Paladin Family Practice

Paladin Family Practice Restoring trust in medicine with accessible, honest care. No insurance middlemen. Run by Dr. Lawson Smith in the Shenandoah Valley.

I wanted to briefly touch on a clip that has been making the rounds on social media. It features Bryan Ardis, who is a c...
06/11/2026

I wanted to briefly touch on a clip that has been making the rounds on social media. It features Bryan Ardis, who is a chiropractor, speaking with podcast host Rebecca Weiss about GLP-1 medications like Ozempic and Wegovy.

Link: https://www.facebook.com/share/v/1HZXcf6FDM/?mibextid=wwXIfr

The problem with the clip is that he is not really addressing the fair concerns about these medications. There are real things to discuss with GLP-1 medications: nausea, vomiting, constipation, gallbladder disease, pancreatitis risk, muscle loss if patients are not getting enough protein or resistance training, cost, supply issues, and weight regain if the medication is stopped without sustainable lifestyle changes. Those are fair concerns.

Instead, he builds a misleading argument around what these medications are made from.

First, he says there is “no GLP-1” in Ozempic or Wegovy. That is technically true, but it is misleading. Ozempic and Wegovy contain semaglutide, which is a GLP-1 receptor agonist. That means it is designed to activate the same receptor as your body’s natural GLP-1 hormone. Semaglutide is not the exact native GLP-1 hormone, because native GLP-1 is broken down very quickly in the body. The medication was modified so that it lasts much longer. This is common in medicine. We often modify natural hormones or peptides to make them last longer or work more predictably. Examples include long-acting insulin analogs, long-acting testosterone esters, and other modified peptide or hormone-based medications.

Second, he suggests that Ozempic or Wegovy contain exendin-4 from Gila monster venom. That is not correct. Exendin-4 is a real peptide that was originally identified from the Gila monster, and it led to the development of exenatide, which is an older GLP-1 medication sold as Byetta or Bydureon. But Ozempic and Wegovy are not exenatide. They are semaglutide. Semaglutide is a modified analog of human GLP-1, not Gila monster venom.

There is also a broader point here. Many medications have been developed from compounds first identified in plants, bacteria, fungi, animals, or venoms. That does not automatically make them dangerous. ACE inhibitors, for example, were developed after research involving snake venom peptides. Digoxin comes from foxglove. Penicillin came from mold. The source of a discovery does not determine whether a medication is safe or unsafe. What matters is the actual molecule, the dose, and how it behaves in the body.

The phrase “the dose makes the poison” is important here. Venom contains many different compounds. Scientists may identify one specific peptide from that mixture, study it, modify it, purify it, and turn it into a medication. That is very different from injecting venom. Presenting it as “this comes from venom” without explaining that distinction is fear-based and misleading.

So my main concern with the clip is not that GLP-1 medications are perfect. They are not. They have side effects. They are not appropriate for every patient. They should be used with attention to nutrition, protein intake, strength training, long-term planning, and medical monitoring.

But the argument in this clip is not a serious discussion of those real risks. It is mostly using technical-sounding claims to create fear. The accurate summary is this: Ozempic and Wegovy do not contain native GLP-1, and they do not contain Gila monster venom. They contain semaglutide, a GLP-1 receptor agonist designed to activate the GLP-1 receptor and last longer than the body’s natural GLP-1 hormone.

This post is for educational purposes only and does not constitute medical advice. Talk to your doctor before making any decisions about testing or treatment.*

A one-time infusion that permanently lowers your cholesterol. That's the promise behind a new gene editing therapy that ...
06/04/2026

A one-time infusion that permanently lowers your cholesterol. That's the promise behind a new gene editing therapy that just had results published in the New England Journal of Medicine.

The treatment is called VERVE-102, made by Eli Lilly. It's a single IV infusion that edits one gene in your liver called PCSK9. That gene controls how much LDL cholesterol your body keeps in your blood. Turn it off and your LDL drops.

