The Power of Hormones – by Dr. Max Nieuwdorp

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First a quick note on the author: he’s an MD & PhD, internist, endocrinologist, and professor. He knows his stuff.

There are a lot of books with “the new science of” in the title, and they don’t often pertain to science that is actually new, and in this case, for the most part the science contained within this book is quite well-established.

A strength of this book is that it’s not talking about hormones in just one specific aspect (e.g. menopause, pregnancy, etc) but rather, in the full span of human health, across the spectra of ages and sexes—and yes, also covering hormones that are not sex hormones, so for example also demystifying the different happiness-related neurotransmitters, as well as the hormones responsible for hunger and satiety, weight loss and gain, sleep and wakefulness, etc.

Which is all very good, because there’s a lot of overlap and several hormones fall into several categories there.

Moreover, the book covers how your personal cocktail of hormones impacts how you look, feel, behave, and more—there’s a lot about chronic health issues here too, and how to use the information in this book to if not outright cure, then at least ameliorate, many conditions.

Bottom line: this is an information-dense book with a lot of details great and small; if you read this, you’ll come away with a much better understanding of hormones than you had previously!

Click here to check out The Power of Hormones, and harness that power for yourself!

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  • What is silicosis and what does research say about it?

    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.

    Silicosis is a progressive, debilitating and sometimes fatal lung disease caused by breathing silica dust from cutting, drilling, chipping or grinding materials such as granite, sandstone, slate or artificial stone. The dust gets trapped in the lung tissue, causing inflammation, scarring and permanent damage.

    Silicosis is a job-related lung disease and has no cure. The disease mostly affects workers in construction, stone countertop fabrication, mining, and even those who sandblast and stonewash denim jeans to create a ‘worn out’ look.

    Silica is one of the most common minerals in nature. About 59% of the Earth’s crust is made of silica, found in quartz, granite, sandstone, slate and sand. Historically, people at the highest risk for the disease have worked in natural environments — mining, digging tunnels or doing quarry work. The disease was first documented by the Greek physician Hippocrates, who in 430 B.C. described breathing disorders in metal diggers.

    But in recent decades there’s been renewed attention to the disease due to its more rapid progression and severity among younger workers. Research has shown that the culprit is artificial stone mostly used for countertops for kitchens and bathrooms, which has a very high silica content.

    The new generation of coal miners is also at an increased risk of silicosis, in addition to black lung, because layers of coal have become thinner, forcing them to dig deeper into rock, as explained in a joint investigation by the Pittsburgh Post-Gazette and the Medill Investigative Lab at Northwestern University published on Dec. 4. CBS Sunday Morning also had a report on the same issue among West Virginia coal miners, aired as part of its Dec. 10 episode.

    Silicosis in modern industries

    Artificial, or engineered, stone used for countertops, also known as “quartz,” is formed from finely crushed rocks mixed with resin. Quartz is a natural mineral, but man-made products like many quartz countertops consist of not just quartz, but also resin, colors and other materials that are used to style and strengthen them.

    The silica content of artificial stone is about 90%, compared with the 3% silica content of natural marble and 30% silica content in granite stones, according to the authors of a 2019 systematic review published in the International Journal of Environmental Research and Public Health.

    The first reported case of silicosis associated with working with artificial stone was from Italy in 2010, according to a 2020 study published in Allergy. Since then, more studies have documented the growing number of cases among artificial stone workers, many of whom are from marginalized populations, such as immigrants.

    A July 2023 study published in JAMA Internal Medicine found that in California, the disease mainly occurred among young Latino immigrant men. The disease was severe in most men by the time they sought care.

    An August 2022 study, published in Occupational & Environmental Medicine, analyzing the Global Silicosis Registry, with workers in Israel, Spain, Australia and the U.S., found “a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases,” due to exposure from silica dust from engineered stone.

    Other modern occupations such as denim sandblasting, work on dental prostheses, manufacturing of electrical cables and working on jewelry and semi-precious stones also put workers at risk of silicosis.

    In the wake of modern-day silicosis cases, researchers have called for larger studies to better understand the disease and the discovery of effective treatments.

