Nick Karr, MD

Used high-dose nicotine pouches daily for 3 years-6 to 9mg, sometimes two at once. Felt like a nootropic cheat code-until it didn’t. Tolerance hits fast. I quit cold turkey after learning why pouches hit slower-and why that actually makes quitting easier. Why (And How) I Quit Daily Nicotine Pouches Cold Turkey youtu.be/A1BWzEl-PSg

@shevereshtus Fries on top - the good ol yeshiva slice 🍕

Non-Jews don’t use WhatsApp and their pizza places don’t even sell French fries. Oh and when you ask them what’s their favorite sushi to buy on the side when they get pizza they look at you even more confused than when you bring up the whole French fries thing. Crazy.

Wild how a guy who made a career calling out bad stats now thinks he can dismiss an entire field of research with a smug tweet and no data🙄 1.Calling a meta-analysis “statistical BS” without offering a single real critique isn’t edgy. It’s lazy. The study you screenshot literally followed the gold standard for evidence synthesis. 2.One author disclosed his supplement ties in a correction, which is standard and transparent. Trying to spin that into a scandal is just bad faith. 3.Saying there’s “zero evidence” protein helps older people is flat-out wrong. There are multiple studies showing the opposite. Try looking up Moore 2015 or Kirk 2009 4.“Some people grow on low protein” is a classic anecdotal fallacy. That’s the same weak logic you’ve spent years ridiculing in others. This isn’t science. It’s performance. You’re not exposing fraud. You’re just throwing stones from the sidelines with nothing to back it up. If you’re going to call out “Bro Science,” don’t become the bro in the process…

The protein story is based on statistical BS, amateur data fudging. Bro Science is really for idiots. 1- Some do very well growing muscles on minimal protein ing., others poorly on large doses. 2- Remove the line, see the fraud. 3- One of the authors failed to reveal he was SHILLING for a protein supplement company. 4- For older people, ZERO evidence that supplementation work. 5- There is a variance among individuals but can be partially due to OTHER stuff they do, ingest, etc. (h/t @maxflowminclout). cc:@EricTopol

Your body is talking. These 10 simple movement tests can predict how long you’ll live. You can try every one at home. This might be the most practical longevity video I’ve made. youtu.be/BMjGUDdInoc

Ever feel like your signal’s just not connecting- mentally, physically, emotionally? This video breaks down how modern tech habits are quietly wrecking your libido, and what you can do to fix it. Is Tech Killing Your Libido? 6 Fixes That Work youtu.be/wMtvx2V9kms

The Marklund study is observational and measures biomarkers, not direct dietary intake. It shows association, not causation. Even the paper admits uncertainty, heterogeneity, and ongoing controversy around LA and AA. Cherry-picking this while ignoring RCTs showing increased mortality from LA rich oils isn’t evidence-based, it’s agenda driven. Science isn’t settled with smug soundbites

while the biochemical mechanisms paul cites are really sciency, what he doesn’t tell you is that higher seed oil consumption is linked to better cardiometabolic health ahajournals.org/doi/10.1161/CI…

Not surprised in the least. You don’t have to like the out the findings. But that doesn’t make them less true 🤷🏼‍♂️ Cannabis and Heart Attacks: The Shocking New Study You Need to See youtu.be/jdQ2hazm97E

@BEERius88 @geekdadteach @MarioNawfal Well I guess that proves it

@geekdadteach @MarioNawfal Smoke every day.. the same doctors say I'm healthy as can be... 90th percentile on every meaningful metric.. which doctor should I listen too?

🇺🇸 NEW STUDY SAYS CANNABIS MIGHT BE BREAKING YOUR HEART?! A new UCSF study found that long-term cannabis use (yes, even edibles) messes with your blood vessels like tobacco does. Users had blood flow issues that could lead to heart attacks, high blood pressure, and other not-so-chill outcomes. Doesn’t matter if you smoke it or snack it, your arteries aren’t vibing. “Not benign,” says science. Translation: your heart’s not getting high on this news. Source: Fox News

@geekdadteach @MarioNawfal True, but there’s a ton of research that already suggests marijuana has massive impacts on ASCVD Cannabis and Heart Attacks: The Shocking New Study You Need to See youtu.be/jdQ2hazm97E

@D_The_Husband Exactly The idea that size/strength don’t matter in BJJ is ridiculous That’s like saying speed/flexibility/mobility are meaningless

@noahkaufmanmd The best part is how he restricted comments to only people he follows or mentioned 🙄

What an absolute JERK. Max, learn some professionalism. Dr. Digiorgio should be paid 2-3x and his opinions need to be heard. Dissapointed in you. Low blow and pathetic. Virtue signaling gone bananas. Grow the fuck up.

Unfortunately this doesn’t surprise me. I have actually had two coworkers at two different facilities sustain significant complications from mistakes made when admitted to facilities where they were an employee! Both of them ER nurses. It’s why it’s so important to advocate for yourself.

