Could Kacsmaryk ban COVID vaccines next?

Or, could he try, at a minimum? At least the mRNA vaxxes, with all the conspiracy theories about them?

Frankly, I'm surprised nobody has yet court-shopped to file a case with him.

I have no doubt that's running through the head of Pfizer CEO Albert Bourla as one of 200 signatories from the Big Pharma world asking for Kacsmaryk's ruling on mifepristone to be overturned.

The pharmaceutical heads are (rightly on this count) worried about someone gutting FDA's science-based (in general) process, and of course worried about someone (other than themselves) gutting FDA's review process in general.

Per Alexander Zaitchik, as reviewed by Joe Costello, the regulatory capture movement by Big Pharma is nothing new, either, but goes back to the Greatest Generation era emerging from World War II.

So, this is 90 percent legit, but also 10 percent whose ox is being gored.

And, if somebody DOES do the court-shopping and Kacsmaryk said "no," then his hypocrisy would truly be laid bare.

Coronavirus week 123: Are there legitimate, non-conspiratorial reasons to discuss "Big Pharma"?

Kaiser Health News, an outlet of the Kaiser Family Foundation, representing a hospital biz that ain't exactly small potatoes, raised that issue relatively recently.

I included the link, without extracting details, in my blog post about "vaccine losers" last month.

That, in fact, needs separate linking, for these people, to quote this paragraph:

(A)s society moves into the next phase of the pandemic, the pharmaceutical industry may be moving into more familiar territory: developing products that may be a smidgen better than what came before, selling — sometimes overselling — their increased effectiveness in the absence of adequate controlled studies or published data, advertising them as desirable for all when only some stand to benefit significantly, and in all likelihood raising the price later. 

This last point is concerning because the government no longer has funds to purchase covid vaccines after this autumn. Funding to cover the provider fees for vaccinations and community outreach to those who would most benefit from vaccination has already run out. So updated boosters now and in the future will likely go to the “worried well” who have good insurance rather than to those at highest risk for infection and progression to severe disease.

What else do you want to be said? 

Maybe that other countries, as the story notes, do a non-wingnut version of cost-benefit analysis in such cases? OR that, to riff on Offit, vaxxes in general were oversold a full year ago, and now the vaccine public health world, less skeptical division, is sleeping in the bed it made?

And, from that same piece, here is more of why, contra "Your Local Epidemiologist" but per the likes of Paul Offit, you should be skeptical.

The updated booster vaccine formulations are identical to the original covid vaccines except for a tweak in the mRNA code to match the omicron BA.5 virus. Studies by Pfizer showed that its updated omicron BA.1 booster provides a 1.56 times higher increase in neutralizing antibody titers against the BA.1 virus as compared with a booster using its original vaccine. Moderna’s studies of its updated omicron BA.1 booster demonstrated very similar results. However, others predict that a 1.5 times higher antibody titer would yield only slight improvement in vaccine effectiveness against symptomatic illness and severe disease, with a bump of about 5% and 1% respectively.

So, a 5 percent boost, on average for all ages, from the mighty bivalent booster, especially if you're uninsured or underinsured? Why doesn't alleged left-liberal Walker Bragman talk about that angle? And, yeah, he's going to get hammered here as long as he doesn't.

Note the "all ages," per the cost-benefit issue not done here. Because:

As population immunity builds up through vaccination and infection, it’s unclear whether additional vaccine boosters, updated or not, would benefit all ages equally. In 2022, the U.S. has seen covid hospitalization rates among people 65 and older increase relative to younger age groups. And while covid vaccine boosters seem to be cost-effective in the elderly, they may not be in younger populations. The CDC’s Advisory Committee on Immunization Practices considered limiting the updated boosters to people 50 and up, but eventually decided that doing so would be too complicated.

So, the likes of Bragman and Katelyn Jetalina should stop pushing the bivalent for people under 50.

But, they DID study it on mice, didn't they?

Well, good biological scientists know that mice research data is often not worth the serum it's written with. So does this piece:

Though the studies of the updated omicron BA.5 boosters were conducted only in mice, the agency’s authorization is in line with precedent: The FDA clears updated flu shots for new strains each year without demanding human testing. But with flu vaccines, scientists have decades of experience and a better understanding of how increases in neutralizing antibody titers correlate with improvements in vaccine effectiveness. That’s not the case with covid vaccines. And if mouse data were a good predictor of clinical effectiveness, we’d have an HIV vaccine by now.

