Richard Harris MD, PharmD, MBA (2025)

21/04/2025

I didn't want to see another doctor because I was afraid I was going to be judged. This patient almost had a critical delay in her GLP medication, which was working for her. Find out how this conversation went by watching this video.

Become a patient or download our free healthy habits and mindset ebook - https://linktr.ee/DrharrisMD

14/04/2025

Besides having diabetes, high blood pressure, and being overweight, I'm pretty healthy. I heard this from a stranger on an airplane after he learned I'm a doctor. I began to ask him some clarifying questions and outlined how I assess an individual's health status.

Become a patient or download our free healthy habits and mindset eBook - https://linktr.ee/DrharrisMD

09/04/2025

I have a bad diet. I hear this from patients all the time, and instead of judging them or immediately telling them what to do, my first question is usually, "What makes you think you have a bad diet?" This video dives into my approach when patients tell me they have a bad diet.

Book a discovery call to see if we are a good fit to work together - heal.me/ghw

02/04/2025

I don't have time to work out, which is a common response I receive from patients after discussing how exercise can help prevent and lower the risks associated with several diseases.

This video discusses one such encounter and how I addressed this limiting belief and helped guide a patient from "I don't have time to workout" to "having a full workout plan within 15 minutes."

22/01/2025

Coffee drinking timing and mortality in US adults

PMID: 39776171
https://pubmed.ncbi.nlm.nih.gov/39776171/

I love a good cup of joe, and many Americans do as well. Coffee intake in most prospective studies shows a lower risk of type 2 diabetes, cardiovascular disease, and even death. Recently, there has been an interest in examining differences in behaviors like food intake with circadian rhythms. This study from the NHANES database examined the timing of coffee intake with all-cause mortality, CVD mortality, and cancer mortality.

Coffee intake was taken via 2 24-hour food recalls in the NHANES cohort and validated agaisnt a 7 day dietary recall from the WLVS and MLVS cohorts. After adjusting for several confounding variables compared to non-drinkers, morning coffee drinkers had a 16% and 31% reduced risk of all-cause mortality and cardiovascular-specific mortality, respectively, independent of the amount of coffee intake. All-day coffee drinking patterns were not associated with all-cause or CVD-specific mortality. Neither pattern was associated with cancer-specific mortality.

Potential mechanisms for why all-day coffee intake may not offer the same benefit include previous evidence supporting that heavy afternoon or evening coffee consumption lowered peak melatonin levels by 30%. Lower melatonin levels have been associated with higher oxidative stress, blood pressure, and CVD risk. Another mechanism could be that coffee's anti-inflammatory effects are heightened in the early hours due to a circadian increase in inflammatory markers in the morning.

The findings of this study align with the general recommendation to limit caffeine intake later in the day to help prevent disruptions in the circadian rhythm and sleep. I try to cut off my caffeine intake at noon.

Want to become my patient? Join the waitlist to get notified of when we start seeing patients - https://drharrismd.kit.com/ab0944eb08

17/01/2025

Hello, my name is Richard Harris, and I am an internal medicine physician and pharmacist. Thank you for watching this video about my direct primary care practice, Great Health and Wellness.

In this video, we discuss the following:
1. What is Direct Primary Care (DPC)? 0:49
2. Why did I want to create a virtual DPC clinic? 1:19
3. What is my practice philosophy? 1:59
4. How DPC is different from what you may be used to. 2:47
5. Why I do not take insurance. 5:21
6. What you can expect as a patient. 7:59

Become A Patient - heal.me/ghw or check the link in my bio.

22/11/2024

I've found in my career that safe treatment means something different to providers and patients. This video discusses how I evaluate medical interventions from a cost, benefit, and risk framework. We discuss the number needed to treat and the number needed to harm and why these are essential to the cost/benefit/risk analysis.

01/10/2024

Welcome to the first Health Musings with your host, Dr. Richard Harris. In this episode, we discuss musing and how fasting helps me feel closer to God with food noise. The Health Musings segment aims to talk about health issues from a more holistic or different perspective than I've seen online. I hope you enjoy this first segment. Please let me know what topics you would like to see me ramble about.

23/08/2024

A randomized, double-blind, placebo-controlled study to evaluate the benefits of a standardized Nigella sativa oil containing 5% thymoquinone in reducing the symptoms of seasonal allergy

PMID: 39121267
Study link: https://pubmed.ncbi.nlm.nih.gov/39121267/

Allergic rhinitis (AR) is a common condition caused by inflammation of the nasal passages in response to an allergen. Between 10% to 30% of the global population is affected by AR. Previous evidence has supported the use of black seed oil for treating AR, but the problem is that the extracts were not standardized. Herbal products can vary in the amounts of active ingredients depending on how they are harvested (flower, plant, root) and processed. This study standardized N. sative oil (NSO) to 5% thymoquinone (TQ) (thought to be the main bioactive compound in NSO) and compared it to a placebo in individuals with seasonal AR.

