Charles J. Gruich, M.D.

I would like to announce that our medical clinic, located at 2356 Pass Rd., Suite 100, will be closing effective Wednesday, September 18, 2024. The last day the clinic will be open to see patients will be Tuesday, September 17th. Patients requesting copies of medical records may call the office at 228-388-7080 and make arrangements.

Dr. Gruich will be available for house calls/home visits beginning November 1, 2024.

LONG COVID HELP

You, or someone you know, who’s had a Covid infection, may have lingering symptoms. Symptoms like brain fog, easy fatigue, malaise, headaches, insomnia, changes in smell and taste, palpitations, dizziness, depression, anxiety, chest pain, and balance issues. This is commonly referred to as Long Covid. A difficult, if not impossible, thing to treat, there now seems to be available a remedy of sorts. It’s not a quick one, but for some, it works quicker than others.

Long Covid symptoms last anywhere from weeks to months. My last case was a woman in her 40s whose symptoms were still present at 13 months.

The prevailing theories on what causes Long Covid is:
1. Virus or viral elements remain in tissues.
2. Autoimmunity is induced by the respiratory infection.
3. The Epstein-Barr virus is reactivated.
4. The gut microbiome, which controls the immune system, is disrupted.

But a more specific theory is that the spike protein on the virus, the protruding spikey thing you see in media images, that this spike protein continues to circulate, and remain in cells, not having been eliminated by the immune system, causing inflammatory symptoms.

For most people, their immune systems seem to clear out at least the lion’s share of this spike protein. But for others, it hangs around. In fact, the Covid injection itself is specifically designed to instruct normal cells to manufacture the spike protein so that your immune system can recognize the real McCoy when it enters the body. For how long? This has been debatable. We do know however that there is recent confirmation that the spike protein from the mRNA Covid injections given to pregnant women are passing through her breasts when she lactates, appearing in the intestinal tract of breast-feeding newborns. Two plus two equals four.

So, the upshot of getting cured from the Long Covid is to adopt, or utilize measures that will rid the body’s cells and circulation of the spike protein. And what might those measures be?

An effective one is through autophagy.

What is autophagy?

Autophagy (“self-eating”) is the body’s way of “cleaning” itself up, ridding itself of cellular waste occurring from free radicals, allowing all cellular functions, including the immune system, to operate much more efficiently. Autophagy removes those elements in the cell that “get in the way” of those immune cells that need to do what they do.

In fact, a 2020 study by Blanca Garcia-Perez identifies an association between those with Long Covid who seem to have a “crippled” autophagy process.

There are two basic ways one can induce or “kick-in” this autophagy. One, is by eating certain foods that are known to induce autophagy. The other is through intermittent fasting.

Foods that are high in spermidine, or resveratrol, known to increase autophagy are: wheat germ, grapes skins, nuts, grapefruit, mango, mushroom, apples, red wine, onions, berries, turmeric, soybeans, and milk thistle. The Japanese Knotwood Root powder is very good and has an excellent bioavailability, meaning it is absorbed very well.

The other way is by intermittently fasting. Either by daily fasting, or skipping one or two meals a day, two or three times a week. This causes the body to sense we are “dying” or deteriorating. So autophagy kicks in and inside the body’s cells there occurs a cacophony of activity with various intracellular elements, “sweeping up”, “pushing out,” cellular debris, and/or recycling the elements inside the cell that are of no use and are “taking up space.” This improves the efficiency of specific immune cells.

Eating these foods and others, that induce autophagy, along with intermittent fasting, are the more effective means to try to get through the Long Haul Covid. Other measures are also helpful: hydroxychlorine, Ivermectin, cortisone, vitamin C, D, and zinc, antioxidants like turmeric, and omega-3 fatty acids.

As always, check with your personal physician to determine if this is something that can fit in with your medical regimen.

Stay healthy

MEDICAL CANNABIS: WHERE ARE WE?

A couple of months ago I saw a man in his 20s complaining of a one-week history of constant morning vomiting lasting 6-8 hours, from the time he arose in the morning until, sometimes, early afternoon. Long story short, after he stopped using ma*****na his problem resolved.

I remember about 20 years ago I had a female patient, with bipolar disorder, in her early 30s, share with me that when she smoked ma*****na that her moods stabilized; that she felt “normal”. When I first heard this, I thought she might be imagining it. But I made a point to ask later patients with bipolar if they ever tried ma*****na. After composing their surprise that they would be asked that question, more than a few admitted they had, and that they had a positive, “normal,” experience.

