Drug Metabolism (When You’re Not Average!)
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When Your Medications Run Out… Of You
Everybody knows that alcohol can affect medications’ effects, but what of smoking, and what of obesity? And how does the alcohol thing work anyway?
It’s all about the enzymes
Medicines that are processed by the liver (which is: most medicines) are metabolized there by specialist enzymes, and the things we do can increase or decrease the quantity of those enzymes—and/or how active they are.
Dr. Kata Wolff Pederson and her team of researchers at Aarhus University in Denmark examined the livers of recently deceased donors in ways that can’t (ethically) be done with live patients, and were able to find the associations between various lifestyle factors and different levels of enzymes responsible for drug metabolism.
And it’s not always how you might think!
Some key things they found:
- Smokers have twice as high levels of enzyme CYP1A2 than non-smokers, which results in the faster metabolism of a lot of drugs.
- Drinkers have 30% higher levels of enzyme CYP2E1, which also results in a faster metabolism of a lot of drugs.
- Patients with obesity have 50% lower levels of enzyme CYP3A4, resulting in slower metabolism of many drugs
This gets particularly relevant when we take into account the next fact:
- Of the individuals in the study, 40% died from poisoning from a mixture of drugs (usually: prescription and otherwise)
Read in full: Sex- and Lifestyle-Related Factors are Associated with Altered Hepatic CYP Protein Levels
Read a pop-sci article about it: Your lifestyle can determine how well your medicine will work
How much does the metabolism speed matter?
It can matter a lot! If you’re taking drugs and carefully abiding by the dosage instructions, those instructions were assuming they know your speed of metabolism, and this is based on an average.
- If your metabolism is faster, you can get too much of a drug too quickly, and it can harm you
- If your metabolism is faster, it also means that while yes it’ll start working sooner, it’ll also stop working sooner
- If it’s a painkiller, that’s inconvenient. If it’s a drug that keeps you alive, then well, that’s especially unfortunate.
- If your metabolism is slower, it can mean your body is still processing the previous dose(s) when you take the next one, and you can overdose (and potentially die)
We touched on this previously when we talked about obesity in health care settings, and how people can end up getting worse care:
As for alcohol and drugs? Obviously we do not recommend, but here’s some of the science of it with many examples:
Why it’s a bad idea to mix alcohol with some medications
Take care!
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Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
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Peripheral neuropathy (and what can be done about it)
Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:
- Diabetes
- Alcoholism
- Infection
- Injury
The manifestations can be different:
- In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
- In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
- In the case of infection, a lot depends on the nature of the infection and the body’s response.
- In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
- This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)
This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)
Prevention is better than cure
If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:
- Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
- Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
- Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
- We’ll do a main feature on this soon!
- Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.
- There are many kinds available, so read reviews, but here’s an example product on Amazon
Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:
A standing desk
A vertical ergonomic mouse
An ergonomic split keyboard
A Kindle*
*Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.
If you already have peripheral neuropathy
Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?
Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.
And, all of these are good options; do you see what they have in common?
It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).
By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.
But also don’t forget: rest
- Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
- Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
- Use a brace if necessary to help the affected part stay aligned correctly
- You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.
One more top tip
We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.
So you might want to check that out:
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The Medicinal Chef – by Dale Pinnock
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The philosophy here is very much like our own—to borrow from Hippocrates: “let food be thy medicine”. Obviously please do also let medicine be thy medicine if you need it, but the point is that food is a very good starting place for combatting a lot of disease.
To this end, instead of labelling the recipes with such things as “V”, “Ve”, “GF” and suchlike, it assumes we can tell those things from the ingredients lists, and instead labels things per what they are especially good for:
- S: skin
- J: joints & bones
- R: respiratory system
- I: immune system
- M: metabolic health
- N: nervous system and mental health
- H: heart and circulation
- D: digestive system
- U: reproductive & urinary systems
As for the recipes themselves… They’re a lot like the recipes we share here at 10almonds in their healthiness, skill level, and balance of easy-to-find ingredients with the occasional “order it online” items that punch above their weight. In fact, we’ll probably modify some of the recipes for sharing here.
Bottom line: if you’re looking for genuinely healthy recipes that are neither too basic nor too arcane, this book has about 80 of them.
Click here to check out The Medicinal Chef: Healthy Every Day, and be healthy every day!
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Avocado vs Blueberries – Which is Healthier?
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Our Verdict
When comparing avocado to blueberries, we picked the avocado.
Why?
These two fruits aren’t as similar as some of the comparisons we’ve made—we often go for “can be used in the same way culinarily” comparisons. But! They are both popularly in the “superfood” category, so it’s interesting to consider:
In terms of macros, avocado has more protein, (healthy!) fat, and fiber, while blueberries have more carbs. An easy win for avocado here, unless you’re on a calorie-controlled diet perhaps, since avocado is also higher in those. About that fat; it’s mostly monounsaturated, with some polyunsaturated and saturated, and is famously a good source of omega-3 in the form of ALA.
In the category of vitamins, avocado has more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, E, K, and choline, while blueberries are not higher in any vitamins. So, not a tricky decision here.
When it comes to minerals, avocado has more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while blueberries are higher in manganese. Another win for avocados.
