Fact or Cap? TikTok Health Trends with Dr. Raj Sindwani

Podcast Transcript

Speaker 1:

There's so much health advice out there. Lots of different voices and opinions, but who can you trust? Trust the experts, the world's brightest medical minds, our very own Cleveland Clinic experts. We ask them tough intimate health questions, so you get the answers you need. This is the Health Essentials Podcast brought to you by Cleveland Clinic and Cleveland Clinic Children's. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.

Kate Kaput:

Hi, and thank you for joining us for this episode of the Health Essentials Podcast. My name is Kate Kaput, and I'll be your host. Today we're talking to Ear, Nose and Throat Specialist, Dr. Raj Sindwani about health related tips, tricks and trends on TikTok. TikTok is great for plenty of things, including going down the rabbit hole of choreography, cooking and cats. But what about health advice? Every week it seems like a new viral health trend makes waves on the social media app, with content creators sharing so-called hacks to cure what ails you. Dr. Sindwani is here to weigh in on some of the most popular and in some cases, most dangerous TikTok trends, debunking some of the bad ones and giving you the green light to try a few of the safe ones. Dr. Sindwani, thank you so much for being here with us today.

Dr. Raj Sindwani:

Thanks for having me, Kate.

Kate Kaput:

I'd like to start by asking you to tell us about your work here at Cleveland Clinic. What kind of work do you do and what kind of patients do you typically see?

Dr. Raj Sindwani:

Sure. So I'm in the Head and Neck Institute of the Cleveland Clinic in the Section of Rhinology and Skull-Based Surgery. So I have a pretty varied practice. I see people with tumors in their nose, and I see people with a host of nasal complaints, ranging from difficulty breathing through your nose, to polyps, to drainage from your nose. So I span the gamut, anything related to the nose, basically.

Kate Kaput:

OK. So because you specialize in ear, nose and throat conditions, we're going to focus today on TikTok health tips related to those areas. But we're also going to tap into some of your general medical knowledge too, to discuss a few topics that go beyond your area of specialty.

First, though, let's talk about how to responsibly consume content on TikTok, especially when it comes to health and wellness tips. There's a lot of information out there. So how can people separate truth from fiction, or as they say on TikTok fact and cap?

Dr. Raj Sindwani:

Yeah. And I think therein lies the question, right, Kate? It's hard. If you don't have a medical background, it's hard to know what source you're relying on here. So in the end, if there ever is a question or if something doesn't pass the smell test, so to speak, doesn't seem right to you, you should really check with your doctor.

Kate Kaput:

Smell test and ear, nose and throat doctor joke there. I like that.

Dr. Raj Sindwani:

A little bit.

Kate Kaput:

All right. So let's go through a few TikTok tips in particular, starting with your ears. There are a ton of TikTok videos out there about how to clean your ears out on your own. Some TikTokers say pouring hydrogen peroxide into your ear canal can help resolve ear wax build up. So fact or cap? Is that safe?

Dr. Raj Sindwani:

Well, it's kind of fact and kind of cap. So I'd back up a little bit and say, your ears make wax for a reason. That wax helps to control the pH of the ear canal. It helps collect debris and so on. So it's there for a reason. So your ears are supposed to have the wax. Now it can become problematic when it doesn't auto clean, like your oven. Our ears also auto clean. But if it gets stuck, it can block things and be uncomfortable or even muffle your hearing.

So if you use a little bit of hydrogen peroxide or even baking soda in an ounce or to water, you can dribble a little bit of that in your ear canal to soften the wax. There are products also available over the counter that are meant to do exactly that, soften the wax. It won't necessarily remove the wax though. So usually some of these things, if they don't work with a few drops are followed by some irrigation or then a trip to your family doctor or an ear, nose and throat doctor.

Kate Kaput:

OK. So another big trend is ear candling. Can you explain to us what this is and whether it's safe? I'm going to guess based on your last answer, that the answer is no, that you should see a doctor. But I would love for you to tell us more about ear candling and what it is.

