How they did it: STAT reporters expose how ailing seniors suffer when Medicare Advantage plans use algorithms to deny care
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In a call with a long-time source, what stood out most to STAT reporters Bob Herman and Casey Ross was just how viscerally frustrated and angry the source was about an algorithm used by insurance companies to decide how long patients should stay in a nursing home or rehab facility before being sent home.
The STAT stories had a far-reaching impact:
- The U.S. Senate Committee on Homeland Security and Government Affairs took a rare step of launching a formal investigation into the use of algorithms by the country’s three largest Medicare Advantage insurers.
- Thirty-two House members urged the Centers for Medicare and Medicaid Services to increase the oversight of algorithms that health insurers use to make coverage decisions.
- In a rare step, CMS launched its own investigation into UnitedHealth. It also stiffened its regulations on the use of proprietary algorithms and introduced plans to audit denials across Medicare Advantage plans in 2024.
- Based on STAT’s reporting, Medicare Advantage beneficiaries filed two class-action lawsuits against UnitedHealth and its NaviHealth subsidiary, the maker of the algorithm, and against Humana, another major health insurance company that was also using the algorithm.
- Amid scrutiny, UnitedHealth renamed NaviHealth.
The companies never allowed an on-the-record interview with their executives, but they acknowledged that STAT’s reporting was true, according to the news organization.
Ross and Herman spoke with The Journalist’s Resource about their project and shared the following eight tips.
1. Search public comments on proposed federal rules to find sources.
Herman and Ross knew that the Centers for Medicare and Medicaid Services had put out a request for public comments, asking stakeholders within the Medicare Advantage industry how the system could improve.
There are two main ways to get Medicare coverage: original Medicare, which is a fee-for-service health plan, and Medicare Advantage, which is a type of Medicare health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans have increasingly become popular in recent years.
Under the Social Security Act, the public has the opportunity to submit comments on Medicare’s proposed national coverage determinations. CMS uses public comments to inform its proposed and final decisions. It responds in detail to all public comments when issuing a final decision.
The reporters began combing through hundreds of public comments attached to a proposed Medicare Advantage rule that was undergoing federal review. NaviHealth, the UnitedHealth subsidiary and the maker of the algorithm, came up in many of the comments, which include the submitters’ information.
“These are screaming all-caps comments to federal regulators about YOU NEED TO SOMETHING ABOUT THIS BECAUSE IT’S DISGUSTING,” Ross says.
“The federal government is proposing rules and regulations all the time,” adds Herman, STAT’s business of health care reporter. “If someone’s going to take the time and effort to comment on them, they must have at least some knowledge of what’s going on. It’s just a great tool for any journalist to use to figure out more and who to contact.”
The reporters also found several attorneys who had complained in the comments. They began reaching out to them, eventually gaining access to confidential documents and intermediaries who put them in touch with patients to show the human impact of the algorithm.
2. Harness the power of the reader submission box.
At the suggestion of an editor, the reporters added a reader submission box at the bottom of their first story, asking them to share their own experiences with Medicare Advantage denials.
The floodgates opened. Hundreds of submissions arrived.
By the end of their first story, Herman and Ross had confidential records and some patients, but they had no internal sources in the companies they were investigating, including Navihealth. The submission box led them to their first internal source.
The journalists also combed through LinkedIn and reached out to former and current employees, but the response rate was much lower than what they received via the submission box.
The submission box “is just right there,” Herman says. “People who would want to reach out to us can do it right then and there after they read the story and it’s fresh in their minds.”
3. Mine podcasts relevant to your story.
The reporters weren’t sure if they could get interviews with some of the key figures in the story, including Tom Scully, the former head of the Centers for Medicare and Medicaid Services who drew up the initial plans for NaviHealth years before UnitedHealth acquired it.
But Herman and another colleague had written previously about Scully’s private equity firm and they had found a podcast where he talked about his work. So Herman went back to the podcast — where he discovered Scully had also discussed NaviHealth.
The reporters also used the podcast to get Scully on the phone for an interview.
“So we knew we had a good jumping off point there to be like, ‘OK, you’ve talked about NaviHealth on a podcast, let’s talk about this,’” Herman says. “I think that helped make him more willing to speak with us.”
