Low-Dose Aspirin & Anemia
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We recently wrote about…
How To Survive A Heart Attack When You’re Alone
…and one of the items was “if you have aspirin readily available, then after calling an ambulance is the time to take it—but don’t exert yourself trying to find some”.
But what of aspirin as a preventative?
Many people take low-dose aspirin daily as a way to reduce the risk of atherothrombosis specifically (and thus, indirectly, they hope to reduce the risk of heart attacks).
The science of how helpful this is both clear and complicated—that is to say, the stats are not ambiguous*, but there are complicating factors of which many people are unaware.
*it will reduce the overall risk of cardiovascular events, but will not affect CVD mortality; in other words, it may improve your recovery from minor cardiac events, but is not likely to save you from major ones.
And also, it has unwanted side effects that can constitute a more relevant threat for many people. We’ll share more on that at the end of today’s article, but first…
A newly identified threat from daily aspirin use
A large (n=313,508) study of older adults (median age 73) were sorted into those who used low-dose aspirin as a preventative, and those who did not.
The primary outcome was incidence of anemia sufficient to require treatment, and the secondary outcome was major bleeding. And, at least 1 in 5 of those who experienced anemia also experienced bleeding.
The bleeding issue was not “newly identified” and will not surprise many people; after all, the very reason that aspirin is taken as a CVD preventative is for its anti-clotting property of allowing blood to flow more freely.
The anemia, however, has been getting increasing scientific scrutiny lately, after long going unnoticed in the wild. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
Here’s the paper itself:
Want to know more?
As promised, here’s what we wrote previously about some of aspirin’s other risks:
Aspirin, CVD Risk, & Potential Counter-Risks
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Can You Reverse Gray Hair? A Dermatologist Explains
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Betteridge’s Law of Headlines states “any headline that ends in a question mark can be answered by the word no“—it’s not really a universal truth, but it’s true surprisingly often, and, as board certified dermatologist “The Beauty MD” Dr. Sam Ellis explains, it’s true in this case.
But, all is not lost.
Physiological Factors
Hair color is initially determined by genes and gene expression, instructing the body to color it with melanin (brown and black) and/or pheomelanin (blonde and red). If and when the body produces less of those pigments, our hair will go gray.
Factors that affect if/when our hair will go gray include:
- Genetics: primary determinant, essentially a programmed change
- Age: related to the above, but critically, the probability of going gray in any given year increases with age
- Ethnicity: the level of melanin in our skin is an indicator of how long we are likely to maintain melanin in our hair. Black people with the darkest skintones will thus generally go gray last, whereas white people with the lightest skintones will generally go gray first, and so on for a spectrum between the two.
- Medical conditions: immune conditions such as vitiligo, thyroid disease, and pernicious anemia promote an earlier loss of pigmentation
- Stress: oxidative stress, mainly, so factors like smoking will cause earlier graying. But yes, also chronic emotional stress does lead to oxidative stress too. Interestingly, this seems to be more about norepinephrine than cortisol, though.
- Nutrient deficiencies: the body can make a lot of things, but it needs the raw ingredients. Not having the right amounts of important vitamins and minerals will result in a loss of pigmentation (amongst other more serious problems). Vitamins B6, B9, and B12 are talked about in the video, as are iron and zinc. Copper is also needed for some hair colors. Selenium is needed for good hair health in general (but not too much, as an excess of selenium paradoxically causes hair loss), and many related things will stop working properly without adequate magnesium. Hair health will also benefit a lot from plenty of vitamin B7.
So, managing the above factors (where possible; obviously some of the above aren’t things we can influence) will result in maintaining one’s hair pigment for longer. As for texture, by the way, the reason gray hair tends to have a rougher texture is not for the lack of pigment itself, but is due to decreased sebum production. Judicious use of exogenous hair oils (e.g. argan oil, coconut oil, or whatever your preference may be) is a fine way to keep your grays conditioned.
However, once your hair has gone gray, there is no definitive treatment with good evidence for reversing that, at present. Dye it if you want to, or don’t. Many people (including this writer, who has just a couple of streaks of gray herself) find gray hair gives a distinguished look, and such harmless signs of age are a privilege not everyone gets to reach, and thus may be reasonably considered a cause for celebration
For more on all of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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What Does Kaempferol Do, Anyway?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝In the this or that article, you said kampeferol was a famously good flavonol on a par with quercetin, does it do the same thing or does it do something different, and is it worth supplementing?❞
So, this will be in reference to a This-or-That from last week:
Cantaloupe vs Cucumber – Which is Healthier?
