4 DAYS AGO • 8 MIN READ

🥵 Why You Get A Fever And Others Don't

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Dr Karan's Weekly Dose

A weekly newsletter to help you live a happier, healthier life!

We're currently only 8% of the way towards recruiting for the landmark endometriosis clinical trial we're doing at LOAM.

This is often the bottleneck in most trials: the recruiting.

Sometimes trials fail before they've even begun because they don't recruit enough participants rapidly enough, or at all.

It's actually crazy to think that if we get this trial finished, it will only be the sixth clinical trial ever to research endometriosis and the microbiome. That is wild, and exactly why we need to do this.

If you know someone with endometriosis, please share it with them!

PS, Thursday of last week LOAM turned 1 year old!

It was a real full circle moment as I also got the results of my annual blood test, which showed I had normal ApoB and LDL cholesterol still (woop!).

It was my high cholesterol diagnosis which got me sucked into the rabbit hole of fiber science and nutrition in 2018 and as I fell further in, it eventually became LOAM!

Here's to many more years feeding guts and microbiomes across the globe!

What you'll learn in this newsletter:

  1. ⏰ The 30-Second Test That Predicts Mortality
  2. 🥵 The Bacteria Behind The Fever
  3. 👌 It's OK To Look After No 1

General health

⏰The 30-Second Test That Predicts Mortality

30% of 65-year-olds have a fall every year while 50% of 80-year olds do.

If you’ve seen it happen to someone of that age, you’ll know not just how dangerous it can be in the moment, but how it can also wreck people’s confidence.

And while you may be some way away from your 60s or 80s, the fact is, the kinds of problems with balance, leg strength and flexibility that increase your chances of falling begin decades earlier.

So, what if there were a 30-second test you could do right now that could help predict whether you’re at greater risk of a fall than someone else your age?

Well, humour me for a second.

If you’re sitting down while you’re reading this…stand up…and then sit down again.

However, if you’re standing up, just sit down for a second (if you can. If you’re on a busy train or bus, this might have to wait) and then stand up.

That’s the test.

Standing up and sitting down.

You just have to do it for 30 seconds, and the number of times you can do it can reveal so much about your overall strength and fitness, including:

  • Predicting the number of falls in older men (mean age 91...91!), where the fewer repetitions they could do correlated with the number of falls they suffered over one year (PMID: 28464024).
  • Predicting all-cause mortality in adults aged 51–80 (PMID: 23242910).
  • Identifying which individuals are most likely to suffer complications when recovering from surgery (PMID: 33356620) and cancer treatment (PMID: 38957165).

I’ve been genuinely blown away by how powerful this simple test seems to be.

Most of the research into it has been done with older adults, and if you’re aged 60+ and can do more than 14 repetitions for men, or 12 for women, you’re doing well.

However, the 1-minute average (median) for 20–24-year-old males is 50, while it’s 47 for women of the same age (PMID: 23974352), so halve those values if you do it for 30 seconds.

Here are your "do-now" actionables:

1️⃣ Given how simple it is to do, it’s a no-brainer to me that you should try the sit-to-stand test for yourself.

2️⃣ By all means try to improve your score, but only compare your results with yourself, no one else.

3️⃣ If you spend large parts of the day sitting down, stand up and walk about for 1 or 2 minutes every half an hour.

4️⃣ Walking more and walking up stairs will build strength in your legs and improve cardiovascular fitness.

5️⃣ Single-leg strength is also important. Simply standing on one leg for 30 seconds is a good single-leg workout.


Gut health

🥵 The Bacteria Behind The Fever

If you’ve ever experienced a fever after receiving a vaccine, but wondered why someone else who received the same vaccine didn’t, a new study (PMID 42848888) might provide an answer.

Researchers tracked 171 adults after they received a COVID-19 vaccine.

Each day, participants had their temperature taken three times to monitor fever, and provided blood and stool samples to measure gut microbiome composition and immune markers.

Here are the findings:

  • Receiving the vaccine had no significant effect on overall gut microbiome composition.
  • However, individuals who experienced fever tended to have chronic low-grade intestinal inflammation and more bacteria associated with a particular type of flagellin.

Flagellins are the whip-like structures that some bacteria use to move around.

But they’re more than just microscopic motors.

Flagellin can also act as a molecular signal recognised by certain immune cells.

When the immune system detects flagellin, it can activate signalling pathways that trigger an inflammatory response.

To test the hypothesis that a flagellin-dominated gut microbiome is associated with heightened inflammation, the researchers transferred gut microbiome samples from fever-positive participants into human colonic organoids — essentially lab-grown models of the colon made from human cells.

The result? An increased inflammatory response.

Finally, when they added components associated with a typical Western diet, such as certain food additives, to these lab-grown models, they saw increased production of bacterial flagellin.

