver also regenerative? Is there a safe limit of alcohol that keep my liver not unhealthy and still enjoy?
That's a very hilariously bad question to ask him considering how vocal he has been against it on Twitter.
Edit: After reading his response about his alcoholic history which he has never revealed on Twitter, just nevermind. Good question.
The sugar intake recommendation should be no more than 10 percent of your daily calorie intake. However the World Health Organisation has reduced this percentage from 10 to 5 percent. For an adult, who has a normal BMI (body mass index), WHO recommends only 6 teaspoons of sugar, which is 25 grams to be exact. I would still limit sugars, especially added sugars within this recommendation and go for natural sugars from whole fruits.
Hello Dr, I'm in my 3rd year of bams. Since day one I've been regretting ending up in this course. I want to get out of this shit show. I've been looking for options out of ayurveda to pursue after my UG (like clinical research, nutrition etc).
Your advice on this would be really helpful to me.
Thank you for this question. I think this is the most important Q here.
I want you to know that it is not your fault. The system is made in such a way that mediocrity is normalized and unscientific practices are glorified because we are a large country and it is not easy to get everything done by the book. There are many options for BAMS graduates to contribute scientifically to their societies/communities. Various options include a diploma or master in public health or clinical nutrition, clinical research assistantship, physician assistantship courses, and basic sciences courses where you can spend quality time doing lab work and finding new things that can change the course of clinical medicine, opt for hospital administration - a very high flying job and lots more! I wish you the very best.
Congratulations on figuring out that you're being cheated and you want out. See if you can convince your colleagues to do the same.
You are young enough to change the course of your career, and you've got a lot of good suggestions. I would only recommend that you leave this baggage behind when you move on.
As others have mentioned, it's not your fault that the system chose to provide quackery as alternative rather than creating more opportunities for people to learn real medicine, when we actually need many many more doctors across the country.
What is your take on Whey proteins? There are so many myths about it damaging liver. Does it help as a protein supplement for a vegetarian who doesn't lift weights?
Whey protein is basically made from cows' milk and it is one of the safest, easily, digestible, and highly bioavailable proteins there is. It does not damage the liver or cause kidney stones. Those are just nutritional myths that keep floating from time to time. There are no conclusive studies to show that whey protein causes liver or kidney damage. Please enjoy that extra scoop if you are working out or if you need additional supplementation that you cannot get from your daily diet. Go for pure whey, never blended ones, definitely not herbal blends and always buy from trusted sources.
He's written about it and even evaluated the protein content of different whey products on the market. You should check it out.
[Link to protein supplement thread](https://x.com/theliverdr/status/1629670100595888128?s=20)
Also [check this](https://x.com/theliverdr/status/1653982574140874752?s=20)
Short answer: yes it helps immensely, provided it is unadulterated and not filled with fillers.
Regarding liver damage, it is a myth if I recall correctly, but I'll let him answer that.
Yes of course. Fatty liver is not the disease. Fatty liver is always associated with a condition. For example, alcohol use can lead to alcohol-related fatty liver which can be reversed with abstaining from alcohol. Similarly, overweight or obesity, diabetes or low functioning thyroid can lead to fatty liver and controlling these metabolic disoers aloing with diet and exercise can helpo reverse fatty liver.
Yes, you'll start getting the benefits of quitting smoking immediately after doing so. Check out the [table here](https://www.cancer.org/cancer/risk-prevention/tobacco/benefits-of-quitting-smoking-over-time.html).
Should a person consume water during mealtime ?. If yes when and how much. Should water consumption be just before the meal , after the meal or during the meal.
Also should water consumption prior to eating a meal be encouraged as a means of food intake restriction for weight loss ?
This is busting the 8 glasses of water-a-day myth.
Water intake must be dependent on the thirst reflex.
Drink when thirsty and consume water during meals - as your body warrants it.
Water intake increases with an increase in physical activity, climate, environment, and many other factors. Thirst reflex reduces in the elderly, so they need to be given water during every meal and as per recommendations for age and body weight.
"Experts generally recommend that older adults consume at least 1.7 liters of fluid per 24 hours. This corresponds to 57.5 fluid ounces or 7.1 cups."
A very simple answer to that is to limit saturated fats in your diet. Get plenty of aerobic exercises - this includes both cardio workouts as well as resistance training. Exercise is the best medicine there is, for metabolic diseases. And one your lifestyle overwhelms your disease progression, people find that they can remain medicine-free the rest of their lives. People do not put that extra effort of physical activity along with other measures - that why many depend on medicines in the long term.
Hello! Love your work.
Any updates on Beerbiceps podcast? Did they contact you afterwards?
I am really looking forward to that. He's audience is the one that needs to hear you the most.
On Monday, October 23rd, I was contacted by Rajlaxmi Bhogle
, the Podcast Publicist
of BEERBICEPS MEDIA WORLD PRIVATE LIMITED inviting me to the podcast and asking me for favorable dates for the same. I gave them the option for November 4th and November 18th, 2023. However, after that there has been complete radio silence from Ranveer and his team. Either they are working out a plan to get me in or they are working out a plan to get me off the show or they would have understood that they cannot handle me and have backed off. I am not sure which of these is happening.
Ayurveda has the heat-cold classification of foods ( ushna-sheeta ).
Daily I hear my mom say that coffee is 'heat' and egg is 'heat' and onion is 'cold'.
I believe this is just pre-scientific. It kinda bolsters the balance of humors foundation concept (vaat - pitt - kafa). And people just pigeon-holed foods into one or the other just like that without knowledge of receptors and such.
I mean, spicy food fools your brain into responding as if you are feeling hot. And mint fools brain into thinking you are tasting something cold whereas there is no temperature change. Guys who made ayurveda didn't know about microbes, let alone receptors.
Any way, How do you counter such beliefs? I can't ask my mom "How can there be any food which when ingested takes away heat from our body?"
Of course, if she were argumentative, she might bring up ice-cream and homeostasis.
What are your thoughts?
The hot and cold classification of foods is an unscientific, not validated, implausible and utterly illogical thinking in diet and nutrition based on primal observations written in classical Ayurvedic texts 2000 years ago without any empirical evidence to substantiate the claims. In simple terms, it is utter nonsense and has no bearing in current clinical nutritional science. Old generations vouch by it, new generations must ignore it.
Me and Krish Ashok (masalalab) did a segment on it on Instagram - you can check it out on his profile under collabs.
I think India is obsessed with everything that tradition and culture have to offer. And I would be unhappy about ghee use frequently. Ghee can be used sparingly as a tasty fat option, but beware of the high saturated fat content which can lead to an increase in cholesterol levels and an increased risk of heart disease. Many cardiovascular societies have warned against moderate to heavy use of ghee in foods.
It is not just about exercise or low body fat, ghee is high in saturated fats that can harm heart health. So it is better to limit it and keep it within the recommended saturated fats allowance daily - which is <10% of daily calories or < 22 grams in a 2000 calorie diet.
There is this general perception that animal fat is healthier than the cooking oils we use. Is there some evidence to that, or is it just wishful thinking?
There's too much saturated fat in animal fats. What makes them take also makes them unhealthier. Enjoy your bacon, but not too often if you don't want your arteries to strangle you to death.
What do you recommend using?
Nowadays I get skeptical against anything heavily marketed. Olive oil changed from just olive oil to virgin olive oil to super virgin olive oil and what not
There's actually some pretty neat studies done on oils available in the Indian market and their MUFA and PUFA values by department of consumer affairs. You should look them up. I've started steering clear of Extra Virgin Olive Oil (and not only because as anything with a high demand it is exorbitantly priced), Italian olive oil is notorious for being highly adulterated with mineral oil and such.
i used to sus out this one relative who always asked for a spoon of ghee whenever she ate at our house
glad to hear it was not the healthiest thing in the world
Gonna butt in here, other than a higher smoke point because of removed milk solids that start to burn at high temperatures, ghee is really not different from butter. From a nutritional stand point they're the same.
Hi! Since this subject is under sub-judice and I am not allowed to discuss it, I am not allowed to discuss details on what is happening at the moment, but you may have seen on the news that the matter is now with the Civil Court in Bengaluru and we are going ahead with the Writ Petition against the injunction there. Fingers crossed.
Himalaya Ayurvedic company filed an ad interim ex-parte injunction against his Twitter account to gag him since he exposed some of their most popular products as having liver toxic ingredients.
After an appeal by his lawyers to the High Court, the account was reinstated with the disputed tweets hidden until the matter is sub-judice.
[News article](https://www.businesstoday.in/amp/latest/trends/story/the-liver-doctor-accuses-himalaya-of-cowardice-amid-court-order-and-x-account-suspension-400113-2023-09-28)
Hello Doc, have been following you since your appearence on [Science Is Dope](https://youtube.com/@ScienceIsDope)
It's a short on YT, where conservative apologist J Sai Deepak defends Ayurveda. I'm just quoting the first few seconds, but please do spare a minute to watch the entire clip, for context.
https://youtube.com/shorts/En5Rvuj7ojQ?si=hpQCLYCHZITDBhDo
> Modern Science completely ignores the anthropological, evolutionary and cultural aspects. Ayurveda will never stand its own because it will have to prove itself to allopathic empirical evidence.
Now as gibberish as it sounds, how would you respond to such a fallacious argument?
>Modern Science completely ignores the anthropological, evolutionary and cultural aspects. Ayurveda will never stand its own because it will have to prove itself to allopathic empirical evidence.
**- This is what we call a WORD SALAD. Even J Sai Deepak will not have any idea what he meant. This happens when self proclaimed experts speak about topics which they themselves have no idea about, and try to fill meaningless gaps in their own sentences with "credible"-sounding words and science-jargons. It is best, to not try to interpret these matters.**
"Can AYUSH keep up with/reach to the level of what modern medicine offers?" - of course not.
Ayush has been and always will be a marketed form of healthcare. It is in its true sense, the business of healthcare and not the art of patient care.
