Burned Out By Tuesday?

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Avoiding Burnout, The Active Way

This is Dr. Claudine Holt. She’s double board-certified, in Occupational & Environmental Medicine, and Lifestyle Medicine.

In short: preventative medicine in all parts of our life.

Hopefully, you are reading this bright-eyed and bushy-tailed and ready to take on another exciting day in this wonderful, beautiful world!

On the other hand, it’s possible that you’re reading this semi-focussed, looking for a crumb of dopamine as much as you are looking for information.

If you’ve ever had the “What a week!” / “It’s only Tuesday” moment, this one’s for you.

What does Dr. Holt want us to know?

You can recover from burnout without guilt

Sometimes, we overreach ourselves. Sometimes, life overreaches us! Sometimes it’s not that we overcommitted—it’s just that we were taking each day as it comes, but sometimes several days gang up on us at once.

Sometimes, even, we can feel exhausted when it seems like we haven’t done anything.

Note: if you feel exhausted and it seems like you haven’t done anything, then be aware: you are exhausted for a reason!

What that reason might be may vary, but contrary to popular belief, energy does not just vanish. It went somewhere.

This goes double if you have any chronic illness(es), even if you’re not aware of having had a flare-up, chances are you were just exceptionally busy (on a cellular level).

And it’s easy to think that “mere” cellular activity shouldn’t be exhausting, but that is 100% of where our energy transactions happen—whether or not we are consciously aware of them!

See also: Eat To Beat Chronic Fatigue ← yes, this also covers when you are too exhausted to shop and cook like a TV chef

Dr. Holt specializes in working with burned out medical professionals (and also specifically specializes in working with women), but there are lessons for everyone in her advice. For example:

Fiction: ”Medicine is my calling–it’s who I am.”

Fact: You are more than medicine! Remember that your career is just one aspect of your life. Don’t forget to create your big-picture vision and tend the garden of the other areas of your life too.

~ Dr. Claudine Holt

Read more: Dr. Claudine Holt | Burnout: Fact vs Fiction

This same thing can go for whatever part of your identity frequently follows “I’m a…”, and is somewhere that you put a lot of your energy; it could equally be a non-professional job like “homemaker”, or a relational status like “husband”, or a cultural identifier like “Christian”, or a hobby like “gardener” (assuming that is not also your profession, in which case, same item, different category).

Indeed, a lot of women especially get hit by “the triple burden” of professional work, housework, and childcare. And it’s not even necessarily that we resent any of those things or feel like they’re a burden; we (hopefully) love our professions, homes, children. But, here’s the thing:

No amount of love will add extra hours to the day.

So what does she recommend doing about it, when sometimes we’re juggling things that can’t be dropped?

Start simple, but start!

Dr. Holt recommends to start with a smile (yes even if, and sometimes especially when, the circumstances do not feel like they merit it), and deploy some CBT tools:

Two Hacks to Quickly Rise Above Burnout (Or Any Circumstance)

We’ve expanded on this topic here:

How To Manage Chronic Stress

With a more level head on, it becomes easier to take on the next step, which creating healthy boundariesand that doesn’t just mean with other people!

It also means slaying our own perfectionism and imposter syndrome—both things that will have us chasing our tails 36 hours per day if we let them.

See also:

❝Burnout is the culture of our times. A culture that expects us to do more and think our way out of everything. A culture that asks for more than the body can bear. Unfortunately, even though the situation might not be of our creation, burnout culture is our inheritance.

An inheritance we can either perpetuate—or change—depending on what we embody.❞

Source: The Embodied MD on Burnout with Dr Claudine Holt

That “embodiment” is partly our choices and actions that we bring and own just as we bring and own our body—and it’s partly our relationship with our body itself, and learning to love it, and work with it to achieve wonderful things, instead of just getting through the day.

Which yes, does also mean making space for good diet, exercise, sleep and so forth, per:

These Top Five Things Make The Biggest Difference To Health

Want to know more?

You might like to check out Dr. Holt’s website:

The Embodied M.D. | Burnout Coach

…where she also offers resources such as a blog and a podcast.

Enjoy!

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  • Microplastics are in our brains. How worried should I be?

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    Plastic is in our clothes, cars, mobile phones, water bottles and food containers. But recent research adds to growing concerns about the impact of tiny plastic fragments on our health.

    A study from the United States has, for the first time, found microplastics in human brains. The study, which has yet to be independently verified by other scientists, has been described in the media as scary, shocking and alarming.

