Antihistamines’ Generation Gap
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Are You Ready For Allergy Season?
For those of us in the Northern Hemisphere, fall will be upon us soon, and we have a few weeks to be ready for it. A common seasonal ailment is of course seasonal allergies—it’s not serious for most of us, but it can be very annoying, and can disrupt a lot of our normal activities.
Suddenly, a thing that notionally does us no real harm, is making driving dangerous, cooking take three times as long, sex laughable if not off-the-table (so to speak), and the lightest tasks exhausting.
So, what to do about it?
Antihistamines: first generation
Ye olde antihistamines such as diphenhydramine and chlorpheniramine are probably not what to do about it.
They are small molecules that cross the blood-brain barrier and affect histamine receptors in the central nervous system. This will generally get the job done, but there’s a fair bit of neurological friendly-fire going on, and while they will produce drowsiness, the sleep will usually be of poor quality. They also tax the liver rather.
If you are using them and not experiencing unwanted side effects, then don’t let us stop you, but do be aware of the risks.
See also: Long-term use of diphenhydramine ← this is the active ingredient in Benadryl in the US and Canada, but safety regulations in many other countries mean that Benadryl has different, safer active ingredients elsewhere.
Antihistamines: later generations
We’re going to aggregate 2nd gen, 3rd gen, and 4th gen antihistamines here, because otherwise we’ll be writing a history article and we don’t have room for that. But suffice it to say, later generations of antihistamines do not come with the same problems.
Instead of going in all-guns-blazing to the CNS like first-gens, they are more specific in their receptor-targetting, resulting in negligible collateral damage:
Special shout-out to cetirizine and loratadine, which are the drugs behind half the brand names you’ll see on pharmacy shelves around most of the world these days (including many in the US and Canada).
Note that these two are very often discussed in the same sentence, sit next to each other on the shelf, and often have identical price and near-identical packaging. Their effectiveness (usually: moderate) and side effects (usually: low) are similar and comparable, but they are genuinely different drugs that just happen to do more or less the same thing.
This is relevant because if one of them isn’t working for you (and/or is creating an unwanted side effect), you might want to try the other one.
Another honorable mention goes to fexofenadine, for which pretty much all the same as the above goes, though it gets talked about less (and when it does get mentioned, it’s usually by its most popular brand name, Allegra).
Finally, one that’s a little different and also deserving of a special mention is azelastine. It was recently (ish, 2021) moved from being prescription-only to being non-prescription (OTC), and it’s a nasal spray.
It can cause drowsiness, but it’s considered safe and effective for most people. Its main benefit is not really the difference in drug, so much as the difference in the route of administration (nasal rather than oral). Because the drug is in liquid spray form, it can be absorbed through the mucus lining of the nose and get straight to work on blocking the symptoms—in contrast, oral antihistamines usually have to go into your stomach and take their chances there (we say “usually”, because there are some sublingual antihistamines that dissolve under the tongue, but they are less common.)
Better than antihistamines?
Writer’s note: at this point, I was given to wonder: “wait, what was I squirting up my nose last time anyway?”—because, dear readers, at the time I got it I just bought one of every different drug on the shelf, desperate to find something that worked. What worked for me, like magic, when nothing else had, was beclometasone dipropionate, which a) smelled delightfully of flowers, which might just be the brand I got, b) needs replacing now because I got it in March 2023 and it expired July 2024, and c) is not an antihistamine at all.
But, that brings us to the final chapter for today: systemic corticosteroids
They’re not ok for everyone (check with your doctor if unsure), and definitely should not be taken if immunocompromised and/or currently suffering from an infection (including colds, flu, COVID, etc) unless your doctor tells you otherwise (and even then, honestly, double-check).
But! They can work like magic when other things don’t. Unlike antihistamines, which only block the symptoms, systemic corticosteroids tackle the underlying inflammation, which can stop the whole thing in its tracks.
Here’s how they measure up against antihistamines:
❝The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.❞
~ Dr. Robert Puy et al.
Take care!
