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Human dose extrapolation featured article

Animal models used widely in biomedical research to predict toxicity, safety, and efficacy of human interventions (including drugs, nutritional components, and bioactive compounds) are complicated by differences in xenobiotic or drug metabolism between animals and humans.

These differences arise from species' physiological, anatomical, metabolic, life span, and genetic diversity. Among the more straightforward is that larger animals, such as humans, generally require smaller drug doses than a strict weight basis would predict due to differences in body surface area.

Body surface area

A simple empirical approach called allometric scaling allows a dose to be scaled and normalized based on differences in body surface area to extrapolate doses from animal science to human research, resulting in a correction factor unique to the species.

For example:

  • 10 milligrams (mg) per kilogram (kg) body weight dose in rats is divided by a correction factor...

Episodes

Posted on January 8th 2020 (over 5 years)

Dr. Rhonda Patrick on Kevin Rose Show: metformin, magnesium L-threonate, fish oil, brain health, sulforaphane, goitrogenic activity, sauna, and more.

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  • Human dose extrapolation
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    Human dose extrapolation mechanistically integrates drug-specific ADME and target-binding kinetics using physiologically based pharmacokinetic allometric scaling.

News & Publications

  • People with severe treatment-resistant depression—those who don’t respond to five or more treatments—often struggle for years, cycling through medications and therapies that fail to provide relief. Standard treatments, including neuromodulation techniques like deep brain stimulation, have limited success and carry considerable risks. A recent study found that a single dose of psilocybin, a psychedelic compound found in certain mushrooms, provided rapid and lasting relief for people with treatment-resistant depression.

    Researchers conducted a 12-week, open-label trial involving 12 adults with severe treatment-resistant depression. Participants received a single 25-milligram dose of synthetic psilocybin and met with therapists before, during, and after the dosing session to help process their experiences. Using a standard depression symptom scale, researchers assessed changes in depression severity at three weeks, with additional assessments up to 12 weeks.

    By week three, the participants' depressive symptoms had dropped markedly, with an average reduction in severity of nearly 16 points on a standard scale. These improvements persisted through week 12. However, participants with post-traumatic stress disorder experienced less benefit, indicating that having more than one neuropsychiatric condition may influence treatment response.

    This was a small study, but the findings suggest that psilocybin, combined with psychological support, could be a powerful tool for people with severe treatment-resistant depression. Larger studies may yield more conclusive results. Learn more about psilocybin in this episode featuring the late Dr. Roland Griffiths.

  • Ozempic, Wegovy, and other glucagon-like peptide-1 (GLP-1) drugs have catapulted into the mainstream of diabetes care, with more than 15 million people in the U.S. currently taking one. Evidence suggests GLP-1 drugs have many off-target effects—both good and bad—but healthcare providers don’t currently know the full extent of the drugs' effects. However, a recent analysis found that GLP-1s may reduce the risk of dementia, seizures, respiratory illnesses, cardiometabolic disorders, and certain infections more effectively than other diabetes drugs and typical care.

    Using the U.S. Department of Veterans Affairs healthcare databases, researchers identified roughly two million people with diabetes who were using a GLP-1 drug, one of three common anti-diabetes drugs (sulfonylureas, DPP4 inhibitors, or SGLT2 inhibitors), or continuing their usual care without adding new therapies. They tracked the participants' health for about 3.6 years.

    They found that GLP-1 use was associated with a reduced risk of dementia (8%), seizures (10%), respiratory illnesses (10% to 25%), cardiometabolic disorders (7% to 22%), and certain infections (12% to 25%). However, the drugs were associated with an increased risk of gastrointestinal issues (5% to 20%), low blood pressure (10%), kidney problems (10% to 15%), arthritic disorders (10% to 16%), and pancreatitis (15% to 20%).

    These findings suggest that GLP-1 receptor agonists offer promising benefits for people with diabetes while highlighting potential risks. Further research will illuminate the full range of the drugs' effects. Learn more about GLP-1 drugs in this clip featuring Dr. Rhonda Patrick.

  • Cannabis use during adolescence has profound effects on critical cognitive functions, particularly sustained attention—the ability to focus on a task over time. A recent study found that problems with sustained attention in early adolescence may predict increased cannabis use later in life.

    The study involved more than 1,000 participants, starting at age 14 and continuing until age 23. Researchers measured the participants' attention performance and brain connectivity throughout the study. They also monitored their substance use over time to uncover long-term patterns.

