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Ask Doctor DawnAn hour of medical questions, answers, debate, dialogue, discussion, & health in the news. Author: Dr. Dawn Motyka - JivaMedia.com
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Ivermectin Evidence and Critical Thinking, CBC-Based Inflammation Formulas, and Transperineal Prostate Biopsy
Sunday, 28 June, 2026
Broadcast from KSQD, Santa Cruz on 6-25-2026: Dr. Dawn devotes the show's opening to ivermectin for COVID. She walks through critical thinking principles—considering the source, cross-verification, and recognizing self-interested claims—before reviewing the evidence. The most-cited 2021 Bulgarian study of 300 people showing 77% reduction lacked accessible methods, and larger trials capable of detecting even small benefits failed to confirm efficacy. On safety, the standard 12mg parasitic dose every few weeks is well-tolerated due to the blood-brain barrier and efflux pumps that keep ivermectin out of the brain, but daily long-term dosing has caused encephalopathy, liver and kidney damage, and birth defects. Critical drug interactions—macrolide antibiotics, verapamil, proton pump inhibitors, and beta blockers—disable the efflux mechanism, and high-fat meals increase absorption 2.5-fold. Dr. Dawn shares two inflammation formulas calculable from any CBC. The Systemic Inflammatory Index (neutrophils × platelets ÷ lymphocytes) flags runaway inflammation: 200-500 is good, above 900 warrants investigation and correlates with worse stroke outcomes and rising tumor burden. The SIRI (neutrophils x monocytes ÷ lymphocytes) detects chronic tissue inflammation and early innate immune activation: below 500 is good, above 1500 indicates trouble and correlates with cardiovascular mortality and arterial plaque from M1 macrophage activity. Dr. Dawn shares two takeaways from the Institute for Functional Medicine annual conference: in patients at high cardiovascular risk by cholesterol, each gram daily of combined EPA/DHA produces a 9% risk reduction, with bruising as the dose-limit signal. Additionally, a 15-minute walk within 30 minutes of a meal nearly eliminates postprandial inflammation. An emailer asks whether an endocrinologist's claim that vitamin D leaches calcium from bones is true. Dr. Dawn confirms that very high vitamin D (above 150 nanograms, with concern starting above 90) elevates 1,25-vitamin D, which stimulates osteoclast formation and increases C-telopeptide markers of bone breakdown. A crowdsourced question asks how histamines work in women. Dr. Dawn explains histamine functions as a CNS neurotransmitter promoting alertness, wakefulness, and pain perception (deficient in narcolepsy), and as a GI signal driving acid secretion, motility, and visceral sensation. Gut bacteria can convert histidine to histamine, and fish left to spoil can trigger anaphylactic-like reactions from accumulated bacterial histamine. She notes stomach acid treatments Tagamet and Zantac are H2 blockers rather than the more familiar H1 antihistamines, and confirms histamine correlates with hormones but not particularly with minerals. A crowdsourced question on B vitamins for women in their mid-twenties prompts Dr. Dawn to recommend prenatal vitamins for those who might become pregnant, and B100 complex with calcium taken with a little apple cider vinegar for those on restricted diets or eating mostly fast food. Another question asks about chest versus belly breathing. Dr. Dawn explains babies demonstrate proper diaphragmatic breathing (belly protrudes on inhalation) while accessory muscle use signals fight-or-flight—or pneumonia in a non-crying infant. Chest breathing raises adrenaline; belly breathing calms it in adults. How do I stop compulsive scratching? Dr. Dawn explains neurodermatitis has its own ICD-10 code alongside compulsive nail-biting and hair-pulling, and it is diagnosed by sparing of unreachable areas like the mid-back between shoulder blades. Treatment includes nail clipping, lubricants, covering scabbed areas, and Prozac—which uniquely among antidepressants has a secondary indication for neurodermatitis. Zurich researchers combined immature human nerve cells with magnetic nanoparticles to create 6-micrometer NPC bots that can be magnetically positioned at spinal cord injury sites and then triggered by pulsatile magnetic stimulation to mature into nerve tissue. Mice with severed spinal cords regained movement and brain-muscle electrical signals by day 34 after daily 30-minute treatments. A study of 15,000 people with myalgic encephalomyelitis/chronic fatigue syndrome identified eight genetic regions distinguishing them from controls. Two relate to immune response to infection—consistent with the post-infectious onset many sufferers describe, including roughly half of long COVID patients—and others link to the nervous system and chronic pain. Dr. Dawn frames ME-CFS as an immune system stuck in the "on" position, unable to brake against an enemy that is long gone. An emailer asks about prostate biopsy approaches. Dr. Dawn explains the new transperineal biopsy (through skin between scrotum and anus) reduces post-biopsy infection from 1.5% to near zero and eliminates prophylactic antibiotics, though it requires more anesthesia and time. Cancer detection rates match the transrectal approach when both use MRI targeting, and she expects the transperineal approach to become standard.
