May 26, 2021 • 34 mins
We're excited to share another show we think you'll enjoy: Body Stuff with Dr. Jen Gunter, from the TED Audio Collective.
Do I really need 8 glasses of water a day? Is it actually possible to "boost" my immune system? You’re constantly bombarded with news stories, ads, and social media posts telling you how to optimize your health—but a lot of these sources that pretend to be backed by science have another agenda. Dr. Jen Gunter is here to bust the lies you’re told—and sold—about your health, debunking some of the stickiest myths out there while helping you to understand how your body really works. We're playing episode one for you today, and if you like what you hear, you can get more episodes of Body Stuff by following the show wherever you're listening to this.
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Episode Transcript
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Speaker 1 (00:00):
Hi there, Virgie. Here today, we've got something a little
different for you. It's an episode of a new show
from the Ted Audio collective called Body Stuff with Doctor
Jen Gunter. In every episode, the podcast bust the lies
you're told about your personal health. I'm a huge fan
(00:23):
of doctor Jen's work, and I have a feeling you
will be too. If you like what you hear. You
can find and follow Body Stuff with Doctor Jen Gunter
wherever you're listening to this. Okay, here's the first episode.
I'm doctor Jen Gunter. I love science and I hate
(00:45):
when people twist it. Your immune system needs a big
scorbal supplement's milk a week, and there's a lot of
twisted medical misinformation out there. Are toxins literally purify you. Yeah,
(01:07):
that's ridiculous. Chugging a gallon of water means you'll eat
fewer calories. Oh, it's so painful. We're exposed to medical myths,
whether we're looking for them or not. There are news
stories Instagram and Facebook, post Flying Past twenty four seven,
TikTok Twitter. Who has balid information and who's just trying
(01:31):
to sell you something? How do you sort the medicine
from the mayhem I'm doctor Jen Gunter, and I'm here
to help. From the Ted Audio Collective, this is body stuff.
I'm a doctor, a practicing gynecologist, and I've made up
(01:52):
my mission to give women the facts that they need
to understand their bodies. In my twenty five years of
talking with pay, I've learned that medical misinformation is a
problem for everyone, and every single one of us is susceptible.
So this show is about debunking some of the stickiest
(02:13):
myths out there while helping you understand how your body
really works today. Why you don't need eight glasses of
water every day, you need a water day. We're going
back in time to find the origins of that myth,
(02:35):
and then we're going to meet a kidney expert who's
going to illuminate just how hard our bodies work for
us to maintain our hydration. It works like an exquisitely
designed atomic balance machine, right, you need to keep everything
in balance. But first I want to tell you about
something that happened to me when I was ten years old.
(02:55):
It was a time in my life when I got
asked a lot about my urine and it ended up
setting me on a path to become a doctor. It
was the first good weekend of spring nineteen seventy seven
in Winnipeg, Manitoba, the kind where the sun feels hot
and you're just raring to get outside. I was messing
(03:19):
around with my brother's skateboard, going down the street, and
then all of a sudden, I was flat on my
back on the concrete and I was in a terrible
amount of pain. It felt like my insides were on fire.
The next day, I'm sure I didn't look well, so
we went to the pediatrician, who took one look at
(03:41):
me and called a general surgeon, who took one look
at me and sent us to the emergency department. They
gave me something called an angiogram, and I remember the
doctor pointing to the X ray screen explaining what he
was seeing, and of course it just looked like a
snowstorm to me. But that's when I learned that when
I fell off my skateboard, i'd ruptured my spleen. The
(04:03):
good news was I wasn't going to need surgery, but
there was something else. It looked like I had hydro nephrosis,
meaning my kidney was full of fluid, and I needed
to see a pediatric urologist. He sat us down in
his consultation room and started to explain to my mom
(04:23):
what needed to happen. And I could tell she was
very confused. I think the doctor could tell as well,
and so he gestured to me and said, hey, you
come over here. This is your body. You should know
how it works. So I came over and I sat down.
I traded places with my mom, and he drew a
(04:45):
little diagram and he explained how the kidney worked and
what he thought was wrong, and the test that I
was going to have to have, and the surgery that
I was probably going to have to have as well.
And that doctor took the time to explain my body
to me. It really helped me not feel scared or overwhelmed.
(05:08):
And that experience made me decide I wanted to be
a doctor. I loved the science and I wanted to
be able to give to my patients what that doctor
gave me that day, that empowerment of knowing how your
body works and how to use that knowledge to help
improve your health. Eventually, I did have surgery to remove
(05:36):
my left kidney. I've lived most of my life with
just one kidney, the organ that's largely responsible for regulating
our body's hydration. But you want to know something, None
of my doctors ever told me to worry about how
much water I was drinking. I graduated from medical school
(05:57):
when I was twenty three, so I've been a doctor
more than half my life, and I've seen firsthand the
problems that happen when people get misconceptions about their health.
And a lot of these misconceptions they start with the Internet.
I'm not one of those doctors who rolls her eyes
when her patient comes in with reams of advice from
(06:19):
doctor Google. That tells me that my patient is engaged,
she wants to learn. But there are a lot of
bogus recommendations out there, and often they're being pushed by
brands and influencers. A lot of them sound like they're
making sense in a sort of science ish way, like
the eight glasses of water a day thing. Hey, we're
(06:41):
made of water, so why wouldn't we need lots of water?
But that's not science. So what's behind this myth? How
did we get to eight glasses of water a day? Anyway?
There are a couple of potential origin stories. One is
(07:01):
a paper from nineteen forty five that suggests the body
uses about eighty four ounces of water a day. And
there's another paper from nineteen seventy four from a pair
of nutritionists who recommended an equivalent of six to eight
glasses of water a day for the body to function appropriately.
But these papers became distorted over time like a bad
(07:22):
game of telephone. These experts were recommending that we drink
six to eight glasses of water a day on top
of everything else. They were saying, this is the amount
of water the body needs to function, But that water
doesn't have to be water you drink from a glass
(07:42):
out of your tap. Water is in everything. Think about
a breastfed baby. All they're drinking is milk. The body
is able to remove the water from the milk, so
the baby never gets dehydrated. In the same way, once
we start eating slid food, our bodies continue to extract
water from everything we consume. Everything we eat or drink counts,
(08:08):
So the water in your apple counts, the water that's
in the bread that you eat counts, even coffee counts.
