The Painkilling Power Of Opioids, Without The Harm?

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When it comes to painkilling medications, they can generally be categorized into two kinds:

  • non-opioids (e.g. ibuprofen, paracetamol/acetaminophen, aspirin)
  • ones that actually work for something more serious than a headache

That’s an oversimplification, but broadly speaking, when there is serious painkilling to be done, that’s when doctors consider it’s time to break out the opioids.

Nor are all opioids created equal—there’s a noteworthy difference between codeine and morphine, for instance—but the problems of opioids are typically the same (tolerance, addiction, and eventual likelihood of overdose when one tries to take enough to make it work after developing a tolerance), and it becomes simply a matter of degree.

See also: I’ve been given opioids after surgery to take at home. What do I need to know?

So, what’s the new development?

A team of researchers have found that the body can effectively produce its own targetted painkilling peptides, similar in function to benzodiazepines (an opioid drug), but—and which is a big difference—confined to the peripheral nervous system (PNS), meaning that it doesn’t enter the brain.

  • The peptides killing the pain before it can reach the brain is obviously good because that means the pain is simply not experienced
  • The peptides not having any effect on the brain, however, means that the mechanism of addiction of opioids simply does not apply here
  • The peptides not having any effect on the brain also means that the CNS can’t be “put to sleep” by these peptides in the same way it can if a high dose of opioids is taken (this is what typically causes death in opioid overdoses; the heart simply beats too slowly to maintain life)

The hope, therefore, is to now create medications that target the spinal ganglia that produce these peptides, to “switch them on” at will.

Obviously, this won’t happen overnight; there will need to be first a lot of research to find a drug that does that (likely this will involve a lot of trial and error and so many mice/rats), and then multiple rounds of testing to ascertain that the drug is safe and effective for humans, before it can then be rolled out commercially.

But, this is still a big breakthrough; there arguably hasn’t been a breakthrough this big in pain research since various opioid-related breakthroughs in the 70s and 80s.

You can see a pop-science article about it here:

Chronic pain, opioids and natural benzos: Researchers discover how body can make its own “sleeping pills”

And you can see the previous research (from earlier this year) that this is now building from, about the glial cells in the spinal ganglia, here:

Peripheral gating of mechanosensation by glial diazepam binding inhibitor

But wait, there’s more!

Remember what we said about affecting the PNS without affecting the CNS, to kill the pain without killing the brain?

More researchers are already approaching the same idea to deal with the same problem, but from the angle of gene therapy, and have already had some very promising results with mice:

Structure-guided design of a peripherally restricted chemogenetic system

…which you can read about in pop-science terms (with diagrams!) here:

New gene therapy could alleviate chronic pain, researchers find

While you’re waiting…

In the meantime, approaches that are already available include:

Take care!

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  • Elderberries vs Gooseberries – Which is Healthier?

    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.

    Our Verdict

    When comparing elderberries to gooseberries, we picked the elderberries.

    Why?

    These are both berries more likely found in your garden or local wood than in the supermarket, but if you have convenient access to them, they’re great options for eating!

    In terms of macros, elderberry has nearly 2x the carbs and/but also nearly 2x the fiber, which in glycemic index terms, mostly cancels out (although: elderberry has the slightly lower glycemic index of the two)

    In the category of vitamins, both are great but elderberries are winning with more of vitamins A, B1, B2, B3, B6, and C, while gooseberries have more vitamin B5.

    When it comes to minerals, elderberries again lead with more calcium, iron, phosphorus, and potassium, while gooseberries have more magnesium.

    There is an extra category today, which is “extra medicinal properties”, and elderberries have extra immune-boosting qualities, whereas gooseberries—while being as polyphenol-laden as one usually expects berries to be—do not confer the same kind of benefit in this regard.

    You can check out the information about elderberry’s extra properties in the links section below; meanwhile, if you’re choosing between these berries, that’s the clear winner in every category today!

    Want to learn more?

    You might like to read:

    Take care!

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  • Delay Ageing – by Dr. Colin Rose

    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.

    Note: the title is spelled that way because it is British English. We generally write in US English here at 10almonds, but we’ll first quote directly from Dr. Rose as written:

    ❝I have written Delay Ageing because there is some very important recent University research on ageing and age related illness that deserves to be made accessible to a general audience.❞

    What is this research? Well, there’s quite a lot over its 300-odd pages (exact number depends on the edition and whether we count end matter), and most of it is tweaks and refinements on things with which you’ll probably be at least brushingly familiar if you’re a regular 10almonds reader.