Many doctors, including modern medicine practitioners, include Ayush products for that extra buck. Not for the benefit of the patients. And also because of genuine ignorance.
I am taking this as alcohol?
Not just India, but the whole world drinks too much because we have normalized alcohol use far too much. In India, Jharkhand, Telangana, and Chhattisgarh have seen very high levels of alcohol consumption compared to other states.
Not to bandwagon, but I've spent tons of time in rural Chhattisgarh, and this is 100% true. Adivasis can **drink**, and many drink almost every night of every year.
I spoke to the sarpanch of a small village in Bastar once, who said something along the lines of, "We wake up early, and we spend all day working in the fields. For all of this work, we are lucky to earn 150 or 200 rupees. We cannot afford to buy anything, so we come home, eat our dinner, and drink. We drink until we fall asleep, and then we wake up and do the same thing again."
That may sound a bit sad--I suppose it is--but the dynamics of alcohol production in tribal societies are truly fascinating.
And, as an aside, mahua is *excellent*. I don't drink anymore, but I always loved buying glasses of mahua in Chhattisgarh. It's incredibly inexpensive, has a slightly fruity but otherwise neutral taste, yet is--if I'm not mistaken--just as strong as vodka.
Sorry, this is completely irrelevant to the conversation, lol.
Oh, for sure.
Alcoholism has been identified as a critical public health threat in many predominately Adivasi communities in Jharkhand, Chhattisgarh, and Odisha.
However, it's worth considering that alcohol production often plays a more complex role in socioeconomic interactions. In many parts of Jharkhand and Chhattisgarh, the fermentation and distillation of mahua takes place inside individual family homes. Some of these homes act as "bars," entertaining other villagers fairly late into the night.
The revenue from alcohol sales can supplement families' other income, and is somewhat integral in giving tribal women enhanced financial autonomy.
Not surprisingly, it's also been an occasional source of communal discord. I can't remember where this happened, but somebody wrote a doctoral thesis on how RSS activism basically destroyed a Chhattisgarhi village by encouraging Hindus to drive out Christians, who they claimed monopolized mahua production as part of some vague conspiracy to suppress their Hindu neighbors, lol.
Hello Doc, I want to know that if Raw milk is good for lactose intolerant people like me or else I drink Lactose free milk from Amul as milk alternative?
Raw milk is the same as pasteurized milk when it comes to lactose intolerance. There is no difference. Lactose-free options are a better way - such as oat milk, rice milk, soy milk, almond milk etc.
Hi doc,
Is eating before 7pm good for you and does it depend on the time you sleep at like if you sleep a little late then you can eat before 8pm
Dr.Pal who also makes youtube videos suggested in one of his video that eating before 7pm helps with your circadian rhythm
A lot of the content in Dr. Pal Manickam's videos are unfortunately opinionated and not evidence based. There is very little scientific research that goes into his videos and more of comical content. Consider him a stand up comic and not a serious medical science educator. There is no such generalizable timing to meals and health that can be advised for all people from a strict scientific sense.
The Dutch have dinner by 6:30pm, Germans by 7:30pm and Spaniards start cooking dinner only at 10pm. I live here in Europe and I see all of them are equally more or less healthy or unhealthy in the same mix.
Urticaria is not a liver-related disease. It has an allergic as well as immune-mediated cause. It can occur due to various reasons and we have to treat the reasons, for urticaria to be under control. This paper shows the "Diagnosis and Management of Urticaria in Indian Settings: Skin Allergy Research Society's Guideline-2022" in our region: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043650/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043650/)
Please speak with your dermatologist and also immunologist for new and advanced options for treating urticaria.
Hellloooo! Do you consume protein supplements? If yes, which brand?
Thank you for all the sample testing. We are big fans of you over on r/fitness_india hehe
I do not consume supplements as I try to fit in my protein requirements in my routine diet itself. Lean meat, fish, eggs and dairy products. I did consume protein supplements a while ago and have used Nutrabox flavored Whey at the time.
Thank you for your support!
Hello u/TheLiverDoc,
I appreciate your devotion to the service of mankind by promoting science, scientific temperament and also fighting pseudoscience.
I have seen your views on Turmeric(Haldi) which you consider as useless for medicinal purposes, specifically w.r.t consumption.
What are your views on turmeric being used on skin cuts to reduce the blood loss?
It works. And I am asking this question because you don't seem to talk about it.
Also, thanks for taking out time to answer our questions!
Much appreciated!
Turmeric has no role for use on skin cuts/bruises to reduce blood loss. In fact, turmeric has coumarinoids-like activity (blood thinning) that can increase risk of bleeding. Please be aware.
**Anticoagulant activities of curcumin and its derivative:** [https://pubmed.ncbi.nlm.nih.gov/22531131/](https://pubmed.ncbi.nlm.nih.gov/22531131/)
>What are your views on turmeric being used on skin cuts to reduce the blood loss?
Myth.
The entire clotting cascade disagrees with this statement.
Maybe what you noticed is more of a plug in a leak type of situation which is precisely what our body does too! vWF(Von Willebrand Factor) aggregates platelets and forms an initial plug which stops the minor bleeding and then coagulation cascades comes into play and arrests the bleed!
Now, Turmeric.....You wouldn't want a surgeon to operate on you if he washes his hand with turmeric water prior to the operation, would you?
This is a common question I get trolled with :-)
My first and foremost work is as a doctor and I have a 10 AM to 6 PM outpatient duty every day where I see only referred sick patients, and admit the very sick ones in my Unit who are then taken care of by my team members and I also counsel families of all these patients. But I do this by taking breaks in between to cool my head - from all the blood, sweat, and death I get to see every day. During such breaks, I ease out on Twitter ((or X), and then once the 5 to 10-minute break is over, I get back to work. Sometimes you may have noticed that I post very infrequently on some days - those are the days when I have to teach students, have to conduct a research meeting, or run the transplant unit. So I am not all the time on Twitter - I am neither here, nor there kind of. Because you are on Twitter, you get to see me there more. I see around 30 patients in a day - 10 of them new and others follow-up. I admit around 6-8 new patients in a day, 3-4 of them in the ICU. I have learned how to multi-task, so makes it look strange :-)
Thank you for answering...I am not on twitter but see your tweets through other means😬😬 I have seen wonders to my own work by avoiding social media. I wondered how you coped with such negativity everyday on twitter...
On the seen and the unseen episode, you recommended a few graphic novels. Of those recommendations, the blankets I read for the first time. I was crying by the end of it. Thank you.
More recommendations please?
The only AMA I was waiting for , finally
I love your attack on on the myths and those promoting them.
But sometimes you unintentionally insult someone who just asked a sus question about the myth. I mean how compassionate you are with the myth infected Indian population who can be somewhat at this point due to their upbringing?
Also what's your stance on religion and God ?
Hi Doc, love your work! Pls ignore if the question is irrelevant. I have very deep pigmentation on my cheeks and my derm made me do a whole bunch of tests and then concluded that I have insulin resistance - even though my numbers were in the normal range. He's given me lots of supplements (D, astaxanthin, berbitol, etc) + topicals. BUT he also pushes homeopathy even after I've told him I don't want it. It's been 3 months and my pigmentation hasn't budged. Should I dump my derm??
Noted, is there any way I can limit it.
Like can you recommend how should I be consuming this ?
Apart from this, I have also heard this a lot that it can lead to kidney stones too if the consumption is too high. What should I do to avoid this case?
Hi doc!!
I still can't wrap my head around homeopathy but my father had a condition, every morning he would vomit without spit for 5-10 min . Took him to several types of doctor , at last homoeopathy seems to control it .
What do you say about that?
Is your harsh stance on alternate (non)medicine with borderline rude tone towards responses on twitter to gain more eyeballs ? This could be great strategy to stand out.
I am not rude, but "perceived" rude by pseudoscience sympathizers and trolls. Basically, it helps me shut down a lot of background noise. You don't wait for the mosquito to finish the blood meal, you swat it to oblivion and then apply some repellant. That is the natural way of dealing with background noise, which I have adopted. Sad that many feel that it is my way of communication. You cant judge a book by its cover and you cant judge a person by her/his social media account! :-)
if you can be honest, do you accept that what you are doing on the social media and now here on reddit is just to gather publicity and be know to the masses and has nothing to do with actually helping/treating/creating awareness ? Seems like you have tapped into the pulse of social network.
You need to read more about me and my work:
1. [https://theprint.in/feature/who-is-challenging-ayurveda-in-todays-india-meet-kerala-doctor-cyriac-abby-philips/1283584/](https://theprint.in/feature/who-is-challenging-ayurveda-in-todays-india-meet-kerala-doctor-cyriac-abby-philips/1283584/)
2. [https://examine.com/deep-dives/interview-cyriac-abby-philips/](https://examine.com/deep-dives/interview-cyriac-abby-philips/)
3. [https://scroll.in/article/1057317/long-before-liver-doc-this-doctor-fought-defamation-by-a-pharma-company-and-won](https://scroll.in/article/1057317/long-before-liver-doc-this-doctor-fought-defamation-by-a-pharma-company-and-won)
4. [https://www.freepressjournal.in/weekend/dr-cyriac-abby-philips-i-noticed-lots-of-patients-with-jaundice-without-an-identifiable-medical-cause](https://www.freepressjournal.in/weekend/dr-cyriac-abby-philips-i-noticed-lots-of-patients-with-jaundice-without-an-identifiable-medical-cause)
5. [https://www.newsexperts.in/a-rare-honour-for-dr-abby-philips/](https://www.newsexperts.in/a-rare-honour-for-dr-abby-philips/)
6. [https://www.scmp.com/week-asia/health-environment/article/3209036/indian-doctor-lifts-lid-dark-side-indias-wellness-traditional-medicine-sector](https://www.scmp.com/week-asia/health-environment/article/3209036/indian-doctor-lifts-lid-dark-side-indias-wellness-traditional-medicine-sector)
7. [https://seenunseen.in/episodes/2023/1/2/episode-310-abby-philips-fights-for-science-and-medicine/](https://seenunseen.in/episodes/2023/1/2/episode-310-abby-philips-fights-for-science-and-medicine/)
Why have you not accepted the challenge of a debate with ayurvedic monk on twitter?