Any fluid counts. Look, I get this as a real
record scratch freeze frame moment for a lot of people.
But we don't just get the water we need from
plain water. And if you have one of those days
(08:31):
where you just drink coffee all morning and you don't
feel great, maybe you're a little headachy or a little jittery,
it's not because you're dehydrated. Maybe you had a little
too much coffee or you had it on an empty stomach.
If you like drinking six glasses eight glasses of water
day and your doctor hasn't advised against it, that's probably fine.
(08:54):
What I'm saying is that there's nothing medical about this number.
We get to make choice races about what we put
into our body, and this is one of those choices.
If you think about it, just using common sense and
putting the medicine aside, does it seem realistic that we
evolve needing to consume that much clean water every day
(09:16):
In the span of human history, access to clean, plentiful
drinking water is a relatively recent phenomenon, and even today,
in many parts of the world, accessing clean drinking water
sadly isn't as easy as walking into your kitchen and
filling up a glass. It seems unlikely that our ancestors
(09:36):
carry giant water bottles around with them at all times.
And yet the mythspread and spread and spread. But why
is this myth so sticky? It turns out there's a
mix of factors, including a little bit of intrigue and
one particular culprit that deserves a lot of the blame,
(10:00):
the beverage industry. Sometimes water just isn't time unquenched. Thirst
has become a chronic problem America. If you are going
to sell something, you've got to have a reason to
(10:20):
sell it. You've got to create a market for it.
Things like pre hydrate. I mean, what's that mean? Drink
ahead of your first train. You've got to tolerate more fluid.
Your brain doesn't know when you are thirsty. Doctor deb
Cohen went to medical school in the UK, but instead
of becoming a clinician a doctor who sees patients, she
(10:42):
became a journalist. Back in twenty twelve, during the lead
up to the London Olympics, she was the investigative editor
at the British Medical Journal. She wrote a report called
The Truth about Sports Strengths and It's set off a
bar arm in the beverage industry. The report looked at
(11:04):
the history of sports drinks like Gatorade and how they're advertising.
Basically invented the modern fear of dehydration. It was really
in the kind of the boom of the marathon era
in the nineteen seventies that sports drinks really took off.
It started life in Florida at the University of Florida
and Robert Cade was the renal physician and he developed
(11:26):
this drink for the Gators football team. It was effectively water, sugar,
dasher sodium, and a bit of lemon juice, so quite simple,
and it was supposed to help alleviate cramps. And then
it was brought up by Quaker Oats and they spotted
a big market, and that's really where the science of
(11:49):
dehydration started. Okay, so we're not talking about clinical dehydration,
which is a real condition. For example, the time I
had food poisoning and I was up all night vomiting,
so I had to go to the emergency department and
get an intravenous But this is healthy people, So this
is a whole different phenomenon. And so what they turned
(12:11):
into an illness was exercise induced dehydration. Exercise induced dehydration,
now that sounds a lot more important than you're a
bit First, you if you've been running and sweating. If
you tell people that it's all about the science, then
people are more likely to believe it. Beverage companies, especially Gatorade,
(12:34):
commissioned studies looking for results that would bolster their sales pitches.
By the time doctor Cohens started looking into these studies,
there were a lot of them. Glaxo smith Kline at
the time, the company behind a popular British sports drink
called lucas Aid, claimed they had more than a hundred
clinical trials. That's a lot of studies, and the studies
(12:58):
were a little bit off. Some of the studies we're
actually having a bit of a laugh about. So what
you would do is you would starve people overnight, you'd
fast them overnight, and then you'd ask them to cycle
to exhaustion. One group you would give a sports drink
containing sugar, and the other group you would give water. Well,
(13:20):
guess what, the people have had a bit of sugar
are going to well perform the people that have been
starved and had water. It's not rocket science. And so
they are all sorts of these all sorts of these
kinds of studies that they do, and you look at
it and go that just does not happen, and it
doesn't matter that it's not clinically relevant. Now you've got
something that looks statistically different, and you can peg a
(13:43):
marketing campaign around that exactly. And if you throw enough
darts at a dark boat, if you've got your eyes blindfolded,
then one of them is going to hit the dark boat.
At some point. The studies were junk, but the science
fish conclusions they made began to spread, especially the idea
that we couldn't rely on our own bodies to tell
us while we were thirsty. One of Gatorade scientists even
(14:07):
said in two thousand and eight, and I quote, the
human thirst mechanism is an inaccurate short term indicator of
fluid needs. Unfortunately, there is no clear physiological signal that
dehydration is occurring. I think even the Mayo Clinic had
information that was based on science that have been ultimately
(14:29):
derived from the sports strengths industry about when you should
hydrate and how you should hydrate, and it filtered down
to influence school guidance in the UK where kids playing
soccer would have to go and stop every fifteen minutes
twenty minutes to rehydrates. And you speak to the teachers
and be like, yeah, it's just kids like running around.
(14:51):
They just need to peel all the time, So kids
running off constantly. Even the US military was in on
the quasi science. In the early eighties, the Pentagon was
citing Gatorade Sports Science Institute studies claiming their drinking sports
drinks could prevent heat stroke, a huge concern for soldiers
fighting desert wars. But those studies were bunk. There was
(15:14):
no evidence that drinking fluids reduced the risk of heat stroke.
Even today, the US military remains Gatorade's the biggest customer,
your taxpayer dollars at work. I was warned off several
times as well from doing the story. Are you sure
you know what you're doing? And a spot some people
in the US quite a bit of sources, and they
(15:36):
tried to have studies published that were negative and they
just could not get them published. And they'd been warned
off doing their research as well, and they were saying
to me, do you realize how what you're doing here?
And I literally probably naively just thought, well, sugary water, guys,
I mean, how big a deal is this? But as
(16:00):
doctor Cohen started her investigation, she began to see. There
was a lot of money intertwined with the junk science.
Sports drink companies spent huge sums sponsoring youth sports, funding
sports medicine doctors, and putting their logos on the world's
most beloved teams, and it was like a holy grail.
(16:21):
You go to sports conferences, to sports medicinal sports science conferences.
It's displayed everywhere you know sponsored and you don't criticize
the sports drink. So sports strinths have somewhat fallen out
of favor since their heyday in the nineteen eighties and nineties.
