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Discoveries That Make a Difference

Bodywork: What if the Founding Fathers had lived today?

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Adam’s Journal

Happy 250th, America! Our nation’s big birthday celebration has me thinking about – what else? – health. But with a colonial spin.

The Founding Fathers are often depicted as old men when they were doing things like leading the Continental Army against the British or penning the Declaration of Independence. However, I thought lifespans were a lot shorter in 1776.

I’m curious – how did folks like George Washington, Thomas Jefferson and Benjamin Franklin live so long? And would they have lived even longer today?

Dr. Scofield Prescribes

For someone born in British colonial America in the early to mid-1700s, life expectancy at birth was generally about 35 to 40 years. Those figures, though, are a bit deceiving; infant and childhood mortality dragged them down dramatically.

In many areas, up to 20% of babies died before age 1. And even those who survived beyond the crib were not out of the woods; infectious illnesses like smallpox, measles and diphtheria, along with dysentery and diarrheal diseases brought on by contaminated food and water, claimed many a child’s life.

Nevertheless, if you made it to age 20, you could expect to live another four decades or more. So, Washington (who lived to age 67), Jefferson (83) and Franklin (84) weren’t extreme outliers.

Like many wealthier colonists, they had certain advantages that tilted the actuarial odds in their favor. They enjoyed better nutrition and more stable food supplies, better housing, less physically demanding labor, and access to physicians.

Still, if this trio of Founding Fathers had been born in the mid-20th century, odds are they would have enjoyed even longer lives.

Washington developed a severe sore throat after riding for hours in cold, wet weather. Within a day, he could barely breathe or swallow.

Medical historians believe he was suffering from an acute bacterial infection. But bacterial infections – now quite treatable – were unknown two-plus centuries ago. So, his doctors treated him with standard therapies of the day, which included enemas and bloodletting.

Not surprisingly, the treatments didn’t help. And the bloodletting, which removed an estimated 40% of his blood volume, may well have hastened his demise.

The picture is not quite as stark for Franklin and Jefferson. Franklin developed lung problems likely caused by pneumonia that ultimately proved fatal. Jefferson seems to have succumbed to chronic kidney disease, possibly complicated by pneumonia or another infection.

Today, the picture would look quite different. Antibiotics, along with some inpatient support, would likely have restored Washington’s health. A similar course of therapy would probably have added years to Franklin’s life. And blood pressure control, dialysis, antibiotics and a possible kidney transplant might well have done the same for Jefferson.

When America was born, doctors couldn’t detect bacteria, couldn’t measure blood pressure, and had no antibiotics. Since then, medicine has undergone its own revolution. On our nation’s 250th birthday, that’s certainly something worth celebrating.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. He is currently pursuing a master’s degree in medical history from Johns Hopkins University. Adam Cohen is a curious guy and is also OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Do men snore more than women?

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Adam’s Journal

I guess it’s no surprise that we have health-curious coworkers at the Oklahoma Medical Research Foundation. Here’s the latest question from an inquisitive colleague:

My husband snores so loudly at night sometimes that it keeps me awake. A lot of my friends say the same thing about their husbands. Do men tend to snore more than women – or does it just seem that way?

Casey Arnold

Dr. Scofield Prescribes

Your perception is correct: Men do snore more than women.

The American Academy of Sleep Medicine reports that about 40% of adult men are habitual snorers, while adult women habitually snore at just over half that rate – about 24%. A 2022 review article in the sleep-medicine literature cites similar figures.

An analysis of 63 different research studies on snoring found a consistent male predominance in snoring. In particular, it found this sex disparity was most pronounced in younger adulthood. To understand why, let’s look at what causes snoring.

Snoring occurs when airways vibrate or collapse during sleep. Most often, this happens when structures in the upper airway – between your voice box and your nose and mouth – vibrate.

The area most often involved is the space between the soft palate and tongue, which narrows and becomes floppy during sleep. This happens more frequently in men because they tend to have larger neck circumferences, more fat around the neck and upper body, and longer airways.

In addition, the female sex hormones estrogen and progesterone appear to help maintain airway muscle tone, reducing its tendency to collapse.

However, after menopause, these hormone levels decline. As a result, snoring – and its more disruptive and dangerous cousin, obstructive sleep apnea – becomes more common in women, and the sex gap narrows.

Across age groups, men are diagnosed with obstructive sleep apnea two to three times more frequently than women. The same factors that increase the risk for snoring also increase the chances of obstructive sleep apnea.

Some researchers have noted that women – perhaps out of embarrassment – are less likely to report snoring to healthcare providers than men. So, statistics may underreport the levels of snoring in females.