    They found that poor sustained attention at age 14, in conjunction with weaker connectivity in attention-related brain networks, predicted higher cannabis use in young adulthood. Differences in these brain networks were stable over time, and the findings were consistent when tested in an external group of participants.

    These findings suggest that sustained attention and its underlying brain networks serve as reliable early markers of susceptibility to cannabis use. Cannabis use may disrupt the delicate balance of brain chemicals like dopamine, a neurotransmitter critical for attention and motivation. Learn how to improve attention by leveraging the effects of dopamine in this episode featuring Dr. Andrew Huberman.

  • Rapamycin, a compound initially discovered as an antifungal agent, has garnered considerable interest in longevity research due to its ability to inhibit mTOR, a protein that plays a critical role in cellular growth and aging. Studies in animal models have demonstrated rapamycin’s potential to extend lifespan and improve healthspan. However, translating these findings into human applications has proven complex, as substantial risks often accompany the benefits.

    Bryan Johnson is an internet personality who has made a name for himself by talking about his sometimes extravagant n=1 biohacking attempts to reverse aging. Recently, Johnson announced a reversal on his position on rapamycin: He thinks it might be making him age worse.

    Johnson tested various rapamycin dosing protocols to explore its anti-aging potential while minimizing adverse effects. These protocols included weekly doses of 5, 6, and 10 milligrams, biweekly doses of 13 milligrams, and an alternating weekly schedule of 6 and 13 milligrams.

    Although data from preclinical trials were promising, Johnson concluded that the long-term use of rapamycin in humans does not outweigh its drawbacks. Side effects, including intermittent skin and soft tissue infections, impaired lipid metabolism, elevated glucose levels, and increased resting heart rate, persisted regardless of dosage adjustments. After ruling out other potential causes, he attributed these issues to rapamycin and ultimately decided to discontinue its use.

    Other research supports his observations, demonstrating that chronic rapamycin use can impair lipid profiles, induce insulin resistance, and contribute to glucose intolerance and pancreatic beta-cell toxicity. While anecdotal evidence suggests that rapamycin may slow tumor growth, its suppression of natural killer cells raises concerns about impaired immune surveillance and potentially increased cancer risk over time.

    Further complicating the picture, a recent pre-print study presented new findings about rapamycin’s effects on aging. The study assessed the effects of rapamycin across 16 epigenetic aging clocks and found that it accelerated aging markers in humans. This analysis is noteworthy because most assessments have relied on only one or two aging clocks, raising concerns about the reliability of the findings.

    As Johnson notes, longevity research is a rapidly evolving field that requires continuous scrutiny of emerging studies and biomarkers. For now, his experience underscores the importance of balancing potential benefits against risks when exploring experimental compounds like rapamycin. Learn more about rapamycin in our overview article.

  • Cannabis use is prevalent among teens, whose brains are undergoing massive developmental changes. Evidence suggests that THC (tetrahydrocannabinol), the primary psychoactive ingredient in cannabis, has profound effects on the brain, impairing neurodevelopment. A recent study in mice found that adolescent cannabis use influences gene expression and neural connections, potentially altering the brain’s structure.

    Researchers exposed adolescent male mice to THC and then analyzed changes in gene expression and brain cell structure within the cerebral cortex—a brain region responsible for memory, thinking, learning, reasoning, problem-solving, emotions, consciousness, and sensory functions. They also scanned the brains of more than 450 adolescent human males to compare the cerebral cortex thickness of those who tried cannabis before age 16 to those who did not.

    They found that adolescent mice exposed to THC exhibited less dendritic branching and fewer neural spines, indicating a loss of complexity in brain cells. Similarly, human teens who used cannabis had thinner cortex regions. Further analysis linked these structural changes to genes involved in brain development, including processes like learning and memory.

    These findings suggest that early cannabis exposure interferes with the normal development of brain structure, especially in areas critical for learning and emotional regulation. This interference likely occurs through effects on specific genes and brain cells responsible for building neural connections during adolescence.

    Teens aren’t the only ones at risk for the harmful developmental effects of THC exposure—the compound can pass into breast milk, influencing an infant’s neurodevelopment. Learn more in this clip featuring Dr. Rhonda Patrick.

  • Genes play critical roles in determining how long a person lives, but a new study suggests that the secret to longevity may be as simple as “food as medicine.” Centenarians—people who live 100 years or more—typically eat healthy, balanced diets and require fewer medications than their shorter-lived peers.

