Jay Lankau

Spring is the time for new beginnings, cleaning out your dusty musty basement, battling seasonal allergies, and, of course, discovering the latest TikTok trends.

With potentially permanent daylight savings on the table, that extra time spent luxuriating in the sunshine could mean more time to scroll (and scroll and scroll) through the latest health fads on the platform – for better or for worse.
 

The good: Doctor explains menstrual pain in an unexpected place

For a long time, menstrual cycles were considered taboo, and discussing them is still seen as inappropriate in many parts of the world. Organizations and online resources such as Clue or Flo are seeking to normalize period-talk. Pixar has jumped on board with its latest film, Turning Red, which depicts a 13-year-old’s experience getting her first period. With a 95% rating on Rotten Tomatoes, it’s clear that the public is willing to talk about periods.

Many people feel shame around discussing their periods, but this is something that social media has actually handled positively (for once).

Karan Raj, MD, a National Health Service surgeon and educator at Imperial College London, uses his TikTok account to educate his followers and explain health concerns and issues. Dr. Raj stitched this video from someone else that was captioned, “When you’re on your [period] and feel the stab in your booty.”

In his video, Dr. Raj uses anatomical diagrams to explain exactly what’s going on with this pain in the butt. The pain, which Dr. Raj says is called proctalgia fugax, is caused by a type of hormone released during menstruation called prostaglandins. Prostaglandins tell the uterus to contract and shed its lining, but the uterus isn’t the only part of the body receiving that message from the prostaglandins.

“The prostaglandins also cause contraction of the rectum, pelvic floor muscles, and muscles around the anal canal,” Dr. Raj tells viewers. “These intense contractions can cause muscle spasms and anal cramps.”
 

The bad: Lettuce water sleep aid

This video from Elliott Norris (@callmebelly) shows him preparing an unusual sleep aid. It’s one of many videos of people trying the same trend, usually with the tag #lettucewater attached.

As Mr. Elliott explains, the rumor is that boiling romaine lettuce and then drinking the water is a way to help one fall asleep faster, or sleep better at night. At the end of the video, Mr. Elliott even said that it worked for him. So where does this come from, and is it just a placebo?

Videos on TikTok recreating this trend cite a 2017 study titled, “Sleep-inducing effect of lettuce (Lactuca sativa) varieties on pentobarbital-induced sleep” (there’s even a New York Times article about it). The star of the study is lactucarium, a milky white substance that›s found in lettuce, usually visible if you squeeze it or break the stalks. The study suggests that lactucarium has “sedative-hypnotic” properties after lettuce extract was used in tandem with pentobarbital on mice, and it was found that the mice›s sleep latency then decreased.

In an article from Parade discussing the trend, Rachel Salas, MD, MEd, weighs in. Dr. Salas is the assistant medical director at Johns Hopkins Center for Sleep and Wellness in Baltimore, so you could say she knows a thing or two about sleep. Her response to the mice study was that its limitations made the results not entirely reliable.

According to Dr. Salas, there was no control group, the extract the mice were given is much more concentrated than what’s found in lettuce, and the mice were given a sedative that was going to make them sleepy anyway: “The mice were drugged to put the animals to sleep soon after they took the lettuce water.”

So while Dr. Salas thinks it’s good that people are open to talking about sleeping solutions, “lettuce tea” just doesn’t have any evidence to back up what people claim it does.
 

The ugly: Using a book to pop ganglion cysts

Everyone knows how popular pimple popping, blackhead squeezing, and cyst squashing are on social media. Dermatologist Sandra Lee, better known as Dr. Pimple Popper, used her YouTube platform of the same name – which boasts over 7.42 million subscribers – to cinch a reality television show on TLC. Viewers on TikTok are no different and love the satisfying (and often gross) relief of clearing out a nasty pimple or two.

In this stitched TikTok from emergency medicine physician Fayez Ajib, DO, aka @lifeofadoctor, Dr. Ajib reacts to an original video of someone popping a ganglion cyst with a textbook.

There are plenty of other videos on TikTok of people using books to smack ganglion cysts, which develop on the wrist. People have looked for remedies for ganglion cysts since the 1700s, at which point many strange options arose, as discussed in BBC Future. The one that still holds up, however, is smacking the cyst with a heavy book, like a Bible (hence the ganglion cyst’s nickname, “Bible bump”).

In his video, Dr. Ajib explains why smacking the cyst is a bad idea, even if it appears to temporarily resolve the issue.

“Not only have people broken the delicate bones in their wrist from getting hit,” Dr. Ajib says, “but they actually have a high chance of recurrence. A doctor will actually remove the sac itself rather than just draining it from being hit.”

The lessons we glean from TikTok remain the same: Leave it up to the professionals.

A version of this article first appeared on Medscape.com.

Spring is the time for new beginnings, cleaning out your dusty musty basement, battling seasonal allergies, and, of course, discovering the latest TikTok trends.

With potentially permanent daylight savings on the table, that extra time spent luxuriating in the sunshine could mean more time to scroll (and scroll and scroll) through the latest health fads on the platform – for better or for worse.
 

The good: Doctor explains menstrual pain in an unexpected place

For a long time, menstrual cycles were considered taboo, and discussing them is still seen as inappropriate in many parts of the world. Organizations and online resources such as Clue or Flo are seeking to normalize period-talk. Pixar has jumped on board with its latest film, Turning Red, which depicts a 13-year-old’s experience getting her first period. With a 95% rating on Rotten Tomatoes, it’s clear that the public is willing to talk about periods.

Many people feel shame around discussing their periods, but this is something that social media has actually handled positively (for once).

Karan Raj, MD, a National Health Service surgeon and educator at Imperial College London, uses his TikTok account to educate his followers and explain health concerns and issues. Dr. Raj stitched this video from someone else that was captioned, “When you’re on your [period] and feel the stab in your booty.”

In his video, Dr. Raj uses anatomical diagrams to explain exactly what’s going on with this pain in the butt. The pain, which Dr. Raj says is called proctalgia fugax, is caused by a type of hormone released during menstruation called prostaglandins. Prostaglandins tell the uterus to contract and shed its lining, but the uterus isn’t the only part of the body receiving that message from the prostaglandins.

“The prostaglandins also cause contraction of the rectum, pelvic floor muscles, and muscles around the anal canal,” Dr. Raj tells viewers. “These intense contractions can cause muscle spasms and anal cramps.”
 

The bad: Lettuce water sleep aid

This video from Elliott Norris (@callmebelly) shows him preparing an unusual sleep aid. It’s one of many videos of people trying the same trend, usually with the tag #lettucewater attached.

As Mr. Elliott explains, the rumor is that boiling romaine lettuce and then drinking the water is a way to help one fall asleep faster, or sleep better at night. At the end of the video, Mr. Elliott even said that it worked for him. So where does this come from, and is it just a placebo?

Videos on TikTok recreating this trend cite a 2017 study titled, “Sleep-inducing effect of lettuce (Lactuca sativa) varieties on pentobarbital-induced sleep” (there’s even a New York Times article about it). The star of the study is lactucarium, a milky white substance that›s found in lettuce, usually visible if you squeeze it or break the stalks. The study suggests that lactucarium has “sedative-hypnotic” properties after lettuce extract was used in tandem with pentobarbital on mice, and it was found that the mice›s sleep latency then decreased.

In an article from Parade discussing the trend, Rachel Salas, MD, MEd, weighs in. Dr. Salas is the assistant medical director at Johns Hopkins Center for Sleep and Wellness in Baltimore, so you could say she knows a thing or two about sleep. Her response to the mice study was that its limitations made the results not entirely reliable.

According to Dr. Salas, there was no control group, the extract the mice were given is much more concentrated than what’s found in lettuce, and the mice were given a sedative that was going to make them sleepy anyway: “The mice were drugged to put the animals to sleep soon after they took the lettuce water.”

So while Dr. Salas thinks it’s good that people are open to talking about sleeping solutions, “lettuce tea” just doesn’t have any evidence to back up what people claim it does.
 

The ugly: Using a book to pop ganglion cysts

Everyone knows how popular pimple popping, blackhead squeezing, and cyst squashing are on social media. Dermatologist Sandra Lee, better known as Dr. Pimple Popper, used her YouTube platform of the same name – which boasts over 7.42 million subscribers – to cinch a reality television show on TLC. Viewers on TikTok are no different and love the satisfying (and often gross) relief of clearing out a nasty pimple or two.

In this stitched TikTok from emergency medicine physician Fayez Ajib, DO, aka @lifeofadoctor, Dr. Ajib reacts to an original video of someone popping a ganglion cyst with a textbook.

There are plenty of other videos on TikTok of people using books to smack ganglion cysts, which develop on the wrist. People have looked for remedies for ganglion cysts since the 1700s, at which point many strange options arose, as discussed in BBC Future. The one that still holds up, however, is smacking the cyst with a heavy book, like a Bible (hence the ganglion cyst’s nickname, “Bible bump”).

In his video, Dr. Ajib explains why smacking the cyst is a bad idea, even if it appears to temporarily resolve the issue.

“Not only have people broken the delicate bones in their wrist from getting hit,” Dr. Ajib says, “but they actually have a high chance of recurrence. A doctor will actually remove the sac itself rather than just draining it from being hit.”

The lessons we glean from TikTok remain the same: Leave it up to the professionals.

A version of this article first appeared on Medscape.com.

Spring is the time for new beginnings, cleaning out your dusty musty basement, battling seasonal allergies, and, of course, discovering the latest TikTok trends.

