Vit D + Calcium: Too Much Of A Good Thing?

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Vit D + Calcium: Too Much Of A Good Thing?

  • Myth: you can’t get too much calcium!
  • Myth: you must get as much vitamin D as possible!

Let’s tackle calcium first:

❝Calcium is good for you! You need more calcium for your bones! Be careful you don’t get calcium-deficient!❞

Contingently, those comments seem reasonable. Contingently on you not already having the right amount of calcium. Most people know what happens in the case of too little calcium: brittle bones, osteoporosis, and so forth.

But what about too much?

Hypercalcemia

Having too much calcium—or “hypercalcemia”— can lead to problems with…

  • Groans: gastrointestinal pain, nausea, and vomiting. Peptic ulcer disease and pancreatitis.
  • Bones: bone-related pains. Osteoporosis, osteomalacia, arthritis and pathological fractures.
  • Stones: kidney stones causing pain.
  • Moans: refers to fatigue and malaise.
  • Thrones: polyuria, polydipsia, and constipation
  • Psychic overtones: lethargy, confusion, depression, and memory loss.

(mnemonic courtesy of Sadiq et al, 2022)

What causes this, and how do we avoid it? Is it just dietary?

It’s mostly not dietary!

Overconsumption of calcium is certainly possible, but not common unless one has an extreme diet and/or over-supplementation. However…

Too much vitamin D

Again with “too much of a good thing”! While keeping good levels of vitamin D is, obviously, good, overdoing it (including commonly prescribed super-therapeutic doses of vitamin D) can lead to hypercalcemia.

This happens because vitamin D triggers calcium absorption into the gut, and acts as gatekeeper to the bloodstream.

Normally, the body only absorbs 10–20% of the calcium we consume, and that’s all well and good. But with overly high vitamin D levels, the other 80–90% can be waved on through, and that is very much Not Good™.

See for yourself:

How much is too much?

The United States’ Office of Dietary Supplements defines 4000 IU (100μg) as a high daily dose of vitamin D, and recommends 600 IU (15μg) as a daily dose, or 800 IU (20μg) if aged over 70.

See for yourself: Vitamin D Fact Sheet for Health Professionals ← there’s quite a bit of extra info there too

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  • I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

    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.

    It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities.

    Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in fight or flight situations.

    But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the common cold, flu and COVID.

    Pexels/Ketut Subiyanto

    Stress makes it harder to fight off viruses

    When the immune system starts to break down, a virus that would normally have been under control starts to flourish.

    Once you begin to feel sick, the stress response rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to fight.

    In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of studies where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their nose.

    These participants were then quarantined in a hotel and monitored closely to determine who became ill.

    One of the most important factors predicting who got sick was prolonged psychological stress.

    Cortisol suppresses immunity

    “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for weeks or months.

    When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and cortisol.

    Human brain illustration
    The hypothalamus sets off an alarm system in response to a real or perceived threat. stefan3andrei/Shutterstock

    In a typical stress response, cortisol levels quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an immediate threat.

    But in the longer term, chronic stress can be harmful. A Harvard University study from 2022 showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They classified this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness.

    Those suffering distress had close to a 50% greater risk of long COVID compared to other participants. Cortisol has been shown to be high in the most severe cases of COVID.

    Stress causes inflammation

    Inflammation is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right levels.

    The immune cells also store a memory of that threat to respond faster and more effectively the next time.

    Initially, circulating immune cells detect and flock to the site of infection. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the threat.

    During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny nose.

    Man blows nose
    Our immune response can trigger symptoms such as a runny nose. Alyona Mandrik/Shutterstock

    What about chronic stress?

    Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate stressor.

    The immune system becomes desensitised and unresponsive to this cortisol suppression, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins).

    Immune cells become exhausted and start to malfunction. The body loses the ability to turn down the inflammatory response.

    Over time, the immune system changes the way it responds by reprogramming to a “low surveillance mode”. The immune system misses early opportunities to destroy threats, and the process of recovery can take longer.

    So how can you manage your stress?

    We can actively strengthen our immunity and natural defences by managing our stress levels. Rather than letting stress build up, try to address it early and frequently by:

    1) Getting enough sleep

    Getting enough sleep reduces cortisol levels and inflammation. During sleep, the immune system releases cytokines, which help fight infections and inflammation.

    2) Taking regular exercise

    Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes toxins. Physical activity also lowers stress hormone levels through the release of positive brain signals.

    3) Eating a healthy diet

    Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress levels. Staying hydrated helps the body to flush out toxins.

