Burned Out By Tuesday?

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Avoiding Burnout, The Active Way

This is Dr. Claudine Holt. She’s double board-certified, in Occupational & Environmental Medicine, and Lifestyle Medicine.

In short: preventative medicine in all parts of our life.

Hopefully, you are reading this bright-eyed and bushy-tailed and ready to take on another exciting day in this wonderful, beautiful world!

On the other hand, it’s possible that you’re reading this semi-focussed, looking for a crumb of dopamine as much as you are looking for information.

If you’ve ever had the “What a week!” / “It’s only Tuesday” moment, this one’s for you.

What does Dr. Holt want us to know?

You can recover from burnout without guilt

Sometimes, we overreach ourselves. Sometimes, life overreaches us! Sometimes it’s not that we overcommitted—it’s just that we were taking each day as it comes, but sometimes several days gang up on us at once.

Sometimes, even, we can feel exhausted when it seems like we haven’t done anything.

Note: if you feel exhausted and it seems like you haven’t done anything, then be aware: you are exhausted for a reason!

What that reason might be may vary, but contrary to popular belief, energy does not just vanish. It went somewhere.

This goes double if you have any chronic illness(es), even if you’re not aware of having had a flare-up, chances are you were just exceptionally busy (on a cellular level).

And it’s easy to think that “mere” cellular activity shouldn’t be exhausting, but that is 100% of where our energy transactions happen—whether or not we are consciously aware of them!

See also: Eat To Beat Chronic Fatigue ← yes, this also covers when you are too exhausted to shop and cook like a TV chef

Dr. Holt specializes in working with burned out medical professionals (and also specifically specializes in working with women), but there are lessons for everyone in her advice. For example:

Fiction: ”Medicine is my calling–it’s who I am.”

Fact: You are more than medicine! Remember that your career is just one aspect of your life. Don’t forget to create your big-picture vision and tend the garden of the other areas of your life too.

~ Dr. Claudine Holt

Read more: Dr. Claudine Holt | Burnout: Fact vs Fiction

This same thing can go for whatever part of your identity frequently follows “I’m a…”, and is somewhere that you put a lot of your energy; it could equally be a non-professional job like “homemaker”, or a relational status like “husband”, or a cultural identifier like “Christian”, or a hobby like “gardener” (assuming that is not also your profession, in which case, same item, different category).

Indeed, a lot of women especially get hit by “the triple burden” of professional work, housework, and childcare. And it’s not even necessarily that we resent any of those things or feel like they’re a burden; we (hopefully) love our professions, homes, children. But, here’s the thing:

No amount of love will add extra hours to the day.

So what does she recommend doing about it, when sometimes we’re juggling things that can’t be dropped?

Start simple, but start!

Dr. Holt recommends to start with a smile (yes even if, and sometimes especially when, the circumstances do not feel like they merit it), and deploy some CBT tools:

Two Hacks to Quickly Rise Above Burnout (Or Any Circumstance)

We’ve expanded on this topic here:

How To Manage Chronic Stress

With a more level head on, it becomes easier to take on the next step, which creating healthy boundariesand that doesn’t just mean with other people!

It also means slaying our own perfectionism and imposter syndrome—both things that will have us chasing our tails 36 hours per day if we let them.

See also:

❝Burnout is the culture of our times. A culture that expects us to do more and think our way out of everything. A culture that asks for more than the body can bear. Unfortunately, even though the situation might not be of our creation, burnout culture is our inheritance.

An inheritance we can either perpetuate—or change—depending on what we embody.❞

Source: The Embodied MD on Burnout with Dr Claudine Holt

That “embodiment” is partly our choices and actions that we bring and own just as we bring and own our body—and it’s partly our relationship with our body itself, and learning to love it, and work with it to achieve wonderful things, instead of just getting through the day.

Which yes, does also mean making space for good diet, exercise, sleep and so forth, per:

These Top Five Things Make The Biggest Difference To Health

Want to know more?

You might like to check out Dr. Holt’s website:

The Embodied M.D. | Burnout Coach

…where she also offers resources such as a blog and a podcast.

Enjoy!

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  • What is mitochondrial donation? And how might it help people have a healthy baby one day?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Mitochondria are tiny structures in cells that convert the food we eat into the energy our cells need to function.

    Mitochondrial disease (or mito for short) is a group of conditions that affect this ability to generate the energy organs require to work properly. There are many different forms of mito and depending on the form, it can disrupt one or more organs and can cause organ failure.

    There is no cure for mito. But an IVF procedure called mitochondrial donation now offers hope to families affected by some forms of mito that they can have genetically related children free from mito.

    After a law to allow mitochondrial donation in Australia was passed in 2022, scientists are now preparing for a clinical trial to see if mitochondrial donation is safe and works.

    Jonathan Borba/Pexels

    What is mitochondrial disease?

    There are two types of mitochondrial disease.

    One is caused by faulty genes in the nuclear DNA, the DNA we inherit from both our parents and which makes us who we are.

