Antidepressants: Personalization Is Key!
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Antidepressants: Personalization Is Key!
Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:
- Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
- Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
- Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
- Four respondents said “They are no better than placebo, and are more likely to harm”
- Two respondents said “They merely mask the problem, and thus don’t really help”
So what does the science say?
❝They are no better than placebo, and are more likely to harm? True or False?❞
True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:
- Placebo Effect in the Treatment of Depression and Anxiety ← randomly assigned antidepressants are, shockingly, luck of the draw in usefulness
- Antidepressants versus placebo in major depression: an overview ← “wow this science is messy”
- Comparative efficacy and acceptability of 21 antidepressant drugs: a systematic review and network meta-analysis ← “oh look, it makes a difference which antidepressant we give to people”
Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.
Otherwise it is like getting a flu shot and being surprised when you still catch a cold!
❝They merely mask the problem, and thus don’t really help: True or False?❞
False, categorically.
The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).
❝They may help some people, but the side-effects are alarming: True or False?❞
True or False depending on more factors than we can cover here.
Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.
One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.
❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞
True! Contingently.
That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.
*common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.
For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.
Want to know more about the different kinds?
Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:
Mind | Comparing Antidepressants
Want a drug-free approach?
You might like our previous main feature:
The Mental Health First-Aid That You’ll Hopefully Never Need
Take care!
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The Medicinal Chef – by Dale Pinnock
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The philosophy here is very much like our own—to borrow from Hippocrates: “let food be thy medicine”. Obviously please do also let medicine be thy medicine if you need it, but the point is that food is a very good starting place for combatting a lot of disease.
To this end, instead of labelling the recipes with such things as “V”, “Ve”, “GF” and suchlike, it assumes we can tell those things from the ingredients lists, and instead labels things per what they are especially good for:
- S: skin
- J: joints & bones
- R: respiratory system
- I: immune system
- M: metabolic health
- N: nervous system and mental health
- H: heart and circulation
- D: digestive system
- U: reproductive & urinary systems
As for the recipes themselves… They’re a lot like the recipes we share here at 10almonds in their healthiness, skill level, and balance of easy-to-find ingredients with the occasional “order it online” items that punch above their weight. In fact, we’ll probably modify some of the recipes for sharing here.
Bottom line: if you’re looking for genuinely healthy recipes that are neither too basic nor too arcane, this book has about 80 of them.
Click here to check out The Medicinal Chef: Healthy Every Day, and be healthy every day!
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Intuitive Eating – by Evelyn Tribole and Elyse Resch
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You may be given to wonder: if this is about intuitive eating, and an anti-diet approach, why a whole book?
There’s a clue in the other part of the title: “4th Edition”.
The reason there’s a 4th edition (and before it, a 3rd and 2nd edition) is because this book is very much full of science, and science begets more science, and the evidence just keeps on rolling in.
While neither author is a doctor, each has a sizeable portion of the alphabet after their name (more than a lot of doctors), and this is an incredibly well-evidenced book.
The basic premise from many studies is that restrictive dieting does not work well long-term for most people, and instead, better is to make use of our bodies’ own interoceptive feedback.
You see, intuitive eating is not “eat randomly”. We do not call a person “intuitive” because they speak or act randomly, do we? Same with diet.
Instead, the authors give us ten guiding principles (yes, still following the science) to allow us a consistent “finger on the pulse” of what our body has to say about what we have been eating, and what we should be eating.
Bottom line: if you want to be a lot more in tune with your body and thus better able to nourish it the way it needs, this book is literally on the syllabus for many nutritional science classes, and will stand you in very good stead!
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Is Dairy Scary?
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Is Dairy Scary?
Milk and milk products are popularly enjoyed as a good source of calcium and vitamin D.
In contrast, critics of dairy products (for medical reasons, rather than ethical, which is another matter entirely and beyond the scope of this article) point to risks of cancer, heart disease, and—counterintuitively—osteoporosis. We’ll focus more on the former, but touch on the latter two before closing.
Dairy & Cancer
Evidence is highly conflicting. There are so many studies with so many different results. This is partially explicable by noting that not only is cancer a many-headed beast that comes in more than a hundred different forms and all or any of them may be affected one way or another by a given dietary element, but also… Not all milk is created equal, either!
Joanna Lampe, of the Public Health Sciences division, Fred Hutchinson Cancer Research Center in Seattle, writes:
❝Dairy products are a complex group of foods and composition varies by region, which makes evaluation of their association with disease risk difficult. For most cancers, associations between cancer risk and intake of milk and dairy products have been examined only in a small number of cohort studies, and data are inconsistent or lacking❞
In her systematic review of studies, she noted, for example, that:
- Milk and dairy products contain micronutrients and several bioactive constituents that may influence cancer risk and progression
- There’s probable association between milk intake and lower risk of colorectal cancer
- There’s a probable association between diets high in calcium and increased risk of prostate cancer
- Some studies show an inverse association between intake of cultured dairy products and bladder cancer (i.e., if you eat yogurt you’re less likely to get bladder cancer)
Since that systemic review was undertaken, more research has been conducted, and the results are… Not conclusive, but converging towards a conclusion:
- Dairy products can increase or decrease cancer risk
- The increase in cancer risk seems strongest when milk is consumed in quantities that result in too much calcium. When it comes to calcium, you can absolutely have too much of a good thing—just ask your arteries!
