Preventive Medicine Tips

08/08/2025

Does Lithium Deficiency cause Alzheimer’s Disease? I break down the big paper that is Everywhere this week!

07/12/2025

My latest Modern Medicine Podcast with Hematologist Dr Jon Croopnick. We talk about Blood tests you need, vegetarian diets and the future of Cancer treatment! Also RFK, exercise and pre diabetes and Ma*****na and Heart Risk. Subscribe to the channel and Please like share or comment below! Thanks- Dr. Teehan

https://www.facebook.com/61569041794468/posts/12214118765063472

The guest is Dr. Jonathan Croopnick, a hematologist and oncologist. He talks about cancer treatment advancements, the effectiveness of complete blood counts ...

03/19/2025

Legal or not, let’s stop calling Cannabis healthy.

The picture being painted by the ever expanding body of literature regarding Cannabis’ adverse effects on health continues to look bleaker with a new paper to be released next month in the Journal of The American College of Cardiology. This paper is set to deal another blow to this narrative by detailing substantial adverse effects on the heart including an almost 600% greater risk of heart attack in young Cannabis users versus non users .

Already there is an exponentially growing encyclopedia of studies supporting the adverse neuropsychiatric impact of even modest Cannabis use that seems to grow by the week. And while there are still many questions, no one that has been paying attention should be surprised by the steady stream of papers supporting even modest Cannabis use can lead to serious adverse neuropsychiatric outcomes, major and minor mental illness and structural and functional changes to the brain (in essence brain damage.)

Now In recent months there has been numerous papers that continue to support adverse Cardiovascular outcomes caused by use of the recently legalized in many places drug. The yet to be officially released paper titled "Cannabis Use and Risk of Myocardial Infarction" adds even more strength to the growing literature showing that Cannabis use is as bad for the heart as it is for the brain.

Researchers retrospectively looked at data for almost 5 million healthy individuals under 50 for 8 years and after excluding those with known confounders (like hypertension, diabetes, high cholesterol and to***co use) found that Cannabis users had over 600% greater chance of having a heart attack compared to a cohort of similar non cannabis users. There was also a 430% greater chance of having an ischemic stroke as well as substantially higher rates of Major Adverse Cardiovascular Events, Heart Failure and All Cause Mortality.

The authors based out of Boston Medical Center comment that the study supports that Cannabis “appears to pose a substantial and independent risk” for the noted outcomes even in a young population without traditional risk factors for heart disease.

The findings in this paper continue to debunk the absurd and unscientific notion that Cannabis use somehow promotes health. Any substance with a body of literature detailing these sort of harms on the heart (and also the brain) should not be mass marketed to the public as being healthy or supporting a healthy lifestyle. Individuals that choose to legally use Cannabis should do so being well aware of the potential harms just like with to***co and alcohol.

A few interesting observations about this paper:

(1) The authors identified Cannabis use based on the presence of ICD-10 codes in patient charts for Cannabis use disorder. This could lead to something called exposure misclassification, a phenomenon where the exposure in a study is underestimated . The authors comment on this in the discussion. It is my experience (and practice in clinic) that only extremely heavy cannabis users would get this diagnosis added. It is quite possible that many users in the non Cannabis group used Cannabis, but not to the level to merit the diagnosis from their doctor. This type of misclassification would bias to the Null and UNDERESTIMATE the strength of the association because it Is likely the non Cannabis group included some Cannabis users . (You can read more about when doctors would code for CUD here: https://www.aafp.org/pubs/fpm/blogs/inpractice/entry/marijuana_use.html)

(2) The study does not attempt to quantify cannabis use only define it as a yes or no, so no dose response relationship can be ascertained based on these methods. It is safe to say that these strong associations are most applicable to regular, heavy users (individuals who use several times a week). While it is clear in this paper that individuals who use Cannabis daily or near daily appear to have substantially higher risk of stroke or heart attack, it remains unclear how these findings might relate to less frequent users. In addition to being unable to ascertain if there is a dose response relationship, it is also unclear based on this paper if there is a threshold effect (i.e a level of frequency of use that does not pose risk to the heart).

(3) The strength of the observed risk in this paper is jaw dropping. The take home from this paper is that regular Cannabis use leads to a 6x greater risk of heart attack and a 4.5x greater risk of stroke. To put this in context it is widely held that that relative risk for to***co use for heart attack is somewhere around 2.5-3.0. Will further studies support that regular Cannabis use is twice as dangerous for the heart as to***co? It is improbable to explain away an association this strong with confounding, bias or methodologic flaws.

(4) The study does not distinguish between smoking Cannabis or other delivery methods, such as edible products. It seems easy to imagine why smoking Cannabis would cause heart disease, but is harder to conceptualize that eating it would do so. Could THC itself directly manifest atherosclerosis? This study does not distinguish whether eating or smoking is any safer. Individuals should assume the risk applies to all delivery methods.

The bottom line about all this is that following the science means exactly that. An effective legal Cannabis system must be based on accurate scientific information regarding likely adverse health consequences available to the consumer. Otherwise we are creating another public health crisis.

