Bryan Shapiro MD, MPH

@FuhrerElonMusk @kasza_leslie @Sunny_Rae1 @awgaffney I agree!

@BShapiroMD @kasza_leslie @Sunny_Rae1 @awgaffney I think you are grossly underestimating how much longer you’re going to be employed at UC Irvine Medical Center.

@kasza_leslie @Sunny_Rae1 @awgaffney I think you are grossly underestimating the somatic effects of chronic stress. Enormous body of work on this.

@BShapiroMD @Sunny_Rae1 @awgaffney There certainly are trauma and psychological stressors, but these conditions are very real and very under diagnosed. Functional neurological diagnoses are mostly a way to put a label on incompletely evaluated. Difficult to diagnose conditions. We agree to disagree on this.

@kasza_leslie @Sunny_Rae1 @awgaffney I disagree. The patients I see with these constellation of dx are suffering tremendously, but 100% have had major trauma and psychosocial stressors and are eager for answers to their pain, finding non-specific syndromes, many of which are unfalsifiable. lymescience.org/chronic-lyme-d…

@Sunny_Rae1 @BShapiroMD @awgaffney Dr Shapiro, you are completely wrong about this. My practice experience mirrors Dr. Duncan’s experience. Dr. Duncan is a recognized international authority on this subject matter, always thorough, patient and meticulous in her evaluations. These disorders well recognized. /1

@transhumanoXY @awgaffney I teach my residents to avoid this exact impulse. Very important to think beyond one’s own specialty. Psychiatrists are MDs after all.

@BShapiroMD @awgaffney If all you have is a hammer, everything looks like a nail

@Sunny_Rae1 @awgaffney Thanks for asking! It's my experience seeing these patients for over 9 years at an academic hospital, both outpatient and on the consultation-liaison service where I interface with neurologists, rheumatologists and other specialists regularly.

@BShapiroMD @awgaffney Is that your Dunning experience or your Kruger experience?

@doubletamponne @Soozinn @ScotCanadaLaura @awgaffney I disagree with this.

@Soozinn @ScotCanadaLaura @BShapiroMD @awgaffney Besides, people with EDS are more prone to neurodivergence, including autism and ADHD, than the general population.

@doubletamponne @Soozinn @awgaffney Patients presenting with this constellation of diagnoses. Often young and otherwise healthy.

@BShapiroMD @Soozinn @awgaffney Dude, you literally wrote EDS first. You said what you said. Own it.

@Soozinn @awgaffney My claim wasn't that heritable EDS is an invalid construct. Glad you've found answers!

Diagnosed with “lax ligaments” as a baby. Called double-jointed, had weakness, orthopedic shoes, etc. Mom had same condition. As an adult, head of rheumatology at a university medical center properly dx’d Ehlers Danlos Syndrome, a documented GENETIC connective tissue disorder. Hey Doc, your experience is sorely lacking if your conclusion is this was caused by stress.

@AlobhaPatrick Normal reactions to adverse life events can be clinically significant. This doesn't mean it warrants a medical intervention.

Which is why the phrase “clinically significant” is riddled throughout the DSM-5-TR

@ianeilbacher @awgaffney Further reading: neuroplastic and nociplastic pain

@BShapiroMD @awgaffney Even if this were true, which the evidence does not support, this is a physiological explanation of pathology.

@dan_prick @awgaffney No biological tests diagnose hEDS. Patients seeking these types of dx often get one eventually from an unsophisticated clinician. They may be valid constructs, but way overdiagnosed just like many psychiatric conditions with sx checklists. This is my experience on the ground.

@BShapiroMD @awgaffney The problem is that you are in no position to impugn the diagnostic ability of those far more qualified than you to determine who meet criteria for a disease that has multiple identifiable biological abnormalities.

@dan_prick @awgaffney The problem is that the criteria for hEDS are vague and nonspecific leading to overdiagnosis.

@BShapiroMD @awgaffney Your “theory” is demonstrably incorrect. There are inherited biological alterations in the extracellular matrix of EDS patients with widespread implications: sciencedirect.com/science/articl… You will continue to get pushback in the comments until you admit you’re out of your depth here.

@knittynattie @awgaffney Symptoms are real. Mind and body are connected.

@BShapiroMD @awgaffney So, what you’re saying is it’s all in her / their head.

@MikhailaFuller Did the initial research on hyperbolic tapering and currently work alongside Mark Horowitz at Outro. Happy to discuss this topic further with you to raise awareness!

I’m looking for stories from people who have been injured by pharmaceuticals to add to a website I put together on pharmaceutical induced injury. Please share. Hopefully this website can help push for much needed change. My story is on there already.

@RoizMichael83 I think it involves a3, Kb2, then a4 and proceeding with the pawn race. If a4 immediately, black has Qb2+ trading queens after white's b8=Q+

There is something esthetic in such studies with few pieces on the board. White plays and wins.

@DinaBelenkaya Is he still upset about getting checkmated by me OTB on YouTube

I am going to interview Hans Niemann. Do you have any questions for him?

@weldeiry Thank you for this. I got diagnosed with non-Hodgkins lymphoma ipsilateral to my Pfizer COVID injection 2-3 months prior. After the booster dose, I was awoken by a severe panic attack and rapidly resolving fever suggestive of a very strong immune response.

I am pleased to share the peer-reviewed published manuscripts by Kuperwasser and El-Deiry “COVID vaccination and post-infection cancer signals: Evaluating patterns and potential biological mechanisms” and El-Deiry “Hypothesis: HPV E6 and COVID spike proteins cooperate in targeting tumor suppression by p53” both published today but censored due to cybercriminial attack on the @Oncotarget @OncotargetJrnl website. The authors are happy to share the full PDFs with any interested reader upon request by email.

Freedom of the Press is protected under the First Amendment of the US Constitution. But: Censorship is alive and well in the US and has come into medicine in a big awful way. The future is bleak if weaponized censorship in medicine continues to suppress any narratives that stand up to pharma, that expose inconvenient or suppressed truth. #injusticeinscience #injusticeinmedicine @HHSGov @RobertKennedyJr @NIHDirector_Jay @FBIDirectorKash @DHSgov @FBI @Oncotarget @OncotargetJrnl @SabinehazanMD @SenRonJohnson @RWMaloneMD @RetsefL @KUPERWASSERLAB @Jikkyleaks @JanJekielek @MaryanneDemasi @danaparish @RandPaul

@Dividend__Doc @AllenFrancesMD This is because the underlying diagnosis is so often complex PTSD, founded in early childhood trauma, which can mimic essentially every primary psychiatric disorder we have (and thus, polypharmacy)

@AllenFrancesMD I review dozens of cases daily for a major payer. every case has 4-5 diagnoses. MDD, PTSD, GAD, and, of course, schizoaffective disorder! And maybe OCD too! Nearly all inpatients now have hallucinations - even standard admits for SI. The field is in a very sorry state.

Soon everyone will be labelled with a mental disorder (many with 2,3,4). Careless overdiagnoses destigmatizes "mental disorder" by making it ubiquitous- but also makes concept meaningless & causes massive over-treatment. Label is useful for the few/harmful misused for the many.