The Truth About Handwashing
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Washing Our Hands Of It
In Tuesdays’s newsletter, we asked you how often you wash your hands, and got the above-depicted, below-described, set of self-reported answers:
- About 54% said “More times per day than [the other options]”
- About 38% said “Whenever using the bathroom or kitchen
- About 5% said “Once or twice per day”
- Two (2) said “Only when visibly dirty”
- Two (2) said “I prefer to just use sanitizer gel”
What does the science have to say about this?
People lie about their handwashing habits: True or False?
True and False (since some people lie and some don’t), but there’s science to this too. Here’s a great study from 2021 that used various levels of confidentiality in questioning (i.e., there were ways of asking that made it either obvious or impossible to know who answered how), and found…
❝We analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.❞
Note: the abstract alone doesn’t make it clear how the anonymization worked (it is explained later in the paper), and it was noted as a limitation of the study that the participants may not have understood how it works well enough to have confidence in it, meaning that the 78.1% is probably also inflated, just not as much as the 94.5% in the direct questioning group.
Here’s a pop-science article that cites a collection of studies, finding such things as for example…
❝With the use of wireless devices to record how many people entered the restroom and used the pumps of the soap dispensers, researchers were able to collect data on almost 200,000 restroom trips over a three-month period.
The found that only 31% of men and 65% of women washed their hands with soap.❞
Source: Study: Men Wash Their Hands Much Less Often Than Women (And People Lie About Washing Their Hands)
Sanitizer gel does the job of washing one’s hands with soap: True or False?
False, though it’s still not a bad option for when soap and water aren’t available or practical. Here’s an educational article about the science of why this is so:
UCI Health | Soap vs. Hand Sanitizer
There’s also some consideration of lab results vs real-world results, because while in principle the alcohol gel is very good at killing most bacteria / inactivating most viruses, it can take up to 4 minutes of alcohol gel contact to do so, as in this study with flu viruses:
In contrast, 20 seconds of handwashing with soap will generally do the job.
Antibacterial soap is better than other soap: True or False?
False, because the main way that soap protects us is not in its antibacterial properties (although it does also destroy the surface membrane of many bacteria and for that matter viruses too, killing/inactivating them, respectively), but rather in how it causes pathogens to simply slide off during washing.
Here’s a study that found that handwashing with soap reduced disease incidence by 50–53%, and…
❝Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap.❞
Read more: Effect of handwashing on child health: a randomised controlled trial
Want to wash your hands more than you do?
There have been many studies into motivating people to wash their hands more (often with education and/or disgust-based shaming), but an effective method you can use for yourself at home is to simply buy more luxurious hand soap, and generally do what you can to make handwashing a more pleasant experience (taking a moment to let the water run warm is another good thing to do if that’s more comfortable for you).
Take care!
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Oral retinoids can harm unborn babies. But many women taking them for acne may not be using contraception
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Oral retinoids are a type of medicine used to treat severe acne. They’re sold under the brand name Roaccutane, among others.
While oral retinoids are very effective, they can have harmful effects if taken during pregnancy. These medicines can cause miscarriages and major congenital abnormalities (harm to unborn babies) including in the brain, heart and face. At least 30% of children exposed to oral retinoids in pregnancy have severe congenital abnormalities.
Neurodevelopmental problems (in learning, reading, social skills, memory and attention) are also common.
Because of these risks, the Australasian College of Dermatologists advises oral retinoids should not be prescribed a month before or during pregnancy under any circumstances. Dermatologists are instructed to make sure a woman isn’t pregnant before starting this treatment, and discuss the risks with women of childbearing age.
But despite this, and warnings on the medicines’ packaging, pregnancies exposed to oral retinoids continue to be reported in Australia and around the world.
In a study published this month, we wanted to find out what proportion of Australian women of reproductive age were taking oral retinoids, and how many of these women were using contraception.
Our results suggest a high proportion of women are not using effective contraception while on these drugs, indicating Australia needs a strategy to reduce the risk oral retinoids pose to unborn babies.