In this trial, at the highest dose, LDL fell up to 62%. One infusion. Effects held steady over the follow-up period.

The idea behind it is interesting. Some people are born with this gene already switched off naturally. They carry very low cholesterol their entire lives and have dramatically lower rates of heart disease. This therapy is trying to give that same advantage to people who weren't born with it.

Now, the caveats. And there are real ones.

This was a very early, very small study. 35 patients. Side effects were mostly mild, but the follow-up period is short. Larger trials haven't started yet. We don't know what 5, 10, or 20 years looks like after this kind of edit.

And here's the part that deserves serious thought: this is permanent. You can stop taking a statin. You can't un-edit your genes. Permanence is the selling point, but it's also the risk. If something unexpected shows up down the road, there's no off switch.

I'm sharing this because the science is worth watching, not because I think anyone should be lining up for it. This is how medicine advances. Slowly, carefully, with a lot more data still needed. I'll keep following it.

https://www.nejm.org/doi/full/10.1056/NEJMoa2601283

This post is for educational purposes only and does not constitute medical advice. Talk to your doctor before making any decisions about testing or treatment.*

You've probably heard that fiber is good for your gut. And it is. But the science is more nuanced than most people reali...
05/31/2026

You've probably heard that fiber is good for your gut. And it is. But the science is more nuanced than most people realize.
A 2021 Stanford study published in Cell compared two approaches: a high-fiber diet versus a high-fermented-foods diet. The results weren't even close.

The high-fiber group saw inconsistent results. Microbiome diversity didn't reliably increase, and some participants actually saw a rise in inflammatory markers. The benefits depended heavily on what their gut microbiome already looked like going in.
The fermented foods group? Microbiome diversity increased across the board.

Multiple inflammatory markers dropped. The results were consistent across virtually all participants.

We're talking about foods like sauerkraut, kimchi, kefir, and kombucha. Low-sugar varieties, eaten consistently. Not a supplement. Not a pill. Just real food.
This doesn't mean fiber is bad. It's still important long-term. But if you're trying to reduce inflammation and improve gut health, fermented foods appear to be a more reliable starting point for most people.

https://med.stanford.edu/news/all-news/2021/07/fermented-food-diet-increases-microbiome-diversity-lowers-inflammation.html

This post is for educational purposes only and does not constitute medical advice. Talk to your doctor before making any decisions about testing or treatment.

They are not uninsured because they do not work.Often, they are uninsured because they do.They work full time. They are ...
05/28/2026

They are not uninsured because they do not work.

Often, they are uninsured because they do.

They work full time. They are self-employed. They run small businesses. They work for small businesses that cannot afford traditional health benefits. Or they have insurance, but the deductible is so high that every visit, lab, scan, and prescription still feels like cash-pay medicine.

These are the people who often fall into the gap.

They may make too much to qualify for Medicaid, but not enough to comfortably afford private health insurance. And when something goes wrong, they are forced to do the math before they get care.

“How much will the visit cost?”

“What if I need labs?”

“What if I need an ultrasound, CT scan, or MRI?”

“What if the medication is too expensive?”

So they wait.

Not because they do not care about their health.
Not because they are irresponsible.
They wait because the system has made healthcare feel financially dangerous.

This is one of the places where Direct Primary Care can make a real difference.

At Paladin Family Practice, members pay a predictable monthly fee for direct access to primary care. No per-visit fee. No surprise bill for asking a question. No rushed appointment where you barely have time to explain what is going on.

But the value goes beyond access.

One of my favorite parts of building this practice has been shopping around locally for affordable labs, imaging, medications, and specialist options. Sometimes the difference between one facility and another can be hundreds or even thousands of dollars.

That means we can ask practical questions before money is spent:

Do we really need this test?
Where is the most affordable place to get it?
Can we use a cash-pay lab price?
Is there a medication coupon?
Is there a lower-cost pharmacy option?
Can this be handled here instead of urgent care?

