Dealing With Waking Up In The Night
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I’m now in my sixties and find that I invariably wake up at least once during the night. Is this normal? Even if it is, I would still like, once in a while, to sleep right through like a teenager. How might this be achieved, without pills?❞
Most people wake up briefly between sleep cycles, and forget doing so. But waking up for more than a brief moment is indeed best avoided. In men of your age, if you’re waking to pee (especially if it’s then not actually that easy to pee), it can be a sign of an enlarged prostate. Which is again a) normal b) not optimal.
By “without pills” we’ll assume you mean “without sleeping pills”. There are options to treat an enlarged prostate, including well-established supplements. We did a main feature on this:
Prostate Health: What You Should Know
If the cause of waking up is something else, then again this is common for everyone as we get older, and again it’s not optimal. But since there are so many possible causes (and thus solutions), it’s more than we can cover in less than a main feature, so we’ll have to revisit this later.
Meanwhile, take care!
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The Brain-Skin Doctor
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Of Brains And Breakouts
This is Dr. Claudia Aguirre. She’s a molecular neuroscientist, and today she’s going to be educating us about skin.
What? Why?
When we say “neuroscience”, we generally think of the brain. And indeed, that’s a very important part of it.
We might think about eyes, which are basically an extension of the brain.
We don’t usually think about skin, which (just like our eyes) is constantly feeding us a lot of information about our surroundings, via a little under three million nerve endings. Guess where the other ends of those nerves lead!
There’s a constant two-way communication going on between our brain and our skin.
What does she want us to know?
Psychodermatology
The brain and the skin talk to each other, and maladies of one can impact the other:
- Directly, e.g. stress prompting skin breakouts (actually this is a several-step process physiologically, but for the sake of brevity we’ll call this direct)
- Indirectly, e.g. nervous disorders that result in people scratching or picking at their skin, which prompts a whole vicious cycle of one thing making the other worse
Read more: Psychodermatology: The Brain-Skin Connection
To address both kinds of problems, clearly something beyond moisturizer is needed!
Mindfulness (meditation and beyond)
Mindfulness is a well-evidenced healthful practice for many reasons, and Dr. Aguirra argues the case for it being good for our skin too.
As she points out,
❝Cultural stress and anxiety can trigger or aggravate many skin conditions—from acne to eczema to herpes, psoriasis, and rosacea.
Conversely, a disfiguring skin condition can trigger stress, anxiety, depression, and even suicide.
Chronic, generalized anxiety can create chronic inflammation and exacerbate inflammatory skin conditions, such as those I mentioned previously.
Chronic stress can result in chronic anxiety, hypervigilance, poor sleep, and a whole cascade of effects resulting in a constant breakdown of tissues and organs, including the skin.❞
So, she recommends mindfulness-based stress reduction (MBSR), for the above reasons, along with others!
Read more: Mind Matters
How to do it: No-Frills, Evidence-Based Mindfulness
And as for “and beyond?”
Do you remember in the beginning of the pandemic, when people were briefly much more consciously trying to avoid touching their faces so much? That, too, is mindfulness. It may have been a stressed and anxious mindfulness for many*, but mindfulness nonetheless.
*which is why “mindfulness-based stress reduction” is not a redundant tautology repeated more than once unnecessarily, one time after another 😉
So: do try to keep aware of what you are doing to your skin, and so far as is reasonably practicable, only do the things that are good for it!
The skin as an endocrine organ
Nerves are not the only messengers in the body; hormones do a lot of our body’s internal communication too. And not just the ones everyone remembers are hormones (e.g. estrogen, testosterone, although yes, they do both have a big impact on skin too), but also many more, including some made in the skin itself!
Dr. Aguirra gives us a rundown of common conditions, the hormones behind them, and what we can do if we don’t want them:
Read more: Rethinking The Skin As An Endocrine Organ
Take-away advice:
For healthy skin, we need to do more than just hydrate, get good sleep, have good nutrition, and get a little sun (but not too much).
- We should also practice mindfulness-based stress reduction, and seek help for more serious mental health issues.
- We should also remember the part our hormones play in our skin, and not just the obvious ones.