    4) Socialising and practising meditation or mindfulness

    These activities increase endorphins and serotonin, which improve mood and have anti-inflammatory effects. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce cortisol levels.

    Sathana Dushyanthen, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley

    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.

    Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.

    (In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)

    Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).

    The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂

    Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.

    Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!

    PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!

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  • Cashew & Chickpea Balti

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    When it comes to curries, the humble balti is perhaps the best when you don’t have all day to let something simmer. Filled with healthful spices, this one also comes complete with lots of fiber as well as healthy proteins and fats, with most of its calories coming from the nuts themselves, and the haricot paste base makes for a deliciously creamy curry without having to add anything unhealthy.

    You will need

    • 1 cup cashews, soaked in warm water for at least 5 minutes, and drained (if allergic, omit)
    • 1 can chickpeas (keep the water)
    • 1 can haricot beans (keep the water)
    • 1 can crushed tomatoes
    • 2 medium (or 3 small) red onions, sliced
    • red or green chilis, quantity per your preference re heat, chopped
    • ½ bulb garlic, crushed
    • ½ oz fresh ginger, peeled and finely chopped
    • 1 tbsp tomato paste
    • 1 tbsp garam masala
    • 1 tbsp ground coriander
    • 1 tbsp black pepper, coarse ground
    • 2 tsp turmeric
    • 1 tsp mustard seeds (if allergic, omit)
    • 1 tsp sweet cinnamon
    • 1 tsp coriander seeds
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Avocado oil, for frying (extra virgin olive-oil, or cold-pressed coconut oil, are fine alternatives)
    • Garnish: handful fresh cilantro, chopped (or parsley, if you have the “cilantro tastes like soap” gene)

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat a little oil in a large sauté pan (we’re going to need space to work; a large wok is traditional but a sauté pan is convenient), and add the garlic, ginger, mustard seeds, and coriander seeds, stirring for about 2 minutes, then add the onions and chilis, stirring for another 3 minutes. The onions and chilis won’t be fully cooked yet, but that’s fine, we just needed to get them started.

    2) Add the crushed tomatoes, stirring them in, and when they get to temperature, turn the heat down to a simmer.

    3) Add the chickpeas to the pan, but separately put the chickpea water into a high-speed blender.

    4) Add the haricot beans, including the water they came in, to the high-speed blender, as well as the tomato paste and the remaining spices (including the MSG or salt), and blend on high until smooth. Add the curry paste (that’s what you’ve just made in the blender) to the pan, and stir in well.

    5) Add the cashews, stirring in well. Taste, and adjust any spices if necessary for your liking. If the onions still aren’t fully cooked, let them simmer until they are, but it shouldn’t take long.

    10almonds tip: if perchance you made it too spicy, you can add a little lime juice and the acidity will counteract the heat. Adding lemon juice, lime juice, or some kind of vinegar (depending on what works with the flavor profile of your recipe) is a good last resort to have up your sleeve for fixing a dish that got too spicy.

    6) Add the garnish, and serve—we recommend serving it with our Tasty Versatile Rice, but any carb is fine.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • All of your hepatitis B vaccine questions answered

    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.

    Hepatitis B is a viral infection that can cause liver disease in people of any age or background. Vaccination is 95 percent effective against the virus. But in recent years, false claims, rumors, and myths about the hepatitis B vaccine have become increasingly common.

    Here’s everything you need to know about the lifesaving hepatitis B vaccine.

    What is hepatitis B?

    Hepatitis B is a liver infection caused by the hepatitis B virus. The virus attacks the liver, causing severe short-term and long-term infections. 

    Short-term hepatitis B infections may cause “fever, fatigue, loss of appetite, nausea, vomiting, jaundice (yellow skin or eyes, dark urine, clay-colored bowel movements), and pain in the muscles, joints, and stomach,” according to the Centers for Disease Control and Prevention. 

    A long-term hepatitis B infection occurs when the virus stays in the body beyond the initial infection, causing chronic illness. Hepatitis B infections become chronic in 90 percent of infected infants, half of infected young children, and between 5 to 10 percent of infected adults. 

    “Most people who go on to develop chronic hepatitis B do not have symptoms, but it is still very serious and can lead to liver damage (cirrhosis), liver cancer, and death. Chronically infected people can spread hepatitis B virus to others, even if they do not feel or look sick themselves,” says the CDC. 

    How does the hepatitis B virus spread?

    The hepatitis B virus is spread through body fluids, including blood, semen, and saliva. It can also be transmitted from birthing parent to child during pregnancy and childbirth. 