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Chaat Masala Spiced Potato Salad With Beans
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This is an especially gut-healthy dish; the cooked-and-cooled potatoes are not rich with resistant starches (that’s good), the beans bring protein (as well as more fiber and micronutrients), and many of the spices bring their own benefits. A flavorful addition to your table!
You will need
- 1 lb new potatoes, boiled or steamed, with skin on, quartered, cooled ← this is a bit of a “mini recipe”, but we expect you can handle it
- 5 oz blanched broad beans
- 2 oz sun-dried tomatoes, chopped
- ¼ bulb garlic, crushed
- 1 tbsp extra virgin olive oil
- 2 tsp amchoor
- 2 tsp ground cumin
- 2 tsp ground coriander
- 1 tsp ground ginger
- 1 tsp ground asafoetida
- 1 tsp black pepper, coarse ground
- 1 tsp red chili powder
- 1 tsp ground turmeric
- ½ tsp MSG or 1 tsp low-sodium salt
- Juice of ½ lemon
And then…
- To garnish: finely chopped cilantro, or if you have the “cilantro tastes like soap” gene, then substitute with parsley
- To serve: a nice chutney; you can use our Spiced Fruit & Nut Chutney recipe
Method
(we suggest you read everything at least once before doing anything)
1) Mix all the ingredients from the main section, ensuring an even distribution on the spices.
2) Add the garnish, and serve with the chutney. That’s it. There was more work in the prep (and potentially, finding all the ingredients) today.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we scored all five today!
- Lycopene’s Benefits For The Gut, Heart, Brain, & More ← don’t underestimate those sun-dried tomatoes, either!
Take care!
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How to be kind to yourself (without going to a day spa)
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“I have to be hard on myself,” Sarah told me in a recent telehealth psychology session. “I would never reach my potential if I was kind and let myself off the hook.”
I could empathise with this fear of self-compassion from clients such as Sarah (not her real name). From a young age, we are taught to be kind to others, but self-kindness is never mentioned.
Instead, we are taught success hinges on self-sacrifice. And we need a healthy inner critic to bully us forward into becoming increasingly better versions of ourselves.
But research shows there doesn’t have to be a trade-off between self-compassion and success.
Self-compassion can help you reach your potential, while supporting you to face the inevitable stumbles and setbacks along the way.
What is self-compassion?
Self-compassion has three key ingredients.
1. Self-kindness
This involves treating yourself with the same kindness you would extend towards a good friend – via your thoughts, feelings and actions – especially during life’s difficult moments.
For instance, if you find yourself fixating on a minor mistake you made at work, self-kindness might involve taking a ten-minute walk to shift focus, and reminding yourself it is OK to make mistakes sometimes, before moving on with your day.
2. Mindfulness
In this context, mindfulness involves being aware of your own experience of stress or suffering, rather than repressing or avoiding your feelings, or over-identifying with them.
Basically, you must see your stress with a clear (mindful) perspective before you can respond with kindness. If we avoid or are consumed by our suffering, we lose perspective.
3. Common humanity
Common humanity involves recognising our own experience of suffering as something that unites us as being human.
For instance, a sleep-deprived parent waking up (for the fourth time) to feed their newborn might choose to think about all the other parents around the world doing exactly the same thing – as opposed to feeling isolated and alone.
It’s not about day spas, or booking a manicure
When Sarah voiced her fear that self-compassion would prevent her success, I explained self-compassion is distinct from self-indulgence.
“So is self-compassion just about booking in more mani/pedis?” Sarah asked.
Not really, I explained. A one-off trip to a day spa is unlikely to transform your mental health.
Instead, self-compassion is a flexible psychological resilience factor that shapes our thoughts, feelings and actions.
It’s associated with a suite of benefits to our wellbeing, relationships and health.
A one-off trip to a day spa is unlikely to transform your mental health.
baranq/ShutterstockWhat does the science say?
Over the past 20 years, we’ve learned self-compassionate people enjoy a wide range of benefits. They tend to be happier and have fewer psychological symptoms of distress.
Those high on self-compassion persevere following a failure. They say they are more motivated to overcome a personal weakness than those low on self-compassion, who are more likely to give up.