Dr. Raj Sindwani:

Absolutely. And you're right. The answer is no to the ear candling. There's been a lot of debate about this, but essentially what ear candling does is there's a hollow candle that people will place into the opening to your ear canal. The wax is caught before it drips onto your ear or into your ear canal. And the idea here, which has not been proven, is that by lighting the candle, there's some negative pressure or a little vacuum that's created that encourages the wax to come up and out of your ear and thereby cleaning your ear.

Again, this has not been proven and it actually can be very dangerous. There are reports of people having perforations or holes in their eardrum, the wax can catch your hair on fire. You can get burned. You can have wax that actually dribbles into the ear and causes more blockage. So I think this one is definitely cap.

Kate Kaput:

OK. All of that sounds terrible. Unproven and unsafe. So just say no to ear candling. You alluded to this to start, but do you really even need to clean out your ears on your own? Ear wax falls out on its own for the most part, correct? And if you are going to clean out your ears or try to loosen things up, like you said, what is the safest way to do that?

Dr. Raj Sindwani:

You're exactly right. You do not need to clean your ears. They clean themselves. And usually it's when we're sleeping, that that ear canal will push the wax out. It'll migrate to the edge and it'll probably fall off on your pillow or something like that.

Now, if it becomes a problem, meaning you can't hear or your ear is sore or something like that. And you're sure it's wax, because of course a lot of things could cause those types of ear symptoms, then an idea to soften the wax could be to put in a few drops of mineral oil or vegetable oil, or even a few drops of 3% hydrogen peroxide.

Kate Kaput:

All right. So speaking of ears and moving onto noses, there are plenty of TikTok videos of doctors removing foreign bodies from people's orifices, including one video of an ENT removing a live cockroach from someone's ear canal. And another story that has gone viral, in which a woman found a bead that had been stuck inside her nose for more than 20 years. So can you talk to us about the importance of having a doctor perform these extractions instead of trying to remove things like this yourself?

Dr. Raj Sindwani:

Yeah, absolutely. It should be intuitive, but if you think something is actually stuck in your ear canal, let alone a live thing in your ear canal. I think you're going to want someone to do that who can see in there. And if you were to see an ENT or you came to see me, we would actually use a microscope to magnify and see what exactly is going on deep in the ear canal, and then gently and safely remove whatever that object is.

Kate Kaput:

And I would imagine that in trying to do it yourself, you can actually probably cause more harm. Is that correct?

Dr. Raj Sindwani:

Absolutely. The ear canal is very tender and pain sensitive, number one. So it will be unpleasant and even hurt. You could get bleeding from the ear and deep in the ear canal is an eardrum, which helps us hear. So because you don't know how deep you're pushing whatever instrument you're going to use to try to remove the foreign object, you can actually poke through and cause a hole in your eardrum.

Kate Kaput:

Ooh, that one makes me feel shivery. So don't take things out of your ears and nose on your own. Definitely see a doctor. OK. So onto an extraction that might not even be necessary. We've seen some TikTokers dip Q-tips® into hot wax and then stick them up their nostril to remove nasal hairs. So fact or cap? Is this safe? Is this something that works? Is this something that people should be doing in the first place?

Dr. Raj Sindwani:

Yeah. Cap on this one too, Kate. At the end of the day, all of these structures, whether it's wax or in this case now nose hairs, serve a purpose. The hairs in our nose are meant to capture debris from going into our nose and then eventually potentially into our lungs. Now, if your nose hairs are a little bit long or unsightly and you want to trim them, I think that's a little bit of a different ball of wax, so to speak. And clippers should be used. Putting anything hot or sharp in the nose, really should be avoided.

Kate Kaput:

I love your ENT puns. Sounds good. Trim, don't remove entirely and definitely not with hot wax. Got it.

Dr. Raj Sindwani:

Definitely not. Exactly.