4. When covering AI initiatives, proceed with caution.
“A source of mine once said to me, ‘AI is not magic,’” Ross says. “People need to just ask questions about it because AI has this aura about it that it’s objective, that it’s accurate, that it’s unquestionable, that it never fails. And that is not true.”
AI is not a neutral, objective machine, Ross says. “It’s based on data that’s fed into it and people need to ask questions about that data.”
He suggests several questions to ask about the data behind AI tools:
- Where does the data come from?
- Who does it represent?
- How is this tool being applied?
- Do the people to whom the tool is being applied match the data on which it was trained? “If racial groups or genders or age of economic situations are not adequately represented in the training set, then there can be an awful lot of bias in the output of the tool and how it’s applied,” Ross says.
- How is the tool applied within the institution? Are people being forced to forsake their judgment and their own ability to do their jobs to follow the algorithm?
5. Localize the story.
More than half of all Medicare beneficiaries have Medicare Advantage and there’s a high likelihood that there are multiple Medicare Advantage plans in every county across the nation.
“So it’s worth looking to see how Medicare Advantage plans are growing in your area,” Herman says.
Finding out about AI use will most likely rely on shoe-leather reporting of speaking with providers, nursing homes and rehab facilities, attorneys and patients in your community, he says. Another source is home health agencies, which may be caring for patients who were kicked out of nursing homes and rehab facilities too soon because of a decision by an algorithm.
The anecdote that opens their first story involves a small regional health insurer in Wisconsin, which was using NaviHealth and a contractor to manage post-acute care services, Ross says.
“It’s happening to people in small communities who have no idea that this insurer they’ve signed up with is using this tool made by this other company that operates nationally,” Ross says.
There are also plenty of other companies like NaviHealth that are being used by Medicare Advantage plans, Herman says. “So it’s understanding which Medicare Advantage plans are being sold in your area and then which post-acute management companies they’re using,” he adds.
Some regional insurers have online documents that show which contractors they use to evaluate post-acute care services.
6. Get familiar with Medicare’s appeals databases
Medicare beneficiaries can contest Medicare Advantage denials through a five-stage process, which can last months to years. The appeals can be filed via the Office of Medicare Hearings and Appeals.
“Between 2020 and 2022, the number of appeals filed to contest Medicare Advantage denials shot up 58%, with nearly 150,000 requests to review a denial filed in 2022, according to a federal database,” Ross and Herman write in their first story. “Federal records show most denials for skilled nursing care are eventually overturned, either by the plan itself or an independent body that adjudicates Medicare appeals.”
There are several sources to find appeals data. Be mindful that the cases themselves are not public to protect patient privacy, but you can find the number of appeals filed and the rationale for decisions.
CMS has two quality improvement organizations, or QIOs, Livanta and Kepro, which are required to file free, publicly-available annual reports, about the cases they handle, Ross says.
Another company, Maximus, a Quality Improvement Contractor, also files reports on prior authorization cases it adjudicates for Medicare. The free annual reports include data on raw numbers of cases and basic information about the percentage denials either overturned or upheld on appeal, Ross explains.
CMS also maintains its own database on appeals for Medicare Part C (Medicare Advantage plans) and Part D, which covers prescription drugs, although the data is not complete, Ross explains.
7. Give your editor regular updates.
“Sprinkle the breadcrumbs in front of your editors,” Ross says.
“If you wrap your editors in the process, you’re more likely to be able to get to the end of [the story] before they say, ‘That’s it! Give me your copy,’” Ross says.
8. Get that first story out.
“You don’t have to know everything before you write that first story,” Ross says. “Because with that first story, if it has credibility and it resonates with people, sources will come forward and sources will continue to come forward.”
Read the stories
Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need
UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care
UnitedHealth used secret rules to restrict rehab care for seriously ill Medicare Advantage patients
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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If You’re Poor, Fertility Treatment Can Be Out of Reach
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Mary Delgado’s first pregnancy went according to plan, but when she tried to get pregnant again seven years later, nothing happened. After 10 months, Delgado, now 34, and her partner, Joaquin Rodriguez, went to see an OB-GYN. Tests showed she had endometriosis, which was interfering with conception. Delgado’s only option, the doctor said, was in vitro fertilization.
