Natural Alternatives for Depression Treatment
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Questions and Answers 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!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
Natural alternatives to medication for depression?
Great question! We did a mean feature a while back, but we definitely have much more to say! We’ll do another main feature soon, but in the meantime, here’s what we previously wrote:
See: The Mental Health First-Aid That You’ll Hopefully Never Need
^This covers not just the obvious, but also why the most common advice is not helpful, and practical tips to actually make manageable steps back to wellness, on days when “literally just survive the day” is one’s default goal.
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Intermittent Fasting, Intermittently?
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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 😎
❝Have you come across any research on alternate-day intermittent fasting—specifically switching between one day of 16:8 fasting and the next day of regular eating patterns? I’m curious if there are any benefits or drawbacks to this alternating approach, or if the benefits mainly come from consistent intermittent fasting?❞
Short and unhelpful answer: no
Longer and hopefully more helpful answer:
As you probably know, usually people going for approaches based on the above terms either
- practise 16:8 fasting (fast for 16 hours each day, eat during an 8-hour window) or
- practise alternate-day fasting (fast for 24 hours, eat whenever for 24 hours, repeat)
…which latter scored the best results in this large meta-analysis of studies:
There is also the (popular) less extreme version of alternate-day fasting, sometimes called “eat stop eat”, which is not a very helpful description because that describes almost any kind of eating/fasting, but it usually refers to “once per week, take a day off from eating”.
You can read more about each of these (and some other variants), here:
Intermittent Fasting: What’s The Truth?
What you are describing (doing 16:8 fasting on alternate days, eating whenever on the other days) is essentially: intermittent fasting, just with one 16-hour fast per 48 hours instead of per the usual 24 hours.
See also: International consensus on fasting terminology ← the section on the terms “STF & PF” covers why this gets nudged back under the regular IF umbrella
Good news: this means there is a lot of literature into the acute (i.e., occurring the same day, not long-term)* benefits of 16:8 IF, and that means that you will be getting those benefits, every second day.
You remember that meta-analysis we posted above? While it isn’t mentioned in the conclusion (which only praised complete alternate-day fasting producing the best outcomes overall), sifting through the results data discovers that time-restricted eating (which is what you are doing, by these classifications) was the only fasting method to significantly reduce fasting blood glucose levels.
(However, no significant differences were observed between any IF form and the reference (continuous energy restriction, CER, i.e. calorie-controlled) diets in fasting insulin and HbA1c levels)
*This is still good news in the long-term though, because getting those benefits every second day is better than getting those benefits on no days, and this will have a long-term impact on your healthy longevity, just like how it is better to exercise every second day than it is to exercise no days, or better to abstain from alcohol every second day than it is to abstain on no days, etc.
In short, by doing IF every second day, you are still giving your organs a break sometimes, and that’s good.
All the same, if it would be convenient and practical for you, we would encourage you to consider either the complete alternate-day fasting (which, according to a lot of data, gives the best results overall),or time-restricted eating (TRE) every day (which, according to a lot of data, gives the best fasting blood sugar levels).
You could also improve the TRE days by shifting to 20:4 (i.e., 20 hours fasting and 4 hours eating), this giving your organs a longer break on those days.
Want to learn more?
For a much more comprehensive discussion of the strengths and weaknesses of different approaches to intermitted fasting, check out:
Enjoy!
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How To Reduce Or Quit Alcohol
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Rethinking Drinking
When we’re looking at certain health risks, there are often five key lifestyle factors that have a big impact; they are:
- Have a good diet
- Get good exercise
- Get good sleep
- Reduce (or eliminate) alcohol
- Don’t smoke
Today, we’re focussing the alcohol bit. Maybe you’d like to quit, maybe just cut down, maybe the topic just interests you… So, here’s a quick rundown of some things that will help make that a lot easier:
With a big enough “why”, you can overcome any “how”
Research and understand the harm done by drinking, including:
And especially as we get older, memory problems:
Alcohol-related dementia: an update of the evidence
And as for fear of missing out, or perhaps even of no longer being relaxed/fun… Did you ever, while sober, have a very drunk person try to converse with you, and you thought “I wish that were me”?
Probably not
Know your triggers
Why do you drink? If your knee-jerk response is “because I like it”, dig deeper. What events prompt you to have a drink?
