Five Supplements That Actually Work Vs Arthritis
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This is Dr. Diana Girnita, a double board-certified physician (internal medicine & rheumatology) who, in addition to her MD, also has a PhD in immunology—bearing in mind that rheumatoid arthritis is an autoimmune condition.
Her mission is to help people with any form of arthritis (rheumatoid or otherwise) and those with many non-arthritic autoimmune conditions (ranging from tendonitis to lupus) to live better.
Today, we’ll be looking at her recommendations of 5 supplements that actually help alleviate arthritis:
Collagen
Collagen famously supports skin, nails, bones, and joint cartilage; Dr. Girnita advises that it’s particularly beneficial for osteoarthritis.
Specifically, she recommends either collagen peptides or hydrolyzed collagen, as they are most absorbable. However, collagen can also be sourced from foods like bone broth, fish with skin and bones, and gelatin-based foods.
If you’re vegetarian/vegan, then it becomes important to simply consume the ingredients for collagen, because like most animals, we can synthesize it ourselves provided we get the necessary nutrients. For more on that, see:
We Are Such Stuff As Fish Are Made Of
Glucosamine & chondroitin
Technically two things, but almost always sold/taken together. Naturally found in joint cartilage, it can slow cartilage breakdown and reduce pain in osteoarthritis.
Studies show pain relief, especially in moderate-to-severe cases; best taken long-term. Additionally, it’s a better option than NSAIDs for patients with heart or gastrointestinal issues.
10almonds tip: something that’s tricker to find as a supplement than glucosamine and chondroitin, but you might want to check it out:
Cucumber Extract Beats Glucosamine & Chondroitin… At 1/135th Of The Dose?!
Omega-3 fatty acids
Dr. Girnita recommends this one because unlike the above recommendations that mainly help reduce/reverse the joint damage itself, omega-3 reduces inflammation, pain, and stiffness, and can decrease or eliminate the need for NSAIDs in rheumatoid arthritis and psoriatic arthritis.
She recommends 2-4g EPA/DHA daily; ideally taken with a meal for better absorption.
She also recommends to look for mercury-free options—algae-derived are usually better than fish-derived, but check for certification either way! See also:
What Omega-3 Fatty Acids Really Do For Us
Boswellia serrata (frankincense)
Popularly enjoyed as an incense but also available in supplement form, it contains boswellic acid, which reduces inflammation and cartilage damage.
Dr. Girnita recommends 100 mg daily, but advises that it may interact with some antidepressants, anti-anxiety medications, and NSAIDs—so speak with your pharmacist/doctor if unsure.
We also wrote about this one here:
Science-Based Alternative Pain Relief
Curcumin (turmeric)
Well-known for its potent anti-inflammatory properties, it’s comparable to NSAIDs in pain relief for most common forms of arthritis.
Dr. Girnita recommends 1–1.5g of curcumin daily, ideally combined with black pepper for better absorption:
Why Curcumin (Turmeric) Is Worth Its Weight In Gold
Lastly…
Dr. Girnita advises to not blindly trust supplements, but rather, to test them for 2–3 months while keeping a journal of your symptoms. If it improves things for you, keep it up, if not, discontinue. Humans can be complicated and not everything will work exactly the same way for everyone!
For more on dealing with chronic pain specifically, by the way, check out:
Managing Chronic Pain (Realistically!)
Take care!
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Cold Medicines & Heart Health
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Cold Medicines & Heart Health
In the wake of many decongestants disappearing from a lot of shelves after a common active ingredient being declared useless*, you may find yourself considering alternative decongestants at this time of year.
*In case you missed it:
It doesn’t seem to be dangerous, by the way, just also not effective:
FDA Panel Says Common OTC Decongestant, Phenylephrine, Is Useless
Good for your nose, bad for your heart?
With products based on phenylephrine out of the running, products based on pseudoephedrine, a competing drug, are enjoying a surge in popularity.
Good news: pseudoephedrine works!
Bad news: pseudoephedrine works because it is a vasoconstrictor, and that vasoconstriction reduces nasal swelling. That same vasoconstriction also raises overall blood pressure, potentially dangerously, depending on an assortment of other conditions you might have.
Further reading: Can decongestants spike your blood pressure? What to know about hypertension and cold medicine
Who’s at risk?
The warning label, unread by many, reads:
❝Do not use this product if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland, unless directed by a doctor❞
Source: Harvard Health | Don’t let decongestants squeeze your heart
What are the other options?