    But what exactly are microplastics? What do they mean for our health? Should we be concerned?

    Daniel Megias/Shutterstock

    What are microplastics? Can you see them?

    We often consider plastic items to be indestructible. But plastic breaks down into smaller particles. Definitions vary but generally microplastics are smaller than five millimetres.

    This makes some too small to be seen with the naked eye. So, many of the images the media uses to illustrate articles about microplastics are misleading, as some show much larger, clearly visible pieces.

    Microplastics have been reported in many sources of drinking water and everyday food items. This means we are constantly exposed to them in our diet.

    Such widespread, chronic (long-term) exposure makes this a serious concern for human health. While research investigating the potential risk microplastics pose to our health is limited, it is growing.

    How about this latest study?

    The study looked at concentrations of microplastics in 51 samples from men and women set aside from routine autopsies in Albuquerque, New Mexico. Samples were from the liver, kidney and brain.

    These tiny particles are difficult to study due to their size, even with a high-powered microscope. So rather than trying to see them, researchers are beginning to use complex instruments that identify the chemical composition of microplastics in a sample. This is the technique used in this study.

    The researchers were surprised to find up to 30 times more microplastics in brain samples than in the liver and kidney.

    They hypothesised this could be due to high blood flow to the brain (carrying plastic particles with it). Alternatively, the liver and kidneys might be better suited to dealing with external toxins and particles. We also know the brain does not undergo the same amount of cellular renewal as other organs in the body, which could make the plastics linger here.

    The researchers also found the amount of plastics in brain samples increased by about 50% between 2016 and 2024. This may reflect the rise in environmental plastic pollution and increased human exposure.

    The microplastics found in this study were mostly composed of polyethylene. This is the most commonly produced plastic in the world and is used for many everyday products, such as bottle caps and plastic bags.

    This is the first time microplastics have been found in human brains, which is important. However, this study is a “pre-print”, so other independent microplastics researchers haven’t yet reviewed or validated the study.

    Plastic bag and plastic bottle left on beach
    The most common plastic found was polyethylene, which is used to make plastic bags and bottle caps. Maciej Bledowski/Shutterstock

    How do microplastics end up in the brain?

    Microplastics typically enter the body through contaminated food and water. This can disrupt the gut microbiome (the community of microbes in your gut) and cause inflammation. This leads to effects in the whole body via the immune system and the complex, two-way communication system between the gut and the brain. This so-called gut-brain axis is implicated in many aspects of health and disease.

    We can also breathe in airborne microplastics. Once these particles are in the gut or lungs, they can move into the bloodstream and then travel around the body into various organs.

    Studies have found microplastics in human faeces, joints, livers, reproductive organs, blood, vessels and hearts.

    Microplastics also migrate to the brains of wild fish. In mouse studies, ingested microplastics are absorbed from the gut into the blood and can enter the brain, becoming lodged in other organs along the way.

    To get into brain tissue, microplastics must cross the blood-brain-barrier, an intricate layer of cells that is supposed to keep things in the blood from entering the brain.

    Although concerning, this is not surprising, as microplastics must cross similar cell barriers to enter the urine, testes and placenta, where they have already been found in humans.

    Is this a health concern?

    We don’t yet know the effects of microplastics in the human brain. Some laboratory experiments suggest microplastics increase brain inflammation and cell damage, alter gene expression and change brain structure.

    Aside from the effects of the microplastic particles themselves, microplastics might also pose risks if they carry environmental toxins or bacteria into and around the body.

    Various plastic chemicals could also leach out of the microplastics into the body. These include the famous hormone-disrupting chemicals known as BPAs.

    But microplastics and their effects are difficult to study. In addition to their small size, there are so many different types of plastics in the environment. More than 13,000 different chemicals have been identified in plastic products, with more being developed every year.

    Microplastics are also weathered by the environment and digestive processes, and this is hard to reproduce in the lab.

    A goal of our research is to understand how these factors change the way microplastics behave in the body. We plan to investigate if improving the integrity of the gut barrier through diet or probiotics can prevent the uptake of microplastics from the gut into the bloodstream. This may effectively stop the particles from circulating around the body and lodging into organs.

    How do I minimise my exposure?

    Microplastics are widespread in the environment, and it’s difficult to avoid exposure. We are just beginning to understand how microplastics can affect our health.

    Until we have more scientific evidence, the best thing we can do is reduce our exposure to plastics where we can and produce less plastic waste, so less ends up in the environment.