With potentially permanent daylight savings on the table, that extra time spent luxuriating in the sunshine could mean more time to scroll (and scroll and scroll) through the latest health fads on the platform – for better or for worse.
 

The good: Doctor explains menstrual pain in an unexpected place

For a long time, menstrual cycles were considered taboo, and discussing them is still seen as inappropriate in many parts of the world. Organizations and online resources such as Clue or Flo are seeking to normalize period-talk. Pixar has jumped on board with its latest film, Turning Red, which depicts a 13-year-old’s experience getting her first period. With a 95% rating on Rotten Tomatoes, it’s clear that the public is willing to talk about periods.

Many people feel shame around discussing their periods, but this is something that social media has actually handled positively (for once).

Karan Raj, MD, a National Health Service surgeon and educator at Imperial College London, uses his TikTok account to educate his followers and explain health concerns and issues. Dr. Raj stitched this video from someone else that was captioned, “When you’re on your [period] and feel the stab in your booty.”

In his video, Dr. Raj uses anatomical diagrams to explain exactly what’s going on with this pain in the butt. The pain, which Dr. Raj says is called proctalgia fugax, is caused by a type of hormone released during menstruation called prostaglandins. Prostaglandins tell the uterus to contract and shed its lining, but the uterus isn’t the only part of the body receiving that message from the prostaglandins.

“The prostaglandins also cause contraction of the rectum, pelvic floor muscles, and muscles around the anal canal,” Dr. Raj tells viewers. “These intense contractions can cause muscle spasms and anal cramps.”
 

The bad: Lettuce water sleep aid

This video from Elliott Norris (@callmebelly) shows him preparing an unusual sleep aid. It’s one of many videos of people trying the same trend, usually with the tag #lettucewater attached.

As Mr. Elliott explains, the rumor is that boiling romaine lettuce and then drinking the water is a way to help one fall asleep faster, or sleep better at night. At the end of the video, Mr. Elliott even said that it worked for him. So where does this come from, and is it just a placebo?

Videos on TikTok recreating this trend cite a 2017 study titled, “Sleep-inducing effect of lettuce (Lactuca sativa) varieties on pentobarbital-induced sleep” (there’s even a New York Times article about it). The star of the study is lactucarium, a milky white substance that›s found in lettuce, usually visible if you squeeze it or break the stalks. The study suggests that lactucarium has “sedative-hypnotic” properties after lettuce extract was used in tandem with pentobarbital on mice, and it was found that the mice›s sleep latency then decreased.

In an article from Parade discussing the trend, Rachel Salas, MD, MEd, weighs in. Dr. Salas is the assistant medical director at Johns Hopkins Center for Sleep and Wellness in Baltimore, so you could say she knows a thing or two about sleep. Her response to the mice study was that its limitations made the results not entirely reliable.

According to Dr. Salas, there was no control group, the extract the mice were given is much more concentrated than what’s found in lettuce, and the mice were given a sedative that was going to make them sleepy anyway: “The mice were drugged to put the animals to sleep soon after they took the lettuce water.”

So while Dr. Salas thinks it’s good that people are open to talking about sleeping solutions, “lettuce tea” just doesn’t have any evidence to back up what people claim it does.
 

The ugly: Using a book to pop ganglion cysts

Everyone knows how popular pimple popping, blackhead squeezing, and cyst squashing are on social media. Dermatologist Sandra Lee, better known as Dr. Pimple Popper, used her YouTube platform of the same name – which boasts over 7.42 million subscribers – to cinch a reality television show on TLC. Viewers on TikTok are no different and love the satisfying (and often gross) relief of clearing out a nasty pimple or two.

In this stitched TikTok from emergency medicine physician Fayez Ajib, DO, aka @lifeofadoctor, Dr. Ajib reacts to an original video of someone popping a ganglion cyst with a textbook.

There are plenty of other videos on TikTok of people using books to smack ganglion cysts, which develop on the wrist. People have looked for remedies for ganglion cysts since the 1700s, at which point many strange options arose, as discussed in BBC Future. The one that still holds up, however, is smacking the cyst with a heavy book, like a Bible (hence the ganglion cyst’s nickname, “Bible bump”).

In his video, Dr. Ajib explains why smacking the cyst is a bad idea, even if it appears to temporarily resolve the issue.

“Not only have people broken the delicate bones in their wrist from getting hit,” Dr. Ajib says, “but they actually have a high chance of recurrence. A doctor will actually remove the sac itself rather than just draining it from being hit.”

The lessons we glean from TikTok remain the same: Leave it up to the professionals.

A version of this article first appeared on Medscape.com.

It’s the season of love. In that spirit, we’re offering you a bouquet of absurd TikTok health trends that physicians love to hate — and explain the absurdity of. Lean in and get a whiff of the latest good, bad, and ugly videos making the rounds on the internet’s most perplexing platform. But don’t get too close; these videos are especially ripe.

The bad: NyQuil chicken

You know something bad has happened when your TikTok search ends with a warning from the app that says “Learn how to recognize harmful trends and hoaxes.” That’s what shows up now when you try to find out what the “NyQuil chicken” or “sleepy chicken” trend is (or was) all about.

TikTok videos, including this one from TikTok user @janelleandkate, show users trying out a trend meant to cook up a meal that will also cure your cold symptoms. The trend involves cooking chicken in a pan full of the cold and flu medicine NyQuil. The NyQuil chicken idea stems from a Twitter meme from 2017, so it is possible that some of the recent videos are fake (blue food coloring is easy to get, people).

However, in the instance that people believe the videos to be real and want to try the trend out, it is important to warn that this shouldn’t be attempted.

Aaron Hartman, MD, assistant clinical professor of family medicine at Virginia Commonwealth University, told the website Mic about the trend’s dangers: “When you cook cough medicine like NyQuil, however, you boil off the water and alcohol in it, leaving the chicken saturated with a super concentrated amount of drugs in the meat. If you ate one of those cutlets completely cooked, it’d be as if you’re actually consuming a quarter to half a bottle of NyQuil.”

And that’s not good for anyone. What ever happened to an old fashioned herb marinade?

The good: Can you fart yourself blind? Doc explains

It’s something we’ve all wondered about, right?

TikTok and YouTube’s mainstay plastic surgeon Anthony Youn, MD, took it upon himself to reply to a comment saying “I once farted so hard I went blind for 3 minutes.” This phenomenon, according to Dr. Youn, is very rare, but not impossible, though we wouldn’t exactly want to try it for ourselves.

In the humorous (but very informative!) video, Dr. Youn explains that particularly pungent flatulence can contain large amounts of hydrogen sulfide, a gas that is known for smelling like rotten eggs. According to the Occupational Safety and Health Administration, hydrogen sulfide is produced in a number of industries, like oil and gas refining, mining, and paper processing. Exposure to higher concentrations of hydrogen sulfide can be dangerous, with prolonged exposure at a 2-5 parts per million (ppm) concentration causing nausea, headaches, and airway problems in some asthma patients. At very high concentrations, it can be fatal.

Thankfully, a person’s gas is not at all that dangerous. When it comes to the commentor’s claim, Dr. Youn says that something else hydrogen sulfide can do is reduce blood pressure.

“If it reduces blood pressure to the central retinal artery,” Dr. Youn says, “your silent but deadly toot could theoretically make you go blind.”

Thank goodness we can lay that question to rest.
 

The ugly: Eye boogers from hell

Get a look at this!

This video from @mikaylaadiorr has amassed over 8 million likes and over 89,000 comments, and shows someone, who we can assume is Mikayla, pulling some sort of long string-like material out of the corner of her eye. It’s like a clown’s never-ending handkerchief, only goopy.

These mucus eye strings are caused by untreated eye conditions, like dry eye or pink eye (conjunctivitis), but pulling the mucus out is actually a symptom of what is called mucus fishing syndrome. As you know, our eyes are covered in layers of mucus and tears, which keeps our eyeballs lubricated and also protects us from bacteria and viruses. It’s possible to dry out the eyes by pulling some mucus off, but our eyes aren’t big fans of that, so they’ll create more mucus to keep from drying out.

A person who might get a bit addicted to pulling the strings out has likely developed mucus fishing syndrome, which is considered a body-focused repetitive behavior (BFRB); other BFRBs include skin-picking (dermatillomania) or picking hairs out (trichotillomania).

Popular TikToker and Oregon ophthalmologist Will Flanary, MD, aka Dr. Glaucomflecken, responded to the videos, which have been encouraging others to try it.

“This is called mucus fishing syndrome,” the ophthalmologist explained via text captions in his video. “The trauma from pulling mucus out of your eye causes more mucus to form. You get caught in a never-ending cycle that gets worse over time. So…stop it.”

Fingers off the mucus, people.

A version of this article first appeared on Medscape.com.

It’s the season of love. In that spirit, we’re offering you a bouquet of absurd TikTok health trends that physicians love to hate — and explain the absurdity of. Lean in and get a whiff of the latest good, bad, and ugly videos making the rounds on the internet’s most perplexing platform. But don’t get too close; these videos are especially ripe.

The bad: NyQuil chicken

You know something bad has happened when your TikTok search ends with a warning from the app that says “Learn how to recognize harmful trends and hoaxes.” That’s what shows up now when you try to find out what the “NyQuil chicken” or “sleepy chicken” trend is (or was) all about.

TikTok videos, including this one from TikTok user @janelleandkate, show users trying out a trend meant to cook up a meal that will also cure your cold symptoms. The trend involves cooking chicken in a pan full of the cold and flu medicine NyQuil. The NyQuil chicken idea stems from a Twitter meme from 2017, so it is possible that some of the recent videos are fake (blue food coloring is easy to get, people).