    Dr. Rose addresses the nine hallmarks of aging, of which there are ten, ranging from such things as “telomeres get shorter” and “DNA accumulates damage”, to “stem cells become exhausted” and “cells fail to communicate properly”, and asks the question “what if we were to target all these things simultaneously?”.

    Rather than going for drugs on drugs on drugs (half of them to deal with undesired side effects of the previous ones), Dr. Cole leaves no stone unturned to find lifestyle interventions that will improve each of these, even if just a little. Because, all those “little” improvements add up and even compound, and on the flipside, mean that factors of aging aren’t adding up and compounding so much or so quickly anymore.

    The rather broad umbrella of “lifestyle interventions” obviously includes food under its auspices, and with it, nutraceuticals. So to give one example, if you’re taking a fisetin supplement (a natural senolytic agent), you’ll find science vindicating that here. And much more.

    The style is… Less pop-science and more “textbook written for laypersons”, and you may be thinking “isn’t that the same?” and the difference is that the textbook has a lot less polish and finesse, but often more precise information.

    Bottom line: if you’d like to combat aging on 10 different fronts with easily implementable lifestyle interventions, and know exactly what is doing what and how, then this is the book for you.

    Click here to check out Delay Ageing, and delay aging!

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  • What You Don’t Know Can Kill You

    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.

    Knowledge Is Power!

    This is Dr. Simran Malhotra. She’s triple board-certified (in lifestyle medicine, internal medicine, and palliative care), and is also a health and wellness coach.

    What does she want us to know?

    Three things:

    Wellness starts with your mindset

    Dr. Malhotra shifted her priorities a lot during the initial and perhaps most chaotic phase of the COVID pandemic:

    ❝My husband, a critical care physician, was consumed in the trenches of caring for COVID patients in the ICU. I found myself knee-deep in virtual meetings with families whose loved ones were dying of severe COVID-related illnesses. Between the two of us, we saw more trauma, suffering, and death, than we could have imagined.

    The COVID-19 pandemic opened my eyes to how quickly life can change our plans and reinforced the importance of being mindful of each day. Harnessing the power to make informed decisions is important, but perhaps even more important is focusing on what is in our control and taking action, even if it is the tiniest step in the direction we want to go!❞

    ~ Dr. Simran Malhotra

    We can only make informed decisions if we have good information. That’s one of the reasons we try to share as much information as we can each day at 10almonds! But a lot will always depend on personalized information.

    There are one-off (and sometimes potentially life-saving) things like health genomics:

    The Real Benefit Of Genetic Testing

    …but also smaller things that are informative on an ongoing basis, such as keeping track of your weight, your blood pressure, your hormones, and other metrics. You can even get fancy:

    Track Your Blood Sugars For Better Personalized Health

    Lifestyle is medicine

    It’s often said that “food is medicine”. But also, movement is medicine. Sleep is medicine. In short, your lifestyle is the most powerful medicine that has ever existed.

    Lifestyle encompasses very many things, but fortunately, there’s an “80:20 rule” in play that simplifies it a lot because if you take care of the top few things, the rest will tend to look after themselves:

    These Top Few Things Make The Biggest Difference To Overall Health

    Gratitude is better than fear

    If we receive an unfavorable diagnosis (and let’s face it, most diagnoses are unfavorable), it might not seem like something to be grateful for.

    But it is, insofar as it allows us to then take action! The information itself is what gives us our best chance of staying safe. And if that’s not possible e.g. in the worst case scenario, a terminal diagnosis, (bearing in mind that one of Dr. Malhotra’s three board certifications is in palliative care, so she sees this a lot), it at least gives us the information that allows us to make the best use of whatever remains to us.

    See also: Managing Your Mortality

    Which is very important!

    …and/but possibly not the cheeriest note on which to end, so when you’ve read that, let’s finish today’s main feature on a happier kind of gratitude:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    Want to hear more from Dr. Malhotra?

    Showing how serious she is about how our genes do not determine our destiny and knowledge is power, here she talks about her “previvor’s journey”, as she puts it, with regard to why she decided to have preventative cancer surgery in light of discovering her BRCA1 genetic mutation:

    Click Here If The Embedded Video Doesn’t Load Automatically

    Take care!

    Share This Post

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  • Zucchini & Oatmeal Koftas

    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.

