A cartoon of a woman nurse working at a desk with health insurance rejections.

Woman Petitions Health Insurer After Company Approves — Then Rejects — Her Infusions

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

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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  • What You Should Have Been Told About The Menopause Beforehand

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What You Should Have Been Told About Menopause Beforehand

    Dr. Jen Gunter provides important information on menopause.

    This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.

    When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?

    And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!

    So, what does Dr. Gunter want us to know?

    It’s a time of changes, not an end

    The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.

    And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.

    Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and not to mention but we’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).

    However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.

    Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.

    Bridges can be dangerous to cross! But they can also get us safely where we’re going.

    Ok, so how do we manage those things?

    Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.

    See also: Meet Goop’s Number One Enemy

    For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).

    This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.

    Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.

    To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:

    Dr. Gunter’s Guide To The Hormone Menoverse

    What about natural therapies?

    There are some non-hormonal things that work, but these are mostly things that:

    • give a statistically significant reduction in symptoms
    • give the same statistically significant reduction in symptoms as placebo

    As Dr. Gunter puts it:

    ❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.

    In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.

    Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”

    You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞

    ~ Gunter, 2023

    However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!

    For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:

    Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended

    Want to know more?

    Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.

    Enjoy!

    Share This Post

  • The Bitter Truth About Coffee (or is it?)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    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:

    Enjoy!

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  • The Brain As A Work-In-Progress

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    And The Brain Goes Marching On!

    In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:

    • About 64% of people said “Never”
    • About 16% of people said “25 years”
    • About 9% of people said “65 years”
    • About 5% of people said “13 years”
    • About 3% of people said “18 years”
    • About 3% of people said “45 years”

    Some thoughts, before we get into the science:

    An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:

    • “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
    • When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages

    Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!

    Why we picked those ages

    We picked those ages as poll options for reasons people might be drawn to them:

    • 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
    • 18 years: age of legal majority in N. America and many other places
    • 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
    • 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
    • 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research

    Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!

    Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.

    So, what does the science say?

    Our brains are never finished developing: True or False?

    True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.

    Glossary:

    • Neurogenesis: the process of creating new brain cells
    • Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs

    We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.

    For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:

    How To Grow New Brain Cells (At Any Age)

    Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.

    Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Our brains are still developing up to the age of 25: True or False?

    True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.

    A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:

    ❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞

    ~ Dr. Jay Giedd

    Source: Structural Magnetic Resonance Imaging of the Adolescent Brain

    There are several things to note here:

    • The above statement is talking about the physical size of the brain growing
    • Nowhere does he say “and stops developing at 25”

    However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.

    This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.

    The study didn’t misrepresent this, by the way, but the popular press did!

    Another 2012 study looked at various metrics of brain development, and found:

    • Synapse overproduction into the teens
    • Cortex pruning into the late 20s
    • Prefrontal pruning into middle age at least (they stopped looking)
    • Myelination beyond middle age (they stopped looking)

    Source: Experience and the developing prefrontal cortexcheck out figure 1, and make sure you’re looking at the human data not the rat data

    So how’s the most recent research looking?

    Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:

    Brain charts for the human lifespancheck out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!

    Want to know how not to get caught out by science being misrepresented by the popular press? Check out:

    How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

    Take care!

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  • Huperzine A: A Natural Nootropic

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Huperzine A: A Natural Nootropic

    Huperzine A is a compound, specifically a naturally occurring sesquiterpene alkaloid, that functions as an acetylcholinesterase inhibitor. If that seems like a bunch of big words, don’t worry, we’ll translate in a moment.

    First, a nod to its origins: it is found in certain kinds of firmoss, especially the “toothed clubmoss”, Huperzia serrata, which grows in many Asian countries.

    What’s an acetylcholinesterase inhibitor?

    Let’s do this step-by-step:

    • An acetylcholinesterase inhibitor is a compound that inhibits acetylcholinesterase.
    • Acetylcholinesterase is an enzyme that catalyzes (speeds up) the breakdown of acetylcholine.
    • Acetylcholine is a neurotransmitter; it’s an ester of acetic acid and choline.
      • This is the main neurotransmitter of the parasympathetic nervous system, and is also heavily involved in cognitive functions including memory and creative thinking.

    What this means: if you take an acetylcholinesterase inhibitor like huperzine A, it will inhibit acetylcholinesterase, meaning you will have more acetylcholine to work with. That’s good.

    What can I expect from it?

    Huperzine A has been well-studied for a while, mostly for the prevention and treatment of Alzheimer’s disease:

    However, research has suggested that huperzine A is much better as a prevention than a treatment:

    ❝A central event in the pathogenesis of Alzheimer’s disease (AD) is the accumulation of senile plaques composed of aggregated amyloid-β (Aβ) peptides.