Did you know that vitamin D is also a hormone, by the way? It’s not the only hormone at play in your skin by a long way, but it is an important one:
Society for Endocrinology | Vitamin D
Want to know more?
You might like this interview with Dr. Aguirre:
The Brain in Our Skin: An Interview with Dr. Claudia Aguirre
Take care!
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Aspirin, CVD Risk, & Potential Counter-Risks
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Aspirin Pros & Cons
In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:
- About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
- About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
- About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”
So, what does the science say?
Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?
True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:
- decreases the risk of atherothrombosis
- increases the risk of bleeding, especially in the gastrointestinal tract
When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither
While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.
In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones
The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.
In the words of the Journal of the American College of Cardiology:
❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).
Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).
Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞
~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)
Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology
Or if you’d prefer a more pop-science presentation:
Many older adults still use aspirin for CVD prevention, contrary to clinical guidance
Aspirin can cause liver and/or kidney damage: True or False?
True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.
Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).
Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.
For numbers, symptoms, and treatment, see this very clear and helpful resource:
An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose
Take care!
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Does PRP Work For Hair Loss?
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Dr. Ankit Gupta takes us through the details of this hair loss remedy for androgenic alopecia.
The bald truth
Platelet-Rich Plasma (PRP) is a controversial treatment for androgenic hair loss.
What it involves: blood is drawn and separated using a centrifuge. PRP—including growth proteins and hormones—is extracted from the blood; about 30 ml of blood is needed to produce 5 ml of PRP. This is then injected directly into the scalp. As this can be painful, local anaesthetic is sometimes used first. This usually involves monthly sessions for the first 3 months, then booster sessions every 3–6 months thereafter.
Does it work? Research is young; so far 60% of trials have found it worked; 40% found it didn’t. When it works, effectiveness (in terms of hair restoration) is considered to be between 25–43%. Results are inconsistent and seem to vary from person to person.
In short, this doctor’s recommendation is to consider it after already having tried standard treatments such as finasteride and/or minoxidil, as they are more likely to work and don’t involve such exciting procedures as injecting your own blood extracts back into your head.
For more on all of this, plus links to the 13 papers cited, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Hair-Loss Remedies, By Science
- Hair Growth: Caffeine and Minoxidil Strategies
- Gentler Hair Health Options
Take care!
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Who Screens The Sunscreens?
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We Screen The Sunscreens!
Yesterday, we asked you what your sunscreen policy was, and got a spread of answers. Apparently this one was quite polarizing!
One subscriber who voted for “Sunscreen is essential to protect us against skin aging and cancer” wrote:
❝My mom died of complications from melanoma, so we are vigilant about sun and sunscreen. We are a family of campers and hikers and gardeners—outdoors in all seasons—and we never burn❞
Our condolences with regard to your mom! Life is so precious, and when something like that happens, it tends to stick with us. We’re glad you and your family are taking care of yourselves.
Of the subscribers who voted for “I put some on if I think I might otherwise get sunburned”, about half wrote to express uncertainties:
- uncertainty about how safe it is, and
- uncertainty about how helpful it is
…so we’re going to tackle those questions in a moment. But what of those who voted for “Sunscreen is full of harmful chemicals that can cause cancer”?
Of those, only one wrote a message, which was to say one has to be very careful of what is in the formula.
Let’s take a look, then…
Sunscreen is full of harmful chemicals that can cause cancer: True or False?
False—according to current best science. Research is ongoing!
There are four main chemicals (found in most sunscreens) that people tend to worry about:
- Abobenzone
- Oxybenzone
- Octocrylene
- Ecamsule
Now, these two sound like four brands of rocket fuel, but then, dihydrogen monoxide (DHMO), which is also found in most sunscreens, sounds like a deadly toxin too. That’s water, by the way.
But what of these four chemicals? Well, as we say, research is ongoing, but we found a study that measured all four, to see how much got into the blood, and what adverse effects, if any, this caused.
We’ll skip to their conclusion:
❝In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.❞
Now, “exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens” sounds alarming, so why did they close with the words “These results do not indicate that individuals should refrain from the use of sunscreen”?
