Do CBD Gummies Work?
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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
❝I take CBD gummies. I don’t know if they are worth buying. Can you find a study on the effectiveness of gummies❞
If you take them, and you’re not sure whether they’re worth it, then it sounds like you’re not getting any observable benefit from them?
If so, that would seem to answer your question, since presumably the reason that you are taking them is for relaxation and/or pain relief, so if you’re not getting the results you want, then no, they are not worth it.
However! CBD gummies are an incredibly diverse and not-well-studied product, so far, given the relative novelty of their legality. By diverse we mean, they’re not well-standardized.
In other words: the CBD gummies you get could be completely unlike CBD gummies from a different source.
CBD itself (i.e. in forms other than just gummies, and mostly as oil) has been studied somewhat better, and we did a main feature on it here:
And while we’re at it:
Cannabis Myths vs Reality ← This one is about cannabis products in general, and includes discussion of THC content and effects, which might not be so relevant to you, but may to some readers.
Companies selling CBD and CBD gummies may make bold claims that are not yet backed by science, so if you are buying them for those reasons, you might want to be aware:
Selling cannabidiol products in Canada: a framing analysis of advertising claims by online retailers
One thing that we would add is that even though CBD is generally recognized as safe, it is possible to overdose on CBD gummies, so do watch your limits:
A Case of Toxicity from Cannabidiol Gummy Ingestion
Take care!
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Retrain Your Brain – by Dr. Seth Gillihan
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15-Minute Arabic”, “Sharpen Your Chess Tactics in 24 Hours”, “Change Your Life in 7 Days”, “Cognitive Behavioral Therapy in 7 weeks”—all real books from this reviewer’s shelves.
The thing with books with these sorts of time periods in the titles is that the time period in the title often bears little relation to how long it takes to get through the book. So what’s the case here?
You’ll probably get through it in more like 7 days, but the pacing is more important than the pace. By that we mean:
Dr. Gillihan starts by assuming the reader is at best “in a rut”, and needs to first pick a direction to head in (the first “week”) and then start getting one’s life on track (the second “week”).
He then gives us, one by one, an array of tools and power-ups to do increasingly better. These tools aren’t just CBT, though of course that features prominently. There’s also mindfulness exercises, and holistic / somatic therapy too, for a real “bringing it all together” feel.
And that’s where this book excels—at no point is the reader left adrift with potential stumbling-blocks left unexamined. It’s a “whole course”.
Bottom line: whether it takes you 7 hours or 7 months, “Cognitive Behavioral Therapy in 7 Weeks” is a CBT-and-more course for people who like courses to work through. It’ll get you where you’re going… Wherever you want that to be for you!
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What I Wish People Knew About Dementia – by Dr. Wendy Mitchell
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We hear a lot from doctors who work with dementia patients; sometimes we hear from carers too. In this case, the author spent 20 years working for the NHS, before being diagnosed with young-onset dementia, at the age of 58. Like many health industry workers who got a life-changing diagnosis, she quickly found it wasn’t fun being on the other side of things, and vowed to spend her time researching, and raising awareness about, dementia.
Many people assume that once a person has dementia, they’re basically “gone before they’re gone”, which can rapidly become a self-fulfilling prophecy as that person finds themself isolated and—though this word isn’t usually used—objectified. Talked over, viewed (and treated) more as a problem than a person. Cared for hopefully, but again, often more as a patient than a person. If doctors struggle to find the time for the human side of things with most patients most of the time, this is only accentuated when someone needs more time and patience than average.
Instead, Dr. Mitchell—an honorary doctorate, by the way, awarded for her research—writes about what it’s actually like to be a human with dementia. Everything from her senses, how she eats, the experience of eating in care homes, the process of boiling an egg… To relationships, how care changes them, to the challenges of living alone. And communication, confusion, criticism, the language used by professionals, or how things are misrepresented in popular media. She also talks about the shifting sense of self, and brings it all together with gritty optimism.
The style is deeply personal, yet lucid and clear. While dementia is most strongly associated with memory loss and communication problems, this hasn’t affected her ability to write well (7 years into her diagnosis, in case you were wondering).
