Peony Against Inflammation & More
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Yes, this is about the flower, especially white peony (Paeonia lactiflora), and especially the root thereof (Paeoniae radix alba). Yes, the root gets a different botanical name but we promise it is the same plant. You will also read about its active glycoside paeoniflorin, and less commonly, albiflorin (a neuroprotective glycoside present in the root).
It’s one of those herbs that has made its way out of Traditional Chinese Medicine and into labs around the world.
It can be ingested directly as food, or as a powder/capsule, or made into tea.
Anti-inflammatory
Peony suppresses inflammatory pathways, which thus reduces overall inflammation. In particular, this research review found:
❝Pharmacologically, paeoniflorin exhibits powerful anti-inflammatory and immune regulatory effects in some animal models of autoimmune diseases including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE)❞
The reviewers also (albeit working from animal models) suggest it may be beneficial in cases of kidney disease and liver disease, along with other conditions.
Here’s a larger review, which also has studies involving humans (and in vivo studies), that found it to effectively help treat autoimmune conditions including rheumatoid arthritis and psoriasis, amongst others:
❝Modern pharmacological research on TGP is based on the traditional usage of PRA, and its folk medicinal value in the treatment of autoimmune diseases has now been verified. In particular, TGP has been developed into a formulation used clinically for the treatment of autoimmune diseases.
Based on further research on its preparation, quality control, and mechanisms of action, TGP is expected to eventually play a greater role in the treatment of autoimmune diseases. ❞
(TGP = Total Glucosides of Paeony)
Antidepressant / Anxiolytic
It also acts as a natural serotonin reuptake inhibitor (as per many pharmaceutical antidepressants), by reducing the expression of the serotonin transporter protein:
Gut Microbiota-Based Pharmacokinetics and the Antidepressant Mechanism of Paeoniflorin
(remember, most serotonin is produced in the gut)
Here’s how that played out when tested (on rats, though):
Against PMS and/or menopause symptoms
Peony is widely used in Traditional Chinese Medicine to reduce these symptoms in general. However, we couldn’t find a lot of good science for that, although it is very plausible (as the extract contains phytoestrogens and may upregulate estrogen receptors while dialling down testosterone production). Here’s the best we could find for that, and it’s a side-by-side along with licorice root:
❝Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin❞
Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production
(note: that it didn’t affect estradiol levels is reasonable; it contains phytoestrogens after all, not estradiol—and in fact, if you are taking estradiol, you might want to skip this one, as its phytoestrogens could compete with your estradiol for receptors)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Women want to see the same health provider during pregnancy, birth and beyond
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Hazel Keedle, Western Sydney University and Hannah Dahlen, Western Sydney University
In theory, pregnant women in Australia can choose the type of health provider they see during pregnancy, labour and after they give birth. But this is often dependent on where you live and how much you can afford in out-of-pocket costs.
While standard public hospital care is the most common in Australia, accounting for 40.9% of births, the other main options are:
- GP shared care, where the woman sees her GP for some appointments (15% of births)
- midwifery continuity of care in the public system, often called midwifery group practice or caseload care, where the woman sees the same midwife of team of midwives (14%)
- private obstetrician care (10.6%)
- private midwifery care (1.9%).
Given the choice, which model would women prefer?
Our new research, published BMC Pregnancy and Childbirth, found women favoured seeing the same health provider throughout pregnancy, in labour and after they have their baby – whether that’s via midwifery group practice, a private midwife or a private obstetrician.
Assessing strengths and limitations
We surveyed 8,804 Australian women for the Birth Experience Study (BESt) and 2,909 provided additional comments about their model of maternity care. The respondents were representative of state and territory population breakdowns, however fewer respondents were First Nations or from culturally or linguistically diverse backgrounds.
We analysed these comments in six categories – standard maternity care, high-risk maternity care, GP shared care, midwifery group practice, private obstetric care and private midwifery care – based on the perceived strengths and limitations for each model of care.
Overall, we found models of care that were fragmented and didn’t provide continuity through the pregnancy, birth and postnatal period (standard care, high risk care and GP shared care) were more likely to be described negatively, with more comments about limitations than strengths.
What women thought of standard maternity care in hospitals
Women who experienced standard maternity care, where they saw many different health care providers, were disappointed about having to retell their story at every appointment and said they would have preferred continuity of midwifery care.
Positive comments about this model of care were often about a midwife or doctor who went above and beyond and gave extra care within the constraints of a fragmented system.
The model of care with the highest number of comments about limitations was high-risk maternity care. For women with pregnancy complications who have their baby in the public system, this means seeing different doctors on different days.
Some respondents received conflicting advice from different doctors, and said the focus was on their complications instead of their pregnancy journey. One woman in high-risk care noted:
The experience was very impersonal, their focus was my cervix, not preparing me for birth.
Why women favoured continuity of care
Overall, there were more positive comments about models of care that provided continuity of care: private midwifery care, private obstetric care and midwifery group practice in public hospitals.
Women recognised the benefits of continuity and how this included informed decision-making and supported their choices.
