Inhaled Eucalyptus’s Immunomodulatory and Antimicrobial Effects
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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
❝At the first hint of a cough or a cold, I resort to steam inhalation. Some people add herbs or aromatic oils to the boiling water. What do you recommend?❞
First of all, please do be careful:
Western science’s view is predominantly “this is popular and/but evidence for its usefulness is lacking”:
But! Traditional Chinese Medicine indicates shuanghuanglian, yuxingcao and qingkailing, which the China Food and Drug Administration has also approved:
Chinese Medicine in Inhalation Therapy: A Review of Clinical Application and Formulation Development
Indian scientists are also looking at modern scientific applications of certain Ayurvedic herbs:
Promising phytochemicals of traditional Indian herbal steam inhalation therapy to combat COVID-19
In terms of what is likely more available to you, there are several reasons to choose eucalyptus over popular alternatives:
Immune-modifying and antimicrobial effects of Eucalyptus oil and simple inhalation devices
For the sake of being methodical, here’s an example product on Amazon, though we’re sure you’d have no trouble finding this in your local pharmacy if you prefer.
Take care!
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Woman Petitions Health Insurer After Company Approves — Then Rejects — Her Infusions
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When KFF Health News published an article in August about the “prior authorization hell” Sally Nix said she went through to secure approval from her insurance company for the expensive monthly infusions she needs, we thought her story had a happy ending.
That’s because, after KFF Health News sent questions to Nix’s insurance company, Blue Cross Blue Shield of Illinois, it retroactively approved $36,000 worth of treatments she thought she owed. Even better, she also learned she would qualify for the infusions moving forward.
Good news all around — except it didn’t last for long. After all, this is the U.S. health care system, where even patients with good insurance aren’t guaranteed affordable care.
To recap: For more than a decade, Nix, of Statesville, North Carolina, has suffered from autoimmune diseases, chronic pain, and fatigue, as well as a condition called trigeminal neuralgia, which is marked by bouts of electric shock-like pain that’s so intense it’s commonly known as the “suicide disease.”
“It is a pain that sends me to my knees,” Nix said in October. “My entire family’s life is controlled by the betrayal of my body. We haven’t lived normally in 10 years.”
Late in 2022, Nix started receiving intravenous immunoglobulin infusions to treat her diseases. She started walking two miles a day with her service dog. She could picture herself celebrating, free from pain, at her daughter’s summer 2024 wedding.
“I was so hopeful,” she said.
But a few months after starting those infusions, she found out that her insurance company wouldn’t cover their cost anymore. That’s when she started “raising Cain about it” on Instagram and Facebook.
You probably know someone like Sally Nix — someone with a chronic or life-threatening illness whose doctor says they need a drug, procedure, or scan, and whose insurance company has replied: No.
Prior authorization was conceived decades ago to rein in health care costs by eliminating duplicative and ineffective treatment. Not only does overtreatment waste billions of dollars every year, but doctors acknowledge it also potentially harms patients.
However, critics worry that prior authorization has now become a way for health insurance companies to save money, sometimes at the expense of patients’ lives. KFF Health News has heard from hundreds of people in the past year relating their prior authorization horror stories.
When we first met Nix, she was battling her insurance company to regain authorization for her infusions. She’d been forced to pause her treatments, unable to afford $13,000 out-of-pocket for each infusion.
Finally, it seemed like months of her hard work had paid off. In July, Nix was told by staff at both her doctor’s office and her hospital that Blue Cross Blue Shield of Illinois would allow her to restart treatment. Her balance was marked “paid” and disappeared from the insurer’s online portal.
But the day after the KFF Health News story was published, Nix said, she learned the message had changed. After restarting treatment, she received a letter from the insurer saying her diagnoses didn’t actually qualify her for the infusions. It felt like health insurance whiplash.
“They’re robbing me of my life,” she said. “They’re robbing me of so much, all because of profit.”
Dave Van de Walle, a spokesperson for Blue Cross Blue Shield of Illinois, said the company would not discuss individual patients’ cases.
“Prior authorization is often a requirement for certain treatments,” Van de Walle said in a written statement, “and BCBSIL administers benefits according to medical policy and the employer’s benefit.”