    An easy place to start is to avoid foods and drinks packaged in single-use plastic or reheated in plastic containers. We can also minimise exposure to synthetic fibres in our home and clothing.

    Sarah Hellewell, Senior Research Fellow, The Perron Institute for Neurological and Translational Science, and Research Fellow, Faculty of Health Sciences, Curtin University; Anastazja Gorecki, Teaching & Research Scholar, School of Health Sciences, University of Notre Dame Australia, and Charlotte Sofield, PhD Candidate, studying microplastics and gut/brain health, University of Notre Dame Australia

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

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  • The Comfort Zone – by Kristen Butler

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    Are you sitting comfortably? Then we’ll begin. Funny, how being comfortable can be a good starting point, then we are advised “You have to get out of your comfort zone”.

    And yet, when we think of our personal greatest moments in life, they were rarely uncomfortable moments. Why is that?

    Kristen Butler wants us to resolve this paradox, with a reframe:

    The comfort zone? That’s actually the “flow” zone.

    Just as “slow and steady wins the race”, we can—like the proverbial tortoise—take our comfort with us as we go.

    The discomfort zone? That’s the stress zone, the survival zone, the “putting out fires” zone. From the outside, it looks like we’re making a Herculean effort, and perhaps we are, but is it actually so much better than peaceful consistent productivity?

    Butler writes in a way that will be relatable for many, and may be a welcome life-ring if you feel like you’ve been playing catch-up for a while.

    Is she advocating for complacency, then? No, and she discusses this too. That “complacency zone” is really the “burnout zone” after being in the “survival zone” for too long.

    She lays out for us, therefore, a guide for growing in comfort, expanding the comfort zone yes, but by securely pushing it from the inside, not by making a mad dash out and hoping it follows us.

    Bottom line: if you’ve been (perhaps quietly) uncomfortable for a little too long for comfort, this book can reframe your approach to get you to a position of sustainable, stress-free growth.

    Click here to check out The Comfort Zone, and start building yours!

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  • Reishi Mushrooms: Which Benefits Do They Really Have?

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    Reishi Mushrooms

    Another Monday Research Review, another mushroom! If we keep this up, we’ll have to rename it “Mushroom Monday”.

    But, there’s so much room for things to say, and these are fun guys to write about, as we check the science for any spore’ious claims…

    Why do people take reishi?

    Popular health claims for the reishi mushroom include:

    • Immune health
    • Cardiovascular health
    • Protection against cancer
    • Antioxidant qualities
    • Reduced fatigue and anxiety

    And does the science agree?

    Let’s take a look, claim by claim:

    Immune health

    A lot of research for this has been in vitro (ie, with cell cultures in labs), but promising, for example:

    Immunomodulating Effect of Ganoderma lucidum (Lingzhi) and Possible Mechanism

    (that is the botanical name for reishi, and the Chinese name for it, by the way)

    That’s not to say there are no human studies though; here it was found to boost T-cell production in stressed athletes:

    Effect of Ganoderma lucidum capsules on T lymphocyte subsets in football players on “living high-training low”

    Cardiovascular health

    Here we found a stack of evidence for statistically insignificant improvements in assorted measures of cardiovascular health, and some studies where reishi did not outperform placebo.

    Because the studies were really not that compelling, instead of taking up room (and your time) with them, we’re going to move onto more compelling, exciting science, such as…

    Protection against cancer

    There’s a lot of high quality research for this, and a lot of good results. The body of evidence here is so large that even back as far as 2005, the question was no longer “does it work” or even “how does it work”, but rather “we need more clinical studies to find the best doses”. Researchers even added:

    ❝At present, lingzhi is a health food supplement to support cancer patients, yet the evidence supporting the potential of direct in vivo anticancer effects should not be underestimated.❞

    ~ Yuen et al.

    Check it out:

    Anticancer effects of Ganoderma lucidum: a review of scientific evidence

    Just so you know we’re not kidding about the weight of evidence, let’s drop a few extra sources:

    By the way, we shortened most of those titles for brevity, but almost all of the continued with “by” followed by a one-liner of how it does it.

    So it’s not a “mysterious action” thing, it’s a “this is a very potent medicine and we know how it works” thing.

    Antioxidant qualities

    Here we literally only found studies to say no change was found, one that found a slight increase of antioxidant levels in urine. It’s worth noting that levels of a given thing (or its metabolites, in the case of some things) in urine are often quite unhelpful regards knowing what’s going on in the body, because we get to measure only what the body lost, not what it gained/kept.