The model of care with the highest number of positive comments was care from a privately practising midwife. Women felt they received the “gold standard of maternity care” when they had this model. One woman described her care as:
Extremely personable! Home visits were like having tea with a friend but very professional. Her knowledge and empathy made me feel safe and protected. She respected all of my decisions. She reminded me often that I didn’t need her help when it came to birthing my child, but she was there if I wanted it (or did need it).
However, this is a private model of care and women need to pay for it. So there are barriers in accessing this model of care due to the cost and the small numbers working in Australia, particularly in regional, rural and remote areas, among other barriers.
Women who had private obstetricians were also positive about their care, especially among women with medical or pregnancy complications – this type of care had the second-highest number of positive comments.
This was followed by women who had continuity of care from midwives in the public system, which was described as respectful and supportive.
However, one of the limitations about continuity models of care is when the woman doesn’t feel connected to her midwife or doctor. Some women who experienced this wished they had the opportunity to choose a different midwife or doctor.
What about shared care with a GP?
While shared care between the GP and hospital model of care is widely promoted in the public maternity care system as providing continuity, it had a similar number of negative comments to those who had fragmented standard hospital care.
Considering there is strong evidence about the benefits of midwifery continuity of care, and this model of care appears to be most acceptable to women, it’s time to expand access so all Australian women can access continuity of care, regardless of their location or ability to pay.
Hazel Keedle, Senior Lecturer of Midwifery, Western Sydney University and Hannah Dahlen, Professor of Midwifery, Associate Dean Research and HDR, Midwifery Discipline Leader, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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HRT Side Effects & Troubleshooting
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This is Dr. Heather Hirsch. She’s a board-certified internist, and her clinical expertise focuses on women’s health, particularly in midlife and menopause, and its intersection with chronic diseases (ranging from things associated with sexual health, to things like osteoporosis and heart disease).
So, what does she want us to know?
HRT can be life-changingly positive, but it can be a shaky start
Hormone Replacement Therapy (HRT), and in this context she’s talking specifically about the most common kind, Menopausal Hormone Therapy (MHT), involves taking hormones that our body isn’t producing enough of.
If these are “bioidentical hormones” as used in most of the industrialized world and increasingly also in N. America, then this is by definition a supplement rather than a drug, for what it’s worth, whereas some non-bioidentical hormones (or hormone analogs, which by definition function similarly to hormones but aren’t the same thing) can function more like drugs.
We wrote a little about his previously:
Hormone Replacement Therapy: A Tale Of Two Approaches
For most people most of the time, bioidentical hormones are very much the best way to go, as they are not only more effective, but also have fewer side effects.
That said, even bioidentical hormones can have some undesired effects, so, how to deal with those?
Don’t worry; bleed happy
A reprise of (usually quite light) menstrual bleeding is the most common side effect of menopausal HRT.
This happens because estrogen affects* the uterus, leading to a build-up and shedding of the uterine lining.
*if you do not have a uterus, estrogen can effect uterine tissue. That’s not a typo—here we mean the verb “effect”, as in “cause to be”. It will not grow a new uterus, but it can cause some clumps of uterine tissue to appear; this means that it becomes possible to get endometriosis without having a uterus. This information should not be too shocking, as endometriosis is a matter of uterine tissue growing inconveniently, often in places where it shouldn’t, and sometimes quite far from the uterus (if present, or its usual location, if absent). However, the risk of this happening is far lower than if you actually have a uterus:
What you need to know about endometriosis
Back to “you have a uterus and it’s making you wish you didn’t”:
This bleeding should, however, be light. It’ll probably be oriented around a 28-day cycle even if you are taking your hormones at the same dose every day of the month, and the bleeding will probably taper off after about 6 months of this.
If the bleeding is heavier, all the time, or persists longer than 6 months, then speak to your gynecologist about it. Any of those three; it doesn’t have to be all three!
Bleeding outside of one’s normal cycle can be caused by anything from fibroids to cancer; statistically speaking it’s probably nothing too dire,but when your safety is in question, don’t bet on “probably”, and do get it checked out:
When A Period Is Very Late (i.e., Post-Menopause)
Dr. Hirsch recommends, as possible remedies to try (preferably under your gynecologist’s supervision):
- lowering your estrogen dose
- increasing your progesterone dose
- taking progesterone continuously instead of cyclically
And if you’re not taking progesterone, here’s why you might want to consider taking this important hormone that works with estrogen to do good things, and against estrogen to rein in some of estrogen’s less convenient things:
Progesterone Menopausal HRT: When, Why, And How To Benefit
(the above link contains, as well as textual information, an explanatory video from Dr. Hirsch herself)
Get the best of the breast
Calm your tits. Soothe your boobs. Destress your breasts. Hakuna your tatas. Undo the calamity beleaguering your mammaries.
Ok, more seriously…
Breast tenderness is another very common symptom when starting to take estrogen. It can worry a lot of people (à la “aagh, what is this and is it cancer!?”), but is usually nothing to worry about. But just to be sure, do also check out:
Keeping Abreast Of Your Cancer Risk: How To Triple Your Breast Cancer Survival Chances
Estrogen can cause feelings of breast fullness, soreness, nipple irritation, and sometimes lactation, but this later will be minimal—we’re talking a drop or two now and again, not anything that would feed a baby.
