Great article. I would also mention that Vitamin D when supplemented must always be accompanied by magnesium and vitamin K2 in order to keep calcium levels in the blood from rising. Also, acupuncture in the inguinal crease followed by DMSO topical administration increases circulation, lowers inflammation and softens scar tissue. Be well.
Sooo, you’re saying for me to stop standing on my under desk treadmill and turn it on more often, no matter how many people ask me on Zoom calls “are you walking”? 😂
Yes! Zoom calls are the perfect time to walk. Really focused work is hard for me to do while moving though, sometimes I have to jump off and think hard lol.
Reading/scanning this on a small screen - did you discuss yogic inversions? I think it's not included here. Western medicine misses this relatively easy way to reverse gravity effects, and it doesn't fix everything but it can certainly help!
Headstands, handstands, shoulder stands, all the supported versions of those, and on the back with legs up the wall, maybe bolsters under the hips.. there are adaptations that make inversion accessible for almost all bodies!
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
Just when I thought I could stand all day no problem, and this was good for me...I need to do something else! J/k I try to apply the Pomodoro method of 20 minutes on, then a 3 min stretch break. Will do more of that after reading this.
Thank you for mentioning the light aspect and the fact that UV is not bad! It can help us detoxify and even fight cancer.
There is a "Diagram showing the ionic concentration and potential difference as a function of distance from the charged surface of a particle suspended in a dispersion medium" at wickedpedia here https://en.wikipedia.org/wiki/Zeta_potential The top of that article is below
"Zeta potential is the electrical potential at the slipping plane. This plane is the interface which separates mobile fluid from fluid that remains attached to the surface.[1]
Zeta potential is a scientific term for electrokinetic potential[2][3] in colloidal dispersions. In the colloidal chemistry literature, it is usually denoted using the Greek letter zeta (ζ), hence ζ-potential. The usual units are volts (V) or, more commonly, millivolts (mV). From a theoretical viewpoint, the zeta potential is the electric potential in the interfacial double layer (DL) at the location of the slipping plane relative to a point in the bulk fluid away from the interface. In other words, zeta potential is the potential difference between the dispersion medium and the stationary layer of fluid attached to the dispersed particle.
The zeta potential is caused by the net electrical charge contained within the region bounded by the slipping plane, and also depends on the location of that plane. Thus, it is widely used for quantification of the magnitude of the charge. ... ... ... ."
I think supplementation in general should be shied away from, and especially with hormones like vitamin D. I think the body is designed to work with natural sources, eg I would eat grass fed ie pasture raised butter for K2, and get some natto too. And for D I would use co dliver oil, or actual canned cod liver, and definitely sun in the summers to boost it in the northern climes.
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
Try to stop all pills and supplements. Drink the most pure electrolyte rich water possible. Quit your desk/standing job and become a bare foot farmer. Walking good. Sitting/standing bad. Stop looking at your devices and look at a campfire instead. Wear only natural fibers. Eat beef and eggs seasoned with sea salt.
Thanks for the summary! If that’s the case, this isn’t feasible for most of the world. However I can def try incorporating some of this advice to my life.
the answer was a bit tongue in cheek. Basically try to move around more frequently to avoid blood stasis in the pelvis and legs which leads to this syndrome of congestion or stagnation in the pelvis and legs which leads to many common diseases of aging, in men BPH and urinary problems is linked to it, and in women fertility issues and urinary problems. In both sexes cancers of the pelvis. And as it worsens it worsens the sympathetic nervous system dominance that drives many other diseases. Other things to increase are sunlight, magnesium, potassium, manganese. Avoid artificial light as much as possible. Get very bright light exposure in the morning and throughout the day, avoid light at night, keep it dim, turn it off early. Interesting how all of these directly lead to the disease process in question. There's more and you're right I need to summarize it eventually.
Great article. I would also mention that Vitamin D when supplemented must always be accompanied by magnesium and vitamin K2 in order to keep calcium levels in the blood from rising. Also, acupuncture in the inguinal crease followed by DMSO topical administration increases circulation, lowers inflammation and softens scar tissue. Be well.
🤯 Wow, lots to absorb here. Thanks so much for the info Dr Haider and Shabaz!
Sooo, you’re saying for me to stop standing on my under desk treadmill and turn it on more often, no matter how many people ask me on Zoom calls “are you walking”? 😂
Yes! Zoom calls are the perfect time to walk. Really focused work is hard for me to do while moving though, sometimes I have to jump off and think hard lol.
Reading/scanning this on a small screen - did you discuss yogic inversions? I think it's not included here. Western medicine misses this relatively easy way to reverse gravity effects, and it doesn't fix everything but it can certainly help!
I love it, thanks for bringing that up. I did not discuss it. I'll have to look it up. I'm guessing something like standing on your head?
Headstands, handstands, shoulder stands, all the supported versions of those, and on the back with legs up the wall, maybe bolsters under the hips.. there are adaptations that make inversion accessible for almost all bodies!
