Black Cohosh vs The Menopause

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Black Cohosh, By Any Other Name…

Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.

Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!

Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)

Does it work?

In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:

❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.

However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞

~ Dr. Ryochi Sadahiro et al., 2023

Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis

Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:

❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.

Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.

As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.

With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞

~ Dr. Castelo-Branco et al., 2020

Source: Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms – an update on the evidence

(iCR = isopropanolic Cimicifuga racemosa)

So, is this estrogenic or not?

This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:

❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞

~ Dr. Gail Mahady, 2003

Source: Is Black Cohosh Estrogenic?

(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)

The short answer: no, black cohosh is not estrogenic

Is it safe?

As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profileincluding for breast cancer patients, at that. See for example:

Where can I get some?

We don’t sell it, but here for your convenience is an example product on Amazon

Enjoy!

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  • Dopamine Nation – by Dr. Anna Lembke

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    We live in an age of abundance, though it often doesn’t feel like it. Some of that is due to artificial scarcity, but a lot of it is due to effectively whiting out our dopamine circuitry through chronic overuse.

    Psychiatrist Dr. Anna Lembke explores the neurophysiology of pleasure and pain, and how each can (and does) lead to the other. Is the answer to lead a life of extreme neutrality? Not quite.

    Rather, simply by being more mindful of how we seek each (yes, both pleasure and pain), we can leverage our neurophysiology to live a better, healthier life—and break/avoid compulsive habits, while we’re at it.

    That said, the book itself is quite compelling reading, but as Dr. Lembke shows us, that certainly doesn’t have to be a bad thing.

    Bottom line: if you sometimes find yourself restlessly cycling through the same few apps (or TV channels) looking for dopamine that you’re not going to find there, this is the book for you.

    Click here to check out Dopamine Nation, and get a handle on yours!

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  • Growing Young – by Marta Zaraska

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This one will be a slightly mixed review, but we think the book has more than enough of value to make it a very worthwhile read.

    The premise of the book is that, as the subtitle suggests, positive social qualities increase personal longevity.

    Author (and science journalist) Marta Zaraska looks at a lot of research to back this up, and also did a lot of travelling and digging into stories. This is of great value, because she notes where a lot of misconceptions have arisen.

    To give one example, it’s commonly noted that marriage (or as-though-marriage life partnerships) is generally* associated with longer life.

    *Statistics suggest that marriage-related longevity is enjoyed by men married to women, and people in same-sex marriages regardless of gender, but is not so much the case for women married to men.

    However! Zaraska notes a factor she learned from Gottman’s research (yes, that Gottman), that what matters is not the official status of a relationship, so much as the sense of secure lifelong commitment to it.

    These kinds of observations (throughout the book) add an extra layer beyond “common wisdom”, and allow us to better understand what’s really going on. The book’s main weaknesses, meanwhile, are twofold:

    • The author is (in this reviewer’s opinion) unduly dismissive of physical health lifestyle factors such as diet and exercise, because they “only” account for a similar bonus to healthy longevity.
    • Like many, she does not always consider where correlation might not mean causation. For example, she cites that volunteering free time increases healthspan by 22%, but neglects to note that perhaps it is having the kind of socioeconomic situation that allows one free time to volunteer, that gives the benefit.

    Bottom line: the book has its flaws, but we think that only serves to make it more engaging. After all, reading should not be a purely passive activity! Zaraska’s well-studied insights give plenty of pointers for tweaking the social side of anyone’s quest for healthy longevity.

    Click here to check out Growing Young, increase your healthspan, and take joy in doing it!

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  • Managing Sibling Relationships In Adult Life

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    Managing Sibling Relationships In Adult Life

    After our previous main feature on estrangement, a subscriber wrote to say:

    ❝Parent and adult child relationships are so important to maintain as you age, but what about sibling relationships? Adult choices to accept and move on with healthier boundaries is also key for maintaining familial ties.❞

    And, this is indeed critical for many of us, if we have siblings!

    Writer’s note: I don’t have siblings, but I do happen to have one of Canada’s top psychologists on speed-dial, and she has more knowledge about sibling relationships than I do, not to mention a lifetime of experience both personally and professionally. So, I sought her advice, and she gave me a lot to work with.

    Today I bring her ideas, distilled into my writing, for 10almonds’ signature super-digestible bitesize style.

    A foundation of support

    Starting at the beginning of a sibling story… Sibling relationships are generally beneficial from the get-go.

    This is for reasons of mutual support, and an “always there” social presence.

    Of course, how positive this experience is may depend on there being a lack of parental favoritism. And certainly, sibling rivalries and conflict can occur at any age, but the stakes are usually lower, early in life.

