Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer – by Dr. Patrick Walsh & Janet Farrar Worthington
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Prostate cancer is not glamorous or fun, and neither is this book.
Nevertheless, it’s a disease that affects 12% of men in general, and 60% of men aged 60+, with that percentage climbing every year after that.
So, if you have a prostate or love someone who has one, this book is worthwhile reading—yes, even as a preventative.
Like many cancers, prostate cancer is easy to treat if caught very early, becomes harder to treat as it goes, and almost impossible to cure if it gets as far as metastasis (i.e., it spread). Like all cancers, it’s better off avoided entirely if possible.
This book covers all the stages:
- How to avoid it
- How to check for it
- How to “nip it in the bud”
- Why some might want to delay treatment (!)
- What options are available afterwards
This latter is quite extensive, and covers not just surgery, but radiation, thermo- or cryoablation, and hormone therapy.
And as for surgery, not just “remove the tumor”, but other options like radical prostatectomy, and even orchiectomy. Not many men will choose to have their testicles removed to stop them from feeding the prostate, but the point is that this book is comprehensive.
It’s asking whenever possible “is there another option?” and exploring all options, with information and without judgment, at each stage.
The writing style (likely co-author Worthington’s influence; she is an award-winning science-writer) is very “for the layman”, and that’s really helpful in demystifying a lot of what can be quite opaque in the field of oncology.
Bottom line: absolutely not an enjoyable read, but a potentially lifesaving one, especially given the odds we mentioned up top.
Click here to check out Dr. Patrick Walsh’s Guide To Surviving Prostate Cancer, and be prepared!
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NADᐩ Against Aging
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Nicotinamide adenine dinucleotide, or “NAD” to its friends, is a coenzyme produced in the human body (amongst other places), and it is critical for cellular energy metabolism, but there’s more to it than that.
Today we’ll be looking mostly at NAD+, of which the + indicates the positive formal charge of one of its nitrogen atoms. We won’t get too much into the chemistry of this, but we will mention that it’s a cofactor with NADH—the former accepting electrons and the latter donating electrons.
Both NAD+ and NADH are critical to good health, but we’re going to focus on NAD+ for the simple reason that it gets depleted with aging.
Note: it gets depleted with aging.
Chronological age is not so important here, but there is a direct relationship between biological aging and NAD+ depletion.
For example, healthy centenarians tend not to have depleted NAD+ levels. Further, its depletion (in those in whom it is depleted) is then a causal factor for many age-related diseases:
❝Remarkably, ageing is accompanied by a gradual decline in tissue and cellular NAD+ levels in multiple model organisms, including rodents and humans.
This decline in NAD+ levels is linked causally to numerous ageing-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia and frailty.
Many of these ageing-associated diseases can be slowed down and even reversed by restoring NAD+ levels.❞
~ Dr. Rosalba Perrone et al.
Read in full: NAD+ metabolism and its roles in cellular processes during ageing
As for restoring those NADᐩ levels, that does help in interventional trials, whether by supplementing directly, or with NAD precursors*:
❝NAD+ levels steadily decline with age, resulting in altered metabolism and increased disease susceptibility.
Restoration of NAD+ levels in old or diseased animals can promote health and extend lifespan, prompting a search for safe and efficacious NAD-boosting molecules that hold the promise of increasing the body’s resilience, not just to one disease, but to many, thereby extending healthy human lifespan.❞
~ Dr. David Sinclair et al.
Read more: Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
*There are actually also other NAD-boosting molecules besides NAD itself and its precursors. For example, the liver will not produce NADᐩ unless it has aminocarboxymuconate-semialdehyde decarboxylase (or “ACMSD”, to its friends), which limits the production of NADᐩ. Why, you ask? The theory is that it is a kind of evolutionary conservativism, much like not lighting a fire without the ability to put it out. In any case, taking ACMSD-blockers will thus result in an increased endogenous production of NADᐩ.
You can read about this here:
De novo NAD+ synthesis enhances mitochondrial function and improves health
Nor is taking supplements or drugs the only way to get more of it; there’s an enzyme nicotinamide phosphoribosyltransferase (“NAMPT”, to its friends) involved in the synthesis of NADᐩ, and exercise boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
And to underline that point, another study found that resistance training (so, a different kind of exercise from that of the previous study) boosts levels of NADᐩ itself by the same 127%:
One way to get more out of NADᐩ
We’ll get straight to the point: it works very well paired with a senolytic agent, i.e. something that kills aging cells so that they get recycled sooner:
NAD+, Senolytics, or Pyruvate for Healthy Aging?
To read more about senolytics, check out:
Fisetin: The Anti-Aging Assassin
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Alzheimer’s: The Bad News And The Good
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Dr. Devi’s Spectrum of Hope
This is Dr. Gayatri Devi. She’s a neurologist, board-certified in neurology, pain medicine, psychiatry, brain injury medicine, and behavioral neurology.