Basically, it happens when your body hasn’t been so accustomed to normal estrogen levels in a while, and suddenly wakes up with a jolt, saying to itself “Wait what are we doing puberty again now? I thought we did menopause? Are we pregnant? What’s going on? Ok, checking all systems!” and then may calm down not too long afterwards when it notes that everything is more or less as it should be already.
If this persists or is more than a minor inconvenience though, Dr. Hirsch recommends looking at the likely remedies of:
- Adjust estrogen (usually the cause)
- Adjust progesterone (less common)
- If it’s progesterone, changing the route of administration can ameliorate things
What if it’s not working? Is it just me?
Dr. Hirsch advises the most common reasons are simply:
- wrong formulation (e.g. animal-derived estrogen or hormone analog, instead of bioidentical)
- wrong dose (e.g. too low)
- wrong route of administration (e.g. oral vs transdermal; usually transdermal estradiol is most effective but many people do fine on oral; progesterone meanwhile is usually best as a pessary/suppository, but many people do fine on oral)
Writer’s example: in 2022 there was an estrogen shortage in my country, and while I had been on transdermal estradiol hemihydrate gel, I had to go onto oral estradiol valerate tablets for a few months, because that’s what was available. And the tablets simply did not work for me at all. I felt terrible and I have a good enough intuitive sense of my hormones to know when “something wrong is not right”, and a good enough knowledge of the pharmacology & physiology to know what’s probably happening (or not happening). And sure enough, when I got my blood test results, it was as though I’d been taking nothing. It was such a relief to get back on the gel once it became available again!
So, if something doesn’t seem to be working for you, speak up and get it fixed if at all possible.
See also: What You Should Have Been Told About Menopause Beforehand
Want to know more from Dr. Hirsch?
You might like this book of hers, which we haven’t reviewed yet, but present here for your interest:
Enjoy!
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Indistractable – by Nir Eyal
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Have you ever felt that you could accomplish anything you wanted/needed, if only you didn’t get distracted?
This book lays out a series of psychological interventions for precisely that aim, and it goes a lot beyond the usual “download/delete these apps to help you stop checking social media every 47 seconds”.
Some you’ll have heard of before, some you won’t have, and if even one method works for you, it’ll have been well worth your while reading this book. This reviewer, for example, enjoyed the call to identity-based strength, e.g. adopting an “I am indistractable*” perspective going into tasks. This is akin to the strength of, for example, “I don’t drink” over “I am a recovering alcoholic”.
*the usual spelling of this, by the way, is “undistractable”, but we use the author’s version here for consistency. It’s a great marketing gimmick, as all searches for the word “indistractable” will bring up his book.
Nor is the book just about maximizing productivity to the detriment of everything else; this is not about having a 25 hours per day “grindset”. Rather, it even makes sure to cover such things as focusing on one’s loved ones, for instance.
Bottom line: if you’ve tried blocking out the distractions but still find you can’t focus, this book offers next-level solutions
Click here to check out Indistractible, and become indeed indistractable!
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Get Well, Stay Well – by Dr. Gemma Newman
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Dr. Gemma Newman is a GP (British equivalent of what in America is called a “family doctor”) who realized she was functioning great as a diagnostic flowchart interpreter and pill dispensary, but not actually doing much of what she got into the job to do: helping people.
Her patients were getting plenty of treatments, but not getting better. Often, they were getting worse. And she knew why: they come in for treatment for one medical problem, when they have six and a half medical problems probably a stack of non-medical problems that contributed to them,
So, this book sets out to do what she tries to do in her office, but often doesn’t have the time: treat the whole person.
In it, she details what areas of life to look at, what things are most likely to contribute to wellness/unwellness (be those things completely in your power or not), and how to—bit by bit—make all the parts better, and keep them that way.
The writing style is conversational, and while it’s heavily informed by her professional competence, there’s no arcane science here; it’s more about the system of bringing everything together harmoniously.
Bottom line: if you think there’s more to wellness than can be represented on an annual physicals chart, then this is the book to help you get/keep on top of things.
Click here to check out Get Well, Stay Well, and do just that!
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Four Thousand Weeks – by Oliver Burkeman
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This is not, strictly speaking, a time management book. It’s more a “contemplating mortality and making things count while still doing the necessaries”.
Burkeman’s premise is that we get around 4,000 weeks of life, on average. If we live to 120, it’s more like 6,200. Unlucky souls may have to do the best they can with 1,000 or so.
The book is thought-provoking; consider:
- how was your last week?
- how will your next week be?
- what if it were your last?
Of course, we cannot necessarily liquidate all our assets and spend next week burning out in style, because then the following week comes. So, what’s the solution?
That’s something Burkeman lays out over the course of the book, with key ideas including passion projects and figuring out what can be safely neglected, but there’s far more there than we could sum up here.
Bottom line: if you ever find yourself struggling to balance what is expected of you with what is of value to you, this book can help you get the most out of your choices.
Click here to check out Four Thousand Weeks, and make yours count!
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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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