“When she told me that, she broke me inside,” Delgado said, “because I knew it was so expensive.”
Delgado, who lives in New York City, is enrolled in Medicaid, the federal-state health program for low-income and disabled people. The roughly $20,000 price tag for a round of IVF would be a financial stretch for lots of people, but for someone on Medicaid — for which the maximum annual income for a two-person household in New York is just over $26,000 — the treatment can be unattainable.
Expansions of work-based insurance plans to cover fertility treatments, including free egg freezing and unlimited IVF cycles, are often touted by large companies as a boon for their employees. But people with lower incomes, often minorities, are more likely to be covered by Medicaid or skimpier commercial plans with no such coverage. That raises the question of whether medical assistance to create a family is only for the well-to-do or people with generous benefit packages.
“In American health care, they don’t want the poor people to reproduce,” Delgado said. She was caring full-time for their son, who was born with a rare genetic disorder that required several surgeries before he was 5. Her partner, who works for a company that maintains the city’s yellow cabs, has an individual plan through the state insurance marketplace, but it does not include fertility coverage.
Some medical experts whose patients have faced these issues say they can understand why people in Delgado’s situation think the system is stacked against them.
“It feels a little like that,” said Elizabeth Ginsburg, a professor of obstetrics and gynecology at Harvard Medical School who is president-elect of the American Society for Reproductive Medicine, a research and advocacy group.
Whether or not it’s intended, many say the inequity reflects poorly on the U.S.
“This is really sort of standing out as a sore thumb in a nation that would like to claim that it cares for the less fortunate and it seeks to do anything it can for them,” said Eli Adashi, a professor of medical science at Brown University and former president of the Society for Reproductive Endocrinologists.
Yet efforts to add coverage for fertility care to Medicaid face a lot of pushback, Ginsburg said.
Over the years, Barbara Collura, president and CEO of the advocacy group Resolve: The National Infertility Association, has heard many explanations for why it doesn’t make sense to cover fertility treatment for Medicaid recipients. Legislators have asked, “If they can’t pay for fertility treatment, do they have any idea how much it costs to raise a child?” she said.
“So right there, as a country we’re making judgments about who gets to have children,” Collura said.
The legacy of the eugenics movement of the early 20th century, when states passed laws that permitted poor, nonwhite, and disabled people to be sterilized against their will, lingers as well.
“As a reproductive justice person, I believe it’s a human right to have a child, and it’s a larger ethical issue to provide support,” said Regina Davis Moss, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda, an advocacy group.
But such coverage decisions — especially when the health care safety net is involved — sometimes require difficult choices, because resources are limited.
Even if state Medicaid programs wanted to cover fertility treatment, for instance, they would have to weigh the benefit against investing in other types of care, including maternity care, said Kate McEvoy, executive director of the National Association of Medicaid Directors. “There is a recognition about the primacy and urgency of maternity care,” she said.
Medicaid pays for about 40% of births in the United States. And since 2022, 46 states and the District of Columbia have elected to extend Medicaid postpartum coverage to 12 months, up from 60 days.
Fertility problems are relatively common, affecting roughly 10% of women and men of childbearing age, according to the National Institute of Child Health and Human Development.
Traditionally, a couple is considered infertile if they’ve been trying to get pregnant unsuccessfully for 12 months. Last year, the ASRM broadened the definition of infertility to incorporate would-be parents beyond heterosexual couples, including people who can’t get pregnant for medical, sexual, or other reasons, as well as those who need medical interventions such as donor eggs or sperm to get pregnant.
The World Health Organization defined infertility as a disease of the reproductive system characterized by failing to get pregnant after a year of unprotected intercourse. It terms the high cost of fertility treatment a major equity issue and has called for better policies and public financing to improve access.
No matter how the condition is defined, private health plans often decline to cover fertility treatments because they don’t consider them “medically necessary.” Twenty states and Washington, D.C., have laws requiring health plans to provide some fertility coverage, but those laws vary greatly and apply only to companies whose plans are regulated by the state.
In recent years, many companies have begun offering fertility treatment in a bid to recruit and retain top-notch talent. In 2023, 45% of companies with 500 or more workers covered IVF and/or drug therapy, according to the benefits consultant Mercer.
