The OTC Medicine With A Dementia Risk?

Whether you’ve had the sniffles, sneezes or perhaps simply to help you sleep… you’ve probably taken some diphenhydramine, the world’s most popular first-generation antihistamine. It’s in everything from Benadryl to Tylenol, and is used by roughly one-third of adults for allergies, one-in-ten for insomnia, plus motion sickness, anxiety, nausea…even Parkinson’s tremors. 

But there is some updated science worth knowing before you make it your nightly ritual…

How it works and the concern

Diphenhydramine blocks histamine throughout your body and in your brain, which is why it knocks you out. But crossing the blood-brain barrier also means it can bind to acetylcholine receptors… acetylcholine being crucial for memory, attention, and muscle control.

In one clinical trial, just 50 mg of diphenhydramine led to measurable drops in short-term recall and focus tasks and in older adults it lingers up to 18 hours, causing daytime fog, reducing reaction times… and studies link it to more car accidents and falls.

Hidden harms of long-term use

Beyond feeling groggy multiple large studies (including a 2015 JAMA Intern Med paper) show daily use for ≥3 years was tied to a 54 % higher dementia risk versus short-term users. European and Canadian cohorts echo this neurodegenerative red flag.

Smarter, safer swaps

The good news is you don’t have to resign yourself to endless brain-fog if you do these simple swaps:

1. Switch to second-gen antihistamines (loratadine, cetirizine, fexofenadine). They spare your brain’s histamine and acetylcholine… and carry minimal drowsiness.
   
   

2. Prioritize sleep hygiene:
   
   

   • Dark, cool, screen-free wind-down an hour before bed
     

   • Consistent sleep and wake times… yes even on weekends
     

   • A short evening meditation or gentle stretch routine
     
     

3. Reserve diphenhydramine for true emergencies (severe allergic reactions under doctor supervision), not as a nightly habit.
   
   

Actionables for you:

• Audit your medicine cabinet: Circle any OTC product listing diphenhydramine (Benadryl, Tylenol PM, Unisom, etc.).
  

• Make the swap: When allergies strike, reach first for Claritin, Zyrtec or Allegra.
  

• Track your fog: Keep a quick log of “brain days” versus “clear days” after switching. You’ll see the difference.
  

• Talk to your doc: If sleep remains elusive, discuss non-drug options (CBT-I, melatonin timing) before resorting back to diphenhydramine.
  
  

How Your Colon Will Look When You’re 80… 

There is a 70% chance that by the age of 80 you will have something called “diverticular disease” affecting your colon.

Yes I know it sounds like medical gobbledygook but it is pretty common and the incidence is rising in younger adults too thanks to our love affair with ultra-processed, fiber-poor diets. 

Diverticulosis vs. Diverticulitis 

Diverticulosis: Tiny pouches (“diverticula”) that form when the colon’s muscle layer weakens. Mostly harmless… and often entirely symptom-free.

Diverticulitis: When those pouches inflame or become infected, you get constant lower-left abdominal pain, fever, nausea, and abrupt bowel-habit changes. This one needs urgent medical care!

Often because symptoms (bloating, crampy pain, alternating constipation/diarrhea) mimic IBS, it can take a specialist’s scan or colonoscopy to pin down the diagnosis.

What triggers those pouches?

No single culprit, but key suspects include:

• Low fiber intake (< 60 % of RDA on average)
  

• Highly processed foods that speed through your gut
  

• Obesity & physical inactivity
  

• Genetics & subtle differences in colon structure
  

• Chronic constipation, which raises colonic inner-wall pressure
  
  

Debunking the “seeds get stuck” myth

I’ve seen many patients with this over the years and one myth is extremely pervasive - you can’t eat nuts and seeds because they’ll get stuck in the little diverticular pouches!

For decades, doctors cautioned patients to swear off popcorn, nuts, and seeds for fear of lodging them in diverticula. 

Not true… recent NICE guidance states there’s no need to avoid these foods unless you personally flare up after eating them. In fact, those crunchy bits often come packaged with fiber, polyphenols, and good fats… your diverticula’s secret allies.

Your high-fiber “home remedy” kit

Aim for ≥ 30 g fiber/day (the UK/US guidelines).

