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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Having dense breasts is linked to cancer. But advice about breast density can depend on where you live
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Having dense breasts is a clear risk factor for breast cancer. It can also make cancers hard to spot on mammograms.
Yet you might not be aware you have dense breasts, even after mammographic screening.
In Australia, advice for women with dense breasts and their health-care professionals can be inconsistent and confusing.
This is because there’s not currently consensus on whether women who have dense breasts, but no symptoms, benefit from further imaging such as ultrasounds. Concerns include potential cost of these tests and the risk they can produce false positives.
Gorodenkoff/Shutterstock What is breast density?
Breasts are made up of fatty tissue and fibroglandular tissue (including glands that make milk, held together by fibrous tissue).
On a mammogram – an x-ray of the breast – fibroglandular tissue appears white and fatty tissue appears dark. The white areas are referred to as breast density.
Fibroglandular tissue shows up white on a mammogram. Nata Sokhrannova/Shutterstock A higher proportion of fibroglandular tissue means your breasts are dense.
There are four categories to classify breast density:
- A: almost entirely fatty
- B: scattered areas of fibroglandular density
- C: heterogeneously or consistently dense
- D: extremely dense.
Breast density is very common. Around 40% of women aged 40–74 are estimated to have “dense breasts”, meaning they fall in category C or D.
What’s the link to cancer?
Breast density is associated with the risk of breast cancer in two ways.
First, breast density usually decreases with age. But if a woman has high breast density for her age, it increases her likelihood of breast cancer.
One study looked at the risk of breast cancer over the age of 50. It found there was a 6.2% risk for the one-third of women with the lowest density. For the 5% with the highest density, the risk was 14.7%.
Second, breast density “masks” cancers if they develop. Both cancers and breast density appear white on a mammogram, making cancers very hard to see.
Breast cancer screening saves lives through early detection and improved treatment options. But we don’t yet know if telling women about their breast density leads to earlier cancer detection, or lives saved.
In Australia, screening mammography is free for all women* aged 40 and older. This is run through BreastScreen Australia, a joint national, state and territory initiative. Those aged 50-74 are invited to have a mammogram, but it’s available for free without a referral from age 40.
However, the messages Australian women currently receive about breast density – and whether it’s recorded – depends on where they live.
What does the advice say?
In 2023, the Royal Australian and New Zealand College of Radiologists updated its position statement to recommend breast density is recorded during screening and diagnostic tests in Australia and New Zealand.
Meanwhile BreastScreen Australia says it “should not routinely record breast density or provide supplemental testing for women with dense breasts”. However this position statement is from 2020 and is currently under review.
Some state and territory BreastScreen programs, including in Western Australia, South Australia and soon Victoria, notify women if they have dense breasts. Victoria is currently at an early stage of its roll-out.
While the messaging regarding breast density differs by state, none currently recommend further imaging for women with dense breasts without speaking to a doctor about individual risk.
What are the issues?
Providing recommendations for women with dense breasts is difficult.
The European Society of Breast Imaging recommends women with extremely dense breasts aged 50–70 receive an MRI every two to four years, in addition to screening mammography. This is based on a large randomised controlled trial from the Netherlands.
But the Royal Australian and New Zealand College of Radiologists describes this recommendation as “aspirational”, acknowledging cost, staffing and accessibility as challenges.
That is, it is not feasible to provide a supplemental MRI for everyone in the screening population in category D with extremely dense breasts (around 10%).
Further, there is no consensus on appropriate screening recommendations for women in the category C (heterogeneous density).
We need a national approach to breast density reporting in Australia and to do better at identifying who is most likely to benefit from further testing.
BreastScreen Australia is currently undergoing a review of its policy and funding.
One of its goals is to enable a nationally consistent approach to breast screening practices. Hopefully breast density reporting, including funding to support national implementation, will be a priority.
*This includes those recorded female at birth and who are gender diverse.
Jennifer Stone, Principal Research Fellow, School of Population and Global Health, The University of Western Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Eat Dirt – by Dr. Josh Axe
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Dr. Axe describes leaky gut as “a serious disease with a silly name”, and hopes for people to take increased intestinal permeability (as it is otherwise known) seriously, because it can be found at the root of very many diseases, especially inflammatory / autoimmune diseases, which obviously also has significant implications for dementia (of which neuroinflammation is a fair part of the pathogenesis) and cancer (which has been described as largely a matter of immune dysfunction).
He starts strong, albeit anecdotally, with the story of his own mother’s battle with cancer and other diseases, and how her health did a U-turn (for the better) upon taking care of her gut as per the methods described in this book. Dr. Axe doesn’t go so far as to claim the gut-healthy protocol cured her cancer, but makes the (very reasonable) argument that it was a major contributory factor, especially as it was the main input variable that changed.
The book describes the various things that can go wrong with our gut and why, and for each of them presents a solution.
Some of it is as you might guess from the title—live a little dirtier, because the ubiquity of antimicrobials is leaving our immune system slack and maladjusted, causing it to varyingly a) turn on us b) not rise to the occasion when an actual pathogen arrives c) often both. Other matters of consideration include normal gut health nutrition (prebiotics and probiotics, skipping inflammatory foods), matters of medication (especially those that harm the gut), nutraceuticals such as Boswellia serrata, and even stress management.