Still, when researchers objectively record snoring during sleep studies, they find that men snore more frequently and loudly. And that, I suspect, is not a surprise to you or your friends.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Fathers, sons and familial tremors

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Adam’s Journal

With Father’s Day around the corner, I’ve been thinking about my dad, who passed away two years ago this month.

I always remember him – and his father before him – having a slight tremor in his hand. He would have a drink or two to calm it, but especially in his later years, that was not enough.

In his 80s and, finally, his 90s, the shaking in his hands became so pronounced that it was debilitating. He was nearly unable to type on a computer keyboard, and simply signing his name was an arduous task that could take the better part of an hour.

Given this familial history, are my brother and I destined to inherit this condition?

Dr. Scofield Prescribes

Commonly called familial tremor, what you’re describing sounds like what’s known more technically as essential tremor. It’s a neurological condition that runs in families.

Unlike Parkinson’s disease, which also causes shaking in the hands but is accompanied by a host of other neurological symptoms, essential tremor primarily causes tremors and is generally not associated with the progressive neurological decline seen in Parkinson’s. That said – and as you described – it can nevertheless have a profound impact on one’s quality of life and ability to perform countless day-to-day tasks.

There is, as you’ve surmised, a strong genetic component to essential tremor. But the fact that your father and paternal grandfather had the condition does not predestine you, your brother or any other siblings to their fate.

Essential tremor shares many characteristics with what are called “autosomal dominant” disorders. These are conditions where, if one parent has them, each child (regardless of sex) has a 50% chance of inheriting them.

However, research has found that no single gene causes essential tremor. Multiple genes likely contribute.

So while the overall risk for you and each of your siblings inheriting the genes that predispose you to the condition is still likely in the neighborhood of a coin flip, the picture is much more complicated than that.

I promise this is the end of the genetics lesson, but essential tremor displays a trait that geneticists call variable penetrance. Put simply, it means that just because you inherit the genes doesn’t mean you’ll develop the condition.

And even if you do, your symptoms may not be as severe as your father’s were.

We don’t fully understand why this is the case. Environmental factors may also play a role, influencing whether symptoms surface and, if they do, how profound they might be.

I’d encourage you to pay attention to fine-motor tasks: things like signing documents, holding a cup of coffee, or taking photos with a smartphone.

Even a subtle tremor would be a signal. With you now in your late 50s, symptoms would typically, but not always, begin to appear by this time. If you haven’t seen any symptoms, it’s an encouraging sign that you will not continue this family legacy.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Anti-aging drugs – for dogs?

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Adam’s Journal

I read an article about anti-aging drugs for dogs. Last I checked, we hadn’t even developed such a thing for people. Is this for real? And what might it mean – or not – for we two-legged creatures?

Dr. Criley Prescribes

It is, indeed, for real. Right now, there are two major trials of anti-aging drugs for dogs.

The first is for a drug called rapamycin. The U.S. Food and Drug Administration has already approved human use of rapamycin to prevent transplant rejection and to treat some types of cancer. Now, some people have begun taking it off-label to slow aging.

Researchers have begun a trial of rapamycin in dogs to look at a variety of health outcomes. One of them is whether weekly doses of the drug in older dogs leads to longer lifespans.

The second trial involves an investigational compound known as LOY-002. The experimental drug claims to target metabolic drivers of aging and, in early results, has been shown to reduce certain biomarkers – essentially, measurements of chemicals or processes – associated with aging.

The drug’s maker is now conducting a larger trial on dogs 10 years or older. Specifically, researchers are testing whether dogs who receive daily doses of the drug will live longer than their canine counterparts taking placebos.

This drug’s development represents a critical shift in thinking. Instead of targeting specific conditions related to aging – conditions like heart disease, diabetes and neurological disorders – LOY-002 is targeting the process of aging itself.

It’s too early to tell whether either of these drug trials will be successful. But if they are, which would be signaled by approval from the FDA’s Center for Veterinary Medicine, many dog owners would no doubt add the medications to their pets’ routine care.

While optimal nutrition, exercise and veterinary care will remain crucial to dogs’ health and well-being, these drugs could give us more time with our four-legged family members. And that would be a very good thing!

We humans share much with our canine companions, including the aging process and many of the diseases accompanying it. If either of these trials proves out, it could pave the way for anti-aging medications for people – and carry profound implications for us all.

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Dr. Jennie Criley is the attending veterinarian and director of comparative medicine at the Oklahoma Medical Research Foundation. Adam Cohen is OMRF’s senior vice president and general counsel. Submit your health questions to contact@omrf.org.

Are peptides all they’re cracked up to be?