    In the U.S. about 2.3 million workers are exposed to silica dust on the job, according to the American Lung Association. Other estimates show approximately 10 million workers in India, 3.2 million in the European Union and 2 million in Brazil work with material containing silica.

    However, “the reporting system for occupational injuries and illnesses in the United States fails to capture many cases, leading to a poor understanding of silicosis incidence and prevalence,” writes Ryan F. Hoy, who has published extensively on the topic, in a June 2022 article in Respirology.

    A 2015 study in the Morbidity & Mortality Weekly Report found the annual number of silicosis deaths declined from 185 people in 1999 to 111 in 2013, but the decline appeared to have leveled off between 2010 and 2013, the authors write. Another 2015 study in MMWR, examining silicosis deaths between 2001 and 2010, found the death rate from silicosis was significantly higher among Black people compared with whites and other races. Men also have a significantly higher death rate from silicosis than women.

    The 2019 Global Burden of Disease Study estimates that more than 12,900 people worldwide die from silicosis each year.

    Silicosis has no cure, but it’s preventable when workers have access to proper respiratory protection and are educated on safe practices set by regulatory bodies such as the U.S. National Institute for Occupational Safety and Health. The European Network on Silica also has guidelines on handling and using materials containing silica. A March 2023 study published in Environmental Science and Pollution Research International finds that “education, training, and marketing strategies improve respirator use, while training and education motivate workers to use dust control measures.”

    Silicosis symptoms and treatment

    Symptoms of silicosis include cough, fatigue, shortness of breath and chest pain. There’s no specific test for silicosis. The first signs may show in an abnormal chest X-ray and a slowly developing cough, according to the American Lung Association.

    Silicosis symptoms don’t appear right away in most cases, usually taking several years to develop working with silica dust. However, studies indicate that symptoms of silicosis due to exposure to artificial stone appear quicker than exposure to natural silica sources, potentially due to the higher concentration of silica in artificial stone.

    There are three types of silicosis: acute (most commonly caused by working with artificial stone), accelerated and chronic, depending on the level of exposure to silica dust, according to the Centers for Disease Control and Prevention, which explains the severity of each type on its website.

    Complications from silicosis can include tuberculosis, lung cancer, chronic bronchitis, kidney disease and autoimmune disorders. In some cases, silicosis can cause severe scarring of the lung tissue, leading to a condition called progressive massive fibrosis, or PMF. Some patients may require a lung transplant.

    Lung damage from silicosis is irreversible, so treatment of silicosis is aimed at slowing down the disease and relieving its symptoms.

    In 1995, the World Health Organization called for the elimination of silicosis by 2030, but research studies and news stories show it remains a threat to many workers.

    Below, we have gathered several studies on the topic to help journalists bolster their reporting with academic research.

    Research roundup

    Artificial Stone Associated Silicosis: A Systematic Review
    Veruscka Leso, et al. International Journal of Environmental Research and Public Health, February 2019.

    This systematic review aims to verify the association between exposure to silica dust in artificial stone and the development of silicosis.

    Researchers narrowed down their selection from 75 papers to seven studies that met their inclusion criteria. The seven studies were from Australia, Israel and Spain. Most of the studies are observational and impede a definite association between exposure to silica while working with artificial stone and developing silicosis, the authors note.

    However, “the unusually high incidence of the disease that was reported over short periods of investigations, and the comparable occupational histories of affected workers, all being involved in the manufacture and manipulation of engineered stones, may indicate a cause-effect relationship of this type.”

    The review of studies reveals a lack of basic preventive measures such as lack of access to disposable masks; lack of information and training on the dangers of silica dust; and lack of periodic medical examinations, including a chest X-ray, among workers. There was limited environmental monitoring of dust levels at the workplace. Also, there was no dust suppression system, such as the use of water when polishing the stones, or effective ventilation. Machinery and tools weren’t properly set up and didn’t undergo routine checks, the authors write.

    The authors recommend environmental monitoring for assessing silica levels in the workplace and verifying the effectiveness of personal protections. They also recommend the health surveillance of workers exposed to silica dust.