However, in the instance that people believe the videos to be real and want to try the trend out, it is important to warn that this shouldn’t be attempted.

Aaron Hartman, MD, assistant clinical professor of family medicine at Virginia Commonwealth University, told the website Mic about the trend’s dangers: “When you cook cough medicine like NyQuil, however, you boil off the water and alcohol in it, leaving the chicken saturated with a super concentrated amount of drugs in the meat. If you ate one of those cutlets completely cooked, it’d be as if you’re actually consuming a quarter to half a bottle of NyQuil.”

And that’s not good for anyone. What ever happened to an old fashioned herb marinade?

The good: Can you fart yourself blind? Doc explains

It’s something we’ve all wondered about, right?

TikTok and YouTube’s mainstay plastic surgeon Anthony Youn, MD, took it upon himself to reply to a comment saying “I once farted so hard I went blind for 3 minutes.” This phenomenon, according to Dr. Youn, is very rare, but not impossible, though we wouldn’t exactly want to try it for ourselves.

In the humorous (but very informative!) video, Dr. Youn explains that particularly pungent flatulence can contain large amounts of hydrogen sulfide, a gas that is known for smelling like rotten eggs. According to the Occupational Safety and Health Administration, hydrogen sulfide is produced in a number of industries, like oil and gas refining, mining, and paper processing. Exposure to higher concentrations of hydrogen sulfide can be dangerous, with prolonged exposure at a 2-5 parts per million (ppm) concentration causing nausea, headaches, and airway problems in some asthma patients. At very high concentrations, it can be fatal.

Thankfully, a person’s gas is not at all that dangerous. When it comes to the commentor’s claim, Dr. Youn says that something else hydrogen sulfide can do is reduce blood pressure.

“If it reduces blood pressure to the central retinal artery,” Dr. Youn says, “your silent but deadly toot could theoretically make you go blind.”

Thank goodness we can lay that question to rest.
 

The ugly: Eye boogers from hell

Get a look at this!

This video from @mikaylaadiorr has amassed over 8 million likes and over 89,000 comments, and shows someone, who we can assume is Mikayla, pulling some sort of long string-like material out of the corner of her eye. It’s like a clown’s never-ending handkerchief, only goopy.

These mucus eye strings are caused by untreated eye conditions, like dry eye or pink eye (conjunctivitis), but pulling the mucus out is actually a symptom of what is called mucus fishing syndrome. As you know, our eyes are covered in layers of mucus and tears, which keeps our eyeballs lubricated and also protects us from bacteria and viruses. It’s possible to dry out the eyes by pulling some mucus off, but our eyes aren’t big fans of that, so they’ll create more mucus to keep from drying out.

A person who might get a bit addicted to pulling the strings out has likely developed mucus fishing syndrome, which is considered a body-focused repetitive behavior (BFRB); other BFRBs include skin-picking (dermatillomania) or picking hairs out (trichotillomania).

Popular TikToker and Oregon ophthalmologist Will Flanary, MD, aka Dr. Glaucomflecken, responded to the videos, which have been encouraging others to try it.

“This is called mucus fishing syndrome,” the ophthalmologist explained via text captions in his video. “The trauma from pulling mucus out of your eye causes more mucus to form. You get caught in a never-ending cycle that gets worse over time. So…stop it.”

Fingers off the mucus, people.

A version of this article first appeared on Medscape.com.

It’s the season of love. In that spirit, we’re offering you a bouquet of absurd TikTok health trends that physicians love to hate — and explain the absurdity of. Lean in and get a whiff of the latest good, bad, and ugly videos making the rounds on the internet’s most perplexing platform. But don’t get too close; these videos are especially ripe.

The bad: NyQuil chicken

You know something bad has happened when your TikTok search ends with a warning from the app that says “Learn how to recognize harmful trends and hoaxes.” That’s what shows up now when you try to find out what the “NyQuil chicken” or “sleepy chicken” trend is (or was) all about.

TikTok videos, including this one from TikTok user @janelleandkate, show users trying out a trend meant to cook up a meal that will also cure your cold symptoms. The trend involves cooking chicken in a pan full of the cold and flu medicine NyQuil. The NyQuil chicken idea stems from a Twitter meme from 2017, so it is possible that some of the recent videos are fake (blue food coloring is easy to get, people).

However, in the instance that people believe the videos to be real and want to try the trend out, it is important to warn that this shouldn’t be attempted.

Aaron Hartman, MD, assistant clinical professor of family medicine at Virginia Commonwealth University, told the website Mic about the trend’s dangers: “When you cook cough medicine like NyQuil, however, you boil off the water and alcohol in it, leaving the chicken saturated with a super concentrated amount of drugs in the meat. If you ate one of those cutlets completely cooked, it’d be as if you’re actually consuming a quarter to half a bottle of NyQuil.”

And that’s not good for anyone. What ever happened to an old fashioned herb marinade?

The good: Can you fart yourself blind? Doc explains

It’s something we’ve all wondered about, right?

TikTok and YouTube’s mainstay plastic surgeon Anthony Youn, MD, took it upon himself to reply to a comment saying “I once farted so hard I went blind for 3 minutes.” This phenomenon, according to Dr. Youn, is very rare, but not impossible, though we wouldn’t exactly want to try it for ourselves.

In the humorous (but very informative!) video, Dr. Youn explains that particularly pungent flatulence can contain large amounts of hydrogen sulfide, a gas that is known for smelling like rotten eggs. According to the Occupational Safety and Health Administration, hydrogen sulfide is produced in a number of industries, like oil and gas refining, mining, and paper processing. Exposure to higher concentrations of hydrogen sulfide can be dangerous, with prolonged exposure at a 2-5 parts per million (ppm) concentration causing nausea, headaches, and airway problems in some asthma patients. At very high concentrations, it can be fatal.

Thankfully, a person’s gas is not at all that dangerous. When it comes to the commentor’s claim, Dr. Youn says that something else hydrogen sulfide can do is reduce blood pressure.

“If it reduces blood pressure to the central retinal artery,” Dr. Youn says, “your silent but deadly toot could theoretically make you go blind.”

Thank goodness we can lay that question to rest.
 

The ugly: Eye boogers from hell

Get a look at this!

This video from @mikaylaadiorr has amassed over 8 million likes and over 89,000 comments, and shows someone, who we can assume is Mikayla, pulling some sort of long string-like material out of the corner of her eye. It’s like a clown’s never-ending handkerchief, only goopy.

These mucus eye strings are caused by untreated eye conditions, like dry eye or pink eye (conjunctivitis), but pulling the mucus out is actually a symptom of what is called mucus fishing syndrome. As you know, our eyes are covered in layers of mucus and tears, which keeps our eyeballs lubricated and also protects us from bacteria and viruses. It’s possible to dry out the eyes by pulling some mucus off, but our eyes aren’t big fans of that, so they’ll create more mucus to keep from drying out.

A person who might get a bit addicted to pulling the strings out has likely developed mucus fishing syndrome, which is considered a body-focused repetitive behavior (BFRB); other BFRBs include skin-picking (dermatillomania) or picking hairs out (trichotillomania).

Popular TikToker and Oregon ophthalmologist Will Flanary, MD, aka Dr. Glaucomflecken, responded to the videos, which have been encouraging others to try it.

“This is called mucus fishing syndrome,” the ophthalmologist explained via text captions in his video. “The trauma from pulling mucus out of your eye causes more mucus to form. You get caught in a never-ending cycle that gets worse over time. So…stop it.”

Fingers off the mucus, people.

A version of this article first appeared on Medscape.com.

New year, same old TikTok.

You would think after 2021’s often perilous online health trends that the people of the internet would learn a thing or two. Just kidding, who actually thought that? Luckily, physicians on TikTok are ready to offer advice and dispel stupidity as often as TikTok users are ready to dole it out.

Here’s to another year of “wow,” “ugh,” and “omg” moments. But let’s start with great advice from a doctor using TikTok to help save lives.
 

The good: Doctor explains how to survive crowd crush

J. Mack Slaughter, MD, (@drjmackslaughter_md) is an emergency physician who’s built his platform by engaging with and educating people on TikTok and Instagram. He recently reacted to the tragedy at the Travis Scott Astroworld music festival in Houston, where 10 people died due to a crowd surge. “This isn’t the first time this has happened, and it won’t be the last,” Dr. Slaughter captioned his post.

He used a video to spread awareness of how to best react to a crowd surge to his audience of over 368,000 followers, laying out four tips that people can use in case this ever happens to them.

Dr. Slaughter’s four tips are to (1) keep your arms up in front of you to give your chest as much room between someone in front of you as possible; (2) stay upright in order to avoid collapsing; (3) go with the flow of the crowd’s movement to conserve energy; (4) stay away from hard surfaces like walls or barriers “that can’t ebb and flow with the crowd.”

“When you get a densely packed area of people, not only can you lose control over your own movements, but you can have your chest compressed to the point where you can’t inhale,” Dr. Slaughter says. Hopefully, this crowd crush phenomenon is something that no one ever has to experience, but it’s better to have the knowledge on how to get through it.
 

The bad: Papaya seeds and parasites

TikTok user Jacqueline Rae posted about using papaya seeds as a detox method and dewormer in a video that has more than 32.5K likes and over a thousand comments – and she is just one of many TikTok users to promote this. “Papaya seeds on an empty stomach first thing in the morning is an antiparasitic,” Ms. Rae claims.