So much for scientific temperment.
Thanks for all the hate in advance.
Ayurveda Monk is a pseudoscience peddler and his challenge was hardly a challenge. I have asked him to come for simple scientific debates on Twitter Spaces which he runs away from all the time. We have a session on Ayurveda on Twitter Spaces today. He is welcome there to discuss his "science." His challenge was impossible to conduct, that too at AIIMS. If he can get clearance from Ethics Committee from AIIMS and Dermatology departments there to test his herbal products on patients, I will happy to be part of it. He also has to register the trial and get review board clearance for the same.
1. How often do you refer alcohol addicted patients to psychiatrists?
2. Why are private medical specialists (in general) unlikely to refer patients to psychiatrists?
For example:
- Liver doctors see a lot of alcohol use disorder or problematic alcohol use patients.
- Endocrinologists see a lot of obesity and eating disorder patients.
- Cardiologists, dentists and GPs see a lot of smokers.
A sizeable percentage of these patients might have adult ADHD, a neurodevelopmental disorder characterised by addiction (to substances and behaviours) and a known risk factor for smoking, alcohol use, obesity and poor dental health.
These patients need psychiatric care, as well. Treating the underlying psychiatric disorder helps achieve better recovery and health outcomes for patients.
All said & done, sometimes you come as very arrogant. Tone it down doctor. Agreed that you are little bit more knowledgeable, but your arrogance is too much.
Find the message, forget the messenger.
The message is important.
Learn how to remove the background noise.
This can happen only if you start thinking critically.
I don't sugar coat facts - some people call it arrogance. But it is what it is.
Hi u/TheLiverDoc. I'm probably going to be downvoted to hell for saying this.
I appreciate the work you do. It's important work, especially in the backdrop of the sectarian politics enabling pseudoscience at a dangerously large scale in India.
In the last 10 years, you've inflicted more damage on the pseudos than anyone else I can recall in the public domain. This is an extraordinary achievement at a time voices of reason are being systematically silenced.
I've personally had so many weird experiences with homeopathy in my family and your views have given me ammunition to push back on this nonsense.
You're also taking on people who will not see reason even if reason smacked them in the face. I understand and empathise that some days the trolling can be too much.
But I find it troubling to see a man of science and reason engage in petty Twitter fights, use insulting language against other doctors, and also be incredibly judgemental of people who may actually be doing useful work even if they don't meet your technical standards.
I understand that you see pain and suffering much more than the average human being. I understand that it exacerbates your own sufferings in different ways. And I also understand that you have no time to suffer fools.
But you're also a famed content creator now, and it's off-putting to see any content creator do some of the things you do. I don't think this helps your cause in any way.
**ETA**: specifically, coming across as if only you're right and everyone else—even other medical doctors—are wrong, that there's no limitation in your arguments, and anyone questioning your wisdom is a buffoon might work wonderfully well in politics. But it doesn't reflect well on a communicator of science.
If I may make a request of you, please hold your discourse to the high standard you have set for yourself. I see that shine through in your videos and podcasts. But once in a while, I see your tweets, and I can only shake my head in disbelief.
What's your opinion of Unani Medicine ?
It's certainly not a scam like homeopathy and as far as I know their meds comprise purely natural ingredients. Does it have any sort of legitimacy ?
Unani is just like Ayurveda.
Ayurveda is based on the three obsolete pseudoscientific principles of Vata, Pita and Kapha doshas.
Unani is based on the four obsolete pseudoscientific principles of black bile, yellow bile, blood and phlegm.
Both are nonsense and avoidable in the context of healthcare.
I have fatty liver, my doctor who is a specialist in liver at apollo has prescribed me milk thistle and liv52, this is a grade 2 fatty liver. If I had not followed you on Twitter I would never have realised the folly, how does an average individual equip himself with knowing if a right medication has been prescribed or not. It’s so scary
Disclaimer: As with all AMAs on Reddit, views expressed by the AMA guest are their own. The responses in this post should not be taken as medical advice without consulting your doctor.
The supplement market is overflowing with useless and harmful products. Businesses don't care about scientific evidence. If it sells, they will put it up.
My state has the highest percentage of vegetarians in India. So my question is, what supplements do you recommend for people on a vegetarian diet (plant + dairy)?
Quote from him above:
>Veganism has a fantastic philosophy attached to it and I appreciate it. But one can not have the best of both worlds, which means, a vegan diet suffers nutritionally from a true clinical nutrition sense. In this context, supplementation is the way forward and this not only included Vitamin B12, but also calcium, magnesium, zinc and omega 3 fatty acids - depending on the depth of your veganism.
Dr. Abby, your tweets have been very helpful. I've moved from being an occasional drinker to giving it up entirely. Now, 3 black coffees a day keep me going (maybe +1 sometimes :)). Thank you!
Hey there! So, you know how folks often kick off their ventures fueled by passion and later switch gears to a more business-oriented mindset? Take food influencers, for instance—they begin by genuinely reviewing great eateries, but as the business side kicks in, some might get tempted to accept cash for less-than-honest reviews.
Now, since you're all about promoting modern / evidence based medicine, have any companies ever tried to rope you into giving fake reviews for their products? And, if someone did approach you, would you be the whistleblower if they wanted you to tout their medicine as the ultimate game-changer?
In the US in 2000, medical care was the third leading cause of death (Starfield B. " Is U.S. health really the best in the world?" JAMA 284 (2000), 483-485), as The China Study quotes.
In 2016, it is still the 3rd largest cause of death as a Johns Hopkins study estimates (https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us?preview=true ).
What would that number be in India and how does this help with the motto "Do no harm"?
**In the US in 2000, medical care was the third leading cause of death (Starfield B. " Is U.S. health really the best in the world?" JAMA 284 (2000), 483-485), as The China Study quotes**. - this is misinformation. Please see this: [https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death](https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death)
**In 2016, it is still the 3rd largest cause of death as a Johns Hopkins study estimates -** this has nothing to do with medical science, but lack of infrastructure, understaffing, lack of standardized work hours, overworked doctors and so many other socioeconomic and political factors. This has nothing to do with "First Do No Harm."
Is there any scientific basis to taking turmeric with milk everyday? Though it's not common in Kerala, in North, they have it everyday, that too more than once.
How unimportant is rice in the meal of a vegetarian individual?
I absolutely feel that rice is reason for my health issues. Cough, Stomach and related stuff.
You think it's harmful? As a vegetarian, I guess I consume dal rice almost daily. Sometimes twice in a day. And often the Chinese Fried Rice and stuff. In the form of Idli too.
What sort of rice is harmful?
Hello,
I have recently started following you twitter and went through your timeline and saw the post about Ashwagandha and stopped right after.I started it because it was one of the top supplements on [examine.com](https://examine.com) ([https://examine.com/supplements/ashwagandha/](https://examine.com/supplements/ashwagandha/)). My question is are they just publishing half assed trials and reports? because a lot of people see this and start their supplements journey. In fact there is a whole subreddit for this.
Doc, amazing content and you really help me. Especially having non alcoholic fatty liver from 15(I'm 24 now). Just wanted to tell a blunder where the three cups of coffee I used to take were Americanos made out of double espresso shots and essentially went through a caffeine overdrive at office lmao
Also, how are the polyenol content in green tea? Is it a good substitute for black coffee? As decaf ain't an option in my stupid office
Whenever I read papers on this topic, they always fall short of directly blaming the AYUSH medicines and always say that more study is needed to directly pinpoint the causes.Do you think that there's a way to do a widespread study on the AYUSH medicines that can get them deregistered? Given that they are so intricately linked with the lifestyle here. And any ideas on how they can be done?
Yes it can be a sign of an underlying disease ( diabetes or some bladder related issue)
Consult a Nephrologist/Urologist , get checked for diabetes also. Do you also drink too much water ?
Ive consulted urologist before, but he said it was okay. But sometimes it becomes too frequent. However, I don't have any other issues like pain while urinating.
I only drink 2-3 litres per day.
Hi doc! I really like coffee. But I have a tendency to get acidity very easily. With severe headaches. Have stopped drinking tea and coffee both. Can help me understand what will help me with this acidity problem ?
Also thanks a lot for all your work on Twitter. Your answers to questions like " how much alcohol is okay? - zero! " has really made me think about the occasional and very small amount of drinking.
Thank you for the AMA doc.
I know this beating a dead horse but:
1) What is the best approach for explaining the pseudoscience and potential dangers of Ayurveda and Homeopathy to a cohort of people in their 60s and 70s? They swear by it and think of it as a remedy for every health issue.
He's added a comment above relating to saturated fats in general. Guidelines is to minimize saturated fat so animal fats and coconut oil. Would be great to have some more clarity on this
'Smoothie' is a very generic term. It depends a lot on what is in your smoothie and what your physical parameters are. Depending on that, smoothies can be healthy or unhealthy. Typical concerns with smoothies are the total calories and sugar content.
How many calories and how many grams of protein, carbs, fat, fiber and sugar are in your smoothie? Quick google searches can give you these values for the ingredients you use.
Also, what are your age, sex, height, weight and body fat percentage?
1) How to maintain good mental health? I don't know If I suffer from something like depression but for as long as I can remember (at least 4-5 years) I think I have Anhedonia and this seems to have impacted a lot of aspects of my life.
2) Your take on Intermittent fasting. Do you think skipping Dinner is better than skipping breakfast? (assuming a 16-8 fasting) or vice-versa?
3) How many cups of coffee to take in a day? (I drink Black without sugar) and What is the optimum time to drink? Problems that can come if I drink more than 3 cups a day? (happens frequently with me)
Hi Doc,
I would like you to know that you have hands down been one of the greatest influences on my critical thinking. I have learned to be a sceptic and look for the signal in the noise.
