Ear Today, Gone Tomorrow
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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
❝Have just had microsuction to remove wax from my ears. A not unpleasant experience but would appreciate your guidance on how best to discourage the buildup of wax in the first place.❞
Well, certainly do not prod or poke it, and that includes with cotton buds (Q-Tips, for the Americans amongst us). That pushes more down than that it extracts, and creates a denser base of wax.
There is no evidence that ear candles help, and they can cause harm.
Further reading: Experts update best practices for diagnosis and treatment of earwax (cerumen impaction)
Ear drops can help, and if you want a home-remedy edition, olive oil or almond oil can be used; these oils dissolve the wax quite quickly (in fancier words: they are cerumenolytic agents); washing with water (e.g. in the shower or bath) is then all that’s needed. However, to avoid infection, ensure you are using a high-purity oil, and get one to use just for that; don’t just grab a bottle from the kitchen.
For your convenience, here is an example of medical grade almond oil (with dropper!) on Amazon
❝Every article had relevance to me. I ❤️ whole fruit, it’s my go to treat. I use ice packs to ease my arthritic knee pain, works well. I’ve read and loved Dr Gawande’s books. Great handful of almonds today❞
While this wasn’t a question, and we don’t usually publish feedback here, I (your writer here, hi) misread that as “ice picks” in the first instance, an implement we’ve probably all wanted to use to relieve pain at some point, but certainly not recommendable! Anyway, the momentary confusion made me smile, so I thought I’d share the silly thought. Smiling is infectious, and all that… And it’s certainly good for the health!
More seriously, glad you enjoyed!
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Ozempic’s cousin drug liraglutide is about to get cheaper. But how does it stack up?
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Fourteen years ago, the older drug cousin of semaglutide (Ozempic and Wegovy) came onto the market. The drug, liraglutide, is sold under the brand names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So other drug companies are working to develop “generic” versions. These are likely be a fraction of current cost, which is around A$400 a month.
So how does liraglutide compare with semaglutide?
Halfpoint/Shutterstock How do these drugs work?
Liraglutide was not originally developed as a weight-loss treatment. Like semaglutide (Ozempic), it originally treated type 2 diabetes.
The class of drugs liraglutide and semaglutide belong to are known as GLP-1 mimetics, meaning they mimic the natural hormone GLP-1. This hormone is released from your small intestines in response to food and acts in several ways to improve the way your body handles glucose (sugar).
How do they stop hunger?
Liraglutide acts in several regions of the unconscious part of your brain, specifically the hypothalamus, which controls metabolism, and parts of the brain stem responsible for communicating your body’s nutrient status to the hypothalamus.
Its actions here appear to reduce hunger in two different ways. First, it helps you to feel full earlier, making smaller meals more satisfying. Second, it alters your “motivational salience” towards food, meaning it reduces the amount of food you seek out.
Liraglutide’s original formulation, designed to treat type 2 diabetes, was marketed as Victoza. Its ability to cause weight loss was evident soon after it entered the market.
Shortly after, a stronger formulation, called Saxenda, was released, which was intended for weight loss in people with obesity.
How much weight can you lose with liraglutide?
People respond differently and will lose different amounts of weight. But here, we’ll note the average weight loss users can expect. Some will lose more (sometimes much more), others will lose less, and a small proportion won’t respond.
The first GLP-1 mimicking drug was exenatide (Bayetta). It’s still available for treating type 2 diabetes, but there are currently no generics. Exenatide does provide some weight loss, but this is quite modest, typically around 3-5% of body weight.
For liraglutide, those using the drug to treat obesity will use the stronger one (Saxenda), which typically gives about 10% weight loss.
Semaglutide, with the stronger formulation called Wegovy, typically results in 15% weight loss.
The newest GLP-1 mimicking drug on the market, tirzepatide (Mounjaro for type 2 diabetes and Zepbound for weight loss), results in weight loss of around 25% of body weight.
What happens when you stop taking them?
Despite the effectiveness of these medications in helping with weight loss, they do not appear to change people’s weight set-point.
