“The Longevity Vitamin” (That’s Not A Vitamin)
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The Magic of Mushrooms
“The Longevity Vitamin that’s not a vitamin” is a great tagline for what’s actually an antioxidant amino acid nutraceutical, but in this case, we’re not the ones spearheading its PR, but rather, the Journal of Nutritional Science:
Is ergothioneine a “longevity vitamin” limited in the American diet?
It can be found in all foods, to some extent, but usually in much tinier amounts than would be useful. The reason for this is that it’s synthesized by a variety of microbes (mostly fungi and actinobacteria), and enters the food chain via vegetables that are grown in soil that contain such (which is basically all soil, unless you were to go out of your way to sterilize it, or something really unusually happened).
About those fungi? That includes common popular edible fungi, where it is found quite generously. An 85g (3oz) portion of (most) mushrooms contains about 5mg of ergothioneine, the consumption of which is associated with a 16% reduced all-cause mortality:
However… Most Americans don’t eat that many mushrooms, and those polled averaged 1.1mg/day ergothioneine (in contrast with, for example, Italians’ 4.6mg/day average).
Antioxidant properties
While its antioxidant properties aren’t the most exciting quality, they are worth a mention, on account of their potency:
The biology of ergothioneine, an antioxidant nutraceutical
This is also part of its potential bid to get classified as a vitamin, because…
❝Decreased blood and/or plasma levels of ergothioneine have been observed in some diseases, suggesting that a deficiency could be relevant to the disease onset or progression❞
Source: Ergothioneine: a diet-derived antioxidant with therapeutic potential
Healthy aging
Building on from the above, ergothioneine has been specifically identified as being associated with healthy aging and the prevention of cardiometabolic diseases:
❝An increasing body of evidence suggests ergothioneine may be an important dietary nutrient for the prevention of a variety of inflammatory and cardiometabolic diseases and ergothioneine has alternately been suggested as a vitamin, “longevity vitamin”, and nutraceutical❞
~ Dr. Bernadette Moore et al., citing more references every few words there
Source: Ergothioneine: an underrecognised dietary micronutrient required for healthy ageing?
Good for the heart = good for the brain
As a general rule of thumb, “what’s good for the heart is good for the brain” is almost always true, and it appears to be so in this case, too:
❝Ergothioneine crosses the blood–brain barrier and has been reported to have beneficial effects in the brain. In this study, we discuss the cytoprotective and neuroprotective properties of ergotheioneine, which may be harnessed for combating neurodegeneration and decline during aging.❞
Source: Ergothioneine: A Stress Vitamin with Antiaging, Vascular, and Neuroprotective Roles?
Want to get some?
You can just eat a portion of mushrooms per day! But if you don’t fancy that, it is available as a supplement in convenient 1/day capsule form too.
We don’t sell it, but for your convenience, here is an example product on Amazon
Enjoy!
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Applesauce vs Cranberry Sauce – Which is Healthier?
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Our Verdict
When comparing applesauce to cranberry sauce, we picked the applesauce.
Why?
It mostly comes down to the fact that apples are sweeter than cranberries:
In terms of macros, they are both equal on fiber (both languishing at a paltry 1.1g/100g), and/but cranberry sauce has 4x the carbs, of which, more than 3x the sugar. Simply, cranberry sauce recipes invariably have a lot of added sugar, while applesauce recipes don’t need that. So this is a huge relative win for applesauce (we say “relative” because it’s still not great, but cranberry sauce is far worse).
In the category of vitamins, applesauce has more of vitamins B1, B2, B5, B6, B9, and C, while cranberry sauce has more of vitamins E, K, and choline. A more moderate win for applesauce this time.
When it comes to minerals, applesauce has more calcium, copper, magnesium, phosphorus, and potassium, while cranberry sauce has more iron, manganese, and selenium. Another moderate win for applesauce.
Since we’ve discussed relative amounts rather than actual quantities, it’s worth noting that neither sauce is a good source of vitamins or minerals, and neither are close to just eating the actual fruits. Just, cranberry sauce is the relatively more barren of the two.