    These vegetarian (and with one tweak, vegan) koftas are delicious as a snack, light lunch, or side to a larger meal. Healthwise, they contain the healthiest kind of fiber, as well as omega-3 fatty acids, and beneficial herbs and spices.

    You will need

    • ¼ cup oatmeal
    • 1 large zucchini, grated
    • 1 small carrot, grated
    • ¼ cup cheese (your preference; vegan is also fine)
    • 2 tbsp ground flaxseed
    • 2 tbsp nutritional yeast
    • ¼ bulb garlic, minced
    • 2 tsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Small handful fresh parsley, chopped
    • Extra virgin olive oil, for frying

    Method

    (we suggest you read everything at least once before doing anything)

    1) Soak the flaxseed in 2 oz hot water for at least 5 minutes

    2) Combine all of the ingredients except the olive oil (and including the water that the flax has been soaking in) in a big bowl, mixing thoroughly

    3) Shape into small balls, patties, or sausage shapes, and fry until the color is golden and the structural integrity is good. If doing patties, you’ll need to gently flip them to cook both sides; otherwise, rolling them to get all sides is fine.

    4) Serve! Traditional is with some kind of yogurt dip, but we’re not the boss of you, so enjoy them how you like:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

    Don’t Forget…

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  • Colloidal Gold’s Impressive Claims

    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.

    All That Glitters…

    Today we’ll be examining colloidal gold supplementation.

    This issue of 10almonds brought to you by the writer suddenly getting lots of advertisements for this supplement. It’s not a new thing though, and has been around in one form or another since pretty much forever.

    Colloidal gold is…

    • Gold, as in the yellow metal
    • Colloidal, as in “very tiny insoluble particles dispersed though another substance (such as water)”

    What are the claims made for it?

    Honestly, just about everything is claimed for it. But to go with some popular claims:

    • Reduces inflammation
    • Supports skin health
    • Boosts immune function
    • Combats aging
    • Improves cognitive function

    So, what does the science say?

    Does it do those things?

    The short and oversimplified answer is: no

    However, there is a little bit of tangential merit, so we’re going to talk about the science of it, and how the leap gets made between what the science says and what the advertisements say.

    First… What makes gold so special, in general? Historically, three things:

    1. It’s quite rare
    2. It’s quite shiny
    3. It’s quite unreactive
    • The first is about supply and demand, so that’s not very important to us in this article.
    • The second is an aesthetic quality, which actually will have a little bit of relevance, but not much.
    • The third has been important historically (because it meant that shiny gold stayed shiny, because it didn’t tarnish), and now also important industrially too, as gold can be used in many processes where we basically need for nothing to happen (i.e., a very inert component is needed)

    That third quality—its unreactivity—has become important in medicine.

    When scientists need a way to deliver something (without the delivering object getting eaten by the body’s “eat everything” tendencies), or otherwise not interact chemically with anything around, gold is an excellent choice.

    Hence gold teeth, and gold fillings, by the way. They’re not just for the bling factor; they were developed because of their unreactivity and thus safety.

    So, what about those health claims we mentioned above?

    Here be science (creative interpretations not included)

    The most-backed-by-science claim from that list is “reduces inflammation”.

    Websites selling colloidal gold cite studies such as:

    Gold nanoparticles reduce inflammation in cerebral microvessels of mice with sepsis

    A promising title!The results of the study showed:

    ❝20 nm cit-AuNP treatment reduced leukocyte and platelet adhesion to cerebral blood vessels, prevented BBB failure, reduced TNF- concentration in brain, and ICAM-1 expression both in circulating polymorphonuclear (PMN) leukocytes and cerebral blood vessels of mice with sepsis. Furthermore, 20 nm cit-AuNP did not interfere with the antibiotic effect on the survival rate of mice with sepsis.❞

    That “20 nm cit-AuNP” means “20 nm citrate-covered gold nanoparticles”

    So it is not so much the antioxidant powers of gold being tested here, as the antioxidant powers of citrate, a known antioxidant. The gold was the carrying agent, whose mass and unreactivity allowed it to get where it needed to be.

    The paper does say the words “Gold nanoparticles have been demonstrated to own important anti-inflammatory properties“ in the abstract, but does not elaborate on that, reference it, or indicate how.

    Websites selling colloidal gold also cite papers such as:

    Anti-inflammatory effect of gold nanoparticles supported on metal oxides

    Another promising title! However the abstract mentions:

    ❝The effect was dependent on the MOx NPs chemical nature

    […]

    The effect of Au/TiO2 NPs was not related to Au NPs size❞

    MOx NPs = mineral oxide nanoparticles. In this case, the gold was a little more than a carrying agent, though, because the gold is described and explained as being a catalytic agent (i.e., its presence helps the attached mineral oxides react more quickly).

