
Wasting Your Vitamins?
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Are you flushing away your vitamins?
Most likely…but you don’t have to.
We all know what a wasteful expense supplements can sometimes be, but you can optimise your intake to get more bang for your buck!
Top Tips for Getting Your Money’s Worth:
- Liquids are better than tablets—the body can’t absorb nutrients from tablets anywhere as easily as it can from liquids, with some saying as low as a 50% absorption rate for tablets, so if your supplement can come in drinkable form, take it that way!
- Capsules are better than tablets—capsules, depending on the kind, contain either a powder (true capsules) or a liquid (softgels). Once the capsule/softgel is broken down in the stomach, it releases its contents, which will now be absorbed as though you took it as a drink.
- Stay hydrated—on that note, your body can only make use of nutrients that it can easily transport, and if you’re dehydrated, the process is sluggish! Having a big glass of water with your supplements will go a long way to helping your body get them where they’re needed.
- Take with black pepper—studies disagree on exactly how much black pepper improves absorption of nutrients. Some say it improves it by 50%, others say as much as 7x better. The truth is probably that it varies from one nutrient to the next, but what is (almost) universally accepted is that black pepper helps you absorb many nutrients you take orally.
- Take with a meal—bonus if you seasoned it with black pepper! But also: many nutrients are best absorbed alongside food, and many are specifically fat-soluble (so you want to take a little fat around the same time for maximum absorption)
- Consider split doses—a lot of nutrients are best absorbed when spread out a bit. Why? Your body can often only absorb so much at once, and what it couldn’t absorb can, depending on the nutrient, pass right through you. So better to space out the doses—breakfast and dinner make for great times to take them.
- Consider cycling—no, not the two-wheeled kind, though feel free to do that too! What cycling means when it comes to supplements is to understand that your body can build a tolerance to some supplements, so you’ll get gradually less effect for the same dose. Combat this by scheduling a break—five days on, two days off is a common schedule—allowing your body to optimise itself in the process!
- Check Medications—and, as is always safe, make sure you check whether any medications you take can interrupt your supplement absorption!
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Why Adult ADHD Often Leads To Anxiety & Depression
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ADHD’s Knock-On Effects On Mental Health
We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:
In women in particular, it can get missed and/or misdiagnosed:
Miss Diagnosis: Anxiety, ADHD, & Women
…but what we’re really here to talk about today is:
It’s the comorbidities that get you
When it comes to physical health conditions:
- if you have one serious condition, it will (usually) be taken seriously
- if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
- if you have three, people will think you are making at least one of them up for attention now
- if you have more than three, you are considered a hypochondriac and pathological liar
Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.
Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.
If this is you, by the way, we hope at least something in the following might ease things for you a bit:
- Stop Pain Spreading
- Managing Chronic Pain (Realistically!)
- Eat To Beat Chronic Fatigue (While Having The Limitations Of Chronic Fatigue)
- When Painkillers Aren’t Helping, These Things Might
- The 7 Approaches To Pain Management
It’s the same for mental health
In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.
(Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).
Why?
Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.
- “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
- “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
- “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.
Overwhelm and breakdown are almost inevitable.
And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.
Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).
What to do about it
How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.
Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.
Here’s a good starting point for that kind of thing:
When You Know What You “Should” Do (But Knowing Isn’t The Problem)
And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:
Behavioral Activation Against Depression & Anxiety
If things are already bad, then you might also consider:
- How To Set Anxiety Aside and
- The Mental Health First-Aid That You’ll Hopefully Never Need ← this is about getting out of depression
And if things are truly at the worst they can possibly be, then:
How To Stay Alive (When You Really Don’t Want To)
Take care!
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Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now
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Move over, COVID and Flu! We have “hybrid viruses” to contend with now
COVID and influenza viruses can be serious, of course, so let’s be clear up front that we’re not being dismissive of those. But, most people are hearing a lot about them, whereas respiratory syncytial virus (RSV) has flown under a lot of radars.
Simply put, until recently it hasn’t been considered much of a threat except to the young, the old, or people with other respiratory illnesses. Only these days, the prevalence of “other respiratory illnesses” is a lot higher than it used to be!
