THE CASE
Mrs Green aged 60 comes complaining that she feels fatigued and tired, although there are no specific symptoms and she has no fever, pain, bowel upset, bleeding, nor any mental health symptoms. She is sleeping normally and doing all her usual activities easily, and working full time. She is happily married and has no children by choice. She is not clinically anaemic, chest and abdominal exam is normal. Her doctor does “some tests” FBC CRP E and E LFT GGT coeliac screen TFT, B12 folate serum iron, HBa1c, Vitamin D urinalysis myeloma screen HIV hepatitis screen and ends up with about 25 (maybe even 30 or 40??) results to digest and interpret. The serum phosphate is a little low, the sodium is 134 (NR 135–146 mmol/L) the HGBA1C is 38, risen from 32 last year at a “health check” The patient sees the results as she has direct access to her electronic record and rings up saying “What do I need to do about these abnormal results and what tests should I do next? Why did you do an HIV test are you saying I am promiscuous? Can I have a whole-body scan to see what’s wrong?” It says on google I have got pre diabetes!

Show Notes
1) Your results may vary: the imprecision of medical measurements
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m149

2) GET A LIST OF THE VARIATION OF MEASUREMENTS FOR COMMON TESTS FROM THE ABOVE REFERENCE

In episode 604, James and Mike K get Jennifer Young to tackle the topic of nose bleeds and what the evidence shows around the use of topical tranexamic acid and how it compares to other treatments. We go over all the endpoints and give you all the numbers.

Show Notes
1) Tools For Practice
Stop the Drip: Tranexamic Acid Solution for Nosebleeds

2) PEIP Conference Edmonton October 17-18, 2025

In episode 603, James and Mike K invite Jennifer Young back to the podcast to talk about the best available evidence for topical minoxidil and hair growth. We discuss outcomes such as the numbers of hairs per squared centimeter – the main outcome reported – but when available, we also other report on other outcomes and also the side effects. So, if you want to know about numbers of hair per squared centimeter and all the other numbers, tune in.

Show Notes
1) Tools For Practice
Topical minoxidil for androgenetic alopecia: When blood pressure agents make you hairy
2) PEIP Conference Edmonton October 17-18, 2025

In episode 602, James and Mike Kolber go over the best available evidence for the benefits and the harms for one of the most commonly used classes of medications – proton pump inhibitors. We find out the benefit numbers are much larger than the harm numbers. Check out the podcast to get all the numbers you need to help people make decisions.

Show Notes
1) Tools For Practice
Side effects of long-term PPI use: Leaving a bad taste in your mouth?
Proton Pump Inhibitors (PPIs): Is Perpetual Prescribing Inevitable?

2) PEIP Conference Edmonton October 17-18, 2025

3) SPARCTool

4) RX files PPI
Stopping your Proton Pump Inhibitor or “PPI”