So rather than feeling trapped by your inadequacies, self-compassion encourages a growth mindset, helping you reach your potential.
However, self-compassion is not a panacea. It will not change your life circumstances or somehow make life “easy”. It is based on the premise that life is hard, and provides practical tools to cope.
It’s a factor in healthy ageing
I research menopause and healthy ageing and am especially interested in the value of self-compassion through menopause and in the second half of life.
Because self-compassion becomes important during life’s challenges, it can help people navigate physical symptoms (for instance, menopausal hot flushes), life transitions such as divorce, and promote healthy ageing.
I’ve also teamed up with researchers at Autism Spectrum Australia to explore self-compassion in autistic adults.
We found autistic adults report significantly lower levels of self-compassion than neurotypical adults. So we developed an online self-compassion training program for this at-risk population.
Three tips for self-compassion
You can learn self-compassion with these three exercises.
1. What would you say to a friend?
Think back to the last time you made a mistake. What did you say to yourself?
If you notice you’re treating yourself more like an enemy than a friend, don’t beat yourself up about it. Instead, try to think about what you might tell a friend, and direct that same friendly language towards yourself.
2. Harness the power of touch
Soothing human touch activates the parasympathetic “relaxation” branch of our nervous system and counteracts the fight or flight response.
Specifically, self-soothing touch (for instance, by placing both hands on your heart, stroking your forearm or giving yourself a hug) reduces cortisol responses to psychosocial stress.
Yes, hugging yourself can help.
http://krakenimages.com/Shutterstock3. What do I need right now?
Sometimes, it can be hard to figure out exactly what self-compassion looks like in a given moment. The question “what do I need right now” helps clarify your true needs.
For example, when I was 37 weeks pregnant, I woke up bolt awake one morning at 3am.
Rather than beating myself up about it, or fretting about not getting enough sleep, I gently placed my hands on my heart and took a few deep breaths. By asking myself “what do I need right now?” it became clear that listening to a gentle podcast/meditation fitted the bill (even though I wanted to addictively scroll my phone).
Lydia Brown, Senior Lecturer in Psychology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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In Plain English…
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It’s Q&A Time!
This is the bit whereby each week, we respond to subscriber questions/requests/etc
Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!
Q: Love to have someone research all the additives in our medicines, (risk of birth control and breast cancer) and what goes in all of our food and beverages. So much info out there, but there are so many variations, you never know who to believe.
That’s a great idea! There are a lot of medicines and food and beverages out there, so that’s quite a broad brief, but! We could well do a breakdown of very common additives, and demystify them, sorting them into good/bad/neutral, e.g:
- Ascorbic acid—Good! This is Vitamin C
- Acetic acid—Neutral! This is vinegar
- Acetylsalicylic acid—Good or Bad! This is aspirin (a painkiller and blood-thinning agent, can be good for you or can cause more problems than it solves, depending on your personal medical situation. If in doubt, check with your doctor)
- Acesulfame K—Generally Neutral! This is a sweetener that the body can’t metabolize, so it’s also not a source of potassium (despite containing potassium) and will generally do nothing. Unless you have an allergy to it, which is rare but is a thing.
- Sucralose—Neutral! This is technically a sugar (as is anything ending in -ose), but the body can’t metabolize it and processes it as a dietary fiber instead. We’d list it as good for that reason, but honestly, we doubt you’re eating enough sucralose to make a noticeable difference to your daily fiber intake.
- Sucrose—Bad! This is just plain sugar
Sometimes words that sound the same can ring alarm bells when they need not, for example there’s a big difference between:
- Potassium iodide (a good source of potassium and iodine)
- Potassium cyanide (the famous poison; 300mg will kill you; half that dose will probably kill you)
- Cyanocobalamine (Vitamin B12)
Let us know if there are particular additives (or particular medications) you’d like us to look at!
While for legal reasons we cannot give medical advice, talking about common contraindications (e.g., it’s generally advised to not take this with that, as one will stop the other from working, etc) is definitely something we could do.