Let’s break down your question into parts:
- Is it comparable to quercetin?
- Does it have special properties of its own?
- Is it worth supplementing?
Is it comparable to quercetin?
They are both flavonols, and potent ones at that. Similarities include that they’re found in many of the same plants, and that (like most if not all polyphenols) they have antioxidant and anti-inflammatory benefits, which in turn usually translate to anti-aging and anticancer benefits too.
You can read more about quercetin here: Fight Inflammation & Protect Your Brain, With Quercetin
You can read more about polyphenols in general here: 21 Most Beneficial Polyphenols & What Foods Have Them ← quercetin and kaempferol are #1 and #2 on this list, respectively
Does it have special properties of its own?
Yes it does!
❝Epidemiological studies have shown an inverse relationship between kaempferol intake and cancer.
Kaempferol may help by augmenting the body’s antioxidant defense against free radicals, which promote the development of cancer.
At the molecular level, kaempferol has been reported to modulate a number of key elements in cellular signal transduction pathways linked to apoptosis, angiogenesis, inflammation, and metastasis.
Significantly, kaempferol inhibits cancer cell growth and angiognesis and induces cancer cell apoptosis, but on the other hand, kaempferol appears to preserve normal cell viability, in some cases exerting a protective effect.❞
Read in full: A review of the dietary flavonoid, kaempferol on human health and cancer chemoprevention
It is also particularly good for the gut:
❝Most recently, an increasing number of studies have demonstrated the significance of kaempferol in the regulation of intestinal function and the mitigation of intestinal inflammation❞
Read in full: A Critical Review of Kaempferol in Intestinal Health and Diseases
This also means it is particularly efficacious against food allergies:
❝we screened food ingredients with the expectation of finding dietary compounds that exert beneficial effects on intestinal immune tolerance and identified kaempferol, a flavonoid, as the compound that most effectively increased Aldh1a2 mRNA levels❞
(that’s good)
That one’s a bit scientifically denser than we usually try to find when citing sources here, so here’s a pop-science article about the same thing, which explains in more words than we have room to here:
Flavonoid kaempferol could offer natural relief for food allergies ← much lighter reading, but still very informative
Kaempferol (like quercetin, granted) is also a potent neuroprotective agent, not least of all because its anti-inflammatory powers extend to reducing neuroinflammation (not everything does, because not everything we ingest can pass the blood-brain barrier to affect what goes on in the brain):
…and more:
❝it may be used to treat numerous acute and chronic inflammation-induced diseases, including intervertebral disc degeneration and colitis, as well as post-menopausal bone loss and acute lung injury. In addition, it has beneficial effects against cancer, liver injury, obesity and diabetes, inhibits vascular endothelial inflammation, protects the cranial nerve and heart function, and may be used for treating fibroproliferative disorders, including hypertrophic scar.❞
Read in full: Recent progress regarding kaempferol for the treatment of various diseases
Is it worth supplementing?
If you eat a lot of leafy greens, cruciferous vegetables, and/or citrus fruits, and/or drink tea (true teas from tea plants, not miscellaneous herbal infusions), then you probably get a good dose of kaempferol already.
However, if you want to supplement, hawthorn berry is not a bad one to go with, like this example product on Amazon 😎
We wrote about this before, here: Hawthorn For The Heart (& More)
As for teas, if you’re wondering about the merits of black, white, green or red, check out:
Black, White, Green, Red: Which Kind Of Tea Is Best For The Health, According To Science? ← this covers many factors
Enjoy!
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Fall Special
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Some fall-themed advice…
It is now, nominally at least, fall. We’re going to talk about the other kind of “fall” though, the kind that results in broken hips and more.
If you’re thinking “not me; that happens to older more infirm people”, rest assured, it can and statistically probably will happen to you at some point. So, how to play the odds?
First, be robust!
We may not be able to make ourselves like children who bounce easily, but we also don’t have to crumble into dust at the slightest knock, either. There are two important ways we can start to make ourselves robust from the inside out, and they are simple: diet and exercise.