But another product has taken its place, and now it's
(16:43):
the number one selling beverage in the world, bottled water,
and big Bottled Water is very happy to have you
believe that you can't trust your thirst and that you
need a minimum of eight glasses of water a day.
After the break, we're going to talk about why this
myth just won't die. We're back before the break. We
(17:10):
learned the origin of the eight glasses of water a
day myth. We believe myths like this for a lot
of reasons, but a big one is something psychologists call
the illusory truth effect. When a piece of information is widespread,
and you hear it over and over again, you're more
(17:32):
likely to believe that it's true. There are a lot
of examples, statements like we only use ten percent of
our brains, or eating carrots will help you see in
the dark. None of these things are true, but I
bet you've heard them repeated over and over again. Politicians
and marketers take advantage of this all the time, and
(17:53):
it works because when you're assessing whether something you've heard
is true, you typically rely on two things. Whether the
information makes common sense and whether it feels familiar. The
research has shown that familiarity can even be more convincing
than rationality. Rationality is hard, but remembering if you've heard
(18:17):
something before, that's easy. And here's the thing about the
illusory truth effect. No one is immune, not even doctors.
There's a one day a year in March we call
World Kidney Day, dedicated to improving awareness of kidney disease,
and a few years ago the theme of World Kidney
(18:38):
Today was drink a glass of water to help your kidneys,
which is just crazy, right, It doesn't make any sense.
It's not grounded in science, but you know it is
grounded in funding for World kidney day, which I believe
comes from dan in a manufacture of bottled water. It's
like the deep state of hydration. That's doctor Joel Toff.
(19:01):
He's a kidney doctor, otherwise known as an nephrologist. I
called up doctor Toff because what do we do in
medicine When we don't know the answer, We look for
an expert, we call a consult and doctor Toff is
just the chemistry wizard for the job. I'm a lifelong
nerd who has been fascinated by the chemistry of body
fluids going on three decades. I love nerds. There are
(19:25):
an infinite number of fascinating aspects of body physiology or
disease states. And one of the truths about medicine is
that once you start learning about any one of these conditions,
they become more interesting. And back in nineteen ninety five,
when I was a senior in medical school, I became
real interested in fluids and electrolytes. So the precious bodily fluids,
(19:49):
the precious bodily fluids. That's right, that's my favorite movie.
That's a doctor Strange love. Doctor Toff knows that the
most important thing about precious bodily fluids is that they
stay in balance, which brings us to the tragic case
of Jennifer Strange. So I want you to kind of
(20:10):
rewind back to two thousand and seven, and the hottest
thing in two thousand and seven was the Nintendo Wii,
and this radio station got their hands on one and
they were running a radio contest. The contest was don't
we for a Wei? The radio station invited eighteen contestants
down to their studio to see who could drink the
(20:30):
most water without having to pee, and there was one
person who entered. Her name was Jennifer Strange, twenty eight
year old mother of three, and she ended up drinking
two gallons of water in an hour. That's a lot
of water, so much water that a nurse actually called
into the station to warn them this was dangerous. You
(20:51):
can overload your system with too much water. It can
be really unsafe. As Jennifer left the radio station and
she was already complaining of a headache, and what she
actually had was a condition called cerebral edema, which happens
when you wash your body out from all the critical salts,
and when you do this, water will shift from your
(21:14):
bloodstream into your brain. Cause increased swelling of your brain
that cause headaches, nausea, seizures, coma, and death. And she
ended up dying on her own bathroom floor. A couple
of hours later, Jennifer died from a condition called hyponatremia,
meaning a dangerously low level of sodium in her blood.
(21:36):
She threw off her body's delicate balance, something we've evolved
to rely on. It's called homeostasis. The body maintains a
stable internal environment to provide optimal health for the cells
of the body. Right, you can imagine for these cells
to grow and to be healthy, they need regulated amounts
(21:58):
of sodium, potass seem even things like body temperature needs
to be regulated. All these things need to be in
an optimal range for growth and health, and that process
of maintaining everything in that type band is called homeostasis.
We've evolved to maintain homeostasis through finely tuned mechanisms. The
(22:18):
sense when things are awry, when we've gone a little
bit too far in one direction or a little bit
too far in the other, and makes adjustments to return
us to our state of balance. Think about the mechanisms
that maintain us in homeostasis, like autopilots. I think that's perfect, right,
So you can think about body temperature is a classic one, right.
(22:40):
So if we get too hot, we start to sweat,
water evaporates from our skin that lowers our body temperature
back down. We get too cold, we shiver and all
that generates heat and brings us back to a normal
body temperature. So we have processes that control us from
getting too hot and from getting us too cold. Body
temperature is just one example of the autopilots that are
body has to maintain homeostasis, and our kidneys well, they're
(23:05):
the quarterback of homeostasis. They help to maintain the balance
of almost every electrolyte in our body. They help with
blood pressure, they're crucial for maintaining pH and they maintain
our level of hydration. One of these autopilots is called osmolality,
and osmolality is just a measure of the total amount
(23:26):
of compounds in solution. And so an analogous is just
how salty the soup is. As the osmolality goes up,
soup gets more salty. As the osmolality goes down, soup
gets more dilute. In this case, the soup is our
blood to be a little bit more precise. The fluid
part of our blood our plasma, and the kidney regulates
(23:46):
our osmolality so it stays in a healthy range. Jennifer's
Strange died because she drank so much water that she
pushed her osmolality far below the healthy range, and her
kidneys just couldn't keep up. Today, hypenatremia is most often
seen in athletes who are overhydrating while exercising. Doctors first
(24:09):
started seeing it in ultra marathon runners and iron man
triathletes in the nineteen eighties, a period of time that
nicely coincides with the messaging coming out of the Gatorade
Sports Science Institute. And it's not just extreme athletes. Doctors
have seen hypenetremia in high school football players, students in
yoga classes, and more. Thankfully, hypenetremia is relatively rare because
(24:34):
of our body's amazing ability to defend homeostasis. I just
want to run this morning, I went for three mile run,
and I'm the thirsty and a bit hungary. So how's
my one kidney because I only have one keeping me
working right. So you came back from your run, and
presumably during that run, you sweat, you lost a little
bit of fluid that way, and that loss of fluid
(24:57):
is going to make your body salt here, it's gonna
make the soups alter. Your osmality goes up. This is
you're pushing your body out of that homeostatic range and
it needs to return that osmolality back down. And the
way that it does that is two factors. One increased thirst.
