Broadcast from KSQD, Santa Cruz on 4-16-2026: Dr. Dawn opens with a follow-up from an email from Maryland about a friend in Switzerland, who has ongoing neurological and gastrointestinal symptoms. She reviews the earlier effort to connect him with functional-medicine resources in Switzerland, then focuses on a new observation that the patient may have had multiple parasitic infections during travel in Europe. Dawn agrees that this may have left a major gap in the workup and says that, in puzzling neurologic cases, a sleep-deprived EEG can sometimes reveal a “fingerprint” of brain-based dysfunction even if the patient is not actively having symptoms during the test. Dr. Dawn says that for people over 60 who have never had a heart attack or stroke, daily baby aspirin is no longer considered a good routine preventive measure because the bleeding risks, especially gastrointestinal bleeding, can outweigh the cardiovascular benefit. She makes the distinction that aspirin may still make sense for secondary prevention in people who already have established cardiovascular disease. She next reviews several medications that she thinks many older adults should reconsider. She explains that phenylephrine, which replaced easier access to pseudoephedrine in many cold remedies, has been found to work no better than placebo . She also says Colace is not very effective, and she strongly advises older adults to avoid Benadryl because it accumulates with age, increases fall risk, and may be associated with cognitive decline. She adds that beta blockers are no longer preferred first-line treatment for uncomplicated hypertension in many older patients, and that medications targeting the angiotensin pathway are generally favored instead. Dr. Dawn introduces Mira Achilles in the studio, describing her as her excellent administrative assistant. Mira explains that she gathered health questions from peers from her college world. Mira asks what best supports focus for someone with ADHD working at a desk job. Dr. Dawn says the two evidence-based pillars are cognitive behavioral therapy and exercise. She walks through practical strategies including using calendars, reminders, index cards, and to-do lists; sorting tasks by urgency and importance; breaking large projects into smaller steps; creating small reward loops by checking off progress; and deliberately reducing distractions in the work environment.. She emphasizes that movement and exercise improve attention and executive function, and that ADHD management often improves when sleep timing is stabilized. Another of Mira’s peers asks whether women should avoid very cold showers or ice baths during the luteal phase or around menstruation. Dr. Dawn says the answer is not absolute, but she cautions that cold exposure can hit women differently depending on hormonal state. She notes that the luteal phase may make vasoconstriction and cold sensitivity more pronounced, and she raises concerns about the physiologic stress of cold immersion, including possible adverse effects on circulation and rewarming. Her overall tone is cautious rather than enthusiastic, especially for people who are already prone to feeling chilled or reactive. Another contributor asks why some people faint when seeing needles, blood, or medical procedures. Dr. Dawn explains the vasovagal response: a reflex in which blood pressure and heart rate suddenly drop, reducing blood flow to the brain. She offers simple countermeasures such as crossing the legs, tightening muscles, squatting, or using hand-grip tension to help push blood back toward the brain and prevent passing out. Dr. Dawn closes by asking whether cortisol is a “good” or a “bad” hormone. Dr. She answers that cortisol is essential: it helps regulate daily rhythms, energy balance, and the broader hormonal system, so it is not something to think of as inherently harmful. At the same time, she says problems arise when cortisol is chronically dysregulated or excessive, so the goal is to maintain a healthy rhythm and avoid overwhelming the adrenal system. Please go to KSQD.org and donate to support Ask Dr. Dawn on KSQD.
