How To Beat Loneliness & Isolation
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Overcoming Loneliness & Isolation
One of the biggest mental health threats that faces many of us as we get older is growing isolation, and the loneliness that can come with it. Family and friends thin out over the years, and getting out and about isn’t always as easy as it used to be for everyone.
Nor is youth a guaranteed protection against this—in today’s world of urban sprawl and nothing-is-walkable cities, in which access to social spaces such as cafés and the like means paying the rising costs with money that young people often don’t have… And that’s without getting started on how much the pandemic impacted an entire generation’s social environments (or lack thereof).
Why is this a problem?
Humans are, by evolution, social creatures. As individuals we may have something of a spectrum from introvert to extrovert, but as a species, we thrive in community. And we suffer, when we don’t have that.
What can we do about it?
We can start by recognizing our needs, such as they are, and identifying to what extent they are being met (or not).
- Some of us may be very comfortable with a lot of alone time—but need someone to talk to sometimes.
- Some of us may need near-constant company to feel at our best—and that’s fine too! We just need to plan accordingly.
In the former case, it’s important to remember that needing someone to talk to is not being a burden to them. Not only will our company probably enrich them too, but also, we are evolved to care for one another, and that itself can bring fulfilment to them as much as to you. But what if you don’t a friend to talk to?
- You might be surprised at who would be glad of you reaching out. Have a think through whom you know, and give it a go. This can be scary, because what if they reject us, or worse, they don’t reject us but silently resent us instead? Again, they probably won’t. Human connection requires taking risks and being vulnerable sometimes.
- If that’s not an option, there are services that can fill your need. For some, therapy might serve a dual purpose in this regard. For others, you might want to check out the list of (mostly free) resources at the bottom of this article
In the second case (that we need near-constant company to feel at our best) we probably need to look more at our overall lifestyle, and find ways to be part of a community. That can include:
- Living in a close-knit community (places with a lot of retirees in one place often have this; or younger folk might look at communal living/working spaces, for example)
- Getting involved in local groups (you can check out NextDoor.com or MeetUp.com for this)
- Volunteering for a charity (not only are acts of service generally fulfilling in and of themselves, but also, you will probably be working with other people of a charitable nature, and such people tend to make for good company!)
Need a little help?
There are many, many organizations that will love to help you (or anyone else) overcome loneliness and isolation.
Rather than list them all here and make this email very long by describing how each of them works, here’s a great compilation of resources:
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HRT: Bioidentical vs Animal
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HRT: A Tale Of Two Approaches
In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).
- A little over a third said “It can be medically beneficial, but has some minor drawbacks”
- A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
- Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
- Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”
So what does the science say?
Which HRT?
One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:
❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞
And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.
So to quickly clear up any confusion:
- Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
- Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.
There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).
A quick jumping-off point if you’re interested in that:
Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer
this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.
Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.
In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.
Bioidentical hormones are safer: True or False?
True! This is an open-and-shut case:
❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.
Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞
Further research since that review has further backed up its findings.
Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?
So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.
HRT can increase the risk of breast cancer: True or False?
Contingently True, but for most people, there is no significant increase in risk.
First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.
There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:
❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.
Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞
In fewer words:
- Estradiol by itself: no increased risk of breast cancer
- Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
- Estradiol with actual progesterone: back to no increased risk of breast cancer
So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!
However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:
❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.
Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞
Source: HRT in difficult circumstances: are there any absolute contraindications?
HRT makes you happier, healthier, and smell nice too: True or False?
Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.
The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.
More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:
Read more: Skin, hair and beyond: the impact of menopause
We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.
HRT does have some drawbacks: True or False?
True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.
For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.
It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.
If you experience anything more alarming than that, then indeed check with your doctor.
HRT is a dangerous scam and sham: True or False?
False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.
The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.
As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.
They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.
See for example:
Our apologies, gentlemen
We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!
To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space
Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.
That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.
Meanwhile… take care, all!
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Surviving with Beans And Rice – by Eliza Whool
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If you’d like to be well-set the next time a crisis shuts down supply lines, this is one of those books you’ll want to have read.
Superficially, “have in a large quantity of dried beans and rice” is good advice, but obvious. Why a book?
Whool gives a lot of advice on keeping your nutrition balanced while subsisting on the same quite few ingredients, which is handy.
More than that, she offers 100 recipes using the ingredients that will be in your long-term pantry. That’s over three months without repeating a meal! And if you don’t think rice and beans can be tasty and exciting and varied, then most of the chefs of the Global South might want to have a word about that.
Anyway, we’re not here to sell you rice and beans (we’re just enthusiastic and correct). What we are here to do is to give you a fair overview of this book.
