How To Clean Your Brain (Glymphatic Health Primer)
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That’s not a typo! The name “glymphatic system” was coined by the Danish neuroscientist Dr. Maiken Nedergaard, and is a nod to its use of glial cells to do a similar job to that of the peripheral lymphatic system—but this time, in the CNS. Today, we have Dr. Jin Sung to tell us more:
Brainwashing (but not like that)
The glymphatic system may sound like a boring job, but so does “sanitation worker” in a city—yet the city would grind to a messy halt very very quickly without them. Same goes for your brain.
Diseases that are prevalent when this doesn’t happen the way it should include Alzheimer’s (beta-amyloid clearance) and Parkinson’s (alpha-synuclein clearance) amongst others.
Things Dr. Sung recommends for optimal glymphatic function include: sleep (7–9 hours), exercise (30–45 minutes daily), hydration (half your bodyweight in pounds, in ounces, so if your body weighs 150 lbs, that means 75 oz of water), good posture (including the use of good ergonomics, e.g. computer monitor at right height, car seat correct, etc), stress reduction (reduces inflammatory cytokines), getting enough omega-3 (the brain needs certain fats to work properly, and this is the one most likely to see a deficit), vagal stimulation (methods include humming, gargling, and gagging—please note we said vagal stimulation; easy to misread at a glance!), LED light therapy, and fasting (intermittent or prolonged).
For more on each of these, including specific tips, enjoy:
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Want to learn more?
You might also like to read:
- Ask Not What Your Lymphatic System Can Do For You…
- The Vagus Nerve (And How You Can Make Use Of It)
- Casting Yourself In A Healthier Light
- Intermittent Fasting: How Does It Work?
Take care!
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Sizing Aside: Are You Wearing The Right Bra For Your Breast Shape?
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It’s well-known that most women wear incorrectly-fitting bras. Even with careful measurements, buying “off-the-rack” can be a challenge, because the sizing system only takes two measurements, when there are actually many more things to consider. Today’s video demystifies a lot of what else is going on!
For example…
Some of the different breast shapes/arrangements to consider:
- Wide-set breasts: likely to find there’s a bit of a gap between your breasts and the inside (nearest to your sternum) parts of the cups—while spilling out a little at the outside edges. The solution? Bras that offer side-support, to keep things pointing more forwards. Central-closing bras can also help gather things together, and a balconette bra can redistribute things more evenly. Any of these options will be a lot more comfortable.
- Small breasts: bralettes are your friend, keeping things comfortable while not wearing more bra than necessary to do the job (of course going braless is also an option, but we’re talking bra-fitting here, not bra-flinging-off never to be seen again)
- Deflated breasts: often the case for someone who used to have larger breasts, but they lost size for hormonal reasons rather than for weight loss reasons. This often occurs a little while after childbirth, and also happens a lot in menopause. The bra recommendation for this? A push-up plunge bra with ¾ coverage not only provides cleavage if that’s wanted, but also, will keep things much more snug and thus more evenly-distributed. If ever you’ve found yourself needing to adjust yourself every now and gain while out, this will fix that and keep you comfortable for much longer.
There’s more, along with a visual guide, so do check it out:
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Further reading
While we haven’t written about this specifically (maybe we’ll do a “Life Hacks” edition one of these days), we have written about…
Keeping Abreast Of Your Cancer Risk
Take care!
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A Supplement To Rival St. John’s Wort Against Depression
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Do You Feel The SAMe?
S-Adeonsyl-L-Methionone (SAMe) is a chemical found naturally in the body, and/but enjoyed widely as a supplement. The main reasons people take it are:
- Improve mood (antidepressant effect)
- Improve joints (reduce osteoarthritis symptoms)
- Improve liver (detoxifying effect)
Let’s see what the science says for each of those claims…
Does it improve mood?
It seems to perform comparably to St. John’s Wort (which is good; it performs comparably to Prozac).
Best of all, it does this with fewer contraindications (St. John’s Wort has so many contraindications).
Here’s how they stack up:
This looks very promising, though it’d be nice to see a larger body of research, to be sure.
Does it reduce osteoarthritis symptoms?
The good news: it performs comparably to ibuprofen, with fewer side effects!
The bad news: it also performs comparably to placebo!
Read into that what you will about ibuprofen’s usefulness vs OA symptoms.
Read all about it:
S-Adenosylmethionine for osteoarthritis of the knee or hip
If you were hoping for something for OA or similar symptoms, you might like our previous main features:
- Avoiding/Managing Osteoarthritis
- Managing Chronic Pain (Realistically!)
- The 7 Approaches To Pain Management
- (Science-Based) Alternative Pain Relief
Does it help against liver disease?
According to adverts for SAMe: absolutely!
According to science: we don’t know
The science for this is so weak that it’d be unworthy of mention if it weren’t for the fact that SAMe is so widely sold as good against hepatotoxicity.
To be clear: maybe it really is great! Science hasn’t yet disproved its usefulness either.
It is popularly assumed to be beneficial due to there being an association between lower levels of SAMe in the body (remember, it is also produced inside our bodies) and development of liver disease, especially cholestasis.