Contraception options
Using birth control to avoid pregnancy during oral retinoid treatment is essential for women who are sexually active. Some contraception methods, however, are more reliable than others.
Long-acting-reversible contraceptives include intrauterine devices (IUDs) inserted into the womb (such as Mirena, Kyleena, or copper devices) and implants under the skin (such as Implanon). These “set and forget” methods are more than 99% effective.
Oral retinoids taken during pregnancy can cause complications in babies. Gorodenkoff/Shutterstock The effectiveness of oral contraceptive pills among “perfect” users (following the directions, with no missed or late pills) is similarly more than 99%. But in typical users, this can fall as low as 91%.
Condoms, when used as the sole method of contraception, have higher failure rates. Their effectiveness can be as low as 82% in typical users.
Oral retinoid use over time
For our study, we analysed medicine dispensing data among women aged 15–44 from Australia’s Pharmaceutical Benefit Scheme (PBS) between 2013 and 2021.
We found the dispensing rate for oral retinoids doubled from one in every 71 women in 2013, to one in every 36 in 2021. The increase occurred across all ages but was most notable in young women.
Most women were not dispensed contraception at the same time they were using the oral retinoids. To be sure we weren’t missing any contraception that was supplied before the oral retinoids, we looked back in the data. For example, for an IUD that lasts five years, we looked back five years before the oral retinoid prescription.
Our analysis showed only one in four women provided oral retinoids were dispensed contraception simultaneously. This was even lower for 15- to 19-year-olds, where only about one in eight women who filled a prescription for oral retinoids were dispensed contraception.
A recent study found 43% of Australian year 10 and 69% of year 12 students are sexually active, so we can’t assume this younger age group largely had no need for contraception.
One limitation of our study is that it may underestimate contraception coverage, because not all contraceptive options are listed on the PBS. Those options not listed include male and female sterilisation, contraceptive rings, condoms, copper IUDs, and certain oral contraceptive pills.
But even if we presume some of the women in our study were using forms of contraception not listed on the PBS, we’re still left with a significant portion without evidence of contraception.
What are the solutions?
Other countries such as the United States and countries in Europe have pregnancy prevention programs for women taking oral retinoids. These programs include contraception requirements, risk acknowledgement forms and regular pregnancy tests. Despite these programs, unintended pregnancies among women using oral retinoids still occur in these countries.
But Australia has no official strategy for preventing pregnancies exposed to oral retinoids. Currently oral retinoids are prescribed by dermatologists, and most contraception is prescribed by GPs. Women therefore need to see two different doctors, which adds costs and burden.
Preventing pregnancy during oral retinoid treatment is essential. Krakenimages.com/Shutterstock Rather than a single fix, there are likely to be multiple solutions to this problem. Some dermatologists may not feel confident discussing sex or contraception with patients, so educating dermatologists about contraception is important. Education for women is equally important.
A clinical pathway is needed for reproductive-aged women to obtain both oral retinoids and effective contraception. Options may include GPs prescribing both medications, or dermatologists only prescribing oral retinoids when there’s a contraception plan already in place.
Some women may initially not be sexually active, but change their sexual behaviour while taking oral retinoids, so constant reminders and education are likely to be required.
Further, contraception access needs to be improved in Australia. Teenagers and young women in particular face barriers to accessing contraception, including costs, stigma and lack of knowledge.
Many doctors and women are doing the right thing. But every woman should have an effective contraception plan in place well before starting oral retinoids. Only if this happens can we reduce unintended pregnancies among women taking these medicines, and thereby reduce the risk of harm to unborn babies.
Dr Laura Gerhardy from NSW Health contributed to this article.
Antonia Shand, Research Fellow, Obstetrician, University of Sydney and Natasha Nassar, Professor of Paediatric and Perinatal Epidemiology and Chair in Translational Childhood Medicine, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Quit Like a Woman – by Holly Whitaker
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We’ve reviewed “quit drinking” books before, so what makes this one different?