And so increased thirst is a sensation that your body
(25:18):
gets that'll change your behavior. It'll make you go to
the sink, pour yourself a glass of water and drink it.
So in addition to thirst, your kidney is going to
respond to that increase in osmolality. And the way that
it does that is it's going to change the type
of urine that you make. You're always making urine, you're
always getting rid of You're constantly getting rid of waste products.
But one of the variables is how much water is
(25:39):
excreted along with those waste products. In other words, if
you're drinking a lot of water, you're going to pay more,
but that doesn't mean you're getting rid of more waste.
You're getting rid of the same amount of waste. It's
just diluted in more water. Yeah. My tagline on Twitter says,
thinking the kidney's product is urine, it's like thinking a
(26:00):
factories product is pollution. Urine is the byproduct. What the
kidney produces is homeostasis. So how much water should we drink?
We should drink enough water so that you're not thirsty.
I tell my patients, you know, anytime that you're thirsty,
go ahead and drink a glass of water, and maybe
(26:22):
have one glass of water on top of that. It's
not going to harm you. But I don't advise my
patients to count their glasses of water unless unless they
have kidney stones in their past, or if they have
autosomal dominant polycistic kidney disease. If you have an intact
thirst mechanism and you have access to water, are you
(26:43):
going to get dehydrated? No, let's put it this way.
People with increased sodium will drink from a toilet. The
derived to drinking is so strong you will not get dehydrated.
If there's a glass within a mile of you, you'll
get that water. Then you'll be fine. See. Now you
can be liberated from any anxieties you've ever had about
(27:05):
whether you're drinking and off water. You're welcome. Then doctor
Tooff told me something really cool about how our bodies
know when we've dranken of water. Yeah. So there are
what we call osmoreceptors. They're located in a center part
of the brink called the hypothalamus, and they're going to
constantly measure the osmolality of the body. And they're actually
(27:29):
the butt is very sophisticated. It knows when you're drinking,
and it'll start to suppress the hormone that drives thirst
as soon as you start to drink, right. It doesn't
even wait for that fluid to lower the osmolality in
the body. It's absolutely aware of what happens when you drink,
and it says, hey, we're gonna slow this cycle down.
(27:49):
We know that you're already compensating for what we're seeing,
so it'll suppress those hormones that are driving that thirst
once you start to drink. Yeah, I thought that was fascinating.
You know that it takes about ten minutes for the
water that you drink, you know, to get into your bloodstream,
and that your brain, you know, knows, you know, within
a minute or so that you've consumed enough and it's
already like making the calculations based on you know what
(28:12):
it's sensing in your mouth and your esophagus. I mean,
it's such a fascinating autopilot, right. It's just way more
advanced than we had thought. The body is amazing, isn't it? Okay,
(28:49):
I have a few more little things I want to
clear up now that I have my own kidney consultant.
So let's play a little game kidney fact or fiction.
Staying hydrated makes your skin glue factor fiction fiction. No
(29:09):
evidence that it improves the glow of skin. That said,
if you really get dehydrated, skin's not going to be
in good shape. Drinking eight glasses of water makes your
brain work better? Yes, or now? So, there is some
data that this was done in school children that increasing
hydration right before some tests improved some aspects of cognition.
(29:31):
There are two studies that I could find on this.
Neither of them were very large, neither of them are
very convincing. But I also didn't find the big test
that said this is absolutely fiction. I would guess fiction,
but I would leave a possibility that there's some truth
to that. Caffeine is a diuretic factor fiction fiction This
(29:51):
has been studied pretty rigorously. There is no evidence at
all that caffeine dehydrates. You can include that cup of
war when you count your cups of water if this
is something that you'd like to do, and coffee is
no different. So there you go. Friends, if you'd rather
have a cup of coffee than a glass of water,
you do you. Before I can let doctor Talf go,
(30:16):
I had just one more question, so I got to ask,
did you check the color of your urine? Oh? Absolutely,
I'm like every other person. No, I'm always interested in it.
I'm always interested in it because it gives me a
you know, it's a window into what's happening in my kidney, right,
and I'm naturally intrigued by that. But I don't think
it changes my behavior. If I'm thirsty, I drink. You
(30:38):
let your body run the outer pilot. Yeah, here's one
of the big secrets of medicine. It's not as hard
as you might think, and it certainly doesn't all belong
(30:59):
in ivory town hours or dressed up in lab coats.
I had an AHA moment when I was twenty or
twenty one years old, sitting in medical school, and the
professor started talking about hydronephrosis, the exact same diagnosis that
I had when I was a kid, and he explained
(31:21):
it using the same language as my pediatric urologist. I
sat there thinking, Wow, that knowledge is held up. What
I heard when I was ten is not any different
than what I'm hearing now ten years later in medical school.
My knowledge is held up over all this time, And
how empowering was it for me to actually understand how
(31:45):
my body worked when I was going through all those
scary things. A lot of medicine is very complex, and
if you're going to be a doctor, you need to
know all the background and the nitty gritty details matter
a lot. But if you're just worried about taking care
of your own health or your families, there's a lot
in your power to understand. One of my favorite things
(32:07):
about being a doctor is when I explain something to
a patient about how their body works and they have
that moment of realization. All the puzzle pieces fall into
place and they say, Wow, I didn't know how that worked,
and now I do. I hope you'll stick around for
(32:29):
the rest of the season of body stuff. We'll be
breaking down how your body works while busting one medical
myth at a time. Next week, we're diving right in
with your digestive system. Why just poop smell bad? Because
of it? Things inside? Not many of us are comfortable
talking about our poop, but I'm not many of us.