    Growing warmer or colder

    Generally speaking, as people age, sibling relationships likely get warmer and less conflictual.

    Why? Simply put, we mature and (hopefully!) get more emotionally stable as we go.

    However, two things can throw a wrench into the works:

    1. Long-term rivalries or jealousies (e.g., “who has done better in life”)
    2. Perceptions of unequal contribution to the family

    These can take various forms, but for example if one sibling earns (or otherwise has) much more or much less than another, that can cause resentment on either or both sides:

    • Resentment from the side of the sibling with less money: “I’d look after them if our situations were reversed; they can solve my problems easily; why do they resent that and/or ignore my plight?”
    • Resentment from the side of the sibling with more money: “I shouldn’t be having to look after my sibling at this age”

    It’s ugly and unpleasant. Same goes if the general job of caring for an elderly parent (or parents) falls mostly or entirely on one sibling. This can happen because of being geographically closer or having more time (well… having had more time. Now they don’t, it’s being used for care!).

    It can also happen because of being female—daughters are more commonly expected to provide familial support than sons.

    And of course, that only gets exacerbated as end-of-life decisions become relevant with regard to parents, and tough decisions may need to be made. And, that’s before looking at conflicts around inheritance.

    So, all that seems quite bleak, but it doesn’t have to be like that.

    Practical advice

    As siblings age, working on communication about feelings is key to keeping siblings close and not devolving into conflict.

    Those problems we talked about are far from unique to any set of siblings—they’re just more visible when it’s our own family, that’s all.

    So: nothing to be ashamed of, or feel bad about. Just, something to manage—together.

    Figure out what everyone involved wants/needs, put them all on the table, and figure out how to:

    • Make sure outright needs are met first
    • Try to address wants next, where possible

    Remember, that if you feel more is being asked of you than you can give (in terms of time, energy, money, whatever), then this discussion is a time to bring that up, and ask for support, e.g.:

    “In order to be able to do that, I would need… [description of support]; can you help with that?”

    (it might even sometimes be necessary to simply say “No, I can’t do that. Let’s look to see how else we can deal with this” and look for other solutions, brainstorming together)

    Some back-and-forth open discussion and even negotiation might be necessary, but it’s so much better than seething quietly from a distance.

    The goal here is an outcome where everyone’s needs are met—thus leveraging the biggest strength of having siblings in the first place:

    Mutual support, while still being one’s own person. Or, as this writer’s psychology professor friend put it:

    ❝Circling back to your original intention, this whole discussion adds up to: siblings can be very good or very bad for your life, depending on tons of things that we talked about, especially communication skills, emotional wellness of each person, and the complexity of challenges they face interdependently.❞

    Our previous main feature about good communication can help a lot:

    Save Time With Better Communication

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  • Body by Science – by Dr. Doug McGuff & John Little

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The idea that you’ll get a re-sculpted body at 12 minutes per week is a bold claim, isn’t it? Medical Doctor Doug McGuff and bodybuilder John Little team up to lay out their case. So, how does it stand up to scrutiny?

    First, is it “backed by rigorous research” as claimed? Yes… with caveats.

    The book uses a large body of scientific literature as its foundation, and that weight of evidence does support this general approach:

    • Endurance cardio isn’t very good at burning fat
    • Muscle, even just having it without using it much, burns fat to maintain it
    • To that end, muscle can be viewed as a fat-burning asset
    • Muscle can be grown quickly with short bursts of intense exercise once per week

    Why once per week? The most relevant muscle fibers take about that long to recover, so doing it more often will undercut gains.

    So, what are the caveats?

    The authors argue for slow reps of maximally heavy resistance work sufficient to cause failure in about 90 seconds. However, most of the studies cited for the benefits of “brief intense exercise” are for High Intensity Interval Training (HIIT). HIIT involves “sprints” of exercise. It doesn’t have to be literally running, but for example maxing out on an exercise bike for 30 seconds, slowing for 60, maxing out for 30, etc. Or in the case of resistance work, explosive (fast!) concentric movements and slow eccentric movements, to work fast- and slow-twitch muscle fibers, respectively.

    What does this mean for the usefulness of the book?

    • Will it sculpt your body as described in the blurb? Yes, this will indeed grow your muscles with a minimal expenditure of time
    • Will it improve your body’s fat-burning metabolism? Yes, this will indeed turn your body into a fat-burning machine
    • Will it improve your “complete fitness”? No, if you want to be an all-rounder athlete, you will still need HIIT, as otherwise anything taxing your under-worked fast-twitch muscle fibers will exhaust you quickly.

    Bottom line: read this book if you want to build muscle efficiently, and make your body more efficient at burning fat. Best supplemented with at least some cardio, though!