Ooops. I sank your battleship.

And, there's more. And, if you will, I buried the nut graf:

Unfortunately, history shows that — as with other pharmaceutical products — once a vaccine arrives and is accompanied by marketing, salesmanship trumps science: Many people with money and insurance will demand it whether data ultimately proves it is necessary for them individually or not. ... 

The federal government has been paying a negotiated price of $15 to $19.50 a dose of mRNA vaccine under a purchasing agreement signed during the height of the pandemic. When those government agreements lapse, analysts expect the price to triple or quadruple, and perhaps even more for updated yearly covid boosters, which Moderna’s CEO said would evolve “like an iPhone.” To deploy these shots and these dollars wisely, a lot less hype and a lot more information might help.

There you are.

Bragman offers enough left-liberal bona fides elsewhere that he needs to stop being a two-sider tribalist on this issue, as in tribalist of antivaxxers vs "COVID maximalists" or whatever term you prefer.

Coronavirus, Week 76B: More untruths refudiated

First, Atlantic reports on people saying their doctors told them not to get vaccinated, and looks at what may be behind the doctors' statements.

Second? For the COVID denialists touting "Dutch study" on social media? Here's a good breakdown of what that study actually says, linking to a Science mag piece for more information. TLDR? Natural immunity DOES protect you as well as a vaccine IF AND ONLY IF you get sick enough to have to go to a hospital and be ventilated.

Third, Jonathan Bernstein writes the 1 millionth "most are vax-hesitant, not vax-resistant" piece. Wrong. See my refutation of Yasmin Tayag earlier today.

Fourth, a note for antivaxxer and COVID denying leftists — ivermectin is made by "Big Pharma" Merck, which is explicitly NOT trying to run to the Big Pharma bank. As for money Pfizer is allegedly making? I'm not justifying all of it, but I will say there's first a difference between gross and net profits. And, lack of civil liability? Antivaxxers claiming that on Twitter are just gaslighting people versus the realities of the federal vaccine court, or else they're ignorant of how it works. In either case, they're spreading misinformation if they're ignorant, lies if they know better

Fifth? Lurking in the shadows? One new study says that almost half of those hospitalized with COVID are either asymptomatic or mildly so. 

Sixth and related, as for COVID denialists saying "we can't believe a disease can be carried asymptomatically by so many people," I present, after 10 seconds of Googling, salmonella and typhoid, including in the latter case Typhoid Mary, who had immediately popped into my mind. More on her here. Now, tis true, both of them are bacterial, not viral, but ... the person on Twitter just mentioned "disease," not virological disease.

But, on the viral side? HIV long lurks asymptomatically. Asymptomatic polio has also been documented. 

Back on the bacterial side, cholera is highly asymptomatic, it seems.

Seventh? See just how much of a hypocrite butt-hurt COVID antivaxxer Robert Malone is. He built on a decade of previous work, was trying to invent an mRNA vaccine — the very thing he claims today is unsafe — a decade after he claims he was deliberately written out of patent opportunities — and much work had to come after him. He has a place, but not a big place.

Eighth? Contra the COVIDZero gaslighters on Twitter, most antiviral vaccines have never claimed to eliminate what they vaccinate against. (Unfortunately,  unlike Coke Zero, CovidZERO is not being phased out.)

And, now, a couple of protection items.

First? Want to know your COVID risk based on actual real world scenarios? Click the link.

Second? If you're one of the 1 million Texans who got ONLY the first shot of either Pfizer or Moderna and are 90 days or more overdue on the second shot, well, you're at risk. Derp.

Third, Daily Kos suggests Washington state should require vax passports to keep Idaho's vax resistant on their side of the state line and force Gov. Little to clean up his own mess. Agreed.

Good! FDA to crack down on supplements makers

Now, thanks to Congress in general and former Sen. Orrin Hatch in particular, the FDA's power over supplements is limited, but it sounds like it plans to fully use the powers it has, at least on the new claims that supplements can fight Alzheimer's

About time.

I'm sure this will piss off many (other) Greens who think supplements are pure and pristine and natural (they're not, and you're committing the naturalistic fallacy) or else less capitalistic than Big Pharma (also not true; why do you think Orrin Hatch got the industry such a regulatory pass?)