(32:52):
We're going to talk about why today we're so freaked
out by feces and we're going to find out what
our poop can tell us about our health. Body Stuff
is a member of the Ted Audio collective. It's hosted
by me doctor Jen Gunter and brought to you by
TED and Transmitter Media. This episode was produced by Lacy
(33:13):
Roberts and edited by Sarah Knicks. The rest of the
team includes Camille Peterson, Alice Wilder, Gretta Khane, Michelle, quint
Ban Ban Chang, and Roxanne high Lash. Alex Overington is
our sound designer and mix engineer. Paul Durban and Nierja
Robindon fact checked this episode. Special thanks to my one
(33:35):
kidney for keeping me going. We're back next week with
more Body Stuff. Make sure you follow Body Stuff in
your favorite podcast app so you get every episode delivered
straight to your device, and leave us a review. We
love hearing from our listeners. See you next week. An
(34:01):
un
Hi there, Virgie. Here today, we've got something a little
different for you. It's an episode of a new show
from the Ted Audio collective called Body Stuff with Doctor
Jen Gunter. In every episode, the podcast bust the lies
you're told about your personal health. I'm a huge fan
(00:23):
of doctor Jen's work, and I have a feeling you
will be too. If you like what you hear. You
can find and follow Body Stuff with Doctor Jen Gunter
wherever you're listening to this. Okay, here's the first episode.
I'm doctor Jen Gunter. I love science and I hate
(00:45):
when people twist it. Your immune system needs a big
scorbal supplement's milk a week, and there's a lot of
twisted medical misinformation out there. Are toxins literally purify you. Yeah,
(01:07):
that's ridiculous. Chugging a gallon of water means you'll eat
fewer calories. Oh, it's so painful. We're exposed to medical myths,
whether we're looking for them or not. There are news
stories Instagram and Facebook, post Flying Past twenty four seven,
TikTok Twitter. Who has balid information and who's just trying
(01:31):
to sell you something? How do you sort the medicine
from the mayhem I'm doctor Jen Gunter, and I'm here
to help. From the Ted Audio Collective, this is body stuff.
I'm a doctor, a practicing gynecologist, and I've made up
(01:52):
my mission to give women the facts that they need
to understand their bodies. In my twenty five years of
talking with pay, I've learned that medical misinformation is a
problem for everyone, and every single one of us is susceptible.
So this show is about debunking some of the stickiest
(02:13):
myths out there while helping you understand how your body
really works today. Why you don't need eight glasses of
water every day, you need a water day. We're going
back in time to find the origins of that myth,
(02:35):
and then we're going to meet a kidney expert who's
going to illuminate just how hard our bodies work for
us to maintain our hydration. It works like an exquisitely
designed atomic balance machine, right, you need to keep everything
in balance. But first I want to tell you about
something that happened to me when I was ten years old.
(02:55):
It was a time in my life when I got
asked a lot about my urine and it ended up
setting me on a path to become a doctor. It
was the first good weekend of spring nineteen seventy seven
in Winnipeg, Manitoba, the kind where the sun feels hot
and you're just raring to get outside. I was messing
(03:19):
around with my brother's skateboard, going down the street, and
then all of a sudden, I was flat on my
back on the concrete and I was in a terrible
amount of pain. It felt like my insides were on fire.
The next day, I'm sure I didn't look well, so
we went to the pediatrician, who took one look at
(03:41):
me and called a general surgeon, who took one look
at me and sent us to the emergency department. They
gave me something called an angiogram, and I remember the
doctor pointing to the X ray screen explaining what he
was seeing, and of course it just looked like a
snowstorm to me. But that's when I learned that when
I fell off my skateboard, i'd ruptured my spleen. The
(04:03):
good news was I wasn't going to need surgery, but
there was something else. It looked like I had hydro nephrosis,
meaning my kidney was full of fluid, and I needed
to see a pediatric urologist. He sat us down in
his consultation room and started to explain to my mom
(04:23):
what needed to happen. And I could tell she was
very confused. I think the doctor could tell as well,
and so he gestured to me and said, hey, you
come over here. This is your body. You should know
how it works. So I came over and I sat down.
I traded places with my mom, and he drew a
(04:45):
little diagram and he explained how the kidney worked and
what he thought was wrong, and the test that I
was going to have to have, and the surgery that
I was probably going to have to have as well.
And that doctor took the time to explain my body
to me. It really helped me not feel scared or overwhelmed.
(05:08):
And that experience made me decide I wanted to be
a doctor. I loved the science and I wanted to
be able to give to my patients what that doctor
gave me that day, that empowerment of knowing how your
body works and how to use that knowledge to help
improve your health. Eventually, I did have surgery to remove
(05:36):
my left kidney. I've lived most of my life with
just one kidney, the organ that's largely responsible for regulating
our body's hydration. But you want to know something, None
of my doctors ever told me to worry about how
much water I was drinking. I graduated from medical school
(05:57):
when I was twenty three, so I've been a doctor
more than half my life, and I've seen firsthand the
problems that happen when people get misconceptions about their health.
And a lot of these misconceptions they start with the Internet.
I'm not one of those doctors who rolls her eyes
when her patient comes in with reams of advice from
(06:19):
doctor Google. That tells me that my patient is engaged,
she wants to learn. But there are a lot of
bogus recommendations out there, and often they're being pushed by
brands and influencers. A lot of them sound like they're
making sense in a sort of science ish way, like
the eight glasses of water a day thing. Hey, we're
(06:41):
made of water, so why wouldn't we need lots of water?
But that's not science. So what's behind this myth? How
did we get to eight glasses of water a day? Anyway?
There are a couple of potential origin stories. One is
(07:01):
a paper from nineteen forty five that suggests the body
uses about eighty four ounces of water a day. And
there's another paper from nineteen seventy four from a pair
of nutritionists who recommended an equivalent of six to eight
glasses of water a day for the body to function appropriately.
But these papers became distorted over time like a bad
(07:22):
game of telephone. These experts were recommending that we drink
six to eight glasses of water a day on top
of everything else. They were saying, this is the amount
of water the body needs to function, But that water
doesn't have to be water you drink from a glass
(07:42):
out of your tap. Water is in everything. Think about
a breastfed baby. All they're drinking is milk. The body
is able to remove the water from the milk, so
the baby never gets dehydrated. In the same way, once
we start eating slid food, our bodies continue to extract
water from everything we consume. Everything we eat or drink counts,
(08:08):
So the water in your apple counts, the water that's
in the bread that you eat counts, even coffee counts.
Any fluid counts. Look, I get this as a real
record scratch freeze frame moment for a lot of people.
But we don't just get the water we need from
plain water. And if you have one of those days
(08:31):
where you just drink coffee all morning and you don't
feel great, maybe you're a little headachy or a little jittery,
it's not because you're dehydrated. Maybe you had a little
too much coffee or you had it on an empty stomach.