    “Stakeholders, manufacturers, occupational risk prevention services, insurance companies for occupational accidents and diseases, business owners, occupational health physicians, general practitioners, and also employees should be engaged, not only in designing/planning processes and operational working environments, but also in assessing the global applicability of proactive preventive and protective measures to identify and control crystalline silica exposure, especially in new and unexpected exposure scenarios, the full extent of which cannot yet be accurately predicted,” they write.

    Silica-Related Diseases in the Modern World
    Ryan F. Hoy and Daniel C. Chambers. Allergy, November 2020.

    The study is a review of the mineralogy of silica, epidemiology, clinical and radiological features of the various forms of silicosis and other diseases associated with exposure to silica.

    The primary factor associated with the development of silicosis is the intensity and duration of cumulative exposure to silica dust. Most countries regulate silica dust occupational exposure limits, generally in the range of 0.05 mg/m3 to 0.1 mg/m3, although the risk of dust exposure to workers still remains high at those levels.

    The study provides a list of activities that could expose workers to silica dust. They include abrasive blasting of sand and sandstone; cement and brick manufacturing; mixing, glazing or sculpting of china, ceramic and pottery; construction involving bricklaying, concrete cutting, paving and demolition; sandblasting denim jeans; working with and polishing dental materials; mining and related milling; handling raw material during paint manufacturing; road and highway construction and repair; soap and cosmetic production; blasting and drilling tunnels; and waste incineration.

    “Despite the large number of workers in the construction sector, there have been few studies of [silica dust] exposure in this industry,” the authors note.

    Other than silicosis, conditions associated with silica exposure include sarcoidosis, an inflammatory disease that commonly affects the lungs and lymph nodes, autoimmune disease, lung cancer and pulmonary infections.

    “Recent outbreaks of silica-associated disease highlight the need for constant vigilance to identify and control new and well-established sources of silica exposure. While there are currently no effective treatments for silicosis, it is a completely preventable lung disease,” the authors write.

    A Systematic Review of the Effectiveness of Dust Control Measures Adopted to Reduce Workplace Exposure
    Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail and Brian Davies. Environmental Science and Pollution Research International, March 2023.

    This study provides an overview of various interventions and their effectiveness in preventing exposure to silica dust based on a review of 133 studies from 16 countries, including the U.S., Canada, China, India, Taiwan and Australia, and published between 2010 and 2020.

    These dust control measures range from simple work practices such as the use of respirators to more sophisticated technologies, such as water and air curtains and foam technology, the authors note.

    The review finds increasing research interest in dust reduction, mainly in China. But overall, regulatory influence remains inadequate in preventing miners’ exposure to silica dust.

    “Results from the review suggest that adopted interventions increase knowledge, awareness, and attitudes about respirator usage and generate positive perceptions about respirator usage while reducing misconceptions,” the authors write. “Interventions can increase the use, proper use, and frequency of use of respirators and the adoption readiness for dust controls but may not provide sustained motivation in workers for the continual use of dust controls or [personal protective equipment.]”

    Notes from the Field: Surveillance of Silicosis Using Electronic Case Reporting — California, December 2022–July 2023
    Jennifer Flattery, et al. Morbidity and Mortality Weekly Report, November 2023.

    This study examines the use of electronic case reporting to identify silicosis cases in California. Electronic case reporting, or eCR, is the automated, real-time exchange of case report information between electronic health records at health facilities at state and local public health agencies in the U.S. It is a joint effort between the Association of Public Health Laboratories, the Council of State and Territorial Epidemiologists, and the CDC. Currently, 208 health conditions can be reported using eCR. All 50 states and other U.S.-affiliated jurisdictions are connected to eCR. Once a public health agency receives a case report, it reaches out to the patient for contact tracing or other actions.

    From October 2022 to July 2023, the California Department of Public Health received initial silicosis case reports for 41 individuals. A review of medical records confirmed 19 cases and 16 probable cases. Six of the 41 cases were considered unlikely to be silicosis after a review of medical records.

    Notably, engineered stone countertop fabrication was a significant source of exposure, especially among Hispanic and Latino workers.

    At least seven of the 19 confirmed cases were associated with the fabrication of engineered stone — quartz — countertops. The 19 patients’ ages ranged from 33 to 51 and all were Hispanic or Latino. One patient died and two had both lungs replaced. One was evaluated for a lung transplant.