Kate Kaput:

Something else that TikTokers are sticking up their nose is raw garlic, which they say can help with congestion. We've seen this story go viral. In the videos, we see that when someone pulls a clove of the garlic out of their nostril, the snot comes pouring out, which they say shows that it works. So what's really happening here? Fact or cap on this one?

Dr. Raj Sindwani:

A good question, Kate. And I've seen those videos too. And to be honest, when I first saw them pull the garlic back out after leaving it in place for five to 10 minutes, it is pretty impressive, all the mucus or snot that comes out. But really what's going on is, they're not actually cleaning their sinuses at all. What they've done is introduced the garlic into the front part of their nose, which can be an irritant to the nose, causing your nose to make more mucus. So the mucus that runs out I think is just because the garlic is causing your nose to become irritated and inflamed, and that's new mucus that you've made that then comes out. It actually hasn't done anything to the original mucus, which might still be trapped in your sinuses.

Kate Kaput:

So in doing this one, you've actually doubled your problem. You had mucus and then you put the garlic up your nose and now you have extra mucus and you haven't solved the original problem?

Dr. Raj Sindwani:

Well, that's also best case scenario, because the main takeaway here is not only does it not help, but it could hurt. Garlic can be an irritant and cause inflammation. You can get dermatitis from the oils in the garlic clove and worst case, you might even get something stuck or a piece of garlic dislodge in your nose in which case you might need an ENT doctor, for example, to go in afterwards and chase it. It could cause infection. It can cause trauma and you might even get a bad nose bleed.

Kate Kaput:

OK. So we're back where we started a couple questions ago about not putting things up your nose and in your ears to begin with, because then you might need to see a doctor. So speaking of congestion, some doctors on TikTok have pointed out that many of us are using nasal spray incorrectly. That instead of angling the spray right up the nose, it should actually be angled sort of toward our ear, so that the spray can enter the nasal cavity and move through the sinuses. Can you weigh in on this and tell us how should we actually be using nasal spray? How does it work?

Dr. Raj Sindwani:

Yeah. That actually is a good one. And that is fact, that when you use any sort of nasal spray, you're trying to get medicine or saline or whatever's in the spray bottle, into the nose and the sinuses. And there's a couple of reasons why you would orient the spray bottle outwards like this into the nostril, but then out towards your ear on either side. One is you might be directing it, and you are, a little bit towards the sinus openings, rather than to your breathing passages of your nose, which are towards the middle.

But the other thing that you're doing is orienting the tip of the nozzle of the spray bottle away from the septum. The septum is this middle partition and it has tons of blood vessels in it. So when you hear of people getting nose bleeds, after a certain spray. Often patients will come in and say, "Oh, I can't use that spray. Whatever's in it, causes nosebleeds." It's probably not what's in the bottle. It's what you're doing with the bottle. And the fact that you're traumatizing the front middle part of the nose called the septum.

Kate Kaput:

Oh, that's so interesting. I hadn't even heard that part. So, I've heard some doctors on TikTok say, and I think this is a helpful way to remember it, "If you taste it, you waste it." Basically that if you are angling the nasal spray into your nose in such a way that it's going to end up now in your throat, you're not doing it right. Does that sound right?

Dr. Raj Sindwani:

That may be partly true. It is true that it'll take longer potentially for you to get that taste from your nose. But at the end of the day, whatever you put into the nose, there's a whole mechanism and physiology at play there, that will push that spray or whatever is in the bottle all the way to the back and eventually it'll be swallowed into your stomach. So you may still taste it. And it doesn't mean that it's not working. But I still think you need to adhere to that important premise of pointing it outwardly towards the ear.

Kate Kaput:

OK. Very helpful. So a TikTok tip that doesn't involve sticking anything up your nose. One user suggests freezing liquid vapor rub, the kind that you can buy at the drug store, in ice cube trays, and then putting one of those frozen cubes into a hot shower. The thinking there is that the steam from the water activates the vapor rub and that the menthol will help with your congestion. Fact or cap? Is this a safe way to use vapor rub? Can it help?