• Breakfast: High-fiber oats + fresh berries or diced apple (8–10 g)
  

• Bread & grains: Switch to wholemeal or granary loaves; swap white pasta/rice for wholewheat pasta or brown rice (+ 5–10 g)
  

• Legumes & Veg: Stir ¼ cup red lentils or kidney beans into your mince; add grated carrot or chopped peppers to sauces (+ 6–8 g)
  

• Snacks: Raw veg sticks + hummus; a handful of almonds or pumpkin seeds (+ 3–4 g)

Pro tip: Ramp up fiber gradually… a sudden jump can spark gas or bloating. Give your microbiome a week or two to adapt.

Hydration & movement

Hydrate: Aim for 1 mL water per kcal (e.g. ~2 L on a 2,000 kcal diet). Water softens stools so they glide past diverticula without drama.

Move: Even 30 minutes of walking, cycling or yoga most days helps keep your colon in rhythm…reducing pressure and preventing constipation.

If you still struggle to hit fiber targets, consider fiber supplements (e.g. psyllium husk), these can fill in any fiber gaps and keep your gut running smoothly.

P.S If you want to learn more about the gut, microbiome science sign up to my newsletter dedicated to bring you short, snappy actionable tips on this:

P.P.S only sign up if you’re really obsessed with gut stuff and the microbiome!

Things I Wish I Knew Earlier:

Embracing The Unseen

Imagine two travelers standing at the edge of a dense forest. 

One demands to know every bird call before stepping forward, maps every clearing, and predicts each path. The other inhales deeply, feels the breeze shift, and simply trusts that each step will reveal new wonders. In life, as in the woods, uncertainty is our ever-present companion… and the rarest skill may not be knowledge, but the capacity to bear the unknown.

The psychology of not knowing

The intolerance of uncertainty… that tendency to feel anxiety at the mere prospect of unpredictability. 

Studies show that people high in this trait are prone to rumination, worry, and decision paralysis. Conversely, high uncertainty tolerance correlates with resilience, creativity, and a willingness to experiment. When you can live with questions instead of rushing for answers, you free your mind to explore possibilities, learn new skills, and recover more swiftly from setbacks.

Our brains have evolved to crave certainty… stable social bonds, predictable food sources, clear rewards. Learning to sit with uncertainty actually grows the neural pathways that regulate that alarm. Like building a mental “tolerance muscle,” repeated exposure to the unknown recalibrates our threat response, making us more composed and curious when fresh challenges arise.

Life lessons from the edge of control

1. Show up every day: Rewards rarely announce themselves in advance. James Clear (Atomic Habits) speaks of “compounding interest” in habits: your consistent actions; writing a paragraph, practicing an instrument, tending your health… yield rich dividends precisely because the outcome is invisible at first. Tolerance of uncertainty keeps you present through the dry spells until results blossom.
   
   

2. Embrace “good enough”: Perfectionism is the enemy of progress. Allow yourself to ship an imperfect idea or do a half-baked workout. Each attempt, however messy, teaches your brain that uncertainty is merely feedback.
   
   

3. Reframe fear as fuel: When you notice uncertainty triggering a zing of stress, pause and ask: What’s the adventure here? That mental pivot allows you to turn a moment of dread into creative momentum.
   
   

In a world that clamors for certainty… plant your flag on the edge of what you don’t yet know. The greatest rewards, after all, await those courageous enough to stand tall in the face of uncertainty.

Strengthen Your Gut–Brain Connection:

Science-Backed Actionables

On my wedding day I actually ended up wearing my Oura ring and I looked down at my phone and noticed my heart rate and stress had unsurprisingly peaked in the morning of the big day!

We know that the brain can wreak havoc on the gut (nervous poops, nausea etc) but this gut-brain connection can even influence your food choices, affect your skin health, immune system (make you more likely to get a cold) and more!

Your gut and brain chatter constantly via the vagus nerve, microbial metabolites, and immune signals. When this “gut–brain axis” falters, you may feel brain fog, low mood, bloating, or erratic bowel movements. Thankfully there are practical steps you can take today to fortify that two-way street.