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Adam’s Journal

In my (deep sigh) seemingly never-ending odyssey to heal my torn hamstring, I recently visited a physician who suggested that I try peptides. I’ve heard a lot about them lately, but I confess I don’t really know what they are. Are peptides a safe and effective option for injuries like mine?

Dr. Scofield Prescribes

Yes, peptides seem to be all the rage these days. Wellness influencers, tech moguls and even our Secretary of Health and Human Services are trumpeting the promise of peptides for everything from skin care and building muscle to longer lives.

Peptides are short chains of amino acids – basically fragments of proteins. They occur naturally in our bodies and play many useful roles in our cells, including helping digestion, regulating blood pressure and reducing inflammation.

Peptides can also be synthesized and turned into medications. There are several peptide therapies approved by the U.S. Food and Drug Administration. Some that you might know are insulin and GLP-1 drugs. (Fun fact: the P in GLP-1 stands for peptide.)

Beyond these FDA-approved therapies is a much larger “gray market” of peptides. Until 2023, compounding pharmacies could make certain other peptides when prescribed by a doctor. But due to safety concerns, the FDA removed a group of them from the list that compounding pharmacies could make.

These peptides, which are marketed for a wide variety of health benefits and therapies, have largely been untested in humans. They’re primarily manufactured in China, and those who’ve analyzed them have found that what’s being advertised isn’t always what’s actually being sold to buyers. The products also can be tainted.

Health Secretary Robert F. Kennedy Jr. has declared himself “a big fan of peptides.” He says he has used peptides to treat injuries he’s suffered, “with really good effect.”

Kennedy announced that in July, the FDA will evaluate seven of the most popular ones. Most observers believe this signals that the agency will soon allow compounding pharmacies to make them again.

On the list are two peptides – known as BPC-157 and TB-500 – that have been shown in pre-clinical trials to combat inflammation and promote tissue healing.

A 2025 paper from researchers at the University of Utah looked at the research studies conducted with BPC-157. They determined that while studies involving animals and cell cultures, along with small human studies, suggested the peptide held potential to promote healing, “human data are extremely limited,” and “rigorous, large-scale trials are lacking.”

The data are even more limited on TB-500. A review of the two peptides in The American Journal of Sports Medicine this year noted that research studies had yet to generate reliable human data on the peptides’ safety, side effects, proper dosage, or which conditions they should – or shouldn’t – be used to treat.

Against this uncertain backdrop, I would strongly caution against using peptides. Unless and until large-scale human clinical trials demonstrate peptides’ safety and effectiveness, anyone who takes them is simply experimenting upon themselves.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Will a new name improve care for a medical condition?

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Adam’s Journal

This week, we have a question from Carli Hartley, our co-worker at the Oklahoma Medical Research Foundation:

Polycystic ovarian syndrome was recently renamed polyendocrine metabolic ovarian syndrome in hopes that it would help improve care for this disorder that impacts 1 in 8 women. As someone with the condition, I’m curious how this name change will help improve care. And will it help increase research on this disorder?

Dr. Scofield Prescribes

Polycystic ovarian syndrome has been a misnomer for almost a century. Doctors first described the condition in 1935. Their characterization was based only on seven women, each of whom had enlarged ovaries with multiple small cysts.

However, we now know these cysts were just the tip of the iceberg. And, in fact, many patients diagnosed with the condition don’t have ovarian cysts at all.

Confused?

To allay this confusion, an international consortium of physicians and researchers has renamed the condition. The new name, polyendocrine metabolic ovarian syndrome (PMOS), not only gets rid of the cysts, but it points to the broader underlying nature of the condition.

PMOS affects an estimated 10-13% of women of reproductive age. A diagnosis requires two of the following three elements: (1) irregular periods; (2) evidence of elevated levels of the hormone androgen; (3) multiple ovarian cysts.

In addition to irregular periods and ovarian cysts, the condition can be marked by symptoms like pelvic pain, excess body hair and acne. Many with PMOS also have an increased risk of obesity, type 2 diabetes, cardiovascular disease and obstructive sleep apnea.

Beyond failing to accurately characterize the condition, the previous name also didn’t capture its scope. The new name attempts to correct these flaws and also recognizes its roots: the endocrine system, a network of glands and organs that act as the body’s chemical messaging system.

By moving PMOS beyond the realm of gynecology and a focus on the ovaries, experts hope it will broaden caregivers’ approaches to treatment. In particular, their aim is to shift the focus from PMOS’ impact on reproduction to encompass its many other effects.