    “While hepatitis B is an infection that lives in bodily fluids, it can survive outside the human body for several days, which means that sharing contaminated household products is a possible source of infection,” said Dr. Christopher Labos, a McGill University cardiologist and epidemiologist, in a 2019 article.

    In 2022, over 250 million people worldwide had chronic hepatitis B, and 1.1 million died from the disease. Most of the deaths were from liver damage and liver cancer. Less than 15 percent of people living with hepatitis B have been diagnosed. 

    How well does the vaccine protect against hepatitis B?

    Hepatitis B vaccination is up to 95 percent effective, providing lasting—and possibly lifelong—protection against the virus. Depending on when the first dose is given, the complete vaccine series consists of two to three doses. 

    The vaccine is most effective for infants and children. The CDC recommends that infants receive it at birth for the most protection. 

    The first dose is followed by two to three additional doses administered before 18 months. Children, adolescents, and adults who weren’t vaccinated as infants should also receive the vaccine. 

    Vaccination is particularly important for high-risk groups, including health workers and those who are in close contact with individuals living with chronic hepatitis B, people who use intravenous drugs, and people receiving blood transfusions, dialysis, or organ transplants. 

    Is the vaccine safe?

    Vaccines against hepatitis B were first developed in the 1980s, and they have been proven safe for decades. They have a low risk of serious side effects and are safe enough to be given to newborns, pregnant people, and immunocompromised people.

    We also know hepatitis B vaccines work: “Between 1990 (about the time when universal hepatitis B vaccinations started) and 2006, the rate of hepatitis B infection fell by 81 percent to the lowest level ever recorded, and the decline was greatest among children,” added Labos. 

    Hepatitis B rates have continued to decline across all age groups, with the U.S. exceeding its goal of reducing new hepatitis B infections by 20 percent.

    Why do doctors recommend the vaccine for babies?

    Hepatitis B vaccination helps protect infants from a lifetime of potentially life-threatening infections and complications. Nine out of 10 unvaccinated infants infected with hepatitis B will develop chronic infections, which increases their risk of liver failure and liver cancer. 

    The hepatitis B vaccine is administered at birth to help prevent the virus from being transmitted from birthing parent to child. It also helps protect infants who might be in close contact with someone with hepatitis B. This is particularly important because most people who have hepatitis are undiagnosed. 

    Have more questions? Talk to your health care provider to learn more about hepatitis B vaccination.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • How To Recover Quickly From A Stomach Bug

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    How To Recover Quickly From A Stomach Bug

    Is it norovirus, or did you just eat something questionable? We’re not doctors, let alone your doctors, and certainly will not try to diagnose from afar. And as ever, if unsure and/or symptoms don’t go away or do get worse, seek professional medical advice.

    That out of the way, we can give some very good general-purpose tips for this one…

    Help your immune system to help you

    So far as you can, you want a happy healthy immune system. For the most part, we’d recommend the following things:

    Beyond Supplements: The Real Immune-Boosters!

    …but you probably don’t want to be exercising with a stomach bug, so perhaps sit that one out. Exercise is the preventative; what you need right now is rest.

    Hydrate—but watch out

    Hydration is critical for recovery especially if you have diarrhea, but drinking too much water too quickly will just make things worse. Great options for getting good hydration more slowly are:

    • Peppermint tea
      • (peppermint also has digestion-settling properties)
    • Ginger tea
    • Broths
      • These will also help replenish your sodium and other nutrients, gently. Chicken soup for your stomach, and all that. A great plant-based option is sweetcorn soup.
      • By broths, we mean clear(ish) water-based soups. This is definitely not the time for creamier soups.

    ❝Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse.

    Initial dietary choices when refeeding should begin with soups and broth.❞

    Source: American College of Gastroenterology

    Other things to avoid

    Caffeine stimulates the digestion in a way that can make things worse.

    Fat is more difficult to digest, and should also be avoided until feeling better.

    To medicate or not to medicate?

    Loperamide (also known by the brand name Imodium) is generally safe when used as directed.

    Click here to see its uses, dosage, side effects, and contraindications

    Antibiotics may be necessary for certain microbial infections, but should not be anyone’s first-choice treatment unless advised otherwise by your doctor/pharmacist.

    Note that if your stomach bug is not something that requires antibiotics, then taking antibiotics can actually make it worse as the antibiotics wipe out your gut bacteria that were busy helping fight whatever’s going wrong in there:

    A gentler helper

    If you want to give your “good bacteria” a hand while giving pathogens a harder time of it, then a much safer home remedy is a little (seriously, do not over do it; we are talking 1–2 tablespoons, or around 20ml) apple cider vinegar, taken diluted in a glass of water.