Bottom line: if you’d like to read a first-person view of dementia, then this is an excellent opportunity to understand it from the view of, as the subtitle goes, someone who knows.
Click here to check out What I Wish People Knew About Dementia, and then know those things!
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The Sun Exposure Dilemma
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The Sun Exposure Dilemma
Yesterday, we asked you about your policy on sun exposure, and got the above-pictured, below-described, set of answers:
- A little over a third of respondents chose “I recognize the risks, but I think the benefits outweigh them”
- A quarter of respondentschose “I am a creature of the shadows and I avoid the sun at all costs♀️”
- A little over a fifth of respondents chose “I recognize the benefits, but I think the risks outweigh them”
- A little under a fifth of respondents chose “I’m a sun-lover! Give me that vitamin D and other benefits!”
All in all, this is perhaps the most even spread of answers we’ve had for Friday mythbuster polls—though the sample size was smaller than it often is.
Of those who added comments, common themes were to mention your local climate, and the importance of sunscreen and/or taking vitamin D supplements.
One subscriber mentioned having lupus and living in Florida, which is a particularly unfortunate combination:
Lupus Foundation | Lupus & UV exposure: What you need to know
Another subscriber wrote:
❝Use a very good sunscreen with a high SPF all the time. Reapply after swimming or as needed! I also wear polarized sunglasses anytime I’m outside.❞
…which are important things to note too, and a lot of people forget!
See also: Who Screens The Sunscreens? (on fearing chemical dangers, vs the protection given)
But, onto today’s science for the topic at hand…
We need to get plenty of sun to get plenty of vitamin D: True or False?
True or False, depending on so many factors—to the point that many people get it wildly wrong in either direction.
Whether we are getting enough vitamin D depends on many circumstances, including:
- The climate (and depending on latitude, time of year) where we live
- Our genes, and especially (but not only) our skintone
- The clothes we wear (or don’t)
- Our diet (and not just “how much vitamin D do we consume”)
- Chronic diseases that affect vitamin D metabolism and/or requirements and/or sensitivity to the sun
For a rundown on these factors and more, check out:
Should I be getting my vitamin D levels checked?
Notably, on the topic of whether you should stay in the sun for longer to get more vitamin D…
❝The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed (which could be just a few minutes, in a sunny climate) is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.❞
In contrast, she does also note:
❝During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D.❞
See also: Vitamin D & Calcium: Too Much Of A Good Thing?
We can skip the sun and get our vitamin D from diet/supplements: True or False?
True! However, vitamin D is not the only health benefit of sun exposure.
Not only is sunlight-induced serotonin production important for many things ranging from mood to circadian rhythm (which in turn affects many other aspects of health), but also…
While too much sun can cause skin cancer, too little sun could cause other kinds of cancer:
Benefits of Sunlight: A Bright Spot for Human Health
Additionally, according to new research, the circadian rhythm benefits we mentioned above may also have an impact on type 2 diabetes:
Can catching some rays help you fight off type 2 diabetes?
Which way to jump?
A lot of it depends on who you are, ranging from the factors we mentioned earlier, to even such things as “having many moles” or “having blonde hair”.
This latter item, blonde hair, is a dual thing: it’s a matter of genetic factors that align with being prone to being more sensitive to the sun, as well as being a lesser physical barrier to the sun’s rays than dark hair (that can block some UV rays).
So for example, if two people have comparably gray hair now, but one of them used to have dark hair and the other blonde, there will still be a difference in how they suffer damage, or don’t—and yes, even if their skin is visually of the same approximate skintone.
You probably already know for yourself whether you are more likely to burn or tan in the sun, and the former group are less resistant to the sun’s damage… But the latter group are more likely to spend longer in the sun, and accumulate more damage that way.
If you’d like a very comprehensive downloadable, here are the guidelines issued by the UK’s National Institute for Health and Care Excellence:
NICE Guidelines | Sunlight exposure: risks and benefits
…and skip to “At risk groups”, if you don’t want to read the whole thing; “Skin type” is also an important subsection.
Writer’s note: genetics are complicated and not everyone will fall neatly into categories, which is why it’s important to know the individual factors.