    So again, let’s press on:

    Reduced fatigue and anxiety

    Most of the studies for this that we could find pertained to health-related quality of life for cancer patients specifically, so (while they universally give glowing reports of reishi’s benefits to health and happiness of cancer patients), that’s a confounding factor when it comes to isolating its effects on reduction of fatigue and anxiety in people without cancer.

    Here’s one that looked at it in the case of reduction of fatigue, anxiety, and other factors, in patients without cancer (but with neurathenia), in which they found it was “significantly superior to placebo with respect to the clinical improvement of symptoms”.

    Summary:

    • Reishi mushroom’s anti-cancer properties are very, very clear
    • There is also good science to back immune health claims
    • It also has been found to significantly reduce fatigue and anxiety in unwell patients (we’d love to see more studies on its benefits in otherwise healthy people, though)

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  • Beyond Burger vs Beef Burger – Which is Healthier?

    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 Verdict

    When comparing the Beyond Burger to a grass-fed beef burger, we picked the Beyond Burger—but it was very close.

    Why?

    The macronutrient profiles of the two are almost identical, including the amount of protein, the amount of fat, and the amount of that fat that’s saturated.

    Where they stand apart is in two ways:

    1) Red meat is classed as a group 2A carcinogen
    2) The Beyond Burger contains more sodium (about 1/5 of the daily allowance according to the AHA, or 1/4 of the daily allowance according to the WHO)

    Neither of those things are great, so how to decide which is worse?
    •⁠ ⁠Cancer and heart disease are both killers, with heart disease claiming more victims.
    •⁠ ⁠However, we do need some sodium to live, whereas we don’t need carcinogens to live.

    Tie-breaker: the sodium content in the Beyond Burger is likely to be offset by the fact that it’s a fully seasoned burger and will be eaten as-is, whereas the beef burger will doubtlessly have seasonings added before it’s eaten—which may cause it to equal or even exceed the salt content of the Beyond Burger.

    The cancer risk for the beef burger, meanwhile, stays one-sided.

    One thing’s for sure though: neither of them are exactly a cornerstone of a healthy diet, and either are best enjoyed as an occasional indulgence.

    Some further reading:
    •⁠ ⁠Lesser-Known Salt Risks
    •⁠ ⁠Food Choices And Cancer Risk
    •⁠ ⁠Hypertension: Factors Far More Relevant Than Salt

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  • Drug companies pay doctors over A$11 million a year for travel and education. Here’s which specialties received the most

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    Drug companies are paying Australian doctors millions of dollars a year to fly to overseas conferences and meetings, give talks to other doctors, and to serve on advisory boards, our research shows.

    Our team analysed reports from major drug companies, in the first comprehensive analysis of its kind. We found drug companies paid more than A$33 million to doctors in the three years from late 2019 to late 2022 for these consultancies and expenses.

    We know this underestimates how much drug companies pay doctors as it leaves out the most common gift – food and drink – which drug companies in Australia do not declare.

    Due to COVID restrictions, the timescale we looked at included periods where doctors were likely to be travelling less and attending fewer in-person medical conferences. So we suspect current levels of drug company funding to be even higher, especially for travel.

    Monster Ztudio/Shutterstock

    What we did and what we found

    Since 2019, Medicines Australia, the trade association of the brand-name pharmaceutical industry, has published a centralised database of payments made to individual health professionals. This is the first comprehensive analysis of this database.

    We downloaded the data and matched doctors’ names with listings with the Australian Health Practitioner Regulation Agency (Ahpra). We then looked at how many doctors per medical specialty received industry payments and how much companies paid to each specialty.

    We found more than two-thirds of rheumatologists received industry payments. Rheumatologists often prescribe expensive new biologic drugs that suppress the immune system. These drugs are responsible for a substantial proportion of drug costs on the Pharmaceutical Benefits Scheme (PBS).

    The specialists who received the most funding as a group were cancer doctors (oncology/haematology specialists). They received over $6 million in payments.

    This is unsurprising given recently approved, expensive new cancer drugs. Some of these drugs are wonderful treatment advances; others offer minimal improvement in survival or quality of life.

    A 2023 study found doctors receiving industry payments were more likely to prescribe cancer treatments of low clinical value.

    Our analysis found some doctors with many small payments of a few hundred dollars. There were also instances of large individual payments.

    Why does all this matter?