Let’s skip back up to a line from the results:
❝The most common adverse event was rash, which developed in 1 participant with each sunscreen.❞
This was most probably due to the oxybenzone, which can cause allergic skin reactions in some people.
Let us take a moment to remember the most common adverse event that occurs from not wearing sunscreen: sunburn!
You can read the full study here:
None of those ingredients have been found to be carcinogenic, even at the maximal blood plasma concentrations studied, from applications 4x/day to 75% of the body.
UVA rays, on the other hand, are absolutely very much known to cause cancer, and the effect is cumulative.
Sunscreen is essential to protect us against skin aging and cancer: True or False?
True, unequivocally, unless we live indoors and/or otherwise never go about under sunlight.
“But our ancestors—” lived under the same sun we do, and either used sunscreen or got advanced skin aging and cancer.
Sunscreen of times past ranged from mud to mineral lotions, but it’s pretty much always existed. Even non-human animals that have skin and don’t have fur or feathers, tend to take mud-baths in sunny parts of the world.
If you’d like to avoid oxybenzone and other chemicals, though, you might have your reasons. Maybe you’re allergic, or maybe you read that it’s a potential endocrine disruptor with estrogen-like and anti-androgenic properties that you don’t want.
There are other options, to include physical blockers containing zinc and titanium dioxide, which are generally recognized as safe and effective ingredients.
If you’re interested, you can even make your own sunscreen that blocks both UVA and UVB rays (UVA is what causes skin cancer; UVB is “milder” and is what causes sunburn):
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Sunflower Seeds vs Pumpkin Seeds – Which is Healthier?
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Our Verdict
When comparing sunflower seeds to pumpkin seeds, we picked the pumpkin seeds.
Why?
Both seeds have a good spread of vitamins and minerals, but pumpkin seeds have more. Sunflower seeds come out on top for copper and manganese, but everything else that’s present in either of them (in the category of vitamins and minerals, anyway), pumpkin seeds have more.
There is one other thing that sunflower seeds have more of than pumpkin seeds, and that’s fat. The fat is mostly of healthy varieties, so it’s not a negative factor, but it does mean that if you’re eating a calorie-controlled diet, you’ll get more bang for your buck (i.e. better micronutrient-to-calorie ratio) if you pick pumpkin seeds.
If you’re not concerned about fat/calories, and/or you actively want to consume more of those, then sunflower seeds are still a fine choice.
When it comes down to it, a diverse diet is best, so enjoying both might be the best option of all.
Want to get some?
We don’t sell them, but here for your convenience are example products on Amazon:
Sunflower Seeds | Pumpkin Seeds
Enjoy!
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Sunflower Seeds vs Sesame Seeds – Which is Healthier?
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Our Verdict
When comparing sunflower seeds to sesame seeds, we picked the sunflower.
Why?
In moderation, both are very healthy. We say “in moderation” because they’re both about 50% fat and such fats, while vital for life, are generally best enjoyed in small portions. Of that fat, sunflower has the slightly better fat profile; they’re both mostly poly- and monounsaturated fats, but sunflower has 10% saturated fat while sesame has 15%. Aside from fats, sunflower has slightly more protein and sesame has slightly more carbs. While sesame has slightly more fiber, because of the carb profile sunflower still has the lower glycemic index. All in all, a moderate win for sunflower in the macros category.
You may be wondering, with all that discussion of fats, what they’re like for omega-3, and sesame seeds have more omega-3, though sunflower seeds contain it too. Still, a point in sesame’s favor here.
When it comes to vitamins, sunflower has more of vitamins A, B1, B2, B3, B5, B6, B9, C, E, and choline, while sesame is not higher in any vitamins.
In the category of minerals, sunflower has more phosphorus, potassium, and selenium, while sesame has more calcium, copper, iron, and zinc. This is nominally a marginal win for sesame, but it should be noted that sunflower is still very rich in copper, iron, and zinc too (but not calcium).
Adding up the categories makes for a moderate win for sunflower seeds, but as ever, enjoy both; diversity is best!
Want to learn more?
You might like to read:
Sunflower Seeds vs Pumpkin Seeds – Which is Healthier?
Take care!
Don’t Forget…
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