- Diet: The Bare-Bones Truth About Osteoporosis
- Exercise: Osteoporosis Exercises
“But I don’t have osteoporosis”—great! But osteoporosis is preceded by osteopenia, which is generally asymptomatic at first, and also if we’re not very careful about it, we will lose about 1% bone density per year from the age of about 35 onwards, with that rate of loss climbing sharply from the age of 50 onwards, and even more steeply in cases of untreated menopause.
So in other words, don’t take your bone strength for granted; there’s a first time for everything, and you don’t want to find out the hard (and yet, dare we say it, brittle) way.
Second, be dynamic!
Be able to fall and get up safely. If your later life is going to be a triathlon of things you need to train for now, then being able to fall and get up safely should be at the top of the list.
Being able to “deep squat” will help you a lot here, in being able to get up with minimal (or no) use of your hands. We shared a great instructional video about this last week.
It also means that the more your lower body can still take your weight while your torso is closer to the ground (without your legs buckling and collapsing, for instance), the softer and gentler you’ll hit the floor if you do fall, because the final “drop” will be from a lower height.
If at all possible, consider taking some classes of a martial art that involves safely falling—aikido is typically the softest and gentlest and is famously great for people of all ages, but judo or jujitsu will suffice if aikido isn’t available where you are. You don’t have to get a black belt (unless you want to), and any decent instructor will be happy to guide you through the basics of safely falling and then send you on your merry way, if that’s all you wanted.
The benefits of this are twofold:
- Obviously, if you fall, you will have better technique and thus be less likely to incur injury
- As you are falling, you will be less afraid, and thus less likely to tense up mid-fall (tensing up will exacerbate any falling injury)
Click here to find an aikido teacher near you (you can search by country, state, and city)
Third, be balanced!
Spending even just a few minutes each day working on your balance can go a long way.
Standing on one leg (and then the other) is a very good obvious starting point. Please, do so safely. The shower is not the best place to take up this practice, for instance. A nice safe grassy area is great. Your carpeted living room or bedroom is next-best.
Another great approach is the practice of bāguàzhǎng circle-walking.
Bāguà is tai chi’s lesser-known cousin, and those arts are two of the three main schools of wǔdāngquán. But, fear not, you don’t have to don orange robes and live atop the Wudang mountains to get what you need in this case.
To give a text-based summary: bāguàzhǎng circle-walking involves walking in a small circle, with a low center of gravity, moving one’s weight very purposefully from one leg to the other, keeping complete stability the whole time that one is (often!) on one leg.
Once you get good at this, you’ll see that this is essentially a super-enhanced version of the “standing on one leg” exercise, because it’s about keeping balance while on one leg, and/but while moving also.
Naturally, if you do get good at this, you’ll be very unlikely to fall in the first place.
Here’s a visual primer. This video will show the basic footwork, and the video that follows it (it’ll prompt you if you want to watch it) shows how to bring it up to a standard walking speed, without losing fluidity of movement:
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Will Ozempic-style patches help me lose weight? 2 experts explain
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Could a simple patch, inspired by the weight-loss drug Ozempic, really help you shed excess kilos without the pain and effort of an injection?
Promotions of these Ozempic-style, weight-loss patches are popping up online, promising dramatic results with little evidence to back their claims.
Personal recommendations for the patches are common. This includes from some “doctors” on social media. But independent fact checkers have shown these endorsements are AI-generated.
So, before you spend your money, here’s why you should think twice about buying a weight-loss patch.
Independent fact checkers show this endorsement of weight loss patches has been generated by AI. Full Fact/Facebook Kate Wieser/Getty What’s in them? Do they work?
Ozempic-style patches are also known as GLP-1 patches. But they do not contain any pharmaceutical ingredient from Ozempic (semaglutide) or related drugs such as Mounjaro (tirzepatide).
Instead, the Ozempic-style patches contain a mixture of herbal extracts including berberine, green tea (Camellia sinensis), the tropical fruit Garcinia cambogia and bitter orange (Citrus x aurantium L.).
There is some laboratory evidence that select compounds from berberine, the polyphenols in green tea extract and hydroxycitric acid from G. cambogia may have some effect. This includes suppressing appetite, lowering blood glucose (sugar) levels and playing a role in regulating fat metabolism to promote weight loss.
However, laboratory evidence doesn’t automatically translate to what happens in humans. In fact, recent evidence in humans shows these herbs have little effect on weight loss.
Let’s take berberine. Mostly, the evidence indicates that people who take it don’t lose a lot of weight. One scientific review showed that taking up to 3 grams daily for a year had only a small effect on weight and waist circumference.