    Researchers analyzed studies examining the lifestyles, medication use, and overall health of centenarians and near-centenarians aged 95 to 118. Their analysis included 34 studies and involved more than 59,000 participants.

    They identified several healthy lifestyle habits of long-lived adults: Engaging in regular physical activity Avoiding alcohol and tobacco Adhering to a diverse, macronutrient-balanced diet Preferring less salty foods Using few medications—with just over four taken daily, primarily blood pressure medicines or other cardiovascular drugs

    Multiple drug use—known as polypharmacy—is common in older adults. Defined as taking more than five medications daily, polypharmacy is linked with many adverse health effects, especially among older adults, who are at risk of a “prescription cascade”—where the side effects of drugs can be misdiagnosed as symptoms of another disease, creating a vicious cycle of more drug use.

    This analysis suggests that using food as medicine—through healthy, balanced diets—combined with lower drug use contributes to healthy aging and longevity. Learn how other healthy lifestyle behaviors like exercise and dietary supplementation also promote longevity in this episode featuring Dr. Rhonda Patrick.

  • Cocaine affects nearly every organ system in the body, including the gastrointestinal system, drastically altering the gut microbiome. It also increases dopamine levels in the brain, creating a memory of the dopamine reward and strengthening the association between the drug and the pleasurable feelings it produces. A recent study in mice found that cannabidiol, a non-psychoactive compound in marijuana, restores the gut microbiome in cocaine users, reversing memory-associated cocaine addiction.

    Researchers gave adult mice either cocaine + placebo or cocaine + cannabidiol. They collected fecal samples before and after the drug treatments to analyze changes in the gut microbiome.

    They found that the mice that received cocaine + placebo developed a strong preference for environments where they received the drug that lasted even after its cessation, indicating they had a memory of the reward. These mice also experienced long-lasting reductions in their gut microbial diversity. However, the mice that received cocaine + cannabidiol showed a reduced preference for the cocaine-associated environment after drug cessation and exhibited greater gut microbial diversity, with more beneficial microbes and fewer harmful ones.

    These findings suggest that cannabidiol reverses changes in the gut microbiome caused by cocaine and helps reduce the memory of cocaine’s rewarding effects. Beneficial activities like exercise and hard work also boost dopamine levels but without the massive peaks associated with cocaine use. Learn more in this clip featuring Dr. Andrew Huberman.

  • Antidepressant use is increasing worldwide, especially in high-income countries. However, roughly 30 percent of people taking the drugs are resistant to their effects. A recent systematic review and meta-analysis found that people with depressive symptoms who took psilocybin were two times more likely to respond to treatment than those not taking the drug.

    Researchers analyzed the findings of randomized clinical trials that evaluated the effects of psilocybin therapy on depressive symptoms. They included nine studies involving 436 patients in their analysis.

    They found that participants taking psilocybin were two times more likely to respond to treatment than those not taking the drug, especially among those with secondary depression, which can arise due to another medical or psychological issue. Participants experienced few adverse effects, and most were mild and transient. Interestingly, those who had used psychedelics before experienced greater symptom relief, possibly due to “expectancy bias” – a phenomenon where a person’s previous experience makes them expect positive results.

    These findings suggest that psilocybin exerts potent antidepressant effects. Although the treatment response was high, the review’s authors graded the quality of the evidence as “low” due to heterogeneity among the studies, including dose and concomitant psychotherapy.

    Psilocybin is a psychedelic compound present in mushrooms. Learn more about the effects of psilocybin and other psychedelic drugs in this episode featuring Dr. Roland Griffiths.

  • Statins are among the most widely prescribed drugs in the U.S., with more than 92 million users reported in 2018. Although the drugs are generally effective, nearly 22 percent of statin users with cardiovascular disease will experience a major adverse cardiovascular event within five years of drug initiation – a phenomenon known as “residual risk.” Findings from a recent meta-analysis indicate that combined statin-omega-3 therapy markedly reduces the risk of major adverse cardiovascular events and improves lipid and inflammatory markers.

    Researchers analyzed the findings of 14 randomized controlled trials involving more than 40,000 participants. The trials investigated links between statin use, omega-3s, and the risk of cardiovascular disease and related death. Omega-3 doses varied, ranging from 930 milligrams to 4,000 milligrams daily. However, most studies provided a dose of 1,800 milligrams daily.