My oncologist tried to stop my chemotherapy* treatment last week because of a one-page synopsis he had read regarding my recent MRI, which mentioned that one of my brain tumors had progressed. It turns out he had never actually looked at the MRI itself; and the specialist who wrote the synopsis had not actually compared the new images to my previous MRI from 2024. I was skeptical, as my symptoms had not progressed; so I asked my oncologist to show me a comparison of the two most recent MRIs, to demonstrate the growth. So, he brought them up on his screen and showed me a clear difference between image on the left and one on the right. "But the one on the left is the 2017 MRI," I said. "We both know the tumor has grown since then." The doctor was surprised, and said, "You're right. I'm not sure why the 2024 MRI isn't showing up." Anyway, we had to go to a different room and use a different computer to find last year's images. When my oncologist finally brought them up, he realized there was a clear REDUCTION in the size of my tumor, as well as a loss of contrast, indicating that the tumor was dying. So, the chemotherapy was working after all! Had I taken my doctor at his word, and stopped my chemotherapy, I would have soon needed an extremely risky brain surgery that would have changed my life forever. We are living through a crisis of competence in America — or is it in the world as a whole? It is absolutely essential that we remain vigilant and look out for our own health, because we apparently can no longer trust our doctors to do it for us. Remember to ask questions, get second opinions and, above all, don't just assume that your doctor is infallible. Now more than ever, your life is in your own hands.

@BarackObama Stop adding insult to injury

Right now, Republicans in Congress are trying to push through a bill that would put millions of Americans at risk of losing their health care. They want to cut federal funding for Medicaid, take away tax credits that help more people afford coverage, and raise costs for working class families.

@RepGregMurphy Hard? We expected hard What we didn’t expect: - To be the buffer between patients & profit-driven insurers - To be gaslit by hospital admins - To be abandoned by Congress while you raise the conversion factor for everyone but us Spare us the devotion lecture

So troublesome to see so many young doctors complaining about how hard the job is. Your job is about taking care of patients. It’s called dedication. It’s called devotion. If you wanted an easy life, you should’ve chosen something else.

If you’ve ever been told it’s just anxiety, burnout, or stress - but something still feels off - it might be your hormones. This one’s for every woman who’s ever felt dismissed or misdiagnosed It’s Not Burnout — It’s Hormones youtu.be/vnw0_-gK6NA

An 80-year-old man who’s had regular medical care and PSA screening has well under a 1% chance of being newly diagnosed with terminal prostate cancer. For a former president with elite care? Even lower, likely closer to 0.01% to 0.05% per year. Exceptionally rare...

I just watched the @Derek_Fitness breakdown of @Cobratate labs. Unless I missed it (happy to be wrong), it seems like he completely glossed over the elevated LH/FSH + missing SHBG, which is a massive oversight. That pattern actually suggests SERM use, not the opposite

I was a resident doing a surgery rotation. The patient was a pediatric floor patient, severely contracted with cerebral palsy, needing a central line. The chief resident told me to go place a subclavian. It was my first time doing it unassisted, 100% on my own. The surgery resident did not allow me to place the subsequent chest tube by myself…

Her INR was 4 and I was the intern tasked to place a femoral central line for pressers and antibiotics in this septic patient in the emergency department. A mistake I made during this one procedure would become a pivotal life learning moment for me. The procedure started out well… all the way up until I removed the guidewire, at which point I unintentionally withdrew everything, including the now dilated central line. Holding everything in my hand, my upper level who was supervising me at the time said, “ well you’ll never do that again.” She then put on her gloves and completed the procedure on the opposite side after instructing me to hold pressure. I was mortified. I went home, but couldn’t sleep. I made this one mistake mean that I wasn’t a good resident, and I was doomed to become a bad anesthesiologist. I was an impostor who had finally been caught. I’d later learn this is called generalizing where we take a single mistake/incident and catastrophize that mistake to mean something about who we are as a person. I share this because I didn’t have a good perspective at the time. Did I learn from it? Yes. Was it necessary do destroy myself while I did? No. I share this because there’s a physician (in training or after) who right now needs to hear that they are greater than any single failure you’ve had. No single moment defines you or your worth. Or your value as a physician. Remember that failure isn’t in the way of success. It is THE way to success. Don’t let these moments to define you. Keep your head up. You are doing just fine. #MedTwitter #MedX #meded

Just when I thought my Whole Foods run was over, I stumbled upon a gem near the checkout: @SieteFoods heirloom corn tortillas. •No seed oils — just pure, wholesome ingredients •Nixtamalized corn — honoring traditional methods for better flavor and nutrition It’s inspiring to see brands like Siete and @masienda_us leading the way, bringing ancestral food wisdom to our modern tables. The fact that these were prominently displayed speaks volumes about the shift towards real, nourishing foods. Here’s to more brands embracing the roots of culinary tradition for our health and longevity.

@JiujitsuOtter Because they had no regular open mat, and we only rolled maybe one 5 minute round every third class.

If you’ve ever cancelled your membership at a BJJ gym, what was your reason?