- The decrease in cancer seems to be mostly, if not exclusively, from fermented dairy products. This usually means yogurts. The benefit here is not from the milk itself, but rather from the gut-friendly bacteria.
You may be wondering: “Hardened arteries, gut microbiome health? I thought we were talking about cancer?” and yes we are. No part of your health is an island unrelated to other parts of your health. One thing can lead to another. Sometimes we know how and why, sometimes we don’t, but it’s best to not ignore the data.
The bottom line on dairy products and cancer is:
- Consuming dairy products in general is probably fine
- Yogurt, specifically, is probably beneficial
Dairy and Heart Disease
The reason for the concern is clear enough: it’s largely assumed to be a matter of saturated fat intake.
The best combination of “large” and “recent” that we found was a three-cohort longitudinal study in 2019, which pretty much confirms what was found in smaller or less recent studies:
- There is some evidence to suggest that consumption of dairy can increase all-cause mortality in general, and death from (cancer and) cardiovascular disease in particular
- The evidence is not, however, overwhelming. It is marginal.
Dairy and Osteoporosis
Does dairy cause osteoporosis? Research here tends to fall into one of two categories when it comes to conclusions, so we’ll give an example of each:
- “Results are conflicting, saying yes/no/maybe, and basically we just don’t know”
- “Results are conflicting, but look: cross-sectional and case-control studies say yes; cohort studies say maybe or no; we prefer the cohort studies”
See them for yourself:
- Osteoporosis: Is milk a kindness or a curse?
- Consumption of milk and dairy products and risk of osteoporosis and hip fracture
Conclusion: really, the jury is very much still out on this one
Summary:
- Moderate consumption of dairy products is almost certainly fine
- More specifically: it probably has some (small) pros and some (small) cons
- Yogurt is almost certainly healthier than other dairy products, and is almost universally considered a healthy food (assuming not being full of added sugar etc, of course)
- If you’re going to have non-dairy alternatives to milk, choose wisely!
That’s all we have time for today, but perhaps in a future edition we’ll do a run-down of the pros and cons of various dairy alternatives!
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Chromium Picolinate For Blood Sugar Control & Weight Loss
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First, a quick disambiguation:
- chromium found in food, trivalent chromium of various kinds, is safe (in the quantities usually consumed) and is sometimes considered an essential mineral, sometimes considered unnecessary but beneficial. It’s hard to know for sure, since it’s in a lot of foods (naturally, like many trace elements)
- chromium found in pollution, hexavalent chromium (so: twice as many cationic bonds, if this writer’s chemistry serves her correctly) is poisonous.
We’re going to be writing about the food kind, which is also possible to take as a supplement.
In this case, supplementing vs getting from food is quite a big difference, by the way, since (unlike for a lot of things, which are often the other way around) the bioavailability of chromium from food is very low (around 2.5%), whereas chromium picolinate, one of the most commonly-used supplement forms, boasts higher bioavailability.
Does it work for blood sugars?
Yes, it does! At least, it does in the case of people with type 2 diabetes. Rather than bombard you with many individual studies, here’s a systematic review and meta-analysis of 22 criteria-meeting randomized clinical trials that found:
❝The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes.
Chromium monosupplement may additionally improve triglycerides and HDL-C levels.❞
Type 1 diabetes does not have anything like the same weight of evidence, and indeed,
we couldn’t find a single human study. It was beneficial for mice with artificially-induced T1D, thoughwait no, we have an update! We found literally a single human study:Chromium picolinate supplementation for diabetes mellitus
Literally, as in: it’s a case study of one person, and the results were a modest reduction in Hb A1c levels after 3 months of 600μg daily; the researchers concluded that ❝chromium picolinate continues to fall squarely within the scope of “alternative medicine,” with both unproven benefits and unknown risks❞.
As for people without diabetes, it may reduce the risk of diabetes:
Risk of Type 2 Diabetes Is Lower in US Adults Taking Chromium-Containing Supplements
However! This was an observational study, and correlation ≠ causation.
Furthermore, they said:
❝Over one-half the adult US population consumes nutritional supplements, and over one-quarter consumes supplemental chromium. The odds of having T2D were lower in those who, in the previous 30 d, had consumed supplements containing chromium❞
That “over one-quarter consumes supplemental chromium” brought our attention to the fact that this is not talking about specifically chromium “monosupplements” (definitely not quarter of the adult population take those), but rather, “multivitamin and mineral” supplements that also contain a tiny amount (often under 50μg) of chromium.
