Antibiotics? Think Thrice
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Antibiotics: Useful Even Less Often Than Previously Believed (And Still Just As Dangerous)
You probably already know that antibiotics shouldn’t be taken unless absolutely necessary. Not only does taking antibiotics frivolously increase antibiotic resistance (which is bad, and kills people), but also…
It’s entirely possible for the antibiotics to not only not help, but instead wipe out your gut’s “good bacteria” that were keeping other things in check.
Those “other things” can include fungi like Candida albicans.
Candida, which we all have in us to some degree, feeds on sugar (including the sugar formed from breaking down alcohol, by the way) and refined carbs. Then it grows, and puts its roots through your intestinal walls, linking with your neural system. Then it makes you crave the very things that will feed it and allow it to put bigger holes in your intestinal walls.
Don’t believe us? Read: Candida albicans-Induced Epithelial Damage Mediates Translocation through Intestinal Barriers
(That’s scientist-speak for “Candida puts holes in your intestines, and stuff can then go through those holes”)
And as for how that comes about, it’s like we said:
See also: Candida albicans as a commensal and opportunistic pathogen in the intestine
That’s not all…
And that’s just C. albicans, never mind things like C. diff. that can just outright kill you easily.
We don’t have room to go into everything here, but you might like to check out:
Four Ways Antibiotics Can Kill You
It gets worse (now comes the new news)
So, what are antibiotics good for? Surely, for clearing up chesty coughs, lower respiratory tract infections, right? It’s certainly one of the two things that antibiotics are most well-known for being good at and often necessary for (the other being preventing/treating sepsis, for example in serious and messy wounds).
But wait…
A large, nationwide (US) observational study of people who sought treatment in primary or urgent care settings for lower respiratory tract infections found…
(drumroll please)
…the use of antibiotics provided no measurable impact on the severity or duration of coughs even if a bacterial infection was present.
Read for yourself:
And in the words of the lead author of that study,
❝Lower respiratory tract infections tend to have the potential to be more dangerous, since about 3% to 5% of these patients have pneumonia. But not everyone has easy access at an initial visit to an X-ray, which may be the reason clinicians still give antibiotics without any other evidence of a bacterial infection.❞
So, what’s to be done about this? On a large scale, Dr. Merenstein recommends:
❝Serious cough symptoms and how to treat them properly needs to be studied more, perhaps in a randomized clinical trial as this study was observational and there haven’t been any randomized trials looking at this issue since about 2012.❞
This does remind us that, while not a RCT, there is a good ongoing observational study that everyone with a smartphone can participate in:
Dr. Peter Small’s medical AI: “The Cough Doctor”
In the meantime, he advises that when COVID and SARS have been ruled out, then “basic symptom-relieving medications plus time brings a resolution to most people’s infections”.
You can read a lot more detail here:
Antibiotics aren’t effective for most lower tract respiratory infections
In summary…
Sometimes, antibiotics really are a necessary and life-saving medication. But most of the time they’re not, and given their great potential for harm, they may be best simultaneously viewed as the very dangerous threat they also are, and used only when those “heavy guns” are truly what’s required.
Take care!
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5 Ways To Avoid Hearing Loss
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Hear Ye, Hear Ye
Hearing loss is often associated with getting older—but it can strike at any age. In the US, for example…
- Around 13% of adults have hearing difficulties
- Nearly 27% of those over 65 have hearing difficulties
Complete or near-complete hearing loss is less common. From the same source…
- A little under 2% of adults in general had a total or near-total inability to hear
- A little over 4% of those over 65 had a total or near-total inability to hear
Source: CDC | Hearing Difficulties Among Adults: United States, 2019
So, what to do if we want to keep our hearing as it is?
Avoid loud environments
An obvious one, but it bears stating for the sake of being methodical. Loud environments damage our ears, but how loud is too loud?
You can check how loud an environment is by using a free smartphone app, such as:
Decibel Pro: dB Sound Level Meter (iOS / Android)
An 82 dB environment is considered safe for 16 hours. That’s the equivalent of, for example moderate traffic.
Every 3 dB added to that halves the safe exposure time, for example:
- An 85 dB environment is considered safe for 8 hours. That’s the equivalent of heavier traffic, or a vacuum cleaner.
- A 94 dB environment is considered safe for 1 hour. That might be a chainsaw, a motorcycle, or a large sporting event.
Many nightclubs or concert venues often have environments of 110 dB and more. So the safe exposure time would be under two minutes.
Source: NIOSH | Noise and Hearing Loss
With differences like that per 3 dB increase, then you may want to wear hearing protection if you’re going to be in a noisy environment.
Discreet options include things like these -20 dB silicone ear plugs that live in a little case on one’s keyring.
Stop sticking things in your ears
It’s said “nothing smaller than your elbow should go in your ear canal”. We’ve written about this before:
What’s Good (And What’s Not) Against Earwax
Look after the rest of your health
Our ears are not islands unaffected by the rest of our health, and indeed, they’re larger and more complex organs than we think about most of the time, since we only tend to think about the (least important!) external part.