The change could have an immediate impact for some patients, prompting doctors to recommend more screening for metabolic and cardiovascular problems. Today, if patients aren’t trying to get pregnant, they’re often prescribed birth control for their symptoms. With a broader understanding of the condition, more treatments may emerge.

Still, more research is needed, and the new name also aims to spur those studies. Until now, federal grant applications were typically directed to the institute at the National Institutes of Health that covers reproductive health, which has a relatively small budget. Those in the field now hope that, with the change, PMOS research will become eligible for support from other, better-funded NIH institutes, like those that cover diabetes and heart disease.

Over time, let’s hope this name change will, as one researcher put it, “redirect us into thinking about this as a long-term chronic condition and not just a period problem.”

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: What to know about the recent hantavirus outbreak

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Adam’s Journal

By now, we’ve seen the headlines about the outbreak of hantavirus aboard a cruise ship earlier this month. Is this something we need to worry about?

Dr. Scofield Prescribes

The hantavirus is what’s known as a zoonotic virus, meaning it originates in animals and can be spread to humans. For most hantavirus strains, this is as far as it goes. Even if a human catches the virus from rodent exposure – different species of the virus are carried by different rodents, and it most commonly spreads by breathing in particles of dried rodent droppings or urine – that’s where it ends.

However, there is an extremely rare strain of the virus that has the ability to spread from human to human. It’s known as the Andes virus, and it’s deadlier than most other forms of hantavirus. This is because the strain seems to affect the heart and lungs more than most other strains.

As with all forms of hantavirus, there are no targeted treatments or approved vaccines for the Andes virus. Symptoms can be treated with oxygen therapy and fluid replacement, but the Andes virus causes severe respiratory failure and has an estimated fatality rate of 35% to 50%.

Based on genetic sequencing that’s been performed on samples taken from several passengers on the cruise ship, it appears to be a strain quite similar to the Andes virus that caused the new outbreak.

In 2018, the Andes virus spread through a small town in Argentina, infecting 34 people, 11 of them fatally. An analysis found that the outbreak began when one person, infected from a rodent, attended a birthday party of about 100 people.

In the months that followed, three people infected at the party attended other social gatherings while ill and symptomatic. It was, researchers found, those interactions that drove every subsequent infection.

It’s still early, but it appears a similar dynamic may have been at work on the cruise ship. Genetic sequencing found that the viral genomes from different passengers were extremely similar to one another. This suggests that one passenger may first have gotten sick from rodent exposure, then transmitted the virus to other passengers.

Fortunately, the Andes virus doesn’t jump efficiently from human to human. It requires close contact with an infected, symptomatic person.

The 2018 outbreak was contained through isolation and quarantine. And more than 80 healthcare workers who had unprotected contact with patients weren’t infected, which shows how inefficiently the virus moves between people.

This bodes well for the cruise ship outbreak, where symptomatic passengers are being isolated and all others will continue to be monitored. This, along with the virus’ relative inability to hop from one person to another, should limit the outbreak.

And if you’re slated to take a cruise or have other travel plans this summer, I wouldn’t worry about hantavirus. Your risk of acquiring something else – think flu, Covid or norovirus – is much, much higher.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: When should you get vaccinated for shingles?

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Adam’s Journal

In honor of the NBA playoffs, here’s a question from an Oklahoma Medical Research Foundation co-worker:

I read that Indiana Pacers’ star — and 2025 Thunder championship nemesis — Tyrese Haliburton has been struggling for several months with a case of the shingles on his face. He’s only 26.

I thought shingles was more of a concern for older people, especially because vaccination recommendations start at age 50. Can and should you be vaccinated for shingles if you are younger than 50?

Jenny Lee

Dr. Scofield Prescribes

This weakening of immune control typically begins to happen as people age, which is why standard recommendations for Shingrix, the shingles vaccine, begin at 50. However, younger adults can get shingles, and in recent years we’ve seen an uptick in cases in people in their 20s, 30s and 40s.

Although we’re not sure why, the rise of shingles in younger populations is probably due to a number of factors, with stress and sleep deprivation suspected as contributors. The chicken pox vaccine may also impact shingles trends, although that effect is complicated.

By reducing childhood chickenpox, the vaccine has cut adults’ periodic exposures to the virus. Some experts believe those periodic exposures help boost immunity against shingles.

Meanwhile, those vaccinated people are less likely to carry the strain of the virus that most often reactivates as shingles. As a result, studies indicate their future shingles risk is lower than those who were infected naturally.

Unless a person is immunocompromised — such as individuals with HIV, those undergoing chemotherapy, or those receiving treatment for autoimmune disease — vaccination for those under 50 isn’t routinely recommended.