While others focus on the science of addiction and the tips and tricks of habit breaking/forming, this one is more about environmental factors, and that because of society being as it is, we as women often face different challenges when it comes to drinking (or not). Not necessarily easier or harder than men’s in this case, but different. And that sometimes calls for different methods to deal with them. This book explores those.
She also looks at such matters as how to quit alcohol when you’ve never stuck to a diet, and other such very down-to-earth topics, in a well-researched and non-preachy fashion.
Bottom line: if you’ve sometimes tried to quit drinking or even just to cut back, but found the deck stacked against you and things conspire to undermine your efforts, this book will give you a clearer path forward.
Click here to check out Quite Like A Woman, And Take Care Of Yourself!
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Blood-Brain Barrier Breach Blamed For Brain-Fog
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Move Over, Leaky Gut. Now It’s A Leaky Brain.
…which is not a headline that promises good news, and indeed, the only good news about this currently is “now we know another thing that’s happening, and thus can work towards a treatment for it”.
Back in February (most popular media outlets did not rush to publish this, as it rather goes against the narrative of “remember when COVID was a thing?” as though the numbers haven’t risen since the state of emergency was declared over), a team of Irish researchers made a discovery:
❝For the first time, we have been able to show that leaky blood vessels in the human brain, in tandem with a hyperactive immune system may be the key drivers of brain fog associated with long covid❞
~ Dr. Matthew Campbell (one of the researchers)
Let’s break that down a little, borrowing some context from the paper itself:
- the leaky blood vessels are breaching the blood-brain-barrier
- that’s a big deal, because that barrier is our only filter between our brain and Things That Definitely Should Not Go In The Brain™
- a hyperactive immune system can also be described as chronic inflammation
- in this case, that includes chronic neuroinflammation which, yes, is also a major driver of dementia
You may be wondering what COVID has to do with this, and well:
- these blood-brain-barrier breaches were very significantly associated (in lay terms: correlated, but correlated is only really used as an absolute in write-ups) with either acute COVID infection, or Long Covid.
- checking this in vitro, exposure of brain endothelial cells to serum from patients with Long Covid induced the same expression of inflammatory markers.
How important is this?
As another researcher (not to mention: professor of neurology and head of the school of medicine at Trinity) put it:
❝The findings will now likely change the landscape of how we understand and treat post-viral neurological conditions.
It also confirms that the neurological symptoms of long covid are measurable with real and demonstrable metabolic and vascular changes in the brain.❞
~ Dr. Colin Doherty (see mini-bio above)
You can read a pop-science article about this here:
Irish researchers discover underlying cause of “brain fog” linked with long covid
…and you can read the paper in full here:
Want to stay safe?
Beyond the obvious “get protected when offered boosters/updates” (see also: The Truth About Vaccines), other good practices include the same things most people were doing when the pandemic was big news, especially avoiding enclosed densely-populated places, washing hands frequently, and looking after your immune system. For that latter, see also:
Beyond Supplements: The Real Immune-Boosters!
Take care!
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- the leaky blood vessels are breaching the blood-brain-barrier
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What Happens To Your Body When You Stop Drinking Alcohol
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Immediately after we stop drinking is rarely when we feel our best. But how long is it before we can expect to see benefits, instead of just suffering?
Timeline
After stopping drinking alcohol for…
- Seconds: the liver starts making progress filtering out toxins and sugars; ethanol starts to leave the system
- 1 hour: fatigue sets in as the body uses a lot of energy to metabolize and eliminate alcohol. However, sleep quality (if one goes to sleep now) is low because alcohol disrupts the brain patterns required for restful sleep
- 6–12 hours: the immune system starts recovering from the suppression caused by alcohol
- 24 hours: immune system is back to normal; withdrawal symptoms may occur in the case of heavy drinkers
- 3–5 days: resting blood pressure begins to drop, as stress levels decrease (alcohol may seem anxiolytic, but it is actually anxiogenic; it just masks its own effect in this regard). Also, because of insulin responses improving, appetite reduces. The liver, once it has finished dealing your last drinking session (if you used to drink all the time, it probably had a backlog to clear), can now begin to make repairs on itself.