While cranberries famously have some UTI-fighting properties, you cannot usefully gain this benefit from a sauce that (with its very high sugar content and minimal fiber) actively feeds the very C. albicans you are likely trying to kill.
All in all, a pitiful show of nutritional inadequacy from these two products today, but one is relatively less bad than the other, and that’s the applesauce.
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Enjoy!
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Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
Researchers have been investigating ketamine for depression for 30 years.
SB Arts Media/ShutterstockThe first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When Science Brings Hope
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There’s a lot of bad news out there at present, including in the field of healthcare. So as some measure of respite from that, here’s some good news from the world of health science, including some actionable things to do:
Run for your life! Or casually meander for your life; that’s fine too.
Those who enjoy the equivalent of an average of 160mins slow (3mph) walking per day also enjoy the greatest healthspan. Now, there may be an element of two-way causality here (moving more means we live longer, but also, sometimes people move less because of having crippling disabilities, which are themselves not great for healthspan, as well as having the knock-on effect of reducing movement, and so such conditions yield and anti-longevity double-whammy), but for any who are able to, increasing the amount of time per day spend moving, ultimately results (on average) in a lot of extra days in life that we’ll then get to spend moving.
Depending on how active or not you are already, every extra 1 hour walked could add two hours and 49 minutes to life expectancy:
Read in full: Americans over 40 could live extra 5 years if they were all as active as top 25% of population, modeling study suggests
Related: The Doctor Who Wants Us To Exercise Less & Move More
Re-teaching your brain to heal itself
Cancer is often difficult to treat, and brain tumors can be amongst the most difficult with which to contend. Not only is everything in there very delicate, but also it’s the hardest place in the body to get at—not just surgically, but even chemically, because of the blood-brain barrier. To make matters worse, brain tumors such as glioblastoma weaken the function of T-cells (whose job it is to eliminate the cancer) by prolonged exposure.
Research has found a way to restore the responsiveness of these T-cells to immune checkpoint inhibitors, allowing them to go about their cancer-killing activities unimpeded:
Read in full: New possibilities for treating intractable brain tumors unveiled
Related: 5 Ways To Beat Cancer (And Other Diseases)
Here’s to your good health!
GLP-1 receptor agonists, originally developed to fight diabetes and now enjoying popularity as weight loss adjuvants, work in large part by cutting down food cravings by interfering with the chemical messaging about such.
As a bonus, it seems that they also can reduce alcohol cravings, especially by targetting the brain’s reward center; this was based on a large review of studies looking at how GLP-1RA use affects alcohol use, alcohol-related health problems, hospital visits, and brain reactions to alcohol cues:
Read in full: Diabetes medication may be effective in helping people drink less alcohol, research finds
Related: How To Reduce Or Quit Alcohol
Take care!
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Syphilis Is Killing Babies. The U.S. Government Is Failing to Stop the Disease From Spreading.
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ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Karmin Strohfus, the lead nurse at a South Dakota jail, punched numbers into a phone like lives depended on it. She had in her care a pregnant woman with syphilis, a highly contagious, potentially fatal infection that can pass into the womb. A treatment could cure the woman and protect her fetus, but she couldn’t find it in stock at any pharmacy she called — not in Hughes County, not even anywhere within an hour’s drive.
Most people held at the jail where Strohfus works are released within a few days. “What happens if she gets out before I’m able to treat her?” she worried. Exasperated, Strohfus reached out to the state health department, which came through with one dose. The treatment required three. Officials told Strohfus to contact the federal Centers for Disease Control and Prevention for help, she said. The risks of harm to a developing baby from syphilis are so high that experts urge not to delay treatment, even by a day.
Nearly three weeks passed from when Strohfus started calling pharmacies to when she had the full treatment in hand, she said, and it barely arrived in time. The woman was released just days after she got her last shot.
