by linsomniac 9 hours ago
~2 years ago I used ChatGPT "deep research" to investigate a chronic sinus infection I'd been fighting for ~3 years. After seeing 3 GPs and 3 visits with an ENT, I fed all the observations I had into the AI. In particular, I couldn't get the ENT to explain why he visually saw, via a scope, evidence of allergic reaction in my sinuses, but then later concluded, after an allergy test, that it couldn't be treated via allergy medication. I asked this question a few times and he just never answered.
ChatGPT surfaced a NIH study that concluded that 20% of people have allergic reactions that are isolated to a body location, and that shoulder "skin prick" testing may not reveal. I asked him about that and he said "that's not how allergies work". Full stop. He was unwilling to even look at the study.
He prescribed a CPAP and regular nebulizer treatments. Side story: the CPAP place sent me a SMS message that I couldn't recognize was not a phishing attempt, and when I reached out to inquire who they were they never replied.
So I decided: Let me just try taking a second-gen allergy tablet every day and see what happens.
My sinus infections have gone away. Previously I was getting a major sinus infection at least quarterly. Maybe he's right that allergies don't work that way, but allergy tablets have absolutely solved my problem. Which I'm thankful for because I tried a CPAP for a solid month a few years ago and I just could not get used to it, and was sleeping like crap.
Ok, there's a lot to unpack here and you really had the deck stacked against you. First, lets go from the top, once a test says X, disproving that X is really hard. And that's not unique to the medical profession, it's inherent to all humans and we suck at revisiting or revising our decisions, much less at looking at the possibility to even reverse it.
Which moves us to the next two issues: liability and time. Any moment that you ask someone to revise a decision and specially with the stakes that the medical profession has that nobody has the time nor the inclination to open themselves for a mess.
Now, if you really want to be successful, you have to, before they even have a case with you, and specially before the diagnostic loop closes, to suggest the tests that the study has, since that has the biggest chances of looking at the right thing to look. Just be straight that you walked in with a theory. Doctors notice when they're being steered way faster than they notice when you're actually right. That's how you work with the systems that have a overworked mass trying their best.
>before they even have a case with you
My problem is that I needed information from 2 ENT visits to feed into ChatGPT to get that study. On the first visit he scoped my sinuses and immediately said "I can see evidence of allergic reaction, see those white bumps?". On the second visit I got an allergy stick test and it came out negative.
Those helped lead to that NIH study. It would have been very hard to have walked in with that study in hand.
I mean, for the second (third?) option specifically. You will notice that they will be more open to go outside of the standard of care if you have a working theory.
Daily allergy tablets are associated with huge increases in early onset Alzheimer’s. Glad you found something that works, but might be good to get some of the allergen injections :)
That seems to be only for first generation, drowsy-making, tablets. Second gen formulas don't cross over the blood/brain barrier.
https://www.myalzteam.com/resources/zyrtec-and-alzheimers-me...
There IS one year-old finding that suddenly stopping Zyrtec after daily 3-month use may lead to nasty itching, and if that happens you can re-start and then taper off. https://www.fda.gov/drugs/drug-safety-communications/fda-req...
Where are getting that from?
All I can find is about 1st gen antihistamines (i.e. Benadryl, which I doubt many people take daily, because of the drowsiness).
Even for those, evidence seems to be mixed at best. "Huge increases" seems like hyperbole.
Only first gen, 2nd gen does not have this issue anymore or it’s greatly reduced
Misinformation.
Only first-generation antihistamines with anticholinergic effects are associated with cognitive decline in elderly patients.
LMAO at how the two of you sound authoritative and knowledgeable, but neither linked to ANY studies (or at least personal anecdotes) to support your claims.
Yet here we are, warning each other about the dangers of LLM hallucinations. Humans "hallucinate" (provide random authoritative-looking information without anything to back it up) pretty often too.
I believe it depends on which ones, the older gen or certain classes of antihistamines
Wait, what?? Now I'm getting in panic mode because I do take regularly anti-hystaminic tablets/pills (the newer ones, based on ebastine because they don't make me feel sleepy)
You don't seem to need to worry, second gen tablets seem to be fine: https://claude.ai/share/9c6eaaa5-e734-4267-b540-ddc0188daf6b
Posting a claude chat is not actually helpful. The chat doesnt't even cite any sources.
I think this post is a decent summary, the answer is a soft maybe: https://www.health.harvard.edu/mind-and-mood/should-i-worry-...
Second-gen tablets might increase dementia risk by a small-to-medium amount (there's almost certainly still a small degree of CNS activity, and we don't know what causes dementia in the first place), but researching it will be difficult. Dementia is hard to research because of how long it takes to develop, and it's poor coding within health data, and antihistamines are hard to research because they're not often prescribed and aren't available in the health data.
If it's a large effect, those factors wouldn't matter, but smaller risks are harder to detect and more sensitive to bias. If you want to minimise dementia risk, then reducing antihistamine use might be warranted, but you're probably better off addressing the risk factors we do know about: https://www.dementia.org.au/brain-health/risk-factors-develo...