He provides a program so that the reader can follow along step-by-step, and even a chapter of recipes, but the greatest value in the book is the explanation of gut pathology—because understanding that is foundational to recognizing a lot of things (and he does provide diagnostic questionnaires also, which are helpful).
Bottom line: if you’d like to improve almost any aspect of your health, then your gut is almost always an excellent place to start, and this book will set you on the right path.
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Gut Health 2.0
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Gene Expression & Gut Health
This is Dr. Tim Spector. After training in medicine and becoming a consultant rheumatologist, he’s turned his attention to medical research, and is these days a specialist in twin studies, genetics, epigenetics, microbiome, and diet.
What does he want us to know?
For one thing: epigenetics are for more than just getting your grandparents’ trauma.
More usefully: there are things we can do to improve epigenetic factors in our body
DNA is often seen as the script by which our body does whatever it’s going to do, but it’s only part of the story. Thinking of DNA as some kind of “magical immutable law of reality” overlooks (to labor the metaphor) script revisions, notes made in the margins, directorial choices, and ad-lib improvizations, as well as the quality of the audience’s hearing and comprehension.
Hence the premise of one of Dr. Spector’s older books, “Identically Different: Why We Can Change Our Genes”
(*in fact, it was his first, from all the way back in 2013, when he’d only been a doctor for 34 years)
Gene expression will trump genes every time, and gene expression is something that can often be changed without getting in there with CRISPR / a big pair of scissors and some craft glue.
How this happens on the micro level is beyond the scope of today’s article; part of it has to do with enzymes that get involved in the DNA transcription process, and those enzymes in turn are despatched or not depending on hormonal messaging—in the broadest sense of “hormonal”; all the body’s hormonal chemical messengers, not just the ones people think of as hormones.
However, hormonal messaging (of many kinds) is strongly influenced by something we can control relatively easily with a little good (science-based) knowledge: the gut.
The gut, the SAD, and the easy
In broad strokes: we know what is good for the gut. We’ve written about it before at 10almonds:
Making Friends With Your Gut (You Can Thank Us Later)
This is very much in contrast with what in scientific literature is often abbreviated “SAD”, the Standard American Diet, which is very bad for the gut.
However, Dr. Spector (while fully encouraging everyone to enjoy an evidence-based gut-healthy diet) wanted to do one better than just a sweeping one-size-fits-all advice, so he set up a big study with 15,000 identical twins; you can read about it here: TwinsUK
The information that came out of that was about a lot more than just gene expression and gut health, but it did provide the foundation for Dr. Spector’s next project, ZOE.
ZOE crowdsources huge amounts of data including individual metabolic responses to standardized meals in order to predict personalized food responses based on individual biology and unique microbiome profile.
In other words, it takes the guesswork out of a) knowing what your genes mean for your food responses b) tailoring your food choices with your genetic expression in mind, and c) ultimately creating a positive feedback loop to much better health on all levels.
Now, this is not an ad for ZOE, but if you so wish, you can…
- Get the free ZOE gut health guide (this is good, but generic, gut health information)
- Take the ZOE home gut health test (quiz followed by offers of lab tests)
- Browse the ZOE Health Academy, its education wing
Want to know more?
Dr. Spector has a bunch of books out, including some that we’ve reviewed previously:
- Spoon-Fed: Why Almost Everything We’ve Been Told About Food Is Wrong
- The Diet Myth: The Real Science Behind What We Eat
- Food for Life: The New Science of Eating Well
You can also check out our own previous main feature, which wasn’t about Dr. Spector’s work but was very adjacent:
The Brain-Gut Highway: A Two-Way Street
Enjoy!
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100 Hikes of a Lifetime – by Kate Siber
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This is published by National Geographic, so you can imagine the quality of the photos throughout.
Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.
It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.
Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.
Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.
Click here to check out 100 Hikes Of A Lifetime, and live it!
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The Pain-Free Mindset – by Dr. Deepak Ravindran
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First: please ignore the terrible title. This is not the medical equivalent of “think and grow rich”. A better title would have been something like “The Pain-Free Plan”.
Attentive subscribers may notice that this author was our featured expert yesterday, so you can learn about his “seven steps” described in our article there, without us repeating that in our review here.
This book’s greatest strength is also potentially its greatest weakness, depending on the reader: it contains a lot of detailed medical information.
This is good or bad depending on whether you like lots of detailed medical information. Dr. Ravindran doesn’t assume prior knowledge, so everything is explained as we go. However, this means that after his well-referenced clinical explanations, high quality medical diagrams, etc, you may come out of this book feeling like you’ve just done a semester at medical school.
Knowledge is power, though, so understanding the underlying processes of pain and pain management really does help the reader become a more informed expert on your own pain—and options for reducing that pain.
Bottom line: this, disguised by its cover as a “think healing thoughts” book, is actually a science-centric, information-dense, well-sourced, comprehensive guide to pain management from one of the leading lights in the field.
Click here to check out The Pain-Free Mindset, and manage yours more comfortably!
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The Food For Life Cookbook – by Dr. Tim Spector
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We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.
The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.
The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.
Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.
Click here to check out the Food For Life Cookbook, and get cooking for life!
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