The papaya seed trend doesn’t come out of thin air, though. There was a study in 2007 where 60 Nigerian children who showed evidence of having intestinal parasites received papaya seeds as a treatment. For 71% of them, the treatment worked to clear their stool of the parasites. However, this is just one study with a pretty small sample size.

Unfortunately, TikTok’s algorithm can cater to hypochondriacs, and after scrolling through dewormer video after dewormer video, where people tout various products and cleanses, patients may really be convinced they have something they don’t.

Terry Simpson, MD, is a California-based physician and weight loss surgeon whose TikTok (@drterrysimpson) bio says: “Know your guts inside and out.” Dr. Simpson made his own video responding to the papaya seed craze, assuaging any anxiety or fears about contracting parasites.

In his video, Dr. Simpson says that most first-world countries like the United States have very few parasites, so patients shouldn’t be worried about them if they haven’t traveled to other countries recently. Additionally, he explains that what many people are seeing expelled after papaya seed cleanses is just fiber, and parasites aren’t visible to the naked eye.

“Papaya seeds are not a cure for parasites,” Dr. Simpson explains. “If you think you have parasites, see a doctor. One pill will get rid of all of the parasites that you can have, but the chances are you don’t have them.”

Symptoms that make people point toward parasites, such as low energy, frequent diarrhea, or other gut issues, can be symptoms of other issues unrelated to parasites, like irritable bowel syndrome or celiac disease. Because of this, it’s important to get a proper diagnosis amid signs of gut trouble.
 

The ugly: Hydrogen peroxide ear wax cleanse

TikTok user Ayisha Friedman-Negrin (@ayishafrita) got a whopping 2.7 million likes on her video where she puts hydrogen peroxide in her ear (yes, 2.7 million likes). This home remedy, she says, dissolves earwax that is stuck together. She lays her head on one side and waits for the hydrogen peroxide to “sizzle.” It bubbles like a hot spring before yellow-tinged liquid drips out. Yuck.

She isn’t totally wrong – hydrogen peroxide has been used for years to irrigate ears and help soften earwax. But there’s a lot of important information that people replicating this trend on TikTok tend to leave out of their videos. Thankfully, Sina Joorabchi, MD, is here to make sure TikTokers (and the rest of us) aren’t damaging their ears.

Dr. Joorabchi is a board-certified ear, nose, and throat doctor with his own TikTok account (@doctor.sina). He recommends in his video that if hydrogen peroxide is a patient’s go-to ear cleaner, it’s best to stick with one that’s of a 3% hydrogen peroxide concentration, as anything more can damage ears. Additionally, in the original video, Ms. Friedman-Negrin uses too much liquid, and 5 drops a day should work just fine for helping soften earwax.

“Definitely do not attempt [this] if you have an ear infection or history of ear perforation,” Dr. Joorabchi says. “And you don’t want to be using peroxide for an extended period of time. That can cause a lot of ear itching.”

A version of this article first appeared on Medscape.com.

New year, same old TikTok.

You would think after 2021’s often perilous online health trends that the people of the internet would learn a thing or two. Just kidding, who actually thought that? Luckily, physicians on TikTok are ready to offer advice and dispel stupidity as often as TikTok users are ready to dole it out.

Here’s to another year of “wow,” “ugh,” and “omg” moments. But let’s start with great advice from a doctor using TikTok to help save lives.
 

The good: Doctor explains how to survive crowd crush

J. Mack Slaughter, MD, (@drjmackslaughter_md) is an emergency physician who’s built his platform by engaging with and educating people on TikTok and Instagram. He recently reacted to the tragedy at the Travis Scott Astroworld music festival in Houston, where 10 people died due to a crowd surge. “This isn’t the first time this has happened, and it won’t be the last,” Dr. Slaughter captioned his post.

He used a video to spread awareness of how to best react to a crowd surge to his audience of over 368,000 followers, laying out four tips that people can use in case this ever happens to them.

Dr. Slaughter’s four tips are to (1) keep your arms up in front of you to give your chest as much room between someone in front of you as possible; (2) stay upright in order to avoid collapsing; (3) go with the flow of the crowd’s movement to conserve energy; (4) stay away from hard surfaces like walls or barriers “that can’t ebb and flow with the crowd.”

“When you get a densely packed area of people, not only can you lose control over your own movements, but you can have your chest compressed to the point where you can’t inhale,” Dr. Slaughter says. Hopefully, this crowd crush phenomenon is something that no one ever has to experience, but it’s better to have the knowledge on how to get through it.
 

The bad: Papaya seeds and parasites

TikTok user Jacqueline Rae posted about using papaya seeds as a detox method and dewormer in a video that has more than 32.5K likes and over a thousand comments – and she is just one of many TikTok users to promote this. “Papaya seeds on an empty stomach first thing in the morning is an antiparasitic,” Ms. Rae claims.

The papaya seed trend doesn’t come out of thin air, though. There was a study in 2007 where 60 Nigerian children who showed evidence of having intestinal parasites received papaya seeds as a treatment. For 71% of them, the treatment worked to clear their stool of the parasites. However, this is just one study with a pretty small sample size.

Unfortunately, TikTok’s algorithm can cater to hypochondriacs, and after scrolling through dewormer video after dewormer video, where people tout various products and cleanses, patients may really be convinced they have something they don’t.

Terry Simpson, MD, is a California-based physician and weight loss surgeon whose TikTok (@drterrysimpson) bio says: “Know your guts inside and out.” Dr. Simpson made his own video responding to the papaya seed craze, assuaging any anxiety or fears about contracting parasites.

In his video, Dr. Simpson says that most first-world countries like the United States have very few parasites, so patients shouldn’t be worried about them if they haven’t traveled to other countries recently. Additionally, he explains that what many people are seeing expelled after papaya seed cleanses is just fiber, and parasites aren’t visible to the naked eye.

“Papaya seeds are not a cure for parasites,” Dr. Simpson explains. “If you think you have parasites, see a doctor. One pill will get rid of all of the parasites that you can have, but the chances are you don’t have them.”

Symptoms that make people point toward parasites, such as low energy, frequent diarrhea, or other gut issues, can be symptoms of other issues unrelated to parasites, like irritable bowel syndrome or celiac disease. Because of this, it’s important to get a proper diagnosis amid signs of gut trouble.
 

The ugly: Hydrogen peroxide ear wax cleanse

TikTok user Ayisha Friedman-Negrin (@ayishafrita) got a whopping 2.7 million likes on her video where she puts hydrogen peroxide in her ear (yes, 2.7 million likes). This home remedy, she says, dissolves earwax that is stuck together. She lays her head on one side and waits for the hydrogen peroxide to “sizzle.” It bubbles like a hot spring before yellow-tinged liquid drips out. Yuck.

She isn’t totally wrong – hydrogen peroxide has been used for years to irrigate ears and help soften earwax. But there’s a lot of important information that people replicating this trend on TikTok tend to leave out of their videos. Thankfully, Sina Joorabchi, MD, is here to make sure TikTokers (and the rest of us) aren’t damaging their ears.

Dr. Joorabchi is a board-certified ear, nose, and throat doctor with his own TikTok account (@doctor.sina). He recommends in his video that if hydrogen peroxide is a patient’s go-to ear cleaner, it’s best to stick with one that’s of a 3% hydrogen peroxide concentration, as anything more can damage ears. Additionally, in the original video, Ms. Friedman-Negrin uses too much liquid, and 5 drops a day should work just fine for helping soften earwax.

“Definitely do not attempt [this] if you have an ear infection or history of ear perforation,” Dr. Joorabchi says. “And you don’t want to be using peroxide for an extended period of time. That can cause a lot of ear itching.”

A version of this article first appeared on Medscape.com.

New year, same old TikTok.

You would think after 2021’s often perilous online health trends that the people of the internet would learn a thing or two. Just kidding, who actually thought that? Luckily, physicians on TikTok are ready to offer advice and dispel stupidity as often as TikTok users are ready to dole it out.

Here’s to another year of “wow,” “ugh,” and “omg” moments. But let’s start with great advice from a doctor using TikTok to help save lives.
 

The good: Doctor explains how to survive crowd crush

J. Mack Slaughter, MD, (@drjmackslaughter_md) is an emergency physician who’s built his platform by engaging with and educating people on TikTok and Instagram. He recently reacted to the tragedy at the Travis Scott Astroworld music festival in Houston, where 10 people died due to a crowd surge. “This isn’t the first time this has happened, and it won’t be the last,” Dr. Slaughter captioned his post.

He used a video to spread awareness of how to best react to a crowd surge to his audience of over 368,000 followers, laying out four tips that people can use in case this ever happens to them.

Dr. Slaughter’s four tips are to (1) keep your arms up in front of you to give your chest as much room between someone in front of you as possible; (2) stay upright in order to avoid collapsing; (3) go with the flow of the crowd’s movement to conserve energy; (4) stay away from hard surfaces like walls or barriers “that can’t ebb and flow with the crowd.”

“When you get a densely packed area of people, not only can you lose control over your own movements, but you can have your chest compressed to the point where you can’t inhale,” Dr. Slaughter says. Hopefully, this crowd crush phenomenon is something that no one ever has to experience, but it’s better to have the knowledge on how to get through it.
 

The bad: Papaya seeds and parasites

TikTok user Jacqueline Rae posted about using papaya seeds as a detox method and dewormer in a video that has more than 32.5K likes and over a thousand comments – and she is just one of many TikTok users to promote this. “Papaya seeds on an empty stomach first thing in the morning is an antiparasitic,” Ms. Rae claims.