Patients were given 250 mg of NSO with bioperine or placebo twice daily for 15 days. The NSO group experienced improvements in the severity of AR symptoms on TNSS and TOSS screening surveys (sneezing, itching, runny nose, watery eyes, puffy eyes). Improvements were seen as early as five days. At 15 days, the NSO reported the following level of severity for their symptoms - 48.4% moderate, 33.3% mild, 9.9% very mild, and 6.1% no symptoms compared to 34.4% moderate and 65.8% severe symptoms in the placebo group. The mean duration of symptoms decreased from 77.7 minutes to 37.3 minutes in the NSO group compared to 70.0 minutes to 62.78 minutes in the placebo group. There was a significant difference in how patients reported their global impression of change between the NSO and placebo groups. No clinically important changes in blood parameters were noticed in the safety analysis.

15/07/2024

It begins! I've decided after years of mulling the idea and trying to figure out what I want to write about on a topic for a book. It's probably going to take me years to write because I don't really enjoy writing, but I feel like I have a story I need to tell in paper form.

08/07/2024

Association between serum lipid and all-cause mortality in asthmatic populations: a cohort study

PMID: 38907251
Study: https://pubmed.ncbi.nlm.nih.gov/38907251/

The results of this study have been circulating mainly in low-carb/carnivore circles, which tend to ignore the data on LDL-C and CVD risk. This cohort study examined patients with and without asthma and found a 17% decreased risk of death for every unit increase in LDL-C in mmol/L. However, there are some significant issues in the study methodology.

One problem is that only 189 deaths occurred during the study period of around 58 months. This low number of events makes it more difficult to see if there is a true signal there. Another issue is that the patients were not confirmed to have asthma. The patients with asthma that were followed were done so based on being told they have asthma from a physician or healthcare provider. They also didn't stratify their findings by asthma classification, as there is a clinical difference between those with mild asthma and those with severe persistent asthma. Another issue is they should have looked at follow-up data on lipid-lowering drugs. It could be that patients who had to go on lipid-lowering therapy were at an increased risk of death, which led to the signal they saw here.

Of course, those who champion this study as a reason why LDL-C has been gotten wrong by the major medical establishments do not mention that they did not see this association in patients without asthma. You cannot take findings from a disease state and then extrapolate them to people without a disease state. Overall, I would not draw any firm conclusions from this study, but I applaud looking at different health markers and seeing the predictive value in disease vs healthy states.

-C

02/07/2024

A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control
for Adults With Diabetes The EARLY Randomized Clinical Trial

PMID: 38904963
Study: https://pubmed.ncbi.nlm.nih.gov/38904963/

Globally, diabetes affects nearly 537 million adults worldwide. Previous research has shown that meal replacement (MR) is an effective strategy for improving body weight in patients with diabetes. Other studies have found that intermittent fasting can reduce hemoglobin A1c levels in overweight/obese and type 2 diabetes patients. This study combined 5:2 intermittent fasting with MR. The 5:2 method involves unrestricted calorie intake 5 days a week with 2 nonconsecutive low-calorie days (this study used an MR with 500 calories for women and 600 calories for men).

They recruited newly diagnosed (within 1 year) patients with type 2 diabetes who had a BMI of 24 or more and an A1c of 7% to 9%. They divided participants into three groups: one MR, one receiving metformin (titrated to 2g daily), and one receiving empagliflozin (10 mg) for 16 weeks. At 16 weeks, the 5:2 group reduced their A1c by 1.9% compared to 1.6% for metformin and 1.5% for empagliflozin. 88.2% of participants in the 5:2 group achieved an A1c of less than 7% compared to 73.9% in the metformin group and 70.6% in the empagliflozin group. 80% of the 5:2 group reduced their A1c below 6.5% (diagnostic threshold for diabetes) compared to 60.4% for metformin and 55.1% for empagliflozin.

There was also greater weight loss in the 5:2 group (9.7 kg vs 5.5 kg metformin vs 5.8 kg empagliflozin). The 5:2 group also significantly reduced waist and hip circumference, as well as systolic and diastolic blood pressure. Rates of hypoglycemia were 5.9% MR, 6% metformin, and 3.7% empagliflozin. The authors concluded that the 5:2 MR lifestyle intervention may serve as an alternative to metformin and empagliflozin in newly diagnosed patients with type 2 diabetes.

Richard Harris MD, PharmD, MBA