On the capitalism side, the NY Times reported 3 years ago, based on government research, that Merika spends $30 billion a year on supplements. Note to FDA Commish Scott Gottlieb: I partially blame the gummint, including Orrin Hatch, with the founding of the National Center for Complementary and Integrative Health — i.e., the alt-med wing of the National Institutes of Health.

It's true that this is only about 1 percent of what we collectively spend on pharmaceuticals. That said, allowing for research replication viability and related issues, pharmaceuticals are prescribed to actually do something that they normally do. Supplements are self-prescribed by people for things they have not been proven to do and, on the deregulation, don't have to try to prove they can do.

And, because they're not regulated, supplements have a lot less overhead than pharmaceuticals.

The NYT piece also adds this. The biggest supplements users are generally the healthiest people already. In short, the supplements world feeds off of, and further feeds, a low-level hypochondria.

#BigPharma and #neoliberal bullshit from Cory Booker

We start with the photo pasted above.

We then go to the pull quote from Booker at left.

Booker, already positioning himself to try to be the second black neoliberal president in 2020, is trying to do that in part, it seems, by proffering a kinder, gentler, Obamacare. (I see what I and my one thousand twinkles of special snowflakes did there.)

The comment comes after Booker voted against a Bernie Sanders-pushed Senate amendment to create a federal revenue pool to control prescription costs, specifically through Canadian drug importation.

Now, note what I have circled in red on the back side of a Flonase bottle; "Made in Canada."

Now, prescription versions of drugs don't, at least in pill form, list a country of origin, and it's been a long, long time, since I bought prescription Flonase. But, the OTC version of Flonase is the exact same formulation and strength as the prescription version.

So, either GlaxoSmithKline is poisoning Americans with a potentially unsafe product just because it no longer needs a prescription, or Canadian drugs magically get safer without a prescription, or else it's stuffing Cory Booker's political wallet full of Flonase-green dinero.

Of course, this is nothing new. Four years ago, already, Booker was hobnobbing with The Donald, even to the degree of benefiting from an Ivanka Trump fundraiser.

That said, per Yasha Levine, on a lot of social issues, Booker isn't even really a neoliberal.

Of course, per his own Tweets, he's really just a heartless bastard.

RT @rr_nyc: Tired of hearing how morbidly obese poor don't have food either.  Employment is ennobling, even min wage, get 2 jobs

— Cory Booker (@CoryBooker) December 7, 2012

Of course, let's not shame only Booker. Thirteen other Senate Dems opposed the amendment, too.

And shock me that neolib opinion rag Washington Monthly is massaging Booker's hurt butt.

What's healthy, what's not? Fix the p-values and we might, maybe know

Long, long ago, we Americans hear that "fat was bad."

Then more research said, maybe just saturated fats.

Now, with more consensus (for now), it's that trans fats are definitely bad.

Meanwhile contrarians like Gary Taubes and Nina Teicholz are claiming that not only are we eating too many carbs, adn that more fats as well as proteins may be good, but specifically, that more saturated fats are good.

Teicholz is the latest contrarian to deliberately overreact and not only criticize but demonize more traditional research.

This shift seemed like a good idea at the time, but it brought many potential health problems in its wake. In those early clinical trials, people on diets high in vegetable oil ... were more likely to die from violent accidents and suicides."

Teicholz then futher undercuts her own credibility by claiming the possibility, even the likelihood, of causal correlation from vegetable oils changing brain chemistry.

Beyond that, it looks like there's a BUNCH of errors and problems behind the latest research Teicholz cites to support her claims. Outright errors run through the filter of meta-analysis is a sure prescription for bad interpretation.

Also, I've generally found that the likes of Tabues and Teicholz fail to distinguish between simple and complex carbohydrates. It's true that the likes of Ancel Keys, along with all of his  research ethics issues in leading the crusade against saturated fats, also did the same. But, that was 60 years ago. There's no excuse for that today.

The real problem? The p-value of 0.05 in medical research is too high, just as it is in social sciences, and is almost surely a leading contributor to the problem of replicability in psychology and sociology.

I understand why it was set as high as it is, compared to the 0.0001 in modern natural sciences. Researchers wanted a loose value so as to not screen out potentially lifesaving, or health- or mental health-saving treatments and protocols.