Then, sometime later I came across a study on this very thing, the questionable benefits of ma*****na in the treatment of persons with bipolar disorder. Turns out the study found it was a misperception of the user. That in fact, their untreated bipolar symptoms continued, as testified by family members, in spite of the subject’s perception that they were “well”.

Anyway, we now have on the books the legal use of medical ma*****na in Mississippi. It’s quite regulated.

Only certain medical conditions qualify as treatable conditions with ma*****na.

Current law requires a patient to consult a licensed medical ma*****na doctor who determines if one of a list of medical conditions exist. If the doctor diagnoses you with a qualifiable medical condition and you are approved, the doctor will fill out a certification form for medical ma*****na.

You then take this form and apply to the state. People between the ages of 18 and 23 will be required to have written certifications from TWO different medical doctors (MD) or doctor of osteopathic Medicine (DO) from TWO separate medical practices in order to qualify for the medical cannabis program.

The state lists about twenty medical conditions for which ma*****na is deemed an acceptable treatment. They primarily include cancer, epilepsy, chronic pain failed on opiates, and a host of neurodegenerative disorders, like multiple sclerosis, Parkinson’s, agitated Alzheimer’s, and others. Once you apply to the state, the state will process your application and then notify you of your approval and mail your card. With the card, you can then begin buying from designated and state-approved dispensaries. The license will need to be recertified annually, having to see a licensed physician again for the recertification.

The State Health Department began accepting applications for medical ma*****na cards in June 2022, but the MSDH anticipates that medical cannabis will not be available for patients until late 2022.

People under the age of 21 require consent of their parents or guardian who will be responsible for controlling the administration of cannabis as well as its dosage. Minors will NOT be able to enter a dispensary unaccompanied by a parent or legal guardian.

The application fee is $25 and then $25 for every annual renewal.

Also, patients are able to designate caregivers to obtain their medical cannabis from a dispensary. Caregivers’ application is $25. Caregivers must be over 21 years old, and free from criminal convictions or felonies. Patients and caregivers cannot grow their own cannabis in Mississippi.

Regardless of a patient being legally qualified to use ma*****na, employers are still allowed to do drug tests on their employees and apply their determined policy in line with their normal business practices. Meaning if the company’s policy is no drugs in your system and you test positive, then the policy applies to you, in spite of your claim that it is no longer contraband.

Despite it being well-designed and structured, the program is almost certainly vulnerable to abuse from all sides of the matter. This is a “medicine” that’s made its way into the healthcare system born not from a therapeutic source but from a recreational source. Like Adderall, Xanax, Tramadol, and other prescription pleasure-inducing medications, there will almost certainly be diversion and deception, from all quarters. I mean, really – it’s ma*****na.

I’m trying to think of another legal prescription medication that produced such a clamoring for legalization before its legalization, on the same scale as ma*****na.

This is an interesting phenomenon.

Utility-wise, I put it on the same level as alcohol. Alcohol has its therapeutic effects when used appropriately: anxiety, social phobia (“liquid courage”), depression, agitation, sleeplessness, appetite improvement, indigestion, sedation pre-operatively (purportedly in the 50s, UMC did so with toddler surgery).

But like ma*****na, there’s no medical condition that alcohol treats for which we have no indicated prescription medication. Yes, I understand the anecdotal claims, and maybe this might turn out to be the case as studies continue. I can see the headlines now, “Weed has been found to be the only cure for X!”

Anyway, we’re breaking new ground. It’ll be interesting to see how it all pans out.

Be smart, stay healthy.

LOSING WEIGHT WITH WEGOVY
Wouldn’t it be wonderful if we had a medication that you took once a week and you would lose 30 pounds over a year?

Well, actually, we do have one – maybe.

Wegovy® is such a medication. On June 4, the FDA approved its use for long-term weight loss. The generic name is semaglutide. Semaglutide was invented for the treatment of diabetes. But an incidental observation during the testing phase was that some participants in the study lost weight. So, studies were done to determine if it could be marketed as a weight loss product.

The studies show that you can lose on the order of 5-10% of your base weight. For example, if you weigh 200 pounds, you stand to lose 10-20 pounds over a year or so. The weight you lose will stay off IF you have by that time adopted and maintained a diet in which the ingestion of refined carbs and sugar in all its forms is at its lowest. This means either a LOW-CARB, HEALTHY FAT diet, a PLANT-BASED diet, a MEDITERRANEAN diet, or a HIGH-PROTEIN diet.

So, unlike many other prescription medications, the success of this medication hinges on using it in conjunction with eating anti-fat forming food, or foods that do not increase glucose or insulin in large amounts in your body.