    They found that combined statin-omega-3 therapy reduced the residual risk of experiencing myocardial infarction (heart attack) by 28 percent, a major adverse cardiovascular event by 15 percent, angina (chest pain) by 25 percent, and hospitalization for angina by 25 percent. Those receiving the combined treatment also experienced decreased cholesterol, triglycerides, and hsCRP (a marker of inflammation). However, the combined therapy did not reduce the residual risk of fatal and non-fatal stroke, coronary revascularization, and cardiovascular disease-related death.

    These findings suggest that combined statin-omega-3 therapy reduces the residual cardiovascular risks associated with statin therapy alone. Learn more about statins in this episode featuring Dr. Peter Attia.

  • Statins comprise a large class of drugs that lower blood cholesterol levels by blocking the production of an enzyme involved in cholesterol synthesis. Although statins are generally well tolerated, as many as 10 to 20 percent of people taking the drugs experience complications, including myopathy (muscle damage), liver damage, and cognitive problems. A recent study found that atorvastatin, a commonly prescribed statin, reduces muscle cells' energy production.

    The study involved eight inactive but otherwise healthy adults with overweight who took a high dose of atorvastatin (80 milligrams) daily for 56 days. Researchers collected muscle samples from the participants before they took the statin and then again after 14, 28, and 56 days to assess their muscle cells' capacity for energy production.

    They found that over the 56 days, the muscle cells' ability to produce energy via oxidative phosphorylation diminished by more than 30 percent. Additionally, the muscle’s capacity to use oxygen, a key indicator of cardiorespiratory fitness, dropped by as much as 45 percent. The study investigators attributed this decline to the statin’s inhibition of specific components (complexes III and IV) within the mitochondria that are vital for energy production.

    The findings from this very small study shed light on how high-dose atorvastatin therapy can significantly reduce the energy production in muscle cells, driving a decrease in muscle and aerobic fitness. They also underscore the importance of further research in larger groups to balance the health benefits of statins with their potential effects on muscle function. Learn more about statins in this deep-dive discussion with Dr. Peter Attia.

  • Nearly 25 million adults living in the United States take antidepressant medications. Unfortunately, 10 to 30 percent of those taking antidepressants are resistant to the drugs' effects. A recent systematic review and meta-analysis found that patients with depression who took psilocybin were more than three times more likely to experience remission than those who didn’t.

    Researchers evaluated the findings of randomized clinical trials and open-label trials that evaluated depression symptoms among patients diagnosed with life-threatening illnesses or major depressive disorder after receiving psilocybin therapy. They included nine studies involving nearly 600 patients in their final analysis.

    They found that participants taking psilocybin were more than twice as likely to have a positive response to therapy than those not taking the drug. They were also more than three times more likely to experience symptom remission.

    These findings suggest that psilocybin exerts potent antidepressant effects when used with psychotherapy. Several non-pharmacological adjunct therapies have demonstrated effectiveness in modulating the symptoms of depression, including exercise, dietary modification, meditation, sauna use, and light therapy. Learn more about these approaches in our overview article on depression.

    Psilocybin is a psychedelic compound present in mushrooms. Learn more about the effects of psilocybin and other psychedelic drugs in this episode featuring Dr. Roland Griffiths.

  • Graying hair is a cardinal sign of aging, typically beginning in a person’s fourth or fifth decade. Nutritional deficiencies, including low intake of protein, vitamin B12, iron, and copper, can contribute to premature graying. However, a recent review found that some medications may promote gray hair re-pigmentation.

    Researchers reviewed 27 studies and case reports of medication-induced gray hair re-pigmentation, totaling 133 patients. They categorized the various drugs as anti-inflammatories, stimulators of melanogenesis (the production of melanin, the pigment responsible for hair, skin, and eye color), vitamins, medications that accumulate in tissues, and those with an undetermined mechanism. Then, they ranked the quality of the evidence for each study or report.

    They found that medications that reduce inflammation or stimulate melanogenesis can promote diffuse re-pigmentation of gray hair. They also found that vitamin B complex supplementation may contribute to the darkening of gray hair, but they cautioned that evidence supporting this finding was weak.

    These findings suggest that certain medications induce gray hair re-pigmentation. Although these drugs aren’t presently recommended for treating gray hair, their mechanisms provide insights into potential targets for future medications aimed at hair re-pigmentation.