- Some will be pure habit born of convention—perhaps with a meal, for example
- Others may be stress-management—after work, perhaps
- Others may be pseudo-medicinal—a nightcap for better* sleep, for instance
*this will not work. Alcohol may make us sleepy but it will then proceed to disrupt that very sleep and make it less restorative
Become mindful
Now that you know why you’d like to drink less (or quit entirely), and you know what triggers you to drink, you can circumvent that a little, by making deals with yourself, for example
- “I can drink alcohol, if and only if I have consumed a large glass of water first” (cuts out being thirsty as a trigger to drink)
- “I can drink alcohol, if and only if I meditate for at least 5 minutes first” (reduces likelihood of stress-drinking)
- “I can drink alcohol, if and only if it is with the largest meal of the day” (minimizes total alcohol consumption)
Note that these things also work around any FOMO, “Fear Of Missing Out”. It’s easier to say “no” when you know you can have it later if you still want it.
Get a good replacement drink
There are a lot of alcohol-free alcohol-like drinks around these days, and many of them are very good. Experiment and see. But!
It doesn’t even have to be that. Sometimes what we need is not even an alcohol-like drink, but rather, drinkable culinary entertainment.
If you like “punch-in-the-face” flavors (as this writer does), maybe strong black coffee is the answer. If you like “crisp and clear refreshment” (again, same), maybe your favorite herbal tea will do it for you. Or maybe for you it’ll be lemon-water. Or homemade ginger ale.
Whatever it is… make it fun, and make it yours!
Bonus item: find replacement coping strategies
This one goes if you’ve been using alcohol to cope with something. Stress, depression, anxiety, whatever it may be for you.
The thing is, it feels like it helps briefly in the moment, but it makes each of those things progressively worse in the long-run, so it’s not sustainable.
Consider instead things like therapy, exercise, and/or a new hobby to get immersed in; whatever works for you!
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A Supplement To Rival St. John’s Wort Against Depression
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Do You Feel The SAMe?
S-Adeonsyl-L-Methionone (SAMe) is a chemical found naturally in the body, and/but enjoyed widely as a supplement. The main reasons people take it are:
- Improve mood (antidepressant effect)
- Improve joints (reduce osteoarthritis symptoms)
- Improve liver (detoxifying effect)
Let’s see what the science says for each of those claims…
Does it improve mood?
It seems to perform comparably to St. John’s Wort (which is good; it performs comparably to Prozac).
Best of all, it does this with fewer contraindications (St. John’s Wort has so many contraindications).
Here’s how they stack up:
This looks very promising, though it’d be nice to see a larger body of research, to be sure.
Does it reduce osteoarthritis symptoms?
The good news: it performs comparably to ibuprofen, with fewer side effects!
The bad news: it also performs comparably to placebo!
Read into that what you will about ibuprofen’s usefulness vs OA symptoms.
Read all about it:
S-Adenosylmethionine for osteoarthritis of the knee or hip
If you were hoping for something for OA or similar symptoms, you might like our previous main features:
- Avoiding/Managing Osteoarthritis
- Managing Chronic Pain (Realistically!)
- The 7 Approaches To Pain Management
- (Science-Based) Alternative Pain Relief
Does it help against liver disease?
According to adverts for SAMe: absolutely!
According to science: we don’t know
The science for this is so weak that it’d be unworthy of mention if it weren’t for the fact that SAMe is so widely sold as good against hepatotoxicity.
To be clear: maybe it really is great! Science hasn’t yet disproved its usefulness either.
It is popularly assumed to be beneficial due to there being an association between lower levels of SAMe in the body (remember, it is also produced inside our bodies) and development of liver disease, especially cholestasis.
Here’s an example of what pretty much every study we found was like (inconclusive research based mostly on mice):
S-adenosylmethionine in liver health, injury, and cancer
For other options for liver health, consider:
Is it safe?
Safety trials have been done ranging from 3 months to 2 years, with no serious side effects coming to light. So, it appears quite safe.
That said, as with anything, there are contraindications, such as:
- if you have bipolar disorder, skip this unless directed by your health care provider, because it may worsen the symptoms of mania
- if you are on SSRIs or other serotonergic drugs, it may interact with those
- if you are immunocompromised, you might want to skip it can increase the risk of P. carinii growth in such cases
As always, do speak with your doctor/pharmacist for personalized advice.
Summary
SAMe’s evidence-based qualities seem to stack up as follows:
- Against depression: good
- Against osteoarthritis: weak
- Against liver disease: unknown
As for safety, it has been found quite safe for most people.
Where can I get it?
We don’t sell it, but here is an example product on Amazon, for your convenience
Enjoy!
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Stop Pain Spreading
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Put Your Back Into It (Or Don’t)!