It’s not just a comorbidity
It’s easy to think “well of course if you have more than one illness at once, especially similar ones, that’s going to suck” but it’s a bit more than that; it produces newer, more interesting, hybrid viruses. Here’s a research paper from last year’s “flu season”:
Coinfection by influenza A virus and respiratory syncytial virus produces hybrid virus particles
Best to be aware of this if you’re in the “older” age-range
It’s not just that the older we are, the more likely we are to get it. Critically, the older we are, the more likely we are to be hospitalized by it.
And..the older we are, the less likely we are to come back from hospital if hospitalized by it.
Some years back, the intensive care and mortality rates for people over the age of 65 were 8% and 7%, respectively:
Respiratory syncytial virus infection in elderly and high-risk adults
…but a new study this year has found the rates like to be 2.2x that, i.e. 15% intensive care rate and 18% mortality, respectively:
Want to know more?
Here are some hot-off-the-press news articles on the topic:
- Better awareness of RSV in older adults is needed to reduce hospitalizations
- Is there also a connection between RSV and asthma?
- Respiratory syncytial virus coinfections conspire to worsen disease
And as for what to do…
Same general advice as for COVID and Flu, just, ever-more important:
- Try to keep to well-ventilated places as much as possible
- Get any worrying symptoms checked out quickly
- Mask up when appropriate
- Get your shots as appropriate
See also:
Harvard Health Review | Fall shots: Who’s most vulnerable to RSV, COVID, and the flu, and which shots are the right choice for you to help protect against serious illness and hospitalization?
Stay safe!
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The Case Against Sugar – by Gary Taubes
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We generally already know that sugar is bad for the health. Most people don’t know how bad.
Taubes makes, as the title goes, “the case against sugar”. Implicated in everything from metabolic syndrome to cancer to Alzheimer’s, sugar is ruinous to the health.
It’s hard to review this book without making a comparison to William Duffy’s 1975 bestseller, “Sugar Blues“. Stylistically it’s very similar, and the general gist is certainly the same.
However! Where this book beats Sugar Blues is in content; Duffy’s book often makes bold claims without scientific backing. Some of those claims didn’t stand the test of time and are now disproven. Instead, Taubes’ book leans on actual up-to-date science, and talks more about what we actually know, than what we imagine.
If this book has a weak point, it’s when it veers away from its main topic and starts talking about, for example, saturated fat. In this side-topic, the book makes some good points, but is less well-considered, cherry-picks data, and lacks nuance.
On its main topic, though, the investigation of sugar, it is rather more thorough.
Bottom line: if you want a next-level motivation to reduce or eliminate dietary sugar, this book may certainly provide that.
Click here to check out The Case Against Sugar and reduce a lot of your health risks!
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53 Studies Later: The Best Way to Improve VO2 Max
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VO2 max measures maximum oxygen usage during intense exercise and reflects overall health and performance. To have a high VO2 max, efficient functioning of lungs, heart, red blood cells, muscles, and mitochondria is crucial. So, how to get those?
Let’s HIIT it!
High-Intensity Interval Training (HIIT) outperforms moderate-intensity exercise, by a long way. Further, based on the data from the 53 studies mentioned in the title, we can know which of the protocols tested work best, and they are:
- 15×15 Interval Training: 15 seconds sprint (90–95% max heart rate) + 15 seconds active rest (70% max heart rate), repeated 47 times.
- 4×4 Interval Training: 4 minutes sprint (90–95% max heart rate) + 3 minutes active rest (70% max heart rate), repeated 4 times.
Whichever you choose, it is best to then do that 3x per week.
Note that “sprint” can mean any maximum-effort cardio exercise; it doesn’t have to be running specifically. Cycling or swimming, for example, are fine options too, as is jumping rope.
For more on each of these, plus how the science got there, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Do HIIT (Without Wrecking Your Body)
Take care!
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The Green Roasting Tin – by Rukmini Iyer
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You may be wondering: “do I really need a book to tell me to put some vegetables in a roasting tin and roast them?” and maybe not, but the book offers a lot more than that.
Indeed, the author notes “this book was slightly in danger of becoming the gratin and tart book, because I love both”, but don’t worry, most of the recipes are—as you might expect—very healthy.