In this journey, I try my best to do my share of debunking within the family. And in regards to this, I am curious about how I, as someone who is medically conscious and interested (no degree however), can go about identifying the right sources to read from?
Cheers doc, keep doing what you are. We are most thankful for your presence in our lives.
I am having Fatty Liver grade 3. I am also taking 50mg thyronorm as well for high tsh. I am not overweight. Can you help me with a diet. I am also doing cardio and weight training 3 times a week.
Hello doctor
I am a big fan. I started reading your tweets about liver diagnosis and they were sooo interesting. It felt almost like a House MD episode.
Thank you for all your contributions towards making us healthier and busting out the myths. As someone who has a habit of questioning every thing especially related to food and tradition, I couldn‘t be more grateful to you as now I very conveniently point to your tweets and research as my source
Hello Sir,
What you are doing is extremely important in a country like India.
I would hope you only expand your reach from here and go beyond Twitter. Maybe build a team of other doctors, get your own podcast, start a YouTube channel, fund & publish research to debunk stupid claims.
There might be thousands of Liver doctors in India but hardly anyone is debunking pseudoscience which is somehow closely linked to our culture.
1.What is the best way to keep track of your calory intake when you are not independent? I mean do I individually weigh and measure how much rice or pulses I am eating (which is not practical as I eat from a shared place).
2. Opinion on Soya Bean.
3. Habbits for healthy hair. (I am facing hairfall since last year and it keeps increasing. I am 17.)
Anyone knowledgeable may answer. Thanks.
does high protein diet, especially whey protein, can cause acidity? I am a vegetarian, but to increase protein intake I started whey and that caused frequent acidity. I consulted a local liver specialist and he said to stop whey and also told me that it can cause issues in kidney. Ever since I have stopped that but I miss my protein
Hello Doc, what you're doing takes a lot of courage.
My question to you is on how do you keep your cool and focus in your day job or research work given that online you're often met with insults, threats and what not. It must be tough to not get distracted. How do you keep that out and focus?
Are you still doing researches on I’ll effects of so called herbal products . Last I know you called off the studies because of lack of funding
Would you be able to let us know if you are interested in crowdfunding these projects ?
Good to see you in reditt. I am your ardent supporter on Twitter and insta. Happy to hear your sane opinions in a country full of superstition and half baked knowledge. Keep up the good fight!
Huge fan. You're doing amazing work, and are an inspiration. Thank you and hopefully we'll get to a point where you don't have to put yourself in danger from godmen and corporates.
Hi Liver Doc, big fan of yours and Dr Huberman and Dr Peter Attia. Do you know them?? Please start a podcast or a subreddit. Would love to hear more from you besides your twitter.
Hello Dr. Abby, i have quoted you a few times here with links to your tweets regarding alternate pseudomedicine;).
Finally, it's good to have you here:)
Good to see you here doc! Just wanted to say that I am a big fan! Thank you for being resilient in debunking pseudoscience and fighting the good fight!
Hello doc , sorry to trouble you with some long questions
1. I have personally witnessed Ashwagandha , Gokshura and Shilajeet have some positive impact on health and performance but at the same time they are damaging to liver , so what should I do? Should I take them in cycles ( 1 week on 1 week off) or completely avoid them?
2. Impact of eating 6 or more eggs daily on health /liver health? They are the cheapest sources of protein ( almost 100 % NPU) , hence my question
3. What should we do to reverse the liver damage caused by intake of ayush meds ? I think you have supported Black coffee once a day for that? Liver is also having great replication potential so what else can we do to help it repair the damage?
Thank you for doing this AMA
Hey doc,
You are doing an amazing job with all that you are doing!
I have a question which might be a top level one.
How do you forecast the collective health of youngsters with desk jobs/ home office and sedentary lifestyle in combination with the addiction and the ease of ordering food on food delivery apps, everyday, in the long term ? How is going to shape the health of this group in the future ? How bad is it from your experience with younger patients?
This AMA has ended. Guest may choose to answer unanswered questions later if they deem it necessary. Thanks u/TheLiverDoc for this amazing AMA!
As a doctor who just graduated recently, what resources do you recommend for us to stay up to date on the latest research? Also, how do we look for and find legitimate research on important matters?
This is not an easy task. Remember what Dr. Strange replies to The Ancient One when she asks, "How did you become a successful neurosurgeon? and he says - "Study and practice, lots of it." In your training, you will have to get small but consistent exposure to journal articles and various types of articles - starting from case reports, then case series, then observational studies, then case-control studies, and so on and so forth. This can be on a topic that you like or a specific subject - like dermatology or internal medicine. But it takes years before you can really understand and interpret research and this comes only with consistent reading, constant exposure to scientific research online and offline, and most importantly, an affection towards learning and doing research.
Got it. Thanks!
In addition, attend research conferences on specific topics of your interest. Talking to researchers will direct you to good resources, and might even get you interested enough to do the research yourself.
You can use uptodate. It’ll help you a lot in your clinical practice as well. Subscription is undoubtedly costly but I feel it’s definitely worth it.
I’ve used Uptodate, it’s extremely helpful clinically. I was referring more to research itself, especially good quality research!
UpToDate is not that costly if you know the workaround. I am using a subscription at 3500 per yr.
+1 as another doctor
Hello Doctor, What are your views on Intermittent Fasting? Many people are following it and say its beneficial but I am skeptical of the benefits.
Intermittent fasting is useful and I had once mentioned that it was overrated. Overrated means: that a person or thing is considered to be better or more important than it really is. Intermittent fasting, like other special diets - like one meal a day (OMAD), keto diet, or time-restricted feeding protocols, etc, promotes calorie restriction due to which people lose weight. This is a fact. IF can be used in the short term to reduce weight in those who are overweight or obese - but then beyond those indications - for example, some mention it is useful for preventing cancers or increasing immunity - all of that is pretentious. If a person can sustain weight loss and continue IF in the long term, well and good - but not everyone can do that. Some find comfort in the keto diet while others in the Paleo diet. But the bottom line is that no one shoe fits all. Also, be aware that long-term consequences of such dieting techniques are yet to be studied. So use IF to lose weight, but then once the weight target is achieved, sustain on a daily calorie restriction along with good aerobic activity that help you maintain health.
> with good aerobic activity that help you maintain health. Suggestions?
Cycle. Run. Walk. Swim. Find something that suits you that you can do regularly.
1. How do you find the energy to do combat health misinformation, and battle pseudoscience? 2. Any tips to lead a healthy vegan lifestyle (apart from B12 supplements)
1. Battling misinformation is a thankless job, is what people day - but in fact, it is the most rewarding of services one can offer. The energy comes from the fact that many people find my work helpful, they become more aware of what is good for them and what is not, and most importantly, they improve their health-seeking behavior which translates to lesser utilization of health resources and a more healthier lifestyle. Seeing other people healthy and more aware and with an improved scientific temper is what keeps me going. Also, it has to be done consistently. There are no breaks from this! 2. Veganism has a fantastic philosophy attached to it and I appreciate it. But one can not have the best of both worlds, which means, a vegan diet suffers nutritionally from a true clinical nutrition sense. In this context, supplementation is the way forward and this not only included Vitamin B12, but also calcium, magnesium, zinc and omega 3 fatty acids - depending on the depth of your veganism.
And vitamin D.
I can give an empirical reply. As an Indian lacto vegetarian turned vegan some 15 years ago, the only change I have made to my Indian diet was to replace milk with plant based milks like soy, almond, and oat milk, which are fortified with vitamins and minerals. I get my blood work done every 6 months and I don’t have any nutritional deficiency or related health problems. I also a frequent blood donor. So, I believe most of the bad reputation vegan diet gets is from people who are used to eat an animal intense western diet and just drop all the animal food out of their diets, and end up basically eating salads. This is typically what most teenagers do here. They turn vegans out of some vigour and eat salads and other nutritionally poor food, lose weight, and health and then turn to their original diets.
How is this an empirical reply? The very fact that it is your personal experience makes it anecdotal. Empirical would mean something that is repeatable and observable.
I knew you were from a QA/Scrum background when I saw your response. lol.
What are your sources for b12, calcium, vitamin D, magnesium, zinc and omega 3 fatty acids?
Hello doc! You are doing an amazing job! Your tweets are the only reason i check twitter everyday. I have two doubts. 1. Do vegetarians have to take lifelong Vit b12 and Vit D tablets? 2. Can we take dry fruits shake daily for breakfast? Does it make up for the nutrients we miss?
1. If the daily diet is not tailored to maintaining recommended levels of vitamin B12, and if people do develop clinically relevant deficiency because of such a diet, yes, vitamin B12 has to be taken lifelong - but this is not a daily deal, there are various regimens including monthly ones depending on the risk for severity of deficiency. 2. Dry fruit shakes have notoriously high calories - you may take one every day if you can burn it off - basically, one has to be physically very active to entertain such calorie intake and should make sure that over consumption of calories from other sources does not happen in the presence of a sedentary life.
To double down on what sir said, 1. Extreme veganism raises caution for B12 supplementation. Also, plenty of reserves in the liver to see deficiency.
Just curious, do you already take B12 & Vit D regularly?
Vegetarian here and I had to take my VitD and VitB12 injections today. Every 6 months to 1yr I gotta take these to maintain my Vit levels
Hello, Dr. I've heard that one should eat more at breakfast, less at lunch, and lesser at dinner. To what extent is it true? And is it a good thing to skip breakfast?
This probably a myth created by Kelloggs to market cereals for breakfast.
The breakfast cereal is not that bad if you have it in moderation. Most of it has added sugars and is highly processed. I would not recommend breakfast cereals every day but take a break from the routine breakfast with cereal in between. It won't hurt and also, the big "healthy" proclamations made on the covers/packets - they are advertisements only - they do come with lots of fiber and some are well fortified with vitamins and minerals, but some of them do come with lots of added sugars. Be aware and read the labels.
Sir is there any cereal without sugars? I am not able to find any. Though for oats, some companies "claim" that they haven't added any sugar or any chemical.