For example, I am light-skinned with slightly greying dark hair and blue-grey eyes, and/but also have an obscure Sámi gene that means my fair skin makes vitamin D easily, while simultaneously being unusually resistant to burning (I just tan).
And yet! My hobbies include not getting skin cancer, so I tend to still be quite mindful of UV levels in different weathers and times of day, and make choices (schedule, clothing, sunscreen or not) accordingly.
Bottom line:
That big self-perpetuating nuclear explosion in the sky is responsible for many things, good and bad for our health, so be aware of your own risk factors, especially for vitamin D deficiency, and skin cancer.
- If you have a predisposition to both, that’s unfortunate, but diet and supplementation at least can help with the vitamin D while getting modest amounts of sun at most.
- Remember that you can only make so much vitamin D at once, so sunbathing for health benefits need only take a few minutes
- Remember that sunlight is important for our circadian rhythm, which is important for many things.
- That’s governed by specific photoreceptor cells, though, so we don’t need our skin to be exposed for that; we just need to be able to see sunlight.
- If you’re going to be out in the sun, and not covered up, sunscreen is your friend, and yes, that goes for clear cold days under the winter sun too.
- Most phone weather apps these days have a UV index score as part of the data they give. Get used to checking it as often as you’d check for rain.
Stay safe, both ways around!
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In Plain English…
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It’s Q&A Time!
This is the bit whereby each week, we respond to subscriber questions/requests/etc
Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!
Q: Love to have someone research all the additives in our medicines, (risk of birth control and breast cancer) and what goes in all of our food and beverages. So much info out there, but there are so many variations, you never know who to believe.
That’s a great idea! There are a lot of medicines and food and beverages out there, so that’s quite a broad brief, but! We could well do a breakdown of very common additives, and demystify them, sorting them into good/bad/neutral, e.g:
- Ascorbic acid—Good! This is Vitamin C
- Acetic acid—Neutral! This is vinegar
- Acetylsalicylic acid—Good or Bad! This is aspirin (a painkiller and blood-thinning agent, can be good for you or can cause more problems than it solves, depending on your personal medical situation. If in doubt, check with your doctor)
- Acesulfame K—Generally Neutral! This is a sweetener that the body can’t metabolize, so it’s also not a source of potassium (despite containing potassium) and will generally do nothing. Unless you have an allergy to it, which is rare but is a thing.
- Sucralose—Neutral! This is technically a sugar (as is anything ending in -ose), but the body can’t metabolize it and processes it as a dietary fiber instead. We’d list it as good for that reason, but honestly, we doubt you’re eating enough sucralose to make a noticeable difference to your daily fiber intake.
- Sucrose—Bad! This is just plain sugar
Sometimes words that sound the same can ring alarm bells when they need not, for example there’s a big difference between:
- Potassium iodide (a good source of potassium and iodine)
- Potassium cyanide (the famous poison; 300mg will kill you; half that dose will probably kill you)
- Cyanocobalamine (Vitamin B12)
Let us know if there are particular additives (or particular medications) you’d like us to look at!
While for legal reasons we cannot give medical advice, talking about common contraindications (e.g., it’s generally advised to not take this with that, as one will stop the other from working, etc) is definitely something we could do.
For example! St. John’s Wort, very popular as a herbal mood-brightener, is on the list of contraindications for so many medications, including:
- Antidepressants
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Some heart medications, including digoxin and ivabradine
- Some HIV drugs, including indinavir and nevirapine
- Some cancer medications, including irinotecan and imatinib
- Warfarin, an anticoagulant (blood thinner)
- Certain statins, including simvastatin
Q: As I am a retired nurse, I am always interested in new medical technology and new ways of diagnosing. I have recently heard of using the eyes to diagnose Alzheimer’s. When I did some research I didn’t find too much. I am thinking the information may be too new or I wasn’t on the right sites.
