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Join Australia's leading comic speechmaker, Homer Papantonio, and renowned cardiologist, Dr. Ross Walker, for a podcast that blends humor and health in a way you’ve never heard before. "The Seriously Funny Wellbeing Podcast" delivers top-notch insights on wellness and well-being with a satirical twist. Get ready to laugh, learn, and live better—it's not for the faint-hearted!
Homer Papantonio (00:02.699)
G'day everybody, thanks for taking the time to tune into our seriously funny, well-being podcast featuring myself and of course the charismatic and effervescent Dr Ross Walker. Ross, how are you? Are you like an Alka-Seltzer? Are you effervescent? Yeah, yeah.
Ross Walker (00:17.038)
I'm fine, thank you, Homer.
I am effervescent, but I want to tell you, I saw two crows stuck together. They were Velcros.
Homer Papantonio (00:26.505)
Mmm Like Dobermans, we've got two Dobermans in there, like they're called Del Pro dogs. Ross this week's podcast is pharmaceutical side effects placebo and Nasebo As well as exploring even the side effects of vitamin supplements Funny thing about side effects Ross last week my doctor warned me one of the side effects of my new medication Was an increased urge to gamble
I told him I bet $50 that wouldn't happen to me. Okay, so let's go on with medical news. Food and dementia.
Ross Walker (01:06.413)
Before we do, just on that, this friend of mine was telling me that his girlfriend left him because of his desire to gamble on anything. And he says, the first thing I want to do is win her back. Right, and dementia.
Homer Papantonio (01:21.349)
Racing this time, okay. Yep, go ahead, medical news, food and dementia.
Ross Walker (01:27.279)
This is a study that came out of something we mentioned in the last podcast, the UK Biobank on people from the ages of 40 to 70. And the follow-up went for nine years and they looked at some of the genetic risk markers for Alzheimer's disease. 122,000 adults who'd done dietary assessments, average age about 56. And they found that those who had six daily servings of flavonoids, which are strangely plant chemicals. So it's the...
the fruits and vegetables that we talk about all the time, those who did had a 28 % reduction in dementia just by doing that. when a drug comes out from the pharmaceutical industry that reduces dementia by 25 to 30%, we never hear the end of it. Why isn't this being shouted from the rooftops that just having fruits and vegetables every day can reduce your risk for dementia by 28 %? But if you're...
Homer Papantonio (01:58.571)
Yeah, yeah.
Homer Papantonio (02:18.177)
Yes.
Ross Walker (02:26.735)
score very high on the genetic risk factors for dementia and you have high blood pressure and or you have depression. So genetic risk, blood pressure, depression, 43 % reduction in risk for dementia. If you have high blood pressure, 30 % reduction risk for dementia. If you have depression, 48 % reduction in your risk for dementia if you have those six daily servings of flavonoids, i.e. fruit and vegetables.
Very simple message, very important message.
Homer Papantonio (03:00.481)
So the question has to be asked, why don't doctors, is it just too time consuming for them to say look, or is there a, most people, the pharmaceutical industries got their, whatever, you know what I mean.
Ross Walker (03:18.55)
Yeah, no, it's not that. It's just that doctors think, mainly, that if you can't fix it with a script pad or a scalpel, it doesn't work, and that really their job is to dish out pharmaceutical therapy or send people off for procedures. But I believe 80 % of anyone's management is how they look after themselves, of which nutrition is the third most important thing after exercise and happiness.
Homer Papantonio (03:26.589)
Mm-hmm. Yeah.
Ross Walker (03:45.174)
So to me, I say to my patients all the time, I'm like a broken record in my practice. I say 80, 10, 10. 80 % is how you look after yourself, 10 % is drugs if you need them, 10 % supplements. There we go.
Homer Papantonio (03:59.157)
If I was to go into GP's office and say look, I think food, diet and exercise will solve this ailment, they'll say it's got to be evidence based and quackery. They don't want to go there normally, do they?
Ross Walker (04:14.062)
But hang on, hang on, this is published in the Journal of the American Medical Association out one of the most respected medical data banks in the world, the UK Biobank. It is evidence-based.
Homer Papantonio (04:25.609)
Okay, but how did that go into the doctor's office? How did that report? It just stayed out there. Okay.
Ross Walker (04:30.07)
It doesn't, doesn't, it doesn't because they just stays out there. But I'm saying if it was a drug, the drug reps would be banging on every medical door in the country saying, did you hear what our new drugs doing? It's reducing dementia risk by 28%. And if you've got depression, it reduces it by 48%. And if you've got high blood pressure, 30%. And if you're high genetic risk for Alzheimer's disease, 43%. That's how it would be sold to the doctors. And the doctors say, let me prescribe that drug.
I prescribe that drug every day, it's called fruit and vegetables.
Homer Papantonio (05:01.243)
just future of medicine, new types of insulin.
Ross Walker (05:05.772)
Yeah, this is really interesting stuff. And there are two things. One, they've developed through the University of Sydney, University of Norway, an oral insulin that works better than injectable insulin. Because think of it logically. If you swallow something orally, it gets absorbed locally into the liver around the pancreas. And that's where insulin is released from the pancreas. So this oral insulin works much more like normal insulin. The problem before you say, why have we always given it orally?