    The median age of the 35 patients with probable or confirmed silicosis was 65, ranging from 33 to 89 years, and 91% were men.

    “It is important that health care providers routinely ask patients about their work as an important determinant of health,” the authors write. “Being aware of the risks associated with work exposures, as well as the regulations, medical monitoring, and prevention strategies that address those risks can help guide patient care.”

    Additional research

    Understanding the Pathogenesis of Engineered Stone-Associated Silicosis: The Effect of Particle Chemistry on the Lung Cell Response
    Chandnee Ramkissoon, et al. Respirology, December 2023.

    Silicosis, Tuberculosis and Silica Exposure Among Artisanal and Small-Scale Miners: A Systematic Review and Modelling Paper
    Patrick Howlett, et al. PLOS Global Public Health, September 2023.

    Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California
    Jane C. Fazio, et al. JAMA Internal Medicine, July 2023.

    Silicosis and Tuberculosis: A Systematic Review and Meta-Analysis
    P. Jamshidi, et al. Pulmonology, June 2023.

    From Basic Research to Clinical Practice: Considerations for Treatment Drugs for Silicosis
    Rou Li, Huimin Kang and Shi Chen. International Journal of Molecular Science, May 2023.

    Silicosis After Short-Term Exposure
    J. Nowak-Pasternak, A. Lipińska-Ojrzanowska and B. Świątkowska. Occupational Medicine, January 2023.

    Occupational Silica Exposure and Dose-Response for Related Disorders—Silicosis, Pulmonary TB, AIDs and Renal Diseases: Results of a 15-Year Israeli Surveillance
    Rachel Raanan, et al. International Journal of Environmental Research and Public Health, November 2022.

    Demographic, Exposure and Clinical Characteristics in a Multinational Registry of Engineered Stone Workers with Silicosis
    Jeremy Tang Hua, et al. Occupational & Environmental Medicine, August 2022.

    Current Global Perspectives on Silicosis — Convergence of Old and Newly Emergent Hazards
    Ryan F. Hoy, et al. Respirology, March 2022.

    The Association Between Silica Exposure, Silicosis and Tuberculosis: A systematic Review and Metal-Analysis
    Rodney Ehrlich, Paula Akugizibwe, Nandi Siegfried and David Rees. BMC Public Health, May 2021.

    Silicosis, Progressive Massive Fibrosis and Silico-Tuberculosis Among Workers with Occupational Exposure to Silica Dusts in Sandstone Mines of Rajasthan State
    Subroto Nandi, Sarang Dhatrak, Kamalesh Sarkar. Journal of Family Medicine and Primary Care, February 2021.

    Artificial Stone Silicosis: Rapid Progression Following Exposure Cessation
    Antonio León-Jiménez, et al. Chest, September 2020.

    Silica-Associated Lung Disease: An Old-World Exposure in Modern Industries
    Hayley Barnes, Nicole S.L. Goh, Tracy L. Leong and Ryan Hoy. Respirology, September 2019.

    Australia Reports on Audit of Silicosis for Stonecutters
    Tony Kirby. The Lancet, March 2019.

    Artificial Stone-Associated Silicosis: A Rapidly Emerging Occupational Lung Disease
    Ryan F. Hoy, et al. Occupational & Environmental Medicine, December 2017.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Topping Up Testosterone?

    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 Testosterone Drop

    Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.

    (the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)

    This has been called “the male menopause”, or “the andropause”.

    Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.

    Why “the male menopause” is misleading:

    To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).

    Why “the andropause” is misleading:

    It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.

    Is there a better clinical term?

    Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.

    Terms aside, what are the symptoms?

    ❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞

    (Read more)

    …and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:

    Source: Andropause: Current concepts

    Can it be safely ignored?

    If you don’t mind the sexual symptoms, then mostly, yes!

    However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:

    • Depression
    • Loss of muscle mass
    • Increased body fat

    Depression kills, so this does need to be taken seriously. See also:

    The Mental Health First-Aid That You’ll Hopefully Never Need

    (the above is a guide to managing depression, in yourself or a loved one)

    Loss of muscle mass means being less robust against knocks and falls later in life

    Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)

    See also:

    Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.

