TheLiverDoc Profile picture
Sep 16 12 tweets 4 min read
Doctors of all people, MUST NOT scare monger #ranitidine

Dropping from 'essential list' DOES NOT mean it is banned

It can be used and is still in use

'CERTAIN' manufacturer's Ranitidine products were found contaminated with NDMA - a potential...
..cancer causing agent.

US FDA has been investigating this since 2019.

In fact, a study done by the US FDA on conversion of ranitidine into significant NMDA under normal physiology conditions showed that it did not change for worse.

There is NO EVIDENCE that Ranitidine use...
..can cause cancer or HAS caused cancer in humans till now.

Certain batches of OTHER drugs too - like Metformin and Losartan were also found to have NDMA impurity - this DOES NOT mean cancers are caused by use of these drugs

aninews.in/news/national/…
Science embrace changes, limitation and deeply looks into concerns - so as to ensure that future mishaps are averted

But this good nature of scientific practice has been twisted by science-denying lay persons, alternative medicine practitioners and other idiots into a sort of..
..criminality.

Those who are taking Rantac, need not worry. Usually, these drugs are given in short term - even the other medicines for 'gas' are given for short term - such use is perfectly safe.

When patients abuse these medicines over the counter and physicians blindly..
..prescribe in long term, obvious other adverse events happen.

Treating 'gas' is one of the worst medical and self-treatment practice ever - treating the CAUSE of 'gas' (which can be a simple advice on meal timings to identification of gastric cancer) is what is prudent..
And for all those crying that "Ranitidine is cancer causing" because of NDMA, please note the other products with traces of NDMA

- cured/processed meats
- fish
- beer
-tobacco products
- in herbs from soil sources

NDMA traces wer also found in few batches of...
..Sartan group of drugs by the European Medicines Agency.

The issue was with a specific manufacturing process and once this was resolved, the NDMA impurities drastically reduced

ema.europa.eu/en/news/sartan…

In fact, everyone must know this small, interesting fact about NDMA..
.."If 100,000 patients took valsartan from Zhejiang Huahai drug company (wher highest levels of impurities were found) every day for 6 years at the highest dose, there could be 22 extra cases of cancer due to NDMA over lifetimes of those 100,000 patients."

This is impossible..
..in real life scenario.

Also know that NDMA is categorized as 2A carcinogen with limited evidence in humans - EVEN THEN - it is prudent to keep it at check, which is what scientifically progressive societies and medical science is doing for betterment of human lives.
To conclude
There is NO evidence that

Ranitidine causes/can cause cancer
NDMA in Ranitidine is cancer causing
there is significant NDMA generation in humans due to Ranitidine

Ranitidine is NOT banned, is only removed from essential list and is still safe for short term use
Do you know what is absolutely unregulated, unchecked, potential carcinogens unknown and a BIG threat to human lives?

Ayurvedic medicines
Homeopathic remedies
Herbal and dietary supplements
Multiherbal proprietary products

Focus your energy and criticisms where it is required.

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More from @theliverdr

Sep 14
1/5 Long thread alert

on a lay person's absolute lack of scientific temperament

that snowballs into a nonsense story on

unnecessary treatments and primal therapies

bound by strong cultural emotion towards

the ancient pseudoscientific practice of Ayurveda

that misinform...
2/5 ..the author describes her tryst with symptomatic disc herniation which was

diagnosed via modern methods (MRI) [why not initially go to a Vaidya for diagnosis via 'Nadi Pariksha?']

& initial treatment DIRECT from Ayurved (science denialism) which she BELIEVED wud help her
3/5 ...who subjected her to primal Pancakarma + multiple herbs for disc bulge.

Pancakarma therapies are brutal, primitive therapies that can worsen spinal disorders (Ayurveds dont know anatomy well)

& this person was lucky she didnt end up paralyzed.

When in fact,
Read 6 tweets
Sep 11
I am a meat eater.

I love my steaks, those juicy fillets, roast chicken, crispy bacon, mutton kebabs and that chargrilled lobster.