Dr. Raj Sindwani:

I tried to do some research on this and I didn't find a lot of fact to support it, but this one is a common sense one, where to me, I don't have a problem with someone doing that. You're not putting it in your body, like you said. You're not ramming it in places it shouldn't be. And it seems like a reasonable thing to try. So that might be one where it may not help, but I don't think it would hurt you.

Kate Kaput:

OK. So a creative way to make your own sauna of sorts when you're not feeling well. Makes sense. Another tip people have shared is that gelatin can soothe a sore throat, suggesting that you eat marshmallows or Jell-O™ to get rid of throat pain. Fact or cap?

Dr. Raj Sindwani:

I think it depends, as is the answer to many of these questions that you're asking me. There might be a bit of truth to it. It totally depends. If you have an infection in your throat, probably that's not going to help. But if you had a sore throat for a variety of different reasons, it'll be more comfortable swallowing certainly, anything that's soft. So I like the idea of trying it, but don't overlook something that might be more serious than just something like a nominal sore throat.

Kate Kaput:

Good doctor advice. And then I would imagine that gelatin isn't necessarily more helpful than a Popsicle® or soup or something like that. It's like you're saying, just that it's soft and not going to hurt your throat.

Dr. Raj Sindwani:

That's right. And in fact, cold might actually help people think, not numb the throat, but it might make it a little bit more comfortable and hurt less also. That's why after surgery on the throat, you have heard when kids get their tonsils out, we give them a carte blanche on as many popsicles as they want.

Kate Kaput:

Right, the only time that you're allowed to have as many Popsicles as you want as a kid.

Dr. Raj Sindwani:

That's right.

Kate Kaput:

So there's an acupressure rumor out there too, that says that rubbing the sides of your thumb just below the nail can also help relieve the pain of a sore throat. Fact or cap?

Dr. Raj Sindwani:

I'm going to go cap on that one. There's not been a lot of scientific studies that have really translated the techniques of acupuncture into some notable and reliable improvements in some of what we're talking about here. Same thing, I would say for this one, it's not going to hurt you, I just don't think it's going to help you.

Kate Kaput:

My guess is that the answer on this next one might then be the same, but we'll try it anyway. So if you don't have a sore throat, but just a little bit of a tickle in your throat, some TikTokers say that you can scratch your ear and it will get rid of the tickle in your throat. Doctors on TikTok have said that this one might be true, but what do you say? Fact or cap?

Dr. Raj Sindwani:

Yeah. Again, not going to hurt, so if you want to try it, go ahead. My guess is you're probably just distracting yourself by pinching your ears so that you're thinking now about your ear and not about your throat. I'd probably go back to the marshmallow on that one or have a Popsicle.

Kate Kaput:

There you go. Good excuse for a Popsicle or a marshmallow. All right. So let's talk about COVID for a minute. On TikTok, rumor has it that burning an orange peel might help bring back your lost sense of taste or smell. Fact or cap? Is there anything to this one?

Dr. Raj Sindwani:

Yeah, there's something to it, but overall it falls in the cap category. OK. Because just smelling burnt orange or burnt anything is not going to really bring back your sense of smell. When you're talking about COVID and smell or really any viral related smell loss or smell disturbance, in the large majority of people, that smell is going to come back on its own. In fact, in COVID specifically, some studies have suggested that 95% of people will have their smell back by four to six months after the initial infection. But that's still a long time to wait.

So one thing we would recommend is time. If the time doesn't work, sometimes we'll try topical steroids. Fish oils have been suggested, but not proven beyond a shadow of a doubt to help. And then you can try something called smell training. And here's where I think the orange peel idea probably came from. Smell training relies on retraining your brain to smell things over again. And it relies, like primary colors, red, blue, and yellow, to something called the odor prism, where you use primary smells to actually retrain your brain to smell better.

So here you would take four scents: flowery, like rose, fruity, like lemon, aromatic, like lavender or clove, and resonance, like eucalyptus. And you'll one by one, put them under your nose, breathe in deeply for 15 or 20 seconds and using visual imagery, think back to what that rose used to smell like. And studies have actually shown that over time, doing this regularly twice a day, actually can help your smell come back.