Direct Primary Care is not insurance. It does not replace major medical coverage for emergencies, hospitalization, surgery, or major procedures.

But for day-to-day care, chronic conditions, urgent concerns, lab work, medication questions, and cost-conscious guidance, it can be a powerful solution.

Helping patients in this gap is one of the most rewarding parts of my work.

That is exactly who Paladin Family Practice was built to serve.

Learn more or sign up at:
www.PaladinFamilyPractice.com

Disclaimer: This post is for general information only and is not medical advice. If you have symptoms or questions about your health, talk with your clinician.

05/24/2026

Memorial Day weekend, Shenandoah Valley. Flags out, coolers stocked, and every grill in the Valley is about to get fired up. It's also the weekend somebody's going to find out the lid handle is hotter than they thought. Every year I see the same handful of burns walk through the door, so here's the rundown.

The four ways people actually burn themselves at the grill:

Grease flare-up while flipping something fatty
Grabbing the grate, lid, or a metal handle that's hotter than it looked
Lighter fluid flash (usually with eyebrow and forearm hair as collateral damage)
Reaching across the grill and brushing an arm against the edge

What to do, in order:

Get away from the heat. Pull off any rings, watches, or bracelets near the burn before things swell. Run cool (not cold, not ice) tap water over it for a solid 15 to 20 minutes. Most people quit at two minutes because it doesn't feel like it's doing anything. It is. That's the step that decides how deep the burn ends up.

Once it's cooled, cover it loosely with a clean non-stick pad or even plastic wrap in a pinch. Ibuprofen helps with both the pain and the inflammation.

Things not to do, no matter what your uncle says:

Butter, mustard, toothpaste, ice cubes, raw potato. None of it. They either trap heat or set you up for an infection.
Leave the blister alone. That dome of skin is the best dressing you're going to find. If it pops on its own, trim the loose skin with clean scissors and cover it.

Go to the ER if:
The burn is on the face, hands, feet, ge****ls, or wraps around a joint
It's bigger than your palm
The skin looks white, leathery, or charred (deep burns often don't hurt much, which is the part that fools people)
It happened to a small child, an older parent, or someone with diabetes
There was a flash and now you're hoarse or coughing

A new study out of UC San Diego tracked over 11,000 kids from ages 9 through 17. It's the largest study of its kind ever...
05/18/2026

A new study out of UC San Diego tracked over 11,000 kids from ages 9 through 17. It's the largest study of its kind ever done in the U.S.

The findings: teens who use cannabis show slower development in memory, attention, language skills, and processing speed compared to their peers. The effects are dose-dependent, meaning the more they use, the more they fall behind. And THC exposure was specifically linked to worsening memory over time.

This matters because the adolescent brain is still actively developing. The prefrontal cortex, which handles decision-making, impulse control, and working memory, isn't fully mature until your mid-20s. THC disrupts endocannabinoid signaling during this critical window, and the deficits compound over time.

Cannabis is more accessible and more potent than it was 20 years ago, and a lot of kids (and parents) assume it's harmless because it's legal in many states. Legal does not mean safe for a developing brain.

MONDAY, April 20, 2026 (HealthDay News) — W**d can blunt teenagers’ brain development across a range of skills, including memory, attention, language and proces

Big news in autoimmune disease research.A study just published in Nature found something scientists have suspected since...
05/05/2026

Big news in autoimmune disease research.

A study just published in Nature found something scientists have suspected since the 1950s but could never prove.

Some autoimmune diseases may be partly driven by DNA mutations your immune cells pick up over your lifetime. Not inherited. Acquired. These mutations can knock out the natural brakes on your immune system. When the brakes fail, your body attacks itself.