So in many cases, when people stop taking them, they experience a rebound toward their original weight.
People often regain weight when when they stop taking the drug. Mohammed_Al_Ali/Shutterstock What is the dose and how often do you need to take it?
Liraglutide (Victoza) for type 2 diabetes is exactly the same drug as Saxenda for weight loss, but Saxenda is a higher dose.
Although the target for each formulation is the same (the GLP-1 receptor), for glucose control in type 2 diabetes, liraglutide has to (mainly) reach the pancreas.
But to achieve weight loss, it has to reach parts of the brain. This means crossing the blood-brain barrier – and not all of it makes it, meaning more has to be taken.
All the current formulations of GLP-1 mimicking drug are injectables. This won’t change when liraglutide generics hit the market.
However, they differ in how frequently they need to be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide much more attractive, but we won’t see semaglutide as a generic until 2033.)
What are the side effects?
Because all these medicines have the same target in the body, they mostly have the same side effects.
The most common are a range of gastrointestinal upsets including nausea, vomiting, bloating, constipation and diarrhoea. These occur, in part, because these medications slow the movement of food out of the stomach, but are generally managed by increasing the dose slowly.
Recent clinical data suggests the slowing in emptying of the stomach can be problematic for some people, and may increase the risk of of food entering the lungs during operations, so it is important to let your doctor know if you are taking any of these drugs.
Because these are injectables, they can also lead to injection-site reactions.
Gastrointestinal side effects are most common. Halfpoint/Shutterstock During clinical trials, there were some reports of thyroid disease and pancreatitis (inflammation of the pancreas). However, it is not clear that these can be attributed to GLP-1 mimicking drugs.
In animals, GLP-1 mimicking drugs drugs have been found to negatively alter the growth of the embryo. There is currently no controlled clinical trial data on their use during pregnancy, but based on animal data, these medicines should not be used during pregnancy.
Who can use them?
The GLP-1 mimicking drugs for weight loss (Wegovy, Saxenda, Zepbound/Mounjaro) are approved for use by people with obesity and are meant to only be used in conjunction with diet and exercise.
These drugs must be prescribed by a doctor and for obesity are not covered by the Pharmaceutical Benefits Scheme, which is one of the reasons why they are expensive. But in time, generic versions of liraglutide are likely to be more affordable.
Sebastian Furness, ARC Future Fellow, School of Biomedical Sciences, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Bromelain vs Inflammation & Much More
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Let’s Get Fruity
Bromelain is an enzyme* found in pineapple (and only in pineapple), that has many very healthful properties, some of them unique to bromelain.
*actually a combination of enzymes, but most often referred to collectively in the singular. But when you do see it referred to as “they”, that’s what that means.
What does it do?
It does a lot of things, for starters:
❝Various in vivo and in vitro studies have shown that they are anti-edematous, anti-inflammatory, anti-cancerous, anti-thrombotic, fibrinolytic, and facilitate the death of apoptotic cells. The pharmacological properties of bromelain are, in part, related to its arachidonate cascade modulation, inhibition of platelet aggregation, such as interference with malignant cell growth; anti-inflammatory action; fibrinolytic activity; skin debridement properties, and reduction of the severe effects of SARS-Cov-2❞
Some quick notes:
- “facilitate the death of apoptotic cells” may sound alarming, but it’s actually good; those cells need to be killed quickly; see for example: Fisetin: The Anti-Aging Assassin
- If you’re wondering what arachidonate cascade modulation means, that’s the modulation of the cascade reaction of arachidonic acid, which plays a part in providing energy for body functions, and has a role in cell structure formation, and is the precursor of assorted inflammatory mediators and cell-signalling chemicals.
- Its skin debridement properties (getting rid of dead skin) are most clearly seen when using bromelain topically (one can literally just make a pineapple poultice), but do occur from ingestion also (because of what it can do from the inside).
- As for being anti-thrombotic and fibrinolytic, let’s touch on that before we get to the main item, its anti-inflammatory properties.