(this is in response to last week’s piece on lutein, eyes, and brain health)
We’d readily bet that the diagnostic criteria has to do with recording low levels of lutein in the eye (discernible by a visual examination of macular pigment optical density), and relying on the correlation between this and incidence of Alzheimer’s, but we’ve not seen it as a hard diagnostic tool as yet either—we’ll do some digging and let you know what we find! In the meantime, we note that the Journal of Alzheimer’s Disease (which may be of interest to you, if you’re not already subscribed) is onto this:
See also:
- Journal of Alzheimer’s Disease (mixture of free and paid content)
- Journal of Alzheimer’s Disease Reports (open access—all content is free)
Q: As to specific health topics, I would love to see someone address all these Instagram ads targeted to women that claim “You only need to ‘balance your hormones’ to lose weight, get ripped, etc.” What does this mean? Which hormones are they all talking about? They all seem to be selling a workout program and/or supplements or something similar, as they are ads, after all. Is there any science behind this stuff or is it mostly hot air, as I suspect?
Thank you for asking this, as your question prompted yesterday’s main feature, What Does “Balancing Your Hormones” Even Mean?
That’s a great suggestion also about addressing ads (and goes for health-related things in general, not just hormonal stuff) and examining their claims, what they mean, how they work (if they work!), and what’s “technically true but may
be misleading* cause confusion”*We don’t want companies to sue us, of course.
Only, we’re going to need your help for this one, subscribers!
See, here at 10almonds we practice what we preach. We limit screen time, we focus on our work when working, and simply put, we don’t see as many ads as our thousands of subscribers do. Also, ads tend to be targeted to the individual, and often vary from country to country, so chances are good that we’re not seeing the same ads that you’re seeing.
So, how about we pull together as a bit of a 10almonds community project?
- Step 1: add our email address to your contacts list, if you haven’t already
- Step 2: When you see an ad you’re curious about, select “share” (there is usually an option to share ads, but if not, feel free to screenshot or such)
- Step 3: Send the ad to us by email
We’ll do the rest! Whenever we have enough ads to review, we’ll do a special on the topic.
We will categorically not be able to do this without you, so please do join in—Many thanks in advance!
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Total Recovery – by Dr. Gary Kaplan
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First, know: Dr. Kaplan is an osteopath, and as such, will be mostly approaching things from that angle. That said, he is also board certified in other things too, including family medicine, so he’s by no means a “one-trick pony”, nor are there “when your only tool is a hammer, everything starts to look like a nail” problems to be found here. Instead, the scope of the book is quite broad.
Dr. Kaplan talks us through the diagnostic process that a doctor goes through when presented with a patient, what questions need to be asked and answered—and by this we mean the deeper technical questions, e.g. “what do these symptoms have in common”, and “what mechanism was at work when the pain become chronic”, not the very basic questions asked in the initial debriefing with the patient.
He also asks such questions (and questions like these get chapters devoted to them) as “what if physical traumas build up”, and “what if physical and emotional pain influence each other”, and then examines how to interrupt the vicious cycles that lead to deterioration of one’s condition.
The style of the book is very pop-science and often narrative in its presentation, giving lots of anecdotes to illustrate the principles. It’s a “sit down and read it cover-to-cover” book—or a chapter a day, whatever your preferred pace; the point is, it’s not a “dip directly to the part that answers your immediate question” book; it’s not a textbook or manual.
Bottom line: a lot of this work is about prompting the reader to ask the right questions to get to where we need to be, but there are many illustrative possible conclusions and practical advices to be found and given too, making this a useful read if you and/or a loved one suffers from chronic pain.
Click here to check out Total Recovery, and solve your own mysteries!
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Citicoline: Better Than Dietary Choline?
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Citicoline: Better Than Dietary Choline?
Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?
Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.
As for citicoline specifically… it appears to do the job better than dietary sources of choline:
❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.
It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).
Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞
Source: Citicoline: A Superior Form of Choline?
Great! What does it do?
What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.
Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.
One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.
Long version: Citicoline: pharmacological and clinical review, 2022 update
(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)
Spotlight study in memory
For a quick-reading example of how it helps memory specifically:
Keeping dementia at bay
For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.
Dr. Maria Bonvicini et al. looked into this:
❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia
All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞
The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).
Another team looked at 47 pre-existing reviews, and concluded:
❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.
Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.
Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞
Source: Application of Citicoline in Neurological Disorders: A Systematic Review
The dopamine bonus
Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:
❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.
Citicoline allowed effective reduction of levodopa by up to 50%.
Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞
Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review
Where to get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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