But Nix is a Southern woman of the “Steel Magnolia” variety. In other words, she’s not going down without a fight.
In September, she called out her insurance company’s tactics in a http://change.org/ campaign that has garnered more than 21,000 signatures. She has also filed complaints against her insurance company with the U.S. Department of Health and Human Services, U.S. Department of Labor, Illinois Department of Insurance, and Illinois attorney general.
Even so, Nix said, she feels defeated.
Not only is she still waiting for prior authorization to restart her immunoglobulin infusions, but her insurance company recently required Nix to secure preapproval for another treatment — routine numbing injections she has received for nearly 10 years to treat the nerve pain caused by trigeminal neuralgia.
“It is reprehensible what they’re doing. But they’re not only doing it to me,” said Nix, who is now reluctantly taking prescription opioids to ease her pain. “They’re doing it to other patients. And it’s got to stop.”
Do you have an experience with prior authorization you’d like to share? Click here to tell your story.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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How does cancer spread to other parts of the body?
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All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable.
But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain.
This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal.
When cancer spreads in this way, it’s called metastasis. Metastasis is responsible for the majority (67%) of cancer deaths.
Cells are supposed to stick to surrounding tissue
Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells.
Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged.
This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be.
If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens.
Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers.
Some cells settle in a new location.
Scipro/ShutterstockParticular cancers are more likely to metastasise to particular organs that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart.
Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but can escape to settle in other organs like the liver or brain.
When do cancers metastasise?
The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed.
Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later.
For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy.
As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the 11th most commonly diagnosed cancers in Australia.
One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type.
What increases the chances of metastasis and how can it be prevented?
If left untreated, most cancers will eventually acquire the ability to metastasise.
While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around.
The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s cervical, bowel, and breast cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis.
The best way to prevent cancer spreading is to diagnose and treat them early.
Peakstock/ShutterstockNew screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new lung cancer screening program.
Using artificial intelligence (AI) to help examine patient scans is also possible, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs.
More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect many types of cancer at early stages.
One day there might even be a RAT-type test for cancer, like there is for COVID.
Will we be able to prevent metastasis in the future?
Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to target dormant cancer cells and prevent them from waking up.
Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers.
For now, early detection is the best way to ensure a patient can beat their cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Pinch Of Nom, Everyday Light – by Kay Featherstone and Kate Allinson
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One of the biggest problems with “light”, “lean” or “under this many calories” cookbooks tends to be the portion sizes perhaps had sparrows in mind. Not so, here!
Nor do they go for the other usual trick, which is giving us something that’s clearly not a complete meal. All of these recipes are for complete meals, or else come with a suggestion of a simple accompaniment that will still keep the dish under 400kcal.
The recipes are packed with vegetables and protein, perfect for keeping lean while also making sure you’re full until the next meal.
Best of all, they are indeed rich and tasty meals—there’s only so many times one wants salmon with salad, after all. There are healthy-edition junk food options, too! Sausage and egg muffins, fish and chips, pizza-loaded fries, sloppy dogs, firecracker prawns, and more!
Most of the meals are quite quick and easy to make, and use common ingredients.
Nearly half are vegetarian, and gluten-free options involve only direct simple GF substitutions. Similarly, turning a vegetarian meal into a vegan meal is usually not rocket science! Again, quick and easy substitutions, à la “or the plant-based milk of your choice”.
Recipes are presented in the format: ingredients, method, photo. Super simple (and no “chef’s nostalgic anecdote storytime” introductions that take more than, say, a sentence to tell).
All in all, a fabulous addition to anyone’s home kitchen!
Get your copy of “Pinch of Nom—Everyday Light” from Amazon today!
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Undo The Sun’s Damage To Your Skin
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It’s often said that our skin is our largest organ. Our brain or liver are the largest solid organs by mass (which one comes out on top will vary from person to person), our gut is the longest, and our lungs are the largest by surface area. But our skin is large, noticeable, and has a big impact on the rest of our health.
The sun is one of the main damaging factors for our skin; assorted toxins are also a major threat for many people, and once the skin barrier gets broken, it’s a field-day for bacteria.
So, what can we do about it?