    Will testosterone therapy help?

    That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).

    See for example:

    Testosterone Therapy Improves […] and […] in Hypogonadal Men

    (Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)

    Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:

    ❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.

    The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).

    Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞

    Source: Effects of Testosterone Treatment in Older Men

    We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.

    That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).

    And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)

    Click here to see the results table for the vitality trial

    Will it turn me into a musclebound angry ragey ‘roidmonster?

    Were you that kind of person before your testosterone levels declined? If not, then no.

    Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.

    Is testosterone therapy safe?

    A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.

    As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…

    ❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development

    For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.

    Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞

    Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:

    Risks of testosterone replacement therapy in men

    See also: Prostate Health: What You Should Know

    Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!

    For now, take care!

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  • Is owning a dog good for your health?

    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.

    Australia loves dogs. We have one of the highest rates of pet ownership in the world, and one in two households has at least one dog.

    But are they good for our health?

    Mental health is the second-most common reason cited for getting a dog, after companionship. And many of us say we “feel healthier” for having a dog – and let them sleep in our bedroom.

    Here’s what it means for our physical and mental health to share our homes (and doonas) with our canine companions.

    Pogodina Natalia/Shutterstock

    Are there physical health benefits to having a dog?

    Having a dog is linked to lower risk of death over the long term. In 2019, a systematic review gathered evidence published over 70 years, involving nearly four million individual medical cases. It found people who owned a dog had a 24% lower risk of dying from any cause compared to those who did not own a dog.

    A golden retriever pants on the grass next to a ball.
    Having a dog may help lower your blood pressure through more physical activity. Barnabas Davoti/Pexels

    Dog ownership was linked to increased physical activity. This lowered blood pressure and helped reduce the risk of stroke and heart disease.

    The review found for those with previous heart-related medical issues (such as heart attack), living with a dog reduced their subsequent risk of dying by 35%, compared to people with the same history but no dog.

    Another recent UK study found adult dog owners were almost four times as likely to meet daily physical activity targets as non-owners. Children in households with a dog were also more active and engaged in more unstructured play, compared to children whose family didn’t have a dog.

    Exposure to dirt and microbes carried in from outdoors may also strengthen immune systems and lead to less use of antibiotics in young children who grow up with dogs.

    A boy in sunglasses talks to his jack russell terrier on a beach.
    Children in households with a dog were often more active. Maryshot/Shutterstock

    Health risks

    However, dogs can also pose risks to our physical health. One of the most common health issues for pet owners is allergies.

    Dogs’ saliva, urine and dander (the skin cells they shed) can trigger allergic reactions resulting in a range of symptoms, from itchy eyes and runny nose to breathing difficulties.

    A recent meta-analysis pooled data from nearly two million children. Findings suggested early exposure to dogs may increase the risk of developing asthma (although not quite as much as having a cat does). The child’s age, how much contact they have with the dog and their individual risk all play a part.

    Slips, trips and falls are another risk – more people fall over due to dogs than cats.

    Having a dog can also expose you to bites and scratches which may become infected and pose a risk for those with compromised immune systems. And they can introduce zoonotic diseases into your home, including ring worm and Campylobacter, a disease that causes diarrhoea.

    For those sharing the bed there is an elevated the risk of allergies and picking up ringworm. It may result in lost sleep, as dogs move around at night.

    On the other hand some owners report feeling more secure while co-sleeping with their dogs, with the emotional benefit outweighing the possibility of sleep disturbance or waking up with flea bites.

    Proper veterinary care and hygiene practices are essential to minimise these risks.

    A dog peers out from under a doona while a man sleeps.
    Many of us don’t just share a home with a dog – we let them sleep in our beds. Claudia Mañas/Unsplash

    What about mental health?

    Many people know the benefits of having a dog are not only physical.

    As companions, dogs can provide significant emotional support helping to alleviate symptoms of anxiety, depression and post-traumatic stress. Their presence may offer comfort and a sense of purpose to individuals facing mental health challenges.

    Loneliness is a significant and growing public health issue in Australia.

    In the dog park and your neighbourhood, dogs can make it easier to strike up conversations with strangers and make new friends. These social interactions can help build a sense of community belonging and reduce feelings of social isolation.