But that doesn’t help people on Medicaid. Only two states’ Medicaid programs provide any fertility treatment: New York covers some oral ovulation-enhancing medications, and Illinois covers costs for fertility preservation, to freeze the eggs or sperm of people who need medical treatment that will likely make them infertile, such as for cancer. Several other states also are considering adding fertility preservation services.
In Delgado’s case, Medicaid covered the tests to diagnose her endometriosis, but nothing more. She was searching the internet for fertility treatment options when she came upon a clinic group called CNY Fertility that seemed significantly less expensive than other clinics, and also offered in-house financing. Based in Syracuse, New York, the company has a handful of clinics in upstate New York cities and four other U.S. locations.
Though Delgado and her partner had to travel more than 300 miles round trip to Albany for the procedures, the savings made it worthwhile. They were able do an entire IVF cycle, including medications, egg retrieval, genetic testing, and transferring the egg to her uterus, for $14,000. To pay for it, they took $7,000 of the cash they’d been saving to buy a home and financed the other half through the fertility clinic.
She got pregnant on the first try, and their daughter, Emiliana, is now almost a year old.
Delgado doesn’t resent people with more resources or better insurance coverage, but she wishes the system were more equitable.
“I have a medical problem,” she said. “It’s not like I did IVF because I wanted to choose the gender.”
One reason CNY is less expensive than other clinics is simply that the privately owned company chooses to charge less, said William Kiltz, its vice president of marketing and business development. Since the company’s beginning in 1997, it has become a large practice with a large volume of IVF cycles, which helps keep prices low.
At this point, more than half its clients come from out of state, and many earn significantly less than a typical patient at another clinic. Twenty percent earn less than $50,000, and “we treat a good number who are on Medicaid,” Kiltz said.
Now that their son, Joaquin, is settled in a good school, Delgado has started working for an agency that provides home health services. After putting in 30 hours a week for 90 days, she’ll be eligible for health insurance.
One of the benefits: fertility coverage.
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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Melatonin: A Safe, Natural Sleep Aid?
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Melatonin: A safe sleep supplement?
Melatonin is a hormone normally made in our pineal gland. It helps regulate our circadian rhythm, by making us sleepy.
It has other roles too—it has a part to play in regulating immune function, something that also waxes and wanes as a typical day goes by.
Additionally, since melatonin and cortisol are antagonistic to each other, a sudden increase in either will decrease the other. Our brain takes advantage of this, by giving us a cortisol spike in the morning to help us wake up.
As a supplement, it’s generally enjoyed with the intention of inducing healthy, natural, restorative sleep.
Does it really induce healthy, natural, restorative, sleep?
Yes! Well, “natural” is a little subject and relative, if you’re taking it as a supplement, but it’s something your body produces naturally anyway.
Contrast with, for example, benzodiazepines (that whole family of medications with names ending in -azopan or -alozam), or other tranquilizing drugs that do not so much induce healthy sleep, but rather reduce your brain function and hopefully knock you out, and/but often have unwanted side effects, and a tendency to create dependency.
Melatonin, unlike most of those drugs, does not create dependency, and furthermore, we don’t develop tolerance to it. In other words, the same dose will continue working (we won’t need more and more).
In terms of benefits, melatonin not only reduces the time to fall asleep and increases total sleep time, but also (quite a bonus) improves sleep quality, too:
Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders
Because it is a natural hormone rather than a drug with many side effects and interactions, it’s also beneficial for those who need good sleep and/but don’t want tranquilizing:
Any other benefits?
Yes! It can also help guard against Seasonal Affective Disorder, also called seasonal depression. Because SAD is not just about “not enough light = not enough serotonin”, but also partly about circadian rhythm and (the body is not so sure what time of day it is when there are long hours of darkness, or even, in the other hemisphere / other time of year, long hours of daylight), melatonin can help, by giving your brain something to “anchor” onto, provided you take it at the same time each day. See:
- Is seasonal affective disorder a disorder of circadian rhythms?
- The circadian basis of winter depression: the case for low-dose melatonin use
As a small bonus, melatonin also promotes HGH production (important for maintaining bone and muscle mass, especially in later life):
Anything we should worry about?