Last June, Pfizer, the lone U.S. manufacturer of the injections, notified the Food and Drug Administration of an “impending stock out” that it anticipated would last a year. The company blamed “an increase in syphilis infection rates as well as competitive shortages.”
Across the country, physicians, clinic staff and public health experts say that the shortage is preventing them from reining in a surge of syphilis and that the federal government is downplaying the crisis. State and local public health authorities, which by law are responsible for controlling the spread of infectious diseases, report delays getting medicine to pregnant people with syphilis. This emergency was predictable: There have been shortages of this drug in eight of the last 20 years.
Yet federal health authorities have not prevented the drug shortages in the past and aren’t doing much to prevent them in the future.
Syphilis, which is typically spread during sex, can be devastating if it goes untreated in pregnancy: About 40% of babies born to women with untreated syphilis can be stillborn or die as newborns, according to the CDC. Infants that survive can suffer from deformed bones, excruciating pain or brain damage, and some struggle to hear, see or breathe. Since this is entirely preventable, a baby born with syphilis is a shameful sign of a failing public health system.
In 2022, the most recent year for which the CDC has data available, more than 3,700 babies were infected with syphilis, including nearly 300 who were stillborn or died as infants. More than 50% of these cases occurred because, even though the pregnant parent was diagnosed with syphilis, they were never properly treated.
That year, there were 200,000 cases identified in the U.S., a 79% increase from five years before. Infection rates among pregnant people and babies increased by more than 250% in that time; South Dakota, where Strohfus works, had the highest rates — including a more than 400% increase among pregnant women. Statewide, the rate of babies born with the disease, a condition known as congenital syphilis, jumped more than 40-fold in just five years.
And that was before the current shortage of shots.
In Mississippi, the state with the second highest rate of syphilis in pregnant women, Dr. Caroline Weinberg started having trouble this summer finding treatments for her clinic’s patients, most of whom are uninsured, live in poverty or lack transportation. She began spending hours each month scouring medicine suppliers’ websites for available doses of the shots, a form of penicillin sold under the brand name Bicillin L-A.
“The way people do it for Taylor Swift, that’s how I’ve been with the Bicillin shortage,” Weinberg said. “Desperately checking the websites to see what I can snag.”
The shortage is driving up infection rates even further.
In a November survey by the National Coalition of STD Directors, 68% of health departments that responded said the drug shortage will cause syphilis rates in their area to increase, further crushing the nation’s most disadvantaged populations.
“This is the most basic medicine,” said Meghan O’Connell, chief public health officer for the Great Plains Tribal Leaders’ Health Board, which represents 18 tribal communities in South Dakota and three other states. “We allow ourselves to continue to not have enough, and it impacts so many people.”
ProPublica examined what the federal government has done to manage the crisis and the ways in which experts say it has fallen short.
The government could pressure Pfizer to be more transparent.
Twenty years ago, there were at least three manufacturers of the syphilis shot. Then Pfizer, one of the manufacturers, purchased the other two companies and became the lone U.S. supplier.
Pfizer’s supply has fallen short since then. In 2016, the company announced a shortage due to a manufacturing issue; it lasted two years. Even during times when Pfizer had not notified the FDA of an official shortage, clinics across the country told ProPublica, the shots were often hard to get.
Several health officials said they would like to see the government use its power as the largest purchaser of the drug to put pressure on Pfizer to produce adequate supplies and to be more transparent about how much of the drug they have on hand, when it will be widely available and how stable the supply will be going forward.
In response to questions, Pfizer said there are two reasons its supply is falling short. One, the company said, was a surge in use of the pediatric form of the drug after a shortage of a different antibiotic last winter. Pfizer also blamed a 70% increase in demand for the adult shots since last February, which it described as unexpected.
Public health experts say the increase in cases and subsequent rise in demand was easy to see coming. Officials have been raising the alarm about skyrocketing syphilis cases for years. “If Pfizer was truly caught completely off guard, it raises significant questions about the competency of the company to forecast obvious infectious disease trends,” a coalition of organizations wrote to the White House Drug Shortage Task Force in September.