Because as as you give a protein orally, it's broken down immediately to amino acids. So they've used this technique that they've added to the insulin to stop it from being broken down so it just gets absorbed. And also, they've developed another form of insulin that's injectable that only is released when the blood sugar level is high. So it's not causing the big problem with insulin therapy, which is hypoglycemia.
where the sugar drops too much and the person can get very confused, very sweaty, sometimes even go unconscious. So we're now getting much closer to insulins that A, you can swallow or B, if you do have to inject them, they're not gonna make you go hypoglycemic. But I think the really exciting thing is this oral insulin because when they tested it in a whole vast array of animals,
it worked better than the injectable insulin and didn't cause the hypoglycemia that I've just been speaking about. I think it's very exciting stuff. So I think the future of diabetes is totally different to what we're looking at now. So up to about 10 years ago, diabetics had to prick their fingers all the time and inject themselves three, four, five times a day. Now we're talking about the ability to swallow insulin with each meal and just use the glucose monitors that should latch onto your arm for a couple of weeks.
as every two weeks you just replace it so you don't have to keep injecting yourself. It's really exciting stuff.
Homer Papantonio (07:07.201)
Just on diabetes, does endurance exercise, can it actually cure a certain form of diabetes?
Ross Walker (07:20.47)
No, you can't ever say cure. I saw a person, yeah, it can reduce, it certainly may help you go from being diabetic to pre-diabetic to sometimes even non-diabetic. You'll always be insulin resistant because you're born with that gene, but then that gene loads the gun and your environment, your obesity, your inactivity pulls the trigger.
Homer Papantonio (07:23.783)
or reduce the prevalence of.
Homer Papantonio (07:44.79)
Yeah.
Ross Walker (07:47.542)
And I see many people, say to them, if you put on 20 kilos around your gut, you're going to become a diabetic. So I hit them early. But I saw a man the other day who's about 15, 20 kilos, and he was diabetic, now he's non-diabetic. And part of that is exercise. Look, I wouldn't just say one thing. You can't outrun or outcycle a bad diet.
Homer Papantonio (08:05.281)
Mmm.
Ross Walker (08:16.15)
So to me, it's the five keys, not the one key, of which exercise is the second most important key after happiness.
Homer Papantonio (08:24.513)
And on the subject of alcohol, body of evidence, gout. Gout, soon as you say gout, people think red wine foot. Painful foot. Nonsense? Okay.
Ross Walker (08:32.759)
Bye!
Ross Walker (08:37.4)
Yep, yep, it's complete and utter nonsense. Yeah, and this is the point about this one that in the body of evidence this time, I'm talking about a really large study of, I think it was around, how many was it? 2.6 million people. Have you heard of the 23andMe company that's doing DNA analysis in the US? No, well, this company, they've given up the data of 2.6 million people.
Homer Papantonio (08:59.829)
Not as such, no, no, no.
Ross Walker (09:06.446)
and found, as I say all the time, every disease is genetic, as is gout. Now the big link with gout is probably the second commonest genetic abnormality in the world, which is insulin resistance after the MTHFR gene. So insulin resistance, 30 % of Caucasians, 50 % of Asians, and 100 % of people with your coloured skin, people with darker skin or olive skin, are insulin resistant. So you've got the gene, but then your gene loads the gun, the environment pulls the trigger.
So what does insulin resistance set you up for? It sets you up for cardiovascular diseases, sets you up for obesity-related cancers, sets you up for fatty liver, and it sets you up for gout. So that's why people get gout, because they have the insulin resistance gene in most cases. It's the same thing. Most type 2 diabetics have the insulin resistance gene, but there are less common genetic abnormalities that will predispose you to gout or to diabetes or other conditions.
But you are right to some extent. let me make this really important point. Stress of any type causes nothing, but it precipitates everything. So if you have the gene for gout and then you have a binge on red wine or pate or red meat or whatever, that will then create all of these things called purines in your body, which get broken down to uric acid, which is what happens in gout.
And so I actually believe, Homer, that gout should be one per customer. I think once you've had an episode of gout, you should never have it again. Firstly, and least importantly, it's unbelievably painful. Typically, it affects the big toe, but it's just so painful. so you're in agony for a few days, and you don't want to go through that again. But it can affect any joint in the body. But a lot of people don't realize this, that gout
Homer Papantonio (10:46.325)
Mmm. Yep.
Ross Walker (10:59.72)
What it does, the uric acid crystals not only settle in your joints to cause the painful arthritis, but can also settle in your kidneys to put up your blood pressure and damage your kidneys. So you should always prevent it. So once the acute episode has settled down, and we can settle it down with specific drugs that do that, once it's settled down, then you start, in most cases, on a drug called allopurinol.
Homer Papantonio (11:27.083)
Yeah.
Ross Walker (11:27.534)
Allopurinol blocks uric acid production, but the maintenance dose is 300 milligrams a day. So if anyone's listening to this and you've had gout and you say, I don't want to get it again because I don't want my blood pressure to go up and I don't want to damage my kidneys and I don't want to feel that pain, you get 100 milligram allopurinol tablet, you cut it in half, you take 50 milligrams for a month, 100 milligrams for the next month, 200 milligrams for the next month, build up to 300 milligrams until you've gone through the 200.
capsule or 200 tablets in that bottle. And then you get a maintenance 300 milligram tablet that you take for the rest of your life. And your pill say, I don't want to take pharmaceuticals. Well, put up with the kidney damage and the blood pressure. It is such a preventable illness, but it's only preventable with pharmaceuticals. Now, again, I spoke about this on my show a few months ago, and I had people ringing in say, look, you cherry juice, that cured it, or celery, or.
