February 2026
GLP-1 Medications for Cigarette Cessation
Readers of the newsletter may remember a study from February, 2025 showing decreased alcohol cravings and drinks per session with GLP-1 medications like semaglutide (Ozempic, Rybelsus, WeGovy) and tirzepatide (Mounjaro, Zepbound). A new secondary analysis of the same data set shows folks average cigarettes per day decreased in the nine week trial from 20 per day to seven per day.
Dr. Neuman says: “Based on this study, I now recommend that people trying to leave nicotine behind consider GLP-1 medications, in addition to varenicline (Chantix), and bupropion (Wellbutrin).”
http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2829811#note-YOI240094-1
Blood Markers for Alzheimer's Disease
There are now two blood-based markers that have been approved by the FDA for aiding in the diagnosis of Alzheimer's Disease. The disease can be diagnosed clinically, but in some cases that are less obvious, futher testing can help. We used to have only lumbar punctures and PET brain scans, which were expensive and hard to get. In 2025, two tests entered the market, pTau 217/b-Amyloid 1-42 ratio test, and the pTau 181 test.
Dr. Neuman says: "These tests are still expensive. The Labcorp test bundle for blood tests for Alzheimer's costs is $538 (that is after the 50% discount they give to Ally). Insurance coverage is unknown. These tests perform best when the probability of Alzheimer's is highest. Folks without any memory loss would be at higher risk of false positive. There are genetic tests. like APOE e2 and APOE e4, that can help inform us of future risks."
Abdominal Massage for Constipation
In the meta-analysis of 13 randomized trials, adults with constipation who received abdominal massage showed a signifcantly greater increase in bowel movement frequency by 1 and a half per week when done daily. Participants also reported better stool consistency, less straining, and better quality-of-life with abdominal massage.
Here is a great video showing the technique, start at 2:40: https://www.youtube.com/watch?v=oH5xVjw8yEs
Dr. Neuman says: "Bidets (like Toto Toilet or Tushy) and Sqautty Potties complete the collection of tools I recommend for constipation, alongside exercise, water, and added fiber. If all that isn't working, it is time to reach out to me for further options"
Big News in Stroke Prevention
A highly anticipated study showed half the risk of stroke after four years when folks with high-grade asymptomatic carotid stenosis (aka a large plaque [cholesterol] blockage in the neck blood vessels as pictured above) were given a stent and had medical therapy (aspirin, cholesterol medication) compared to just medical therapy alone.
Dr. Neuman says: "Carotid artery plaque accounts for roughly 20% of all strokes. For folks at high risk of stroke, like folks who have had a stroke or ministroke and folks who have known heart or other artery blockages, we used to do ultrasound screening for narrowing (aka plaque is narrowing the tube). There was a procedure, called carotid endarterectomy, that manually cleaned the plaque from the vessels. On follow-up studies in the past, endarterectomy was no better than medications alone, and so the procedure and ultrasound scanning have fallen out of favor. Given these new results, I will now recommend every 2-5 year ultrasound screening for anyone who has had a stroke, ministroke, or heart attack."
