Astaxanthin: Super-Antioxidant & Neuroprotectant
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Think Pink For Brain Health!
Astaxanthin is a carotenoid that’s found in:
- certain marine microalgae
- tiny crustaceans that eat the algae
- fish (and flamingos!) that eat the crustaceans
Yes, it’s the one that makes things pink.
But it does a lot more than that…
Super-antioxidant
Move over, green tea! Astaxanthin has higher antioxidant activity than most carotenoids. For example, it is 2–5 times more effective than alpha-carotene, lutein, beta-carotene, and lycopene:
Antioxidant activities of astaxanthin and related carotenoids
We can’t claim credit for naming it a super-antioxidant though, because:
Astaxanthin: A super antioxidant from microalgae and its therapeutic potential
Grow new brain cells
Axtaxanthin is a neuroprotectant, but that’s to be expected from something with such a powerful antioxidant ability.
What’s more special to astaxanthin is that it assists continued adult neurogenesis (creation of new brain cells):
❝The unique chemical structure of astaxanthin enables it to cross the blood-brain barrier and easily reach the brain, where it may positively influence adult neurogenesis.
Furthermore, astaxanthin appears to modulate neuroinflammation by suppressing the NF-κB pathway, reducing the production of pro-inflammatory cytokines, and limiting neuroinflammation associated with aging and chronic microglial activation.
By modulating these pathways, along with its potent antioxidant properties, astaxanthin may contribute to the restoration of a healthy neurogenic microenvironment, thereby preserving the activity of neurogenic niches during both normal and pathological aging. ❞
That first part is very important, by the way! There are so many things that our brain needs, and we can eat, but the molecules are unable to pass the blood-brain barrier, meaning they either get wasted, or used elsewhere, or dismantled for their constituent parts. In this case, it zips straight into the brain instead.
See also:
How To Grow New Brain Cells (At Any Age)
(Probably) good for the joints, too
First, astaxanthin got a glowing report in a study we knew not to trust blindly:
…and breathe. What a title that was! But, did you catch why it’s not to be trusted blindly? It was down at the bottom…
❝Conflict of interest statement
NOVAREX Co., Ltd. funded the study. Valensa International provided the FlexPro MD® ingredients, and NOVAREX Co., Ltd. encapsulated the test products (e.g., both FlexPro MD® and placebo)❞
Studies where a supplement company funded the study are not necessarily corrupt, but they can certainly sway publication bias, i.e. the company funds a bunch of studies and then pulls funding from the ones that aren’t going the way it wants.
So instead let’s look at:
Astaxanthin attenuates joint inflammation induced by monosodium urate crystals
and
Astaxanthin ameliorates cartilage damage in experimental osteoarthritis
…which had no such conflicts of interest.
They agree that astaxanthin indeed does the things (attenuates joint inflammation & ameliorates cartilage damage).
However, they are animal studies (rats), so we’d like to see studies with humans to be able to say for sure how much it helps these things.
Summary of benefits
Based on the available research, astaxanthin…
- is indeed a super-antioxidant
- is a neuroprotective agent
- also assists adult neurogenesis
- is probablygood for joints too
How much do I take, and is it safe?
A 2019 safety review concluded:
❝Recommended or approved doses varied in different countries and ranged between 2 and 24 mg.
We reviewed 87 human studies, none of which found safety concerns with natural astaxanthin supplementation, 35 with doses ≥12 mg/day.❞
Source: Astaxanthin: How much is too much? A safety review
In short: for most people, it’s very safe and well-tolerated. If you consume it to an extreme, you will likely turn pink, much as you would turn orange if you did the same thing with carrots. But aside from that, the risks appear to be minimal.
However! If you have a seafood allergy, please take care to get a supplement that’s made from microalgae, not one that’s made from krill or other crustaceans, or from other creatures that eat those.
Where can I get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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Why Some People Get Sick More (And How To Not Be One Of Them)
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Some people have never yet had COVID (so far so good, this writer included); others are on their third bout already; others have not been so lucky and are no longer with us to share their stories.
Obviously, even the healthiest and/or most careful person can get sick, and it would be folly to be complacent and think “I’m not a person who gets sick; that happens to other people”.
