Ask Adam: vol. 6

Quartzy co-founder Adam Regelmann is an MD-PhD. He bypassed a career in gastroenterology to launch Quartzy with Columbia colleague Jayant Kulkarni. Each week Adam answers five questions about science, medicine, and pop-culture.

Does being out in the cold actually make you sick?

Colds are caused by viruses; they’re not caused by cold. The question becomes, “Does being cold make you more susceptible to viruses?” Rhinovirus is the most common cause of colds. There is one study that I know of where they found that, in cell culture, cells were more susceptible to rhinovirus when grown at lower temperatures. So there is some evidence that it’s physiologically possible.

Why does walking seem to relieve nasal congestion?

I didn’t know that was a thing, but I can hypothesize. A lot of people think nasal congestion is due to mucus, when in actuality it’s caused by vascular dilatation of the nasal mucosa. A lot of things can cause that: inflammation from virus, sleeping with one side down, some drugs and medications. Topical decongestants like oxymetazoline (Afrin) work by local effect on the vasculature, causing the vessels to constrict. And then you have pseudoephedrine (Sudafed), which is a systemic vasoconstrictor. So this goes back to when we discussed the sympathetic nervous system. Basically, your sympathetic nervous system becomes more amped when you get up to walk. And in addition to making your heart beat faster and things like that, it also causes systemic vasoconstriction, including in your nasal mucosa, and that reduces congestion.  

Is MSG harmful?

MSG has two components: sodium and glutamate. The medical opinion on sodium is constantly changing; you can’t win with sodium. I think, as most things go in life, balance is important. So if you have too much sodium, it’s bad, if you have too little sodium, it’s bad. But the question is, “What is this range?” It’s probably in the range of 2-4 grams a day. If you’re over 4, you’re probably bad, and if you’re under 2, you’re probably bad. Glutamate is an amino acid. Again, this comes down to dose. Our bodies can make glutamate on our own, so we don’t actually need to eat it. But it’s important because not only is it a building block of protein, but it’s a neurotransmitter. So it can have some effects on your nervous system. I’m not sure of the exact mechanism, but MSG has been associated with migraines. So, if you have a big meal of MSG, you might have at least transient high blood pressure (or if your heart isn’t working so great, a congestive heart failure exacerbation) from the sodium and a migraine from the glutamate.

It’s a naturally occurring substance. There are foods that are high in MSG, like tomatoes, soy sauce, miso. The Japanese actually have a word for the taste: “umami,” which means “delicious.” It’s like this flavor you want to keep eating. From a health perspective, mental health is also important. I like to eat it, especially if it’s a natural form.

TV doctors often argue about what a patient needs, even in front of the patient. Does this happen?

Doctors get into a lot of arguments—I would call them more “discussions”—but it would be very unprofessional to do it in front of the patient, and it’s never as heated as it gets on TV. It’s usually very professional. There’s a lot of hierarchy in medicine, and it’s there to clarify to everybody who can make decisions about patient care. In the hospital, there’s a “primary” team, who officially makes the final calls on patient care. However, that team must take the advice of any consulting physicians very seriously, and if they don’t proceed with one of their recommendations, they need to document why. Also, as patients’ situations become more critical, the things that you can do become more and more narrow, so there’s less argument. When a patient is coding, for example, there are very clear guidelines for what should be done.

Have you ever heard someone talk about Quartzy and they didn’t know you were a co-founder?

I was on the train and some Stanford people were talking about an experiment they were doing and said “Sounds good, just put it into Quartzy.” That felt good. I was tempted to chime in, but I didn’t.

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Greg Schindler

Greg has a BA from Stanford (English/Football) and MS from Oregon (Journalism). He's our Director of Marketing and Pastries.

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