The papaya seed trend doesn’t come out of thin air, though. There was a study in 2007 where 60 Nigerian children who showed evidence of having intestinal parasites received papaya seeds as a treatment. For 71% of them, the treatment worked to clear their stool of the parasites. However, this is just one study with a pretty small sample size.

Unfortunately, TikTok’s algorithm can cater to hypochondriacs, and after scrolling through dewormer video after dewormer video, where people tout various products and cleanses, patients may really be convinced they have something they don’t.

Terry Simpson, MD, is a California-based physician and weight loss surgeon whose TikTok (@drterrysimpson) bio says: “Know your guts inside and out.” Dr. Simpson made his own video responding to the papaya seed craze, assuaging any anxiety or fears about contracting parasites.

In his video, Dr. Simpson says that most first-world countries like the United States have very few parasites, so patients shouldn’t be worried about them if they haven’t traveled to other countries recently. Additionally, he explains that what many people are seeing expelled after papaya seed cleanses is just fiber, and parasites aren’t visible to the naked eye.

“Papaya seeds are not a cure for parasites,” Dr. Simpson explains. “If you think you have parasites, see a doctor. One pill will get rid of all of the parasites that you can have, but the chances are you don’t have them.”

Symptoms that make people point toward parasites, such as low energy, frequent diarrhea, or other gut issues, can be symptoms of other issues unrelated to parasites, like irritable bowel syndrome or celiac disease. Because of this, it’s important to get a proper diagnosis amid signs of gut trouble.
 

The ugly: Hydrogen peroxide ear wax cleanse

TikTok user Ayisha Friedman-Negrin (@ayishafrita) got a whopping 2.7 million likes on her video where she puts hydrogen peroxide in her ear (yes, 2.7 million likes). This home remedy, she says, dissolves earwax that is stuck together. She lays her head on one side and waits for the hydrogen peroxide to “sizzle.” It bubbles like a hot spring before yellow-tinged liquid drips out. Yuck.

She isn’t totally wrong – hydrogen peroxide has been used for years to irrigate ears and help soften earwax. But there’s a lot of important information that people replicating this trend on TikTok tend to leave out of their videos. Thankfully, Sina Joorabchi, MD, is here to make sure TikTokers (and the rest of us) aren’t damaging their ears.

Dr. Joorabchi is a board-certified ear, nose, and throat doctor with his own TikTok account (@doctor.sina). He recommends in his video that if hydrogen peroxide is a patient’s go-to ear cleaner, it’s best to stick with one that’s of a 3% hydrogen peroxide concentration, as anything more can damage ears. Additionally, in the original video, Ms. Friedman-Negrin uses too much liquid, and 5 drops a day should work just fine for helping soften earwax.

“Definitely do not attempt [this] if you have an ear infection or history of ear perforation,” Dr. Joorabchi says. “And you don’t want to be using peroxide for an extended period of time. That can cause a lot of ear itching.”

A version of this article first appeared on Medscape.com.

The year is rapidly approaching an end, and with it, we can perhaps look forward to better and brighter days in 2022. With daylight savings, seasonal depression, and cold and flu season making a comeback as temperatures across the Northern Hemisphere drop, some strange remedies have been appearing on TikTok – as they often do.

The good: doctor reveals the truth about dieting

Chisom Ikeji, MD, is a critical care clinical fellow at the University of Pittsburgh Medical Center and on TikTok under the username @drchizmd. In a TikTok with almost 200,000 views and over 18,000 likes, Dr. Ikeji explains to all New Year’s resolution-makers that dieting isn’t all it’s cracked up to be. “Dieting leads to perpetually losing weight and gaining weight on a cycle,” she says, “so that your body never really settles at its set point weight.”

Celebrities and your friends who drink lemon water in the morning may tout all sorts of fad diets and some of them might even work. But Dr. Ikeji explains that diets with gimmicks don’t have lasting power and create cycles of losing and gaining weight. Additionally, associating “points” with foods, or separating them into “good” or “bad” categories, encourages habits that can lead to disordered eating.

The best way to keep weight off is to make actual lifestyle changes that stick. In contrast, going back to dieting every year (the rapid cycle of losing and gaining weight is called  “yo-yo” dieting) can have a bad impact on your health, including increased risk of heart disease and metabolism issues.

“The best thing you can do for your body, and to help you lose weight, is to stop dieting,” Dr. Ikeji says. “Incorporate whole foods into your diet and make sure you move your body. If you don’t, you’ll be chasing that diet into your 80s and feeling guilty over a piece of cake forever. That’s no way to live life.”
 

The bad: vitamin C contraceptive

In this TikTok, user @itsdiosa reveals her contraception hack for anyone with a uterus who may be having unprotected sex. She claims that for those who forget to take the Plan B pill, vitamin C is a worthwhile substitute in preventing unwanted pregnancy. She recommends taking four or five vitamin C tablets a day for a few days for the return of a normal period.

Not surprisingly, Vitamin C isn’t safe or reliable and doesn’t have studies to back up @itsdiosa’s claim. If anything, all you’ll get from taking too much vitamin C is diarrhea and a stomachache.

Karan Rajan, MBBS, from Imperial College London and the University of Sunderland in the United Kingdom, responded to the TikTok to confirm that this claim isn’t backed up by science.

“Vitamin C doesn’t start or stop a period. Period,” he commented on the video.
 

The ugly: garlic sinus decongestant

Now this one went viral one went viral with over 5.2 million likes. In this TikTok, @hwannah5 and her boyfriend try out a trend that involves putting a clove of peeled garlic in each nostril in order to clear up congestion. The bubbles of ooey gooey snot coming out of her boyfriend’s nose certainly make it seem like it’s working, but what’s really going on?

This is hardly new; people have been putting strange things in nasal rinses for some time now and garlic is a tried-and-true favorite. Garlic does have some medically valid uses. These studies have shown that garlic taken orally may improve insulin in people with diabetes, slightly lower cholesterol, and reduce blood pressure in people with hypertension. When it comes to home remedies, people have historically used garlic as an antiseptic, antibacterial, and antifungal agent, though these claims are not widely supported by research. But taking a garlic supplement and sticking raw garlic up your nose are two very different things.

New York-based board-certified dermatologist Whitney Bowe, MD, weighed in on the viral trend.

In her own reaction video, she explained: “Guys, this is actually not safe. What’s happening is the garlic is actually triggering something called contact dermatitis and the mucosa is trying to protect itself by secreting tons of mucus. It’s creating swelling.”

For those tempted by this smelly “remedy,” a few drops of essential oil in a steamy shower is a much more pleasant (and significantly less gross) way to treat congestion.

A version of this article first appeared on Medscape.com.

The year is rapidly approaching an end, and with it, we can perhaps look forward to better and brighter days in 2022. With daylight savings, seasonal depression, and cold and flu season making a comeback as temperatures across the Northern Hemisphere drop, some strange remedies have been appearing on TikTok – as they often do.

The good: doctor reveals the truth about dieting

Chisom Ikeji, MD, is a critical care clinical fellow at the University of Pittsburgh Medical Center and on TikTok under the username @drchizmd. In a TikTok with almost 200,000 views and over 18,000 likes, Dr. Ikeji explains to all New Year’s resolution-makers that dieting isn’t all it’s cracked up to be. “Dieting leads to perpetually losing weight and gaining weight on a cycle,” she says, “so that your body never really settles at its set point weight.”

Celebrities and your friends who drink lemon water in the morning may tout all sorts of fad diets and some of them might even work. But Dr. Ikeji explains that diets with gimmicks don’t have lasting power and create cycles of losing and gaining weight. Additionally, associating “points” with foods, or separating them into “good” or “bad” categories, encourages habits that can lead to disordered eating.

The best way to keep weight off is to make actual lifestyle changes that stick. In contrast, going back to dieting every year (the rapid cycle of losing and gaining weight is called  “yo-yo” dieting) can have a bad impact on your health, including increased risk of heart disease and metabolism issues.

“The best thing you can do for your body, and to help you lose weight, is to stop dieting,” Dr. Ikeji says. “Incorporate whole foods into your diet and make sure you move your body. If you don’t, you’ll be chasing that diet into your 80s and feeling guilty over a piece of cake forever. That’s no way to live life.”
 

The bad: vitamin C contraceptive

In this TikTok, user @itsdiosa reveals her contraception hack for anyone with a uterus who may be having unprotected sex. She claims that for those who forget to take the Plan B pill, vitamin C is a worthwhile substitute in preventing unwanted pregnancy. She recommends taking four or five vitamin C tablets a day for a few days for the return of a normal period.

Not surprisingly, Vitamin C isn’t safe or reliable and doesn’t have studies to back up @itsdiosa’s claim. If anything, all you’ll get from taking too much vitamin C is diarrhea and a stomachache.

Karan Rajan, MBBS, from Imperial College London and the University of Sunderland in the United Kingdom, responded to the TikTok to confirm that this claim isn’t backed up by science.

“Vitamin C doesn’t start or stop a period. Period,” he commented on the video.
 

The ugly: garlic sinus decongestant

Now this one went viral one went viral with over 5.2 million likes. In this TikTok, @hwannah5 and her boyfriend try out a trend that involves putting a clove of peeled garlic in each nostril in order to clear up congestion. The bubbles of ooey gooey snot coming out of her boyfriend’s nose certainly make it seem like it’s working, but what’s really going on?