Yeah, those things may help, but they don't lower your uric acid and stop the damage to the kidneys and the blood pressure. Okay?
Homer Papantonio (12:29.951)
I was going to throw cherries at you on that one. Cherry juice. Cherry, Yep.
Ross Walker (12:32.43)
It may give you some relief, but it doesn't fix the metabolic problem. The only thing that does is allopurinol.
Homer Papantonio (12:43.069)
Okay, so Ross, this is a mandatory introductory segment to our next segment on pharmaceutical side effects along with placebos and it's about a real, this actually happened, humorous experience involving Dave and Jim who are a couple of drinking buddies and we're not condoning alcohol, here are we.
Ross Walker (12:53.219)
Yeah.
Ross Walker (13:05.955)
Nuh-uh.
Homer Papantonio (13:09.299)
Jim who were a couple drinking buddies working as aircraft mechanics in Melbourne. One day the airport was fogged in and they were stuck in the hangar with nothing else to do and Dave said, man I wish we had something to drink. Jim says, me too, you know I've heard you can drink jet fuel and get a buzz and it's quite refreshing.
Do you want to try it? So they pour themselves a couple of glasses of high octane booze and get refreshed and slightly inebriated. The next morning Dave wakes up and is surprised at how good he feels. In fact he feels so great. No hangover, no bad side effects, nothing. Then the phone rings, it's Jim.
Jim says, hey, how do you feel this morning? Dave says, I feel great, how about you? Jim says, I feel great too, you don't have a hangover? Dave says, nah, that jet fuel is great stuff. No hangover, nothing. We ought to do this more often. Yeah, well, there's just one thing, what's that? Have you farted yet? And he replies, no. And Dave replies, well, don't, because I'm in New Zealand.
Ross Walker (14:21.879)
It's one of your better ones. Can I say just on that, seeing you bring up the alcohol jokes, this guy walks into a hardware store and he says to the hardware owner, can I have a bottle of methode please? And the hardware looks at him and hang on a minute, you're that drunk from the park that just drinks methode and gets yourself written. I'm not giving you methode. And the drunk says, look, I've reformed. I've become a painter. I just need methode for my painting job.
Homer Papantonio (14:23.745)
you
Ross Walker (14:51.436)
And the hard-boiled guy feels really guilty and bad. He says, look, mate, I'm really, really sorry. Of course you can have meth, and he gives him a thing of meth, and the drunk looks at him says, can you give me a cold one?
Homer Papantonio (15:00.673)
Okay, pharmaceutical side effects. It's always intrigued me Ross, when I look on the side effect label on any drug. And for instance, just say Zoloft, right? Antidepressant, one of the side effects is depression. One of the, aren't you sort of, so...
Ross Walker (15:15.202)
Yep. Yep.
Yep, yep, yep.
Ross Walker (15:23.18)
Yeah, yeah, of course, yeah.
We did, you know, home on that, do know what you call a bunch of Maoris on Prozac? Once were warriors. Sorry. So, so anyhow, so.
Homer Papantonio (15:35.541)
God. that's always the intrigue and I'm sure the layman that looks at all these side effects, so obviously the cure can't be worse than the ailment it's trying to treat.
Ross Walker (15:45.975)
No, no, no. And look, if you read all the side effects of every drug and that Medico legally, they just have to put all the reported side effects on that, you would never take a drug. So if I line up a hundred people and give them all the same medication, 90 think I'm a genius and 10 want to throw it at me. Because there's about on average a 10 % side effect rate for all drugs. And the common side effects that are minor but can still occur
Homer Papantonio (15:54.741)
Yeah.
Homer Papantonio (16:09.302)
Yep.
Ross Walker (16:13.839)
headaches, dizziness, nausea, vomiting, diarrheal, constipation, skin rash, all of those typical things that can occur with any drug. So no matter what it is, whether it's aspirin, whether it's an antibiotic. Now, for example, we know that in almost 100 % of cases, people who are given chemotherapy for cancers will get side effects that will stop when the chemotherapy stopped. But hopefully in that case, the chemotherapy has killed what it's supposed to kill.
and the normal cells will regrow and the person will get back to normal. But most people during chemotherapy feel dreadful. But then in my specialty in cardiology, we use blood pressure drugs very commonly and about 10 % of people that take them. So for example, there's a group of drugs called ACE inhibitors, drugs such as Covacil or Tritase, people who would have heard these names, which 10 % of cases cause a dry cough.
and it's not an allergy to it, it's just what it's doing to particular chemicals in your lungs and the only way to get rid of that cough is to stop the drug and use an alternative. But the good thing about that in the management of hypertension, we have multiple different classes of drugs that don't do that. So they're very good drugs, the ACE inhibitors, unless you get the cough.
Homer Papantonio (17:33.014)
Yeah.