- 1 week: skin will start looking better, as antidiuretic hormone levels neutralize, leading to a healthier maintenance of hydration
- 2 weeks: cognitive abilities improve as the brain begins to make progress in repairing itself. At the same time, kidneys start to heal.
- 3–4 weeks: the liver begins to regenerate in earnest. You may wonder what took it so long given the liver’s famous regenerative abilities, but in this case, the liver was also the organ that took the most damage from drinking, so its regeneration gets off to a slow start (in contrast, if the liver had “merely” suffered physical trauma, such as being shot, stabbed,
or eaten by eagles,it’d start regenerating vigorously as soon as the immediate wound-response had been tended to). Once it is able to pick up the pace though, overall health improves, as the liver can focus on breaking down other toxins. - 1–2 months: the heart is able to repair itself, and start to become stronger again (dependent on other lifestyle factors, of course).
- 3 months and more: bodily repairs continue (for example, the damage to the liver is often so severe that it can take quite a bit longer to recover completely, and repairs in the brain are always slow, for reasons beyond the scope of this article). Looking at the big picture, at this point we also see other benefits, such as reduced cancer risks.
In short… It’s never too soon to stop, but it’s also never too late, unless you are going to die in the next few days. So long as you’ll be in the land of the living for a few days yet, there’s time to enjoy the benefits of stopping.
Most importantly: the timeline for the most important repairs is not as long as many people might think, and that itself can be very motivating.
For more detail on much of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Can We Drink To Good Health?
- How To Reduce Or Quit Alcohol
- Addiction Myths That Are Hard To Quit
- How To Unfatty A Fatty Liver
Take care!
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Generation M – by Dr. Jessica Shepherd
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Menopause is something that very few people are adequately prepared for despite its predictability, and also something that very many people then neglect to take seriously enough.
Dr. Shepherd encourages a more proactive approach throughout all stages of menopause and beyond; she discusses “the preseason, the main event, and the after-party” (perimenopause, menopause, and postmenopause), which is important, because typically people take up an interest in perimenopause, are treating it like a marathon by menopause, and when it comes to postmenopause, it’s easy to think “well, that’s behind me now”, and it’s not, because untreated menopause will continue to have (mostly deleterious) cumulative effects until death.
As for HRT, there’s a chapter on that of course, going into quite some detail. There is also plenty of attention given to popular concerns such as managing weight changes and libido changes, as well as oft-neglected topics such as brain changes, as well as things considered more cosmetic but that can have a big impact on mental health, such as skin and hair.
The style throughout is pop-science; friendly without skimping on detail and including plenty of good science.
Bottom line: if you’d like a fairly comprehensive overview of the changes that occur from perimenopause all the way to menopause and well beyond, then this is a great book for that.
Click here to check out Generation M, and live well at every stage of life!
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An Accessible New Development Against Alzheimer’s
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Dopamine vs Alzheimer’s
One of the key hallmarks of Alzheimer’s disease is the formation of hardened beta-amyloid plaques around neurons. The beta-amyloid peptides themselves are supposed to be in the brain, but the hardened pieces of them that form the plaques are not.
While the full nature of the relationship between those plaques and Alzheimer’s disease is not known for sure (there are likely other factors involved, and “the amyloid hypothesis” is at this stage nominally just that, a hypothesis), one thing that has been observed is that increasing or reducing the plaques increases or reduces (respectively) Alzheimer’s symptoms such as memory loss.
Neprilysin
There is an enzyme, neprilysin, that can break down those plaques.
Neprilysin is made naturally in the brain, and/but we cannot take it as a supplement or medication, because it’s too big to pass through the blood-brain barrier.
A team of researchers led by Dr. Takaomi Saido genetically manipulated mice to produce more neprilysin, and those mice resultantly experienced fewer beta-amyloid plaques and better memory in their old age.