This is hardly new; people have been putting strange things in nasal rinses for some time now and garlic is a tried-and-true favorite. Garlic does have some medically valid uses. These studies have shown that garlic taken orally may improve insulin in people with diabetes, slightly lower cholesterol, and reduce blood pressure in people with hypertension. When it comes to home remedies, people have historically used garlic as an antiseptic, antibacterial, and antifungal agent, though these claims are not widely supported by research. But taking a garlic supplement and sticking raw garlic up your nose are two very different things.

New York-based board-certified dermatologist Whitney Bowe, MD, weighed in on the viral trend.

In her own reaction video, she explained: “Guys, this is actually not safe. What’s happening is the garlic is actually triggering something called contact dermatitis and the mucosa is trying to protect itself by secreting tons of mucus. It’s creating swelling.”

For those tempted by this smelly “remedy,” a few drops of essential oil in a steamy shower is a much more pleasant (and significantly less gross) way to treat congestion.

A version of this article first appeared on Medscape.com.

The year is rapidly approaching an end, and with it, we can perhaps look forward to better and brighter days in 2022. With daylight savings, seasonal depression, and cold and flu season making a comeback as temperatures across the Northern Hemisphere drop, some strange remedies have been appearing on TikTok – as they often do.

The good: doctor reveals the truth about dieting

Chisom Ikeji, MD, is a critical care clinical fellow at the University of Pittsburgh Medical Center and on TikTok under the username @drchizmd. In a TikTok with almost 200,000 views and over 18,000 likes, Dr. Ikeji explains to all New Year’s resolution-makers that dieting isn’t all it’s cracked up to be. “Dieting leads to perpetually losing weight and gaining weight on a cycle,” she says, “so that your body never really settles at its set point weight.”

Celebrities and your friends who drink lemon water in the morning may tout all sorts of fad diets and some of them might even work. But Dr. Ikeji explains that diets with gimmicks don’t have lasting power and create cycles of losing and gaining weight. Additionally, associating “points” with foods, or separating them into “good” or “bad” categories, encourages habits that can lead to disordered eating.

The best way to keep weight off is to make actual lifestyle changes that stick. In contrast, going back to dieting every year (the rapid cycle of losing and gaining weight is called  “yo-yo” dieting) can have a bad impact on your health, including increased risk of heart disease and metabolism issues.

“The best thing you can do for your body, and to help you lose weight, is to stop dieting,” Dr. Ikeji says. “Incorporate whole foods into your diet and make sure you move your body. If you don’t, you’ll be chasing that diet into your 80s and feeling guilty over a piece of cake forever. That’s no way to live life.”
 

The bad: vitamin C contraceptive

In this TikTok, user @itsdiosa reveals her contraception hack for anyone with a uterus who may be having unprotected sex. She claims that for those who forget to take the Plan B pill, vitamin C is a worthwhile substitute in preventing unwanted pregnancy. She recommends taking four or five vitamin C tablets a day for a few days for the return of a normal period.

Not surprisingly, Vitamin C isn’t safe or reliable and doesn’t have studies to back up @itsdiosa’s claim. If anything, all you’ll get from taking too much vitamin C is diarrhea and a stomachache.

Karan Rajan, MBBS, from Imperial College London and the University of Sunderland in the United Kingdom, responded to the TikTok to confirm that this claim isn’t backed up by science.

“Vitamin C doesn’t start or stop a period. Period,” he commented on the video.
 

The ugly: garlic sinus decongestant

Now this one went viral one went viral with over 5.2 million likes. In this TikTok, @hwannah5 and her boyfriend try out a trend that involves putting a clove of peeled garlic in each nostril in order to clear up congestion. The bubbles of ooey gooey snot coming out of her boyfriend’s nose certainly make it seem like it’s working, but what’s really going on?

This is hardly new; people have been putting strange things in nasal rinses for some time now and garlic is a tried-and-true favorite. Garlic does have some medically valid uses. These studies have shown that garlic taken orally may improve insulin in people with diabetes, slightly lower cholesterol, and reduce blood pressure in people with hypertension. When it comes to home remedies, people have historically used garlic as an antiseptic, antibacterial, and antifungal agent, though these claims are not widely supported by research. But taking a garlic supplement and sticking raw garlic up your nose are two very different things.

New York-based board-certified dermatologist Whitney Bowe, MD, weighed in on the viral trend.

In her own reaction video, she explained: “Guys, this is actually not safe. What’s happening is the garlic is actually triggering something called contact dermatitis and the mucosa is trying to protect itself by secreting tons of mucus. It’s creating swelling.”

For those tempted by this smelly “remedy,” a few drops of essential oil in a steamy shower is a much more pleasant (and significantly less gross) way to treat congestion.

A version of this article first appeared on Medscape.com.

With the holidays just around the corner (how did that happen?), it’s a good time to remind yourself of the things you’re grateful for.

Perhaps you’re grateful for spending chilly evenings under a warm blanket binge-watching your favorite shows or being able to safely gather with loved ones. If you’re William Shatner, maybe you’re grateful for that quick trip to space (because apparently, that’s a thing now) and the poetic tweets it induced. Down here on earth, TikTok has surpassed 1 billion users, and while we’re not grateful, necessarily, we are entertained.

Here are the latest ugly, good, and bad TikToks that have been trending lately.
 

The Ugly: Scalp popping

Warning: Don’t watch this if you’re easily freaked out by weird body sounds. It’s like cracking your knuckles but way, way worse.

This TikTok from @asmr.barber has 1.7 million likes, and lots of people are trying it out for themselves. The viral video features the (disturbed) art of scalp popping, also known as hair cracking. It features what is assumed to be some sort of barber or professional (here’s hoping) twisting a client’s hair around his fingers and then yanking, creating an audible popping sound. Many are posting their own hair-cracking attempts on the platform. It’s unclear if this is supposed to feel good or just be grossly satisfying, though some users claim it helps with migraines.

But it turns out this might be more than kind of gross; it can be dangerous, too.

Anthony Youn, MD, a board-certified plastic surgeon, comments on the trend with concern: “What the hell is going on here?” Not something you want to hear from a doctor. Dr. Youn explained that the popping sound comes from the galea aponeurotica, a fibrous sheet of connective tissue under your scalp, being pulled off the skull.

In a comment, Dr. Youn continued to warn people of replicating this trend: “It can tear the inside of the scalp, which can bleed a ton on the inside. Think boxer or MMA fighter with scalp hematoma.”

Let’s keep our scalps attached to our skulls, people. If I never have to hear that sound again, I’ll be eternally grateful.
 

The Good: Doctor demonstrates correct EpiPen use

This reaction TikTok from medical student Mutahir Farhan (aka @madmedicine) has over 252,000 likes and hundreds of comments. In it, Ms. Farhan watches a video of a young woman attempting to administer an EpiPen to her friend, with the caption “How NOT to use an EpiPen” over it (in bright red, of course).

The woman in the video is using the wrong end of the EpiPen against her friend’s leg, so it isn’t working. When she uses her thumb to press down and help, her thumb is actually pressed against the needle end and the EpiPen sticks her instead of her friend. Ouch!

Ms. Farhan goes on to explain the anatomy of the EpiPen and shows his audience of 1.1 million followers where to inject it.

“You gotta remember that the orange tip is where the needle comes out. Otherwise, you’re going to end up stabbing yourself with epinephrine, like that girl in the video,” Ms. Farhan says. He goes on to instruct the important, but often overlooked, follow-up: “After you stab someone with epinephrine, call 911 or go to the ER, so that we can make sure they’re actually okay and good to go.”
 

The Bad: Liquid chlorophyll

Here is another one of those tricky trends that are so widespread and popular that it’s hard to find exactly where it originated from. A video from @lenamaiah has over 5 million views and 800,000 likes, which even by TikTok standards, is a lot. TikTok is rife with similar videos, which feature drops of liquid chlorophyll being added to water and smoothies.

The pretty emerald hue is mesmerizing and it’s hard to resist trying it out when it’s being peddled by seemingly every pretty, smooth-skinned pseudo-model on the platform. In this video, Lena says drinking a glass of water with a few drops of chlorophyll can reduce inflammation, get rid of eye bags, boost your vitamin levels, reduce free radical damage, detoxify your system, and file your taxes. Okay, I made that last one up, but it follows, doesn’t it? This stuff sounds pretty good. Maybe too good.

Chlorophyll, if you skipped biology class (somehow, I doubt you did), is what makes plants green. Medscape has a detailed explanation of chlorophyll, but all you really need to know is that it’s the secret to that cool thing plants do: photosynthesis, or turning sunlight into energy. Scientists have been trying to find uses for it in people since the 1940s. Unfortunately, studies never found much that it can do for us, aside from being kind of deodorizing. So, while it’s been historically marketed as toothpaste and deodorant, the new TikTok claims of it being a cure-all or the next big skincare supplement are not widely substantiated by scientific studies. The only real evidence of it being effective is word of mouth from those who claim to like the way they look or feel since taking it, which isn’t enough for doctors to recommend it.

TikTok’s resident dermatologist, Muneeb Shah, DO, stitched a TikTok from another user, with his captions explaining, “[There’s] no scientific evidence for liquid chlorophyll [helping] rosacea or acne.”

His advice: “Chlorophyll is great, but just eat more veggies.”

A version of this article first appeared on Medscape.com.

With the holidays just around the corner (how did that happen?), it’s a good time to remind yourself of the things you’re grateful for.

Perhaps you’re grateful for spending chilly evenings under a warm blanket binge-watching your favorite shows or being able to safely gather with loved ones. If you’re William Shatner, maybe you’re grateful for that quick trip to space (because apparently, that’s a thing now) and the poetic tweets it induced. Down here on earth, TikTok has surpassed 1 billion users, and while we’re not grateful, necessarily, we are entertained.