Assuming taking a recommended dose only (0.5mg–10mg per day), toxicity is highly unlikely, especially given that it has a half-life of only 40–60 minutes, so it’ll be eliminated quite quickly.
However! It does indeed induce sleepiness, so for example, don’t take melatonin and then try to drive or operate heavy machinery—or, ideally, do anything other than go to bed.
It can interfere with some medications. We mentioned that melatonin helps regulate immune function, so for example that’s something to bear in mind if you’re on immunosuppressants or otherwise have an autoimmune disorder. It can also interfere with blood pressure medications and blood thinners, and may make epilepsy meds less effective.
As ever, if in doubt, please speak with your doctor and/or pharmacist.
Where to get it?
As ever, we don’t sell it (or anything else), but for your convenience, here is an example product on Amazon.
Enjoy!
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Goat Milk Greek Yogurt vs Almond Milk Greek Yogurt – Which is Healthier?
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Our Verdict
When comparing goat milk yogurt to almond milk yogurt, we picked the almond milk yogurt.
Why?
Surprised? Honestly, we were too!
Much as we love almonds, we were fully expecting to write about how they’re very close in nutritional value, but the dairy yogurt has more probiotics, but no, as it turns out when we looked into them, they’re quite comparable in that regard.
It’s easy to assume “goat milk yogurt is more natural and therefore healthier”, but in both cases, it was a case of taking a fermentable milk, and fermenting it (an ancient process). “But almond milk is a newfangled thing”, well, new-ish…
So what was the deciding factor?
In this case, the almond milk yogurt has about twice the protein per (same size) serving, compared to the goat milk; all the other macros are about the same, and the micronutrients are similar. Like many plant-based milks and yogurts, this one is fortified with calcium and vitamin D, so that wasn’t an issue either.
In short: the only meaningful difference was the protein, and the almond came out on top.
However!
The almond came out on top only because it is strained; this can be done (or not) with any kind of yogurt, be it from an animal or a plant.
In other words: if it had been different brands, the goat milk yogurt could have come out on top!
The take-away idea here is: always read labels, because as you’ve just seen, even we can get surprised sometimes!
seriously if you only remember one thing from this today, make it the above
Other thing worth mentioning: yogurts, and dairy products in general, are often made with common allergens (e.g. dairy, nuts, soy, etc). So if you are allergic or intolerant, obviously don’t choose the one to which you are allergic or intolerant.
That said… If you are lactose-intolerant, but not allergic, goat’s milk does have less lactose than cow’s milk. But of course, you know your limits better than we can in this regard.
Want to try some?
Amazon is not coming up with the goods for this one (or anything even similar, at time of writing), so we recommend trying your local supermarket (and reading labels, because products vary widely!)
What you’re looking for (be it animal- or plant-based):
- Live culture probiotic bacteria
- No added sugar
- Minimal additives in general
- Lastly, check out the amounts for protein, calcium, vitamin D, etc.
Enjoy!
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Cost of living: if you can’t afford as much fresh produce, are canned veggies or frozen fruit just as good?
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The cost of living crisis is affecting how we spend our money. For many people, this means tightening the budget on the weekly supermarket shop.
One victim may be fresh fruit and vegetables. Data from the Australian Bureau of Statistics (ABS) suggests Australians were consuming fewer fruit and vegetables in 2022–23 than the year before.
The cost of living is likely compounding a problem that exists already – on the whole, Australians don’t eat enough fruit and vegetables. Australian dietary guidelines recommend people aged nine and older should consume two serves of fruit and five serves of vegetables each day for optimal health. But in 2022 the ABS reported only 4% of Australians met the recommendations for both fruit and vegetable consumption.
Fruit and vegetables are crucial for a healthy, balanced diet, providing a range of vitamins and minerals as well as fibre.
If you can’t afford as much fresh produce at the moment, there are other ways to ensure you still get the benefits of these food groups. You might even be able to increase your intake of fruit and vegetables.
New Africa/Shutterstock Frozen
Fresh produce is often touted as being the most nutritious (think of the old adage “fresh is best”). But this is not necessarily true.
