Managing [E-word] Dysfunction Reactions
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!
As for questions we’re answering today…
Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?
When it comes to that particular issue, one or more of these three factors are often involved:
- Hormones
- Circulation
- Psychology
The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.
To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:
Hormones
Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.
This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.
Circulation
Look after your heart health; eat for your heart health, and exercise regularly!
Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.
Psychology
[E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!
Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).
So, to recap, we recommend:
- Have your hormones checked
- Look after your circulation
- Make the decision to have fun!
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Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm
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In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.
Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.
Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.
However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.
What does the evidence say?
One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.
Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.
Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).
A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.
Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.
What about the harms?
The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.
A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.
We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.
In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.
More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.
Chronic back pain can be debilitating. CGN089/Shutterstock High costs
The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.
Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.
Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.
Industry influence
If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.
Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.
In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.
A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.
It’s not all bad news
Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.
New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.
If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.
Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hearty Healthy Ukrainian Borscht
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In the West, borscht is often thought of as Russian, but it is Ukrainian in origin and popular throughout much of Eastern Europe, with many local variations. Today’s borscht is a vegetarian (and vegan, depending on your choice of cooking fat) borscht from Kyiv, and it’s especially good for the gut, heart, and blood sugars.
You will need
- 1 quart vegetable stock; ideally you made this yourself from vegetable offcuts you kept in the freezer, but failing that, your supermarket should have low-sodium stock cubes
- 4 large beets, peeled and cut into matchsticks
- 1 can white beans (cannellini beans are ideal), drained and rinsed
- 1 cup sauerkraut
- 1 large onion, finely chopped
- 1 green bell pepper, roughly chopped
- 1 large russet potato, peeled and cut into large chunks
- 3 small carrots, tops removed and cut into large chunks
- 1 tbsp tomato paste
- ½ bulb garlic, finely chopped
- 2 tsp black pepper, coarse ground
- 1 bunch fresh dill, chopped. If you cannot get fresh, substitute with parsley (1 bunch fresh, chopped, or 1 tbsp dried). Do not use dried dill; it won’t work.
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point, though that latter shouldn’t be necessary here if you are attentive with the stirring. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has arguably too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
- On standby: a little vinegar (your preference what kind)
Salt is conspicuous by its absence, but there should be enough already from the other ingredients, especially the sauerkraut.
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a large sauté pan (cast iron is perfect if you have it), add the onion and pepper, and stir until the onion is becoming soft.
2) Add the carrots and beets and stir until they are becoming soft. If you need to add a little more oil, that’s fine.
3) Add the tomato paste, and stir in well.
4) Add a little (about ½ cup) of the vegetable stock and stir in well until you get a consistent texture with the tomato paste.
5) Add the sauerkraut and the rest of the broth, and cook for about 20 minutes.
6) Add the potatoes and cook for another 10 minutes.
7) Add the beans and cook for another 5 minutes.
8) Add the garlic, black pepper, and herbs. Check that everything is cooked (poke a chunk of potato with a fork) and that the seasoning is to your liking. The taste should be moderately sour from the sauerkraut; if it is sweet, you can stir in a little vinegar now to correct that.
9) Serve! Ukrainian borscht is most often served hot (unlike Lithuanian borscht, which is almost always served cold), but if the weather’s warm, it can certainly be enjoyed cold too:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Eat More (Of This) For Lower Blood Pressure
- No, Beetroot Isn’t Vegetable Viagra. But Here’s What It Can Do
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal
Take care!
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10 Lessons For A Healthy Mind & Body
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Sadia Badiei, food scientist of “Pick Up Limes” culinary fame, has advice in and out of the kitchen:
Pick up a zest for life
Here’s what she picked up, and we all can too:
- “I can’t do it… yet”: it’s never too late to adopt a growth mindset by adding “yet” to your self-doubt, focusing on progress and the possibility of improvement.
- The spotlight effect: people are generally too absorbed in their own lives to focus on you, so don’t worry too much about others’ perceptions.
- Nutrition by addition: focus on adding healthier foods to your diet rather than eliminating the less healthy ones to avoid restrictive mindsets. You can still eliminate the less healthy ones if you want to! It just shouldn’t be the primary focus. Focusing on a conceptually negative thing is rarely helpful.