Ross Walker (17:35.341)
those sort of drugs can also damage kidneys. So that's why it's important that the doctors aware of the side effects tells you what they potentially could be and will do something about it and adjust and use alternatives if you get side effects. So when someone gets a side effect, it may be that the dose just needs adjusting. So for example, many of my colleagues are using very heavy doses of statins to lower cholesterol. And often they're in people that aren't an average 80,
kilo man, there's sort of 55 kilo women who are quite small and their body just can't tolerate the level of drugs, they just need to pull the dose back. But the studies say you've got to use this dose. Yes you do for the average person but not for people who aren't as big, for example. So could be too strong for that person because of their size, because of their age, we have to adjust the dose of drugs based on someone's age, their kidney function and whether they've got other diseases as well.
But here's another interesting thing, and I see this all the time. People may not be getting a side effect to the drug, but to the filler that the drug comes in. And so therefore, you've got to say to the pharmacist that you go to, okay, what fillers are being used here? Because many people, for example, are lactose intolerant. And so therefore, if you give a drug to someone who's got a lactose filler in it,
then they will get a bad gut reaction to that or sorbitol or one of these other things that are used often as fillers. And look, people say, well, why can't they just make the drug without the fillers? Well, you need the fillers to keep the drug in the state that it needs to be in so it can be digested and break down. So the fillers are vital, but not all fillers are created equal. And that's why it's
Homer Papantonio (19:17.218)
But may I say, people listening to this would be unaware that drugs have filled us in.
Ross Walker (19:24.023)
well they do. I mean, if you actually look at the side of a bottle or go to a pharmacist and say, tell me what fillers are in, often there are three or four five different things like lactose or sorbitol, different magnesium compounds, just to keep the drug in the suspension that it's necessary for it to be in to be administered. And this is the problem. It's not just a straightforward, we're giving you this pill, that's all you're getting. Also, the covering of the pill might be something else.
Homer Papantonio (19:48.993)
Yeah, so what is that? Is that plastic on capsules?
Ross Walker (19:52.812)
No, no, it's gelatin. Typically, the capsules are typically gelatin. So again,
Homer Papantonio (19:56.125)
Okay, so it's not like the plastic that you refer to as being toxic. Okay, okay.
Ross Walker (19:59.533)
No, no, no, no, no, no, no, it's totally different. But again, you might have a drug for one indication that damages healthy cells. So for example, statins are a great example here. Statins do their job. So I think the medical profession gives statins far too much power, and I think the public gives statins far too much pain. So for example, I saw a fellow who'd already had bypass surgery, and everyone who's had a bypass, a heart attack, or a stent should be on a statin if they can tolerate it.
As I say all the time, 80, 10, 10, it's only 10 % of their management. If they can't tolerate it, they're missing out on 10 % of their management. But this guy came in to see me and he said, I said, why are you here? He said, I've had bypass and my other cardiologist wants to put me on a statin and I know you're the natural cardiologist so you won't give it to me. And I go, no, that's not true. I think you should be on a statin. Why don't you want to take a statin? Why don't like the side effects? What side effects have you had? I've never had a side effect. Have you taken statins? Yeah, I've taken them.
Well, why don't you take them? Because I don't like the side effects. Where's this coming from? He's read on the internet that statins cause dementia, which they don't. That's nonsense. That they can damage your muscles, which they may do. That they can damage your brain in terms of give you memory, concentration, depression. And they do that in some people. But if they don't do it, it's another layer of protection. So.
Homer Papantonio (21:04.171)
Yeah, yeah.
Homer Papantonio (21:15.071)
Yeah, yeah.
Homer Papantonio (21:20.651)
So this is a true story. A very good mate of mine, he's lovely old fellow, he's a world 90 year old cycling champion, road cycling champion, lovely guy. I'll say his name, Freddie, his first name. Freddie goes to a GP or a cardiologist and the cardiologist puts him on statins at 90.
Ross Walker (21:29.004)
Yep, yep, yep.
Yeah, good on you, Freddie.
Ross Walker (21:40.737)
At 90, the guy's a total idiot.
Homer Papantonio (21:45.503)
He said he went off the master about six months. said, I just, don't feel good. don't know. Yeah. I don't know. What's the difference between a statin and a beta blocker? Are they? Okay. I don't.
Ross Walker (21:50.19)
But wait, why did the cardiologist put a 90-year-old on us that?
Ross Walker (21:57.038)
They're totally different drugs. Statins are to lower cholesterol. A beta blocker is to regulate your heartbeat to drop your blood pressure. Different thing.
Homer Papantonio (22:01.953)
Heart rate, okay. So it was a statin G, yeah. And he went back in the, he said I don't want him and he went off of him. But again, what's the rationale to a GP or cardiologist giving him, prescribing a statin G?
Ross Walker (22:17.967)
the rationale is very straightforward. It's ignorance of the data. There is no studies that show a benefit of lowering cholesterol in anyone who has a calcium score below 100. No benefit at all. Or if you're over 75 and you don't have cardiovascular disease, no studies have shown any benefits from statins. So I'm saying if you made it to 75 without cardiovascular disease, statins aren't even a part of this. But the thing that prompted me to want to talk about all of this stuff.
Homer Papantonio (22:21.471)
Yeah.
Homer Papantonio (22:31.179)
Yeah.
Ross Walker (22:47.041)
is not just generally talking about statins. I had an email sent to me from a woman whose brother has been, whose life has been made a misery from statin therapy because it induced a thing called peripheral neuropathy, where the statins actually damage the nerves in your hands and your feet. And this man had a very painful peripheral neuropathy and no one told him it was from the statin. And so his sister researched on the internet.