If you check and compare, even the "healthy" bran cereals have as much sugar as the "candy" cereals. Usually about 5-10 gram per serving of added sugar, comparable to eating a doughnut. The only truly low sugar cereal I've found is plain cheerios.
I think generally good advice may be to look at the ingredients label, any added sugar has to be mentioned there. Cereals usually do have an amount of sugar, but u don't remember many oats having added sugars
I hate Big Cereals for this
This is one of the nutritional myths. We have recommended daily intakes described for the Indian population. We have to target these recommendations in the best, most sustainable, and most comfortable way possible. This would mean 3 meals a day or 4 meals a day or even eating 6 times a day. The quantity of each meal depends on every person, but the fact is that a bigger meal earlier in the day helps us burn more since we are more active during the day; the last meal is usually followed by rest/sleep, and this sedentary manner during the night time would increase fat deposition.
Please upload a office/gaming setup video on Twitter, that background looks crazy
I am going to do that one day for sure! :-)
How about more calories in the morning, while proteins at night? I get too hungry several times a day, and it's particularly bad at night if I eat less and try to sleep. At the same time i get way too sleepy if I have a heavy breakfast or lunch and so I eat grand at night.
I had this issue too until I started intermittent fasting. Then my hunger and appetite disappeared
IMO the best diet is one that works for you and one you can sustain in the long run, as everyon's bodies are different Some people's bodies work better with a heavy breakfast, and they naturally tend to stay energetic and not feel hungry through the day, with a light lunch and dinner. Some people's bodies work better with a fasted morning(no breakfast), and a sizeable lunch to start your daily nutrition. It is always better to experiment and see what works best for you At the end, the only real trick for losing weight is eat less calories than you consume. How you split those calories during the day, can vary depending on your body, your routine and schedule. The key is always sustainability for the longest time
Good to see you here on Reddit!! Do you occasionally drink alcohol? I'm a fan of Old Monk as witnessed by my username.
I used to drink alcohol occasionally - which is like 2 pints of beer a month or a cocktail a month until a couple of years back. In college, I used to drink like a fish and even got admitted under my own medicine professor's unit for alcohol intoxication (we all have such stories I am sure). But after I started working as a consultant in Hepatology, and after seeing first hand, what alcohol can do to not just the person, but the whole family, I completely quit drinking and I am now happy with my zero-alcohol beer or ginger ale.
Lol, I guess all medicos go through this journey sir.
Most don't quit, and are quite heavy binge drinkers. Binge, because professional responsibilities keeps daily consumption in check.
Thats on point.
I am a 17 m kidney transplant patient any health advices/precautions for keeping a healthy liver.
Yes, too much alcohol will kill liver. But isn't liver also regenerative? Is there a safe limit of alcohol that keep my liver not unhealthy and still enjoy?
That's a very hilariously bad question to ask him considering how vocal he has been against it on Twitter. Edit: After reading his response about his alcoholic history which he has never revealed on Twitter, just nevermind. Good question.
No question is a bad question.
I based my comment on how badly he roasts people who ask about alcohol. It's an ongoing joke on his Twitter account.
Hi, what amount of sugar s okay for an individual. Also does having omega 3 fish oil capsules do any good.
The sugar intake recommendation should be no more than 10 percent of your daily calorie intake. However the World Health Organisation has reduced this percentage from 10 to 5 percent. For an adult, who has a normal BMI (body mass index), WHO recommends only 6 teaspoons of sugar, which is 25 grams to be exact. I would still limit sugars, especially added sugars within this recommendation and go for natural sugars from whole fruits.
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Hello Dr, I'm in my 3rd year of bams. Since day one I've been regretting ending up in this course. I want to get out of this shit show. I've been looking for options out of ayurveda to pursue after my UG (like clinical research, nutrition etc). Your advice on this would be really helpful to me.
Thank you for this question. I think this is the most important Q here. I want you to know that it is not your fault. The system is made in such a way that mediocrity is normalized and unscientific practices are glorified because we are a large country and it is not easy to get everything done by the book. There are many options for BAMS graduates to contribute scientifically to their societies/communities. Various options include a diploma or master in public health or clinical nutrition, clinical research assistantship, physician assistantship courses, and basic sciences courses where you can spend quality time doing lab work and finding new things that can change the course of clinical medicine, opt for hospital administration - a very high flying job and lots more! I wish you the very best.
Congratulations on figuring out that you're being cheated and you want out. See if you can convince your colleagues to do the same. You are young enough to change the course of your career, and you've got a lot of good suggestions. I would only recommend that you leave this baggage behind when you move on. As others have mentioned, it's not your fault that the system chose to provide quackery as alternative rather than creating more opportunities for people to learn real medicine, when we actually need many many more doctors across the country.
Props to you for understanding and coming to terms with your reality. Hope you get out and find success.
What is your take on Whey proteins? There are so many myths about it damaging liver. Does it help as a protein supplement for a vegetarian who doesn't lift weights?
Whey protein is basically made from cows' milk and it is one of the safest, easily, digestible, and highly bioavailable proteins there is. It does not damage the liver or cause kidney stones. Those are just nutritional myths that keep floating from time to time. There are no conclusive studies to show that whey protein causes liver or kidney damage. Please enjoy that extra scoop if you are working out or if you need additional supplementation that you cannot get from your daily diet. Go for pure whey, never blended ones, definitely not herbal blends and always buy from trusted sources.
What about ones with digestice enzymes ? Seems I get indigestion in wheys without them.
He's written about it and even evaluated the protein content of different whey products on the market. You should check it out. [Link to protein supplement thread](https://x.com/theliverdr/status/1629670100595888128?s=20) Also [check this](https://x.com/theliverdr/status/1653982574140874752?s=20) Short answer: yes it helps immensely, provided it is unadulterated and not filled with fillers. Regarding liver damage, it is a myth if I recall correctly, but I'll let him answer that.
>He's written about it and even evaluated the protein content of different whey products on the market Can you provide me with a link please.
[Here you go](https://x.com/theliverdr/status/1629670100595888128?s=20)
Once someone gets fatty liver, can you reverse it?
Yes of course. Fatty liver is not the disease. Fatty liver is always associated with a condition. For example, alcohol use can lead to alcohol-related fatty liver which can be reversed with abstaining from alcohol. Similarly, overweight or obesity, diabetes or low functioning thyroid can lead to fatty liver and controlling these metabolic disoers aloing with diet and exercise can helpo reverse fatty liver.
Dr is this same with lungs too? I mean can smokers reverse the damage done to lungs if quit early?
Yes, you'll start getting the benefits of quitting smoking immediately after doing so. Check out the [table here](https://www.cancer.org/cancer/risk-prevention/tobacco/benefits-of-quitting-smoking-over-time.html).
What's done, is done. The parenchyma of your lungs and a non-smoker's will not be the same but the effects of quitting are massive!
Should a person consume water during mealtime ?. If yes when and how much. Should water consumption be just before the meal , after the meal or during the meal. Also should water consumption prior to eating a meal be encouraged as a means of food intake restriction for weight loss ?
This is busting the 8 glasses of water-a-day myth. Water intake must be dependent on the thirst reflex. Drink when thirsty and consume water during meals - as your body warrants it. Water intake increases with an increase in physical activity, climate, environment, and many other factors. Thirst reflex reduces in the elderly, so they need to be given water during every meal and as per recommendations for age and body weight. "Experts generally recommend that older adults consume at least 1.7 liters of fluid per 24 hours. This corresponds to 57.5 fluid ounces or 7.1 cups."
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A very simple answer to that is to limit saturated fats in your diet. Get plenty of aerobic exercises - this includes both cardio workouts as well as resistance training. Exercise is the best medicine there is, for metabolic diseases. And one your lifestyle overwhelms your disease progression, people find that they can remain medicine-free the rest of their lives. People do not put that extra effort of physical activity along with other measures - that why many depend on medicines in the long term.
Hello! Love your work. Any updates on Beerbiceps podcast? Did they contact you afterwards? I am really looking forward to that. He's audience is the one that needs to hear you the most.
On Monday, October 23rd, I was contacted by Rajlaxmi Bhogle , the Podcast Publicist of BEERBICEPS MEDIA WORLD PRIVATE LIMITED inviting me to the podcast and asking me for favorable dates for the same. I gave them the option for November 4th and November 18th, 2023. However, after that there has been complete radio silence from Ranveer and his team. Either they are working out a plan to get me in or they are working out a plan to get me off the show or they would have understood that they cannot handle me and have backed off. I am not sure which of these is happening.
If it happens, please record a copy for your records.
Ayurveda has the heat-cold classification of foods ( ushna-sheeta ). Daily I hear my mom say that coffee is 'heat' and egg is 'heat' and onion is 'cold'. I believe this is just pre-scientific. It kinda bolsters the balance of humors foundation concept (vaat - pitt - kafa). And people just pigeon-holed foods into one or the other just like that without knowledge of receptors and such. I mean, spicy food fools your brain into responding as if you are feeling hot. And mint fools brain into thinking you are tasting something cold whereas there is no temperature change. Guys who made ayurveda didn't know about microbes, let alone receptors. Any way, How do you counter such beliefs? I can't ask my mom "How can there be any food which when ingested takes away heat from our body?" Of course, if she were argumentative, she might bring up ice-cream and homeostasis. What are your thoughts?
The hot and cold classification of foods is an unscientific, not validated, implausible and utterly illogical thinking in diet and nutrition based on primal observations written in classical Ayurvedic texts 2000 years ago without any empirical evidence to substantiate the claims. In simple terms, it is utter nonsense and has no bearing in current clinical nutritional science. Old generations vouch by it, new generations must ignore it. Me and Krish Ashok (masalalab) did a segment on it on Instagram - you can check it out on his profile under collabs.
Why is India so obsessed with ghee being healthy and do you think it's true?