Tretinoin: the skin’s rejuvenator
Tretinoin is also called retinoic acid, not to be mistaken for retinol, although they are both retinoids. Tretinoin is much stronger.
As for what it’s stronger at:
It’s usually prescribed for the treatment of sun-damage, acne, and wrinkles. Paradoxically, it works by inflaming the skin (and then making it better, and having done so, keeping it better).
In few words: it encourages your skin to speed up its life cycle, which means that cells die and are replaced sooner, which means the average age of skin cells will be considerably younger at any given time.
This is the same principle as we see at work when it comes to cellular apoptosis and autophagy in general, and specifically the same idea as we discussed when talking about senolytics, compounds that kill aging cells:
Fisetin: The Anti-Aging Assassin
About that paradoxical inflammation…
❝The topical use of tretinoin as an antiacne agent began almost a half century ago. Since that time it has been successfully used to treat comedonal and inflammatory acne.
Over the intervening years, the beneficial effects of tretinoin have grown from an understanding of its potent cornedolytie-related properties to an evolving appreciation of its antiinflammatory actions.
…
The topical use of clindamycin and tretinoin as a combination treatment modality that includes antibacterial, comedolytic, and antiinflammatoiy properties has proven to be a very effective therapy for treating the various stages of acne
…
It is now becoming increasingly clear that there may be good reasons for these observations.❞
~ Drs. Schmidt & Gans, lightly edited here for brevity
Read in full: Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne
Against damage by the sun
The older we get, the more likely sun damage is a problem than acne. And in the case of tretinoin,
❝In several well-controlled clinical trials, the proportion of patients showing improvement was significantly higher with 0.01 or 0.05% tretinoin cream than with placebo for criteria such as global assessment, fine and coarse wrinkling, pigmentation and roughness.
Improvements in the overall severity of photodamage were also significantly greater with tretinoin than with placebo.
…
Several placebo-controlled clinical studies have demonstrated that topical tretinoin has significant efficacy in the treatment of photodamaged skin. Improvements in subjective global assessment scores were recorded in:
49–100% of patients using once-daily 0.01% tretinoin,
68–100% of patients using 0.05% tretinoin, and
0–44% of patients using placebo.❞
~ Drs. Wagstaff & Noble
…which is quite compelling.
Read in full: Tretinoin: A Review of its Pharmacological Properties and Clinical Efficacy in the Topical Treatment of Photodamaged Skin
This is very well-established by now; here’s an old paper from when the mechanism of action was unknown (here in the current day, 17 mechanisms of action have been identified; beyond the scope of this article as we only have so much room, but it’s nice to see science building on science):
❝Tretinoin cream has been used extensively to reverse the changes of photoaging. It is the first topical therapy to undergo controlled clinical testing and proved to be efficacious. These results have been substantiated with photography, histopathologie examination, and skin surface replicas.
…
Tretinoin cream has an excellent safety record; a local cutaneous hypervitaminosis A reaction is the only common problem.❞
~ Dr. Goldfarb et al.
Read in full: Topical tretinoin therapy: Its use in photoaged skin
Is it safe?
For most people, when used as directed*, yes. However, it’s likely to irritate your skin at first, and that’s normal. If this persists more than a few weeks, or seems unduly severe, then you might want to stop and talk to your doctor again.
*See also: Scarring following inappropriate use of 0.05% tretinoin gel
(in the case of a young woman who used it 4x daily instead of 1x daily)
Want to try some?
Tretinoin is prescription-only, so speak with your doctor/pharmacist about that. Alternatively, retinal (not retinol) is the strongest natural alternative that works on the same principles; here’s an example product on Amazon 😎
Take care!
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Cannabis Myths vs Reality
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Cannabis Myths vs Reality
We asked you for your (health-related) opinion on cannabis use—specifically, the kind with psychoactive THC, not just CBD. We got the above-pictured, below-described, spread of responses:
- A little over a third of you voted for “It’s a great way to relax, without most of the dangers of alcohol”.
- A little under a third of you voted for “It may have some medical uses, but recreational use is best avoided”.
- About a quarter of you voted for “The negative health effects outweigh the possible benefits”
- Three of you voted for “It is the gateway to a life of drug-induced stupor and potentially worse”
So, what does the science say?