Homer Papantonio (23:01.216)
Yeah.
Ross Walker (23:14.857)
some of it's nonsense, but some of it's right. And found that there is a definite proportion of peripheral neuropathy in people taking statins. And I think it's probably about 1 % of people who take statins. It will damage their nerves to some extent. And so therefore, in that situation, I stopped the statins for three months, see if the symptoms go away. If they do go away, but they definitely need a statin, I'd start at a lower dose with ubiquinol, with a thing called alpha lipoic acid that rebuilds nerves.
and with the BJA100 that I use all the time. But what I'm saying is that sometimes these drugs can cause very, very serious side effects. Any drugs at all, not just statins, but any drugs can cause serious side effects. Might be one in 50,000 people, but if you're that one person, it's not good. So that's why the vital thing is when you start a new drug, you've got to say to your doctor, I'm on these other drugs or I'm taking all these supplements. Could you put this into your system because
Doctors and pharmacists have a system where they can compare drugs and supplements and see if there's an interaction between them all. I'd like to know what are the common side effects of what I'm taking and potentially if I get any side effects, what should we do about it in terms of alternatives? So there's a lot of things. See, I'll tell you another, this is just an anecdote, not a clinical trial, but a distant relative, not of mine, but of my brother's or a...
a relative of my brother's, was diagnosed with multiple myeloma. And she thought green tea was very good for you, which it is. So she used to have a lot of green tea, she thought that would help the myeloma. But there's a treatment for myeloma called Velcade, which is intravenous therapy, but green tea blocks its action. And she wasn't getting better, the oncologist didn't know why she wasn't getting better.
didn't even ask her about the green tea. And when she brought up the topic, he then said, you can't use Velcade with green tea. So it's just one example how one particular substance interacts with another substance. That's why everyone listening to this, full disclosure to your doctors, tell them exactly what you're taking, tell them exactly what you're eating, so the doctor can make sure. I'll give you another statin example. If you take statins, especially Lipitor and Zocor, you can't use grapefruit.
Ross Walker (25:41.295)
because the grapefruit blocks an enzyme in the liver that markedly increases the level of the statins in the bloodstream and can markedly increase risk for side effects. you just really need to have a very frank and open relationship with your doctor about all of these things.
Homer Papantonio (25:55.525)
Are you always doing that balancing act between prescribing pharmaceuticals to a patient or supplements? And you how you always draw that analogy, the bicycle and the...
Ross Walker (26:11.298)
Yeah, sure.
Homer Papantonio (26:11.745)
racing car. You're always sort of struggling on either side. Even during the pandemic, you when people said, you might have said get vaccinated and other people say, look, I want to take vitamin D and Ibometin and everything else. At what point do you say, you, or do you let the patient decide? Have there been a...
Ross Walker (26:27.438)
Mm-hmm.
Ross Walker (26:32.719)
No, give, give, it's look, doctors should be two things to people, Homer. They should be advisors and servants. We have no right to make value judgments. I saw a man the other day, lovely man, he said, doctor, I want to you I'm an anti-vaxxer. And I said to him, okay, well, I totally disagree with you, but I don't want to discuss it. We're not here to talk about vaccines. We're here to talk about your cardiovascular health. So I will respect people's opinions, whether I agree with them or not.
I'll give people the facts and then I'll often say to them, and I think this is a legitimate thing to do, if I was sitting there, this is what I'd want, this is what I would do with my knowledge. If I was sitting where you are with your condition, this is what I would take. And I think that's a legitimate thing to say to people because, I tell you, this was interesting, this happened to me about 15 years ago. I saw a patient and they said to me, the last cardiologist was there and I said to him,
what would you do if it was your mother? And he looked at the person and said that was the most offensive question I've ever been asked in my life. And I thought to myself, it's a very damn good question. It's because everyone should be treated by a doctor how they'd want their relatives treated. So it's the same thing.
Homer Papantonio (27:43.931)
The cardiologist, your colleague took offense at the question.
Ross Walker (27:46.956)
He took offense to the question from the patient, what would you do if it was your mother? I think it's a damn good question. So basically with drugs, with drugs, with supplements, with the whole thing, everything has the potential for side effects. Drugs probably 100 times more than supplements, but even supplements can cause side effects in some people, not that often. But often there is an interaction between a drug and a supplement. All the stuff I use for cardiovascular health, which we'll talk about in another podcast.
works beautifully with the drugs as well. But again, I everyone to get the impression this is 80, 10, 10. 80 % is lifestyle, 10 % drugs if you need them, 10 % supplements. So I think we should move on now to the placebo versus the nocebo effect. Because this is really, really interesting. When you think about placebo, what is placebo? Well, the definition is an improvement in illness or reduction in symptoms.
from interventions possessing absolutely no known physical effects. So basically just sugar pills. What is, well, maybe, maybe. What is nocebo? It's undesirable symptoms or illnesses from interventions possessing no known physical effects. So I'll give you a great example here. You mentioned before beta blockers and your mate, Freddy, even though he's probably on statins. So.
Homer Papantonio (28:46.945)
you
It's like a hoax-telt, isn't it? Yeah, Yeah, okay.