Here are the latest ugly, good, and bad TikToks that have been trending lately.
 

The Ugly: Scalp popping

Warning: Don’t watch this if you’re easily freaked out by weird body sounds. It’s like cracking your knuckles but way, way worse.

This TikTok from @asmr.barber has 1.7 million likes, and lots of people are trying it out for themselves. The viral video features the (disturbed) art of scalp popping, also known as hair cracking. It features what is assumed to be some sort of barber or professional (here’s hoping) twisting a client’s hair around his fingers and then yanking, creating an audible popping sound. Many are posting their own hair-cracking attempts on the platform. It’s unclear if this is supposed to feel good or just be grossly satisfying, though some users claim it helps with migraines.

But it turns out this might be more than kind of gross; it can be dangerous, too.

Anthony Youn, MD, a board-certified plastic surgeon, comments on the trend with concern: “What the hell is going on here?” Not something you want to hear from a doctor. Dr. Youn explained that the popping sound comes from the galea aponeurotica, a fibrous sheet of connective tissue under your scalp, being pulled off the skull.

In a comment, Dr. Youn continued to warn people of replicating this trend: “It can tear the inside of the scalp, which can bleed a ton on the inside. Think boxer or MMA fighter with scalp hematoma.”

Let’s keep our scalps attached to our skulls, people. If I never have to hear that sound again, I’ll be eternally grateful.
 

The Good: Doctor demonstrates correct EpiPen use

This reaction TikTok from medical student Mutahir Farhan (aka @madmedicine) has over 252,000 likes and hundreds of comments. In it, Ms. Farhan watches a video of a young woman attempting to administer an EpiPen to her friend, with the caption “How NOT to use an EpiPen” over it (in bright red, of course).

The woman in the video is using the wrong end of the EpiPen against her friend’s leg, so it isn’t working. When she uses her thumb to press down and help, her thumb is actually pressed against the needle end and the EpiPen sticks her instead of her friend. Ouch!

Ms. Farhan goes on to explain the anatomy of the EpiPen and shows his audience of 1.1 million followers where to inject it.

“You gotta remember that the orange tip is where the needle comes out. Otherwise, you’re going to end up stabbing yourself with epinephrine, like that girl in the video,” Ms. Farhan says. He goes on to instruct the important, but often overlooked, follow-up: “After you stab someone with epinephrine, call 911 or go to the ER, so that we can make sure they’re actually okay and good to go.”
 

The Bad: Liquid chlorophyll

Here is another one of those tricky trends that are so widespread and popular that it’s hard to find exactly where it originated from. A video from @lenamaiah has over 5 million views and 800,000 likes, which even by TikTok standards, is a lot. TikTok is rife with similar videos, which feature drops of liquid chlorophyll being added to water and smoothies.

The pretty emerald hue is mesmerizing and it’s hard to resist trying it out when it’s being peddled by seemingly every pretty, smooth-skinned pseudo-model on the platform. In this video, Lena says drinking a glass of water with a few drops of chlorophyll can reduce inflammation, get rid of eye bags, boost your vitamin levels, reduce free radical damage, detoxify your system, and file your taxes. Okay, I made that last one up, but it follows, doesn’t it? This stuff sounds pretty good. Maybe too good.

Chlorophyll, if you skipped biology class (somehow, I doubt you did), is what makes plants green. Medscape has a detailed explanation of chlorophyll, but all you really need to know is that it’s the secret to that cool thing plants do: photosynthesis, or turning sunlight into energy. Scientists have been trying to find uses for it in people since the 1940s. Unfortunately, studies never found much that it can do for us, aside from being kind of deodorizing. So, while it’s been historically marketed as toothpaste and deodorant, the new TikTok claims of it being a cure-all or the next big skincare supplement are not widely substantiated by scientific studies. The only real evidence of it being effective is word of mouth from those who claim to like the way they look or feel since taking it, which isn’t enough for doctors to recommend it.

TikTok’s resident dermatologist, Muneeb Shah, DO, stitched a TikTok from another user, with his captions explaining, “[There’s] no scientific evidence for liquid chlorophyll [helping] rosacea or acne.”

His advice: “Chlorophyll is great, but just eat more veggies.”

A version of this article first appeared on Medscape.com.

With the holidays just around the corner (how did that happen?), it’s a good time to remind yourself of the things you’re grateful for.

Perhaps you’re grateful for spending chilly evenings under a warm blanket binge-watching your favorite shows or being able to safely gather with loved ones. If you’re William Shatner, maybe you’re grateful for that quick trip to space (because apparently, that’s a thing now) and the poetic tweets it induced. Down here on earth, TikTok has surpassed 1 billion users, and while we’re not grateful, necessarily, we are entertained.

Here are the latest ugly, good, and bad TikToks that have been trending lately.
 

The Ugly: Scalp popping

Warning: Don’t watch this if you’re easily freaked out by weird body sounds. It’s like cracking your knuckles but way, way worse.

This TikTok from @asmr.barber has 1.7 million likes, and lots of people are trying it out for themselves. The viral video features the (disturbed) art of scalp popping, also known as hair cracking. It features what is assumed to be some sort of barber or professional (here’s hoping) twisting a client’s hair around his fingers and then yanking, creating an audible popping sound. Many are posting their own hair-cracking attempts on the platform. It’s unclear if this is supposed to feel good or just be grossly satisfying, though some users claim it helps with migraines.

But it turns out this might be more than kind of gross; it can be dangerous, too.

Anthony Youn, MD, a board-certified plastic surgeon, comments on the trend with concern: “What the hell is going on here?” Not something you want to hear from a doctor. Dr. Youn explained that the popping sound comes from the galea aponeurotica, a fibrous sheet of connective tissue under your scalp, being pulled off the skull.

In a comment, Dr. Youn continued to warn people of replicating this trend: “It can tear the inside of the scalp, which can bleed a ton on the inside. Think boxer or MMA fighter with scalp hematoma.”

Let’s keep our scalps attached to our skulls, people. If I never have to hear that sound again, I’ll be eternally grateful.
 

The Good: Doctor demonstrates correct EpiPen use

This reaction TikTok from medical student Mutahir Farhan (aka @madmedicine) has over 252,000 likes and hundreds of comments. In it, Ms. Farhan watches a video of a young woman attempting to administer an EpiPen to her friend, with the caption “How NOT to use an EpiPen” over it (in bright red, of course).

The woman in the video is using the wrong end of the EpiPen against her friend’s leg, so it isn’t working. When she uses her thumb to press down and help, her thumb is actually pressed against the needle end and the EpiPen sticks her instead of her friend. Ouch!

Ms. Farhan goes on to explain the anatomy of the EpiPen and shows his audience of 1.1 million followers where to inject it.

“You gotta remember that the orange tip is where the needle comes out. Otherwise, you’re going to end up stabbing yourself with epinephrine, like that girl in the video,” Ms. Farhan says. He goes on to instruct the important, but often overlooked, follow-up: “After you stab someone with epinephrine, call 911 or go to the ER, so that we can make sure they’re actually okay and good to go.”
 

The Bad: Liquid chlorophyll

Here is another one of those tricky trends that are so widespread and popular that it’s hard to find exactly where it originated from. A video from @lenamaiah has over 5 million views and 800,000 likes, which even by TikTok standards, is a lot. TikTok is rife with similar videos, which feature drops of liquid chlorophyll being added to water and smoothies.

The pretty emerald hue is mesmerizing and it’s hard to resist trying it out when it’s being peddled by seemingly every pretty, smooth-skinned pseudo-model on the platform. In this video, Lena says drinking a glass of water with a few drops of chlorophyll can reduce inflammation, get rid of eye bags, boost your vitamin levels, reduce free radical damage, detoxify your system, and file your taxes. Okay, I made that last one up, but it follows, doesn’t it? This stuff sounds pretty good. Maybe too good.

Chlorophyll, if you skipped biology class (somehow, I doubt you did), is what makes plants green. Medscape has a detailed explanation of chlorophyll, but all you really need to know is that it’s the secret to that cool thing plants do: photosynthesis, or turning sunlight into energy. Scientists have been trying to find uses for it in people since the 1940s. Unfortunately, studies never found much that it can do for us, aside from being kind of deodorizing. So, while it’s been historically marketed as toothpaste and deodorant, the new TikTok claims of it being a cure-all or the next big skincare supplement are not widely substantiated by scientific studies. The only real evidence of it being effective is word of mouth from those who claim to like the way they look or feel since taking it, which isn’t enough for doctors to recommend it.

TikTok’s resident dermatologist, Muneeb Shah, DO, stitched a TikTok from another user, with his captions explaining, “[There’s] no scientific evidence for liquid chlorophyll [helping] rosacea or acne.”

His advice: “Chlorophyll is great, but just eat more veggies.”

A version of this article first appeared on Medscape.com.

CrossFit, the widely known fitness platform and brand with thousands of affiliated gyms, is moving into primary care with the launch of its newest service, CrossFit Precision Care.

Developed by family medicine physician Julie Foucher, MD, and other CrossFit-trained doctors, the new service aims to help CrossFit members build plans to protect and improve their health, according to a statement by the company.

CrossFit Precision Care plans to meet this goal through utilizing doctors who understand the CrossFit philosophy, individualized care, data-driven recommendations, proactive lifestyle changes, and continual health optimization. Informing these plans and changes are CrossFit Precision Care’s analysis through a few different methods.