    Ex vivo electrophysiological experiments showed that 10 μM of Aβ1-40 significantly decreased the effect of the AChE inhibitor huperzine A on the synaptic potential parameters. ❞

    ~ Dr. Irina Zueva

    Source: Can Activation of Acetylcholinesterase by β-Amyloid Peptide Decrease the Effectiveness of Cholinesterase Inhibitors?

    In other words: the answer to the titular question is “Yes, yes it can”

    And, to translate Dr. Zueva’s words into simple English:

    • People with Alzheimer’s have amyloid-β plaque in their brains
    • That plaque reduces the effectiveness of huperzine A

    So, what if we take it in advance? That works much better:

    ❝Pre-treatment with [huperzine A] at concentrations of 50, 100, and 150 µg/mL completely inhibited the secretion of PGE2, TNF-α, IL-6, and IL-1β compared to post-treatment with [huperzine A].

    This suggests that prophylactic treatment is better than post-inflammation treatment. ❞

    ~ Dr. Thu Kim Dang

    Source: Anti-neuroinflammatory effects of alkaloid-enriched extract from Huperzia serrata

    As you may know, neuroinflammation is a big part of Alzheimer’s pathology, so we want to keep that down. The above research suggests we should do that sooner rather than later.

    Aside from holding off dementia, can it improve memory now, too?

    There’s been a lot less research done into this (medicine is generally more concerned with preventing/treating disease, than improving the health of healthy people), but there is some:

    Huperzine-A capsules enhance memory and learning performance in 34 pairs of matched adolescent students

    ^This is a small (n=68) old (1999) study for which the full paper has mysteriously disappeared and we only get to see the abstract. It gave favorable results, though.

    The effects of huperzine A and IDRA 21 on visual recognition memory in young macaques

    ^This, like most non-dementia research into HupA, is an animal study. But we chose to spotlight this one because, unlike most of the studies, it did not chemically lobotomize the animals first; they were and remained healthy. That said, huperzine A improved the memory scores most for the monkeys that performed worst without it initially.

    Where can I get it?

    As ever, we don’t sell it, but here’s an example product on Amazon for your convenience

    Enjoy!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Sugar Blues – by William Dufty

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is a “read it cover to cover” book. It charts the rise of sugar’s place in world diets in general and the American diet in particular, and draws many conclusions about the effect this has had on us.

    This book will challenge you. Sometimes, it will change your mind. Sometimes, you’ll go “no, I’m sure that’s not right”, and you’ll go Googling. Either way, you’ll learn something.

    And that, for us, is the most important measure of any informational book: did we gain something from it? In Sugar Blues, perhaps the single biggest “gain” for the reader is that it’s an eye-opener and a call-to-arms—the extent to which you heed that is up to you, but it sure is good to at least be familiar with the battlefield.

    Check Out Sugar Blues on Amazon Today!

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    Learn to Age Gracefully

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  • The Brain As A Work-In-Progress

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    And The Brain Goes Marching On!

    In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:

    • About 64% of people said “Never”
    • About 16% of people said “25 years”
    • About 9% of people said “65 years”
    • About 5% of people said “13 years”
    • About 3% of people said “18 years”
    • About 3% of people said “45 years”

    Some thoughts, before we get into the science:

    An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:

    • “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
    • When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages

    Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!

    Why we picked those ages

    We picked those ages as poll options for reasons people might be drawn to them:

    • 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
    • 18 years: age of legal majority in N. America and many other places
    • 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
    • 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
    • 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research

    Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!

    Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.

    So, what does the science say?

    Our brains are never finished developing: True or False?

    True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.

    Glossary:

    • Neurogenesis: the process of creating new brain cells
    • Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs

    We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.

    For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:

    How To Grow New Brain Cells (At Any Age)

    Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.

    Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Our brains are still developing up to the age of 25: True or False?

    True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.

    A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:

    ❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞

    ~ Dr. Jay Giedd

    Source: Structural Magnetic Resonance Imaging of the Adolescent Brain

    There are several things to note here:

    • The above statement is talking about the physical size of the brain growing
    • Nowhere does he say “and stops developing at 25”

    However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.

    This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.

    The study didn’t misrepresent this, by the way, but the popular press did!

    Another 2012 study looked at various metrics of brain development, and found:

    • Synapse overproduction into the teens
    • Cortex pruning into the late 20s
    • Prefrontal pruning into middle age at least (they stopped looking)
    • Myelination beyond middle age (they stopped looking)

    Source: Experience and the developing prefrontal cortexcheck out figure 1, and make sure you’re looking at the human data not the rat data

    So how’s the most recent research looking?

    Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:

    Brain charts for the human lifespancheck out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!

    Want to know how not to get caught out by science being misrepresented by the popular press? Check out:

    How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

    Take care!

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