As for formatting: the 75 recipes are divided first into vegan or vegetarian, and then into quick/medium/slow, in terms of how long they take.
However, even the “slow” recipes don’t actually take more effort, just, more time in the oven.
One of the greatest strengths of this book is that not only does it offer a wide selection of wholesome mains, but also, if you’re putting on a big spread, these can easily double up as high-class low-effort sides.
Bottom line: if you’d like to eat more vegetables in 2024 but want to make it delicious and with little effort, put this book on your Christmas list!
Click here to check out The Green Roasting Tin, and level-up yours!
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He Thinks His Wife Died in an Understaffed Hospital. Now He’s Trying to Change the Industry.
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For the past year, police Detective Tim Lillard has spent most of his waking hours unofficially investigating his wife’s death.
The question has never been exactly how Ann Picha-Lillard died on Nov. 19, 2022: She succumbed to respiratory failure after an infection put too much strain on her weakened lungs. She was 65.
For Tim Lillard, the question has been why.
Lillard had been in the hospital with his wife every day for a month. Nurses in the intensive care unit had told him they were short-staffed, and were constantly rushing from one patient to the next.
Lillard tried to pitch in where he could: brushing Ann’s shoulder-length blonde hair or flagging down help when her tracheostomy tube gurgled — a sign of possible respiratory distress.
So the day he walked into the ICU and saw staff members huddled in Ann’s room, he knew it was serious. He called the couple’s adult children: “It’s Mom,” he told them. “Come now.”
All he could do then was sit on Ann’s bed and hold her hand, watching as staff members performed chest compressions, desperately trying to save her life.
A minute ticked by. Then another. Lillard’s not sure how long the CPR continued — long enough for the couple’s son to arrive and take a seat on the other side of Ann’s bed, holding her other hand.
Finally, the intensive care doctor called it and the team stopped CPR. Time of death: 12:37 p.m.
Lillard didn’t know what to do in a world without Ann. They had been married almost 25 years. “We were best friends,” he said.
Just days before her death, nurses had told Lillard that Ann could be discharged to a rehabilitation center as soon as the end of the week. Then, suddenly, she was gone. Lillard didn’t understand what had happened.
Lillard said he now believes that overwhelmed, understaffed nurses hadn’t been able to respond in time as Ann’s condition deteriorated. And he has made it his mission to fight for change, joining some nursing unions in a push for mandatory ratios that would limit the number of patients in a nurse’s care. “I without a doubt believe 100% Ann would still be here today if they had staffing levels, mandatory staffing levels, especially in ICU,” Lillard said.
Last year, Oregon became the second state after California to pass hospital-wide nurse ratios that limit the number of patients in a nurse’s care. Michigan, Maine, and Pennsylvania are now weighing similar legislation.
But supporters of mandatory ratios are going up against a powerful hospital industry spending millions of dollars to kill those efforts. And hospitals and health systems say any staffing ratio regulations, however well-intentioned, would only put patients in greater danger.
Putting Patients at Risk
By next year, the United States could have as many as 450,000 fewer nurses than it needs, according to one estimate. The hospital industry blames covid-19 burnout, an aging workforce, a large patient population, and an insufficient pipeline of new nurses entering the field.
But nursing unions say that’s not the full story. There are now 4.7 million registered nurses in the country, more than ever before.
The problem, the unions say, is a hospital industry that’s been intentionally understaffing their units for years in order to cut costs and bolster profits. The unions say there isn’t a shortage of nurses but a shortage of nurses willing to work in those conditions.
The nurse staffing crisis is now affecting patient care. The number of Michigan nurses who say they know of a patient who has died because of understaffing has nearly doubled in recent years, according to a Michigan Nurses Association survey last year.
Just months before Ann Picha-Lillard’s death, nurses and doctors at the health system where she died had asked the Michigan attorney general to investigate staffing cuts they believed were leading to dangerous conditions, including patient deaths, according to The Detroit News.
But Lillard didn’t know any of that when he drove his wife to the hospital in October 2022. She had been feeling short of breath for a few weeks after she and Lillard had mild covid infections. They were both vaccinated, but Ann was immunocompromised. She suffered from rheumatoid arthritis, a condition that had also caused scarring in her lungs.