If you want to read more of the above before moving on, though, here’s the full text:
Anti-thrombotic and fibrinolytic
While it does have anti-thrombotic effects, largely by its fibrinolytic action (i.e., it dissolves the fibrin mesh holding clots together), it can have a paradoxically beneficial effect on wound healing, too:
For more specifically on its wound-healing benefits:
In Vitro Effect of Bromelain on the Regenerative Properties of Mesenchymal Stem Cells
Anti-inflammatory
Bromelain is perhaps most well-known for its anti-inflammatory powers, which are so diverse that it can be a challenge to pin them all down, as it has many mechanisms of action, and there’s a large heterogeneity of studies because it’s often studied in the context of specific diseases. But, for example:
❝Bromelain reduced IL-1β, IL-6 and TNF-α secretion when immune cells were already stimulated in an overproduction condition by proinflammatory cytokines, generating a modulation in the inflammatory response through prostaglandins reduction and activation of cascade reactions that trigger neutrophils and macrophages, in addition to accelerating the healing process❞
~ Dr. Taline Alves Nobre et al.
Read in full:
Bromelain as a natural anti-inflammatory drug: a systematic review
Or if you want a more specific example, here’s how it stacks up against arthritis:
❝The results demonstrated the chondroprotective effects of bromelain on cartilage degradation and the downregulation of inflammatory cytokine (tumor necrosis factor (TNF)-α, IL-1β, IL-6, IL-8) expression in TNF-α–induced synovial fibroblasts by suppressing NF-κB and MAPK signaling❞
~ Dr. Perephan Pothacharoen et al.
Read in full:
More?
Yes more! You’ll remember from the first paper we quoted today, that it has a long laundry list of benefits. However, there’s only so much we can cover in one edition, so that’s it for today
Is it safe?
It is generally recognized as safe. However, its blood-thinning effect means it should be avoided if you’re already on blood-thinners, have some sort of bleeding disorder, or are about to have a surgery.
Additionally, if you have a pineapple allergy, this one may not be for you.
Aside from that, anything can have drug interactions, so do check with your doctor/pharmacist to be sure (with the pharmacist usually being the more knowledgeable of the two, when it comes to drug interactions).
Want to try some?
You can just eat pineapples, but if you don’t enjoy that and/or wouldn’t want it every day, bromelain is available in supplement form too.
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Why Your Brain Blinds You For 2 Hours Every Day
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…and then covers its tracks so that you don’t notice:
Now you see it…
The world you experience is not an accurate representation of reality. Your brain actively constructs your perception, editing your memories as they happen and manipulating your sense of time. What you perceive as the present moment is actually a processed and reconstructed version of past events.
Nor is your vision anywhere near as detailed as it seems. Only a small central portion is in high resolution, while the rest is blurry. Your brain compensates for this by filling in the gaps with its best guess and/or what it believes is there from the last time you saw it. Your eyes constantly make rapid movements called saccades, and during these (i.e. when your eyes are moving), your vision momentarily shuts down—making you effectively blind for (in total, if we add them all up) about two hours every day (according to this video, anyway; our calculations find it to be more than that, but you get the idea). Your brain stitches together the visual input, creating a seamless experience that feels continuous (much like an animation reel composed of still images).
Why does it do this?
It’s because your senses operate at different speeds—light reaches your eyes in nanoseconds, sound in milliseconds, and touch signals in tens of milliseconds. However, your brain processes these inputs together, creating the illusion of a smooth and simultaneous experience. In reality, what you perceive as the present is actually a delayed and selectively edited version of the past.
Instead of showing you the world as it is, your brain predicts what will happen next. In high-speed situations, such as playing table tennis, if your brain relied on past sensory data, you wouldn’t react in time. Instead, it estimates an object’s future position and presents that prediction as your visual reality.
This also means that because your brain effectively sees things slightly sooner than you do, your brain has already prepared multiple possible responses and when an event occurs, it quickly selects the most likely course of action, deleting the alternatives before you are even aware of them. By the time you think you’ve made a decision, your body has already acted.
This goes for more than just the things we think of as requiring quick reactions!