By the way, I knew none of this in medical school… I just find it deeply fascinating and something I wanted to dive into myself:

1. Load up on polyphenols

Polyphenols are plant compounds that your gut bugs love, producing soothing short-chain fatty acids (SCFAs) in return. In one randomized trial, adults who drank a 200 mg daily pomegranate polyphenol extract saw a 30 % increase in SCFA levels (notably butyrate) in just 4 weeks… and reported a 15 % drop in stress markers.

• Action: Aim for 1–2 servings per day of high-polyphenol foods; think berries (blueberries, raspberries), dark chocolate (≥70 %), green tea, or extra-virgin olive oil.
  
  

2. Embrace fermented foods

Live cultures reinforce your microbiome’s resilience and produce neuroactive compounds like GABA and serotonin. In a 60-person trial, 8 weeks of daily 50 g kimchi raised beneficial Lactobacillus by 20 % and reduced anxiety scores by 12 %. Likewise, 1 cup of kefir daily for a month improved gut transit time by 18 % and elevated mood ratings.

• Action: Start with 1–2 tablespoons of sauerkraut or kimchi at lunch, or swap your morning yogurt for plain kefir.
  
  

3. Diaphragmatic breathing for vagal tone

Deep belly breathing directly soothes the vagus nerve, which in turn regulates gut motility and the migrating motor complex (MMC)... the “intestinal housekeeper.” A controlled trial found just 10 minutes of diaphragmatic breathing daily boosted heart-rate variability (a marker of vagal tone) by 30 % in one week, translating to smoother digestion and less bloating.

• Action: Lie on your back, place one hand on your belly, inhale for a 4-count so your abdomen rises, then exhale for 6. Repeat for 5–10 minutes each morning or right before meals.
  
  

4. Prioritize sleep & consistent meal timing

Your gut microbes follow a circadian rhythm. A landmark study showed irregular eating windows disrupted microbial diversity by 20 %, whereas a consistent 10-hour eating window preserved diversity and improved glucose tolerance. Poor sleep fragments gut–brain signaling, raising inflammatory cytokines that dull mood and motility.

• Action: Aim for 7–8 hours of sleep nightly and eat meals within the same 10–12 hour daylight-aligned window.
  
  

5. Move mindfully

Moderate exercise enhances SCFA production and blood flow to both gut and brain. In sedentary adults, 30 minutes of brisk walking 5 days/week increased fecal SCFAs by 25 % and improved cognitive test scores by 10 % over 12 weeks.

• Action: Schedule three 30-minute walks or cycle sessions per week, ideally after meals to nudge along that MMC “clean-up” wave.

  
  
  P.s for more deep dives on health topics check out my podcast.. this weeks episode was my all time favourite (no prizes for guessing why!):

Your Brain On ChatGPT

If you’ve ever used ChatGPT to brainstorm, outline, or even write entire paragraphs, you might chalk it up to “just getting the first draft out.” 

But a new MIT study, “Your Brain on ChatGPT: Accumulation of Cognitive Debt when Using an AI Assistant for Essay-Writing,” shows that relying too heavily on AI measurably rewires how our brains focus, create, and retain knowledge. 

The experiment in a nutshell

• Participants: 54 SAT-style essay writers
  
  

• Tools: Brain-only (no aid), Google Search, GPT-4o
  
  

• Design: Four sessions of essay-writing with high-density EEG tracking connectivity across 32 brain regions.
  
  

• Flip test: Those who started unaided switched to GPT (Brain→LLM); habitual GPT users switched to solo writing (LLM→Brain).
  
  

Key findings & surprising stats

1. Weaker executive control with pure GPT use
   

   • Frontoparietal & temporal connectivity; areas tied to deep thinking… were lowest when writers used GPT exclusively.
     
     
     

2. Order matters
   

   • Brain→LLM writers (think solo first, then AI revise) showed a spike in brain-wide connectivity above any previous session.
     

   • LLM→Brain writers (start with AI, finish solo) hit their lowest connectivity levels, and their essays leaned on bland, AI-favored phrases…despite high grades. (is this a cost you’re happy with?)
     
     

3. Memory & ownership collapse
   

   • In their first AI session, none of the GPT-users could quote a sentence they’d just written. Solo writers almost all could.
     