We’ve written before about Managing Chronic Pain (Realistically!), and today we’re going to tackle a particular aspect of chronic pain management.
- It’s a thing where the advice is going to be “don’t do this”
- And if you have chronic pain, you will probably respond “yep, I do that”
However, it’s definitely a case of “when knowing isn’t the problem”, or at the very least, it’s not the whole problem.
Stop overcompensating and address the thing directly
We all do it, whether in chronic pain, or just a transient injury. But we all need to do less of it, because it causes a lot of harm.
Example: you have pain in your right knee, so you sit, stand, walk slightly differently to try to ease that pain. It works, albeit marginally, at least for a while, but now you also have pain in your left hip and your lumbar vertebrae, because of how you leaned a certain way. You adjust how you sit, stand, walk, to try to ease both sets of pain, and before you know it, now your neck also hurts, you have a headache, and you’re sure your digestion isn’t doing what it should and you feel dizzy when you stand. The process continues, and before long, what started off as a pain in one knee has now turned your whole body into a twisted aching wreck.
What has happened: the overcompensation due to the original pain has unduly stressed a connected part of the body, which we then overcompensate for somewhere else, bringing down the whole body like a set of dominoes.
For more on this: Understanding How Pain Can Spread
“Ok, but how? I can’t walk normally on that knee!”
We’re keeping the knee as an example here, but please bear in mind it could be any chronic pain and resultant disability.
Note: if you found the word “disability” offputting, please remember: if it adversely affects your abilities, it is a disability. Disabilities are not something that only happen to other people! They will happen to most of us at some point!
Ask yourself: what can you do, and what can’t you do?
For example:
- maybe you can walk, but not normally
- maybe you can walk normally, but not without great pain
- maybe you can walk normally, but not at your usual walking pace
First challenge: accept your limitations. If you can’t walk at your usual walking pace without great pain and/or throwing your posture to the dogs, then walk more slowly. To Hell with societal expectations that it shouldn’t take so long to walk from A to B. Take the time you need.
Second challenge: accept help. It doesn’t have to be help from another person (although it could be). It might be accepting the help of a cane, or maybe even a wheelchair for “flare-up” days. Society, especially American society which is built on ideas of self-sufficiency, has framed a lot of such options as “giving up”, but if they help you get about your day while minimizing doing further harm to your body, then they can be good and even health-preserving things. Same goes for painkillers if they help you from doing more harm to your body by balling up tension in a part of your body in a way that ends up spreading out and laying ruin to your whole body.
Speaking of which:
How Much Does It Hurt? Get The Right Help For Your Pain
After which, you might want to check out:
The 7 Approaches To Pain Management
and
Science-Based Alternative Pain Relief
Third challenge: deserves its own section, so…
Do what you can
If you have chronic pain (or any chronic illness, really), you are probably fed up of hearing how this latest diet will fix you, or yoga will fix you, and so on. But, while these things may not be miracle cures…
- A generally better diet really will lessen symptoms and avoid flare-ups (a low-inflammation diet is a great start for lessening the symptoms of a lot of chronic illnesses)
- Doing what exercise you can, being mindful of your limitations yes but still keeping moving as much as possible, will also prevent (or at least slow) deterioration. Consider consulting a physiotherapist for guidance (a doctor will more likely just say “rest, take it easy”, whereas a physiotherapist will be able to give more practical advice).
- Getting good sleep may be a nightmare in the case of chronic pain (or other chronic illnesses! Here’s to those late night hyperglycemia incidents for Type 1 Diabetics that then need monitoring for the next few hours while taking insulin and hoping it goes back down) but whatever you can do to prioritize it, do it.
Want to read more?
We reviewed a little while ago a great book about this; the title sounds like a lot of woo, but we promise the content is extremely well-referenced science:
…and if your issue is back pain specifically, we highly recommend:
Healing Back Pain: The Mind-Body Connection – by Dr. John Sarno
Take care!
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This salt alternative could help reduce blood pressure. So why are so few people using it?
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One in three Australian adults has high blood pressure (hypertension). Excess salt (sodium) increases the risk of high blood pressure so everyone with hypertension is advised to reduce salt in their diet.
But despite decades of strong recommendations we have failed to get Australians to cut their intake. It’s hard for people to change the way they cook, season their food differently, pick low-salt foods off the supermarket shelves and accept a less salty taste.
Now there is a simple and effective solution: potassium-enriched salt. It can be used just like regular salt and most people don’t notice any important difference in taste.
Switching to potassium-enriched salt is feasible in a way that cutting salt intake is not. Our new research concludes clinical guidelines for hypertension should give patients clear recommendations to switch.