Nor is COVID the only thing out there to worry about; there’s always the latest outbreak-du-jour of something, and there are always the perennials such as cold and flu—which are also not to be underestimated, because both weaken us to other things, and flu has killed very many, from the 50,000,000+ in the 1918 pandemic, to the 700,000ish that it kills each year nowadays.
And then there are the combination viruses:
Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now
So, why are some people more susceptible?
Firstly, some people are simply immunocompromised. This means for example that:
- perhaps they have an inflammatory/autoimmune disease of some kind (e.g. lupus, rheumatoid arthritis, type 1 diabetes), or…
- perhaps they are taking immunosuppressants for some reason (e.g. because they had an organ transplant), or…
- perhaps they have a primary infection that leaves them vulnerable to secondary infections. Most infections will do this to some degree or another, but some are worse for it than others; untreated HIV is a clear example. The HIV itself may not kill people, but (if untreated) the resultant AIDS will leave a person open to being killed by almost any passing opportunistic pathogen. Pneumonia of various kinds being high on the list, but it could even be something as simple as the common cold, without a working immune system to fight it.
See also: How To Prevent (Or Reduce) Inflammation
And for that matter, since pneumonia is a very common last-nail-in-the-coffin secondary infection (especially: older people going into hospital with one thing, getting a secondary infection and ultimately dying as a result), it’s particularly important to avoid that, so…
See also: Pneumonia: What We Can & Can’t Do About It
Secondly, some people are not immunocompromised per the usual definition of the word, but their immune system is, arguably, compromised.
Cortisol, the stress hormone, is an immunosuppressant. We need cortisol to live, but we only need it in small bursts here and there (such as when we are waking up the morning). When high cortisol levels become chronic, so too does cortisol’s immunosuppressant effect.
Top things that cause elevated cortisol levels include:
- Stress
- Alcohol
- Smoking
Thus, the keys here are to 1) not smoke 2) not drink, ideally, or at least keep consumption low, but honestly even one drink will elevate cortisol levels, so it’s better not to, and 3) manage stress.
See also: Lower Your Cortisol! (Here’s Why & How)
Other modifiable factors
Being aware of infection risk and taking steps to reduce it (e.g. avoiding being with many people in confined indoor places, masking as appropriate, handwashing frequently) is a good preventative strategy, along with of course getting any recommended vaccines as they come available.
What if they fail? How can we boost the immune system?
We talked about not sabotaging the immune system, but what about actively boosting it? The answer is yes, we certainly can (barring serious medical reasons why not), as there are some very important lifestyle factors too:
Beyond Supplements: The Real Immune-Boosters!
One final last-line thing…
Since if we do get an infection, it’s better to know sooner rather than later… A recent study shows that wearable activity trackers can (if we pay attention to the right things) help predict disease, including highlighting COVID status (positive or negative) about as accurately (88% accuracy) as rapid screening tests. Here’s a pop-science article about it:
Wearable activity trackers show promise in detecting early signals of disease
Take care!
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The Painkilling Power Of Opioids, Without The Harm?
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When it comes to painkilling medications, they can generally be categorized into two kinds:
- non-opioids (e.g. ibuprofen, paracetamol/acetaminophen, aspirin)
- ones that actually work for something more serious than a headache
That’s an oversimplification, but broadly speaking, when there is serious painkilling to be done, that’s when doctors consider it’s time to break out the opioids.
Nor are all opioids created equal—there’s a noteworthy difference between codeine and morphine, for instance—but the problems of opioids are typically the same (tolerance, addiction, and eventual likelihood of overdose when one tries to take enough to make it work after developing a tolerance), and it becomes simply a matter of degree.
See also: I’ve been given opioids after surgery to take at home. What do I need to know?
So, what’s the new development?
A team of researchers have found that the body can effectively produce its own targetted painkilling peptides, similar in function to benzodiazepines (an opioid drug), but—and which is a big difference—confined to the peripheral nervous system (PNS), meaning that it doesn’t enter the brain.