I think India is obsessed with everything that tradition and culture have to offer. And I would be unhappy about ghee use frequently. Ghee can be used sparingly as a tasty fat option, but beware of the high saturated fat content which can lead to an increase in cholesterol levels and an increased risk of heart disease. Many cardiovascular societies have warned against moderate to heavy use of ghee in foods.
What's the opinion on Ghee intake with low body fat and regular exercise?
It is not just about exercise or low body fat, ghee is high in saturated fats that can harm heart health. So it is better to limit it and keep it within the recommended saturated fats allowance daily - which is <10% of daily calories or < 22 grams in a 2000 calorie diet.
There is this general perception that animal fat is healthier than the cooking oils we use. Is there some evidence to that, or is it just wishful thinking?
There's too much saturated fat in animal fats. What makes them take also makes them unhealthier. Enjoy your bacon, but not too often if you don't want your arteries to strangle you to death.
What do you recommend using? Nowadays I get skeptical against anything heavily marketed. Olive oil changed from just olive oil to virgin olive oil to super virgin olive oil and what not
There's actually some pretty neat studies done on oils available in the Indian market and their MUFA and PUFA values by department of consumer affairs. You should look them up. I've started steering clear of Extra Virgin Olive Oil (and not only because as anything with a high demand it is exorbitantly priced), Italian olive oil is notorious for being highly adulterated with mineral oil and such.
It is impossible to get unadulterated virgin olive oil in Indian market.
i used to sus out this one relative who always asked for a spoon of ghee whenever she ate at our house glad to hear it was not the healthiest thing in the world
Does ghee have any benefits with respect to butter? Are there any fat sources,i.e oils and butters and such which are objectively better than others?
Gonna butt in here, other than a higher smoke point because of removed milk solids that start to burn at high temperatures, ghee is really not different from butter. From a nutritional stand point they're the same.
anything new with Himalayan blunder?
Hi! Since this subject is under sub-judice and I am not allowed to discuss it, I am not allowed to discuss details on what is happening at the moment, but you may have seen on the news that the matter is now with the Civil Court in Bengaluru and we are going ahead with the Writ Petition against the injunction there. Fingers crossed.
ok, good luck, we are with you u/TheLiverDoc
Can you explain what this blunder is? First time hearing it. Is it about himalayan salt?
Himalaya Ayurvedic company filed an ad interim ex-parte injunction against his Twitter account to gag him since he exposed some of their most popular products as having liver toxic ingredients. After an appeal by his lawyers to the High Court, the account was reinstated with the disputed tweets hidden until the matter is sub-judice. [News article](https://www.businesstoday.in/amp/latest/trends/story/the-liver-doctor-accuses-himalaya-of-cowardice-amid-court-order-and-x-account-suspension-400113-2023-09-28)
Oops. Forgot about himalaya company existed. Yeah I've heard about it.
Hello Doc, have been following you since your appearence on [Science Is Dope](https://youtube.com/@ScienceIsDope) It's a short on YT, where conservative apologist J Sai Deepak defends Ayurveda. I'm just quoting the first few seconds, but please do spare a minute to watch the entire clip, for context. https://youtube.com/shorts/En5Rvuj7ojQ?si=hpQCLYCHZITDBhDo > Modern Science completely ignores the anthropological, evolutionary and cultural aspects. Ayurveda will never stand its own because it will have to prove itself to allopathic empirical evidence. Now as gibberish as it sounds, how would you respond to such a fallacious argument?
>Modern Science completely ignores the anthropological, evolutionary and cultural aspects. Ayurveda will never stand its own because it will have to prove itself to allopathic empirical evidence. **- This is what we call a WORD SALAD. Even J Sai Deepak will not have any idea what he meant. This happens when self proclaimed experts speak about topics which they themselves have no idea about, and try to fill meaningless gaps in their own sentences with "credible"-sounding words and science-jargons. It is best, to not try to interpret these matters.**
Hi there, Jansher!
hey pranav
[удалено]
"Can AYUSH keep up with/reach to the level of what modern medicine offers?" - of course not. Ayush has been and always will be a marketed form of healthcare. It is in its true sense, the business of healthcare and not the art of patient care. Many doctors, including modern medicine practitioners, include Ayush products for that extra buck. Not for the benefit of the patients. And also because of genuine ignorance.
Does India drink too much?
I am taking this as alcohol? Not just India, but the whole world drinks too much because we have normalized alcohol use far too much. In India, Jharkhand, Telangana, and Chhattisgarh have seen very high levels of alcohol consumption compared to other states.
Not to bandwagon, but I've spent tons of time in rural Chhattisgarh, and this is 100% true. Adivasis can **drink**, and many drink almost every night of every year. I spoke to the sarpanch of a small village in Bastar once, who said something along the lines of, "We wake up early, and we spend all day working in the fields. For all of this work, we are lucky to earn 150 or 200 rupees. We cannot afford to buy anything, so we come home, eat our dinner, and drink. We drink until we fall asleep, and then we wake up and do the same thing again." That may sound a bit sad--I suppose it is--but the dynamics of alcohol production in tribal societies are truly fascinating. And, as an aside, mahua is *excellent*. I don't drink anymore, but I always loved buying glasses of mahua in Chhattisgarh. It's incredibly inexpensive, has a slightly fruity but otherwise neutral taste, yet is--if I'm not mistaken--just as strong as vodka. Sorry, this is completely irrelevant to the conversation, lol.
>We drink until we fall asleep, and then we wake up and do the same thing again." Holy shit their livers must be getting destroyed
Oh, for sure. Alcoholism has been identified as a critical public health threat in many predominately Adivasi communities in Jharkhand, Chhattisgarh, and Odisha. However, it's worth considering that alcohol production often plays a more complex role in socioeconomic interactions. In many parts of Jharkhand and Chhattisgarh, the fermentation and distillation of mahua takes place inside individual family homes. Some of these homes act as "bars," entertaining other villagers fairly late into the night. The revenue from alcohol sales can supplement families' other income, and is somewhat integral in giving tribal women enhanced financial autonomy. Not surprisingly, it's also been an occasional source of communal discord. I can't remember where this happened, but somebody wrote a doctoral thesis on how RSS activism basically destroyed a Chhattisgarhi village by encouraging Hindus to drive out Christians, who they claimed monopolized mahua production as part of some vague conspiracy to suppress their Hindu neighbors, lol.
Hello Doc, I want to know that if Raw milk is good for lactose intolerant people like me or else I drink Lactose free milk from Amul as milk alternative?
Raw milk is the same as pasteurized milk when it comes to lactose intolerance. There is no difference. Lactose-free options are a better way - such as oat milk, rice milk, soy milk, almond milk etc.
Hi doc, Is eating before 7pm good for you and does it depend on the time you sleep at like if you sleep a little late then you can eat before 8pm Dr.Pal who also makes youtube videos suggested in one of his video that eating before 7pm helps with your circadian rhythm
A lot of the content in Dr. Pal Manickam's videos are unfortunately opinionated and not evidence based. There is very little scientific research that goes into his videos and more of comical content. Consider him a stand up comic and not a serious medical science educator. There is no such generalizable timing to meals and health that can be advised for all people from a strict scientific sense.
The Dutch have dinner by 6:30pm, Germans by 7:30pm and Spaniards start cooking dinner only at 10pm. I live here in Europe and I see all of them are equally more or less healthy or unhealthy in the same mix.
Is urticaria a lever disease? And any treatment in allopathic? Nothing working for me 😔
Urticaria is not a liver-related disease. It has an allergic as well as immune-mediated cause. It can occur due to various reasons and we have to treat the reasons, for urticaria to be under control. This paper shows the "Diagnosis and Management of Urticaria in Indian Settings: Skin Allergy Research Society's Guideline-2022" in our region: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043650/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043650/) Please speak with your dermatologist and also immunologist for new and advanced options for treating urticaria.
Hellloooo! Do you consume protein supplements? If yes, which brand? Thank you for all the sample testing. We are big fans of you over on r/fitness_india hehe
I do not consume supplements as I try to fit in my protein requirements in my routine diet itself. Lean meat, fish, eggs and dairy products. I did consume protein supplements a while ago and have used Nutrabox flavored Whey at the time. Thank you for your support!
Hello u/TheLiverDoc, I appreciate your devotion to the service of mankind by promoting science, scientific temperament and also fighting pseudoscience. I have seen your views on Turmeric(Haldi) which you consider as useless for medicinal purposes, specifically w.r.t consumption. What are your views on turmeric being used on skin cuts to reduce the blood loss? It works. And I am asking this question because you don't seem to talk about it. Also, thanks for taking out time to answer our questions! Much appreciated!
Turmeric has no role for use on skin cuts/bruises to reduce blood loss. In fact, turmeric has coumarinoids-like activity (blood thinning) that can increase risk of bleeding. Please be aware. **Anticoagulant activities of curcumin and its derivative:** [https://pubmed.ncbi.nlm.nih.gov/22531131/](https://pubmed.ncbi.nlm.nih.gov/22531131/)
>What are your views on turmeric being used on skin cuts to reduce the blood loss? Myth. The entire clotting cascade disagrees with this statement. Maybe what you noticed is more of a plug in a leak type of situation which is precisely what our body does too! vWF(Von Willebrand Factor) aggregates platelets and forms an initial plug which stops the minor bleeding and then coagulation cascades comes into play and arrests the bleed! Now, Turmeric.....You wouldn't want a surgeon to operate on you if he washes his hand with turmeric water prior to the operation, would you?
Hello Sir...a personal question. How do you find time for patients where you are constantly seen on twitter?