She’s also a Clinical Professor of Neurology, and Director of Long Island Alzheimer’s Disease Center, Fellow of the American Academy of Neurology, and we could continue all day with her qualifications, awards and achievements but then we’d run out of space. Suffice it to say, she knows her stuff.
Especially when it comes to the optimal treatment of stroke, cognitive loss, and pain.
In her own words:
❝Helping folks live their best lives—by diagnosing and managing complex neurologic disorders—that’s my job. Few things are more fulfilling! For nearly thirty years, my focus has been on brain health, concussions, Alzheimer’s and other dementias, menopause related memory loss, and pain.❞
Alzheimer’s is more common than you might think
According to Dr. Devi,
❝97% of patients with mild Alzheimer’s disease don’t even get diagnosed in their internist offices, and half of patients with moderate Alzheimer’s don’t get diagnosed.
What that means is that the percentage of people that we think about when we think about Alzheimer’s—the people in the nursing home—that’s a very, very small fraction of the entirety of the people who have the condition❞
As for what she would consider the real figures, she puts it nearer 1 in 10 adults aged 65 and older.
Source: Neurologist dispels myths about Alzheimer’s disease
Her most critical advice? Reallocate your worry.
A lot of people understandably worry about a genetic predisposition to Alzheimer’s, especially if an older relative died that way.
See also: Alzheimer’s, Genes, & You
However, Dr. Devi points out that under 5% of Alzheimer’s cases are from genetics, and the majority of Alzheimer’s cases can be prevented be lifestyle interventions.
See also: Reduce Your Alzheimer’s Risk
Lastly, she wants us to skip the stigma
Outside of her clinical practice and academic work, this is one of the biggest things she works on, reducing the stigma attached to Alzheimer’s both publicly and professionally:
Alzheimer’s Disease in Physicians: Assessing Professional Competence and Tempering Stigma
Want more from Dr. Devi?
You might enjoy this interview:
Click Here If The Embedded Video Doesn’t Load Automatically!
And here’s her book:
Enjoy!
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The Mental Health First-Aid That You’ll Hopefully Never Need
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Take Your Mental Health As Seriously As General Health!
Sometimes, health and productivity means excelling—sometimes, it means avoiding illness and unproductivity. Both are essential, and today we’re going to tackle some ground-up stuff. If you don’t need it right now, great; we suggest to read it for when and if you do. But how likely is it that you will?
- One in four of us are affected by serious mental health issues in any given year.
- One in five of us have suicidal thoughts at some point in our lifetime.
- One in six of us are affected to at least some extent by the most commonly-reported mental health issues, anxiety and depression, in any given week.
…and that’s just what’s reported, of course. These stats are from a UK-based source but can be considered indicative generally. Jokes aside, the UK is not a special case and is not measurably worse for people’s mental health than, say, the US or Canada.
While this is not an inherently cheery topic, we think it’s an important one.
Depression, which we’re going to focus on today, is very very much a killer to both health and productivity, after all.
One of the most commonly-used measures of depression is known by the snappy name of “PHQ9”. It stands for “Patient Health Questionnaire Nine”, and you can take it anonymously online for free (without signing up for anything; it’s right there on the page already):
Take The PHQ9 Test Here! (under 2 minutes, immediate results)
There’s a chance you took that test and your score was, well, depressing. There’s also a chance you’re doing just peachy, or maybe somewhere in between. PHQ9 scores can fluctuate over time (because they focus on the past two weeks, and also rely on self-reports in the moment), so you might want to bookmark it to test again periodically. It can be interesting to track over time.
In the event that you’re struggling (or: in case one day you find yourself struggling, or want to be able to support a loved one who is struggling), some top tips that are useful:
Accept that it’s a medical condition like any other
Which means some important things:
- You/they are not lazy or otherwise being a bad person by being depressed
- You/they will probably get better at some point, especially if help is available
- You/they cannot, however, “just snap out of it”; illness doesn’t work that way
- Medication might help (it also might not)
Do what you can, how you can, when you can
Everyone knows the advice to exercise as a remedy for depression, and indeed, exercise helps many. Unfortunately, it’s not always that easy.
Did you ever see the 80s kids’ movie “The Neverending Story”? There’s a scene in which the young hero Atreyu must traverse the “Swamp of Sadness”, and while he has a magical talisman that protects him, his beloved horse Artax is not so lucky; he slows down, and eventually stops still, sinking slowly into the swamp. Atreyu pulls at him and begs him to keep going, but—despite being many times bigger and stronger than Atreyu, the horse just sinks into the swamp, literally drowning in despair.