Homer Papantonio (29:06.849)
Yeah. Yeah.
Ross Walker (29:09.838)
30 % of men who take beta blockers can get a degree of erectile dysfunction if they're told it will happen. If they're not told, 15 % will get a degree of erectile dysfunction. So the placebo effect is very powerful when it comes to males and erectile function. As one example, many people who take statins will believe that their aches and pains are due to the statins. And when they stop the statins, their aches and pains go away.
But I don't know too many people over the age of 60 who don't have aches and pains anyhow. So a lot of these studies now where they have to have a randomized controlled trial where half the people get the active ingredient, half get a sugar pill or a placebo, even the people who are getting placebo who don't know what they're getting, they're still about up to anywhere between a...
a 10 to 30 % rate of side effects, depending on what you're, and these are in people getting sugar pills. And often the side effect rate is exactly the same as the active ingredient. So overall, the placebo effect, so I give you a pill and you think you're taking a pill that's going to help you, you have a 21 to 40 % chance, depending on which study you look at, of getting a benefit from that sugar pill. Because the brain is very powerful and there are chemicals released
through the gastrointestinal tract when you swallow a pill, even the act of swallowing something, whether it's active or inactive, can release a whole lot of powerful chemicals in the body and in the brain to accentuate a potential benefit from that pill. But equally, when you swallow a pill and you think it potentially could cause you harm, there is also an increased risk for harm with that pill that can be blocked with particular drugs because it is having a
physicochemical effects. So I just think it's really, really interesting that placebos are a very important part of the medical culture because we use them for clinical trials. And some doctors probably duplicitously do use placebos when they've got probably not much else to offer people.
Homer Papantonio (31:19.733)
So for sleeper is more...
would be or effective for psychiatric ailments.
Ross Walker (31:29.484)
No, not at all. No, no, no, no, there's no psychiatric basis to this.
Homer Papantonio (31:34.684)
But if someone, if I give you a placebo, I'm a psychiatrist or psychologist and gives you a prescriber, an anti-depressive drug to you that's a placebo, it's a placebo, it's a very subjective, if you go back to the patient, how is the same thing, what effect, placebo effect on that?
Ross Walker (31:46.316)
Antidepressant, yeah, yeah.
Yeah.
Ross Walker (31:57.998)
No, but you're making the point that it's just a psychological thing. I'm saying there's a physical reaction in your body by the act of swallowing a pill, whether there's anything active in that pill or not.
Homer Papantonio (32:09.857)
But how can you separate that physical and psychological?
Ross Walker (32:13.376)
Well, you actually can't. that's the problem. For example, I'm a great believer in supplements because a lot of the studies on supplements, there's no studies at all to show that supplements in the short term have an effect on sudden cardiac events, death, et cetera, because you need to have thousands and thousands of people getting an active or a placebo. the pharmaceutical, sorry, the supplement companies don't have enough money to sponsor those trials.
And also because it takes a lot longer for the supplements to work, it's not going to work over two or three years anyhow. But when you look at people who take supplements and you do trials on them, you can measure markers in their bloodstream that are pointers to disease. So I'll give you one example. There's vitamin E in its natural form, which is D-alpha-tocofrol.
doesn't work as well unless you combine it with vitamin C. So they're almost blood brothers. But when you look at all the trials of synthetic vitamin E, which is DL-alpha decoferol, they don't work, and sometimes they can even cause harm. But when you look at the two trials of natural vitamin E combined with vitamin C, one was called ASAP and the other one was called IVAS, both studies showed a 25 % reduction
in the progression of carotid atherosclerosis, which is a marker for you having a stroke. Now it didn't show a 25 % reduction in stroke, just in the progression of the disease in the carotid arteries. So I'm saying that's all you need for a supplement because you know at the worst with supplements, you're blowing your dough, but at the best you're getting these benefits that over many years will accumulate. So for example, the Harvard studies, the Nurses Health Study, the Male Physician Trial,
Homer Papantonio (33:45.835)
Mmm.
Ross Walker (34:09.282)
have looked at multivitamin intake over a 20 year period. And the studies in men, men who took a multivitamin every day for 20 years, and not many of those left, you're looking at one now, had a 44 % reduction in cardiovascular disease. Now that wasn't a placebo controlled trial. And it could just be that the people who go through the act of swallowing a pill are also more inclined to look after themselves better.
So no one really knows for these things.
Homer Papantonio (34:39.251)
How about this scenario? And it's very subjective. I'm big on ubiquinol, coenzyme, Q10. It is huge for, like when I race on the bike, I haven't been doing too much of it lately, but when I train hard and race hard, I know that at a certain level it kicks in. I normally have 300 to 450, sometimes 700.
Ross Walker (34:46.636)
Yeah, as am I.
Homer Papantonio (35:05.927)
Mg the ubiquinol a day and I notice a discernible difference there. It might be subjective but I know it helps. could be even psychological.
Ross Walker (35:07.757)
Yep.
Yep. Yep.
Ross Walker (35:16.302)
Well, it could be, but who cares? If you're performing better and you feel better doing it, what's the problem? And also, when you look at ubiquinol as one example, there is some very, very strong work that it does improve endothelial function, the lining of blood vessels, that it does improve muscle function, cardiac function. So there's no reason why it wouldn't be doing what you're saying it's doing.