- The peptides killing the pain before it can reach the brain is obviously good because that means the pain is simply not experienced
- The peptides not having any effect on the brain, however, means that the mechanism of addiction of opioids simply does not apply here
- The peptides not having any effect on the brain also means that the CNS can’t be “put to sleep” by these peptides in the same way it can if a high dose of opioids is taken (this is what typically causes death in opioid overdoses; the heart simply beats too slowly to maintain life)
The hope, therefore, is to now create medications that target the spinal ganglia that produce these peptides, to “switch them on” at will.
Obviously, this won’t happen overnight; there will need to be first a lot of research to find a drug that does that (likely this will involve a lot of trial and error and so many mice/rats), and then multiple rounds of testing to ascertain that the drug is safe and effective for humans, before it can then be rolled out commercially.
But, this is still a big breakthrough; there arguably hasn’t been a breakthrough this big in pain research since various opioid-related breakthroughs in the 70s and 80s.
You can see a pop-science article about it here:
And you can see the previous research (from earlier this year) that this is now building from, about the glial cells in the spinal ganglia, here:
Peripheral gating of mechanosensation by glial diazepam binding inhibitor
But wait, there’s more!
Remember what we said about affecting the PNS without affecting the CNS, to kill the pain without killing the brain?
More researchers are already approaching the same idea to deal with the same problem, but from the angle of gene therapy, and have already had some very promising results with mice:
Structure-guided design of a peripherally restricted chemogenetic system
…which you can read about in pop-science terms (with diagrams!) here:
New gene therapy could alleviate chronic pain, researchers find
While you’re waiting…
In the meantime, approaches that are already available include:
- The 7 Approaches To Pain Management
- Managing Chronic Pain (Realistically!)
- Science-Based Alternative Pain Relief ← when painkillers aren’t helping, these things might!
Take care!
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Overcoming Tendonitis – by Dr. Steven Low & Dr. Frank Skretch
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If you assumed tendonitis to be an inflammatory condition, you’re not alone. However, it’s not; the “-itis” nomenclature is a misnomer, and while one can rarely go wrong with reducing chronic/systemic inflammation, it’s not the cure for tendonitis.
What, then, is tendonitis and what does cure it? It’s a non-inflammatory proliferation disorder, meaning, something is growing (or in this case, simply being replaced) in a way it shouldn’t. As to fixing it, that’s more complex.
This book does cover 20 interventions (sorted into “major” and “minor”), ranging from exercise therapies to surgery, with many things between. It also examines popular myths that do not help, such as rest, ice, heat, and analgesics.
The style of this book is hard science, but don’t worry, it explains everything along the way. It does however mean that if you’re not very accustomed to wading through scientific material, you can’t just dip into the middle of the book and be guaranteed to understand what’s going on. Indeed, before even getting to discussing tendonitis/tendinopathy, the first chapter is very reassuringly dedicated to “understanding the levels and classification of evidence in studies”, along with the assorted scales and guidelines of the Center for Evidence-Based Medicine.
The rest, however, is about the etiology, diagnosis, and treatment of tendonitis and tendinopathy more generally. One interesting thing is that, according to the abundant high-quality evidence presented in this book, what works for one body part’s tendonitis does not necessarily work for another body part, so we get quite a part-by-part rundown.
Bottom line: this book has a wealth of useful, applicable information about management of tendonitis, making it indispensable if you or a loved one suffer from such—but settle in, because it’s not a light read.
Click here to check out Overcoming Tendonitis, and overcome tendonitis!
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State of Slim – by Dr. James Hill & Dr. Holly Wyatt
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The premise of this book is “people in Colorado are on average the slimmest in the US”, and sets about establishing why, and then doing what Coloradans are doing. As per the subtitle (drop 20 pounds in 8 weeks), this is a weight loss book and does assume that you want to lose weight—specifically, to lose fat. So if that’s not your goal, you can skip this one already.
The authors explain, as many diet and not-diet-but-diet-adjacent book authors do, that this is not a diet—and then do refer to it as the Colorado Diet throughout. So… Is it a diet?
The answer is a clear “yes, but”—and the caveat is “yes, but also some associated lifestyle practices”.