    We said that was the most-backed claim, and as you can see, it has some basis but is rather tenuous since the gold by itself won’t do anything; it just helps the mineral oxides.

    Next best-backed claim builds from that, which is “supports skin health”.

    Sometimes colloidal gold is sold as a facial tonic. By itself it’ll distribute (inert) gold nanoparticles across your skin, and may “give you a healthy glow”, because that’s what happens when you put shiny wet stuff on your face.

    Healthwise, if the facial tonic also contains some of the minerals we mentioned above, then it may have an antioxidant effect. But again, no minerals, no effect.

    The claim that it “combats aging” is really a tag-on to the “antioxidant” claim.

    As for the “supports immune health” claim… Websites selling colloid gold cite studies such as:

    Efficacy and Immune Response Elicited by Gold Nanoparticle- Based Nanovaccines against Infectious Diseases

    To keep things brief: gold can fight infectious diseases in much the same way that forks can fight hunger. It’s an inert carrying agent.

    As for “improves cognitive function”? The only paper we could find cited was that mouse sepsis study again, this time with the website saying “researchers found that rats treated with colloidal gold showed improved spatial memory and learning ability“ whereas the paper cited absolutely did not claim that, not remotely, not even anything close to that. It wasn’t even rats, it was mice, and they did not test their memory or learning.

    Is it safe?

    Colloidal gold supplementation is considered very safe, precisely because gold is one of the least chemically reactive substances you could possibly consume. It is special precisely because it so rarely does anything.

    However, impurities could be introduced in the production process, and the production process often involves incredibly harsh reagents to get the gold ions, and if any of those reagents are left in the solution, well, gold is safe but sodium borohydride and chloroauric acid aren’t!

    Where can I get some?

    In the unlikely event that our research review has given you an urge to try it, here’s an example product on Amazon

    Take care!

    Don’t Forget…

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  • What Macronutrient Balance Is Right For You?

    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 😎

    ❝I want to learn more about macros. Can you cover that topic?❞

    That’s a little broader than we usually go for, given the amount of space we have, but let’s give it a go!

    Macronutrients, or “macros”, are the nutrients that we typically measure in grams rather than milligrams or micrograms, and are:

    In terms of how much we need of each, you can read more in the above-linked articles, but:

    • General scientific consensus is we need plenty of fiber (30 or 40g per day is good) and water (highly dependent on climate and activity), and there’s a clear minimum requisite for protein (usually put at around 1g of protein per day per 1kg of body weight).
    • There is vigorous debate in the general health community about what the best ratio of carbs to fat is.

    The reality is that humans are quite an adaptable species, and while we absolutely do need at least some of both (carbohydrates and fats), we can play around with the ratios quite a bit, provided we don’t get too extreme about it.

    While some influence is social and often centered around weight loss (see for example keto which seeks to minimize carbs, and volumetrics, which seeks maximise volume-to-calorie ratio, which de facto tends to minimize fats), some of what drives us to lean one way or the other will be genetics, too—dependent on what our ancestors ate more or less of.

    Writer’s example: my ancestors could not grow much grain (or crops in general) where they were, so they got more energy from such foods as whale and seal fat (with protein coming more from reindeer). Now, biology is not destiny, and I personally enjoy a vegan diet, but my genes are probably why I am driven to get most of my daily calories from fat (of which, a lot of fatty nuts (don’t tell almonds, but I prefer walnuts and cashews) and healthy oils such as olive oil, avocado oil, and coconut oil).

    However! About that adaptability. Provided we make changes slowly, we can usually adjust our diet to whatever we want it to be, including whether we get our energy more from carbs or fats. The reason we need to make changes slowly is because our gut needs time to adjust. For example, if your vegan writer here were to eat her ancestrally-favored foods now, I’d be very ill, because my gut microbiome has no idea what to do with animal products anymore, no matter what genes I have. In contrast, if an enthusiastic enjoyer of a meat-heavy diet were to switch to my fiber-rich diet overnight, they’d be very ill.

    So: follow your natural inclinations, make any desired changes slowly, and if in doubt, it’s hard to go wrong with enjoying carbs and fats in moderation.

    Learn more: Intuitive Eating Might Not Be What You Think

    Take care!

    Don’t Forget…

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