Here’s an example of what pretty much every study we found was like (inconclusive research based mostly on mice):
S-adenosylmethionine in liver health, injury, and cancer
For other options for liver health, consider:
Is it safe?
Safety trials have been done ranging from 3 months to 2 years, with no serious side effects coming to light. So, it appears quite safe.
That said, as with anything, there are contraindications, such as:
- if you have bipolar disorder, skip this unless directed by your health care provider, because it may worsen the symptoms of mania
- if you are on SSRIs or other serotonergic drugs, it may interact with those
- if you are immunocompromised, you might want to skip it can increase the risk of P. carinii growth in such cases
As always, do speak with your doctor/pharmacist for personalized advice.
Summary
SAMe’s evidence-based qualities seem to stack up as follows:
- Against depression: good
- Against osteoarthritis: weak
- Against liver disease: unknown
As for safety, it has been found quite safe for most people.
Where can I get it?
We don’t sell it, but here is an example product on Amazon, for your convenience
Enjoy!
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What Your Doctor May Not Tell You About Fibromyalgia – by Dr. R. Paul St Amand
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The core claim of the book is that guaifenesin, an over-the-counter expectorant (with a good safety profile) usually taken to treat a chesty cough, is absorbed from the gastrointestinal tract, and is rapidly metabolized and excreted into the urine—and on the way, it lowers uric acid levels, which is a big deal for fibromyalgia sufferers.
He goes on to explain how the guaifenesin, by a similar biochemical mechanism, additionally facilitates the removal of other excess secretions that are associated with fibromyalgia.
The science for all this is… Compelling and logical, while not being nearly so well-established yet as his confidence would have us believe.
In other words, he could be completely wrong, because adequate testing has not yet been done. However, he also could be right; scientific knowledge is, by the very reality of scientific method, always a step behind hypothesis and theory (in that order).
Meanwhile, there are certainly many glowing testimonials from fibromyalgia sufferers, saying that this helped a lot.
Bottom line: if you have fibromyalgia and do not mind trying a relatively clinically untested (yet logical and anecdotally successful) protocol to lessen then symptoms (allegedly, to zero), then this book will guide you through that and tell you everything to watch out for.
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Are You Taking PIMs?
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Getting Off The Overmedication Train
The older we get, the more likely we are to be on more medications. It’s easy to assume that this is because, much like the ailments they treat, we accumulate them over time. And superficially at least, that’s what happens.
And yet, almost half of people over 65 in Canada are taking “potentially inappropriate medications”, or PIMs—in other words, medications that are not needed and perhaps harmful. This categorization includes medications where the iatrogenic harms (side effects, risks) outweigh the benefits, and/or there’s a safer more effective medication available to do the job.
You may be wondering: what does this mean for the US?
Well, we don’t have the figures for the US because we’re working from Canadian research today, but given the differences between the two country’s healthcare systems (mostly socialized in Canada and mostly private in the US), it seems a fair hypothesis that if it’s almost half in Canada, it’s probably more than half in the US. Socialized healthcare systems are generally quite thrifty and seek to spend less on healthcare, while private healthcare systems are generally keen to upsell to new products/services.
The three top categories of PIMs according to the above study:
- Gabapentinoids (anticonvulsants also used to treat neuropathic pain)
- Proton pump inhibitors (PPIs)
- Antipsychotics (especially, to people without psychosis)
…but those are just the top of the list; there are many many more.
The list continues: opioids, anticholinergics, sulfonlyurea, NSAIDs, benzodiazepines and related rugs, and cholinesterase inhibitors. That’s where the Canadian study cuts off (although it also includes “others” just before NSAIDs), but still, you guessed it, there are more (we’re willing to bet statins weigh heavily in the “others” section, for a start).
There are two likely main causes of overmedication:
The side effect train
This is where a patient has a condition and is prescribed drug A, which has some undesired side effects, so the patient is prescribed drug B to treat those. However, that drug also has some unwanted side effects of its own, so the patient is prescribed drug C to treat those. And so on.
For a real-life rundown of how this can play out, check out the case study in:
The Hidden Complexities of Statins and Cardiovascular Disease (CVD)
The convenience factor
No, not convenient for you. Convenient for others. Convenient for the doctor if it gets you out of their office (socialized healthcare) or because it was easy to sell (private healthcare). Convenient for the staff in a hospital or other care facility.
This latter is what happens when, for example, a patient is being too much trouble, so the staff give them promazine “to help them settle down”, notwithstanding that promazine is, besides being a sedative, also an antipsychotic whose common side effects include amenorrhea, arrhythmias, constipation, drowsiness and dizziness, dry mouth, impotence, tiredness, galactorrhoea, gynecomastia, hyperglycemia, insomnia, hypotension, seizures, tremor, vomiting and weight gain.
This kind of thing (and worse) happens more often towards the end of a patient’s life; indeed, sometimes precipitating that end, whether you want it or not:
Mortality, Palliative Care, & Euthanasia
How to avoid it
Good practice is to be “open-mindedly skeptical” about any medication. By this we mean, don’t reject it out of hand, but do ask questions about it.