    ❝Several studies indicate apple cider vinegar (ACV)’s usefulness in lowering postprandial glycemic response, specifically by slowing of gastric motility❞

    (Slowing gastric motility is usually exactly what you want in the case of a stomach bug, and apple cider vinegar)

    Source: Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review

    See also:

    Take care!

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  • Why You Can’t Skimp On Amino Acids

    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.

    Our body requires 20 amino acids (the building blocks of protein), 9 of which it can’t synthesize (thus called: “essential”) and absolutely must get from food. Normally, we get these amino acids from protein in our diet, and we can also supplement them by taking amino acid supplements if we wish.

    Specifically, we require (per kg of bodyweight) a daily average of:

    1. Histidine: 10 mg
    2. Isoleucine: 20 mg
    3. Leucine: 39 mg
    4. Lysine: 30 mg
    5. Methionine: 10.4 mg
    6. Phenylalanine*: 25 mg
    7. Threonine: 15 mg
    8. Tryptophan: 4 mg
    9. Valine: 26 mg

    *combined with the non-essential amino acid tyrosine

    Source: Protein and Amino Acid Requirements In Human Nutrition: WHO Technical Report

    Why this matters

    A lot of attention is given to protein, and making sure we get enough of it, especially as we get older, because the risk of sarcopenia (muscle mass loss) increases with age:

    Protein vs Sarcopenia

    However, not every protein comes with a complete set of essential amino acids, and/or have only trace amounts of of some amino acids, meaning that a dietary deficiency can arrive if one’s diet is too restrictive.

    And, if we become deficient in even just one amino acid, then bad things start to happen quite soon. We only have so much space, so we’re going to oversimplify here, but:

    1. Histidine: is needed to produce histamine (vital for immune responses, amongst other things), and is also important for maintaining the myelin sheaths on nerve cells.
    2. Isoleucine: is very involved in muscle metabolism and makes up the bulk of muscle tissue.
    3. Leucine: is critical for muscle synthesis and repair, as well as wound healing in general, and blood sugar regulation.
    4. Lysine: is also critical in muscle synthesis, as well as calcium absorption and hormone production, as well as making collagen.
    5. Methionine: is very important for energy metabolism, zinc absorption, and detoxification.
    6. Phenylalanine: is a necessary building block of a lot of neurotransmitters, as well as being a building block of some amino acids not listed here (i.e., the ones your body synthesizes, but can’t without phenylalanine).
    7. Threonine: is mostly about collagen and elastin production, and is also very important for your joints, as well as fat metabolism.
    8. Tryptophan: is the body’s primary precursor to serotonin, so good luck making the latter without the former.
    9. Valine: is mostly about muscle growth and regeneration.

    So there you see, the ill effects of deficiency can range from “muscle atrophy” to “brain stops working” and “bones fall apart” and more. In short, any essential amino acid deficiency not remedied will ultimately result in death; we literally become non-viable as organisms without these 9 things.

    What to do about it (the “life hack” part)

    Firstly, if you eat a lot of animal products, those are “complete” proteins, meaning that they contain all 9 essential amino acids in sensible quantities. The reason that all animal products have these, is because they are just as essential for the other animals as they are for us, so they, just like us, must consume (and thus contain) them.

    However, a lot of animal products come with other health risks:

    Do We Need Animal Products To Be Healthy? ← this covers which animal products are definitely very health-risky, and which are probably fine according to current best science

    …so many people may prefer to get more (or possibly all) dietary protein from plants.

    However, plants, unlike us, do not need to consume all 9 essential amino acids, and this may or may not contain them all.

    Soy is famously a “complete” protein insofar as it has all the amino acids we need.

    But what if you’re allergic to soy?

    Good news! Peas are also a “complete” protein and will do the job just fine. They’re also usually cheaper.

    Final note

    An oft-forgotten thing is that some other amino acids are “conditionally essential”, meaning that while we can technically synthesize them, sometimes we can’t synthesize enough and must get them from our diet.

    The conditions that trigger this “conditionally essential” status are usually such things as fighting a serious illness, recovering from a serious injury, or pregnancy—basically, things where your body has to work at 110% efficiency if it wants to get through it in one piece, and that extra 10% has to come from somewhere outside the body.

    Examples of commonly conditionally essential amino acids are arginine and glycine.

    Arginine is critical for a lot of cell-signalling processes as well as mitochondrial function, as well as being a precursor to other amino acids, including creatine.

    As for glycine?

    Check out: The Sweet Truth About Glycine

    Enjoy!

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