Pfizer said it is consistently communicating with the CDC and FDA about its supply and that it has been transparent with public health groups and policymakers.
The FDA has a group dedicated to addressing drug shortages. But Valerie Jensen, associate director of that staff, said the FDA can’t force manufacturers to make more of a drug. “It is up to manufacturers to decide how to respond to that increased demand.” she said. “What we’re here to do is help with those plans.”
Pfizer said it had a target of increasing production by about 20% in 2023 but faced delays toward the end of the year. The company did not explain the reason for those delays.
The company said it has invested $38 million in the last five years in the Michigan facility where it makes the shots and that it is increasing production capacity. It also said it is adding evening shifts at the facility and actively recruiting and training new workers. Pfizer said it also reduced manufacturing time from 110 to 50 days. By the end of June, the company expects the supply to recover, which it described as having eight weeks of inventory based on its forecast demands with no disruptions in sight.
The government could manufacture the drug itself.
Having only one supplier for a drug, especially one of public health importance, makes the country vulnerable to shortages. With just one manufacturer, any disruption — contamination at a plant, a shortage of raw materials, a severe weather event or a flawed prediction of demand — can put lives at risk. What’s ultimately needed, public health experts say, is another manufacturer.
Congressional Democrats recently introduced a bill that would authorize the U.S. Department of Health and Human Services to manufacture generic drugs in exactly this scenario, when there are few manufacturers and regular shortages. Called the Affordable Drug Manufacturing Act, it would also establish an office of drug manufacturing.
This same bill was introduced in 2018, but it didn’t have bipartisan support and was never taken up for a vote. Sen. Elizabeth Warren, the Massachusetts Democrat who introduced the bill in the Senate, said she’s hopeful this time will be different. Lawmakers from both parties understand the risks created by drug shortages, and COVID-19 helped everyone understand the role the government can play to boost manufacturing.
Still, it’s unlikely to be passed with the current gridlock in Congress.
The government could reserve syphilis drugs for infected patients.
Responding to the shortage of shots to treat the disease, the CDC in July asked health care providers nationwide to preserve the scarce remaining doses for people who are pregnant. The shots are considered the gold standard treatment for anyone with syphilis, faster and with fewer side effects than an alternative pill regimen. And for people who are pregnant, the pills are not an option; the shots are the only safe treatment.
Despite that call, the military is giving shots to new recruits who don’t have syphilis, to prevent outbreaks of severe bacterial respiratory infections. The Army has long administered this treatment at boot camps held at Fort Leonard Wood, Fort Moore and Fort Sill. The Army has been unable to obtain the shots several times in the past few years, according to the U.S. Army Center for Initial Military Training. But the Defense Health Agency’s pharmacy operations center has been working with Pfizer to ensure military sites can get them, a spokesperson for the Defense Health Agency said.
“Until we think about public health the way we think about our military, we’re not going to see a difference,” said Dr. John Vanchiere, chief of pediatric infectious diseases at Louisiana State University Health Shreveport.
Some public health officials, including Alaska’s chief medical officer, Dr. Anne Zink, questioned whether the military should be using scarce shots for prevention.
“We should ask if that’s the best use,” she said.
Using antibiotics to prevent streptococcal outbreaks is a well-established, evidence-based public health practice that’s also used by other branches of the armed services, said Lt. Col. Randy Ready, a public affairs officer with the Army’s Initial Military Training center. “The Army continues to work with the CDC and the entire medical community in regards to public health while also taking into account the unique missions and training environments our Soldiers face,” including basic training, Ready said in a written statement.
The government isn’t stockpiling syphilis drugs.
In rare instances, the federal government has created stockpiles of drugs considered key to public health. In 2018, confronting shortages of various drugs to treat tuberculosis, the CDC created a small stockpile of them. And the federal Administration for Strategic Preparedness and Response keeps a national stockpile of supplies necessary for public health emergencies, including vaccines, medical supplies and antidotes needed in case of a chemical warfare attack.