There is one other category that’s important to consider in this case, and that’s polyphenols. We’d be here all day if we listed them all, but in total, blueberries have about 1193x the polyphenol content that avocados do. Blueberries got the reputation for antioxidant properties for a reason; it is well-deserved!
So, out of the two, we declare avocado the overall more nutritious of the two, but blueberries absolutely deserve the acclaim they get also.
Want to learn more?
You might like to read:
Give Us This Day Our Daily Dozen
Take care!
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Growing Young – by Marta Zaraska
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This one will be a slightly mixed review, but we think the book has more than enough of value to make it a very worthwhile read.
The premise of the book is that, as the subtitle suggests, positive social qualities increase personal longevity.
Author (and science journalist) Marta Zaraska looks at a lot of research to back this up, and also did a lot of travelling and digging into stories. This is of great value, because she notes where a lot of misconceptions have arisen.
To give one example, it’s commonly noted that marriage (or as-though-marriage life partnerships) is generally* associated with longer life.
*Statistics suggest that marriage-related longevity is enjoyed by men married to women, and people in same-sex marriages regardless of gender, but is not so much the case for women married to men.
However! Zaraska notes a factor she learned from Gottman’s research (yes, that Gottman), that what matters is not the official status of a relationship, so much as the sense of secure lifelong commitment to it.
These kinds of observations (throughout the book) add an extra layer beyond “common wisdom”, and allow us to better understand what’s really going on. The book’s main weaknesses, meanwhile, are twofold:
- The author is (in this reviewer’s opinion) unduly dismissive of physical health lifestyle factors such as diet and exercise, because they “only” account for a similar bonus to healthy longevity.
- Like many, she does not always consider where correlation might not mean causation. For example, she cites that volunteering free time increases healthspan by 22%, but neglects to note that perhaps it is having the kind of socioeconomic situation that allows one free time to volunteer, that gives the benefit.
Bottom line: the book has its flaws, but we think that only serves to make it more engaging. After all, reading should not be a purely passive activity! Zaraska’s well-studied insights give plenty of pointers for tweaking the social side of anyone’s quest for healthy longevity.
Click here to check out Growing Young, increase your healthspan, and take joy in doing it!
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Lyme Disease At-A-Glance
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Good info as always…was wondering if you have any recommendations for fighting Lyme disease naturally along wDr advice? Dr’s aren’t real keen on alternatives so always interested. Thanks❞
That depends on whether we’re looking at prevention or cure!
Prevention:
- Try not to get bitten by Lyme-disease-carrying ticks. Boots and long socks are your friends. As are long-gauntletted gloves for gardening.
- If you are in a high-risk area and/or engage in high-risk activities, check your body daily.
- This is because it usually takes 36–48 hours of being attached for a tick to cause an infection
- Obviously best if you can get a partner or close friend to help you with this, unless you have mastered some advanced pretzel positions of yoga.
- Contrary to many folk remedies, the safest way to remove a tick is with tweezers (carefully!).
- If you find and remove a tick, or otherwise suspect you have developed symptoms, go to your doctor immediately (not next week; today; time really counts for this).
Cure:
- No. Sorry. Regretfully, antibiotics are the only known effective treatment.
However! As with almost any kind of recovery, getting good rest, including good quality sleep, will hasten things. Also sensible is reducing stress if possible, and anything that could worsen inflammation.
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Coconut Milk vs Soy Milk – Which is Healthier?
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Our Verdict
When comparing coconut milk to soy milk, we picked the soy.
Why?
First, because there are many kinds of both, let’s be clear which ones we’re comparing. For both, we picked the healthiest options commonly available, which were:
- Soy milk, unsweetened, fortified
- Coconut milk, raw (liquid expressed from grated meat and water)
Macronutrients are our first consideration; coconut milk has about 3x the carbs and about 14x the fat. Now, the fats are famously healthy medium-chain triglycerides (MCTs), but still, one cup of coconut milk contains about 2.5x the recommended daily amount of saturated fat, so it’s wise to go easy on that. Coconut milk also has about 4x the fiber, but still, because the saturated fat difference, we’re calling this one a win for soy milk.
In the category of vitamins, the fortified soy milk wins. In case you’re curious: milk in general (animal or plant) is generally fortified with vitamin D (in N. America, anyway; other places may vary), and vitamin B12. In this case, the soy milk has those, plus some natural vitamins, meaning it has more of vitamins A, B1, B2, B6, and D, while coconut milk has more of vitamins B3, B5, and C. A fair win for soy milk.
When it comes to minerals, the only fortification for the soy milk is calcium, of which it has more than 7x what coconut milk has. The coconut milk, however, has more copper, iron, magnesium, phosphorus, and potassium. An easy win for coconut milk.
Adding up the sections gives us a win for soy milk—but if consumed in moderation as part of a diet otherwise low in saturated fat, a case could be made for the coconut.
The real take-away here today is not this specific head-to-head but rather: milks (animal or plant) vary a lot, have a lot of different fortifications and/or additives, and yes that goes even for brands (cow milk brands do this a lot) who don’t advertise their additives because their branding is going for a “natural” look. So, read labels, and make informed decisions about which additives you do or don’t want.
Enjoy!
Want to learn more?
You might like to read:
Take care!
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