The same source as above recommends antihistamines as an option to be considered, citing:
❝Antihistamines such as […] cetirizine (Zyrtec) and loratadine (Claritin) can help with a stuffy nose and are safe for the heart.❞
But we’d be remiss not to mention drug-free options too, for example:
- Saline rinse with a neti pot or similar
- Use of a humidifier in your house/room
- Steam inhalation, with or without eucalyptus etc
See also: Inhaled Eucalyptus’s Immunomodulatory and Antimicrobial Effects
Take care!
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The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
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There’s a lot more to breast cancer care than “check your breasts regularly”. Because… And then what? “Go see a doctor” obviously, but it’s a scary prospect with a lot of unknowns.
Dr. Simmons demystifies these unknowns, from both her position as an oncologist (and breast surgeon) and also her position as a breast cancer survivor herself.
What she found, upon getting to experience the patient side of things, was that the system is broken in ways she’d never considered before as a doctor.
This book is the product of the things she’s learned both within her field, and elsewhere because of realizing the former’s areas of shortcoming.
She gives a step-by-step guide, from diagnosis onwards, advising taking as much as possible into one’s own hands—especially in the categories of information and action. She also explains the things that make the biggest difference to cancer outcomes when it comes to eating, sleeping, and so forth, the best attitude to have to be neither despairing and giving up, nor overconfident and complacent.
She does also talk complementary therapies, be they supplements or more out-of-the-box approaches and the evidence for them where applicable, as well as doing some high-quality mythbusting about more prescription-based considerations such as HRT.
Bottom line: if you or a loved one have a breast cancer diagnosis, or you just prefer knowing this sort of thing than not, then this book is a top-tier “insider’s guide”.
Click here to check out the Smart Woman’s Guide To Breast Cancer, and take control!
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Rapamycin Can Slow Aging By 20% (But Watch Out)
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Rapamycin’s Pros & Cons
Rapamycin is generally heralded as a wonderdrug that (according to best evidence so far) can slow down aging, potentially adding decades to human lifespan—and yes, healthspan.
It comes from a kind of soil bacteria, which in turn comes from the island of Rapa Nui (a Chilean territory best known for its monumental moai statues), hence the name rapamycin.
Does it work?
Yes! Probably! With catches!
Like most drugs that are tested for longevity-inducing properties, research in humans is very slow. Of course for drugs in general, they must go through in vitro and in vivo animal testing first before they can progress to human randomized clinical trials, but for longevity-inducing drugs, it’s tricky to even test in humans, without waiting entire human lifetimes for the results.
Nevertheless, mouse studies are promising:
Rapamycin: An InhibiTOR of Aging Emerges From the Soil of Easter Island
(“Easter Island” is another name given to the island of Rapa Nui)
That’s not a keysmash in the middle there, it’s a reference to rapamycin’s inhibitory effect on the kinase mechanistic target of rapamycin, sometimes called the mammalian target of rapamycin, and either way generally abbreviated to “mTOR”—also known as “FK506-binding protein 12-rapamycin-associated protein 1” or “FRAP1“ to its friends, but we’re going to stick with “mTOR”.
What’s relevant about this is that mTOR regulates cell growth, cell proliferation, cell motility, cell survival, protein synthesis, autophagy, and transcription.
Don’t those words usually get associated with cancer?
They do indeed! Rapamycin and its analogs have well-demonstrated anti-cancer potential:
❝Rapamycin, the naturally occurring inhibitor of mTOR, along with a number of recently developed rapamycin analogs (rapalogs) consisting of synthetically derived compounds containing minor chemical modifications to the parent structure, inhibit the growth of cell lines derived from multiple tumor types in vitro, and tumor models in vivo.
Results from clinical trials indicate that the rapalogs may be useful for the treatment of subsets of certain types of cancer.❞
…and as such, gets used sometimes as an anticancer drug—especially against renal cancer. See also:
Research perspective: Cancer prevention with rapamycin
What’s the catch?
Aside from the fact that its longevity-inducing effects are not yet proven in humans, the mouse models find its longevity effects to be sex-specific, extending the life of male mice but not female ones:
Rapamycin‐mediated mouse lifespan extension: Late‐life dosage regimes with sex‐specific effects
One hypothesis about this is that it may have at least partially to do with rapamycin’s immunomodulatory effect, bearing in mind that estrogen is immune-enhancing and testosterone is immunosuppressant.
And rapamycin? That’s another catch: it is an immunosuppressant.
