The Dopamine Precursor And More
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What Is This Supplement “NALT”?
N-Acetyl L-Tyrosine (NALT) is a form of tyrosine, an amino acid that the body uses to build other things. What other things, you ask?
Well, like most amino acids, it can be used to make proteins. But most importantly and excitingly, the body uses it to make a collection of neurotransmitters—including dopamine and norepinephrine!
- Dopamine you’ll probably remember as “the reward chemical” or perhaps “the motivation molecule”
- Norepinephrine, also called noradrenaline, is what powers us up when we need a burst of energy.
Both of these things tend to get depleted under stressful conditions, and sometimes the body can need a bit of help replenishing them.
What does the science say?
This is Research Review Monday, after all, so let’s review some research! We’re going to dive into what we think is a very illustrative study:
A 2015 team of researchers wanted to know whether tyrosine (in the form of NALT) could be used as a cognitive enhancer to give a boost in adverse situations (times of stress, for example).
They noted:
❝The potential of using tyrosine supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis.❞
More on this later, but first, the positive that they also found:
❝In contrast, tyrosine does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that tyrosine is an effective enhancer of cognition, but only when neurotransmitter function is intact and dopamine and/or norepinephrine is temporarily depleted❞
That “but only”, is actually good too, by the way!
You do not want too much dopamine (that could cause addiction and/or psychosis) or too much norepinephrine (that could cause hypertension and/or heart attacks). You want just the right amount!
So it’s good that NALT says “hey, if you need some more, it’s here, if not, no worries, I’m not going to overload you with this”.
Read the study: Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands
About that limitation…
Remember they said that it seemed unlikely to help in treating clinical disorders with impaired neurotransmitter function and/or synthesis?
Imagine that you employ a chef in a restaurant, and they can’t keep up with the demand, and consequently some of the diners aren’t getting fed. Can you fix this by supplying the chef with more ingredients?
Well, yes, if and only if the problem is “the chef wasn’t given enough ingredients”. If the problem is that the oven (or the chef’s wrist) is broken, more ingredients aren’t going to help at all—something different is needed in those cases.
So it is with, for example, many cases of depression.
See for example: Tyrosine for depression: a double-blind trial
About blood pressure…
You may be wondering, “if NALT is a precursor of norepinephrine, a vasoconstrictor, will this increase my blood pressure adversely?”
Well, check with your doctor as your own situation may vary, but under normal circumstances, no. The effect of NALT is adaptogenic, meaning that it can help keep its relevant neurotransmitters at healthy levels—not too low or high.
See what we mean, for example in this study where it actually helped keep blood pressure down while improving cognitive performance under stress:
Effect of tyrosine on cognitive function and blood pressure under stress
Bottom line:
For most people, NALT is a safe and helpful way to help keep healthy levels of dopamine and norepinephrine during times of stress, giving cognitive benefits along the way.
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What Too Much Exercise Does To Your Body And Brain
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“Get more exercise” is a common rallying-cry for good health, but it is possible to overdo it. And, this is not just a matter of extreme cases of “exercise addiction”, but even going much above certain limits can already result in sabotaging one’s healthy gains. But how, and where does the line get drawn?
Too Much Of A Good Thing
The famous 150 minutes per week of moderate exercise (or 75 minutes of intense exercise) is an oft-touted figure. This video, on the other hand, springs for 5 hours of moderate exercise or 2.5 hours intense exercise as a good guideline.
We’re advised that going over those guidelines doesn’t necessarily increase health benefits, and on the contrary, may reduce or even reverse them. For example, we are told…
- Light to moderate running reduces the risk of death, but running intensely more than 3 times a week can negate these benefits.
- Extreme endurance exercises, like ultra-marathons, may cause heart damage, heart rhythm disorders, and artery enlargement.
- Women who exercise strenuously every day have a higher risk of heart attacks and strokes compared to those who exercise moderately.
- Excessive exercise in women can lead to the “female athlete triad” (loss of menstruation, osteoporosis, and eating disorders).
- In men, intense exercise can lower libido due to fatigue and reduced testosterone levels.
- Both men and women are at increased risk of overuse injuries (e.g., tendinitis, stress fractures) and impaired immunity from excessive exercise.
- There is a 72-hour window of impaired immunity after intense exercise, increasing the risk of infections.
Exercise addiction is rare, though, with this video citing “around 1 million people in the US suffer from exercise addiction”.