But a //predominantly// plant based diet is what is good for liver & heart.

Everyone must know this.

Indulge your cravings only occasionally.
Sources:
✅️Plant based diet reduce fatty liver disease
clinicalnutritionjournal.com/article/S0261-…
✅️Plant based diet reverse fatty liver
link.springer.com/article/10.100…
✅️Mediterranean diets with polyphenols reduce liver fat
gut.bmj.com/content/70/11/…
✅️Red meat & fatty liver
journals.lww.com/ajg/Abstract/2…
All "carnivore crazies" jumping on this thread, plz note that type of meat, preparation techniques, cooking methods, sides etc varies in the West vs India. And it further differs between States/regions/communities and cultures in India. Plz dnt generalize ur pro-meat arguments!
Read 9 tweets
Sep 8
1/
I thot the Indian Ayush guidelines for treatment of #COVID19 was the biggest nonsense I would see and read during the pandemic.

That was until now, when I had the misfortune of reading traditional Chinese medicine guidelines on treating elderly with Covid.

This is something
2/
The Shanghai expert consensus on clinical protocol for traditional Chinese medicine treatment of COVID-19 among the elderly population (second edition)

Updated for September 2022. Yupp.
They have updates though!

sciencedirect.com/science/articl…
3/
"The goals of TCM treatment are to shorten COVID-19 nucleic acid polymerase chain reaction negativity conversion time, slow disease progression, and reduce mortality."

- sound about reasonable right?

Let us see how they do it.
Read 12 tweets
Sep 6
I have liver disease patients who are non-meat eaters and dont consume dairy-based proteins

Soy protein is a good source of protein and much more

Here is why**

**and its all meta analysis from scientific literature,
not a 'nutritionist gym trainer's opinion'

A 🧵
1/
Soy protein

significantly reduces serum total cholesterol, LDL cholesterol, and triacylglycerol and significantly increases HDL cholesterol

Benefits were observed after >12 wk duration of consumption

2005
academic.oup.com/ajcn/article/8…
2/
Soy protein

41 randomized controlled trials

Reduction in total cholesterol, LDL, triglycerides & increase in HDL

Replacing foods high in saturated fat, trans-saturated fat, and cholesterol with soy protein beneficial effect on heart disease

2006
ajconline.org/article/S0002-…
Read 13 tweets
Sep 4
1/17
Common queries!
How to keep liver healthy?
What foods for liver health?
Safe measures for liver detox?

These Qs aren't realistic because
a. Liver is part of the human body
Not separate
Healthy body = healthy liver
Liver detoxifies us, not other way around

Still here goes!
2/17
Alcohol

2009 study: 6g-19g/d increased survival (men >40y)
Wine was supposedly best, at 2g/d
As dose increases, life reduces

2022 study: 1-2 std drinks/d in HEALTHY adults >40y reduce stroke, heart disease, diabetes

Every person is diff
There is no safe level of alcohol
3/17
Coffee

Min 3 cups of coffee (no sugar, ideally no milk) associated with reduced fatty liver, reduction in liver fibrosis (pre-cirrhosis stage) and prevention of liver cancer, also seems like it has some protection against alcohol-liver injury.

More cups, better the odds.
Read 17 tweets
Sep 3
1/51
The young wife is teary eyed.

She looks at the husband, as ER docs put him on the ventilator.

Heart failing, breathing labored, in shock.

The couple did not have children.

If he goes, she's alone.

Our team was the only one standing between solitude
and her beloved.
2/51
Three years back at the age of 35y Shiva developed pain abdomen on the right side along with recurrent bouts of high grade fever and severe itching

Paracetamol did relieve the fever, but at the end of it all, he was so tired and his itching gave him sleepless nights
3/51
The first two such episodes, were self limiting over 3 to 5 days. He was wary of hospitals, and so took symptomatic care at home.

However, the third fever and abdominal pain episode few months later, shook him to the core. Rigors and chills and he was disoriented.
Read 51 tweets

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