See the scene: The Neverending Story movie clip – Artax and the Swamp of Sadness (1984)
Wow, they really don’t make kids’ movies like they used to, do they?
But, depression is very much like that, and advice “exercise to feel less depressed!” falls short of actually being helpful, when one is too depressed to do it.
If you’re in the position of supporting someone who’s depressed, the best tool in your toolbox will be not “here’s why you should do this” (they don’t care; not because they’re an uncaring person by nature, but because they are physiologically impeded from caring about themself at this time), but rather:
“please do this with me”
The reason this has a better chance of working is because the depressed person will in all likelihood be unable to care enough to raise and/or maintain an objection, and while they can’t remember why they should care about themself, they’re more likely to remember that they should care about you, and so will go with your want/need more easily than with their own. It’s not a magic bullet, but it’s worth a shot.
What if I’m the depressed person, though?
Honestly, the same, if there’s someone around you that you do care about; do what you can to look after you, for them, if that means you can find some extra motivation.
But I’m all alone… what now?
Firstly, you don’t have to be alone. There are free services that you can access, for example:
- US: https://nami.org/help
- Canada: https://www.wellnesstogether.ca/en-CA
- UK: https://www.samaritans.org/
…which varyingly offer advice, free phone services, webchats, and the like.
But also, there are ways you can look after yourself a little bit; do the things you’d advise someone else to do, even if you’re sure they won’t work:
- Take a little walk around the block
- Put the lights on when you’re not sleeping
- For that matter, get out of bed when you’re not sleeping. Literally lie on the floor if necessary, but change your location.
- Change your bedding, or at least your clothes
- If changing the bedding is too much, change just the pillowcase
- If changing your clothes is too much, change just one item of clothing
- Drink some water; it won’t magically cure you, but you’ll be in slightly better order
- On the topic of water, splash some on your face, if showering/bathing is too much right now
- Do something creative (that’s not self-harm). You may scoff at the notion of “art therapy” helping, but this is a way to get at least some of the lights on in areas of your brain that are a little dark right now. Worst case scenario is it’ll be a distraction from your problems, so give it a try.
- Find a connection to community—whatever that means to you—even if you don’t feel you can join it right now. Discover that there are people out there who would welcome you if you were able to go join them. Maybe one day you will!
- Hiding from the world? That’s probably not healthy, but while you’re hiding, take the time to read those books (write those books, if you’re so inclined), learn that new language, take up chess, take up baking, whatever. If you can find something that means anything to you, go with that for now, ride that wave. Motivation’s hard to come by during depression and you might let many things slide; you might as well get something out of this period if you can.
If you’re not depressed right now but you know you’re predisposed to such / can slip that way?
Write yourself instructions now. Copy the above list if you like.
Most of all: have a “things to do when I don’t feel like doing anything” list.
If you only take one piece of advice from today’s newsletter, let that one be it!
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The Dopamine Myth
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The Dopamine Myth
There’s a popular misconception that, since dopamine is heavily involved in addictions, it’s the cause.
We see this most often in the context of non-chemical addictions, such as:
- gambling
- videogames
- social media
And yes, those things will promote dopamine production, and yes, that will feel good. But dopamine isn’t the problem.
Myth: The Dopamine Detox
There’s a trend we’ve mentioned before (it got a video segment a few Fridays back) about the idea of a “dopamine detox“, and how unscientific the idea is.
For a start…
- You cannot detox from dopamine, because dopamine is not a toxin
- You cannot abstain from dopamine, because your brain regulates your dopamine levels to keep them correct*
- If you could abstain from dopamine (and did), you would die, horribly.
*unless you have a serious mental illness, for example:
- forms of schizophrenia and/or psychosis that involve too much dopamine, or
- forms of depression and/or neurodegenerative diseases such as Parkinson’s (and several kinds of dementia) in which you have too little dopamine
- bipolar disorder in which dopamine levels can swing too far each way
See also: Dopamine fasting: misunderstanding science spawns a maladaptive fad
Myth: Dopamine is all about pleasure
Dopamine is a pleasure-giving neurotransmitter, but it serves more purposes than that! It also plays a central role in many neurological processes, including:
- Motivation
- Learning and memory
- Motor functions
- Language faculties
- Linear task processing
Note for example how someone taking dopaminergic drugs (prescription or otherwise; could be anything from modafinil to cocaine) is not blissed out… They’re probably in a good mood, sure, but they’re focused, organized, quick-thinking, and so forth! This is not an ad for cocaine; cocaine is very bad for the health. But you see the features? So, what if we could have a little more dopamine… healthily?
Dopamine—à la carte
Let’s look at the examples we gave earlier of non-chemical addictions that are dopaminergic in nature:
- gambling
- videogames
- social media
They’re not actually that rewarding, are they?