Now, this study cannot prove that changing your diet will reduce your likelihood of experiencing a fever after vaccination. However, it highlights two important points:

1️⃣ The gut and the immune system are tightly interconnected.

2️⃣ The gut microbiome can respond to changes in what we eat, sometimes within just a few days.
​

Which is why I’m so bullish on meeting, or even exceeding the recommended daily amount of 30g of dietary fiber.

And a simple way to get more fibre is to add one LOAM serving to your morning coffee, smoothie or overnight oats (it's formulated to be heat stable so you can even bake with it!).


REFLECTIONS

👌 It's OK To Look After No. 1

You know how on airplanes they always tell you, “In case of an emergency, life jackets can be found under your seat. Parents should put their own life jacket on before helping their children”?

I haven’t flown with my son yet, but that advice, which frankly I’ve always ignored up till now because, why wouldn’t I? suddenly seems a bit hard to swallow.

However, the more I think about it, the more it makes sense.

It’s literally true that in a life-or-death situation, you can’t help anyone if you’re injured, dying or dead.

But to be a little less dramatic, I can’t be a good father or husband, let alone a great one, if I’m not looking after myself.

  • We all know we’re a different person after a good night’s sleep compared to a lousy night.
  • And what about how you feel after you eat a healthy lunch, maybe even taking a walk afterwards, compared to when you have a burger and chips with a couple of beers and later can barely stagger to the sofa?
  • Which version of you do your kids/partner prefer: the one who’s stressed out because of deadlines, or the one who doesn’t even mention work when they’re home?

Just doing the boring basics of sleep, nutrition and exercise has the biggest effect on how good a father or husband I can be. It’s 100% in my family’s interest that I nail those 3 things whenever I can.

Of course, sometimes life just gets in the way, and it’s no one’s fault that you’re not the best version of yourself for a day or two. So what? No one will remember those odd occasions if you consistently show up for your loved ones the rest of the time.

You might even call looking after yourself an act of loving kindness towards the ones who are most important to you.


👋 Who are you again? I’m Karan Rajan - a doctor and curious explorer of all things health and wellness. I'm the founder of LOAM Science, a microbiome company aiming to create the best fiber product in the world! I host the Dr Karan Explores Podcast, where I talk to experts in science and medicine to cut through the BS of modern health advice. If you'd like an easy way to dig through the archive, you can ask me any questions about the podcast and talk to my digital librarian here. I've also written two books "This Book May Save Your Life" and "This Is Vital Information".

If you feel strongly about some health things or just want to say hi? Hit reply... I’d love to hear it and hear from you! (yes I read every reply!!!)f

🤩 WEEKLY HIGHLIGHTS

🤢You've Been Lied To About Period Pain

Endometriosis affects 1 woman in 10. In other words you almost certainly know someone who has it and probably don't know about it. I'm not sure any other health condition is so common, so painful and so misunderstood. Hands down one of the most important videos I've ever made.

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💪The Real Testosterone Epidemic

Were I to believe almost every middle-aged fitness influencer out there, my occasional lack of energy and mid-afternoon slumps are down to my low testosterone levels. In this podcast, I interview Dr Channa Jayasena and among other things answer the million dollar question: if you're already heathy, do you need to get your test tested? Don't forget you can ask my digital twin any question you like related to any of my content.

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💊 Doctor Answers All Your GLP-1 Questions

ICYMI I recently recorded an Ask Me Anything episode of the pod where I answered all your questions about GLP-1s. Can you stay on them forever? Does microdosing actually work? How do they affect women's health and hormones? I answer all these questions and more in this episode.

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📝 WHAT I'M DOING THIS WEEK

☀️Getting Sunlight When I Can

Now that the clocks have gone back, the hours of daylight we experience in the UK will rapidly decrease until December 21st. That makes getting enough sunlight - both for vitamin D production and regulating my circadian rhythm - challenging. It’s why I’m trying to do a 20-minute walk every morning. Sunlight, steps and fresh(ish) air. What’s not to love?

📱Deleting Photos

Most of us have hundreds of photos on our phones that we not only don’t ever look at, but barely even know exist. With all the talk about data centres and their use of electricity and water, it’s sobering to think most of those photos are being stored in some data centre somewhere. Time to do some photographic housekeeping.

👀 Noticing The Little Things

It’s easy to notice the big wins and the failures, but what about the small wins? The delicious meal you cooked? The delightful conversation you had with your kids? The 10 minute workout you did this morning? These micro-wins are easily overlooked, but I suspect there are far more of them than the other two. I’m going to track them for a week and see how many I have.

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay seeking medical advice for any medical condition they may have and should consult their healthcare professionals for any such conditions.

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Dr Karan's Weekly Dose

A weekly newsletter to help you live a happier, healthier life!