This goes in rapamycin’s favor for its use to avoiding rejection when it comes to some transplants (most notably including for kidneys), though the very same immunosuppressant effect is a reason it is contraindicated for certain other transplants (such as in liver or lung transplants), where it can lead to an unacceptable increase in risk of lymphoma and other malignancies:
Prescribing Information: Rapamune, Sirolimus Solution / Sirolimus Tablet
(Sirolimus is another name for rapamycin, and Rapamune is a brand name)
What does this mean for the future?
Researchers think that rapamycin may be able to extend human lifespan to a more comfortable 120–125 years, but acknowledge there’s quite a jump to get there from the current mouse studies, and given the current drawbacks of sex-specificity and immunosuppression:
Advances in anti-aging: Rapamycin shows potential to extend lifespan and improve health
Noteworthily, rapamycin has also shown promise in simultaneously staving off certain diseases associated most strongly with aging, including Alzheimer’s and cardiac disease—or even, starting earlier, to delay menopause, in turn kicking back everything else that has an uptick in risk peri- or post-menopause:
Effect of Rapamycin in Ovarian Aging (Rapamycin)
👆 an upcoming study whose results are thus not yet published, but this is to give an idea of where research is currently at. See also:
Pilot Study Evaluates Weekly Pill to Slow Ovarian Aging, Delay Menopause
Where can I try it?
Not from Amazon, that’s for sure!
It’s still tightly regulated, but you can speak with your physician, especially if you are at risk of cancer, especially if kidney cancer, about potentially being prescribed it as a preventative—they will be able to advise about safety and applicability in your personal case.
Alternatively, you can try getting your name on the list for upcoming studies, like the one above. ClinicalTrials.gov is a great place to watch out for those.
Meanwhile, take care!
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Barley Malt Flour vs chickpea flour – Which is Healthier?
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Our Verdict
When comparing barley malt flour to chickpea flour, we picked the chickpea.
Why?
First, some notes:
About chickpea flour: this is also called besan flour, gram flour, and garbanzo bean flour; they are all literally the same thing by different names, and are all flour made from ground chickpeas.
About barley malt flour: barley is a true grain, and does contain gluten. We’re not going to factor that into today’s decision, but if you are avoiding gluten, avoid barley. As for “malt”; malting grains means putting them in an environment (with appropriate temperature and humidity) that they can begin germination, and then drying them with hot air to stop the germination process from continuing, so that we still have grains to make flour out of, and not little green sprouting plants. It improves the nutritional qualities and, subjectively, the flavor.
To avoid repetition, we’re just going to write “barley” instead of “barley malt” now, but it’s still malted.
Now, let’s begin:
Looking at the macros first, chickpea flour has 2x the protein and also more fiber, while barley flour has more carbs. An easy win for chickpea flour.
In the category of vitamins, chickpea flour has more of vitamins A, B1, B5, B9, E, and K, while barley flour has more of vitamins B2, B3, B6, and C. A modest 6:4 victory for chickpea flour.
When it comes to minerals, things are much more one-sided; chickpea flour has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while barley flour has more selenium. An overwhelming win for chickpea flour.
Adding up these three wins for chickpea flour makes for a convincing story in favor of using that where reasonably possible as a flour! It has a slight nutty taste, so you might not want to use it in everything, but it is good for a lot of things.
Want to learn more?
You might like to read:
- Grains: Bread Of Life, Or Cereal Killer?
- Gluten: What’s The Truth?
- Sprout Your Seeds, Grains, Beans, Etc
Take care!
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Scheduling Tips for Overrunning Tasks
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Your Questions, Our Answers!
Q: Often I schedule time for things, but the task takes longer than I think, or multiplies while I’m doing it, and then my schedule gets thrown out. Any ideas?
A: A relatable struggle! Happily, there are remedies:
- Does the task really absolutely need to be finished today? If not, just continue it in scheduled timeslots until it’s completed.
- Some tasks do indeed need to be finished today (hi, writer of a daily newsletter here!), so it can be useful to have an idea of how long things really take, in advance. While new tasks can catch us unawares, recurring or similar-to-previous tasks can be estimated based on how long they took previously. For this reason, we recommend doing a time audit every now and again, to see how you really use your time.
- A great resource that you should include in your schedule is a “spare” timeslot, ideally at least one per day. Call it a “buffer” or a “backup” or whatever (in my schedule it’s labelled “discretionary”), but the basic idea is that it’s a scheduled timeslot with nothing scheduled in it, and it works as an “overflow” catch-all.
