Ivermectin Evidence and Critical Thinking, CBC-Based Inflammation Formulas, and Transperineal Prostate Biopsy

Broadcast from KSQD, Santa Cruz on 6-25-2026:

Dr. Dawn devotes the show's opening to ivermectin for COVID. She walks through critical thinking principles—considering the source, cross-verification, and recognizing self-interested claims—before reviewing the evidence. The most-cited 2021 Bulgarian study of 300 people showing 77% reduction lacked accessible methods, and larger trials capable of detecting even small benefits failed to confirm efficacy. On safety, the standard 12mg parasitic dose every few weeks is well-tolerated due to the blood-brain barrier and efflux pumps that keep ivermectin out of the brain, but daily long-term dosing has caused encephalopathy, liver and kidney damage, and birth defects. Critical drug interactions—macrolide antibiotics, verapamil, proton pump inhibitors, and beta blockers—disable the efflux mechanism, and high-fat meals increase absorption 2.5-fold.

Dr. Dawn shares two inflammation formulas calculable from any CBC. The Systemic Inflammatory Index (neutrophils × platelets ÷ lymphocytes) flags runaway inflammation: 200-500 is good, above 900 warrants investigation and correlates with worse stroke outcomes and rising tumor burden. The SIRI (neutrophils x monocytes ÷ lymphocytes) detects chronic tissue inflammation and early innate immune activation: below 500 is good, above 1500 indicates trouble and correlates with cardiovascular mortality and arterial plaque from M1 macrophage activity.

Dr. Dawn shares two takeaways from the Institute for Functional Medicine annual conference: in patients at high cardiovascular risk by cholesterol, each gram daily of combined EPA/DHA produces a 9% risk reduction, with bruising as the dose-limit signal. Additionally, a 15-minute walk within 30 minutes of a meal nearly eliminates postprandial inflammation.

An emailer asks whether an endocrinologist's claim that vitamin D leaches calcium from bones is true. Dr. Dawn confirms that very high vitamin D (above 150 nanograms, with concern starting above 90) elevates 1,25-vitamin D, which stimulates osteoclast formation and increases C-telopeptide markers of bone breakdown.

A crowdsourced question asks how histamines work in women. Dr. Dawn explains histamine functions as a CNS neurotransmitter promoting alertness, wakefulness, and pain perception (deficient in narcolepsy), and as a GI signal driving acid secretion, motility, and visceral sensation. Gut bacteria can convert histidine to histamine, and fish left to spoil can trigger anaphylac