For more on finding the right balance, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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What you need to know about the new weight loss drug Zepbound
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In a recent poll, KFF found that nearly half of U.S. adults were interested in taking a weight management drug like the increasingly popular Ozempic, Wegovy, and Mounjaro.
“I can understand why there would be widespread interest in these medications,” says Dr. Alyssa Lampe Dominguez, an endocrinologist and clinical assistant professor at the University of Southern California. “Obesity is a chronic disease that is very difficult to treat. And a lot of the medications that we previously used weren’t as effective.”
Now, there’s a new option available: In November 2023, the FDA approved Zepbound, another weight management medication, developed by the pharmaceutical company Eli Lilly. Zepbound is different from other drugs in many ways, including the fact that it’s proven to be the most effective option so far.
Keep reading to find out more about Zepbound, including who can take it, its side effects, and more.
What is Zepbound?
Zepbound, one of the brand names for tirzepatide, is an injectable drug with a maximum dosage of 15 mg per week. It’s based on incretin, a hormone that’s naturally released in the gut after a meal. (Mounjaro is another brand name for tirzepatide.)
Tirzepatide is considered a dual agonist because it activates the two primary incretin hormones: the glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP) hormones.
According to Dr. Katherine H. Saunders, an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth, tirzepatide is involved with several processes that regulate blood sugar, slow the removal of food from the stomach, and affect brain areas involved in appetite.
This means that people taking the medication feel less hungry and get fuller faster, leading to less food intake and, ultimately, weight loss.
How is Zepbound different from Ozempic?
The medications are different in many ways. Ozempic and Wegovy, which are both brand names for semaglutide, only target the GLP-1 hormone. Studies have shown that Zepbound can lead to a higher percentage of total body weight loss than semaglutide medications. In addition to being more effective, there is some evidence that Zepbound is overall more tolerable than Ozempic or Wegovy.
“I have seen overall lower rates in severity of side effects with the tirzepatide medications. Mounjaro [tirzepatide] in particular is the one that I’ve used up until this point, but there’s a thought that the GIP component of the medication actually decreases nausea,” adds Lampe Dominguez. “Anecdotally, patients that I have switched from semaglutide or Ozempic to Mounjaro say that they have less side effects with Mounjaro.”
How is Zepbound different from Mounjaro?
Zepbound and Mounjaro are the same medication—tirzepatide—but they’re approved for different conditions. Zepbound is FDA-approved for weight loss, while Mounjaro is approved for type 2 diabetes. (However, Mounjaro is also at times prescribed off-label for weight loss.)
What are some of Zepbound’s side effects?
According to the FDA, side effects include nausea, vomiting, diarrhea, constipation, stomach discomfort and pain, fatigue, and burping. See a more comprehensive list of side effects here.
Who can take Zepbound?
Zepbound is FDA-approved for adults with obesity (a BMI of 30 or greater) or who have a BMI of 27 or greater with at least one weight-related condition, like high blood pressure, type 2 diabetes, or high cholesterol.
“I tend to advise patients who don’t meet those criteria to not take these medications because we really don’t know what the risks are,” says Lampe Dominguez, adding that people with lower BMI weren’t included in the medication’s studies. “We don’t know if there are specific risks to using this medication at a lower body mass index [or] if there might be some negative outcomes.”
Both doctors agree that it’s important for people who are interested in starting any weight loss medication to talk to their doctors about the potential risks and benefits. For instance, the FDA notes that Zepbound has caused thyroid tumors in rats, and while it’s unknown if this could also happen to humans, the agency said the medication shouldn’t be used in patients with a personal or family history of medullary thyroid cancer.
“Zepbound is a powerful medication that can lead to severe side effects, vitamin deficiencies, a complete lack of appetite, or too much weight loss if prescribed without the appropriate personalization, education, and close monitoring,” says Saunders.
“With all of these medications, and particularly with Zepbound, we would want to make sure that [patients] don’t have a family history of a specific type of thyroid cancer called medullary thyroid cancer,” says Lampe Dominguez.
How long should people take Zepbound for?
“Anti-obesity medications like Zepbound are not meant for short-term weight loss, but long-term treatment of obesity, which is a chronic disease,” explains Saunders. “We prepare our patients to be on the medication (or some type of medical obesity treatment) long term for their chronic disease, which is only controlled for the duration of time they’re being treated.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Muir Glen Organic vs First Field Original – Which is Healthier?