Much like with to***co and alcohol years of clever product placement in popular culture has lead to wide misperceptions about the health effects of Cannabis use. The idea that Cannabis is a harmless plant continues to be refuted by science. The truth is legal or not we are seeing a substance with real health consequences to the brain and the heart, among other places. That information, just like with alcohol, to***co, tanning beds, hot dogs, PFAS and pretty much anything else that poses health risks must be conveyed to the public

Here is a link to the pre publication paper: https://www.sciencedirect.com/science/article/pii/S2772963X25001152?via%3D

03/13/2025

Interested in Medicine?

Check out EPISODE 3 OF THE MODERN MEDICINE PODCAST with Dr. Dennis Teehan MD MPH

In the News.......
Why is this such a bad flu season?
Measles is no joke: what is driving outbreak in Texas?
Insurance companies taking huge financial losses on Ozempic
NIH Cuts threaten science and innovation

We chat with Former Mass Biotech CEO and current Board Member Robert Coughlin about the future of biotech in medicine

Clinical Case of The Week: A Wild Goose Chase!
Non Medicine Topic of the week: The Gardner Museum Heist
And MORE on this month's Modern Medicine Podcast!

The guest is Robert Coughlin, former CEO of the Mass Biotech Council, joins to shed light on the importance of NIH funding for medical research and the impac...

09/07/2024

Hello to All! This page which I created years ago has been silent for a while. It is time to change that! I am changing the name of this page to "The Modern Medicine Podcast." As a practicing P*P with 10 plus years experience I plan on recording a monthly podcast with several updates on this page a week. We are going to dissect all aspects of the experience in Modern Medicine. From cutting edge analysis of scientific literature to reports from my experiences on the day to day front lines of medicine: The uplifting Patient stories. The Insurance Company nightmares. The crazy things Drug Company reps say and do to get our interest. And everything in between! This will be a page for anyone interested in all aspects of Modern Medicine that will delve into the day to day experience of what it is like to practice medicine in America in 2024. Like, share, follow and stay tuned!

Wishing you all great health! Best- Dr. Dennis Teehan MD MPH

05/24/2020

Good evening. This is from my personal fb page about situation in Massachusetts. Thought I would share. My best to all- Dr. Teehan

A word about our future path. The average age of a covid death in Massachusetts in 82. The average age of a diagnosed covid case is 52. The average age of a Massachusetts resident is 40. What does this imply about our data about covid-19 and the future path? It tells us that we have disproportionately identified older and sicker cases from the spectrum of infections. To use an analogy I made many months ago, identified cases are the tip of the iceberg. We are seeing that this tip is the minority of infections (which I had long speculated) and now we see it is demographically skewed vs the general population, to such extent that the entire iceberg is probably skewed. The below link is a news article in Globe about a study that estimates the true prevalence of covid-19. It puts the number at about 900,000 cases, far above the 91,000 that have been diagnosed (I have consistently estimated we have underdiagnosed covid by a factor of 8-12). This equates to around 13% of the population in state. This tells us the infection fatality rate while still devastating is far lower than feared. However, To accurately estimate the true IFR and therefore make projections about the cost of herd immunity and the future is more complicated than simple multiplication to reach 70% of the population. The challenge is to account for the demographic differences in age between the observed cases (the iceberg now) and the general population (the iceberg when 4.5 million people are infected leading to herd immunity).

For example, the disease ravished our nursing homes and elderly and sick. Of the 91000 identified cases 19,000 came from nursing homes. Of the 6300 deaths a GHASTLY 3900 have come from long term care facilities. The 900,000 or so that have been infected thus far in a Massachusetts probably do not reflect demographics of the general population. For sure those 900,000 infections of the overall iceberg are far younger and healthier than the 90,000 identified cases that represent the tip of that ice berg. But those initial 90000 cases come from some of our oldest and sickest residents and there are only so many in that population. They have been hit so hard in the first cycle of the pandemic that they are probably weighing down the remaining 900000. It is likely that The 6 million Massachusetts residents who have not been infected are healthier and younger than the 900000 people who got the disease already, if only because the pandemic ravaged health care and l long term care facilities disproportionately.

These demographic differences have to be accounted for. How accurately a Model factors this in is a major contributor to the accuracy of its projections! Who those 4.5 million remaining infections are based on age general health and presence of chronic disease/known risk factors will be a major factor in number of deaths. This is because we know the risk of dying from Covid is literally orders of magnitude (aka severe multiples of ten) larger or smaller between different segments of the population. Hypothetically 4.5 million healthy non obese people under 60 without diabetes, hypertension or other serious medical problems may experience only a few dozen deaths to reach heard immunity. In Massachusetts there have been 310 deaths under 60 amongst 58,000 cases, which probably equates to around 600000 infections. Assuming that 98% of deaths have identified medical risk factors, a path to herd immunity in a totally healthy young population under 60 would probably kill around 30 or so people. Of course this is unrealistic because demographically any population in Massachusetts of that size has many older and sicker people (not to mention a third of us are obese and about 12-15% diabetic). Whereas a population of 4.5 million sick, elderly diabetic nursing home patients would probably experience several hundred thousand deaths. So How a model projects these demographic differences is critical to what it projects and Any estimate of the true IFR of covid-19 must account for these demographic differences. Since no one knows the true answer all projections are subject to be wrong.