    The other is caused by faulty genes in the mitochondria’s own DNA. Mito caused by faulty mitochondrial DNA is passed down through the mother. But the risk of disease is unpredictable, so a mother who is only mildly affected can have a child who develops serious disease symptoms.

    Mitochondrial disease is the most common inherited metabolic condition affecting one in 5,000 people.

    Some people have mild symptoms that progress slowly, while others have severe symptoms that progress rapidly. Mito can affect any organ, but organs that need a lot of energy such as brain, muscle and heart are more often affected than other organs.

    Mito that manifests in childhood often involves multiple organs, progresses rapidly, and has poor outcomes. Of all babies born each year in Australia, around 60 will develop life-threatening mitochondrial disease.

    What is mitochondrial donation?

    Mitochondrial donation is an experimental IVF-based technique that offers people who carry faulty mitochondrial DNA the potential to have genetically related children without passing on the faulty DNA.

    It involves removing the nuclear DNA from the egg of someone who carries faulty mitochondrial DNA and inserting it into a healthy egg donated by someone not affected by mito, which has had its nuclear DNA removed.

    The donor egg (in blue) has had its nuclear DNA removed. Author provided

    The resulting egg has the nuclear DNA of the intending parent and functioning mitochondria from the donor. Sperm is then added and this allows the transmission of both intending parents’ nuclear DNA to the child.

    A child born after mitochondrial donation will have genetic material from the three parties involved: nuclear DNA from the intending parents and mitochondrial DNA from the egg donor. As a result the child will likely have a reduced risk of mito, or no risk at all.

    Pregnant woman reads in bed
    The procedure removes the faulty DNA to reduce the chance of it passing on to the baby. Josh Willink/Pexels

    This highly technical procedure requires specially trained scientists and sophisticated equipment. It also requires both the person with mito and the egg donor to have hormone injections to stimulate the ovaries to produce multiple eggs. The eggs are then retrieved in an ultrasound-guided surgical procedure.

    Mitochondrial donation has been pioneered in the United Kingdom where a handful of babies have been born as a result. To date there have been no reports about whether they are free of mito.

    Maeve’s Law

    After three years of public consultation The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 was passed in the Australian Senate in 2022, making mitochondrial donation legal in a research and clinical trial setting.

    Maeve’s law stipulates strict conditions including that clinics need a special licence to perform mitochondrial donation.

    To make sure mitochondrial donation works and is safe before it’s introduced into Australian clinical practice, the law also specifies that initial licences will be issued for pre-clinical and clinical trial research and training.

    We’re expecting one such licence to be issued for the mitoHOPE (Healthy Outcomes Pilot and Evaluation) program, which we are part of, to perfect the technique and conduct a clinical trial to make sure mitochondrial donation is safe and effective.

    Before starting the trial, a preclinical research and training program will ensure embryologists are trained in “real-life” clinical conditions and existing mitochondrial donation techniques are refined and improved. To do this, many human eggs are needed.

    The need for donor eggs

    One of the challenges with mitochondrial donation is sourcing eggs. For the preclinical research and training program, frozen eggs can be used, but for the clinical trial “fresh” eggs will be needed.

    One possible source of frozen eggs is from people who have stored eggs they don’t intend to use.

    A recent study looked at data on the outcomes of eggs stored at a Melbourne clinic from 2012 to 2021. Over the ten-year period, 1,132 eggs from 128 patients were discarded. No eggs were donated to research because the clinics where the eggs were stored did not conduct research requiring donor eggs.

    However, research shows that among people with stored eggs, the number one choice for what to do with eggs they don’t need is to donate them to research.

    This offers hope that, given the opportunity, those who have eggs stored that they don’t intend to use might be willing to donate them to mitochondrial donation preclinical research.

    As for the “fresh” eggs needed in the future clinical trial, this will require individuals to volunteer to have their ovaries stimulated and eggs retrieved to give those people impacted by mito a chance to have a healthy baby. Egg donors may be people who are friends or relatives of those who enter the trial, or it might be people who don’t know someone affected by mito but would like to help them conceive.

    At this stage, the aim is to begin enrolling participants in the clinical trial in the next 12 to 18 months. However this may change depending on when the required licences and ethics approvals are granted.

    Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University; Catherine Mills, Professor of Bioethics, Monash University; Mary Herbert, Professor, Anatomy & Developmental Biology, Monash University, and Molly Johnston, Research fellow, Monash Bioethics Centre, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Good Health From Head To Toe

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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

    Q: I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?

    Very important stuff! We wrote about this not long back:

    (one good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!)

    Q: Foods that help build stronger bones and cut inflammation? Thank you!

    We’ve got you…

    For stronger bones / To cut inflammation

    That “stronger bones” article is about the benefits of collagen supplementation for bones, but there’s definitely more to say on the topic of stronger bones, so we’ll do a main feature on it sometime soon!

    Q: Veganism, staying mentally sharp, best exercises for weight gain?