Homer Papantonio (35:39.617)
It's a bit like Omega 3. Now, it's the truth that the heart has got more coenzyme or ubiquinol in it than any other organ. True. Well, the same with the brain and Omega 3s. It is coincidental that you feel better, think better when you take a reasonably high dosage.
Ross Walker (35:47.406)
Yeah, yeah, yeah.
Ross Walker (36:00.834)
No, but interestingly, a mate of mine called Professor Andrew Papinkas from Swinburne University in Melbourne did a study, and I say everyone should start a good quality multivitamin, which we should talk about in another podcast, a multivitamin and an omega-3 from age 30. He's done plenty of studies to show they work synergistically to improve brain function.
Homer Papantonio (36:06.539)
Yep.
Homer Papantonio (36:24.737)
Wow. So I think we can wind that up. But we missed out on controversies. Calcified arteries, behavioural change. Can we slip that in now?
Ross Walker (36:37.359)
I'll do it just quickly. was a study done out of Edith Cowan University in Perth. And they basically looked at people having DEXA scans for bone health, picking up osteoporosis. And basically men and women aged between 60 to 80 years old. On the DEXA scans, they could pick up abdominal aortic calcification. So in 50 % of the people having the study, for 12 weeks to study. But 50 % of people, they told them the results.
that they had calcification in the aorta. The other 50 % they didn't. And they gave both of them advice about diet and exercise. The people who knew they had abdominal aortic calcification were much better after 12 weeks in their diet and exercise. Now that's only three months. And as I said to you, after 12 months, 50 % of people have stopped anything. But the studies of coronary artery calcification, the thing that I introduced into Australia 25 years ago,
in conjunction with the Sydney Advanced Hospital and Dr. David Grout. I must always give them credit as well. But studies have been done beyond a doubt, showing that people who know the results of their coronary calcium score will put a much bigger effort into lifestyle if they know they've got calcification in their arteries, and also their doctors will be much more aggressive in their cholesterol lowering therapy and their blood pressure therapy. So this is just showing that information is power.
Homer Papantonio (37:37.845)
Hahaha
Yeah, yeah.
Ross Walker (38:03.693)
When you know what's going on in your body, you'll put more effort into your lifestyle and into your taking your drugs and doing everything else. So it really marries in with everything we've just been talking about with placebo and nocebo. so I think it's so important that we do screen people and find out this information and then try to influence their behaviour for their own good.
Homer Papantonio (38:25.601)
And the subject of another podcast is how you have successfully, and whether successfully reduced, if not eliminated calcification arteries.
Ross Walker (38:38.446)
Well, I haven't, no, no, no, you'll never eliminate calcification, but you can reverse it. You can certainly reverse it. yeah, that's easy. Love to talk about that. If people follow your advice, it's just that straightforward. As I said, the people who follow my advice and my practice, nothing ever happens to them. It's the ones who don't, they're the ones that have the problem. It's so straightforward, but it's just getting that into people's heads.
Homer Papantonio (38:42.337)
But you've reduced the score.
Homer Papantonio (38:46.805)
Yeah. Is it easy?
Homer Papantonio (38:57.258)
Yeah, yeah.
Homer Papantonio (39:03.009)
But is it a worthwhile pursuit to reduce the calcification? Should you just let it... Okay.
Ross Walker (39:07.456)
No, it's the wrong question, my friend. The calcification is a marker for how much fat you have. It's a worthwhile pursuit to shrink the fat down. That's what I do with my programs. I really don't care what the calcium does. I care what the fat's doing. So when I do a calcium score, I measure the current calcium score and the plaque volume, which is more an indication of fat. And then I track the plaque volume over time to see that it's shrinking. Then I know I'm winning.
Homer Papantonio (39:13.855)
Yeah.
Homer Papantonio (39:30.401)
Uh-uh.
Homer Papantonio (39:35.297)
So in my case, if I've got 240 in the one artery, whatever that is, the descending, whatever, which you can still die from.
Ross Walker (39:38.243)
Yeah.
Ross Walker (39:41.943)
left anterior to center yet.
No, not if you follow the program.
Homer Papantonio (39:47.393)
So how do you reduce that?
Ross Walker (39:52.387)
Hang on, hang on, this is a big topic, this is not the topic for today. Let's do it and I'll write it down. So we've got supplements.
Homer Papantonio (39:55.347)
Okay, okay, all right. Now we should, because every second person now is having a Colin McAlton score test and they are without the CT angiogram. Yes. Okay, so we've got some emails from listeners.
Ross Walker (40:05.888)
as they damn well should, without the CT angiogram. They shouldn't have the CT angiogram. We'll talk about that in another podcast.
Homer Papantonio (40:23.63)
episode
Homer Papantonio (40:28.513)
Sorry, I you had that.
Ross Walker (40:31.63)
Yeah, we don't have to repeat the same question.
Homer Papantonio (40:33.249)
No, I think, yep.
Ross Walker (40:36.184)
Well, just while you're doing it, I just wanted to tell you, my granddad always said, as one door closes, another opens. He was a lovely man, but he was a terrible cabinet maker.
Homer Papantonio (40:46.017)
I've only got the one and it's Kim from Burley Hits. I'm a 63 year old female, have gone through menopause but over the last two years I've had stress, severe stress. I know my cortisol levels are high. I've put on 10 kilos. Does my risk of estrogen increasing as well?