In November, the Biden administration announced it was creating a new syphilis task force. When asked why the federal government doesn’t stockpile syphilis treatments, Adm. Rachel Levine, the HHS official who leads the task force, said officials don’t routinely stockpile drugs, because they have expiration dates.
In a written statement, an HHS spokesperson said that Bicillin has a shelf life of two years and that the Strategic National Stockpile “does not deploy products that are commercially available.” In general, the spokesperson wrote, stockpiles are most effective before a national shortage begins and can’t overcome the problems of limited suppliers or fragile supply chains. “There is also a risk that stockpiles can exacerbate shortages, particularly when supply is already low, by removing drugs from circulation that would have otherwise been available,” the spokesperson wrote.
Stephanie Pang, a senior director with the coalition of STD directors, said that given the critical role of this drug and the severe access concerns, she thinks a stockpile is necessary. “I don’t have another solution that actually gets drugs to patients,” Pang said.
The government could declare a federal emergency.
Some public health officials say the federal government needs to treat the syphilis crisis the way it did Ebola or monkeypox.
Declare a federal emergency, said Dr. Michael Dube, an infectious disease specialist for more than 30 years. That would free up money for more public health staff and fund more creative approaches that could lead to a long-term solution to the near-constant shortages, he said. “I’d hate to have to wait for some horrible anecdotes to get out there in order to get the public’s and the policymakers’ minds on it,” said Dube, who oversees medical care for AIDS Healthcare Foundation wellness clinics across the country.
Citing an alarming surge in syphilis cases, the Great Plains Tribes wrote to the HHS secretary last week asking that the agency declare a public health emergency in their areas. In the request, they asked HHS to work globally to find adequate syphilis treatment and send the needed medicine to the Great Plains region.
During the 2014 outbreak of Ebola in West Africa, Congress gave hundreds of millions of dollars to HHS to help develop new rapid tests and vaccines. Facing a global outbreak of monkeypox in 2022, a White House task force deployed more than a million vaccines, regularly briefed the public and sent extra resources to Pride parades and other places where people at risk were gathered.
Levine, leader of the federal syphilis task force, countered that declaring an emergency wouldn’t make much of a difference. The government, she said, already has a “dramatic and coordinated response” involving several agencies.
The FDA recently approved an emergency import of a similar syphilis treatment made by a French manufacturer that had plenty on hand. According to the company, Provepharm, the imported shots are enough to cover approximately one or two months of typical use by all people in the U.S. (The FDA would not say how many doses Provepharm sent, and the company said it was not allowed to reveal that number under the federal rules governing such emergency imports.)
Clinics applaud that development. But many of them can’t afford the imported shots.
The government could do more to rein in the cost.
Clinics and hospitals that primarily serve low-income patients often qualify for a federal program that allows them to purchase drugs at steeply discounted prices. Pharmaceutical companies that want Medicaid to cover their outpatient drugs must participate in the program.
One factor in determining the discount price is whether a pharmaceutical company has raised the price of a drug by more than the rate of inflation. Because Pfizer has hiked the price of its Bicillin shots significantly over the years, the government requires that it be sold to qualifying clinics for just pennies a dose. Otherwise, a single Pfizer shot can retail for upwards of $500. The French shots are comparable in retail price and not eligible for the discount program.
Several clinic directors also said they worried that drug distributors were reserving the limited supply of the Pfizer shot for organizations that could pay full price. For several days in January, for example, the website of Henry Schein, a medical supplier, showed doses of the shot available at full price, while doses at the penny pricing were out of stock, according to screenshots shared with ProPublica. When asked whether it was only selling shots at full price, a spokesperson for Henry Schein did not respond to the question.
Local health departments that qualify for the discount program told ProPublica they’ve had to pay full price at other distributors, because it was the only stock available.