The diet component is basically a very low-carb diet to start with (with the day’s ration of carbs being a small amount of oats and whatever you can get from some non-starchy vegetables such as greens, tomatoes, etc), and then reintroducing more carbohydrate centric foods one by one, stopping after whole grains. If you are vegan or vegetarian, you can also skip this one already, because this advises eating six animal protein centric meals per day.
The non-diet components are very general healthy-living advices mixed in with popular “diet culture” advices, such as practice mindful eating, don’t eat after 8pm, exercise more, use small plates, enjoy yourself, pre-portion your snacks, don’t drink your calories, get 8 hours sleep, weigh all your food, etc.
Bottom line: this is a very mixed bag, even to the point of being a little chaotic. It gives sometimes contradictory advice, and/but this results in a very “something for everyone” cafeteria approach to dieting. The best recommendation we can give for this book is “it has very many ideas for you to try and see if they work for you”.
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Aspirin, CVD Risk, & Potential Counter-Risks
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Aspirin Pros & Cons
In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:
- About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
- About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
- About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”
So, what does the science say?
Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?
True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:
- decreases the risk of atherothrombosis
- increases the risk of bleeding, especially in the gastrointestinal tract
When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither
While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.
In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones
The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.
In the words of the Journal of the American College of Cardiology:
❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).
Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).
Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞
~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)
Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology
Or if you’d prefer a more pop-science presentation:
Many older adults still use aspirin for CVD prevention, contrary to clinical guidance
Aspirin can cause liver and/or kidney damage: True or False?
True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.
Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).
Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.
For numbers, symptoms, and treatment, see this very clear and helpful resource:
An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose
Take care!
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With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu
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GREELEY, Colo. — In early August, farmworkers gathered under a pavilion at a park here for a picnic to celebrate Farmworker Appreciation Day. One sign that this year was different from the others was the menu: Beef fajitas, tortillas, pico de gallo, chips, beans — but no chicken.
Farms in Colorado had culled millions of chickens in recent months to stem the transmission of bird flu. Organizers filled out the spread with hot dogs.
No matter the menu, some dairy workers at the event said they don’t exactly feel appreciated. They said they haven’t received any personal protective equipment beyond gloves to guard against the virus, even as they or colleagues have come down with conjunctivitis and flu-like symptoms that they fear to be bird flu.
“They should give us something more,” one dairy worker from Larimer County said in Spanish. He spoke on the condition of anonymity out of fear he’d lose his job for speaking out. “What if something happens to us? They act as if nothing is wrong.”
Agricultural health and safety experts have been trying to get the word out about how to protect against bird flu, including through bilingual videos on TikTok showing the proper way to gear up with respirators, eye protection, gloves, and coveralls. And Colorado’s health and agriculture departments have offered a free month’s supply of protective equipment to any producer who requests it.
But so far, many farms aren’t taking them up on it: According to numbers provided by the state health department in late August, fewer than 13% of the state’s dairies had requested and received such PPE.
The virus is known to infect mammals — from skunks, bears, and cows to people and house pets. It began showing up in dairy cattle in recent months, and Colorado has been in the thick of it. Ten of the 13 confirmed human cases in the U.S. this year have occurred in Colorado, where it continues to circulate among dairy cows. It isn’t a risk in cooked meat or pasteurized milk but is risky for those who come into contact with infected animals or raw milk.
Weld County, where the farmworker event was held, is one of the nation’s top milk producers, supplying enough milk each month this year to fill about 45 Olympic-size swimming pools, according to U.S. Department of Agriculture data. Neighboring counties are notable producers, too.
Concerns are growing about undiagnosed illness among farmworkers because of a lack of testing and safety precautions. One reason for concern: Bird flu and seasonal flu are capable of gene trading, so if they ended up in the same body at the same time, bird flu might end up with genes that boost its contagiousness. The virus doesn’t appear to be spreading easily between people yet. That could change, and if people aren’t being tested then health officials may be slow to notice.
Strains of seasonal flu already kill some 47,000 people in the U.S. a year. Public health officials fear the havoc a new form of the flu could wreak if it spreads among people.
The Centers for Disease Control and Prevention recommends that dairy workers don a respirator and goggles or a face shield, among other protections, whether they are working with sick animals or not.