Who qualifies to take it? Anyone with a BMI over 30, or a BMI over 27 with high blood pressure, heart disease, or diabetes. Other disqualifiers are disorders of the kidney, liver, thyroid, pancreas, and gallbladder, eye problems like retinopathy, stomach disorders, depression, suicidal thoughts, mental health issues, breastfeeding, pregnancy, tachycardia, GERD, or constipation.

The way you take Wegovy is as follows: To start, the lowest dose fixed-dose injection is administered under the skin, in the abdomen or thigh, once a week. Then every 4 weeks the dose is slightly increased. This is to avoid the primary side-effects of abdominal pain, nausea, and diarrhea. The dose is increased over 5 months to the therapeutic/maximum weekly dose of 2.4 mg.

How much does it cost? The upfront, in your face, no make-up price is $1,400/month, for 4 fixed-dose syringes. Currently, with a GoodRx coupon, you can get it cheap at Winn-Dixie in the neighborhood of $1,336. Some insurance companies might cover much of it. Paying cash, or with an insurance card, saves you $200. And Novo Nordisk, on their website, says if you qualify per their standards, you might only pay as little as $25/month, but only after you wallow around in the company’s website, jumping through some digital hoops.

Ok, if you haven’t already done the math. Taking it for 15 months at $1,400/month, comes to $21,000 outlay. If you are able to get it somehow, with or without insurance, for something less, say maybe $300/month, this comes to $4,500 outlay. If this is the course you take, and your BMI is well over 30, and you qualify, as an alternative you may want to consider bariatric surgery. I’ve had three patients, all women who, because of insurance and financial limitations, opted to have their bariatric surgery done in Tijuana, Mexico, in the range of $5,500 - $7,000. They were all happy with their experience and all are now 1-3 years post op and are doing well without complications. Just saying.

How long can you take it? I can’t find anything on the safety of taking the Wegovy beyond 68 weeks. In the case of the use of semaglutide in diabetes, the presumption is for years. But Wegovy is indicated for non-diabetics, and in higher doses. I think the long-term effects with Wegovy are unknown.

Supplied: As of this writing, I called several pharmacies, and no one has it in stock. Interesting. The company itself apologizes on its website for lack of supplies, we are told, because of its demand. This may be true. Then again, as past history has taught, it may be the company’s strategy to gin up interest and demand, to buttress the high price, to bring more profits. Maybe not. Or the company may want practitioners to gravitate toward its other brands of semaglutide, Ozempic, which does not have an indication for weight loss. Who knows?

Now you know why earlier I cautiously qualified this medication with a “maybe”.

If you qualify and decide to try Wegovy, know that without changing your current way of eating, and adopting a LOW-CARB, HEALTHY FAT diet, that you will almost certainly regain the weight you lose. If you are unable to make the dietary changes now, you will most likely be unable to make the changes weeks, months, or a year from now – at least that’s been my professional observation.

Lastly, a comprehensive review in 2013 determined there are four diets that provide superior control over blood glucose, insulin toxicity, and weight loss. They are LOW-CARB DIET, LOW GLYCEMIC-INDEX DIET (Ref. “The Belly Fat Cure” by Jorge Cruise), MEDITERRANEAN DIET, and HIGH-PROTEIN diet. The LOW-CARB diet is the most effective in reducing body weight, waist size, and blood glucose. I suggest you give these a shot first, and maybe save more than a few bucks down the road, all the while becoming the new you.
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When it comes to your overall health – be smart.

Good Luck!

We draw labs in the office with one-day turn around on results. Routine office visits are $70. -- A1C $20, and Lipid panel with cholesterol, triglycerides, HDL, LDL is $25.

As a physician, I never thought the day would come when I would be advising patients to eat fat. Even long before I went to medical school, the powers that be in all health matters were advising the American people to avoid eating dietary fat.

This health paradigm has been entrenched in the American health landscape since the 50s when heart attacks were on the rise. On observing the plaques found in the heart’s arteries, it led to the presumption that fat increased blood cholesterol levels. Oh, how so smart we were! This presumption, it turns out, was made in the same way as if an alien from a hovering craft were to observe that ambulances were the cause of car wrecks because one was observed to present at every car wreck.

But after an exhaustive study of the available studies on dietary fat, no evidence was found that dietary fat was associated with an increased risk of cardiovascular disease or stroke.1 This little medical nugget was initially served up by one Dr. Siri-Tarino in 2009, and was verified by other studies and researchers. This pretty much blew a hole in the narrative that for so long had demonized fat. So much so to the point that in 2016, the Dietary Guidelines for Americans, which is published every few years, removed restrictions on total dietary fat in a healthy diet.2

Now to those who having read this last paragraph have left their seat jumping up ecstatically and proudly, internally rationalizing their daily consumption of cheeseburgers, chili-pies, and such – not so fast!