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Our Verdict
When comparing Muir Glen Organic Ketchup to First Field Original Ketchup, we picked the First Field.
Why?
This one was a little unfair to you, as you can’t turn them around to read the ingredients here. But the point we want to share the most today is: you have to turn them around and read the ingredients! You absolutely cannot rely on appearances!
While the Muir Glen Organic may have a very “greenwashed” aesthetic going on and the word “organic” is more eye-catching than any other word on the label, it contains 4x as much sugar and 4x as much sodium.
Side-by-side, they have, per tablespoon:
First Field Original: 1g sugar, 60mg sodium
Muir Glen Organic: 4g sugar, 240mg sodiumBut what about the importance of being organic?
Well, we have one more surprise for you: the First Field ketchup is organic too, non-GMO, and contains no added concentrates either.
This isn’t an ad for First Field (by all means enjoy their products or don’t; we’re not invested), but it is a heartfelt plea to always check the backs of products and read the labels, because fronts of products can’t be relied upon at all.
I’m sure we all get caught out sometimes, but the less often, the better!
PS: we write this, of course, before seeing the results of your voting. Maybe it won’t be a “Muir Glen Organic” sweep in the polls. But either way, it’s a call to vigilance, and a “very good, carry on” to everyone who does this already
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Why You’re Tired & How To Fix It
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This is Sadia Badiei. A dietician by academic and professional background, she’s nowadays hung up her lab coat for a chef’s jacket, and is best known for her “Pick Up Limes” brand. Today, we’ll be taking her advice on managing energy levels with what’s on our plates!
Quick note: our usual medical/legal disclaimer applies, and this article cannot diagnose you from afar, and thus neither can it make any certain prescription; this is for educational purposes, and aimed at being applicable to most of our readers.
There are many possible things that can cause chronic fatigue, and not all of them can be fixed by diet. Your doctor will have access to tests and such that we, being a humble health science publication, do not.
You may recognize her; we’ve featured her videos occasionally, mostly recently:
Pick Up A Zest For Life: 10 Lessons For A Healthy Mind & Body
But, what does she want us to know about living life with more energy?
It starts with balance
Badiei makes the case that we should strive for a nutritionally-balanced diet; that may not come as much of a revelation, but what does that look like for a vegan (Badiei advocates for plant-based eating)?
She recommends that our diet consist of:
- About 50% fruits and vegetables
- About 25% grains and starches
- About 25% proteins
- Modest amounts of fats
- A little of well-chosen dairy substitutions
- Finally, a few judicious supplements to top it off
That does add up to more than 100%, but 1) we did say “About n%” and 2) this is not a bad thing to note, actually, since Badiei advocates (as we do) for focussing more on what we add into our diet, rather than what we take out.
Breaking it down a little further, she recommends making sure to get “the foundational seven”, which is a little like “Dr. Greger’s Daily Dozen”, but in this case it’s counted on a per-food-type basis.
Thus, she recommends:
- Dark green leafy vegetables
- Assorted other non-starchy vegetables (your choice what kind)
- Fruit, of any kinds (unlike Dr. Greger separating berries)
- Grains and starches (so for example, potatoes are lumped in with rice here, botanically very different, but often fulfil a similar culinary role)
- Nuts and seeds
- Legumes
- Fortified dairy alternatives
For full details including how much of each, and “what counts”, etc, see:
Pick Up Limes | The Nourish Method
Time your carbs
Slow-release carbohydrates, those with the most fiber, are best most of the time, giving us more sustained fuel, keeping us energized for longer after meals—even if we would rather sleep:
She cites: Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep
Quick-release carbohydrates, those with what’s generally considered a less favorable carb:fiber ratio, are best if we’re going to eat nearer to bedtime. We know, eating before bed is often considered a bit of a no-no, but Badiei bids us indulge if we so desire, as the quicker-absorbed carbohydrates support tryptophan reaching our brain more efficiently, and thus promote sleep onset.
See also: Should You Go Light Or Heavy On Carbs?
About that fat
We mentioned (or rather, Badiei’s citation mentioned) saturated fat. It is indeed linked with difficulty falling asleep, and/but omega-3 fatty acids, on the other hand, promote better sleep.