For example! St. John’s Wort, very popular as a herbal mood-brightener, is on the list of contraindications for so many medications, including:
- Antidepressants
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Some heart medications, including digoxin and ivabradine
- Some HIV drugs, including indinavir and nevirapine
- Some cancer medications, including irinotecan and imatinib
- Warfarin, an anticoagulant (blood thinner)
- Certain statins, including simvastatin
Q: As I am a retired nurse, I am always interested in new medical technology and new ways of diagnosing. I have recently heard of using the eyes to diagnose Alzheimer’s. When I did some research I didn’t find too much. I am thinking the information may be too new or I wasn’t on the right sites.
(this is in response to last week’s piece on lutein, eyes, and brain health)
We’d readily bet that the diagnostic criteria has to do with recording low levels of lutein in the eye (discernible by a visual examination of macular pigment optical density), and relying on the correlation between this and incidence of Alzheimer’s, but we’ve not seen it as a hard diagnostic tool as yet either—we’ll do some digging and let you know what we find! In the meantime, we note that the Journal of Alzheimer’s Disease (which may be of interest to you, if you’re not already subscribed) is onto this:
See also:
- Journal of Alzheimer’s Disease (mixture of free and paid content)
- Journal of Alzheimer’s Disease Reports (open access—all content is free)
Q: As to specific health topics, I would love to see someone address all these Instagram ads targeted to women that claim “You only need to ‘balance your hormones’ to lose weight, get ripped, etc.” What does this mean? Which hormones are they all talking about? They all seem to be selling a workout program and/or supplements or something similar, as they are ads, after all. Is there any science behind this stuff or is it mostly hot air, as I suspect?
Thank you for asking this, as your question prompted yesterday’s main feature, What Does “Balancing Your Hormones” Even Mean?
That’s a great suggestion also about addressing ads (and goes for health-related things in general, not just hormonal stuff) and examining their claims, what they mean, how they work (if they work!), and what’s “technically true but may
be misleading* cause confusion”*We don’t want companies to sue us, of course.
Only, we’re going to need your help for this one, subscribers!
See, here at 10almonds we practice what we preach. We limit screen time, we focus on our work when working, and simply put, we don’t see as many ads as our thousands of subscribers do. Also, ads tend to be targeted to the individual, and often vary from country to country, so chances are good that we’re not seeing the same ads that you’re seeing.
So, how about we pull together as a bit of a 10almonds community project?
- Step 1: add our email address to your contacts list, if you haven’t already
- Step 2: When you see an ad you’re curious about, select “share” (there is usually an option to share ads, but if not, feel free to screenshot or such)
- Step 3: Send the ad to us by email
We’ll do the rest! Whenever we have enough ads to review, we’ll do a special on the topic.
We will categorically not be able to do this without you, so please do join in—Many thanks in advance!
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How To Reduce Or Quit Alcohol
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Rethinking Drinking
When we’re looking at certain health risks, there are often five key lifestyle factors that have a big impact; they are:
- Have a good diet
- Get good exercise
- Get good sleep
- Reduce (or eliminate) alcohol
- Don’t smoke
Today, we’re focussing the alcohol bit. Maybe you’d like to quit, maybe just cut down, maybe the topic just interests you… So, here’s a quick rundown of some things that will help make that a lot easier:
With a big enough “why”, you can overcome any “how”
Research and understand the harm done by drinking, including:
And especially as we get older, memory problems:
Alcohol-related dementia: an update of the evidence
And as for fear of missing out, or perhaps even of no longer being relaxed/fun… Did you ever, while sober, have a very drunk person try to converse with you, and you thought “I wish that were me”?
Probably not
Know your triggers
Why do you drink? If your knee-jerk response is “because I like it”, dig deeper. What events prompt you to have a drink?
- Some will be pure habit born of convention—perhaps with a meal, for example
- Others may be stress-management—after work, perhaps
- Others may be pseudo-medicinal—a nightcap for better* sleep, for instance
*this will not work. Alcohol may make us sleepy but it will then proceed to disrupt that very sleep and make it less restorative
Become mindful
Now that you know why you’d like to drink less (or quit entirely), and you know what triggers you to drink, you can circumvent that a little, by making deals with yourself, for example
- “I can drink alcohol, if and only if I have consumed a large glass of water first” (cuts out being thirsty as a trigger to drink)
- “I can drink alcohol, if and only if I meditate for at least 5 minutes first” (reduces likelihood of stress-drinking)
- “I can drink alcohol, if and only if it is with the largest meal of the day” (minimizes total alcohol consumption)
Note that these things also work around any FOMO, “Fear Of Missing Out”. It’s easier to say “no” when you know you can have it later if you still want it.