    Doctors usually believe drug company promotion does not affect them. But research tells a different story. Industry payments can affect both doctors’ own prescribing decisions and those of their colleagues.

    A US study of meals provided to doctors – on average costing less than US$20 – found the more meals a doctor received, the more of the promoted drug they prescribed.

    Someone lifting a slice of pizza
    Pizza anyone? Even providing a cheap meal can influence prescribing. El Nariz/Shutterstock

    Another study found the more meals a doctor received from manufacturers of opioids (a class of strong painkillers), the more opioids they prescribed. Overprescribing played a key role in the opioid crisis in North America.

    Overall, a substantial body of research shows industry funding affects prescribing, including for drugs that are not a first choice because of poor effectiveness, safety or cost-effectiveness.

    Then there are doctors who act as “key opinion leaders” for companies. These include paid consultants who give talks to other doctors. An ex-industry employee who recruited doctors for such roles said:

    Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations […] If that speaker didn’t make the impact the company was looking for, then you wouldn’t invite them back.

    We know about payments to US doctors

    The best available evidence on the effects of pharmaceutical industry funding on prescribing comes from the US government-run program called Open Payments.

    Since 2013, all drug and device companies must report all payments over US$10 in value in any single year. Payment reports are linked to the promoted products, which allows researchers to compare doctors’ payments with their prescribing patterns.

    Analysis of this data, which involves hundreds of thousands of doctors, has indisputably shown promotional payments affect prescribing.

    Medical students on hospital grounds
    Medical students need to know about this. LightField Studios/Shutterstock

    US research also shows that doctors who had studied at medical schools that banned students receiving payments and gifts from drug companies were less likely to prescribe newer and more expensive drugs with limited evidence of benefit over existing drugs.

    In general, Australian medical faculties have weak or no restrictions on medical students seeing pharmaceutical sales representatives, receiving gifts, or attending industry-sponsored events during their clinical training. They also have no restrictions on academic staff holding consultancies with manufacturers whose products they feature in their teaching.

    So a first step to prevent undue pharmaceutical industry influence on prescribing decisions is to shelter medical students from this influence by having stronger conflict-of-interest policies, such as those mentioned above.

    A second is better guidance for individual doctors from professional organisations and regulators on the types of funding that is and is not acceptable. We believe no doctor actively involved in patient care should accept payments from a drug company for talks, international travel or consultancies.

    Third, if Medicines Australia is serious about transparency, it should require companies to list all payments – including those for food and drink – and to link health professionals’ names to their Ahpra registration numbers. This is similar to the reporting standard pharmaceutical companies follow in the US and would allow a more complete and clearer picture of what’s happening in Australia.

    Patients trust doctors to choose the best available treatments to meet their health needs, based on scientific evidence of safety and effectiveness. They don’t expect marketing to influence that choice.

    Barbara Mintzes, Professor, School of Pharmacy and Charles Perkins Centre, University of Sydney and Malcolm Forbes, Consultant psychiatrist and PhD candidate, Deakin University

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

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  • The Five Invitations – by Frank Ostaseski

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    This book covers exactly what its subtitle promises, and encourages the reader to truly live life fully, something that Ostaseski believes cannot be done in ignorance of death.

    Instead, he argues from his experience of decades working at a hospice, we must be mindful of death not only to appreciate life, but also to make the right decisions in life—which means responding well to what he calls, as per the title of this book, “the five invitations”.

    We will not keep them a mystery; they are:

    1. Don’t wait; do the important things now
    2. Welcome everything; push away nothing
    3. Bring your whole self to the experience
    4. Find a place in the middle of things
    5. Cultivate a “don’t know” mind

    Note, for example, that “do the important things now” requires knowing what is important. For example, ensuring a loved one knows how you feel about them, might be more important than scratching some item off a bucket list. And “push away nothing” does mean bad things too; rather, of course try to make life better rather than worse, but accept the lessons and learnings of the bad too, and see the beauty that can be found in contrast to it. Enjoying the fullness of life without getting lost in it; carrying consciousness through the highs and lows. And yes, approaching the unknown (which means not only death, but also the large majority of life) with open-minded curiosity and wonder.

    The style of the book is narrative and personal, without feeling like a collection of anecdotes, but rather, taking the reader on a journey, prompting reflection and introspection along the way.

    Bottom line: if you’d like to minimize the regrets you have in life, this book is a fine choice.

    Click here to check out The Five Invitations, and answer with a “yes” to the call of life!

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