Ask your prescriber not only what it’s for and what it’ll do, but also what the side effects and risks are, and an important question that many people don’t think to ask, and for which doctors thus don’t often have a well-prepared smooth-selling reply, “what will happen if I don’t take this?”
And look up unbiased neutral information about it, from reliable sources (Drugs.com and The BNF are good reference guides for this—and if it’s important to you, check both, in case of any disagreement, as they function under completely different regulatory bodies, the former being American and the latter being British. So if they both agree, it’s surely accurate, according to best current science).
Also: when you are on a medication, keep a journal of your symptoms, as well as a log of your vitals (heart rate, blood pressure, weight, sleep etc) so you know what the medication seems to be helping or harming, and be sure to have a regular meds review with your doctor to check everything’s still right for you. And don’t be afraid to seek a second opinion if you still have doubts.
Want to know more?
For a more in-depth exploration than we have room for here, check out this book that we reviewed not long back:
To Medicate or Not? That is the Question! – by Dr. Asha Bohannon
Take care!
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The Salt Fix – by Dr. James DiNicolantonio
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This book has a bold premise: high salt consumption is not, as global scientific consensus holds, a serious health risk, but rather, as the title suggests, a health fix.
Dr. DiNicolantonio, a pharmacist, explains how “our ancestors crawled out of the sea millions of years ago and we still crave that salt”, giving this as a reason why we should consume salt ad libitum, aiming for 8–10g per day, and thereafter a fair portion of the book is given over to discussing how many health conditions are caused/exacerbated by sugar, and that therefore we have demonized the wrong white crystal (scientific consensus is that there are many white crystals that can cause us harm).
Indeed, sugar can be a big health problem, but reading it at such length felt a lot like when all a politician can talk about is how their political rival is worse.
A lot of the studies the author cites to support the idea of healthy higher salt consumption rates were on non-human animals, and it’s always a lottery as to whether those results translate to humans or not. Also, many of the studies he’s citing are old and have methodological flaws, while others we could not find when we looked them up.
One of the sources cited is “my friend Jose tried this and it worked for him”.
Bottom line: sodium is an essential mineral that we do need to live, but we are not convinced that this book’s ideas have scientific merit. But are they well-argued? Also no.
Click here to check out The Salt Fix for yourself! It’s a fascinating book.
(Usually, if we do not approve of a book, we simply do not review it. We like to keep things positive. However, this one came up in Q&A, so it seemed appropriate to share our review. Also, the occasional negative review may reassure you, dear readers, that when we praise a book, we mean it)
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Exercise Less, Move More
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Exercise Less, Move More
Today we’re talking about Dr. Rangan Chatterjee. He’s a medical doctor with decades of experience, and he wants us all to proactively stay in good health, rather than waiting for things to go wrong.
Great! What’s his deal?
Dr. Chatterjee advises that we take care of the following four pillars of good health:
- Relaxation
- Food
- Movement
- Sleep
And, they’re not in this order at random. Usually advice starts with diet and exercise, doesn’t it?
But for Dr. Chatterjee, it’s useless to try to tackle diet first if one is stressed-to-death by other things. As for food next, he knows that a good diet will fuel the next steps nicely. Speaking of next steps, a day full of movement is the ideal setup to a good night’s sleep—ready for a relaxing next day.
Relaxation
Here, Dr. Chatterjee advises that we go with what works for us. It could be meditation or yoga… Or it could be having a nice cup of tea while looking out of the window.
What’s most important, he says, is that we should take at least 15 minutes per day as “me time”, not as a reward for when we’ve done our work/chores/etc, but as something integrated into our routine, preferably early in the day.
Food
There are no grand surprises here: Dr. Chatterjee advocates for a majority plant-based diet, whole foods, and importantly, avoiding sugar.
He’s also an advocate of intermittent fasting, but only so far as is comfortable and practicable. Intermittent fasting can give great benefits, but it’s no good if that comes at a cost of making us stressed and suffering!
Movement
This one’s important. Well, they all are, but this one’s particularly characteristic to Dr. Chatterjee’s approach. He wants us to exercise less, and move more.
The reason for this is that strenuous exercise will tend to speed up our metabolism to the point that we will be prompted to eat high calorie quick-energy foods to compensate, and when we do, our body will rush to store that as fat, understanding (incorrectly) that we are in a time of great stress, because why else would we be exerting ourselves that much?
Instead, he advocates for building as much natural movement into our daily routine as possible. Walking more, taking the stairs, doing the gardening/housework.
That said, he does also advise some strength-training on a daily basis—bodyweight exercises like squats and lunges are top of his list.
Sleep
Here, aside from the usual “sleep hygiene” advices (dark cool room, fresh bedding, etc), he also advises we do as he does, and take an hour before bedtime as a purely wind-down time. In gentle lighting, perhaps reading (not on a bright screen!), for example.
Ready to start the next day, relaxed and ready to go.
If you’d like to know more about Dr. Chatterjee’s approach…
You can check out his:
If you don’t know where to start, we recommend the blog! It has a lot of guests there too, including Wim Hof, Gabor Maté, Mindy Pelz, and come to think of it, a lot of other people we’ve also featured ideas from previously!
Enjoy!
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