She cites: The relationship between sleep duration, sleep quality and dietary intake in adults
While you’re enjoying those nuts and seeds (for the omega-3 fatty acids), you might also note that several also star in Badiei’s list of plant-based foods that are rich in tryptophan, such as soy, cashews, pumpkin seeds, sunflower seeds, beans, green vegetables, and mushrooms.
Micronutrients
Badiei’s focus here is on B-vitamins, iron, magnesium, selenium, and zinc. We imagine most of our readers here are taking steps to ensure to get a full daily coverage of vitamins and minerals anyway, but you might want to read what she has to say about iron on a plant-based diet, because the numbers may be different than you think.
The reason for this is that while animal products contain mostly heme iron, which is easier to absorb but associated with a risk increase in some diseases, plant-based foods usually* contain only non-heme iron, which is healthier but not as bioavailable, so if eating only plants, we need more of it:
Pick Up Limes | Iron on a Plant-Based Diet
*If you eat a carnivorous plant, guess what, it’ll have heme iron in it, tangling that food web.
“What if I know I have chronic fatigue for non-dietary reasons?”
Well, that sucks, and we’re not going to pretend the above will magically fix it. However, there are still things that can at least relatively improve your experience:
Eat To Beat Chronic Fatigue! Yes, Even When Fatigued Chronically
(it’s a good guide to being able to consistently eat healthily when your energy levels are consistently at minimal, meaning that a lot of common advice becomes unusable)
Take care!
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Marathons in Mid- and Later-Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!
As for questions we’re answering today…
Q: Is there any data on immediate and long term effects of running marathons in one’s forties?
An interesting and very specific question! We didn’t find an overabundance of studies specifically for the short- and long-term effects of marathon-running in one’s 40s, but we did find a couple of relevant ones:
The first looked at marathon-runners of various ages, and found that…
- there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
- the majority of middle-aged and elderly athletes have training histories of less than seven years of running
From which they concluded:
❝The present findings strengthen the concept that considers aging as a biological process that can be considerably speeded up or slowed down by multiple lifestyle related factors.❞
See the study: Performance, training and lifestyle parameters of marathon runners aged 20–80 years: results of the PACE-study
The other looked specifically at the impact of running on cartilage, controlled for age (45 and under vs 46 and older) and activity level (marathon-runners vs sedentary people).
The study had the people, of various ages and habitual activity levels, run for 30 minutes, and measured their knee cartilage thickness (using MRI) before and after running.
They found that regardless of age or habitual activity level, running compressed the cartilage tissue to a similar extent. From this, it can be concluded that neither age nor marathon-running result in long-term changes to cartilage response to running.
Or in lay terms: there’s no reason that marathon-running at 40 should ruin your knees (unless you are doing something wrong).
That may or may not have been a concern you have, but it’s what the study looked at, so hey, it’s information.
Here’s the study: Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running
Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?
When it comes to that particular issue, one or more of these three factors are often involved:
- Hormones
- Circulation
- Psychology
The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.
To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:
Hormones
Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.
This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.
Circulation
Look after your heart health; eat for your heart health, and exercise regularly!
Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.
Psychology
[E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!
Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).
So, to recap, we recommend:
- Have your hormones checked
- Look after your circulation
- Make the decision to have fun!
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Walking can prevent low back pain, a new study shows
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Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly 70% of people who recover from an episode of low back pain will experience a new episode in the following year.
The recurrent nature of low back pain is a major contributor to the enormous burden low back pain places on individuals and the health-care system.
In our new study, published today in The Lancet, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.
The WalkBack trial
We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).
Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.
The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.
The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.
Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.
People in the control group received no preventative treatment or education. This reflects what typically occurs after people recover from an episode of low back pain and are discharged from care.
What the results showed
We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.
The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.
Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.
Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.
This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.
Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.
Walking has multiple benefits
We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all previous studies have focused on treating episodes of pain, not preventing future back pain.
A limited number of small studies have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.
On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.
Walking also delivers many other health benefits, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.
While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants reported that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.
Why is walking helpful for low back pain?
We don’t know exactly why walking is effective for preventing back pain, but possible reasons could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which block pain signals between your body and brain – essentially turning down the dial on pain.
It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, no studies have investigated this.
Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.
Tash Pocovi, Postdoctoral research fellow, Department of Health Sciences, Macquarie University; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Mark Hancock, Professor of Physiotherapy, Macquarie University; Petra Graham, Associate Professor, School of Mathematical and Physical Sciences, Macquarie University, and Simon French, Professor of Musculoskeletal Disorders, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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