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St. John's Wort: Why This "Natural" Supplement Can Be Medically Dangerous
St. John’s wort is often viewed as a safe, natural supplement, but it is one of the most dangerous herbal products when combined with prescription medications. By strongly inducing liver enzymes and drug transporters, it can lower blood levels of antidepressants, birth control pills, anticoagulants, and transplant medications—sometimes leading to serotonin syndrome, unintended pregnancy, stroke, or organ rejection.

David S. Klein, MD FACA FACPM
4 days ago4 min read


Advanced Glycation End Products (AGEs):
Advanced glycation end products (AGEs) are biologically active compounds formed through non-enzymatic reactions between sugars and proteins, lipids, or nucleic acids. While AGE accumulation is a normal feature of aging, modern dietary patterns, insulin resistance, oxidative stress, and chronic hyperglycemia markedly accelerate their formation. Increasing evidence identifies AGEs as a central and under-recognized contributor to atherosclerotic cardiovascular disease (ASCVD) an

David S. Klein, MD FACA FACPM
Jan 164 min read


Influenza A and B Outbreaks: Why the Flu Season Comes in Waves
This year’s influenza season has followed a familiar clinical pattern, with an early surge of Influenza A infections followed by a later rise in Influenza B cases. While Influenza A is often associated with more severe illness and higher early hospitalization rates, Influenza B can extend the flu season and cause significant disease, particularly in children and older adults. Understanding this progression helps explain why flu activity persists later into the season and unde

David S. Klein, MD FACA FACPM
Jan 153 min read


Migraine vs Sinus Headache
Migraines and sinus headaches are often confused because they can share facial pain, congestion, and watery eyes—but they are fundamentally different conditions that require different treatments. Migraines are a neurological disorder commonly associated with throbbing head pain, nausea, and sensitivity to light and sound, while true sinus headaches result from inflamed or infected sinus cavities and are typically accompanied by thick nasal discharge, fever, and pain that wors

David S. Klein, MD FACA FACPM
Jan 85 min read


THC, REM Sleep, and the Quiet Disruption of Sleep Architecture
THC may shorten sleep onset, but research shows it suppresses REM sleep and disrupts normal sleep architecture. Over time, this can impair memory, mood, and restorative sleep—especially with nightly use. Understanding the difference between sedation and healthy sleep is critical.

David S. Klein, MD FACA FACPM
Jan 55 min read


THE HIDDEN CAUSES OF PERSISTENT FATIGUE: A PHYSICIAN’S GUIDE TO OVERLOOKED METABOLIC AND ENDOCRINE DISORDERS
Chronic fatigue often signals hidden metabolic or endocrine disorders. Learn the overlooked causes—from thyroid and iron issues to insulin resistance and mitochondria.

David S. Klein, MD FACA FACPM
Dec 24, 20254 min read


The Value of Urine PCR in Diagnosing Persistent or Complicated Urinary Tract Infections
Urinary tract infections (UTIs) are traditionally diagnosed using urinalysis followed by culture and sensitivity testing. While effective in most cases, these methods may miss fastidious or slow-growing organisms, fail to identify mixed infections, or return negative results despite continued patient symptoms. Urine polymerase chain reaction (PCR) testing provides a highly sensitive molecular alternative that detects microbial DNA directly, identifies antibiotic-resistance ge

David S. Klein, MD FACA FACPM
Dec 18, 20255 min read


Surgery, Anesthesia and GLP-1 Weight Loss Medicines: The Unseen Danger
If you are preparing for surgery, one of the most important safety steps is to inform your surgeon and anesthesia team if you are taking a GLP-1 medication. These include well-known names such as Ozempic®, Wegovy®, Mounjaro®, Zepbound®, Rybelsus®, Trulicity®, Victoza®, Saxenda®, Byetta®, and Bydureon®. While these drugs provide significant benefits for weight loss and diabetes management, they can also delay stomach emptying—a normal part of their mechanism of action. In ever

David S. Klein, MD FACA FACPM
Dec 16, 20256 min read


Essential Vitamins and Supplements for Liver Health: Managing Fatty Liver Disease MASLD
Managing fatty liver disease MASLD requires a comprehensive approach. Vitamins and supplements can support liver health by reducing oxidative stress, improving metabolism, and lowering inflammation. However, they are part of a broader strategy that includes diet, exercise, and medical care.

David S. Klein, MD FACA FACPM
Dec 11, 20255 min read


Back Pain Due to Cluneal Nerve: Entrapment Cryptogenic Back Pain. When the Problem is NOT the Disc
Back and buttock pain that persists despite standard imaging and conservative therapy often leaves patients and clinicians searching for an underlying explanation. One frequently overlooked cause involves injury or entrapment of the cluneal nerves—three distinct sensory nerve groups that supply the skin over the lower back, sacrum, and buttocks. When compressed or inflamed, these nerves can generate pain syndromes that closely resemble lumbar radiculopathy, sacroiliac dysfunc

David S. Klein, MD FACA FACPM
Nov 28, 20256 min read
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