I'm concerned this could lead to breast cancer. I've started taking a herbal mixture which contains passion flower, lemon balm and rose root. So, what's that mean?
Ross Walker (41:26.798)
Yep. Look, the problem is there's a big interaction between stress and all the other hormones. But when you go through menopause, your estrogen level drops, but the progesterone drops even further. And she may be estrogen dominant, which is part of the weight gain as well. And really, there are specific things you can do in this situation. Now, it depends on how many postmenopausal symptoms she's getting.
Homer Papantonio (41:47.009)
Yep.
Ross Walker (41:55.746)
But I'm a strong believer in bioidentical hormones using a combination for women, progesterone with less testosterone, for men, testosterone with less progesterone, but no estrogen. That's the way I look at this. And that helps balance out any possible estrogen dominance. There's also some natural things you can take that are natural inhibitors of estrogen production. So there's a thing called DIM, which is I think diindole methane or something.
But that can be prescribed by a compounding pharmacist and that might be useful for her as well. again, practicing the five keys is very important. A lot of people don't have the fruits and vegetables, aren't exercising. And when you're under stress, that is rising the cortisone level. So you've got to do some things to try and damp that down. There's a few natural substances. She's mentioned some that she's taking that may help the stress. But I see stress Homer, and this is another, I wrote this down here.
Homer Papantonio (42:54.145)
You
Ross Walker (42:54.87)
another discussion for another podcast. But stress is like a stone in the shoe. You can build the shoe up as much as you like. Until you take the stone out, it's still gonna annoy you. So when you're having stress, there's only a few things you can do with it. One is put up with the stress. Two is change your attitude to the stress. Or three, walk away. And you just gotta decide which is the best way you can handle it because you should not keep putting.
Homer Papantonio (43:19.361)
It's hard for you to walk away when the stone's in the shoe. Yeah, yeah, yeah, yeah. Yeah, yeah.
Ross Walker (43:24.142)
But that's what I'm saying, you've got to take the stone out of the shoe, which is do something about the stress. And look, many people are under enormous stress, and I get that, and I'm not demeaning it at all. I'm just saying, you've got to try and do something about it work through it, if you possibly can.
Homer Papantonio (43:41.921)
There's another mate of mine, Doug, from Wakehole in Queensland. I've really been enjoying your weekly podcast. Congratulations, informative, at times funny. You are funnier than Ross. And again, I don't know how you're going to answer this, Ross. I was after some info, please. What's the multivitamin that Ross recommends? You can't say it. What it is.
Ross Walker (43:54.312)
he didn't say that. He didn't say that. Doug's a man of taste.
Ross Walker (44:07.491)
Now can't say it because the multivitamin that I think is the best, and if they send an email into us, I'm happy to give the information out, but the multivitamin I think the best has in it a fourth generation folic acid, which is the glucosamine salt of five prime methyl tetrahydrofolate and a whole lot of other balanced multivitamins within that. just everyone listening, I'm sorry, but the TGA will not allow doctors to mention
Homer Papantonio (44:14.731)
Yeah, yeah.
Homer Papantonio (44:33.366)
Yeah.
Ross Walker (44:36.846)
products, specific products publicly, because it seems like I'm endorsing that particular product, which clearly I am. And I have no association with the company that makes this product, but I just think it's the best product that has this extra, extra U-butypholic acid that we spoke about on podcast seven when we gave the MTHFR gene. people should go back and listen to that. But send an email in.
Homer Papantonio (44:58.419)
Okay. So, and again, he wants to know what the probiotic is that you recommend. Same thing. Okay.
Ross Walker (45:06.168)
Same deal. This is the same thing. I can't do it because it's a product.
Homer Papantonio (45:11.13)
But you can go on Healthy Living and talk about...
Ross Walker (45:14.912)
I can talk about the ingredients, but I can't talk about the products. Okay, I can't do it on Healthy Living. Again, if I mentioned a particular supplement on Healthy and my radio show is sponsored by Frank Caruso, who makes a lot of high quality vitamins, but I can't talk about his vitamins on the show, even though I do live reads for one or two of the vitamins every day, but I can't say.
Homer Papantonio (45:21.182)
Okay.
Ross Walker (45:42.463)
I endorse this product or you should take this product.
Homer Papantonio (45:46.027)
Yep, yep, that's great. So it's bye from me and Ross, but we've gotta plug the ultimate seriously funny wellbeing keynote package, which is ideal for conference daytime keynotes of combined Ross and I, two or three, so I go on for 70 minutes.
Ross Walker (45:55.376)
yeah, absolutely.
Ross Walker (46:04.588)
And I would stress the word go on. You definitely go on. And on and on and on. Yeah.
Homer Papantonio (46:06.721)
Yeah, yeah. Go on and on and on and then you go on and then we come back and we have a little bit of a facilitation session on a chin wag on well-being and you can ask questions, can hurl abuse, you can yeah, whatever. You can do all that. So, anyways, bye from me, home of Pat Bantonia. Thanks, ciao ciao. Bye.
Ross Walker (46:14.99)
the chin wag.
Ross Walker (46:22.176)
I know, at you, not at me.
Ross Walker (46:29.504)
And from what?
Bye.