Walking is a complex task that involves multiple time layers—your brain processes past feedback, assesses your current state, and predicts future movements. That’s why it was something that cyberneticists found difficult to recreate for a very long time. If something unexpected happens, like slipping cartoon-style on a banana peel, your body reacts before you consciously notice the danger. Your spinal cord and brainstem trigger emergency reflexes to stabilize you before your conscious mind even catches up.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
This Main Feature Should Take You Two Minutes (and 18 Seconds) To Read ← There’s a problem nobody wants to talk about when it comes to speed-reading; can you guess what it is based on what we just talked about above?
Take care!
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Retinoids: Retinol vs Retinal vs Retinoic Acid vs..?
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’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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 confused about retinol, retinal, retinoin, retinoids, etc, and of course every product claims to be the best, what’s the actual science on it?❞
Before we get into these skincare products, let’s first note that for most people, what’s best for the skin is good sleep and hydration, a plants-centric whole foods diet, and good stress management:
See for example: Of Brains And Breakouts: The Brain Skin Doctor
However, the world of potions and lotions can be an alluring one, and there is some merit there too. So, in a nutshell:
- Retinoids are the overall class of chemicals, and not a specific type
- Retinoic acid is the strongest form of this chemical and is prescription-controlled in most places
- “Retinoin” is probably tretinoin (all-trans retinoic acid) with the “t” having fallen off; we can only find it being used as a product name, not an actual substance
- Retinal, when it’s not an adjective referring to the retina (the part of the eye that receives refocussed light) and is instead a noun, is a less potent retinoid than the prescription-only kinds, but still stronger than retinol
- Retinol is a much less potent form, and is the most widely found in skincare products
- Retinoic acid is the strongest form of this chemical and is prescription-controlled in most places
All of them work the same way; it is only how serious they are about it that differs.
The mechanism of action is that they speed up the turnover (shedding cycle) of skin, so that cells are replaced sooner. As with any non-cancerous human tissue, this means that the tissue itself (in this case, your skin) will be biologically younger than if it had been replaced later.
The downside, of course, of this is that—while trying to make your skin healthier and more beautiful—the first thing that will happen is skin shedding. Depending on the retinoid type, dose, and the health of your skin to start with, this may mean anything from needing to exfoliate in the morning, to having to go to hospital with what looks like the world’s worst sunburn. For this reason, it is recommended to start with weaker products and lower doses, and work up carefully.
A note on doses: the recommended doses for these products are always truly tiny, like “use a pea-sized amount of this 0.05% serum on your face”. Take them seriously until you’re absolutely sure from experience that your skin can handle more.
Also, a tip: wear gloves when you apply any of the above products. This is because your fingers are also covered in skin, and if you don’t use gloves, then half the product that you intended for your face will be absorbed into your fingers instead. On the bright side, you’ll have beautifully rejuvenated fingertips, though.
You can learn more about the science of retinoids here, in our article about tretinoin, the usually prescription-only form of retinoic acid:
Tretinoin: Undo The Sun’s Damage To Your Skin
Want to try some?
We don’t sell it, but here for your convenience is an example product of retinal (stronger than retinol) on Amazon 😎
Take care!
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- Retinoids are the overall class of chemicals, and not a specific type
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The Conquest of Happiness – by Bertrand Russell
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When we have all our physical needs taken care of, why are we often still not happy, and what can we do about that?
Mathematician, philosopher, and Nobel prizewinner Bertrand Russell has answers. And, unlike many of “the great philosophers”, his writing style is very clear and accessible.
His ideas are simple and practical, yet practised by few. Rather than taking a “be happy with whatever you have” approach, he does argue that we should strive to find more happiness in some areas and ways—and lays out guidelines for doing so.
Areas to expand, areas to pull back on, areas to walk a “virtuous mean”. Things to be optimistic about; things to not get our hopes up about.
Applying Russell’s model, there’s no more “should I…?” moments of wondering which way to jump.
Bottom line: if you’ve heard enough about “how to be happy” from wishy-washier sources, you might find the work of this famous logician refreshing.
Click here to check out The Conquest of Happiness, and see how much happier you might become!
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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!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