The recipes are just-the-recipes, very simple clear instructions, one two-page spread per recipe. Most of the book is devoted to these. As a quick note, it does cover making things gluten-free if necessary, and other similar adjustments for medical reasons.
The planning-and-storage section of the book is helpful too though, especially as it covers common mistakes to avoid.
Bottom line: this is a great book, and remember what we said about doing the things now that future you will thank you for!
Get yourself a copy of Surviving with Beans And Rice from Amazon today!
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Is Unnoticed Environmental Mold Harming Your Health?
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Environmental mold can be a lot more than just the famously toxic black mold that sometimes makes the headlines, and many kinds you might not notice, but it can colonizes your sinuses and gut just the same:
Breaking the mold
Around 25% of homes in North America are estimated to have mold, though the actual number is likely to be higher, affecting both older and new homes. For that matter, mold can grow in unexpected areas, like inside air conditioning units, even in dry regions.
If mold just sat where it is minding its own business, it might not be so bad, but instead they release their spores, which are de facto airborne mycotoxins, which can colonize places like the sinuses or gut, causing significant health issues.
Not everyone in the same household is affected the same way by mold due to genetic differences and varying pre-existing health conditions. But as a general rule of thumb, mold inflames the brain, nerves, gut, and skin, and can negatively impact the vagal nerve, which is linked to the gut-brain connection. Mycotoxins also damage mitochondria, leading to symptoms like fatigue, brain fog, and cognitive issues. To complicate matters further, mold illness can mimic other conditions like anxiety, chronic fatigue, fibromyalgia, IBS, and more, making it difficult to diagnose.
Testing is possible, though they all have limitations, e.g:
- Home testing: testing the home for mold spores and mycotoxins is crucial for effective treatment; professional mold remediation companies are a good idea (to do a thorough job of cleaning, without also breathing in half the mold while cleaning it).
- Mold allergy testing: mold allergy testing (IgE testing or skin tests) is often used, but it doesn’t diagnose mold-related illnesses linked to severe symptoms like fatigue or neurodegeneration.
- Serum antibody testing: tests for immune reactions (IgG) to mycotoxins may not always show positive results if the immune system is weakened by long-term exposure.
- Urine mycotoxin testing: urine tests can detect mycotoxins in the body, though are likely to be more expensive, being probably not covered by public health in Canada or insurance in the US.
- Organic acid testing: this urine test can indicate mold colonization in areas like the sinuses or gut. Again, cost/availability may vary, though.
For more information on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Walk Yourself Happy – by Dr. Julia Bradbury
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Notwithstanding her (honorary) doctorate, Dr. Bradbury is not, in fact, a scientist. But…
- She has a lot of experience walking all around the world, and her walking habit has seen her through all manner of things, from stress and anxiety to cancer and grief and more.
- She does, throughout this book, consult many scientists and other experts (indeed, some we’ve featured here before at 10almonds), so we still get quite a dose of science too.
The writing style of this book is… Compelling. Honestly, the biggest initial barrier to you getting out of the door will be putting this book down first.If you have good self-discipline, you might make it last longer by treating yourself to a chapter per day
Bottom line: you probably don’t need this book to know how to go for a walk, but it will motivate, inspire, and even inform you of how to get the most out of it. Treat yourself!
Click here to check out Walk Yourself Happy, and prepare for a new healthy habit!
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Self-Care That’s Not Just Self-Indulgence
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Self-Care That’s Not Just Self-Indulgence
Self-care is often seen as an excuse for self-indulgence. Worse, it’s often used as an excuse for self-indulgence—in ways that can end up making us feel worse.
It’s a bit like dietary “cheat days”. If your diet needs cheat days, your diet probably isn’t right for you!
How to recognize the difference between self-care and self-indulgence?
Statistically, the majority of our subscribers are parents (whose children are now mostly grown up, but still, the point is that parenting experience has been gleaned), and/or are or have been caregivers of some form or other.
When a small child is ill, we (hopefully!) look after them carefully:
- We don’t expect too much of them, but…
- …we do expect them to adhere to things consistent with their recovery.
Critically: an important part of self-care is that it actually should be care.
Let’s spell something out: neglect is not care!
How this works for physical and mental health
If you overdo it in physical exercise, it’s right and correct to take a break to recover, and during that time, do things that will hasten one’s recovery. For example:
Overdone It? How To Speed Up Recovery After Exercise
But it’s well-known that if you just do nothing, your condition will likely deteriorate. Also, “a break to recover” is going to be as short as is necessary to recover. Then you’ll ease back into exercise, but you will get back to it.
For mental health it’s just the same. If we for whatever reason need to take a step back, it’s right and correct to do take a break to recover, and during that time, do things that will hasten one’s recovery.