Additionally:
- You can usually cut down the time it takes you to do tasks by setting “Deep Work” rules for yourself. For example: cut out distractions, single-task, work in for example 25-minute bursts with 5-minute breaks, etc
- You can also usually cut down the time it takes you to do tasks by making sure you’re prepared for them. Not just task-specific preparation, either! A clear head on, plenty of energy, the resources you’ll need (including refreshments!) to hand, etc can make a huge difference to efficiency.
See Also: Time Optimism and the Planning Fallacy
Do you have a question you’d like to see answered here? Hit reply or use the feedback widget at the bottom; we’d love to hear from you!
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How To Unfatty A Fatty Liver
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How To Unfatty A Fatty Liver
In Greek mythology, Prometheus suffered the punishment of being chained to a rock, where he would have his liver eaten by an eagle, whereupon each day his liver would grow back, only to be eaten again the next day.
We mere humans who are not Greek gods might not be able to endure quite such punishment to our liver, but it is an incredibly resilient and self-regenerative organ.
In fact, provided at least 51% of the liver is still present and correct, the other 49% will regrow. Similarly, damage done (such as by trying to store too much fat there due to metabolic problems, as in alcoholic or non-alcoholic fatty liver disease) will reverse itself in time, given the chance.
The difference between us and Prometheus
In the myth, Prometheus had his liver regrow overnight every night. Ours don’t recover quite so quickly.
Indeed, the science has good and bad news for us:
❝Liver recolonization models have demonstrated that hepatocytes have an unlimited regenerative capacity. However, in normal liver, cell turnover is very slow.❞
~ Michalopoulos and Bhusan (2020)
Read more: Liver regeneration: biological and pathological mechanisms and implications
If it regenerates, why do people need transplants, and/or die of liver disease?
There are some diseases of the liver that inhibit its regenerative abilities, or (as in the case of cancer) abuse them to our detriment. However, in the case of fatty liver disease, the reason is usually simple:
If the lifestyle factors that caused the liver to become fatty are still there, then its regenerative abilities won’t be able to keep up with the damage that is still being done.
Can we speed it up at all?
Yes! The first and most important thing is to minimize how much ongoing harm you are still doing to it, though.
- If you drink alcohol, stop. According to the WHO, the only amount of alcohol that is safe for you is zero.
- You might like our previous article: How To Reduce Or Quit Alcohol
- Consider your medications, and find out which place a strain on the liver. Many medications are not optional; you’re taking them for an important reason, so don’t quit things without checking with your doctor. Medications that strain the liver include, but are by no means limited to:
- Many painkillers, including acetaminophen (Tylenol), paracetamol, and ibuprofen
- Some immunosuppresent drugs, including azathioprine
- Some epilepsy drugs, including phenytoin
- Some antibiotics, including amoxicillin
- Statins in general
Note: we are not pharmacists, nor doctors, let alone your doctors.
Check with yours about what is important for you to take, and what alternatives might be safe for you to consider.
Dietary considerations
While there are still things we don’t know about the cause(s) of non-alcoholic fatty liver disease, there is a very strong association with a diet that is:
- high in salt
- high in refined carbohydrates
- e.g. white flour and white flour products such as white bread and white pasta; also the other main refined carbohydrate: sugar
- high in red meat
- high in non-fermented dairy
- high in fried foods.
So, consider minimizing those, and instead getting plenty of fiber, and plenty of lean protein (not from red meat, but poultry and fish are fine iff not fried; beans and legumes are top-tier, though).
Also, hydrate. Most people are dehydrated most of the time, and that’s bad for all parts of the body, and the liver is no exception. It can’t regenerate if it’s running on empty!
Read more: Foods To Include (And Avoid) In A Healthy Liver Diet
How long will it take to heal?
In the case of alcoholic fatty liver disease, it should start healing a few days after stopping drinking. Then, how long it takes to fully recover depends on the extent of the damage; it could be weeks or months. In extreme cases, years, but that is rare. Usually if the damage is that severe, a transplant is needed.
In the case of non-alcoholic fatty liver disease, again it depends on the extent of the damage, but it is usually a quicker recovery than the alcoholic kind—especially if eating a Mediterranean diet.
Read more: How Long Does It Take For Your Liver To Repair Itself?
Take good care of yourself!
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- If you drink alcohol, stop. According to the WHO, the only amount of alcohol that is safe for you is zero.