What is potassium-enriched salt?
Potassium-enriched salts replace some of the sodium chloride that makes up regular salt with potassium chloride. They’re also called low-sodium salt, potassium salt, heart salt, mineral salt, or sodium-reduced salt.
Potassium chloride looks the same as sodium chloride and tastes very similar.
Potassium-enriched salt works to lower blood pressure not only because it reduces sodium intake but also because it increases potassium intake. Insufficient potassium, which mostly comes from fruit and vegetables, is another big cause of high blood pressure.
What is the evidence?
We have strong evidence from a randomised trial of 20,995 people that switching to potassium-enriched salt lowers blood pressure and reduces the risks of stroke, heart attacks and early death. The participants had a history of stroke or were 60 years of age or older and had high blood pressure.
An overview of 21 other studies suggests much of the world’s population could benefit from potassium-enriched salt.
The World Health Organisation’s 2023 global report on hypertension highlighted potassium-enriched salt as an “affordable strategy” to reduce blood pressure and prevent cardiovascular events such as strokes.
What should clinical guidelines say?
We teamed up with researchers from the United States, Australia, Japan, South Africa and India to review 32 clinical guidelines for managing high blood pressure across the world. Our findings are published today in the American Heart Association’s journal, Hypertension.
We found current guidelines don’t give clear and consistent advice on using potassium-enriched salt.
While many guidelines recommend increasing dietary potassium intake, and all refer to reducing sodium intake, only two guidelines – the Chinese and European – recommend using potassium-enriched salt.
To help guidelines reflect the latest evidence, we suggested specific wording which could be adopted in Australia and around the world:
Why do so few people use it?
Most people are unaware of how much salt they eat or the health issues it can cause. Few people know a simple switch to potassium-enriched salt can help lower blood pressure and reduce the risk of a stroke and heart disease.
Limited availability is another challenge. Several Australian retailers stock potassium-enriched salt but there is usually only one brand available, and it is often on the bottom shelf or in a special food aisle.
Potassium-enriched salts also cost more than regular salt, though it’s still low cost compared to most other foods, and not as expensive as many fancy salts now available.
A 2021 review found potassium-enriched salts were marketed in only 47 countries and those were mostly high-income countries. Prices ranged from the same as regular salt to almost 15 times greater.
Even though generally more expensive, potassium-enriched salt has the potential to be highly cost effective for disease prevention.
Preventing harm
A frequently raised concern about using potassium-enriched salt is the risk of high blood potassium levels (hyperkalemia) in the approximately 2% of the population with serious kidney disease.
People with serious kidney disease are already advised to avoid regular salt and to avoid foods high in potassium.
No harm from potassium-enriched salt has been recorded in any trial done to date, but all studies were done in a clinical setting with specific guidance for people with kidney disease.
Our current priority is to get people being managed for hypertension to use potassium-enriched salt because health-care providers can advise against its use in people at risk of hyperkalemia.
In some countries, potassium-enriched salt is recommended to the entire community because the potential benefits are so large. A modelling study showed almost half a million strokes and heart attacks would be averted every year in China if the population switched to potassium-enriched salt.
What will happen next?
In 2022, the health minister launched the National Hypertension Taskforce, which aims to improve blood pressure control rates from 32% to 70% by 2030 in Australia.
Potassium-enriched salt can play a key role in achieving this. We are working with the taskforce to update Australian hypertension management guidelines, and to promote the new guidelines to health professionals.
In parallel, we need potassium-enriched salt to be more accessible. We are engaging stakeholders to increase the availability of these products nationwide.
The world has already changed its salt supply once: from regular salt to iodised salt. Iodisation efforts began in the 1920s and took the best part of 100 years to achieve traction. Salt iodisation is a key public health achievement of the last century preventing goitre (a condition where your thyroid gland grows larger) and enhancing educational outcomes for millions of the poorest children in the world, as iodine is essential for normal growth and brain development.
The next switch to iodised and potassium-enriched salt offers at least the same potential for global health gains. But we need to make it happen in a fraction of the time.
Xiaoyue Xu (Luna), Scientia Lecturer, UNSW Sydney; Alta Schutte, SHARP Professor of Cardiovascular Medicine, UNSW Sydney, and Bruce Neal, Executive Director, George Institute Australia, George Institute for Global Health
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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5 dental TikTok trends you probably shouldn’t try at home
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TikTok is full of videos that demonstrate DIY hacks, from up-cycling tricks to cooking tips. Meanwhile, a growing number of TikTok videos offer tips to help you save money and time at the dentist. But do they deliver?