However wonderful for the mice (and a great proof of principle) the above approach is not useful as a treatment for humans whose genomes weren’t modified at our conception in a lab.
Since (as mentioned before) we also can’t take it as a medication/supplement, that leaves one remaining option: find a way to make our already-existing brains produce more of it.
The team’s previous research allowed them to narrow this down to “there is probably a hormone made in the hypothalamus that modulates this”, so they began experimenting with making the mice produce more hormones there.
The DREADD switch
DREADDs, or Designer Receptors Exclusively Activated by Designer Drugs, were the next tool in the toolbox. The scientists attached these designer receptors to dopamine-producing neurons in the mice, so that they could be activated by the appropriate designer drugs—basically, allowing for a “make more dopamine” button, without having to literally wire up the brains with electrodes. The “button” gets triggered instead by a chemical trigger, the designer drug. You can read more about them here:
DREADDs for Neuroscientists: A Primer
The result was positive; when the mice made more dopamine, the result was that they also made more neprilysin. So far, the hypothesis is that the presence of dopamine upregulates the production of neprilysin. In other words, the increased neprilysin levels were caused by the increased dopamine levels (the alternatives would have been: they were both caused by the same thing—in this case that’d be the DREADD activation—or the increase was caused by something else entirely that hadn’t been controlled for).
As to how the causal relationship was determined…
“But I don’t have (or want) a DREADD switch in my head”
Happily for us (and probably happily for the mice too, because dopamine causes feelings of happiness), the experiments continued.
This time, instead of using the DREADD system, they tried simply supplementing the mouse food with l-dopa, a dopamine precursor. L-dopa is often used in the treatment of Parkinson’s disease, because the molecules are small enough to pass through the blood-brain barrier, and can be converted to full dopamine inside the brain itself. So, taking l-dopa normally raises dopamine levels.
The results? The mice who were given l-dopa enjoyed:
- higher dopamine levels
- higher neprilysin levels
- lower beta-amyloid plaque levels
- better memory in tests
The next step for the researchers is to investigate how exactly dopamine regulates neprilysin in the brain, but for now, the relationship between l-dopa consumption and the reduction of Alzheimer’s symptoms seems clear.
You can read about the study here:
The dopaminergic system promotes neprilysin-mediated degradation of amyloid-β in the brain
Is there a catch?
L-dopa has common side effects that are not pleasant; the list begins with nausea and vomiting, and continues with things that one might expect from having “too much of a good thing” when it comes to dopamine, such as dyskinesia (extra movements) and hallucinations.
You can read about it more here at the Parkinson’s Foundation:
Parkinson’s Foundation | Levodopa
However! All is not lost. Rather than reaching for the heavy guns by taking l-dopa unnecessarily, there are other dopamine precursors that don’t have those side effects (and are consequently less restricted, to the point they can be purchased as supplements, or indeed, enjoyed where they occur naturally in some foods).
Top of the list of such safe* and readily-available dopamine precursors is…
N-Acetyl L-Tyrosine (NALT): The Dopamine Precursor & More
If you’d like to try that, here’s an example product on Amazon… Or you could eat fish, white beans, tofu, natto, or pumpkin seeds 😉
*Quick note on safety: “safe” is a relative term and may vary from person to person. Please speak with your own doctor to be sure, check with your pharmacist in case of any meds interactions, and be especially careful taking anything that increases dopamine levels if you have bipolar disorder or are otherwise prone to psychosis of any kind. For most people, this shouldn’t be an issue as our brains have a built-in mechanism for scrubbing excess dopamine and ensuring we don’t end up with too much, but for some people whose dopamine regulation is not so good in that regard, it can cause problems. So again, speak with your doctor to be sure, because we are not doctors, let alone your doctor.
Lastly…
If you’d like an entirely drug-free approach, that’s skipping even the “nutraceuticals”, you might enjoy:
Short On Dopamine? Science Has The Answer
Take care!
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