However, our accuracy of research, plus the number of researchers, especially in health and medicine, plus the compiled history of past research, all tell us that we don't need such loose standards today. If anything, they tell us that such loose standards may even be harmful.

They confuse people on what really is best medical practice.

In addition, they give contrarian diet writers like the above more loopholes to write contrarian books.

And, especially in mental health, but also elsewhere, the loose p-value gives Big Pharma more room to make dubious claims about the effectiveness of many prescriptions.

And, as a combination of Nos. 2 and 3, they cause the US as a whole to waste a bunch of medical spending. 

That said, I'm not going to argue that the current "medical establishment," minus the Big Pharma part, doesn't have some financial vested interests itself. Are they, relative to the overall size of the medical issues involved, of the same degree of financial interest as Big Pharma or contrarians, though? I don't think so.

And, I just mentioned people like Gary Taubes. The folks like Joseph Mercola use the looseness of p-values, and other, related issues, to drive Mack trucks laden with gold through them on the way to their personal Fort Knoxes. These fixes alone won't shut up Mercola, but they'll force the likes of him to rely on studies that are not only more clearly fringe ones, but outdated ones, too.

So, a simple suggestion?

Cut the p-value in health/medicine tighter. Say, 0.03 instead of 0.05. That's still plenty loose enough to not screen out "edgy" but true findings.

The feds, via the National Institutes of Health and the National Institutes of Mental health, have the power to make this happen. Stop funding research that don't adopt the tighter standard.

Will tighter p-values alone make a huge difference?   Maybe not a huge difference, but, they will make a difference. The feds could also stop funding most research that uses meta-analysis, and tighten up other data-related issues, many of which, such as confidence levels, are themselves at least loosely correlated with p-values. All of that together would make a big difference indeed.

And, changing what we readily can on statistical tightness, starting with p-values, would be a signal to the health and medicine fields on the one hand, and social science on the other, that it's a new day in the research world. The tighter standards would signal a need for tighter research in general. And, the requirement of special justification for the use of meta-analysis would signal that the days of cherry-picking are over.

From the same neolib that gave #Obamacare to #BigPharma

Now comes an even bigger giveaway: the Trans-Pacific Partnership.

Doctors Without Borders explains just what's wrong with this baby.

The TPP negotiations, which currently involve eleven Asia-Pacific countries, are being conducted in secret, but leaked texts reveal the most aggressive intellectual property (IP) measures ever suggested in a trade deal with developing countries. The U.S. proposals threaten to roll back internationally-agreed public health safeguards and would put in place far-reaching monopoly protections that keep medicine prices high and out of the reach of millions in the Asia-Pacific region.

Gee, are you surprised?  Somewhere, somebody is again popping out the IOKIYAO line, but it's not OK.

How bad?

Bad enough that it sounds like Monsanto is writing some of this.

One proposed TPP provision would require governments to grant new 20-year patents for modifications of existing medicines, such as a new forms, uses or methods, even without improvement of therapeutic efficacy for patients. ...

Meanwhile, provisions in the proposed investment chapter would give pharmaceutical companies the right to sue governments for instituting any regulation that reduces their expected profits, using private tribunals that circumvent a country’s judicial process. U.S. pharmaceutical company Eli Lilly is using similar provisions in NAFTA to demand $100 million from the Canadian government for invalidating one of its patents.

That bad.

Big Pharma really does kill

Blood Feud: The Man Who Blew the Whistle on One of the Deadliest Prescription Drugs Ever by Kathleen Sharp

My rating: 5 of 5 stars


Yes, the label of "Big Pharma" can be thrown around indiscriminately.



Then, a book like this suggests we need to use it even more.



There's an ugly world out there of drug company sales reps essentially bribing doctors, hospitals and clinics to use their brand of drugs. There's gimmes galore, and far beyond note pads or pens. Add in lines of credit, rebates, discounts, free initial supplies of drugs and more, and its sickening.



Then, the George Bush FDA decided to roll back most of the limited amount of regulation the agency had done before.



Sickening, and more. Ultimately, deadly, in the case of "epo," the drug at the center of this book.



It's within this background that Mark Duxbury gets trapped in a corporate web of pressure, eventually being forcibly extricated by firing after Ortho, a Johnson & Johnson subsidiary, decides to dump him on the curb because it didn't like his testimony in a sales territory legal hearing vis-a-vis Amgen. But, he wasn't fired until he'd undergone an extensive "gaslighting" campaign by his bosses.