- It’s ok to change: embrace change as a sign of growth and evolution, rather than seeing it as a failure or waste of time.
- The way you do one thing is the way you do everything: be mindful of how you approach small tasks, regular tasks, boring tasks, unwanted tasks—you can either create a habit of enthusiasm or a habit of suffering (it’s entirely your choice which)
- Setting goals for success: set goals based on actions you can control (inputs) rather than outcomes that are uncertain. Less “lose 10 lbs”, and more “eat fiber before starch”, for example.
- You probably can’t have it all at once: you can achieve all your dreams, but often not simultaneously; goals and desires unfold in stages over time.
- The five-year rule: before adopting a new lifestyle or habit, ask yourself if you can realistically sustain it for five years to ensure it’s not just a short-term fix. If you struggle with this prognostic, look backwards first instead. Which healthy habits have you maintained for decades, and which were you never able to make stick?
- Are you afraid or excited?: reframe fear as excitement, as both emotions share similar physical sensations and signify that you care about the outcome.
- The voice you hear most: speak kindly to yourself in self-talk to create a softer, more compassionate tone. Your subconscious is always listening, so reinforce healthy rather than unhealthy thought patterns.
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
80-Year-Olds Share Their Biggest Regrets
Take care!
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How To Heal And Regrow Receding Gums
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Hey Sheila – As always, your articles are superb !! So, I have a topic that I’d love you guys to discuss: green tea. I used to try + drink it years ago but I always got an allergic reaction to it. So the question I’d like answered is: Will I still get the same allergic reaction if I take the capsules ? Also, because it’s caffeinated, will taking it interfere with iron pills, other vitamins + meds ? I read that the health benefits of the decaffeinated tea/capsules are not as great as the caffeinated. Any info would be greatly appreciated !! Thanks much !!❞
Hi! I’m not Sheila, but I’ll answer this one in the first person as I’ve had a similar issue:
I found long ago that taking any kind of tea (not herbal infusions, but true teas, e.g. green tea, black tea, red tea, etc) on an empty stomach made me want to throw up. The feeling would subside within about half an hour, but I learned it was far better to circumvent it by just not taking tea on an empty stomach.
However! I take an l-theanine supplement when I wake up, to complement my morning coffee, and have never had a problem with that. Of course, my physiology is not your physiology, and this “shouldn’t” be happening to either of us in the first place, so it’s not something there’s a lot of scientific literature about, and we just have to figure out what works for us.
This last Monday I wrote (inspired in part by your query) about l-theanine supplementation, and how it doesn’t require caffeine to unlock its benefits after all, by the way. So that’s that part in order.
I can’t speak for interactions with your other supplements or medications without knowing what they are, but I’m not aware of any known issue, beyond that l-theanine will tend to give a gentler curve to the expression of some neurotransmitters. So, if for example you’re talking anything that affects that (e.g. antidepressants, antipsychotics, ADHD meds, sleepy/wakefulness meds, etc) then checking with your doctor is best.
❝Can you do something on collagen and keep use posted on pineapple, and yes love and look forward to each issue❞
Glad you’re enjoying! We did write a main feature on collagen a little while back! Here it is:
We Are Such Stuff As Fish Are Made Of
As for pineapple, there’s not a lot to keep you posted about! Pineapple’s protein-digesting, DNA-unzipping action is well-established and considered harmless (if your mouth feels weird when you eat pineapple or drink pineapple juice, this is why, by the way) because no meaningful damage was done.
For example:
- Pineapple’s bromelain action is akin to taking apart a little lego model brick by brick (easy to fix)
- Clastogenic genotoxicity is more like taking a blowtorch to the lego model (less easy to fix)
Fun fact: pineapple is good against inflammation, because of the very same enzyme!
❝I never knew anything about the l- tea. Where can I purchase it?❞
You can get it online quite easily! Here’s an example on Amazon
❝The 3 most important exercises don’t work if you can’t get on the floor. I’m 78, and have knee replacements. What about 3 best chair yoga stretches? Love your articles!❞
Here are six!
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Try This At Home: ABI Test For Clogged Arteries
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.
Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.
The Ankle-Brachial Index Test
Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:
- A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
- Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
- High ABI scores (above 1.4) may indicate artery hardening
Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).
If you need a blood pressure monitor, by the way, here’s an example product on Amazon.
Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.
For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
Don’t Forget…
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Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
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The Alzheimer’s Gut-Brain Connection—Caught On X-Ray!
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.
We’ve written before about Alzheimer’s disease (a lot), and if you’re just joining us, then a great place to start is here:
How To Reduce Your Alzheimer’s Risk
We’ve also written about gut health (a lot), and if you’re just joining us, then a great place to start is here:
Make Friends With Your Gut! (Here’s Why & How)
And as a hat trick, yes, we’ve also written (admittedly not as much) about the gut-brain connection; here’s a primer:
The Brain-Gut Highway: A Two-Way Street
Because of how gut microbes influence brain function, behavior, and cognition, scientists wondered whether one’s microbiome might play a role in Alzheimer’s development. Recently, scientists from Italy’s Institute of Nanotechnology, working with the European Synchrotron Radiation Facility (ESRF), found some concrete answers:
How gut health affects Alzheimer’s
When the gut loses its healthy balance of bacteria, harmful bacteria (and fungi, like C. albicans, also popularly called by its first name, “Candida”) take the wheel. This problem (called “dysbiosis”) allows harmful microbes to produce toxic substances, leading to inflammation and weakening the protective barriers between the gut and brain.
In some cases, like the aforementioned C. albicans, they’ll even put roots through your gut wall (and interact with your nervous system, and they are a common reason for sugar and alcohol cravings—your CNS has literally been hacked by a fungal colony that wants sugar (including the sugar that occurs when alcohol is broken down—and that’s without considering the fact that alcohol also kills several of C. albicans competitors that rank amongst the “good bacteria”). Suffice it to say, the holes it puts in your gut wall aren’t great for the health either.
In any case, once the gut barrier is breached, it’s been hypothesized that harmful bacteria may even travel to the brain, triggering Alzheimer’s.
How the x-rays helped
To better understand gut changes in Alzheimer’s, scientists used a technique called nano- and micro- x-ray phase-contrast tomography (XPCT) at the aforementioned ESRF. That very fancy string of words refers to a commensurately powerful imaging method, which allows researchers to see detailed structures inside the gut without damaging tissue, or even adding contrast agents (like those unpleasant drinks that are sometimes required to be taken before soft-tissue x-rays).
The study examined gut samples from mice with Alzheimer’s (so yes, this does need to be repeated with humans, but in this case there’s no obvious reason why it shouldn’t be the same).
The scans revealed important changes in gut structures, including:
- The tiny finger-like villi and corresponding crypts in the gut lining
- Important cells* that help with digestion and protection
- Neurons involved in gut function
*e.g. Paneth cells, goblet cells, telocytes, and erythrocytes, all of whom would take more explanation than we have room for here, but suffice it to say they’re important to both digestion and correct mucus production (bearing in mind, mucus membranes are one of the main physical barriers to harmful bacteria—as humans, our conscious interactions with mucus are usually only the nuisance that occurs when we get a cold or something, but rest assured, mucus keeps us alive).
In short, all these findings suggest (we’d say “show”, but technically cause and effect have not been proven) gut health indeed plays a crucial role in Alzheimer’s disease pathogenesis and pathology (i.e., how the disease begins and progresses, respectively).
Why it matters
To quote Dr. Alessia Cedola,
❝This technique represents a real breakthrough for the thorough analysis of the gut, and it could be pivotal in early detection and prognosis of the disease.
By gaining a deeper understanding of these processes, we hope to identify new therapeutic targets and develop innovative treatments for this devastating disease.❞
In short: the technology can be used as a super-early diagnostic tool, and ultimately, improve prevention (by encouraging people to focus on gut health) as well as, hopefully, leading to new treatments, too.
Want to see it?
Here’s the paper itself, where there are also abundant very clear images:
Are you on top of your gut health already?
If not, do refer back to that first link we dropped about gut health, up top!
If you are already sure you’re looking after your gut and want to do something else to avoid Alzheimer’s coming to call, you might want to consider:
How To Clean Your Brain (Glymphatic Health Primer) ← your glymphatic system, something many people neglect, is the brain’s cleanup crew, and removes things like the beta-amyloid proteins that are implicated in Alzheimer’s pathogenesis. So, it’s worth knowing how to keep it in working order!
Take care!
Don’t Forget…
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