In other words, this ruins the data and honestly the benefit could have been from anything in the “multivitamin and mineral” supplement, or indeed, could just be “the kind of person who takes supplements is the kind of person who lives a lifestyle that is less conducive to becoming diabetic”.
Does it work for weight loss?
We’re running out of space here, so we’ll be brief:
No.
There are many papers that have concluded this, but here are two:
Chromium picolinate supplementation for overweight or obese adults
and
Is it safe?
Science’s current best answer is “we don’t know; it hasn’t been tested enough; we haven’t even established the tolerable upper limit, which is usually step 1 of establishing safety”.
Nor is there an estimated average requirement (if indeed there even is a requirement, which question is also not as yet answered conclusively by science), and science falls back to “here’s an average of what people consume in their diet, so that’s probably safe, we guess”.
(that average was reckoned as 25μg/day for young women and 25μg/day for young men, by the way; older ages not as yet reckoned)
You can read about this sorry state of affairs here.
Want to try some?
Notwithstanding the above lack of data for safety, it does have benefits for blood sugars, so if that’s a gamble you’re willing to make, then here’s an example product on Amazon.
Note: the dosage per capsule there (800μg) is half of the low end of the dose that was implicated in the serious kidney condition caused in this case study (1200–2400μg), so if you are going to try it, we strongly recommend not taking more than one per day.
Take care!
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Rise And (Really) Shine!
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Q&A with 10almonds Subscribers!
Q: Would love to hear more ideas about effective first thing in the morning time management to get a great start on your day.
A: There are a lot of schools of thought about what’s best in this regard! Maybe we’ll do a main feature sometime. But some things that are almost universally agreed upon are:
- Prepare your to-do list the night before
- Have some sort of buffer between waking up and getting to productivity.
- For me (hi, your writer here) it’s my first coffee of the day. It’s not even about the caffeine, it’s about the ritual of it, it’s a marker that separates my night from the day and tells my brain what gear to get into.
- Others may like to exercise first thing in the morning
- For still yet others, it could be a shower, cold or otherwise
- Some people like a tall glass of lemon water to rehydrate after sleeping!
- If you take drinkable morning supplements such as this pretty awesome nootropic stack, it’s a great time for that and an excellent way to get the brain-juices flowing!
- When you do get to productivity: eat the frog first! What this means is: if eating a frog is the hardest thing you’ll have to do all day, do that first. Basically, tackle the most intimidating task first. That way, you won’t spend your day stressed/anxious and/or subconsciously wasting time in order to procrastinate and avoid it.
- Counterpart to the above: a great idea is to also plan something to look forward to when your working day is done. It doesn’t matter much what it is, provided it’s rewarding to you, that makes you keen to finish your tasks to get to it.
Have a question you’d like to see answered here? Hit reply to this email, or use the feedback widget at the bottom! We always love to hear from you
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Pomegranate vs Cranberries – Which is Healthier?
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Our Verdict
When comparing pomegranate to cranberries, we picked the pomegranate.
Why?
Starting with the macros: pomegranate has nearly 4x the protein (actually quite a lot for a fruit, but this is not too surprising—it’s because we are eating the seeds!), and slightly more carbs and fiber. Their glycemic indices are comparable, both being low GI foods. While both of these fruits have excellent macro profiles, we say the pomegranate is slightly better, because of the protein, and when it comes to the carbs and fiber, since they balance each other out, we’ll go with the option that’s more nutritionally dense. We like foods that add more nutrients!
In the category of vitamins, pomegranate is higher in vitamins B1, B2, B3, B5, B6, B9, K, and choline, while cranberry is higher in vitamins A, C, and E. Both are very respectable profiles, but pomegranate wins on strength of numbers (and also some higher margins of difference).
When it comes to minerals, it is not close; pomegranate is higher in calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while cranberry is higher in manganese. An easy win for pomegranate here.
Both of these fruits have additional “special” properties, though it’s worth noting that:
- pomegranate’s bonus properties, which are too many to list here, but we link to an article below, are mostly in its peel (so dry it, and grind it into a powder supplement, that can be worked into foods, or used like an instant fruit tea, just without the sugar)
- cranberries’ bonus properties (including: famously very good at reducing UTI risk) come with some warnings, including that they may increase the risk of kidney stones if you are prone to such, and also that cranberries have anti-clotting effects, which are great for heart health but can be a risk of you’re on blood thinners or have a bleeding disorder.
You can read about both of these fruits’ special properties in more detail below:
Want to learn more?
You might like to read:
- Health Benefits Of Cranberries (But: You’d Better Watch Out)
- Pomegranate’s Health Gifts Are Mostly In Its Peel
Take care!
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