  • From the publication:

    Firstly, according to the reviewed data from preclinical studies, SSRIs affect to a greater extent, both testosterone and estrogen serum levels compared to the rest of drug classes (Tables 1 and 3). In particular, more than 50% of the reviewed publications report changes in testosterone and estrogen levels after SSRI administration. The same conclusion cannot be drawn from the comparatively fewer studies that investigated other classes of monoaminergic antidepressants. Secondly, data indicated differences between acute and sub-chronic or chronic drug administration on testosterone and estrogen levels. On the one hand, acute antidepressant treatment either decreases or does not affect testosterone and estrogen levels. On the other hand, data from sub-chronic and chronic antidepressant treatment are conflicted, probably due to variable treatment duration and differences in the time and method of sampling. Furthermore, from our reviewed data it appears that testosterone levels are more frequently affected by antidepressants in comparison to estrogen. More specifically, the majority of studies found no changes in estrogen levels following drug administration, whereas the rest of the studies reported either increased or decreased levels of testosterone in both males and females (Tables 1 and 3). Unfortunately, inconsistencies in methods, i.e., inclusion of both sexes, doses, age, duration, and strain, as well as the technical difficulties in measuring low and variable estrogen levels account for the conflicting data and impede any firm conclusions.

  • From the article:

    According to the univariate analysis, significant predictors of aneurysm growth included a patient’s history of ruptured aneurysm, drug abuse, hypertension, and polycystic kidney disease. There was an association between both aspirin use and one type of treatment, stent-assisted coil embolization, and a lower rate of aneurysm growth. In the multivariate analysis, the independent factors associated with aneurysm growth were again patient’s history of ruptured aneurysm, drug abuse, hypertension, and polycystic kidney disease. Only aspirin use proved to be associated with a significant decreased rate of aneurysm growth.

    On the basis of the statistical analyses, use of aspirin appears to exert a protective effect against aneurysm growth and very likely against future rupture.

    The authors point out that their findings are observational and that future, interventional studies should be conducted.

    View full publication

  • From the article:

    Oestrogen helps maintain the structure of blood vessel walls by promoting the division of endothelial cells within the vessel walls, which is important for repair if the vessels become damaged. However, oestrogen levels drop significantly at the menopause.

    Women have been shown to be more likely to develop a cerebral aneurysms after the age of 40 years, and aneurysms are most likely to rupture between the ages of 50 and 59 years.

    The authors asked 60 women with cerebral aneurysms about their use of the oral contraceptive pill and hormone replacement therapy, and this was compared with usage in 4,682 other women drawn from the general public.

    Women with cerebral aneurysms were found to have been significantly less likely to have taken oral contraceptives or hormone replacement therapy. Women with cerebral aneurysms also had an earlier average age of menopause.

    Previous studies have shown that use of the oral contraceptive pill protects against haemorrhagic stroke in later life, while women who start their periods early and/or do not have children are at greater risk.

    View full publication

  • Cystic fibrosis is a progressive, genetic disease that causes persistent lung infections and limits a person’s ability to breathe over time. The average life expectancy of a person with cystic fibrosis is approximately 37 years. Findings from a recent clinical trial indicate that a new drug may help manage the symptoms of the disease and extend their lifespan.

    The phase 3, randomized, double-blind, placebo-controlled trial involved more than 400 people aged 12 years and older who have cystic fibrosis. Participants were randomized to receive either the new drug, commonly known as Trikafta, or a placebo for 24 weeks.

    At the end of the 24-week period, the participants' lung capacity was measured. Those who received the Trikafta scored 14.3 points higher on lung function tests, were 63 percent less likely to have worsening of symptoms, and had better quality of life compared to those given a placebo. Trikafta was considered safe and elicited few, mild side effects.

    The drug works by targeting the underlying genetic mutation that causes the most common form of the disease.

  • The senolytic drug combination of dasatinib and quercetin cleared senescent cells from obese mice in a study by researchers at the Mayo Clinic in Rochester, Minnesota funded by NIA. When the senescent cells were removed, cell growth resumed in the brain regions involved in that process, also known as neurogenesis, and obesity-related anxiety behavior decreased.

    Abstract cellsOver time, accumulation of senescent cells may slow or stop cell regeneration and tissue maintenance, thus contributing to tissue aging.

    Clearing senescent cells from the brain and other tissues can delay, prevent, or alleviate multiple age-related disorders.

    The combination of dasatinib and quercetin was recently shown to prevent cell damage, delay physical dysfunction, and, when used in naturally aging mice, extend their life span.

    The researchers sought to determine whether anxiety-like behavior in obesity can be caused by increased senescent cell burden.

    When the senescent cells had been eliminated from the mice brains, anxious behavior decreased and new nerve cell growth in the brain was detected.