    All great stuff! Let’s do a run-down:

    • Veganism? As a health and productivity newsletter, we’ll only be focusing veganism’s health considerations, but it does crop up from time to time! For example:
    • Staying mentally sharp? You might like the things-against-dementia pieces we linked to in the previous response!
      • It’s also worth noting that some kinds of dementia, such as Alzheimer’s, can begin the neurodegenerative process 20 years before symptoms show, and can be influenced by lifestyle choices 20 years before that, so it’s definitely never too early be on top of these things!
    • Best exercises for weight gain? We’ll do a main feature one of these days (filled with good science and evidence), but in few words meanwhile: core exercises, large muscle groups, heavy weights, few reps, build up slowly. Squats are King.

    Q: I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress

    You’re going to love our Psychology Sunday editions of 10almonds! You might like some of these…

    Q: I’d like to know more about type 2 diabetic foot problems

    You probably know that the “foot problems” thing has less to do with the feet and more to do with blood and nerves. So, why the feet?

    The reason feet often get something like the worst of it, is because they are extremities, and in the case of blood sugars being too high for too long too often, they’re getting more damage as blood has to fight its way back up your body. Diabetic neuropathy happens when nerves are malnourished because the blood that should be keeping them healthy, is instead syrupy and sluggish.

    We’ll definitely do a main feature sometime soon on keeping blood sugars healthy, for both types of diabetes plus pre-diabetes and just general advice for all.

    In the meantime, here’s some very good advice on keeping your feet healthy in the context of diabetes. This one’s focussed on Type 1 Diabetes, but the advice goes for both:

    !

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  • Vaginal Probiotics: What Does The Science Say?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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 😎

    ❝Is there any merit to vaginal probiotics?❞

    What a fun question! First let’s break it down, as this could mean two different things:

    1. Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
    2. Probiotics taken as a vaginal pessary/suppository, to act directly there

    The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.

    See for example:

    Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis

    Some notes:

    • candidal vaginitis means a yeast infection causing vaginal inflammation
    • bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)

    In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.

    While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.

    What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.

    *e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.

    In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.

    That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.

    However, it does make a difference what kind of Lactobacillus is used, for example in this next study…

    • L. fermentum RC-14 worked well (90% success rate)
    • L. rhamnosus GR-1 worked somewhat (40% success rate)
    • L. rhamnosus GG did not work (0% success rate)

    So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.

    Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.

    See also: Make Friends With Your Gut (You Can Thank Us Later)

    You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:

    Treatment of bacterial vaginosis with lactobacilli

    This study got better results, with a 61% success rate:

    Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

    Important note

    Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.

    If your vagina seems happy right now, then do not mess with its happy bacterial balance!

    And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.

    *by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.

    And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.

    Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:

    How To Avoid Urinary Tract Infections (UTIs)

    One other option

    Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:

    The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review

    Lastly…

    Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:

    How Much Difference Do Probiotic Supplements Make To Health?

    Take care!

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  • Yoga for Better Sleep – by Mark Stephens

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The book has, as you might expect:

    • postural exercises
    • breathing exercises
    • meditation exercises

    Instructions given in all of the above categories are clear and easy to follow, and there are photographic illustrations too where appropriate.

    What sets it apart from many books of this kind is that it also has chapters dedicated to various specific circumstances; the many actual reasons people seriously struggle to sleep; not just “screentime too late”, but for example deprepression, sleep apnea, hyperarousal, or even just aging.

    As well as the comprehensive exercises, there are also many tips, tricks, hacks, and workarounds—it’s a practical guidebook with practical advice.

    While the book is about yogic practices, the author also does tackle this holistically, acknowledging that there are many factors going on, and that yogic practices should be one more string to our sleep-improving bow—as we continue with other general good advice for good sleep too, have medical tests if it seems appropriate, that kind of thing. Basically, to have one’s assorted approaches work together with synergistic effect.

    Bottom line: this book will quite possibly put you to sleep! But only in the best possible way.

    Click here to check out Yoga for Better Sleep, and get those valuable Zs in, healthily!

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  • Inheritance – by Dr. Sharon Moalem

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We know genes make a big difference to a lot about us, but how much? And, the genes we have, we’re stuck with, right?

    Dr. Sharon Moalem shines a bright light into some of the often-shadowier nooks and crannies of our genetics, covering such topics as:

    • How much can (and can’t) be predicted from our parents’ genes—even when it comes to genetic traits that both parents have, and Gregor Mendel himself would (incorrectly) think obvious
    • How even something so seemingly simple and clear as genetic sex, very definitely isn’t
    • How traumatic life events can cause epigenetic changes that will scar us for generations to come
    • How we can use our genetic information to look after our health much better
    • How our life choices can work with, or overcome, the hand we got dealt in terms of genes

    The style of the book is conversational, down to how there’s a lot of “I” and “you” in here, and the casual style belies the heavy, sharp, up-to-date science contained within.

    Bottom line: if you’d like insight into the weird and wonderful nuances of genetics as found in this real, messy, perfectly chaotic world, this book is an excellent choice.

    Click here to check out Inheritance, and learn more about yours!

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  • Try This At Home: ABI Test For Clogged Arteries

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.

    The Ankle-Brachial Index Test

    Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:

    • A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
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    • High ABI scores (above 1.4) may indicate artery hardening

    Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).

    If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

    Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

    For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

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    Take care!

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