That’s because the absolute risk for disease remains low. Plus, immunity from the previous shingles vaccine (Zostavax) waned over time, and this may happen with Shingrix, too. So, vaccinating too early might leave less protection later in life, which is when risk is highest.

Still, physicians can legally give the vaccine “off label” to younger adults in certain circumstances. Some doctors might consider vaccination for younger patients who have experienced recurrent shingles or an unusually severe case of the virus, especially if it involved the face or eye.

In such cases, insurance likely would not cover the shots.

So, can you be vaccinated under 50? Yes. But should you consider it? Generally, no, unless you’re immunocompromised or have had a significant prior case of shingles.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Should we all be taking creatine?

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Adam’s Journal

So, I’m going to pose a question that an audience member asked when you traveled around the state as part of the Oklahoma Medical Research Foundation’s “Spotlight Conversations” series:

Should we all be taking creatine?

Dr. Scofield Prescribes

The supplement creatine has long been a favorite of athletes and bodybuilders for boosting muscle mass and athletic performance. But these days, its use has expanded.

Our livers, kidneys and pancreas produce creatine. We also get it in our diet from animal products like red meat and fish.

Our muscles use a product derived from creatine to generate energy, especially during high-intensity activities like lifting weights or sprinting. Most of us get sufficient creatine   (about two grams) from a combination of diet and what our bodies generate.

The idea behind creatine supplementation is that it helps the body rapidly regenerate adenosine triphosphate (ATP), which is the primary source of energy used during short bursts of high-intensity exercise. This enables the body to work harder for longer, which both enhances performance and promotes muscle growth.

In addition to bodybuilders and other athletes, some vegetarians — whose only source of the compound is their own bodies — have taken creatine supplements. In healthy people, the supplements have generally been shown to be safe.

Clinical trials and other studies have found that athletes who take creatine can generate 5–15% more strength or force during repeated short bursts of activity. An analysis of dozens of clinical trials also showed that people who took creatine while resistance training increased their lean body mass by an average of more than two pounds.

Creatine also pulls water into muscle cells, causing them to swell. This can lead to some weight gain, which is most often temporary.

People with kidney disease should consult their doctors before taking creatine, as it could further strain their kidneys. Other potential drawbacks, while usually mild, include gas, bloating and an upset stomach.

Beyond what we see in the mirror, the relatively minor gains that creatine supplementation provides during intense workouts may be invisible to most of us. But as we age and lose muscle mass, the supplement could help counter age-related muscle loss.

It’s important to emphasize that creatine supplementation alone is insufficient to provide benefits. Those gains only come in combination with a regular strength training regimen.

Researchers have begun to look at other potential benefits of creatine supplementation, including cognitive gains, blood sugar control, bone health, and a variety of disease-specific questions. However, the studies so far are limited, and the results have been mixed.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

Bodywork: Are coronary calcium scans for everybody?

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Adam’s Journal

I’ve seen low-cost heart scans advertised at local hospitals. I’ve never had one, but should I? Should we all? How useful are they?

Dr. Scofield Prescribes

You’re most likely talking about a coronary artery calcium scan. These quick, noninvasive tests, widely available for as little as $50, use a type of computed tomography (CT) scan to measure calcified plaque in the coronary arteries.

These are the arteries that supply blood to the heart. Plaque buildup in these arteries, known as coronary artery disease, is a leading cause of heart attacks.

For some people, these scans can be quite helpful. They’re most useful in those who don’t have any symptoms of cardiovascular disease (things like chest pain, shortness of breath, and dizziness) but nevertheless have an increased level of risk due to factors like high blood pressure or elevated cholesterol.

For folks in these “gray” areas, especially between the ages of 40 and 75, coronary artery scans can help tip the balance on whether a person should start taking a statin drug. For instance, someone with elevated cholesterol who shows moderate plaque buildup might be advised to begin statins, while someone who shows no detectable calcified plaque might be advised to wait and focus instead on lifestyle changes.

Coronary calcium scans, though, are not a one-size-fits-all solution.

Unless there is some special circumstance, like a strong family history of heart disease, the test is not recommended as routine screening for very low-risk people. And at the other end of the spectrum — those who have established coronary disease, those already known to be at high risk, and those who have experienced symptoms — the scans add little useful information to inform the treatment path.

Plus, these tests do expose you to radiation, and there is no safe dose of radiation. And if every person got one – as some advertising seems to suggest – the cost would run well into the billions.

Still, these inexpensive, noninvasive scans can be useful in borderline cases, helping to determine whether a person needs a cholesterol-lowering medication. If you believe you might fit into this category, talk to your healthcare provider to see if a coronary artery calcium scan makes sense for you.

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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

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