    For older adults, dog walking can be a valuable loneliness intervention that encourages social interaction with neighbours, while also combating declining physical activity.

    However, if you’re experiencing chronic loneliness, it may be hard to engage with other people during walks. An Australian study found simply getting a dog was linked to decreased loneliness. People reported an improved mood – possibly due to the benefits of strengthening bonds with their dog.

    Three dogs on leash sniff each other.
    Walking a dog can make it easier to talk to people in your neighbourhood. KPegg/Shutterstock

    What are the drawbacks?

    While dogs can bring immense joy and numerous health benefits, there are also downsides and challenges. The responsibility of caring for a dog, especially one with behavioural issues or health problems, can be overwhelming and create financial stress.

    Dogs have shorter lifespans than humans, and the loss of a beloved companion can lead to depression or exacerbate existing mental health conditions.

    Lifestyle compatibility and housing conditions also play a significant role in whether having a dog is a good fit.

    The so-called pet effect suggests that pets, often dogs, improve human physical and mental health in all situations and for all people. The reality is more nuanced. For some, having a pet may be more stressful than beneficial.

    Importantly, the animals that share our homes are not just “tools” for human health. Owners and dogs can mutually benefit when the welfare and wellbeing of both are maintained.

    Tania Signal, Professor of Psychology, School of Health, Medical and Applied Sciences, CQUniversity Australia

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

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  • Peripheral Neuropathy: How To Avoid It, Manage It, Treat It

    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.

    Peripheral neuropathy (and what can be done about it)

    Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:

    • Diabetes
    • Alcoholism
    • Infection
    • Injury

    The manifestations can be different:

    • In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
    • In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
    • In the case of infection, a lot depends on the nature of the infection and the body’s response.
    • In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
      • This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)

    This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)

    Prevention is better than cure

    If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:

    • Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
    • Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
    • Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
      • We’ll do a main feature on this soon!
    • Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.

    Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:

    A standing desk

    A vertical ergonomic mouse

    An ergonomic split keyboard

    A Kindle*

    *Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.

    If you already have peripheral neuropathy

    Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?

    Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.

    And, all of these are good options; do you see what they have in common?

    It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).

    By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.

    But also don’t forget: rest

    • Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
    • Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
    • Use a brace if necessary to help the affected part stay aligned correctly
      • You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.

    One more top tip

    We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.

    So you might want to check that out:

    What Does Lion’s Mane Actually Do, Anyway?

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  • Fermenting Everything – by Andy Hamilton

    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.

    This is not justanother pickling book! This is, instead, what it says on the front cover, “fermenting everything”.

    Ok, maybe not literally everything, but every kind of thing that can reasonably be fermented, and it’s probably a lot more things than you might think.

    From habanero chutney to lacto-lemonade, aioli to kombucha, Ukrainian fermented tomatoes to kvass. We could go on, but we’d soon run out of space. You get the idea. If it’s a fermented product (food, drink, condiment) and you’ve heard of it, there’s probably a recipe in here.

    All in all, this is a great way to get in your gut-healthy daily dose of fermented products!

    He does also talk safety, and troubleshooting too. And so long as you have a collection of big jars and a fairly normally-furnished kitchen, you shouldn’t need any more special equipment than that, unless you decide to you your fermentation skills for making beer (which does need some extra equipment, and he offers advice on that—our advice as a health science publication is “don’t drink beer”, though).

    Bottom line: with this in hand, you can create a lot of amazing foods/drinks/condiments that are not only delicious, but also great for gut health.

    Click here to check out Fermenting Everything, and widen your culinary horizons!

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  • What’s Keeping the US From Allowing Better Sunscreens?

    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.

    When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”

    At issue is not just whether people are using enough sunscreen, but what ingredients are in it.

    The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.

    Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.

    Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.

    In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.

    “It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”

    Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.

    Dermatologists Offer Tips on Keeping Skin Safe and Healthy

    – Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.

    Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.

    But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.

    “It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.

    Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.

    “That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”

    Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”

    Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.

    The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.

    “It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”

    The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.

    “Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.

    D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.

    Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.

    D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.

    As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.

    “The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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