The Health Resources and Services Administration, the federal agency that regulates the discount program, said that a drug manufacturer is ultimately responsible for ensuring that when supplies are available, they are available at the discounted price. When asked about this, Pfizer said that it has “one inventory that is distributed to our trade partners” and that hospitals and clinics that qualify for the discount program are “responsible for ensuring compliance with the program and orders through the wholesaler accordingly.” The company added, “Pfizer plays no part in this process.”
In October, on Weinberg’s regular search for shots for her Mississippi clinic, she found doses of Bicillin for sale at the discounted price and purchased 40. “The idea that we’re supposed to be hoarding treatment is a horrific compact,” she said. Word got out that the clinic, called Plan A, has some shots, and other clinics began sending pregnant patients there.
The clinic’s supply is dwindling. Weinberg is happy to get the shots to patients who need them. But she’s not sure how much longer her reserve will last — or if she’ll be able to find more when they’re gone.
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One More Reason To Prioritize Sleep To Fight Cognitive Decline
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We’ve talked sometimes at 10almonds about how important sleep is for many aspects of health, including for brain health, and including in later life.
There’s a common myth that older people require less sleep; the reality is that sleeping less and not dying of it does not equate to needing less.
See also: Sleep: Yes, You Really Do Still Need It!
And: How Sleep-Deprived Are You, Really?
Quantity is not everything though; quality absolutely matters too. We’ve written about that here:
The 6 Dimensions Of Sleep (And Why They Matter) ← duration is just one dimension out of the six
We’ve even gone into some more obscure, but still very important things, such as: How Your Sleep Position Changes Dementia Risk
We’ve also talked about the role of sleep in memory (and forgetting): How Your Brain Chooses What To Remember
With that in mind…
Some more recent science
This study was about spatial memory, but what’s important (in our opinion) is that it’s about solidifying recent learning.
Researchers measured brain activity in rats for up to 20 hours of sleep following spatial learning tasks. Initially, the neuronal patterns observed during sleep mirrored those from the learning phase. However, as sleep progressed, these patterns transformed to resemble the activity seen when the rats later recalled the locations of food rewards. Interestingly, this reorganization happened during non-REM sleep, which means it wasn’t just a case of “the rats were dreaming about their day” (which is a well-established way in which memories do get encoded), but rather, the newly-learned experiences were being actively encoded in the rest of sleep.
This is critical, because in age-related cognitive decline, it’s very common for very long-term memory (VLTM) to remain intact, while LTM and short-term memory (STM) crumble. For example, someone may remember many details of their life from 20 years ago, but forget where they currently live, or what happened in the conversation two minutes ago.
In other words, the biggest problem is not the storage of memories, but rather the encoding of them in the first place.
Which sleep facilitates!
And it’s also important to note that part about it being the rest of sleep, because when the brain is sleep-deprived, it’ll tend to prioritize REM sleep, which is important, but that means cutting back on other phases of sleep, and from this study, we can see that memory & learning will be amongst the things adversely affected by such cuts.
Here’s the paper, for those interested:
Sleep stages antagonistically modulate reactivation drift
And for those who prefer lighter reading, here’s a pop-science article about the same study, which explains it in more words than we can here:
But wait, there’s more!
Sleep resets neurons for new memories the next day, study finds
So, once again… It is absolutely critical to prioritize good sleep.
Want to know more?
Check out:
Calculate (And Enjoy) The Perfect Night’s Sleep
Take care!
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Semaglutide for Weight Loss?
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Semaglutide for weight loss?
Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).
Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.
*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!
First things first: does it work as marketed for diabetes?
It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:
- Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
- Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes
As you can see, both of them work wonders for pancreatic function and insulin sensitivity!
And, both of them were quite unpleasant for around 20% of participants:
❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞
What about for weight loss, if not diabetic?
It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:
Once-Weekly Semaglutide in Adults with Overweight or Obesity
The most interesting things here are the positive results and the side effects:
❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞
In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.
❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞
~ ibid.
In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!
Any other downsides we should know about?
If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:
❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞
~ Jan, a trial participant at UCLH
Is it injection-only, or is there an oral option?
An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:
A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science
FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement
Where can I get these?
Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:
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