04/23/2020

I have not posted on this page in a while, but I wrote this on my personal page and thought I would post it up here. Food for thought, you could say. Regards- Dr. Dennis Teehan MD MPH

Viruses come and viruses go. The history of life on earth is woven with evolutionary dance of predator and prey. The game of biology is such that when the prey is vulnerable the predator will strike and ultimately thrive. For our current situation with the Covid-19 virus we humans are the prey and the question becomes not only why the virus is such a powerful and effective predator but also why is that happening now?

The Covid-19 is a virulent and powerful enemy. It is likely a pathogen like this would extract its toll at any time in human history. But I don’t think the timing of the current pandemic is entirely an accident either. For years we have heard about the health dangers of the western lifestyle. Obesity, diabetes, hypertension and a sedentary lifestyle all contributing to health risks and some murky concept known as “Chronic Inflammation.”

There is still so much to learn about inflammation and how it contributes to disease processes. When I did my masters in public health, I was lucky to learn from some of the best nutrition scientists in the world about the poorly categorized but powerful relationships between the foods we eat and the way we live and the regulation of our bodies immune system. I had always been a believer in the importance of lifestyle, but even I was shocked to learn that the food we eat and how we live can literally lead to the up or down regulation of potent components of the immune response and profoundly effect our bodies ability to fight disease and heal itself..

We are beginning to learn that Covid-19 preys most strongly on those with chronic illness and the obese. Obesity itself is a powerful influencer of the immune response and we have observed that the outcomes for Obese individuals with Covid-19 are far worse. One NYU study found obesity was the biggest predictor of hospitalization in Covid-19 patients. We also know that other chronic illnesses like Diabetes and Hypertension are powerful predictors and these too are likely contributors to chronic inflammatory states.

A 2017 study in the Archives of medical science found that fat tissues leads directly to the up regulation of of two inflammatory mediators known as interleukin-6 and tumor necrosis factor alpha. This leads to a proinflammatory state and leads to increased stress and damage to cels. IL-6 also induces the liver to produce an inflammatory protein known as CRP, which is known to correlate with increased risk of cardiovascular disease.

We know that inflammatory response is a huge part of the disease process in Covid-19. In fact MGH researchers last week began a clinical trial looking at a medication that blocks IL-6 as a treatment pathway in critically ill Covid patients.

We also know that exercise is a key component of how our bodies regulate inflammation. One recent study from University of Virginia noted that regular exercise leads to increased level of a powerful anti-oxidant known as Superoxide Dismutase. Further research shows that increased levels of this enzyme predict better survival in individuals with Acute Respiratory Distress Syndrome (The study did not specifically look at Covid patients with ARDS).

On a virologic level, we know that the Covid virus enters human cells through a receptor known as the Ace2, which is long known to be upregulated in chronic inflammatory states. To be fair, there are probably also genetic differences in amount of receptor as well.

The link between nutrition, exercise and inflammation is the cutting edge of science. We don’t have all the answers yet. But As much as Covid-19 is a deadly predator under any circumstances we are remiss if we don’t acknowledge that Covid-19 is somewhat a disease of the Western lifestyle and the missing link is how our lifestyle affects our immune response.

In this case A deadly pathogen arose as has happened since the beginning of time and we as a species now with a huge percentage of us with dysregulated immune systems from obesity, a sedentary lifestyle and chronic illness were the ideal prey for it. It seems the very ability of the virus to enter our bodies is dependent on the regulation of our immune response and perhaps this is one of the reason we see such drastic differences in clinical outcomes: from perhaps a majority who have no symptoms to severe disease and death in thousands.

The natural history of this virus being so virulent and human population being so unhealthy created nothing short of the perfect storm for the horror we see today. Viruses come and go, but the timing of this pandemic is no accident. An adept predator acquired the ability to attack vulnerable prey and the result was a devastating pandemic.

10/13/2015

Tom Brady is right. Coca Cola is poison. We are in the midst of diabetes and cardiovascular disease EPIDEMIC. Your body is not meant to handle the type of blood sugar surges and dips that soda will cause. It absolutely impacts inflammation, and many other organ systems. High Glycemic Load Carbohydrate in any and all it's forms is poisonous to human beings, and we have a food system literally based on High Glycemic Load carbohydrate!!!!

10/01/2015

The author recommends health organizations reconsider the evidence to produce more practical guidelines free from marketing bias and that minimize side effects.

07/31/2015

We all know Coca Cola is laden with sugar and that, at a push, you could use it to clean your toilet. But it's a bit of a mystery as to what it does to your body. Now, thanks to Niraj Naik, we hav

07/31/2015

Connecting decision makers to a dynamic network of information, people and ideas, Bloomberg quickly and accurately delivers business and financial...

07/01/2015

Researchers are calling for a reduction in beverage consumption, what they call a threat to global health.