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
Just when I thought I could stand all day no problem, and this was good for me...I need to do something else! J/k I try to apply the Pomodoro method of 20 minutes on, then a 3 min stretch break. Will do more of that after reading this.
Thank you for mentioning the light aspect and the fact that UV is not bad! It can help us detoxify and even fight cancer.
Absolutely, I was surprised when I actually listed everything out how much of an impact light had on relevant mechanisms here.
Zeta potential
There is a "Diagram showing the ionic concentration and potential difference as a function of distance from the charged surface of a particle suspended in a dispersion medium" at wickedpedia here https://en.wikipedia.org/wiki/Zeta_potential The top of that article is below
"Zeta potential is the electrical potential at the slipping plane. This plane is the interface which separates mobile fluid from fluid that remains attached to the surface.[1]
Zeta potential is a scientific term for electrokinetic potential[2][3] in colloidal dispersions. In the colloidal chemistry literature, it is usually denoted using the Greek letter zeta (ζ), hence ζ-potential. The usual units are volts (V) or, more commonly, millivolts (mV). From a theoretical viewpoint, the zeta potential is the electric potential in the interfacial double layer (DL) at the location of the slipping plane relative to a point in the bulk fluid away from the interface. In other words, zeta potential is the potential difference between the dispersion medium and the stationary layer of fluid attached to the dispersed particle.
The zeta potential is caused by the net electrical charge contained within the region bounded by the slipping plane, and also depends on the location of that plane. Thus, it is widely used for quantification of the magnitude of the charge. ... ... ... ."
yeah i could have described it in more detail for sure. Some day I need to go back and add pictures to this...
So are we not to supplement with vitamin D with K at all?
I think supplementation in general should be shied away from, and especially with hormones like vitamin D. I think the body is designed to work with natural sources, eg I would eat grass fed ie pasture raised butter for K2, and get some natto too. And for D I would use co dliver oil, or actual canned cod liver, and definitely sun in the summers to boost it in the northern climes.
Thanks for the information 🌞
Seems to be indicating not to supplement excessively with Vit D. Definitely <3000 IU.
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
This was an attention-grabbing read, and I appreciate the attempt to connect symptoms to anatomy/physiology rather than leaving patients in a “mystery box.”
A few clinician-scientist nuances that I think would make the framing even stronger (and protect readers from over-generalizing):
1. Pelvic congestion syndrome (PCS) is real, and venous reflux/obstruction can absolutely create pelvic pressure + heaviness and sometimes leg symptoms, especially when symptoms are positional (worse with prolonged standing, better when supine). Where it gets tricky is that PCS is a diagnosis of correlation unless you pair imaging findings with a symptom pattern and rule out common mimics.
2. “Standing is the new smoking” is a great headline, but the key physiologic culprit is usually prolonged static standing (minimal calf-muscle pump), not standing/moving in general. In clinic, “stand more” works best as “sit less, move more.”
3. The risk factor list is broad. That’s not inherently wrong, but it raises the base-rate issue: many people will match several items, so the diagnosis can become a magnet for nonspecific symptoms unless you keep tight diagnostic criteria + objective confirmation.
If a reader is wondering “could this be me?”, a pragmatic next step is: does my symptom pattern match venous disease? (positional heaviness, visible varicosities/hemorrhoids/vulvar varices, pelvic heaviness, post-coital ache in women, urinary urgency that tracks pressure), and if so, seek evaluation that can actually adjudicate the hypothesis (often duplex ultrasound + targeted cross-sectional imaging when indicated, ideally reviewed by vascular/interventional folks who see this regularly).
Provocative and potentially useful, just worth keeping the epistemic guardrails up so PCS doesn’t become the new catch-all for every chronic symptom cluster.
What’s the tldr for this article?
If I understood this article correctly:
Try to stop all pills and supplements. Drink the most pure electrolyte rich water possible. Quit your desk/standing job and become a bare foot farmer. Walking good. Sitting/standing bad. Stop looking at your devices and look at a campfire instead. Wear only natural fibers. Eat beef and eggs seasoned with sea salt.
Thanks for the summary! If that’s the case, this isn’t feasible for most of the world. However I can def try incorporating some of this advice to my life.
the answer was a bit tongue in cheek. Basically try to move around more frequently to avoid blood stasis in the pelvis and legs which leads to this syndrome of congestion or stagnation in the pelvis and legs which leads to many common diseases of aging, in men BPH and urinary problems is linked to it, and in women fertility issues and urinary problems. In both sexes cancers of the pelvis. And as it worsens it worsens the sympathetic nervous system dominance that drives many other diseases. Other things to increase are sunlight, magnesium, potassium, manganese. Avoid artificial light as much as possible. Get very bright light exposure in the morning and throughout the day, avoid light at night, keep it dim, turn it off early. Interesting how all of these directly lead to the disease process in question. There's more and you're right I need to summarize it eventually.