Dietary fat comes in two “flavors”. Healthy (Mono- and Polyunsaturated), and Unhealthy (Saturated fat). The Mono- and Poly- is healthy, while the Saturated is unhealthy (in general). Clinical trials continue to show the benefits of eating the one, but not the other.

So, why should you consider eating Healthy dietary fat? Obviously to recommend doing so implies there must be health benefits that come with it. And there are. So, what are they?

Recent studies and clinical trials have revealed the following benefits:

*It improves your satiety, helping you to avoid eating between meals, facilitating weight loss efforts. (replace refined carbs with healthy fat)
*Reduces your risk of heart disease, stroke, and blood vessel disease.
*Reduces LDL cholesterol which is associated with disease of the heart arteries.
*Helps lower blood pressure.
*Improves insulin sensitivity, helping to control glucose better in diabetes.
*Is less inflammatory.
*In pregnancy, helps babies develop neurologically, improving fine motor and communication skills.
*Improves mental health.

So, what foods are Healthy fats and which ones are Unhealthy? Here’s a short list:

Healthy fats: olive oil, most seafoods, fish, (esp. salmon, herring, sardines, mackerel, trout, bass, shrimp, and mullet), avocados, most nuts, most seeds, peanut oil. [Use these foods to replace refined carbohydrates]

Unhealthy fats: processed meats (bologna, pepperoni, salami, etc.), beef hamburger pan-fried, fatty meats (beef short ribs), processed foods (man-made foods), whipped cream, milk chocolate, foods containing milk chocolate, coconut, coconut oil, palm oil, pork ribs, ground pork, veal bratwurst, lamb ribs, pork spare ribs, pork chops (with fat), roasted ham, , pork loin, beef and polish sausage, refined seed oils like sunflower, corn, canola, safflower, and vegetable oils.

Studies prove that a reduced-carbohydrate, higher-fat Mediterranean diet reduces the need for medication by 59%.3 I’m living proof this is the case. Working like a left hook and right uppercut, a LOW-CARB, HEALTHY FAT diet reduces glucose toxicity, and insulin-toxicity on the one hand, while providing appropriate energy and satiety on the other, both combining to induce weight loss, excellent glucose control, and much less fatigue.

Here’s a partial list of healthy fats in my diet, combined with a focused low-carbohydrate intake, that has allowed me to discontinue my statin medication (for high cholesterol) and fenofibrate (for high triglyceride levels).
Salmon, mullet, trout, flounder, shrimp, crab, olive oil, avocados, nuts, eggs, sausage bacon, mini-wrapped frittatas, arugula salad, pork rind breaded chicken tenders, chicken drumsticks wrapped in bacon, slices of celery and carrots, beef stir fry, scrambled eggs, chicken stuffed bell peppers, bbq shrimp skewers, almond and coconut flour pancakes.

So, if you’re overweight, obese, have high cholesterol, or high triglycerides, and you want to lose weight, prevent or improve your diabetes, or have a good chance at discontinuing your prescription medication for high cholesterol or triglycerides, and possibly diabetes, then adopt a LOW CARB, HEALTHY FAT DIET. You will be amazed. Of course, consult with your personal physician if you have special conditions.

By the way, to add impetus to your efforts, intermittent fasting, while not absolutely necessary, will move you off the plateau, or get you across the finish line faster than your neighbor, or coworker, who may be in the same wagon.

Good Luck!

1 Siri-Tarino, Patty W. Arch Intern Med. 2009, 169(7): 659-669 …the association of saturated fat with cardiovascular disease.
2 Dietary Guidelines for Americans. http://health.gov/dietaryguidelines/2015/guidelines/executive-summary/.
3 Giugliano, D, et al. Ann Int Med. 2009 Sep 1; 151(5): 306-313. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy….

MONKEYPOX -- A LITTLE BIT ABOUT IT
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Present excellent talks by leading doctors and researchers explaining the latest info on COVID and related issues. An informative, enlightening 1 hour talk every Wednesday at 6 pm CDT. All public invited.

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Who else wants to cure their diabetes? Get off diabetic medication? Even insulin? If you are not cavalier in your approach to your personal health and are sincerely motivated, and accepting that you will have to pay daily attention and put forth a robust mental effort, then read my latest blog at http//:www.charlesjgruichmd.com/blog. Feel free to send questions either here or to [email protected].

BLOG ​One of the foremost reasons you cannot lose weight, or your A1C won't drop, or your cholesterol remains high, regardless of how hard you try, is most likely because you're eating hidden sugar. ...

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