Kate Kaput:

That's so interesting. I've never heard that one before. Huh? All right. So another way that people are saying that you can get your sense of taste or smell back, and it sounds like you said, it typically comes back on its own. So maybe you shouldn't mess with it anyway, see how it goes. But some people are saying that you can flick the back of your head, right at the base of your skull almost. That flicking the back of your head will help restore your taste and sense of smell. Fact or cap on that one?

Dr. Raj Sindwani:

Cap, plus it could hurt your head too.

Kate Kaput:

Fair. All right. So maybe a little bit of smell training, waiting it out, et cetera.

Dr. Raj Sindwani:

And seeing a doctor if it doesn't get better on its own.

Kate Kaput:

Got it. All right. One more COVID related question. Let's talk about at home tests. We've seen people on TikTok and throughout social media say you can use the nasal swab from the at home test on the back of your throat, even though the instructions say just to do it in your nose. What can you tell us about that?

Dr. Raj Sindwani:

Well, I think this probably came from the fact or the idea that the viral load or how much virus there actually is in COVID does harbor itself at the back of the nose. So initially the thought was, if you go through the throat, maybe you're getting to that high concentration of virus. At the end of the day, though, if you have COVID, those tests are sensitive enough that they will pick up the virus by doing the swab, even at the front of the nose, which is what's recommended.

Now in certain situations where you've had some very major surgery through the nose, et cetera, we might recommend that swabs be done through the mouth. But for the large majority of people, you can feel safe and confident that doing the swab at the front of your nose will be just fine to get that result.

Kate Kaput:

OK. So for the most part, stick to the instructions. We've also seen some people doing a little bit of both, right? They do it in their nose and their throat using the same swab. Can you speak to how hygienic that is or isn't?

Dr. Raj Sindwani:

Yeah. It's your own bodily fluids, but it doesn't sound very hygienic and even maybe a little gross to me. So I think at the end of the day, you probably don't need to do that. For the goal that you're trying to achieve, I think just sticking to the anterior or front nasal swab will get you all the way there.

Kate Kaput:

Got it. And finally, here's one challenge that we know is dangerous. So dangerous, in fact, that TikTok has started asking users to flag any videos that promote it. The blackout challenge or the pass out challenge, dares people to choke themselves until they pass out. Talk to us a little bit about the dangers of trying something like this.

Dr. Raj Sindwani:

Yeah. That does sound just flat out dangerous and should be completely avoided, obviously. Again, that's a common sense thing. If you're going to try to get yourself to black out, who knows what could happen. You could have a serious issue by falling and hitting your head. You are depriving your brain of oxygen for the time you're out. It just doesn't sound like a good thing to do. And I think if anyone stopped to really think about it, I think they would appreciate that.

Kate Kaput:

Yeah. That one sounds like an absolute no-go. And I think especially children using social media are so impressionable and so it's really important to get that information out there, like you said, that this one can be really unsafe. So Dr. Sindwani are there any there TikTok trends that are coming to mind for you that we haven't discussed yet? Or anything you've heard from your patients that they saw on social media?

Dr. Raj Sindwani:

No, those are the main things. The candling has been around for a long time. I know a lot of patients really have been circling around that. And then the garlic one is what got my attention recently. There's been a lot of interest in that, but as we talked about, both of those are caps.

Kate Kaput:

So it seems like in pretty much all cases, rely on your doctor's advice and not the advice of random TikTokers.

Dr. Raj Sindwani:

I would second that opinion. Yes.

Kate Kaput:

Sounds good. Dr. Sindwani, thank you so much for being here with us today and for speaking to us on this interesting and important topic. To learn more about Otolaryngology at Cleveland Clinic, please visit Clevelandclinic.org/ent or to make an appointment called 216-444-8500. Thank you for joining us today.

Speaker 1:

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