A recent study found that not all infected cows show symptoms, so workers could be interacting with contagious animals without realizing it. Even when it is known that animals are infected, farmworkers often still have to get in close contact with them, sometimes under grueling conditions, such as during a recent heat wave when Colorado poultry workers collected hundreds of chickens by hand for culling because of the outbreak. At least six of the workers became infected with bird flu.
One dairy worker in Weld County, who spoke on the condition of anonymity for fear of losing his job, said his employer has not offered any protective equipment beyond gloves, even though he works with sick cows and raw milk.
His bosses asked the workers to separate sick cows from the others after some cows produced less milk, lost weight, and showed signs of weakness, he said. But the employer didn’t say anything about the bird flu, he said, or suggest they take any precautions for their own safety.
He said he bought protective goggles for himself at Walmart when his eyes became itchy and red earlier this summer. He recalled experiencing dizziness, headaches, and low appetite around the same time. But he self-medicated and pushed through, without missing work or going to a doctor.
“We need to protect ourselves because you never know,” he said in Spanish. “I tell my wife and son that the cows are sick, and she tells me to leave, but it will be the same wherever I go.”
He said he’d heard that his employers were unsympathetic when a colleague approached them about feeling ill. He’d even seen someone affiliated with management remove a flyer about how people can protect themselves from the bird flu and throw it in a bin.
The dairy worker in neighboring Larimer County said he, too, has had just gloves as protection, even when he has worked with sick animals — close enough for saliva to wipe off on him. He started working with them when a colleague missed work because of his flu-like symptoms: fever, headache, and red eyes.
“I only wear latex gloves,” he said. “And I see that those who work with the cows that are sick also only wear gloves.”
He said he doesn’t have time to wash his hands at work but puts on hand sanitizer before going home and takes a shower once he arrives. He has not had symptoms of infection.
Such accounts from dairy workers echo those from farmworkers in Texas, as reported by KFF Health News in July.
“Employers who are being proactive and providing PPE seem to be in the minority in most states,” said Bethany Boggess Alcauter with the National Center for Farmworker Health, a not-for-profit organization based in Texas that advocates for improving the health of farmworkers and their families. “Farmworkers are getting very little information.”
But Zach Riley, CEO of the Colorado Livestock Association, said he thinks such scenarios are the exception, not the rule.
“You would be hard-pressed to find a dairy operation that isn’t providing that PPE,” he said. Riley said dairies typically have a stockpile of PPE ready to go for situations like this and that, if they don’t, it’s easily accessed through the state. “All you have to do is ask.”
Producers are highly motivated to keep infections down, he said, because “milk is their life source.” He said he has heard from some producers that “their family members who work on the farm are doing 18-to 20-hour days just to try to stay ahead of it, so that they’re the first line between everything, to protect their employees.”
Colorado’s health department is advertising a hotline that ill dairy workers can call for help getting a flu test and medicine.
Project Protect Food Systems Workers, an organization that emerged early in the covid-19 pandemic to promote farmworker health across Colorado, is distributing PPE it received from the state so promotoras — health workers who are part of the community they serve — can distribute masks and other protections directly to workers if employers aren’t giving them out.
Promotora Tomasa Rodriguez said workers “see it as another virus, another covid, but it is because they don’t have enough information.”
She has been passing out flyers about symptoms and protective measures, but she can’t access many dairies. “And in some instances,” she said, “a lot of these workers don’t know how to read, so the flyers are not reaching them, and then the employers are not doing any kind of talks or trainings.”
The CDC’s Nirav Shah said during an Aug. 13 call with journalists that awareness about bird flu among dairy workers isn’t as high as officials would like it to be, despite months of campaigns on social media and the radio.
“There’s a road ahead of us that we still need to go down to get awareness on par with, say, what it might be in the poultry world,” he said. “We’re using every single messenger that we can.”
KFF Health News correspondents Vanessa G. Sánchez and Amy Maxmen contributed to this report.
Healthbeat is a nonprofit newsroom covering public health published by Civic News Company and KFF Health News. Sign up for its newsletters here.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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