    The scientists note that the data show that senescent cells play a role in causing impaired cell growth due to obesity.

  • Phthalates were 35% higher in participants who had eaten out the previous day compared with those who ate at home.

    Phthalates are ubiquitous in plastic products yet I have not phthalates listed on consumer product labels. Unfortunately, I’m not sure if it is required to be listed.

    In 2013, a randomized trial with five families that involved dietary replacement with organic foods that lacked plastic packaging found that phthalates increased 2000% during the trial because the chemical was found in organic imported spices and dairy products.

    Other studies have found that phthalates are excreted through sweat suggesting that forced perspiration such as from exercise and/or using a sauna or other types of heat stress may be a good way to eliminate these potentially harmful compounds.

    Link to 2013 phthalate trial: https://www.nature.com/articles/jes20139

    One excretion study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504417/

  • [Abstract]

    A few commonly used non-antibiotic drugs have recently been associated with changes in gut microbiome composition, but the extent of this phenomenon is unknown. Here, we screened more than 1,000 marketed drugs against 40 representative gut bacterial strains, and found that 24% of the drugs with human targets, including members of all therapeutic classes, inhibited the growth of at least one strain in vitro. Particular classes, such as the chemically diverse antipsychotics, were overrepresented in this group. The effects of human-targeted drugs on gut bacteria are reflected on their antibiotic-like side effects in humans and are concordant with existing human cohort studies. Susceptibility to antibiotics and human-targeted drugs correlates across bacterial species, suggesting common resistance mechanisms, which we verified for some drugs. The potential risk of non-antibiotics promoting antibiotic resistance warrants further exploration. Our results provide a resource for future research on drug–microbiome interactions, opening new paths for side effect control and drug repurposing, and broadening our view of antibiotic resistance.

  • Hi Rhonda, my wife takes pain medication pretty regularly (at least a 2 in a day a couple of times a week) for headaches and in Joe Rogan’s podcast i heard you mention the negative effects of ibuprofen… Strokes etc…

    I was wondering what you would recommend as a substitute to this issue? I was figuring curcumin could be a possibility. Also, i had an thought about the regular use of pain medication for something like a headache and whether or not regular use could increase the likelihood of headaches. If there is any basis in fact for my thoughts i’d be interested to know as i haven’t really done any research on this.

    Some things to note: She takes contraceptive pills and skips the sugar pills as to not get her period - I feel this is a terrible idea but she won’t listen to me. If you have insight on this, either relating to the original question or as a side note i’d be interested to know your take on it

    Her nutrition is decent. She eats a lot of fruit, nuts, fish and vegetables and takes daily vitamin supplements (fish oil, D3, multi’s, glucosamine, and a few others).

    Cheers Rhonda :)

  • Multiple studies have now linked chronic use of these painkillers with an increased risk of heart attack and stroke. They mechanisms appear to be mediated through the inhibition of an enzyme known as Cox 2. There have been a couple of mechanisms investigated in animal studies. First, NSAIDs have been shown to inhibit the production of a molecule called prostacyclin that relaxes blood vessels and “unglues” platelets. Second, they have been shown to inhibit the production of nitric oxide (which cox 2 also regulates to some degree).

    Other studies have shown that people taking 2 grams of phytosomal curcumin (called Meriva) had pain reduction equivalent to 800 mg of ibuprofen.

    To hear a longer discuss surounding NSAIDS and heart attack risk, as well as the relevance of curcumin in pain-relief make sure to check out JRE#773 or, more recently, Tim Ferriss Show #237 where both topics are discussed.

  • Safety risks are defined as those that lead to withdrawal from the market due to safety concerns, a boxed warning, or FDA issuance of a safety communication. The median time for an FDA action to pose new safety risks or withdraw a drug after the drug already hit the market was 4.2 years after approval. The problem is that many clinical trials used for FDA approval involve fewer than 1,000 participants with follow-up of 6 months or less! Long-term side effects often crop up years later after drugs have been used by much larger numbers of people. Another part of the problem is that clinical trials often cherry-pick participants likely to produce the best results, which is not representative of the entire population. One out of three drugs posing safety concerns after they have been deemed safe is alarming. It seems as though the process of approving drugs needs to be revised including more comprehensive clinical trials with a longer follow-up and more participants. Since it takes the FDA about 4 years to identify safety concerns after a drug has been on the market, perhaps a clinical trial investigating a new drug needs a follow-up of 4 years to determine how safe it is in the first place.