    Click here to check out Body by Science, and get re-sculpting yours!

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  • What Happens To Your Body When You Eat Raw Garlic Everyday

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Garlic’s benefits are not all in its most talked-about active compound, allicin (some are in other parts of the garlic), but the allicin is certainly very potent. However, allicin breaks down easily, which means that cooking reduces its value greatly, meaning that for health purposes, it is best consumed raw. Pickled garlic cloves are great, by the way, and you should try them if you haven’t already.

    Garlic’s benefits (aside from being delicious)

    Benefits that can be expected include:

    1. Boosts immunity: allicin enhances white blood cell function, helping fight off colds and flu
    2. Supports heart health: lowers blood pressure, reduces cholesterol, and prevents blood clots, reducing the risk of heart disease and stroke
    3. Anti-cancer properties: it contains sulfur compounds that may inhibit cancer cell growth, particularly in the digestive system
    4. Improves digestion: stimulates digestive enzymes and promotes gut health, helping with better nutrient absorption and digestion
    5. Enhances brain function: antioxidants in garlic are neuroprotective, reducing cognitive decline
    6. Good for your skin: its antibacterial and anti-inflammatory properties can help improve skin health
    7. Regulates blood sugar levels: helps regulate blood sugar and improves insulin sensitivity
    8. Anti-inflammatory effects: contains compounds that reduce inflammation, helping to combat inflammatory diseases such as arthritis
    9. Supports weight loss: stimulates metabolism, suppresses appetite, and helps break down fats, aiding in weight management
    10. May protect against osteoporosis: increases estrogen levels in women, potentially reducing the risk of osteoporosis (no effect on estrogen levels if you don’t have ovaries)

    The daily dose that this video recommends is 1–2 cloves of garlic or 3600mg of aged garlic extract as a supplement.

    For more on all of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    The Many Health Benefits Of Garlic

    Take care!

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  • How To Plan For The Unplannable

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How To Always Follow Through

    ❝Two roads diverged in a wood, and I—
    I took the one less traveled by,
    And that has made all the difference:
    Now my socks are wet.❞

    ~ with apologies to Robert Frost

    The thing is, much like a different Robert wrote, “The best-laid schemes o’ mice an’ men gang aft agley”, and when we have a plan and the unexpected occurs, we often find ourselves in a position of “well then, now what?”

    This goes for New Year’s Resolutions that lasted until around January the 4th, and it goes for “xyz in a month” plans of diet, exercise, or so forth.

    We’ve written before on bolstering flagging motivation when all is as expected but we just need an extra boost:

    How To Keep On Keeping On… Long Term!

    …but what about when the unexpected happens?

    First rule: wear a belt and suspenders

    Not literally, unless that’s your thing. But you might have heard this phrase from the business world, and it applies to healthful practices too:

    If your primary plan fails, you need a second one already in place.

    In business, we see this as “business continuity management”. For example, your writer here, I have backups for every important piece of tech I own, Internet connections from two different companies in case one goes down, and if there’s a power cut, I have everything accessible and sync’d on a fully-charged tablet so I can complete my work there if necessary. And yes, I have low-tech coffee-brewing equipment too.

    In health, we should be as serious. We all learned back in 2020 that grocery stores and supply chains can fail; how do we eat healthily when all that is on sale is an assortment of random odds and ends? The answer, as we now know because hindsight really is 2020 in this case, is to keep a well-stocked pantry of healthy things with a long shelf life. Also a good stock of whatever supplements we take, and medicines, and water. And maintain them and rotate the stock!

    And what of exercise? We must not rely on gyms, we can use and enjoy them sure, but we should have at least one good go-to routine for which we need nothing more than a bit of floorspace at home.

    If you’re unsure where to start with that one, we strongly recommend this book that we reviewed recently:

    Science of Pilates: Understand the Anatomy and Physiology to Perfect Your Practice – by Tracy Ward

    Second rule: troubleshoot up front

    With any given intended diet or exercise regime or other endeavor, we must ask ourselves: what could prevent me from doing this? Set a timer for at least 10 minutes, and write down as many things as possible. Then plan for those.

    You can read a bit more about some of this here, the below article was written about facing depression and anxiety, but if you can enact your plans when unmotivated and fearful, then you will surely be able to enact them when not, so this information is good anyway:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    Third rule: don’t err the same way twice

    We all screw up sometimes. To err is, indeed, human. So to errantly eat the wrong food, or do so at the wrong time, or miss a day’s exercise session etc, these things happen.

    Just, don’t let it happen twice.

    Once is an outlier; twice is starting to look like a pattern.

    How To Break Out Of Cycles Of Self-Sabotage, And Stop Making The Same Mistakes

    Enjoy!

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