Right now, most autoimmune treatments work by turning down the whole immune system. Helpful, but blunt. If this research holds up, it could open the door to precision treatments that target the broken cells and leave the healthy ones alone.
We are a long way from that being standard care. But this is the kind of science that changes direction.

https://www.sanger.ac.uk/news_item/hidden-mutations-in-immune-cells-linked-to-autoimmune-disease/

This post is for informational purposes only and does not constitute medical advice. Always consult your physician regarding your individual health concerns.

Mutations in immune cells may be the missing piece in the autoimmune disease puzzle.

04/28/2026

It’s the same old game. Doctors treat patients. No middleman. Patients are happy. Third parties see a way to get involved. They create chaos. Preach how they can fix the chaos. They jump in a…

New cholesterol guidelines just came out for the first time since 2018, and there is one change in particular I want to ...
04/27/2026

New cholesterol guidelines just came out for the first time since 2018, and there is one change in particular I want to talk about. The American Heart Association is now recommending that every adult get tested at least once in their lifetime for something called lipoprotein(a), or Lp(a). Most people have never heard of it, and almost nobody has been tested for it.

Lp(a) is a type of lipoprotein, which is basically a particle that carries cholesterol through your bloodstream. It is similar to LDL (the one most people know as "bad cholesterol"), but it has an extra protein attached to it called apolipoprotein(a). That extra protein is what makes Lp(a) different and, honestly, more concerning. It does three things that regular LDL does not do as aggressively: it promotes plaque buildup in your artery walls, it drives inflammation inside those plaques, and it interferes with your body's ability to break down blood clots. So it is not just depositing cholesterol. It is making your arteries more inflamed and more clot-prone at the same time.
Here is the part that surprises most people. Your Lp(a) level is about 90% genetically determined. Diet and exercise do not really move it. You either have high levels or you do not, and you have probably had whatever level you have your entire life without knowing it. About 1 in 5 people worldwide have elevated Lp(a), and if your level is above 125 nmol/L (or about 50 mg/dL), your cardiovascular risk starts to climb. Above 250 nmol/L, that risk roughly doubles.

The other important thing is that a standard cholesterol panel does not include Lp(a). Your doctor has to order it separately. So you could have perfect looking cholesterol numbers on a routine panel and still be walking around with a significant hidden risk factor.

Practical takeaway: if you have never had your Lp(a) checked, it may be worth asking your doctor whether it makes sense for you. It is a simple blood test, it only needs to be done once in your lifetime since the level stays relatively stable, and it could change how you think about your heart health going forward. If your level does come back high, it is also worth mentioning to your parents, siblings, and kids, since they may share the same genetic risk.

Disclaimer: This post is for general information only and is not medical advice. If you have symptoms or questions about your health, talk with your clinician.

Lp(a) is a genetic independent risk factor for heart disease. Knowing your Lp(a) levels can help you reduce your risk of heart disease for you or someone you love.

Texas just launched an investigation into Lululemon over PFAS ("forever chemicals") potentially in their activewear. Her...
04/23/2026

Texas just launched an investigation into Lululemon over PFAS ("forever chemicals") potentially in their activewear.

Here's the full announcement: https://www.texasattorneygeneral.gov/news/releases/attorney-general-ken-paxton-launches-investigation-lululemon-over-potential-presence-toxic-forever

Why should you care? PFAS are a class of synthetic compounds that don't break down in the environment or in your body. They accumulate in your blood, organs, and tissues over time. The research linking them to thyroid disease, hormonal disruption, reproductive harm, and certain cancers is growing fast. And your skin is your largest organ. It absorbs what you put on it.

A company built on "wellness" potentially exposing customers to endocrine disruptors through direct skin contact during exercise, when your pores are open and absorption increases. That's a problem.

Attorney General Ken Paxton issued a Civil Investigative Demand (“CID”) to Lululemon USA Inc. (“Lululemon”) as part of an investigation into whether the company has misled consumers about the safety, quality, and health impacts of its products.

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