Common causes of hearing loss that aren’t the percussive injuries we discussed above include:
- Diabetes
- High blood pressure
- Smoking
- Infections
- Medications
Lest that last one sound a little vague, it’s because there are hundreds of medications that have hearing loss as a potential side-effect. Here’s a list so you can check if you’re taking any of them:
List of Ototoxic Medications That May Cause Tinnitus or Hearing Loss
Get your hearing tested regularly.
There are online tests, but we recommend an in-person test at a local clinic, as it won’t be subject to the limitations and quirks of the device(s) you’re using. Pretty much anywhere that sells hearing aids will probably offer you a free test, so take advantage of it!
And, more generally, if you suddenly notice you lost some or all of your hearing in one or more ears, then get thee to a doctor, and quickly.
Treat it as an emergency, because there are many things that can be treated if and only if they are caught early, before the damage becomes permanent.
Use it or lose it
This one’s important. As we get older, it’s easy to become more reclusive, but the whole “neurons that fire together, wire together” neuroplasticity thing goes for our hearing too.
Our brain is, effectively, our innermost hearing organ, insofar as it processes the information it receives about sounds that were heard.
There are neurological hearing problems that can show up without external physical hearing damage (auditory processing disorders being high on the list), but usually these things are comorbid with each other.
So if we want to maintain our ability to process the sounds our ears detect, then we need to practice that ability.
Important implication:
That means that if you might benefit from a hearing aid, you should get it now, not later.
It’s counterintuitive, we know, but because of the neurological consequences, hearing aids help people retain their hearing, whereas soldiering on without can hasten hearing loss.
On the topic of hearing difficulty comorbidities…
Tinnitus (ringing in the ears) is, paradoxically, associated with both hearing loss, and with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).
Learn more about managing that, here:
Tinnitus: Quieting The Unwanted Orchestra In Your Ears
Take care!
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The Path to Longevity – by Dr. Luigi Fontana
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We’ve reviewed other “expand your healthspan” books, and while they’re good (or else we wouldn’t include them), this is top-tier, up there with Dr. Greger’s books while being more accessible (more on this later).
This book is far more informational than opinionated, and while some reviewers have described the book as motivating them, that’s not at all the tone, and it’s clear that (beyond hoping for the reader to have to information to promote a long healthy life), the author has no particular agenda to push.
One example: while he gives a whole-foods, plant-based diet a “A+” rating, he puts the (often meat/fish-heavy) paleo diet at a close “A-“, depending on the animal products chosen (which can swing it a lot, and he discusses this in some detail).
In the category of criticism… This reviewer has none. Sometimes it seemed something was going unaddressed, but it would be addressed later.
Stylistically, the text is easy-reading and/but has a lot of references to hard science, complete with charts, diagrams, and so forth. The impression that this reviewer got is that Dr. Fontana took pains to convey as much science as possible, with (unlike Dr. Greger) as little jargon as possible. And that goes a long way.
Bottom line: if you’re looking for a “healthy aging” book that has a lot more science than “copy the Blue Zone supercentenarians and hope” without being so scientifically dense as “How Not To Die” or “How Not To Age“, then this is the book for you.
Click here to check out The Path to Longevity, and optimize the path you take!
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The Glucose Goddess Method – by Jessie Inchausspé
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We’ve previously reviewed Inchausspé’s excellent book “Glucose Revolution”. So what does this book add?
This book is for those who found that book a little dense. While this one still gives the same ten “hacks”, she focuses on the four that have the biggest effect, and walks the reader by the hand through a four-week programme of implementing them.
The claim of 100+ recipes is a little bold, as some of the recipes are things like vinegar, vinegar+water, vinegar+water but now we’re it’s in a restaurant, lemon+water, lemon+water but now it’s in a bottle, etc. However, there are legitimately a lot of actual recipes too.
Where this book’s greatest strength lies is in making everything super easy, and motivating. It’s a fine choice for being up-and-running quickly and easily without wading through the 300-odd pages of science in her previous book.
Bottom line: if you’ve already happily and sustainably implemented everything from her previous book, you can probably skip this one. However, if you’d like an easier method to implement the changes that have the biggest effect, then this is the book for you.
Click here to check out The Glucose Goddess Method, and build it into your life the easy way!
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Practical Optimism – by Dr. Sue Varma
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We’ve written before about how to get your brain onto a more positive track (without toxic positivity), but there’s a lot more to be said than we can fit into an article, so here’s a whole book packed full with usable advice.
The subtitle claims “the art, science, and practice of…”, but mostly it’s the science of. If there’s art to be found here, then this reviewer missed it, and as for the practice of, well, that’s down to the reader, of course.
However, it is easy to use the contents of this book to translate science into practice without difficulty.