- Gamblers lose more than they win
- Gamers cease to care about a game once they have won
- Social media more often results in “doomscrolling”
This is because what prompts the most dopamine is actually the anticipation of reward… not the thing itself, whose reward-pleasure is very fleeting. Nobody looks back at an hour of doomscrolling and thinks “well, that was fun; I’m glad I did that”.
See the science: Liking, Wanting and the Incentive-Sensitization Theory of Addiction
But what if we anticipated a reward from things that are not deleterious to health and productivity? Things that are neutral, or even good for us?
Examples of this include:
- Sex! (remember though, it’s not a race to the finish-line)
- Good, nourishing food (bonus: some foods boost dopamine production nutritionally)
- Exercise/sport (also prompts release of endorphins, win/win!)
- Gamified learning apps (e.g. Duolingo)
- Gamified health/productivity apps (anything with bells and whistles and things that go “ding” and measure streaks etc)
Want to know more?
That’s all we have time for today, but you might want to check out:
10 Best Ways to Increase Dopamine Levels Naturally ← Science-based and well-sourced article!
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Superfood-Stuffed Squash
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This stuffed squash recipe is packed with so many nutrient-dense ingredients, yet it feels delightfully decadent—a great recipe to have up your sleeve ready for fall.
You will need
- 1 large or two medium butternut squashes, halved lengthways and seeds removed (keep them; they are full of nutrients! You can sprout them, or dry them to use them at your leisure), along with some of the flesh from the central part above where the seeds are, so that there is room for stuffing
- 2 cups low-sodium vegetable stock
- 1 cup wild rice, rinsed
- 1 medium onion, finely chopped
- ½ cup walnuts, roughly chopped
- ½ cup dried
cranberriesgoji berries ← why goji berries? They have even more healthful properties than cranberries, and cranberries are hard to buy without so much added sugar that the ingredients list looks like “cranberries (51%), sugar (39%), vegetable oil (10%)”, whereas when buying goji berries, the ingredients list says “goji berries”, and they do the same culinary job. - ¼ cup pine nuts
- ½ bulb garlic, minced
- 1 tbsp dried thyme or 2 tsp fresh thyme, destalked
- 1 tbsp dried rosemary or 2 tsp fresh rosemary, destalked
- 1 generous handful fresh parsley, chopped
- 1 tbsp chia seeds
- 1 tbsp nutritional yeast
- 1 tbsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil, for brushing and frying
- Aged balsamic vinegar, to serve (failing this, make a balsamic vinegar reduction and use that; it should have a thicker texture but still taste acidic and not too sweet; the thickness should come from the higher concentration of grape must and its natural sugars; no need to add sugar)
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400°F / 200°C.
2) Brush the cut sides of the squash with olive oil; sprinkle with a pinch of MSG/salt and a little black pepper (grind it directly over the squash if you are using a grinder; hold the grinder high though so that it distributes evenly—waiters in restaurants aren’t just being dramatic when they do that with pepper or Parmesan or such)
3) Arrange them cut-sides-down on a baking tray lined with baking paper, and roast for at least 30 minutes or until tender.
4) While that is roasting, add the chia seeds to the wild rice, and cook them in the low-sodium vegetable stock, using a rice cooker if available. It should take about the same length of time, but if the rice is done first, set it aside, and if the squash is done first, turn the oven down low to keep it warm.
5) Heat some oil in a sauté pan (not a skillet without high sides; we’re going to need space in a bit), and fry the chopped onion until translucent and soft. We could say “about 5 minutes” but honestly it depends on your pan as well as the heat and other factors.
6) Add the seasonings (herbs, garlic, black pepper, MSG/salt, nooch), and cook for a further 2 minutes, stirring thoroughly to distribute evenly.
7) Add the rice, berries, and nuts, cooking for a further 2 minutes, stirring constantly, ensuring everything is heated evenly.
8) Remove the squash halves from the oven, turn them over, and spoon the mixture we just made into them, filling generously.
9) Drizzle a lashing of the aged balsamic vinegar (or balsamic vinegar reduction), to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Brown Rice vs Wild Rice – Which is Healthier?
- Why You Should Diversify Your Nuts!
- Goji Berries: Which Benefits Do They Really Have?
- Chia: The Tiniest Seeds With The Most Value
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- 10 Ways To Balance Blood Sugars
Take care!
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Natural Alternatives for Depression Treatment
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Questions and Answers 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!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
Natural alternatives to medication for depression?
Great question! We did a mean feature a while back, but we definitely have much more to say! We’ll do another main feature soon, but in the meantime, here’s what we previously wrote:
See: The Mental Health First-Aid That You’ll Hopefully Never Need
^This covers not just the obvious, but also why the most common advice is not helpful, and practical tips to actually make manageable steps back to wellness, on days when “literally just survive the day” is one’s default goal.
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Learn to Age Gracefully
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