A quick legal note first: we’re a health science publication, and are writing from that perspective. We do not know your location, much less your local laws and regulations, and so cannot comment on such. Please check your own local laws and regulations in that regard.
Cannabis use can cause serious health problems: True or False?
True. Whether the risks outweigh the benefits is a personal and subjective matter (for example, a person using it to mitigate the pain of late stage cancer is probably unconcerned with many other potential risks), but what’s objectively true is that it can cause serious health problems.
One subscriber who voted for “The negative health effects outweigh the possible benefits” wrote:
❝At a bare minimum, you are ingesting SMOKE into your lungs!! Everyone SEEMS TO BE against smoking cigarettes, but cannabis smoking is OK?? Lung cancer comes in many forms.❞
Of course, that is assuming smoking cannabis, and not consuming it as an edible. But, what does the science say on smoking it, and lung cancer?
There’s a lot less research about this when it comes to cannabis, compared to tobacco. But, there is some:
❝Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long-term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded.❞
Read: Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium
Another study agreed there appears to be no association with lung cancer, but that there are other lung diseases to consider, such as bronchitis and COPD:
❝Smoking cannabis is associated with symptoms of chronic bronchitis, and there may be a modest association with the development of chronic obstructive pulmonary disease. Current evidence does not suggest an association with lung cancer.❞
Read: Cannabis Use, Lung Cancer, and Related Issues
Cannabis edibles are much safer than smoking cannabis: True or False?
Broadly True, with an important caveat.
One subscriber who selected “It may have some medical uses, but recreational use is best avoided”, wrote:
❝I’ve been taking cannabis gummies for fibromyalgia. I don’t know if they’re helping but they’re not doing any harm. You cannot overdose you don’t become addicted.❞
Firstly, of course consuming edibles (rather than inhaling cannabis) eliminates the smoke-related risk factors we discussed above. However, other risks remain, including the much greater ease of accidentally overdosing.
❝Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.❞
Note: that “more frequent” for inhaled cannabis, is because more people inhale it than eat it. If we adjust the numbers to control for how much less often people eat it, suddenly we see that the numbers of hospital admissions are disproportionately high for edibles, compared to inhaled cannabis.
Or, as the study author put it:
❝There are more adverse drug events associated on a milligram per milligram basis of THC when it comes in form of edibles versus an inhaled cannabis. If 1,000 people smoked pot and 1,000 people at the same dose in an edible, then more people would have more adverse drug events from edible cannabis.❞
See the numbers: Acute Illness Associated With Cannabis Use, by Route of Exposure
Why does this happen?
- It’s often because edibles take longer to take effect, so someone thinks “this isn’t very strong” and has more.
- It’s also sometimes because someone errantly eats someone else’s edibles, not realising what they are.
- It’s sometimes a combination of the above problems: a person who is now high, may simply forget and/or make a bad decision when it comes to eating more.
On the other hand, that doesn’t mean inhaling it is necessarily safer. As well as the pulmonary issues we discussed previously, inhaling cannabis has a higher risk of cannabinoid hyperemesis syndrome (and the resultant cyclic vomiting that’s difficult to treat).
You can read about this fascinating condition that’s sometimes informally called “scromiting”, a portmanteau of screaming and vomiting:
Cannabinoid Hyperemesis Syndrome
You can’t get addicted to cannabis: True or False?
False. However, it is fair to say that the likelihood of developing a substance abuse disorder is lower than for alcohol, and much lower than for nicotine.
See: Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013
If you prefer just the stats without the science, here’s the CDC’s rendering of that:
Addiction (Marijuana or Cannabis Use Disorder)
However, there is an interesting complicating factor, which is age. One is 4–7 times more likely to develop a substance abuse disorder, if one starts use as an adolescent, rather than later in life:
Cannabis is the gateway to use of more dangerous drugs: True or False?
False, generally speaking. Of course, for any population there will be some outliers, but there appears to be no meaningful causal relation between cannabis use and other substance use:
Interestingly, the strongest association (where any existed at all) was between cannabis use and opioid use. However, rather than this being a matter of cannabis use being a gateway to opioid use, it seems more likely that this is a matter of people looking to both for the same purpose: pain relief.