If you like drinking six glasses eight glasses of water
day and your doctor hasn't advised against it, that's probably fine.
(08:54):
What I'm saying is that there's nothing medical about this number.
We get to make choice races about what we put
into our body, and this is one of those choices.
If you think about it, just using common sense and
putting the medicine aside, does it seem realistic that we
evolve needing to consume that much clean water every day
(09:16):
In the span of human history, access to clean, plentiful
drinking water is a relatively recent phenomenon, and even today,
in many parts of the world, accessing clean drinking water
sadly isn't as easy as walking into your kitchen and
filling up a glass. It seems unlikely that our ancestors
(09:36):
carry giant water bottles around with them at all times.
And yet the mythspread and spread and spread. But why
is this myth so sticky? It turns out there's a
mix of factors, including a little bit of intrigue and
one particular culprit that deserves a lot of the blame,
(10:00):
the beverage industry. Sometimes water just isn't time unquenched. Thirst
has become a chronic problem America. If you are going
to sell something, you've got to have a reason to
(10:20):
sell it. You've got to create a market for it.
Things like pre hydrate. I mean, what's that mean? Drink
ahead of your first train. You've got to tolerate more fluid.
Your brain doesn't know when you are thirsty. Doctor deb
Cohen went to medical school in the UK, but instead
of becoming a clinician a doctor who sees patients, she
(10:42):
became a journalist. Back in twenty twelve, during the lead
up to the London Olympics, she was the investigative editor
at the British Medical Journal. She wrote a report called
The Truth about Sports Strengths and It's set off a
bar arm in the beverage industry. The report looked at
(11:04):
the history of sports drinks like Gatorade and how they're advertising.
Basically invented the modern fear of dehydration. It was really
in the kind of the boom of the marathon era
in the nineteen seventies that sports drinks really took off.
It started life in Florida at the University of Florida
and Robert Cade was the renal physician and he developed
(11:26):
this drink for the Gators football team. It was effectively water, sugar,
dasher sodium, and a bit of lemon juice, so quite simple,
and it was supposed to help alleviate cramps. And then
it was brought up by Quaker Oats and they spotted
a big market, and that's really where the science of
(11:49):
dehydration started. Okay, so we're not talking about clinical dehydration,
which is a real condition. For example, the time I
had food poisoning and I was up all night vomiting,
so I had to go to the emergency department and
get an intravenous But this is healthy people, So this
is a whole different phenomenon. And so what they turned
(12:11):
into an illness was exercise induced dehydration. Exercise induced dehydration,
now that sounds a lot more important than you're a
bit First, you if you've been running and sweating. If
you tell people that it's all about the science, then
people are more likely to believe it. Beverage companies, especially Gatorade,
(12:34):
commissioned studies looking for results that would bolster their sales pitches.
By the time doctor Cohens started looking into these studies,
there were a lot of them. Glaxo smith Kline at
the time, the company behind a popular British sports drink
called lucas Aid, claimed they had more than a hundred
clinical trials. That's a lot of studies, and the studies
(12:58):
were a little bit off. Some of the studies we're
actually having a bit of a laugh about. So what
you would do is you would starve people overnight, you'd
fast them overnight, and then you'd ask them to cycle
to exhaustion. One group you would give a sports drink
containing sugar, and the other group you would give water. Well,
(13:20):
guess what, the people have had a bit of sugar
are going to well perform the people that have been
starved and had water. It's not rocket science. And so
they are all sorts of these all sorts of these
kinds of studies that they do, and you look at
it and go that just does not happen, and it
doesn't matter that it's not clinically relevant. Now you've got
something that looks statistically different, and you can peg a
(13:43):
marketing campaign around that exactly. And if you throw enough
darts at a dark boat, if you've got your eyes blindfolded,
then one of them is going to hit the dark boat.
At some point. The studies were junk, but the science
fish conclusions they made began to spread, especially the idea
that we couldn't rely on our own bodies to tell
us while we were thirsty. One of Gatorade scientists even
(14:07):
said in two thousand and eight, and I quote, the
human thirst mechanism is an inaccurate short term indicator of
fluid needs. Unfortunately, there is no clear physiological signal that
dehydration is occurring. I think even the Mayo Clinic had
information that was based on science that have been ultimately
(14:29):
derived from the sports strengths industry about when you should
hydrate and how you should hydrate, and it filtered down
to influence school guidance in the UK where kids playing
soccer would have to go and stop every fifteen minutes
twenty minutes to rehydrates. And you speak to the teachers
and be like, yeah, it's just kids like running around.
(14:51):
They just need to peel all the time, So kids
running off constantly. Even the US military was in on
the quasi science. In the early eighties, the Pentagon was
citing Gatorade Sports Science Institute studies claiming their drinking sports
drinks could prevent heat stroke, a huge concern for soldiers
fighting desert wars. But those studies were bunk. There was
(15:14):
no evidence that drinking fluids reduced the risk of heat stroke.
Even today, the US military remains Gatorade's the biggest customer,
your taxpayer dollars at work. I was warned off several
times as well from doing the story. Are you sure
you know what you're doing? And a spot some people
in the US quite a bit of sources, and they
(15:36):
tried to have studies published that were negative and they
just could not get them published. And they'd been warned
off doing their research as well, and they were saying
to me, do you realize how what you're doing here?
And I literally probably naively just thought, well, sugary water, guys,
I mean, how big a deal is this? But as
(16:00):
doctor Cohen started her investigation, she began to see. There
was a lot of money intertwined with the junk science.
Sports drink companies spent huge sums sponsoring youth sports, funding
sports medicine doctors, and putting their logos on the world's
most beloved teams, and it was like a holy grail.
(16:21):
You go to sports conferences, to sports medicinal sports science conferences.
It's displayed everywhere you know sponsored and you don't criticize
the sports drink. So sports strinths have somewhat fallen out
of favor since their heyday in the nineteen eighties and nineties.
But another product has taken its place, and now it's
(16:43):
the number one selling beverage in the world, bottled water,
and big Bottled Water is very happy to have you
believe that you can't trust your thirst and that you
need a minimum of eight glasses of water a day.