If you’re a fan of acronyms, initialisms, and other mnemonics (such as the rhyming “Name, Claim, Tame, and Reframe”), then you’ll love this book as they come thick and fast throughout, and they contribute to the overall ease of application of the ideas within.
The writing style is conversational but with enough clinical content that one never forgets who is speaking—not in the egotistical way that some authors do, but rather, just, she has a lot of professional experience to share and it shows.
Bottom line: if you’d like to be more optimistic without delving into the delusional, this book can really help a lot with that (in measurable ways, no less!).
Click here to check out Practical Optimism, and brighten up your life!
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Breast Milk’s Benefits That Are (So Far) Not Replicable
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Simply The Breast 🎶
In Wednesday’s newsletter, we asked you for your opinion on breast vs formula milk (for babies!), and got the above-depicted, below-described, set of responses:
- 80% said “Breast is best, as the slogan goes, and should be first choice”
- 20% said “They both have their strengths and weaknesses; use whatever”
- 0% said “Formula is formulated to be best, and should be first choice”
That’s the first time we’ve ever had a possible poll option come back with zero votes whatsoever! It seems this topic is relatively uncontentious amongst our readership, so we’ll keep things brief today, but there is still a little mythbusting to be done.
So, what does the science say?
[Breast milk should be the first choice] at least for the few few weeks and months for the benefit of baby’s health as breast milk has protective factors formula does not: True or False?
True! The wording here was taken from one of our readers’ responses, by the way (thank you, Robin). There are a good number of those protective factors, the most well-known of which is passing on immune cells and cell-like things; in other words, immune-related information being passed from parent* to child.
*usually the mother, though in principle it could be someone else and in practice sometimes it is; the only real requirements are that the other person be healthy, lactating, and willing.
As for immune benefits, see for example:
Perspectives on Immunoglobulins in Colostrum and Milk
And for that matter, also:
(Colostrum is simply the milk that is produced for a short period after giving birth; the composition of milk will tend to change later)
In any case, immunoglobulin A is a very important component in breast milk (colostrum and later), as well as lactoferrin (has an important antimicrobial effect and is good for the newborn’s gut), and a plethora of cytokines:
As for that about the gut, lactoferrin isn’t the only breast milk component that benefits this, by far, and there’s a lot that can’t be replicated yet:
Human Breast Milk and the Gastrointestinal Innate Immune System
As long as your infant/child is nutritiously fed, it shouldn’t matter if it comes from breast or formula: True or False?
False! Formula milk will not convey those immune benefits.
This doesn’t mean that formula-feeding is neglectful; as several people who commented mentioned*, there are many reasons a person may not be able to breastfeed, and they certainly should not be shamed for that.
*(including the reader whose words we borrowed for this True/False item; the words we quoted above were prefaced with: “Not everyone is able to breastfeed for many different reasons”)
But, while formula milk is a very good second choice, and absolutely a respectable choice if breast milk isn’t an option (or an acceptable option) for whatever reason, it still does not convey all the health benefits of breast milk—yet! The day may come when they’ll find a way to replicate the immune benefits, but today is not that day.
They both have their strengths and weaknesses: True or False?
True! But formula’s strengths are only in the category of convenience and sometimes necessity—formula conveys no health benefits that breast milk could not do better, if available.
For many babies, formula means they get to eat, when without it they would starve due to non-availability of breast milk. That’s a pretty important role!
Note also: this is a health science publication, not a philosophical publication, but we’d be remiss not to mention one thing; let’s bring it in under the umbrella of sociology:
The right to bodily autonomy continues to be the right to bodily autonomy even if somebody else wants/needs something from your body.
Therefore, while there are indeed many good reasons for not being able to breastfeed, or even just not being safely* able to breastfeed, it is at the very least this writer’s opinion that nobody should be pressed to give their reason for not breastfeeding; “no” is already a sufficient answer.
*Writer’s example re safety: when I was born, my mother was on such drugs that it would have been a very bad idea for her to breastfeed me. There are plenty of other possible reasons why it might be unsafe for someone one way or another, but “on drugs that have a clear ‘do not take while pregnant or nursing’ warning” is a relatively common one.
All that said, for those who are willing and safely able, the science is clear: breast is best.
Want to read more?
The World Health Organization has a wealth of information (including explanations of its recommendations of, where possible, exclusive breastfeeding for the first 6 months, ideally continuing some breastfeeding for the first 2 years), here:
World Health Organization | Breastfeeding
Take care!
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Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants
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There is increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.
Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.
While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.
An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.
Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.
chomplearn/Shutterstock How tongue tie can affect babies
When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.
Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.
Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.
The frenulum is a band of tissue under the tongue that is attached to the gumline base of the mouth. Akkalak Aiempradit/Shutterstock Where to get advice
If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.
Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.
When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.
Getting a tongue tie assessment
During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.
They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.
Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.
A properly qualified lactation consultant can help with positioning and attachment. HarryKiiM Stock/Shutterstock Treatment options
The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.
Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.
If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.
There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.
Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.
We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.
Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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