To be safe, doctors at DMC Huron Valley-Sinai Hospital wanted to keep Ann for observation. After a few days in the facility, she developed pneumonia. Doctors told the couple that Ann needed to be intubated. Ann was terrified but Lillard begged her to listen to the doctors. Tearfully, she agreed.
With Ann on a ventilator in the ICU, it seemed clear to Lillard that nurses were understaffed and overwhelmed. One nurse told him they had been especially short-staffed lately, Lillard said.
“The alarms would go off for the medications, they’d come into the room, shut off the alarm when they get low, run to the medication room, come back, set them down, go to the next room, shut off alarms,” Lillard recalled. “And that was going on all the time.”
Lillard felt bad for the nurses, he said. “But obviously, also for my wife. That’s why I tried doing as much as I could when I was there. I would comb her hair, clean her, just keep an eye on things. But I had no idea what was really going on.”
Finally, Ann’s health seemed to be stabilizing. A nurse told Lillard they’d be able to discharge Ann, possibly by the end of that week.
By Nov. 17, Ann was no longer sedated and she cried when she saw Lillard and her daughter. Still unable to speak, she tried to mouth words to her husband “but we couldn’t understand what she was saying,” Lillard said.
The next day, Lillard went home feeling hopeful, counting down the days until Ann could leave the hospital.
Less than 24 hours later, Ann died.
Lillard couldn’t wrap his head around how things went downhill so fast. Ann’s underlying lung condition, the infection, and her weakened state could have proved fatal in the best of circumstances. But Lillard wanted to understand how Ann had gone from nearly discharged to dying, seemingly overnight.
He turned his dining room table into a makeshift office and started with what he knew. The day Ann died, he remembered her medical team telling him that her heart rate had spiked and she had developed another infection the night before. Lillard said he interviewed two DMC Huron Valley-Sinai nurse administrators, and had his own doctor look through Ann’s charts and test results from the hospital. “Everybody kept telling me: sepsis, sepsis, sepsis,” he said.
Sepsis is when an infection triggers an extreme reaction in the body that can cause rapid organ failure. It’s one of the leading causes of death in U.S. hospitals. Some experts say up to 80% of sepsis deaths are preventable, while others say the percentage is far lower.
Lives can be saved when sepsis is caught and treated fast, which requires careful attention to small changes in vital signs. One study found that for every additional patient a nurse had to care for, the mortality rate from sepsis increased by 12%.
Lillard became convinced that had there been more nurses working in the ICU, someone could have caught what was happening to Ann.
“They just didn’t have the time,” he said.
DMC Huron Valley-Sinai’s director of communications and media relations, Brian Taylor, declined a request for comment about the 2022 staffing complaint to the Michigan attorney general.
Following the Money
When Lillard asked the hospital for copies of Ann’s medical records, DMC Huron Valley-Sinai told him he’d have to request them from its parent company in Texas.
Like so many hospitals in recent years, the Lillards’ local health system had been absorbed by a series of other corporations. In 2011, the Detroit Medical Center health system was bought for $1.5 billion by Vanguard Health Systems, which was backed by the private equity company Blackstone Group.
Two years after that, in 2013, Vanguard itself was acquired by Tenet Healthcare, a for-profit company based in Dallas that, according to its website, operates 480 ambulatory surgery centers and surgical hospitals, 52 hospitals, and approximately 160 additional outpatient centers.
As health care executives face increasing pressure from investors, nursing unions say hospitals have been intentionally understaffing nurses to reduce labor costs and increase revenue. Also, insurance reimbursements incentivize keeping nurse staffing levels low. “Hospitals are not directly reimbursed for nursing services in the same way that a physician bills for their services,” said Karen Lasater, an associate professor of nursing in the Center for Health Outcomes and Policy Research at the University of Pennsylvania. “And because hospitals don’t perceive nursing as a service line, but rather a cost center, they think about nursing as: How can we reduce this to the lowest denominator possible?” she said.