After the break, we're going to talk about why this
myth just won't die. We're back before the break. We
(17:10):
learned the origin of the eight glasses of water a
day myth. We believe myths like this for a lot
of reasons, but a big one is something psychologists call
the illusory truth effect. When a piece of information is widespread,
and you hear it over and over again, you're more
(17:32):
likely to believe that it's true. There are a lot
of examples, statements like we only use ten percent of
our brains, or eating carrots will help you see in
the dark. None of these things are true, but I
bet you've heard them repeated over and over again. Politicians
and marketers take advantage of this all the time, and
(17:53):
it works because when you're assessing whether something you've heard
is true, you typically rely on two things. Whether the
information makes common sense and whether it feels familiar. The
research has shown that familiarity can even be more convincing
than rationality. Rationality is hard, but remembering if you've heard
(18:17):
something before, that's easy. And here's the thing about the
illusory truth effect. No one is immune, not even doctors.
There's a one day a year in March we call
World Kidney Day, dedicated to improving awareness of kidney disease,
and a few years ago the theme of World Kidney
(18:38):
Today was drink a glass of water to help your kidneys,
which is just crazy, right, It doesn't make any sense.
It's not grounded in science, but you know it is
grounded in funding for World kidney day, which I believe
comes from dan in a manufacture of bottled water. It's
like the deep state of hydration. That's doctor Joel Toff.
(19:01):
He's a kidney doctor, otherwise known as an nephrologist. I
called up doctor Toff because what do we do in
medicine When we don't know the answer, We look for
an expert, we call a consult and doctor Toff is
just the chemistry wizard for the job. I'm a lifelong
nerd who has been fascinated by the chemistry of body
fluids going on three decades. I love nerds. There are
(19:25):
an infinite number of fascinating aspects of body physiology or
disease states. And one of the truths about medicine is
that once you start learning about any one of these conditions,
they become more interesting. And back in nineteen ninety five,
when I was a senior in medical school, I became
real interested in fluids and electrolytes. So the precious bodily fluids,
(19:49):
the precious bodily fluids. That's right, that's my favorite movie.
That's a doctor Strange love. Doctor Toff knows that the
most important thing about precious bodily fluids is that they
stay in balance, which brings us to the tragic case
of Jennifer Strange. So I want you to kind of
(20:10):
rewind back to two thousand and seven, and the hottest
thing in two thousand and seven was the Nintendo Wii,
and this radio station got their hands on one and
they were running a radio contest. The contest was don't
we for a Wei? The radio station invited eighteen contestants
down to their studio to see who could drink the
(20:30):
most water without having to pee, and there was one
person who entered. Her name was Jennifer Strange, twenty eight
year old mother of three, and she ended up drinking
two gallons of water in an hour. That's a lot
of water, so much water that a nurse actually called
into the station to warn them this was dangerous. You
(20:51):
can overload your system with too much water. It can
be really unsafe. As Jennifer left the radio station and
she was already complaining of a headache, and what she
actually had was a condition called cerebral edema, which happens
when you wash your body out from all the critical salts,
and when you do this, water will shift from your
(21:14):
bloodstream into your brain. Cause increased swelling of your brain
that cause headaches, nausea, seizures, coma, and death. And she
ended up dying on her own bathroom floor. A couple
of hours later, Jennifer died from a condition called hyponatremia,
meaning a dangerously low level of sodium in her blood.
(21:36):
She threw off her body's delicate balance, something we've evolved
to rely on. It's called homeostasis. The body maintains a
stable internal environment to provide optimal health for the cells
of the body. Right, you can imagine for these cells
to grow and to be healthy, they need regulated amounts
(21:58):
of sodium, potass seem even things like body temperature needs
to be regulated. All these things need to be in
an optimal range for growth and health, and that process
of maintaining everything in that type band is called homeostasis.
We've evolved to maintain homeostasis through finely tuned mechanisms. The
(22:18):
sense when things are awry, when we've gone a little
bit too far in one direction or a little bit
too far in the other, and makes adjustments to return
us to our state of balance. Think about the mechanisms
that maintain us in homeostasis, like autopilots. I think that's perfect, right,
So you can think about body temperature is a classic one, right.
(22:40):
So if we get too hot, we start to sweat,
water evaporates from our skin that lowers our body temperature
back down. We get too cold, we shiver and all
that generates heat and brings us back to a normal
body temperature. So we have processes that control us from
getting too hot and from getting us too cold. Body
temperature is just one example of the autopilots that are
body has to maintain homeostasis, and our kidneys well, they're
(23:05):
the quarterback of homeostasis. They help to maintain the balance
of almost every electrolyte in our body. They help with
blood pressure, they're crucial for maintaining pH and they maintain
our level of hydration. One of these autopilots is called osmolality,
and osmolality is just a measure of the total amount
(23:26):
of compounds in solution. And so an analogous is just
how salty the soup is. As the osmolality goes up,
soup gets more salty. As the osmolality goes down, soup
gets more dilute. In this case, the soup is our
blood to be a little bit more precise. The fluid
part of our blood our plasma, and the kidney regulates
(23:46):
our osmolality so it stays in a healthy range. Jennifer's
Strange died because she drank so much water that she
pushed her osmolality far below the healthy range, and her
kidneys just couldn't keep up. Today, hypenatremia is most often
seen in athletes who are overhydrating while exercising. Doctors first
(24:09):
started seeing it in ultra marathon runners and iron man
triathletes in the nineteen eighties, a period of time that
nicely coincides with the messaging coming out of the Gatorade
Sports Science Institute. And it's not just extreme athletes. Doctors
have seen hypenetremia in high school football players, students in
yoga classes, and more. Thankfully, hypenetremia is relatively rare because
(24:34):
of our body's amazing ability to defend homeostasis. I just
want to run this morning, I went for three mile run,
and I'm the thirsty and a bit hungary. So how's
my one kidney because I only have one keeping me
working right. So you came back from your run, and
presumably during that run, you sweat, you lost a little
bit of fluid that way, and that loss of fluid
(24:57):
is going to make your body salt here, it's gonna
make the soups alter. Your osmality goes up. This is
you're pushing your body out of that homeostatic range and
it needs to return that osmolality back down. And the
way that it does that is two factors. One increased thirst.
And so increased thirst is a sensation that your body
(25:18):
gets that'll change your behavior. It'll make you go to
the sink, pour yourself a glass of water and drink it.