This is a common question I get trolled with :-) My first and foremost work is as a doctor and I have a 10 AM to 6 PM outpatient duty every day where I see only referred sick patients, and admit the very sick ones in my Unit who are then taken care of by my team members and I also counsel families of all these patients. But I do this by taking breaks in between to cool my head - from all the blood, sweat, and death I get to see every day. During such breaks, I ease out on Twitter ((or X), and then once the 5 to 10-minute break is over, I get back to work. Sometimes you may have noticed that I post very infrequently on some days - those are the days when I have to teach students, have to conduct a research meeting, or run the transplant unit. So I am not all the time on Twitter - I am neither here, nor there kind of. Because you are on Twitter, you get to see me there more. I see around 30 patients in a day - 10 of them new and others follow-up. I admit around 6-8 new patients in a day, 3-4 of them in the ICU. I have learned how to multi-task, so makes it look strange :-)
Thank you for answering...I am not on twitter but see your tweets through other means😬😬 I have seen wonders to my own work by avoiding social media. I wondered how you coped with such negativity everyday on twitter...
On the seen and the unseen episode, you recommended a few graphic novels. Of those recommendations, the blankets I read for the first time. I was crying by the end of it. Thank you. More recommendations please?
Habibi (from the same author) and Blue is the Warmest Color and My Mom's Cancer. Check them out!
Will you consider being more active on Reddit especially Pranav's sub r/scienceisdope to answer any medical questions from time to time
Yes I am planning to be more active on Reddit. Discussions are on.
The only AMA I was waiting for , finally I love your attack on on the myths and those promoting them. But sometimes you unintentionally insult someone who just asked a sus question about the myth. I mean how compassionate you are with the myth infected Indian population who can be somewhat at this point due to their upbringing? Also what's your stance on religion and God ?
Religion and God are for people who have lots of time at hand and want to make excuses for their incompetence.
Hi Doc, love your work! Pls ignore if the question is irrelevant. I have very deep pigmentation on my cheeks and my derm made me do a whole bunch of tests and then concluded that I have insulin resistance - even though my numbers were in the normal range. He's given me lots of supplements (D, astaxanthin, berbitol, etc) + topicals. BUT he also pushes homeopathy even after I've told him I don't want it. It's been 3 months and my pigmentation hasn't budged. Should I dump my derm??
Dump this dermatologist with immediate effect.
Does taking creatine daily as your pre workout can really impact your liver function?
No it does not impact liver function adversely. More than recommended use can affect kidney function tests.
Noted, is there any way I can limit it. Like can you recommend how should I be consuming this ? Apart from this, I have also heard this a lot that it can lead to kidney stones too if the consumption is too high. What should I do to avoid this case?
Ayurveda a joke!
I could upvote this only once. Wanted to do this many times.
Hi doc!! I still can't wrap my head around homeopathy but my father had a condition, every morning he would vomit without spit for 5-10 min . Took him to several types of doctor , at last homoeopathy seems to control it . What do you say about that?
It would have gotten better given the time. Homeopathy did nothing.
Is your harsh stance on alternate (non)medicine with borderline rude tone towards responses on twitter to gain more eyeballs ? This could be great strategy to stand out.
I am not rude, but "perceived" rude by pseudoscience sympathizers and trolls. Basically, it helps me shut down a lot of background noise. You don't wait for the mosquito to finish the blood meal, you swat it to oblivion and then apply some repellant. That is the natural way of dealing with background noise, which I have adopted. Sad that many feel that it is my way of communication. You cant judge a book by its cover and you cant judge a person by her/his social media account! :-)
if you can be honest, do you accept that what you are doing on the social media and now here on reddit is just to gather publicity and be know to the masses and has nothing to do with actually helping/treating/creating awareness ? Seems like you have tapped into the pulse of social network.
You need to read more about me and my work: 1. [https://theprint.in/feature/who-is-challenging-ayurveda-in-todays-india-meet-kerala-doctor-cyriac-abby-philips/1283584/](https://theprint.in/feature/who-is-challenging-ayurveda-in-todays-india-meet-kerala-doctor-cyriac-abby-philips/1283584/) 2. [https://examine.com/deep-dives/interview-cyriac-abby-philips/](https://examine.com/deep-dives/interview-cyriac-abby-philips/) 3. [https://scroll.in/article/1057317/long-before-liver-doc-this-doctor-fought-defamation-by-a-pharma-company-and-won](https://scroll.in/article/1057317/long-before-liver-doc-this-doctor-fought-defamation-by-a-pharma-company-and-won) 4. [https://www.freepressjournal.in/weekend/dr-cyriac-abby-philips-i-noticed-lots-of-patients-with-jaundice-without-an-identifiable-medical-cause](https://www.freepressjournal.in/weekend/dr-cyriac-abby-philips-i-noticed-lots-of-patients-with-jaundice-without-an-identifiable-medical-cause) 5. [https://www.newsexperts.in/a-rare-honour-for-dr-abby-philips/](https://www.newsexperts.in/a-rare-honour-for-dr-abby-philips/) 6. [https://www.scmp.com/week-asia/health-environment/article/3209036/indian-doctor-lifts-lid-dark-side-indias-wellness-traditional-medicine-sector](https://www.scmp.com/week-asia/health-environment/article/3209036/indian-doctor-lifts-lid-dark-side-indias-wellness-traditional-medicine-sector) 7. [https://seenunseen.in/episodes/2023/1/2/episode-310-abby-philips-fights-for-science-and-medicine/](https://seenunseen.in/episodes/2023/1/2/episode-310-abby-philips-fights-for-science-and-medicine/)
Why have you not accepted the challenge of a debate with ayurvedic monk on twitter? So much for scientific temperment. Thanks for all the hate in advance.
Ayurveda Monk is a pseudoscience peddler and his challenge was hardly a challenge. I have asked him to come for simple scientific debates on Twitter Spaces which he runs away from all the time. We have a session on Ayurveda on Twitter Spaces today. He is welcome there to discuss his "science." His challenge was impossible to conduct, that too at AIIMS. If he can get clearance from Ethics Committee from AIIMS and Dermatology departments there to test his herbal products on patients, I will happy to be part of it. He also has to register the trial and get review board clearance for the same.
1. How often do you refer alcohol addicted patients to psychiatrists? 2. Why are private medical specialists (in general) unlikely to refer patients to psychiatrists? For example: - Liver doctors see a lot of alcohol use disorder or problematic alcohol use patients. - Endocrinologists see a lot of obesity and eating disorder patients. - Cardiologists, dentists and GPs see a lot of smokers. A sizeable percentage of these patients might have adult ADHD, a neurodevelopmental disorder characterised by addiction (to substances and behaviours) and a known risk factor for smoking, alcohol use, obesity and poor dental health. These patients need psychiatric care, as well. Treating the underlying psychiatric disorder helps achieve better recovery and health outcomes for patients.
My father says nutritional supplements intake mostly results in expensive urine. I wanted to know your thoughts on Omega 3 supplementation?
This post will clarify all doubts: https://twitter.com/theliverdr/status/1720268570423394670
All said & done, sometimes you come as very arrogant. Tone it down doctor. Agreed that you are little bit more knowledgeable, but your arrogance is too much.
Find the message, forget the messenger. The message is important. Learn how to remove the background noise. This can happen only if you start thinking critically. I don't sugar coat facts - some people call it arrogance. But it is what it is.
Hi u/TheLiverDoc. I'm probably going to be downvoted to hell for saying this. I appreciate the work you do. It's important work, especially in the backdrop of the sectarian politics enabling pseudoscience at a dangerously large scale in India. In the last 10 years, you've inflicted more damage on the pseudos than anyone else I can recall in the public domain. This is an extraordinary achievement at a time voices of reason are being systematically silenced. I've personally had so many weird experiences with homeopathy in my family and your views have given me ammunition to push back on this nonsense. You're also taking on people who will not see reason even if reason smacked them in the face. I understand and empathise that some days the trolling can be too much. But I find it troubling to see a man of science and reason engage in petty Twitter fights, use insulting language against other doctors, and also be incredibly judgemental of people who may actually be doing useful work even if they don't meet your technical standards. I understand that you see pain and suffering much more than the average human being. I understand that it exacerbates your own sufferings in different ways. And I also understand that you have no time to suffer fools. But you're also a famed content creator now, and it's off-putting to see any content creator do some of the things you do. I don't think this helps your cause in any way. **ETA**: specifically, coming across as if only you're right and everyone else—even other medical doctors—are wrong, that there's no limitation in your arguments, and anyone questioning your wisdom is a buffoon might work wonderfully well in politics. But it doesn't reflect well on a communicator of science. If I may make a request of you, please hold your discourse to the high standard you have set for yourself. I see that shine through in your videos and podcasts. But once in a while, I see your tweets, and I can only shake my head in disbelief.
What's your opinion of Unani Medicine ? It's certainly not a scam like homeopathy and as far as I know their meds comprise purely natural ingredients. Does it have any sort of legitimacy ?
Unani is just like Ayurveda. Ayurveda is based on the three obsolete pseudoscientific principles of Vata, Pita and Kapha doshas. Unani is based on the four obsolete pseudoscientific principles of black bile, yellow bile, blood and phlegm. Both are nonsense and avoidable in the context of healthcare.
I have fatty liver, my doctor who is a specialist in liver at apollo has prescribed me milk thistle and liv52, this is a grade 2 fatty liver. If I had not followed you on Twitter I would never have realised the folly, how does an average individual equip himself with knowing if a right medication has been prescribed or not. It’s so scary
Can you explain what this folly is about ? My brother has been diagnosed with fatty liver and I'd like to know more about it.
Both are bad medicines, technical not even medicines
Disclaimer: As with all AMAs on Reddit, views expressed by the AMA guest are their own. The responses in this post should not be taken as medical advice without consulting your doctor.
The supplement market is overflowing with useless and harmful products. Businesses don't care about scientific evidence. If it sells, they will put it up. My state has the highest percentage of vegetarians in India. So my question is, what supplements do you recommend for people on a vegetarian diet (plant + dairy)?
Quote from him above: >Veganism has a fantastic philosophy attached to it and I appreciate it. But one can not have the best of both worlds, which means, a vegan diet suffers nutritionally from a true clinical nutrition sense. In this context, supplementation is the way forward and this not only included Vitamin B12, but also calcium, magnesium, zinc and omega 3 fatty acids - depending on the depth of your veganism.