   • Even with practice, AI-assisted writers never fully recovered that recall ability.
     
     

4. Cognitive debt accumulates
   

   • Repeated GPT reliance narrowed topic exploration and diversity of ideas.
     

   • When AI crutches were yanked away, habitual users struggled to regain the breadth and depth of their earlier, human-only work.
     

The researchers describe this as cognitive debt: borrowing mental effort now in exchange for “free” words, only to pay interest later in lost focus, creativity, and memory. 

The trade-off is a real neurological impact. You forgo the thinking in order just to get the answers, but have no real idea of why the answers are what they are.

Which backs up the worry I have when people say  “I just use AI to write a first draft, and then I take over to make it my work”...

Could you pass this test…? 

Anti-Acid Pills & What You Should Do

Proton pump inhibitors (PPIs) like omeprazole and pantoprazole are lifesavers for acid reflux, GERD, and peptic ulcers. 

But if you’ve been popping a PPI every morning for months… or years… it’s time for a check-in. 

Long-term use carries real risks, and in many cases, safer alternatives or lifestyle tweaks can keep heartburn at bay without sacrificing nutrient status or bone health.

The hidden costs of chronic acid suppression

1. Nutrient deficiencies
   

   • Vitamin B₁₂: Stomach acid helps release B₁₂ from food. After a year on PPIs, up to 60 percent of users show lower B₁₂ levels, risking fatigue and neuropathy.
     

   • Magnesium & calcium: Acid aids mineral absorption. Prolonged PPI use is linked to hypomagnesemia (low magnesium), which can trigger muscle cramps and arrhythmias, and to reduced bone density, raising fracture risk by 30 percent.
     

   • Iron: Non-heme iron from plants needs an acidic environment. Chronic acid suppression may cause or worsen anemia.
     
     

2. Infection & gut flora changes
   

   • Reduced acid leaves you vulnerable to C. difficile infections and small-intestinal bacterial overgrowth (SIBO), with symptoms of bloating, diarrhea, and abdominal pain.
     
     

3. Kidney & cardiovascular concerns
   

   • Emerging data link long-term PPI use to a small increase in chronic kidney disease and, in some studies, to cardiovascular events; though causality remains under investigation.
     
     

Who does need long-term PPIs?

• Absolutely indicated for Barrett’s esophagus, severe erosive esophagitis (Los Angeles Grade C–D), Zollinger-Ellison syndrome, or recurrent bleeding ulcers.
  

• Reevaluate chronic use for milder reflux or non-erosive disease; many patients can step down.
  

Action steps: partner with your doctor

1. Ask “Why?”
   – If you’ve been on a PPI > 8 weeks, schedule a medication review. Confirm whether ongoing therapy is essential for your condition.
   
   

2. Blood tests to monitor
   – Serum vitamin B₁₂ and magnesium every 6–12 months
   – Calcium, 25-hydroxy vitamin D, and a complete blood count (CBC) to screen for anemia
   – Consider an iron profile if you’re vegetarian or have chronic fatigue
   
   

Safer alternatives & “step-down” strategies

• H₂-Receptor Blockers (e.g., famotidine): Less potent but often effective for mild reflux and with fewer long-term risks.
  

• Antacids: For occasional “fire-in-the-hole” moments, chewable options like calcium carbonate can double as a calcium supplement.
  
  

Lifestyle modifications

• Meal Timing: Finish eating 2–3 hours before bedtime.
  

• Portion control: Opt for smaller, more frequent meals to reduce gastric distension.
  

• Trigger avoidance: Identify personal culprits; spicy foods, caffeine, alcohol…and limit them.
  

• Weight management: Every 5 percent weight loss can drop acid reflux episodes by 50 percent.
  

• Sleep position: Elevate your head 6–8 inches to use gravity against nighttime reflux.
  

• Stress reduction: Chronic stress can exacerbate reflux; try diaphragmatic breathing (5 minutes, twice daily) to tone your vagus nerve and promote healthy gut motility.
  

PPIs are powerful tools but they’re best used for the right job and for the right duration. 

Discuss your plan with your doctor; and consider whether it’s time to step down, or even step off, the PPI rollercoaster.

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