So in addition to thirst, your kidney is going to
respond to that increase in osmolality. And the way that
it does that is it's going to change the type
of urine that you make. You're always making urine, you're
always getting rid of You're constantly getting rid of waste products.
But one of the variables is how much water is
(25:39):
excreted along with those waste products. In other words, if
you're drinking a lot of water, you're going to pay more,
but that doesn't mean you're getting rid of more waste.
You're getting rid of the same amount of waste. It's
just diluted in more water. Yeah. My tagline on Twitter says,
thinking the kidney's product is urine, it's like thinking a
(26:00):
factories product is pollution. Urine is the byproduct. What the
kidney produces is homeostasis. So how much water should we drink?
We should drink enough water so that you're not thirsty.
I tell my patients, you know, anytime that you're thirsty,
go ahead and drink a glass of water, and maybe
(26:22):
have one glass of water on top of that. It's
not going to harm you. But I don't advise my
patients to count their glasses of water unless unless they
have kidney stones in their past, or if they have
autosomal dominant polycistic kidney disease. If you have an intact
thirst mechanism and you have access to water, are you
(26:43):
going to get dehydrated? No, let's put it this way.
People with increased sodium will drink from a toilet. The
derived to drinking is so strong you will not get dehydrated.
If there's a glass within a mile of you, you'll
get that water. Then you'll be fine. See. Now you
can be liberated from any anxieties you've ever had about
(27:05):
whether you're drinking and off water. You're welcome. Then doctor
Tooff told me something really cool about how our bodies
know when we've dranken of water. Yeah. So there are
what we call osmoreceptors. They're located in a center part
of the brink called the hypothalamus, and they're going to
constantly measure the osmolality of the body. And they're actually
(27:29):
the butt is very sophisticated. It knows when you're drinking,
and it'll start to suppress the hormone that drives thirst
as soon as you start to drink, right. It doesn't
even wait for that fluid to lower the osmolality in
the body. It's absolutely aware of what happens when you drink,
and it says, hey, we're gonna slow this cycle down.
(27:49):
We know that you're already compensating for what we're seeing,
so it'll suppress those hormones that are driving that thirst
once you start to drink. Yeah, I thought that was fascinating.
You know that it takes about ten minutes for the
water that you drink, you know, to get into your bloodstream,
and that your brain, you know, knows, you know, within
a minute or so that you've consumed enough and it's
already like making the calculations based on you know what
(28:12):
it's sensing in your mouth and your esophagus. I mean,
it's such a fascinating autopilot, right. It's just way more
advanced than we had thought. The body is amazing, isn't it? Okay,
(28:49):
I have a few more little things I want to
clear up now that I have my own kidney consultant.
So let's play a little game kidney fact or fiction.
Staying hydrated makes your skin glue factor fiction fiction. No
(29:09):
evidence that it improves the glow of skin. That said,
if you really get dehydrated, skin's not going to be
in good shape. Drinking eight glasses of water makes your
brain work better? Yes, or now? So, there is some
data that this was done in school children that increasing
hydration right before some tests improved some aspects of cognition.
(29:31):
There are two studies that I could find on this.
Neither of them were very large, neither of them are
very convincing. But I also didn't find the big test
that said this is absolutely fiction. I would guess fiction,
but I would leave a possibility that there's some truth
to that. Caffeine is a diuretic factor fiction fiction This
(29:51):
has been studied pretty rigorously. There is no evidence at
all that caffeine dehydrates. You can include that cup of
war when you count your cups of water if this
is something that you'd like to do, and coffee is
no different. So there you go. Friends, if you'd rather
have a cup of coffee than a glass of water,
you do you. Before I can let doctor Talf go,
(30:16):
I had just one more question, so I got to ask,
did you check the color of your urine? Oh? Absolutely,
I'm like every other person. No, I'm always interested in it.
I'm always interested in it because it gives me a
you know, it's a window into what's happening in my kidney, right,
and I'm naturally intrigued by that. But I don't think
it changes my behavior. If I'm thirsty, I drink. You
(30:38):
let your body run the outer pilot. Yeah, here's one
of the big secrets of medicine. It's not as hard
as you might think, and it certainly doesn't all belong
(30:59):
in ivory town hours or dressed up in lab coats.
I had an AHA moment when I was twenty or
twenty one years old, sitting in medical school, and the
professor started talking about hydronephrosis, the exact same diagnosis that
I had when I was a kid, and he explained
(31:21):
it using the same language as my pediatric urologist. I
sat there thinking, Wow, that knowledge is held up. What
I heard when I was ten is not any different
than what I'm hearing now ten years later in medical school.
My knowledge is held up over all this time, And
how empowering was it for me to actually understand how
(31:45):
my body worked when I was going through all those
scary things. A lot of medicine is very complex, and
if you're going to be a doctor, you need to
know all the background and the nitty gritty details matter
a lot. But if you're just worried about taking care
of your own health or your families, there's a lot
in your power to understand. One of my favorite things
(32:07):
about being a doctor is when I explain something to
a patient about how their body works and they have
that moment of realization. All the puzzle pieces fall into
place and they say, Wow, I didn't know how that worked,
and now I do. I hope you'll stick around for
(32:29):
the rest of the season of body stuff. We'll be
breaking down how your body works while busting one medical
myth at a time. Next week, we're diving right in
with your digestive system. Why just poop smell bad? Because
of it? Things inside? Not many of us are comfortable
talking about our poop, but I'm not many of us.
(32:52):
We're going to talk about why today we're so freaked
out by feces and we're going to find out what
our poop can tell us about our health. Body Stuff
is a member of the Ted Audio collective. It's hosted
by me doctor Jen Gunter and brought to you by
TED and Transmitter Media. This episode was produced by Lacy
(33:13):
Roberts and edited by Sarah Knicks. The rest of the
team includes Camille Peterson, Alice Wilder, Gretta Khane, Michelle, quint
Ban Ban Chang, and Roxanne high Lash. Alex Overington is
our sound designer and mix engineer. Paul Durban and Nierja
Robindon fact checked this episode. Special thanks to my one
(33:35):
kidney for keeping me going. We're back next week with
more Body Stuff. Make sure you follow Body Stuff in
your favorite podcast app so you get every episode delivered
straight to your device, and leave us a review. We
love hearing from our listeners. See you next week. An
(34:01):
un
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.