CrossFit’s partner in the endeavor, Wild Health, will provide genomic testing to determine a patient’s genetic predispositions to help optimize the health plans. Blood testing reveals many things that may affect a person’s health, such as hormone status, lipid levels, thyroid function, and cardiovascular risks. An overall lifestyle review includes exercise routines, eating habits, social life, and other patterns or behaviors.
 

Connecting with doctors who understand CrossFit

Dr. Foucher is no stranger to CrossFit. She has competed in the CrossFit Games four times and discusses the sport regularly on Twitter and Instagram. Now, she works directly with CrossFit to help it provide users with individualized data-driven plans.

“I met Eric Roza last July,” Dr. Foucher says of CrossFit’s CEO. “We talked and saw a lot of potential for CrossFit and health care providers to work together, so we started brainstorming.”

When Dr. Foucher and Mr. Roza got to know Wild Health, specifically, two of its physician cofounders, it was a natural fit, she said. Dr. Foucher says that many who train in CrossFit or go to CrossFit-affiliated gyms feel a disconnect with their family doctors: “[CrossFit is] a pretty polarizing topic, but there are also a lot of doctors who know that people are having health improvements with these programs,” she said.

Through use of Wild Health’s precision services and algorithms, CrossFit Precision Care plans to connect its users with CrossFit-trained health care practitioners. This personalized approach allows health care practitioners to build closer relationships with users of the program, who may feel more comfortable working with doctors who understand their lifestyle. Wild Health’s precision medicine approach, with trackable data such as biomarker status and risk scores, gives doctors a more complete picture of a patient’s needs and history, according to a statement on the partnership.
 

A better use of data

“To me,” Dr. Foucher says of family medicine, “that was the best option coming out of residency. It was consistent with my morals.” She says much of the current health care system is algorithm based. If a patient is experiencing certain symptoms, treatment is recommended on the basis of whatever yields the best results from the data – but this doesn’t always factor in a patient’s full history and genetics. It can be difficult for doctors to build trusting and personal relationships with patients. “In our current system, there’s not a lot of time or great tools to do that,” she says.

With the approach Wild Health and CrossFit Precision Care both use, however, Dr. Foucher says she sees a huge opportunity for optimizing patient and health care practitioner relationships.

“I see huge potential here, and I really think that this should be the standard for primary care going forwards,” Dr. Foucher explains. “The nice thing about [this approach] is that it has a really quick learning curve and is relatively easy to implement with patients. Before Wild Health optimized it, the tech and data would take about 10 hours per patient to put together. But now, we can incorporate things that work with wearable tech and track results over time and allow the patient and doctor to use this platform to create relationships. And this is something that can scale to many more patients.”

According to its website, CrossFit Precision Care is currently launching an invite-only beta test version of the program in eight states ahead of an expected national release.

A version of this article first appeared on Medscape.com.

CrossFit, the widely known fitness platform and brand with thousands of affiliated gyms, is moving into primary care with the launch of its newest service, CrossFit Precision Care.

Developed by family medicine physician Julie Foucher, MD, and other CrossFit-trained doctors, the new service aims to help CrossFit members build plans to protect and improve their health, according to a statement by the company.

CrossFit Precision Care plans to meet this goal through utilizing doctors who understand the CrossFit philosophy, individualized care, data-driven recommendations, proactive lifestyle changes, and continual health optimization. Informing these plans and changes are CrossFit Precision Care’s analysis through a few different methods.

CrossFit’s partner in the endeavor, Wild Health, will provide genomic testing to determine a patient’s genetic predispositions to help optimize the health plans. Blood testing reveals many things that may affect a person’s health, such as hormone status, lipid levels, thyroid function, and cardiovascular risks. An overall lifestyle review includes exercise routines, eating habits, social life, and other patterns or behaviors.
 

Connecting with doctors who understand CrossFit

Dr. Foucher is no stranger to CrossFit. She has competed in the CrossFit Games four times and discusses the sport regularly on Twitter and Instagram. Now, she works directly with CrossFit to help it provide users with individualized data-driven plans.

“I met Eric Roza last July,” Dr. Foucher says of CrossFit’s CEO. “We talked and saw a lot of potential for CrossFit and health care providers to work together, so we started brainstorming.”

When Dr. Foucher and Mr. Roza got to know Wild Health, specifically, two of its physician cofounders, it was a natural fit, she said. Dr. Foucher says that many who train in CrossFit or go to CrossFit-affiliated gyms feel a disconnect with their family doctors: “[CrossFit is] a pretty polarizing topic, but there are also a lot of doctors who know that people are having health improvements with these programs,” she said.

Through use of Wild Health’s precision services and algorithms, CrossFit Precision Care plans to connect its users with CrossFit-trained health care practitioners. This personalized approach allows health care practitioners to build closer relationships with users of the program, who may feel more comfortable working with doctors who understand their lifestyle. Wild Health’s precision medicine approach, with trackable data such as biomarker status and risk scores, gives doctors a more complete picture of a patient’s needs and history, according to a statement on the partnership.
 

A better use of data

“To me,” Dr. Foucher says of family medicine, “that was the best option coming out of residency. It was consistent with my morals.” She says much of the current health care system is algorithm based. If a patient is experiencing certain symptoms, treatment is recommended on the basis of whatever yields the best results from the data – but this doesn’t always factor in a patient’s full history and genetics. It can be difficult for doctors to build trusting and personal relationships with patients. “In our current system, there’s not a lot of time or great tools to do that,” she says.

With the approach Wild Health and CrossFit Precision Care both use, however, Dr. Foucher says she sees a huge opportunity for optimizing patient and health care practitioner relationships.

“I see huge potential here, and I really think that this should be the standard for primary care going forwards,” Dr. Foucher explains. “The nice thing about [this approach] is that it has a really quick learning curve and is relatively easy to implement with patients. Before Wild Health optimized it, the tech and data would take about 10 hours per patient to put together. But now, we can incorporate things that work with wearable tech and track results over time and allow the patient and doctor to use this platform to create relationships. And this is something that can scale to many more patients.”

According to its website, CrossFit Precision Care is currently launching an invite-only beta test version of the program in eight states ahead of an expected national release.

A version of this article first appeared on Medscape.com.

CrossFit, the widely known fitness platform and brand with thousands of affiliated gyms, is moving into primary care with the launch of its newest service, CrossFit Precision Care.

Developed by family medicine physician Julie Foucher, MD, and other CrossFit-trained doctors, the new service aims to help CrossFit members build plans to protect and improve their health, according to a statement by the company.

CrossFit Precision Care plans to meet this goal through utilizing doctors who understand the CrossFit philosophy, individualized care, data-driven recommendations, proactive lifestyle changes, and continual health optimization. Informing these plans and changes are CrossFit Precision Care’s analysis through a few different methods.

CrossFit’s partner in the endeavor, Wild Health, will provide genomic testing to determine a patient’s genetic predispositions to help optimize the health plans. Blood testing reveals many things that may affect a person’s health, such as hormone status, lipid levels, thyroid function, and cardiovascular risks. An overall lifestyle review includes exercise routines, eating habits, social life, and other patterns or behaviors.
 

Connecting with doctors who understand CrossFit

Dr. Foucher is no stranger to CrossFit. She has competed in the CrossFit Games four times and discusses the sport regularly on Twitter and Instagram. Now, she works directly with CrossFit to help it provide users with individualized data-driven plans.

“I met Eric Roza last July,” Dr. Foucher says of CrossFit’s CEO. “We talked and saw a lot of potential for CrossFit and health care providers to work together, so we started brainstorming.”

When Dr. Foucher and Mr. Roza got to know Wild Health, specifically, two of its physician cofounders, it was a natural fit, she said. Dr. Foucher says that many who train in CrossFit or go to CrossFit-affiliated gyms feel a disconnect with their family doctors: “[CrossFit is] a pretty polarizing topic, but there are also a lot of doctors who know that people are having health improvements with these programs,” she said.

Through use of Wild Health’s precision services and algorithms, CrossFit Precision Care plans to connect its users with CrossFit-trained health care practitioners. This personalized approach allows health care practitioners to build closer relationships with users of the program, who may feel more comfortable working with doctors who understand their lifestyle. Wild Health’s precision medicine approach, with trackable data such as biomarker status and risk scores, gives doctors a more complete picture of a patient’s needs and history, according to a statement on the partnership.
 

A better use of data

“To me,” Dr. Foucher says of family medicine, “that was the best option coming out of residency. It was consistent with my morals.” She says much of the current health care system is algorithm based. If a patient is experiencing certain symptoms, treatment is recommended on the basis of whatever yields the best results from the data – but this doesn’t always factor in a patient’s full history and genetics. It can be difficult for doctors to build trusting and personal relationships with patients. “In our current system, there’s not a lot of time or great tools to do that,” she says.

With the approach Wild Health and CrossFit Precision Care both use, however, Dr. Foucher says she sees a huge opportunity for optimizing patient and health care practitioner relationships.

“I see huge potential here, and I really think that this should be the standard for primary care going forwards,” Dr. Foucher explains. “The nice thing about [this approach] is that it has a really quick learning curve and is relatively easy to implement with patients. Before Wild Health optimized it, the tech and data would take about 10 hours per patient to put together. But now, we can incorporate things that work with wearable tech and track results over time and allow the patient and doctor to use this platform to create relationships. And this is something that can scale to many more patients.”

According to its website, CrossFit Precision Care is currently launching an invite-only beta test version of the program in eight states ahead of an expected national release.

A version of this article first appeared on Medscape.com.