Here are five popular dental TikTok trends and why you might treat them with caution.
1. Home-made whitening solutions
Many TikTok videos provide tips to whiten teeth. These include tutorials on making your own whitening toothpaste using ingredients such as hydrogen peroxide, a common household bleaching agent, and baking soda (sodium bicarbonate).
In this video, the influencer says:
And then you’re going to pour in your hydrogen peroxide. There’s really no measurement to this.
But hydrogen peroxide in high doses is poisonous if swallowed, and can burn your gums, mouth and throat, and corrode your teeth.
High doses of hydrogen peroxide may infiltrate holes or microscopic cracks in your teeth to inflame or damage the nerves and blood vessels in the teeth, which can cause pain and even nerve death. This is why dental practitioners are bound by rules when we offer whitening treatments.
Sodium bicarbonate and hydrogen peroxide are among the components in commercially available whitening toothpastes. While these commercial products may be effective at removing surface stains, their compositions are carefully curated to keep your smile safe.
2. Oil pulling
Oil pulling involves swishing one tablespoon of sesame or coconut oil in your mouth for up to 20 minutes at a time. It has roots in Ayurvedic medicine, a traditional medicine practice that originates from the Indian subcontinent.
While oil pulling should be followed by brushing and flossing, I’ve had patients who believe oil pulling is a replacement for these practices.
There has been some research on the potential of oil pulling to treat gum disease or other diseases in the mouth. But overall, evidence that supports the effectiveness of oil pulling is of low certainty.
For example, studies that test the effectiveness of oil pulling have been conducted on school-aged children and people with no dental problems, and often measure dental plaque growth over a few days to a couple of weeks.
Chlorhexidine is an ingredient found in some commercially available mouthwashes.
In one study, people who rinsed with chlorhexidine mouthwash (30 seconds twice daily) developed less plaque on their teeth compared to those who undertook oil pulling for eight to 10 minutes.Ultimately, it’s unlikely you will experience measurable gain to your oral health by adding oil pulling to your daily routine. If you’re time-poor, you’re better off focusing on brushing your teeth and gums well alongside flossing.
3. Using rubber bands to fix gaps
This TikTok influencer shows his followers he closed the gaps between his front teeth in a week using cheap clear rubber bands.
But this person may be one of the lucky few to successfully use bands to close a gap in his teeth without any mishaps. Front teeth are slippery and taper near the gums into cone-shaped roots. This can cause bands to slide and disappear into the gums to surround the tooth roots, which can cause infections and pain.
If this happens, you may require surgery that involves cutting your gums to remove the bands. If the bands have caused an infection, you may lose the affected teeth. So it’s best to leave this sort of work to a dental professional trained in orthodontics.
4. Filing or cutting teeth to shape them
My teeth hurt just watching this video.
Cutting or filing teeth unnecessarily can expose the second, more sensitive tooth layer, called dentine, or potentially, the nerve and blood vessels inside the tooth. People undergoing this sort of procedure could experience anything from sensitive teeth through to a severe toothache that requires root canal treatment or tooth removal.
You may notice dentist drills spray water when cutting to protect your teeth from extreme heat damage. The drill in this video is dry with no water used to cool the heat produced during cutting.
It may also not be sterile. We like to have everything clean and sterile to prevent contaminated instruments used on one patient from potentially spreading an infection to another person.
Importantly, once you cut or file your teeth away, it’s gone forever. Unlike bone, hair or nails, our teeth don’t have the capacity to regrow.
5. DIY fillings
Many people on TikTok demonstrate filling cavities (holes) or replacing gaps between teeth with a material made from heated moulded plastic beads. DIY fillings can cause a lot of issues – I’ve seen this in my clinic first hand.
While we may make it look simple in dental surgeries, the science behind filling materials and how we make them stick to teeth to fill cavities is sophisticated.
Filling a cavity with the kind of material made from these beads will be as effective as using sticky tape on sand. Not to mention the cavity will continue to grow bigger underneath the untreated “filled” teeth.
I know it’s easy to say “see a dentist about that cavity” or “go to an orthodontist to fix that gap in your teeth you don’t like”, but it can be expensive to actually do these things. However if you end up requiring treatment to fix the issues caused at home, it may end up costing you much more.
So what’s the take-home message? Stick with the funny cat and dog videos on TikTok – they’re safer for your smile.
Arosha Weerakoon, Senior Lecturer and General Dentist, School of Dentistry, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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