Another review that analysed data from multiple studies found that up to 2.4g of green tea extract supplement daily for 13 weeks and more than 4g of G. cambogia daily for 17 weeks did not affect people’s weight.
For bitter orange extract, a daily dose of up to 54 milligrams of synephrine (a compound isolated from bitter orange extract) for eight weeks did not lead to weight loss.
It is important to note that all these studies are for oral formulations of herbal extracts, such as tablets or capsules, rather than for extracts delivered by patches.
Do they get through the skin?
Whether an extract in a weight-loss patch gets through the skin depends on how the extract was made.
Our skin is highly lipophilic, meaning it absorbs oily or fat-soluble chemicals, and blocks water-loving, or hydrophilic, substances.
So not all medicines can be delivered through the skin. Ozempic, for instance, is administered as an injection because the drug molecule in it is too big and water-loving to pass through the skin.
If the extracts in the patches are made using a water-based process, their ingredients are unlikely to pass through the skin and will simply sit inactive on your body until you remove the patch.
The next issue is that patches can only hold very little herbal extract. In the studies we discussed above, grams of material were needed to see any effect. In reality, Ozempic-style patches typically hold less than 0.1g of extract.
So, even if the ingredients get through the skin, these patches don’t contain enough to have any meaningful effect.
You can’t assume patches are safe
The Therapeutic Goods Administration regulates medical products in Australia, including herbal extracts.
For a herbal product to be permitted for sale in Australia it must be listed on the Australian Register of Therapeutic Goods. There are no Ozempic-style patches on the register.
This means the quality and safety of any patch you buy has not been assessed and cannot be guaranteed.
An Australian study found instances where contamination with undeclared plant materials, heavy metals and prescription drugs, such as warfarin, have been reported in unregistered herbal products. These contaminants are dangerous because they can potentially be absorbed through the skin, then circulate around the body.
In a nutshell
While the idea of Ozempic-style weight-loss patches might seem appealing, they do not work, and their safety is far from guaranteed.
Instead of wasting your money, speak to your doctor or pharmacist who can recommend proven treatments for weight loss. They can provide safe and effective options tailored to help you reach your health goal.
Nial Wheate, Professor, School of Natural Sciences, Macquarie University and Wai-Jo Jocelin Chan, Pharmacist and Lecturer, UNSW Sydney; University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Ageless Brain – by Dr. Dale Bredesen
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We previously reviewed this author’s groundbreaking “The End of Alzheimer’s”, and now in this volume he expands on the work done there, to focus on the practical aspect of, as the subtitle promises, how to sharpen and protect your mind for a lifetime.
When we say “groundbreaking”, this is because it’s not just the usual same old things (that are very important, and/but probably quite well-known to most 10almonds readers), but rather, 36 metabolic factors that are implicated in Alzheimer’s pathology, and the good news is, most of them are within our control.
He explores these, and how to tweak them to our advantage, through much of the first half of the book, before getting to more general advice—some of which is the “same old things”, but some are factors that at best, don’t get much attention: like the relationship between oral health and cognitive health, for example.
The style is more varied this time; sometimes once again on the hard end of pop science, since there’s a lot of technical clinical data and information in here, but he does explain everything as we go, making it still quite readable for the layperson; sometimes, on the other hand, it’s quite light and narrative in style. The author being a physician-scientist in his 70s, he has a lot of experience and that means a lot of stories to tell to illustrate his points.
Bottom line: if you’d like to protect your brain with the very latest science in a comprehensive fashion, this book will enable you to do just that.
Click here to check out The Ageless Brain, and defy brain aging!
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How To Make Your Doctor’s Appointment Do More For You
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Doctor: “So, how are you today?”
Patient: “Can’t complain; how about you?”Hopefully your medical appointments don’t start quite like that, but there can be an element of being “along for the ride” when it comes to consultations. They ask questions, we answer, they prescribe something, we thank them.
In principle, the doctor should be able to handle that; ask the right questions, determine the problem, and not need too much from you. After all, they have been trained to deal with an unconscious patient, so the fact you can communicate at all is a bonus.
However, leaving it all to them isn’t really playing the field.
Before the appointment
Research your issue, as best you understand it. Some doctors will be very averse to you telling them about having done this (taking it as an affront to their expertise), but here’s the thing:
You don’t have to tell them.