Nutrients can decline in transit from the paddock to your kitchen, and while the produce is stored in your fridge. Frozen vegetables may actually be higher in some nutrients such as vitamin C and E as they are snap frozen very close to the time of harvest. Variations in transport and storage can affect this slightly.
Minerals such as calcium, iron and magnesium stay at similar levels in frozen produce compared to fresh.
Another advantage to frozen vegetables and fruit is the potential to reduce food waste, as you can use only what you need at the time.
Freezing preserves the nutritional quality of vegetables and increases their shelf life. Tohid Hashemkhani/Pexels As well as buying frozen fruit and vegetables from the supermarket, you can freeze produce yourself at home if you have an oversupply from the garden, or when produce may be cheaper.
A quick blanching prior to freezing can improve the safety and quality of the produce. This is when food is briefly submerged in boiling water or steamed for a short time.
Frozen vegetables won’t be suitable for salads but can be eaten roasted or steamed and used for soups, stews, casseroles, curries, pies and quiches. Frozen fruits can be added to breakfast dishes (with cereal or youghurt) or used in cooking for fruit pies and cakes, for example.
Canned
Canned vegetables and fruit similarly often offer a cheaper alternative to fresh produce. They’re also very convenient to have on hand. The canning process is the preservation technique, so there’s no need to add any additional preservatives, including salt.
Due to the cooking process, levels of heat-sensitive nutrients such as vitamin C will decline a little compared to fresh produce. When you’re using canned vegetables in a hot dish, you can add them later in the cooking process to reduce the amount of nutrient loss.
To minimise waste, you can freeze the portion you don’t need.
Fermented
Fermented vegetables are another good option. Angela Khebou/Unsplash Fermentation has recently come into fashion, but it’s actually one of the oldest food processing and preservation techniques.
Fermentation largely retains the vitamins and minerals in fresh vegetables. But fermentation may also enhance the food’s nutritional profile by creating new nutrients and allowing existing ones to be absorbed more easily.
Further, fermented foods contain probiotics, which are beneficial for our gut microbiome.
5 other tips to get your fresh fix
Although alternatives to fresh such as canned or frozen fruit and vegetables are good substitutes, if you’re looking to get more fresh produce into your diet on a tight budget, here are some things you can do.
1. Buy in season
Based on supply and demand principles, buying local seasonal vegetables and fruit will always be cheaper than those that are imported out of season from other countries.
2. Don’t shun the ugly fruit and vegetables
Most supermarkets now sell “ugly” fruit and vegetables, that are not physically perfect in some way. This does not affect the levels of nutrients in them at all, or their taste.
Buying fruit and vegetables during the right season will be cheaper. August de Richelieu/Pexels 3. Reduce waste
On average, an Australian household throws out A$2,000–$2,500 worth of food every year. Fruit, vegetables and bagged salad are the three of the top five foods thrown out in our homes. So properly managing fresh produce could help you save money (and benefit the environment).
To minimise waste, plan your meals and shopping ahead of time. And if you don’t think you’re going to get to eat the fruit and vegetables you have before they go off, freeze them.
4. Swap and share
There are many websites and apps which offer the opportunity to swap or even pick up free fresh produce if people have more than they need. Some local councils are also encouraging swaps on their websites, so dig around and see what you can find in your local area.
5. Gardening
Regardless of how small your garden is you can always plant produce in pots. Herbs, rocket, cherry tomatoes, chillies and strawberries all grow well. In the long run, these will offset some of your cost on fresh produce.
Plus, when you have put the effort in to grow your own produce, you are less likely to waste it.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Simply The Pits: These Underarm Myths!
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Are We Taking A Risk To Smell Fresh As A Daisy?
Yesterday, we asked you for your health-related view of underarm deodorants.
So, what does the science say?
They can cause (or increase risk of) cancer: True or False?
False, so far as we know. Obviously it’s very hard to prove a negative, but there is no credible evidence that deodorants cause cancer.
The belief that they do comes from old in vitro studies applying the deodorant directly to the cells in question, like this one with canine kidney tissues in petri dishes:
Antiperspirant Induced DNA Damage in Canine Cells by Comet Assay
Which means that if you’re not a dog and/or if you don’t spray it directly onto your internal organs, this study’s data doesn’t apply to you.