Duxbury ultimately got legal standing for a whistle-blower suit against the "venerable" but not-worth-venerating J&J. But, it was too late.



Essentially a victim of PTSD, he died just months later, not yet 60 years old.



If this sounds like a novel, it's not.



That said, some of the "touches" in the book came off as too "featury." The author, or an editor, should have whacked down more. And, I would have liked to have heard more from Duxbury's early sales compadre at Ortho, Mark McClellan.



It's still a five-star book, though. Including five stars of Big Pharma disgust.



View all my reviews

Big Pharma is Big Editor, too

Big Pharma ghostwrote two family psych books, ghostediting them and all.
Specifically, SmithKline Beecham was the guilty party. I don't believe in conspiracy theories, but when drugmakers do stuff like this, it's easy to see how conspiracy

The FDA officially sells out to Big Food

How can a GMO salmon which not only has growth hormone from a different species of salmon but also a gene from a different genus of fish entirely not be "materially" different from other salmon?

The AquAdvantage salmon has been given a gene from the ocean pout, an eel-like fish, and a growth hormone from a Chinook salmon.

When it's the FDA, in thrall to corporate giants from Big Pharma, through Big Tobacco, to Big Ag and Big Food, making the call, on what's "materially" different or not.

Doesn't Big Biz believe in the "marketplace"? Well, include the "marketplace of ideas." Label stuff as GMO, at least if it includes genes from another species, and certainly if from another genus, or higher up the taxonomical ladder.

And, then, try to market it.

Big Pharma pockets Obama bribery

And raises drug prices 9 percent. That’s just enough to cancel out any savings pledges from the top drugmakers. Gee, what a surprise.

Placebo effect strengthens - as does schadenfreude

Some would-be new antidepressants can't get to market because they can't pass
clinical trials. They can't pass clinical trials because the placebo effect is
getting stronger.

No, it's not less effective drugs, and it's not just anti-Ds or anxiety drugs,
either. Non-psychotropics are having the same problem in a few instances, and
it's clear that, yes, the placebo effect is getting stronger.

And, that it varies in different parts of the U.S., and in different parts of
the world. And, that beyond just being given a pill, things like pill dosage
frequency and even COLOR of the pill are causative factors.

That said, my first feeling for Big Pharma was, of course, schadenfreude.

The full story is here. And, later on, it notes how Big Pharma is now studying the placebo effect to, of course, try to make a buck off of it.

Mod Max Baucus strangles health ins public option

Mod Max Baucus and his Senate Finance Committee Gang of Six have put the finishing touches on gutting the public option on health insurance. And, if you expect a federal government alternatingly lead by neolib Dems and yahoo GOPers to actually regulate health insurance companies tightly enough to save us all money, I have some palm trees in Baucus' Montana to sell you, complete with lobbyist funding to buy them.

Beyond no public option, here’s what else is missing:
• Details of how the government will more tightly regulate health insurers, when the federal government doesn’t even have an office for that right now, and only the semi-toothless Federal Trade Commission to oversee advertising claims.
• Any plan to address fee-for-service doctor payments, which almost everybody agrees is a significant part of the problem.
• Guarantees that big insurers won’t be able to “game” the health-insurance coops that are being proposed as a VERY poor person’s substitute for the public option.

Meanwhile, at the other end of Pennsylvania Avenue, Team Obama continues its sellout to Big Pharma.

So relax, folks. You are going to get screwed; the astroturfers could have saved their Tea Party money; the lobbyist money worked just fine by itself.

Big Pharma ghostwrites medical research

Is something like Wyeth ghostwriting research reports to boost hormone therapy not only an argument for the “public option” on national healthcare, but, for a variety of other issues, namely:

• Big Pharma advertising being regulated like Big Tobacco or Big Alcohol advertising;
• Public financing of Congressional campaigns;
• A “public option” for pharmaceutical coverage, as a separate sidebar;
• Getting rid of Team Obama’s deals with Big Pharma, including blocking reimportation from Canada.

Just about as despicable is DesignWrite, the Princeton-based “medical communications company” (in NYTimes-ese) that did at least 20 such reports. And the doctors who assisted with this.