Get a good replacement drink
There are a lot of alcohol-free alcohol-like drinks around these days, and many of them are very good. Experiment and see. But!
It doesn’t even have to be that. Sometimes what we need is not even an alcohol-like drink, but rather, drinkable culinary entertainment.
If you like “punch-in-the-face” flavors (as this writer does), maybe strong black coffee is the answer. If you like “crisp and clear refreshment” (again, same), maybe your favorite herbal tea will do it for you. Or maybe for you it’ll be lemon-water. Or homemade ginger ale.
Whatever it is… make it fun, and make it yours!
Bonus item: find replacement coping strategies
This one goes if you’ve been using alcohol to cope with something. Stress, depression, anxiety, whatever it may be for you.
The thing is, it feels like it helps briefly in the moment, but it makes each of those things progressively worse in the long-run, so it’s not sustainable.
Consider instead things like therapy, exercise, and/or a new hobby to get immersed in; whatever works for you!
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Parent Effectiveness Training – by Dr. Thomas Gordon
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Do you want your home (or workplace, for that matter) to be a place of peace? This book literally got the author nominated for a Nobel Peace Prize. Can’t really get much higher praise than that.
The title is “Parent Effectiveness Training”, but in reality, the advice in the book is applicable to all manner of relationships, including:
- romantic relationships
- friends
- colleagues
- …and really any human interaction.
It covers some of the same topics we did today (and more) in much more detail than we ever could in a newsletter. It lays out formulae to use, gives plenty of examples, and/but is free from undue padding.
- Pros: this isn’t one of those “should have been an article” books. It has so much valuable content.
- Cons: It is from the 1970s* so examples may feel “dated” now.
In addition to going into much more detail on some of the topics covered in today’s issue of 10almonds, Dr. Gordon also talks in-depth about the concept of “problem-ownership”.
In a nutshell, that means: whose problem is a given thing? Who “has” what problem? Everyone needs to be on the same page about everyone else’s problems in the situation… as well as their own, which is not always a given!
Dr. Gordon presents, in short, tools not just to resolve conflict, but also to pre-empt it entirely. With these techniques, we can identify and deal with problems (together!) well before they arise.
Everybody wins.
Get your copy of “Parent Effectiveness Training” from Amazon today!
*Note: There is an updated edition on the market, and that’s what you’ll find upon following the above link. This reviewer (hi!) has a battered old paperback from the 1970s and cannot speak for what was changed in the new edition. However: if the 70s one is worth more than its weight in gold (and it is), the new edition is surely just as good, if not better!
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The Medicinal Chef – by Dale Pinnock
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The philosophy here is very much like our own—to borrow from Hippocrates: “let food be thy medicine”. Obviously please do also let medicine be thy medicine if you need it, but the point is that food is a very good starting place for combatting a lot of disease.
To this end, instead of labelling the recipes with such things as “V”, “Ve”, “GF” and suchlike, it assumes we can tell those things from the ingredients lists, and instead labels things per what they are especially good for:
- S: skin
- J: joints & bones
- R: respiratory system
- I: immune system
- M: metabolic health
- N: nervous system and mental health
- H: heart and circulation
- D: digestive system
- U: reproductive & urinary systems
As for the recipes themselves… They’re a lot like the recipes we share here at 10almonds in their healthiness, skill level, and balance of easy-to-find ingredients with the occasional “order it online” items that punch above their weight. In fact, we’ll probably modify some of the recipes for sharing here.
Bottom line: if you’re looking for genuinely healthy recipes that are neither too basic nor too arcane, this book has about 80 of them.
Click here to check out The Medicinal Chef: Healthy Every Day, and be healthy every day!
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Learn to Age Gracefully
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