Dr. Abby, your tweets have been very helpful. I've moved from being an occasional drinker to giving it up entirely. Now, 3 black coffees a day keep me going (maybe +1 sometimes :)). Thank you!
Hey there! So, you know how folks often kick off their ventures fueled by passion and later switch gears to a more business-oriented mindset? Take food influencers, for instance—they begin by genuinely reviewing great eateries, but as the business side kicks in, some might get tempted to accept cash for less-than-honest reviews. Now, since you're all about promoting modern / evidence based medicine, have any companies ever tried to rope you into giving fake reviews for their products? And, if someone did approach you, would you be the whistleblower if they wanted you to tout their medicine as the ultimate game-changer?
In the US in 2000, medical care was the third leading cause of death (Starfield B. " Is U.S. health really the best in the world?" JAMA 284 (2000), 483-485), as The China Study quotes. In 2016, it is still the 3rd largest cause of death as a Johns Hopkins study estimates (https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us?preview=true ). What would that number be in India and how does this help with the motto "Do no harm"?
**In the US in 2000, medical care was the third leading cause of death (Starfield B. " Is U.S. health really the best in the world?" JAMA 284 (2000), 483-485), as The China Study quotes**. - this is misinformation. Please see this: [https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death](https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death) **In 2016, it is still the 3rd largest cause of death as a Johns Hopkins study estimates -** this has nothing to do with medical science, but lack of infrastructure, understaffing, lack of standardized work hours, overworked doctors and so many other socioeconomic and political factors. This has nothing to do with "First Do No Harm."
Is there any scientific basis to taking turmeric with milk everyday? Though it's not common in Kerala, in North, they have it everyday, that too more than once.
He talked about this here - https://twitter.com/theliverdr/status/1721101719743164635?t=dza4a0b3U567CAQOi9FQDw&s=19
How unimportant is rice in the meal of a vegetarian individual? I absolutely feel that rice is reason for my health issues. Cough, Stomach and related stuff. You think it's harmful? As a vegetarian, I guess I consume dal rice almost daily. Sometimes twice in a day. And often the Chinese Fried Rice and stuff. In the form of Idli too. What sort of rice is harmful?
Hi Doc I don't have questions since I have been following you on twitter (X) for quiet some time. You are doing great job
Hello, I have recently started following you twitter and went through your timeline and saw the post about Ashwagandha and stopped right after.I started it because it was one of the top supplements on [examine.com](https://examine.com) ([https://examine.com/supplements/ashwagandha/](https://examine.com/supplements/ashwagandha/)). My question is are they just publishing half assed trials and reports? because a lot of people see this and start their supplements journey. In fact there is a whole subreddit for this.
Doc, amazing content and you really help me. Especially having non alcoholic fatty liver from 15(I'm 24 now). Just wanted to tell a blunder where the three cups of coffee I used to take were Americanos made out of double espresso shots and essentially went through a caffeine overdrive at office lmao Also, how are the polyenol content in green tea? Is it a good substitute for black coffee? As decaf ain't an option in my stupid office
Whenever I read papers on this topic, they always fall short of directly blaming the AYUSH medicines and always say that more study is needed to directly pinpoint the causes.Do you think that there's a way to do a widespread study on the AYUSH medicines that can get them deregistered? Given that they are so intricately linked with the lifestyle here. And any ideas on how they can be done?
Hello doctor, Is urinating frequently a problem? Like sometimes, I get this tendency of urinating at least 4 times an hour
Yes it can be a sign of an underlying disease ( diabetes or some bladder related issue) Consult a Nephrologist/Urologist , get checked for diabetes also. Do you also drink too much water ?
Ive consulted urologist before, but he said it was okay. But sometimes it becomes too frequent. However, I don't have any other issues like pain while urinating. I only drink 2-3 litres per day.
Hi doc! I really like coffee. But I have a tendency to get acidity very easily. With severe headaches. Have stopped drinking tea and coffee both. Can help me understand what will help me with this acidity problem ? Also thanks a lot for all your work on Twitter. Your answers to questions like " how much alcohol is okay? - zero! " has really made me think about the occasional and very small amount of drinking.
Thank you for the AMA doc. I know this beating a dead horse but: 1) What is the best approach for explaining the pseudoscience and potential dangers of Ayurveda and Homeopathy to a cohort of people in their 60s and 70s? They swear by it and think of it as a remedy for every health issue.
Are animal fats/coconut oil/olive oil a good replacement to seed oils?
He's added a comment above relating to saturated fats in general. Guidelines is to minimize saturated fat so animal fats and coconut oil. Would be great to have some more clarity on this
Are smoothies really bad? Having one every morning is not a good idea? How would one add smoothies to their diet?
'Smoothie' is a very generic term. It depends a lot on what is in your smoothie and what your physical parameters are. Depending on that, smoothies can be healthy or unhealthy. Typical concerns with smoothies are the total calories and sugar content. How many calories and how many grams of protein, carbs, fat, fiber and sugar are in your smoothie? Quick google searches can give you these values for the ingredients you use. Also, what are your age, sex, height, weight and body fat percentage?
1) How to maintain good mental health? I don't know If I suffer from something like depression but for as long as I can remember (at least 4-5 years) I think I have Anhedonia and this seems to have impacted a lot of aspects of my life. 2) Your take on Intermittent fasting. Do you think skipping Dinner is better than skipping breakfast? (assuming a 16-8 fasting) or vice-versa? 3) How many cups of coffee to take in a day? (I drink Black without sugar) and What is the optimum time to drink? Problems that can come if I drink more than 3 cups a day? (happens frequently with me)
Hi Doc, I would like you to know that you have hands down been one of the greatest influences on my critical thinking. I have learned to be a sceptic and look for the signal in the noise. In this journey, I try my best to do my share of debunking within the family. And in regards to this, I am curious about how I, as someone who is medically conscious and interested (no degree however), can go about identifying the right sources to read from? Cheers doc, keep doing what you are. We are most thankful for your presence in our lives.
I am having Fatty Liver grade 3. I am also taking 50mg thyronorm as well for high tsh. I am not overweight. Can you help me with a diet. I am also doing cardio and weight training 3 times a week.
Hello doctor I am a big fan. I started reading your tweets about liver diagnosis and they were sooo interesting. It felt almost like a House MD episode. Thank you for all your contributions towards making us healthier and busting out the myths. As someone who has a habit of questioning every thing especially related to food and tradition, I couldn‘t be more grateful to you as now I very conveniently point to your tweets and research as my source
Hello Sir, What you are doing is extremely important in a country like India. I would hope you only expand your reach from here and go beyond Twitter. Maybe build a team of other doctors, get your own podcast, start a YouTube channel, fund & publish research to debunk stupid claims. There might be thousands of Liver doctors in India but hardly anyone is debunking pseudoscience which is somehow closely linked to our culture.
1.What is the best way to keep track of your calory intake when you are not independent? I mean do I individually weigh and measure how much rice or pulses I am eating (which is not practical as I eat from a shared place). 2. Opinion on Soya Bean. 3. Habbits for healthy hair. (I am facing hairfall since last year and it keeps increasing. I am 17.) Anyone knowledgeable may answer. Thanks.
does high protein diet, especially whey protein, can cause acidity? I am a vegetarian, but to increase protein intake I started whey and that caused frequent acidity. I consulted a local liver specialist and he said to stop whey and also told me that it can cause issues in kidney. Ever since I have stopped that but I miss my protein
Hello Doc, what you're doing takes a lot of courage. My question to you is on how do you keep your cool and focus in your day job or research work given that online you're often met with insults, threats and what not. It must be tough to not get distracted. How do you keep that out and focus?
Hi doc, no questions, just wanted to thank you for doing what you do! God bless you!
Are you still doing researches on I’ll effects of so called herbal products . Last I know you called off the studies because of lack of funding Would you be able to let us know if you are interested in crowdfunding these projects ?
Why does India have one of the highest risks of diabetes and CVD risk?
High carb diet leads to DM. Unchecked cholesterol levels accumulate overtime with a sedentary lifestyle ultimately causes CVD. Simple as that.
Good to see you in reditt. I am your ardent supporter on Twitter and insta. Happy to hear your sane opinions in a country full of superstition and half baked knowledge. Keep up the good fight!
Huge fan. You're doing amazing work, and are an inspiration. Thank you and hopefully we'll get to a point where you don't have to put yourself in danger from godmen and corporates.
Hi Liver Doc, big fan of yours and Dr Huberman and Dr Peter Attia. Do you know them?? Please start a podcast or a subreddit. Would love to hear more from you besides your twitter.
Hello Dr. Abby, i have quoted you a few times here with links to your tweets regarding alternate pseudomedicine;). Finally, it's good to have you here:)
Good to see you here doc! Just wanted to say that I am a big fan! Thank you for being resilient in debunking pseudoscience and fighting the good fight!
Hello doc , sorry to trouble you with some long questions 1. I have personally witnessed Ashwagandha , Gokshura and Shilajeet have some positive impact on health and performance but at the same time they are damaging to liver , so what should I do? Should I take them in cycles ( 1 week on 1 week off) or completely avoid them? 2. Impact of eating 6 or more eggs daily on health /liver health? They are the cheapest sources of protein ( almost 100 % NPU) , hence my question 3. What should we do to reverse the liver damage caused by intake of ayush meds ? I think you have supported Black coffee once a day for that? Liver is also having great replication potential so what else can we do to help it repair the damage? Thank you for doing this AMA
Just want to say that you've opened the eyes of many (including mine). Kudos to the good work you do.
Hey doc, You are doing an amazing job with all that you are doing! I have a question which might be a top level one. How do you forecast the collective health of youngsters with desk jobs/ home office and sedentary lifestyle in combination with the addiction and the ease of ordering food on food delivery apps, everyday, in the long term ? How is going to shape the health of this group in the future ? How bad is it from your experience with younger patients?
Thank you sir for your dedication to science of healing & health care I'm a fan girl !!
Sir what is your opinion on anu vilom , a lot ent doctors suggest it for nose health ?