Lasater is a proponent of mandatory nurse ratios. “The nursing shortage is not a pipeline problem, but a leaky bucket problem,” she said. “And the solutions to this crisis need to address the root cause of the issue, which is why nurses are saying they’re leaving employment. And it’s rooted in unsafe staffing. It’s not safe for the patients, but it’s also not safe for nurses.”
A Battle Between Hospitals and Unions
In November, almost one year after Ann’s death, Lillard told a room of lawmakers at the Michigan State Capitol that he believes the Safe Patient Care Act could save lives. The health policy committee in the Michigan House was holding a hearing on the proposed act, which would limit the amount of mandatory overtime a nurse can be forced to work, and require hospitals to make their staffing levels available to the public.
Most significantly, the bills would require hospitals to have mandatory, minimum nurse-to-patient ratios. For example: one nurse for every patient in the ICU; one for every three patients in the emergency room; a nurse for triage; and one nurse for every four postpartum birthing patients and well-baby care.
Efforts to pass mandatory ratio laws failed in Washington and Minnesota last year after facing opposition from the hospital industry. In Minnesota, the Minnesota Nurses Association accused the Mayo Clinic of using “blackmail tactics”: Mayo had told lawmakers it would pull billions of dollars in investment from the state if mandatory ratio legislation passed. Soon afterward, lawmakers removed nurse ratios from the legislation.
While Lillard waited for his turn to speak to Michigan lawmakers about the Safe Patient Care Act in November, members of the Michigan Nurses Association, which says it represents some 13,000 nurses, told lawmakers that its units were dangerously understaffed. They said critical care nurses were sometimes caring for up to 11 patients at a time.
“Last year I coded someone in an ICU for 10 minutes, all alone, because there was no one to help me,” said the nurses association president and registered nurse Jamie Brown, reading from another nurse’s letter.
“I have been left as the only specially trained nurse to take care of eight babies on the unit: eight fragile newborns,” said Carolyn Clemens, a registered nurse from the Grand Blanc area of Michigan.
Nikia Parker said she has left full-time emergency room nursing, a job she believes is her calling. After her friend died in the hospital where she worked, she was left wondering whether understaffing may have contributed to his death.
“If the Safe Patient Care Act passed, and we have ratios, I’m one of those nurses who would return to the bedside full time,” Parker told lawmakers. “And so many of my co-workers who have left would join me.”
But not all nurses agree that mandatory ratios are a good idea.
While the American Nurses Association supports enforceable ratios as an “essential approach,” that organization’s Michigan chapter does not, saying there may not be enough nurses in the state to satisfy the requirements of the Safe Patient Care Act.
For some lawmakers, the risk of collateral damage seems too high. State Rep. Graham Filler said he worries that mandating ratios could backfire.
“We’re going to severely hamper health care in the state of Michigan. I’m talking closed wards because you can’t meet the ratio in a bill. The inability for a hospital to treat an emergent patient. So it feels kind of to me like a gamble we’re taking,” said Filler, a Republican.
Michigan hospitals are already struggling to fill some 8,400 open positions, according to the Michigan Health & Hospital Association. That association says that complying with the Safe Patient Care Act would require hiring 13,000 nurses.
Every major health system in the state signed a letter opposing mandatory ratios, saying it would force them to close as many as 5,100 beds.
Lillard watched the debate play out in the hearing. “That’s a scare tactic, in my opinion, where the hospitals say we’re going to have to start closing stuff down,” he said.
He doesn’t think legislation on mandatory ratios — which are still awaiting a vote in the Michigan House’s health policy committee — are a “magic bullet” for such a complex, national problem. But he believes they could help.
“The only way these hospitals and the administrations are gonna make any changes, and even start moving towards making it better, is if they’re forced to,” Lillard said.
Seated in the center of the hearing room in Lansing, next to a framed photo of Ann, Lillard’s hands shook as he recounted those final minutes in the ICU.
“Please take action so that no other person or other family endures this loss,” he said. “You can make a difference in saving lives.”
Grief is one thing, Lillard said, but it’s another thing to be haunted by doubts, to worry that your loved one’s care was compromised before they ever walked through the hospital doors. What he wants most, he said, is to prevent any other family from having to wonder, “What if?”
This article is from a partnership that includes Michigan Public, NPR, and KFF Health News.
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.
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