In contrast, more modern systematic safety reviews have found…
❝Neither is there clear evidence to show use of aluminum-containing underarm antiperspirants or cosmetics increases the risk of Alzheimer’s Disease or breast cancer.
Metallic aluminum, its oxides, and common aluminum salts have not been shown to be either genotoxic or carcinogenic.❞
(however, one safety risk it did find is that we should avoid eating it excessively while pregnant or breastfeeding)
Alternatives like deodorant rocks have fewer chemicals and thus are safer: True or False?
True and False, respectively. That is, they do have fewer chemicals, but cannot in scientific terms be qualifiably, let alone quantifiably, described as safer than a product that was already found to be safe.
Deodorant rocks are usually alum crystals, by the way; that is to say, aluminum salts of various kinds. So if it was aluminum you were hoping to avoid, it’s still there.
However, if you’re trying to cut down on extra chemicals, then yes, you will get very few in deodorant rocks, compared to the very many in spray-on or roll-on deodorants!
Soap and water is a safe, simple, and sufficient alternative: True or False?
True or False, depending on what you want as a result!
- If you care that your deodorant also functions as an antiperspirant, then no, soap and water will certainly not have an antiperspirant effect.
- If you care only about washing off bacteria and eliminating odor for the next little while, then yes, soap and water will work just fine.
Bonus myths:
There is no difference between men’s and women’s deodorants, apart from the marketing: True or False?
False! While to judge by the marketing, the only difference is that one smells of “evening lily” and the other smells of “chainsaw barbecue” or something, the real difference is…
- The “men’s” kind is designed to get past armpit hair and reach the skin without clogging the hair up.
- The “women’s” kind is designed to apply a light coating to the skin that helps avoid chafing and irritation.
In other words… If you are a woman with armpit hair or a man without, you might want to ignore the marketing and choose according to your grooming preferences.
Hopefully you can still find a fragrance that suits!
Shaving (or otherwise depilating) armpits is better for hygiene: True or False?
True or False, depending on what you consider “hygiene”.
Consistent with popular belief, shaving means there is less surface area for bacteria to live. And empirically speaking, that means a reduction in body odor:
However, shaving typically causes microabrasions, and while there’s no longer hair for the bacteria to enjoy, they now have access to the inside of your skin, something they didn’t have before. This can cause much more unpleasant problems in the long-run, for example:
❝Hidradenitis suppurativa is a chronic and debilitating skin disease, whose lesions can range from inflammatory nodules to abscesses and fistulas in the armpits, groin, perineum, inframammary region❞
Read more: Hidradenitis suppurativa: Basic considerations for its approach: A narrative review
And more: Hidradenitis suppurativa: Epidemiology, clinical presentation, and pathogenesis
If this seems a bit “damned if you do; damned if you don’t”, this writer’s preferred way of dodging both is to use electric clippers (the buzzy kind, as used for cutting short hair) to trim hers down low, and thus leave just a little soft fuzz.
What you do with yours is obviously up to you; our job here is just to give the information for everyone to make informed decisions whatever you choose 🙂
Take care!
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Tips for Improving Memory
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Q&A with 10almonds Subscribers!
Q: Any tips, other than supplements, for improving memory?
A: So many tips! Certainly enough to do a main feature on, so again maybe we’ll do that in another issue soon. Meanwhile, here are the absolute most critical things for you to know, understand, and apply:
- Memory is a muscle. Not literally, but in the sense that it will grow stronger if exercised and will atrophy if neglected.
- Counterpart of the above: your memory is not a finite vessel. You can’t “fill it up with useless things”, so no need to fear doing so.
- Your memory is the product of countless connections in your brain. The more connections lead to a given memory, the more memorable it will be. What use is this knowledge to you? It means that if you want to remember something, try to make as many connections to it as possible, so:
- Involve as many senses as possible.
- When you learn things, try to learn them in context. Then when your mind has reason to think about the context, it’ll be more likely to remember the thing itself too.
- Rehearsal matters. A lot. This means repeatedly going over something in your head. This brings about the neural equivalent of “muscle memory”.
- Enjoy yourself if you can. The more fun something is, the more you will mentally rehearse it, and the more mental connections you’ll make to it.
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