Sometimes, if for example it’s just a case of burnout, rest is the best medicine, and even rest can be an active process. See for example:
How To Rest More Efficiently (Yes, Really)
So the question to ask, when it comes to self-care vs self-indulgence, is:
“Is this activity helping me to get better?”
Some examples:
Probably not great self-care activities:
- Oversleeping (unless you were sleep-deprived, in which case, it’s better to get an earlier night than a later morning, if possible)
- Overeating (comfort-eating is a thing, but your actual problems will still be there)
- Mindless activities (mindless scrolling, TV-watching, game-playing, etc)
Probably better self-care activities:
- Enjoyable physical activity (whatever that may be for you)
- Preparing your favorite food, and then enjoying it mindfully
- Engaging in a personal project that might not be that important, but it’s fulfilling to you (hobbies etc can fall into this category)
- Scheduling some time, and committing some resources, to tackling whatever problem(s) you are facing that’s prompting you to need this self-care.
- Doing the tasks you want to hide away from, but making them fun.
What’s your go-to self-care? We love to hear from you, so feel free to hit “reply” to this email, or use the handy feedback form at the bottom!
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How to keep your teeth young
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How to keep your teeth young
The association between aging and teeth is so well-established that it’s entered popular idiom, “too long in the tooth”, and when it comes to visual representations, false teeth are well-associated with old age.
And yet, avoiding such outcomes does not get anywhere near so much attention as, say, avoiding wrinkles or hair loss.
At 10almonds, we’ve covered general dental health before, in a three-part series:
- Toothpastes & Mouthwashes: Which Help And Which Harm?
- Flossing, Better (And Easier!)
- Less Common Oral Hygiene Options
Today, we’re going to be looking specifically at keeping our teeth young. What if you have lost your teeth already? Well, gum health remains important, and it’s foundational for everyone, so…
Look after your gums first and last
Hollywood’s most “perfect” whites would be nothing without the gums holding them in place. So, set aside the cosmetic whitening products that often harm gums (anything containing bleach / hydrogen peroxide, is generally a bad idea), andinstead focus on your gums.
As for avoiding gum disease (periodontitis)?
❝In conclusion, periodontitis might enhance the association of biological aging with all-cause mortality in middle-aged and older adults.
Hence, maintaining and enhancing periodontal health is expected to become an intervention to slow aging and extend life span.❞
Source: Does Periodontitis Affect the Association of Biological Aging with Mortality?
Ways to look after gum health include the obvious “floss” and “brush often” and “use fluoride toothpaste”, along with other options we covered in our “Less Common Oral Hygiene Options” article above.
Also important: don’t smoke. It is bad for everything, and this is no exception.
We expect we probably don’t have many subscribers who smoke, but if you do, please consider making quitting a priority.
See also: Smoking, Gum Disease, and Tooth Loss
Consider supplementing with collagen
Everyone’s all about the calcium and vitamin D for bones (and teeth), but a large part of the mass of both is actually collagen. And unlike calcium, which most people not living in a food desert get plenty of, or vitamin D, which is one of the most popular supplements around, collagen is something that gets depleted as we get older. We’ve written about its importance for bones:
We Are Such Stuff As Fish Are Made Of—Collagen’s benefits are more than skin deep
And as for its role in combatting gum disease and tooth loss:
Nanoscale Dynamics of Streptococcal Adhesion to AGE-Modified Collagen
By the way, that “AGE” there isn’t about chronological age; it’s about advanced glycation end-products. Those are also something you can and should avoid:
A different kind of “spit and polish”
We imagine you have the “polishing” part in hand; that’s tooth-brushing, of course. But spit?
Saliva is hugely important for our oral health, but it’s not something most of us think about a lot. For example, you might not have known (or might have known but not thought much about) that many common medications affect our saliva, including many blood pressure medications and antidepressants:
Impact of ageing and drug consumption on oral health
Because there are so many possibilities, this is the kind of thing to check with your pharmacist or doctor about. But as a rule, if you take a medication whose side-effects include “dry mouth”, this might be you.
Here’s a really useful (academic) article that covers what drugs cause this, how to diagnose it, and what can be done about it:
Hyposalivation in Elderly Patients
If something’s difficult, find a way to make it easier
Sometimes, as we get older, some things that used to be easy, aren’t. We can lose strength, coordination, manual dexterity, memory, attention, and more. Obviously, we try not to, and do what we can to keep ourselves in good health.
But, if you do have some disability that makes for example brushing and/or flossing difficult to do consistently and/or well, consider talking to your doctor to see if there are assistive devices that can help, or some other kind of support that could allow you to do what you need to.
There’s never any shame in getting help if we need it.
Take care!
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