You just have to understand as much as possible, so that you will be as “up to speed” as possible in the conversation, and not be quickly out of your depth.
Have an agenda, based on the above. Literally, have a little set of bullet-points to remind you what you came in to discuss, so that nothing escapes you in the moment. This should also include:
- If you have additional reasons for a particular concern (e.g. family history of a certain problem), make them known
- If you plan to request any specific tests or treatments, be able to clearly state your reasons for the specific tests or treatments
- If you plan to write off any specific tests or treatments as something to which you will not consent, have your reasons ready—in a way that makes it clear it’s something more than “don’t want it”, for example, “I’ve already decided that this treatment would make a sufficient hit to my quality of life, as to make it not worthwhile for me personally” (or whatever the reason may be for you). It needs to be something they can write on their notes instead of simply “patient refused treatment”.
Compile a record of your symptoms (as appropriate), and any previous tests/treatments (as appropriate), in chronological order. If you take all this with you, perhaps in a nice folder, you will enjoy the following advantages:
- not forgetting anything
- ability to answer questions accurately
- give the (correct) impression you take your health seriously, which means they are more likely to do so also—especially because they will now know that if they fob you off and/or mess something up, you’ll be taking a record of that to your next appointment.
Plan your outfit. No, you don’t have to dress for the red carpet, but you want to satisfy two main conditions:
- Accessibility for examination (for example, if you are going in with a knee pain, maybe don’t wear the tight jeans today; if they’re going to take blood, be either sleeveless or have sleeves that are easily moved out of the way, etc)
- General presentability (it’s a sad fact that doctors are not immune to biases, and will treat people better if they respect them more)
During the appointment
Be friendly; doctors (like most people) will respond much better to that than to grumpiness—even if you have good reason for grumpiness and even if the doctor has been trained to help grumpy patients.
Be confident: when we say “be friendly”, that doesn’t mean to necessarily be so agreeable as to not advocate for yourself. In particular:
- If they explain something and it isn’t clear to you, ask them to clarify
- If you disagree with them about a value judgement, say so. By “a value judgement” here we mean things in the realm of subjectivity. If the doctor says you are prediabetic, then you won’t get much mileage out of arguing otherwise; the numbers have the final say on that one. But if the doctor says “the side effects of the treatment you’re requesting will make it not worthwhile for you” and you have understood the side effects and you still disagree, then your opinion counts for more than theirs—it is your decision to make.
- If they dismiss a concern, ask them to put in writing that they dismissed your concern of X, despite you providing evidence that Y, and it being well-known that Z. Often, rather than doing that, they’ll just fold and actually address your concern instead.
Writer’s example in that last category: I recently made a request for a bone density scan. I expect my bone density is great, because I do all the right things, however, as both of my parents suffered from osteoporosis and assorted resultant crushed bones and the terrible consequences thereof, I a) have reasonable grounds for extra concern, and b) I believe that even if my bone density is fine now, it’s good to establish a baseline so I can know, in 5, 10, 20 years etc, whether there has been any deterioration. Now, happily the doctor I saw agreed with my assessment at first presentation and so I got the referral, but had she not been, I would have said “Could you please put in writing that I asked for a bone density scan, and you refused, on the grounds that [details about what happened with my parents], and that osteoporosis is known to have a strong genetic component is not, in your opinion, any reason to worry?”
Be honest, and/but err on the side of overstating your symptoms rather than understating. For example, if it is about a chronic condition and the doctor asks “are you able to do xyz”, take the question as meaning “are you able to do xyz on your worst days?”. You can clarify that if you like in your answer, but you need to include the information that xyz is something that your condition can and sometimes does impede you from doing.
Leave your embarrassment at the door. To the doctor (unless they are a very unprofessional one), you really are just one more patient with symptoms they have (unless your condition is very rare) seen a thousand times before. If your symptom is embarrassing, it will not faze them and you definitely should not hold back from mentioning it, for example. This goes extra in the case of discussions around sexual health, by the way, in which field the details you’d perhaps rather not share with anybody, are the details they need to adequately treat you.
After the appointment
Follow up on anything that doesn’t happen as promised (e.g. referrals, things ordered, etc), to make sure nothing got lost in a bureacratic error.
Get a second opinion if you’re not satisfied with the first one. Doctors are fallible, and as a matter of professional pride, it’s likely the second doctor will be glad to find something the first doctor missed.
See also: Make Your Negativity Work For You
Take care!
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