As a result, growing accessibility of cannabis may actually reduce opioid problems:
- Cannabis as a Gateway Drug for Opioid Use Disorder
- Association between medical cannabis laws and opioid overdose mortality has reversed over time
Some final words…
Cannabis is a complex drug with complex mechanisms and complex health considerations, and research is mostly quite young, due to its historic illegality seriously cramping science by reducing sample sizes to negligible. Simply put, there’s a lot we still don’t know.
Also, we covered some important topics today, but there were others we didn’t have time to cover, such as the other potential psychological benefits—and risks. Likely we’ll revisit those another day.
Lastly, while we’ve covered a bunch of risks today, those of you who said it has fewer and lesser risks than alcohol are quite right—the only reason we couldn’t focus on that more, is because to talk about all the risks of alcohol would make this feature many times longer!
Meanwhile, whether you partake or not, stay safe and stay well.
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The Bitter Truth About Coffee (or is it?)
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The Bitter Truth About Coffee (or is it?)
Yesterday, we asked you for your (health-related) views on coffee. The results were clear: if we assume the responses to be representative, we’re a large group of coffee-enthusiasts!
One subscriber who voted for “Coffee is a healthy stimulant, hydrating, and full of antioxidants” wrote:
❝Not so sure about how hydrating it is! Like most food and drink, moderation is key. More than 2 or 3 cups make me buzz! Just too much.❞
And that fine point brings us to our first potential myth:
Coffee is dehydrating: True or False?
False. With caveats…
Coffee, in whatever form we drink it, is wet. This may not come as a startling revelation, but it’s an important starting point. It’s mostly water. Water itself is not dehydrating.
Caffeine, however, is a diuretic—meaning you will tend to pee more. It achieves its diuretic effect by increasing blood flow to your kidneys, which prompts them to release more water through urination.
See: Effect of caffeine on bladder function in patients with overactive bladder symptoms
How much caffeine is required to have a diuretic effect? About 4.5 mg/kg.
What this means in practical terms: if you weigh 70kg (a little over 150lbs), 4.5×70 gives us 315.
315mg is about how much caffeine might be in six shots of espresso. We say “might” because while dosage calculations are an exact science, the actual amount in your shot of espresso can vary depending on many factors, including:
- The kind of coffee bean
- How and when it was roasted
- How and when it was ground
- The water used to make the espresso
- The pressure and temperature of the water
…and that’s all without looking at the most obvious factor: “is the coffee decaffeinated?”
If it doesn’t contain caffeine, it’s not diuretic. Decaffeinated coffee does usually contain tiny amounts of caffeine still, but with nearer 3mg than 300mg, it’s orders of magnitude away from having a diuretic effect.
If it does contain caffeine, then the next question becomes: “and how much water?”
For example, an Americano (espresso, with hot water added to make it a long drink) will be more hydrating than a ristretto (espresso, stopped halfway through pushing, meaning it is shorter and stronger than a normal espresso).
A subscriber who voted for “Coffee messes with sleep, creates dependency, is bad for the heart and gut, and is dehydrating too” wrote:
❝Coffee causes tachycardia for me so staying away is best. People with colon cancer are urged to stay away from coffee completely.❞
These are great points! It brings us to our next potential myth:
Coffee is bad for the heart: True or False?
False… For most people.
Some people, like our subscriber above, have an adverse reaction to caffeine, such as tachycardia. An important reason (beyond basic decency) for anyone providing coffee to honor requests for decaff.
For most people, caffeine is “heart neutral”. It doesn’t provide direct benefits or cause direct harm, provided it is enjoyed in moderation.
See also: Can you overdose on caffeine?
Some quick extra notes…
That’s all we have time for in myth-busting, but it’s worth noting before we close that coffee has a lot of health benefits; we didn’t cover them today because they’re not contentious, but they are interesting nevertheless:
- Coffee is the world’s biggest source of antioxidants
- 65% reduced risk of Alzheimer’s for coffee-drinkers
- 67% reduced risk of type 2 diabetes for coffee-drinkers
- 43% reduced risk of liver cancer for coffee-drinkers
- 53% reduced suicide risk for coffee-drinkers
Enjoy!
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