Max Baucus feeds away at Big Medicine hog trough

And, no, folks, it’s not a pretty sight, especially not when the future of your healthcare is being bought and sold with Baucus getting 20 percent of the total cut. Yep, from 2003-08, Baucus, senator for a state of less than 1 million people, hauled in 20 percent of all healthcare-related political donations in the Senate.

That said, those lobbyists know their man — and their Senate:

“This is not an overwhelmingly liberal Congress, and it's certainly not a liberal Senate," said John Jonas, a Patton Boggs health-care lobbyist who has attended a Baucus fly-fishing event and other fundraisers. and whose clients include Bristol-Myers Squibb, Pfizer and Northwestern Mutual. “I think Max is uniquely situated to try to accomplish that, because he’s more of a centrist and moderate Democrat than others are.”

Naturally, Mod Max declined to be interviewed.

Take Obama-hospitals deal with grain of salt

The WaPost, with Ms. Health Insurance, Ceci Connolly, writing away trumpets an offer by hospitals of $155 billion in savings over a decade as offering hope to the 47 million, and counting, uninsured Americans.

But, the devilish details say most of this won’t help national healthcare:

Most of the savings — about $100 billion — would come through lower-than-expected Medicare and Medicaid payments to hospitals, said the two industry sources. About $40 billion would be saved by slowly reducing what hospitals get to care for the uninsured, they added. The reductions would probably not begin for several years, after a significant number of people have enrolled in the new insurance programs.

So, only 25 percent of the savings — if they all materialize — will help the uninsured.

I’m not arguing Medicare and Medicaid don’t need the help. Just that this is NOT a big deal for national healthcare. And, it’s not the $200 bil that Team Obama first said that hospitals could save. It’s a take-it-or-leave-it offer.

Beyond that, more than anything else, as with Big PhRMA’s $80 bil offer a week or so ago, this looks like a chance to buy off the idea of public option.

Where healthcare reform stands June 24

President Barack Obama vows that he “absolutely” will get healthcare reform done but refuses to discuss details.

Perhaps that’s because Ted Rall, who calls Obama a “militant moderate (like) Bill Clinton” says that what Obama has on the table will only insure about one-quarter of the uninsured, per Congressional Budget Office scoring of the Dodd-Kennedy plan. So far, The One has remained quiet on the Wyden alternative, which is disliked by big business (no surprise) and by the unions that have killed every real move toward national healthcare since Harry Truman.

(Many liberals and conservatives alike are ignorant of this simple fact. But, since World War II, unions have viewed their level of union-negotiated healthcare as a recruitment tool to get more workers. Well, with private-sector unionization pushing down toward the single-digit level, that’s obviously been a huge success).

In clear short-sightedness, unions don’t get that they would still be free to bargain for supplemental additional coverage, or other benefits, if we get single-payer national healthcare. Canada and Great Britain still have plenty of unions, don’t they?

Meanwhile, various medical-related lobbying groups, like the one for MRI operators, along with rural doctors and others, are starting to go into opposition over worries about reimbursements, etc.

Odds of comprehensive healthcare reform, including single payer, at this time? I’d say 60-40 against. Odds that major unions will, once again, dodge their deserved share of blame if we fail to get real healthcare reform? About 70-30 in favor.

Obama wants to cut federal healthcare costs – but how?

BUT, as is usual with him, he kicks the details of “how” down the road.

I know this is a double-edged sword; once any president, whether this one or not, started laying some specific healthcare cost-cutting cards on the table, especially when he has said he’s looking at prescription drugs, and boom, Big Pharma is all over you.

If Medicare is going broke, blame Big Pharma cheating

The Justice Department has accused Wyeth of bilking Medicare of hundreds of millions of dollars through overcharging for a stomach acid drug.

That’s just one Big Pharma company and just one medication, and we’re already talking hundreds of millions. I’m sure if all the Big Pharma cheating of Medicare were uncovered, we’d be well in the billions.

RealAge is really Big Pharma

RealAge, the popular website for determining what’s allegedly your actual biological age rather than your chronological age, is a front for sending your personal information to Big Pharma. Drug companies may not actually get your name, but they get plenty of other info about you for marketing purposes.

Don’t expect me to visit RealAge again, now that’s its been exposed. Not to mention that it gets flogged by Oprah’s latest guru, Dr. Mehmet Oz.

What, looking at your stools every day can’t tell you your real age, Dr. Oz?