Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
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Peripheral neuropathy (and what can be done about it)
Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:
- Diabetes
- Alcoholism
- Infection
- Injury
The manifestations can be different:
- In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
- In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
- In the case of infection, a lot depends on the nature of the infection and the body’s response.
- In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
- This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)
This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)
Prevention is better than cure
If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:
- Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
- Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
- Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
- We’ll do a main feature on this soon!
- Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.
- There are many kinds available, so read reviews, but here’s an example product on Amazon
Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:
A standing desk
A vertical ergonomic mouse
An ergonomic split keyboard
A Kindle*
*Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.
If you already have peripheral neuropathy
Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?
Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.
And, all of these are good options; do you see what they have in common?
It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).
By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.
But also don’t forget: rest
- Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
- Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
- Use a brace if necessary to help the affected part stay aligned correctly
- You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.
One more top tip
We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.
So you might want to check that out:
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Relationships: When To Stick It Out & When To Call It Quits
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Like A Ship Loves An Anchor?
Today’s article may seem a little bit of a downer to start with, but don’t worry, it picks up again too. Simply put, we’ve written before about many of the good parts of relationships, e.g:
Only One Kind Of Relationship Promotes Longevity This Much!
…but what if that’s not what we have?
Note: if you have a very happy, secure, fulfilling, joyous relationship, then, great! Or if you’re single and happy, then, also great! Hopefully you will still find today’s feature of use if you find yourself advising a friend or family member one day. So without further ado, let’s get to it…
You may be familiar with the “sunk cost fallacy”; if not: it’s what happens when a person or group has already invested into a given thing, such that even though the thing is not going at all the way they hoped, they now want to continue trying to make that thing work, lest their previous investment be lost. But the truth is: if it’s not going to work, then the initial investment is already lost, and pouring out extra won’t help—it’ll just lose more.
That “investment” in a given thing could be money, time, energy, or (often the case) a combination of the above.
In the field of romance, the “sunk cost fallacy” keeps a lot of bad relationships going for longer than perhaps they should, and looking back (perhaps after a short adjustment period), the newly-single person says “why did I let that go on?” and vows to not make the same mistake again.
But that prompts the question: how can we know when it’s right to “keep working on it, because relationships do involve work”, as perfectly reasonable relationship advice often goes, and when it’s right to call it quits?
Should I stay or should I go?
Some questions for you (or perhaps a friend you might find yourself advising) to consider:
- What qualities do you consider the most important for a partner to have—and does your partner have them?
- If you described the worst of your relationship to a close friend, would that friend feel bad for you?
- Do you miss your partner when they’re away, or are you glad of the break? When they return, are they still glad to see you?
- If you weren’t already in this relationship, would you seek to enter it now? (This takes away sunk cost and allows a more neutral assessment)
- Do you feel completely safe with your partner (emotionally as well as physically), or must you tread carefully to avoid conflict?
- If your partner decided tomorrow that they didn’t want to be with you anymore and left, would that be just a heartbreak, or an exciting beginning of a new chapter in your life?
- What things would you generally consider dealbreakers in a relationship—and has your partner done any of them?
The last one can be surprising, by the way. We often see or hear of other people’s adverse relationship situations and think “I would never allow…” yet when we are in a relationship and in love, there’s a good chance that we might indeed allow—or rather, excuse, overlook, and forgive.
And, patience and forgiveness certainly aren’t inherently bad traits to have—it’s just good to deploy them consciously, and not merely be a doormat.
Either way, reflect (or advise your friend/family member to reflect, as applicable) on the “score” from the above questions.
- If the score is good, then maybe it really is just a rough patch, and the tools we link at the top and bottom of this article might help.
- If the score is bad, the relationship is bad, and no amount of historic love or miles clocked up together will change that. Sometimes it’s not even anyone’s fault; sometimes a relationship just ran its course, and now it’s time to accept that and turn to a new chapter.
“At my age…”
As we get older, it’s easy for that sunk cost fallacy to loom large. Inertia is heavy, the mutual entanglement of lives is far-reaching, and we might not feel we have the same energy for dating that we did when we were younger.
And there may sometimes be a statistical argument for “sticking it out” at least for a while, depending on where we are in the relationship, per this study (with 165,039 participants aged 20–76), which found:
❝Results on mean levels indicated that relationship satisfaction decreased from age 20 to 40, reached a low point at age 40, then increased until age 65, and plateaued in late adulthood.
As regards the metric of relationship duration, relationship satisfaction decreased during the first 10 years of the relationship, reached a low point at 10 years, increased until 20 years, and then decreased again.❞
Source: Development of Relationship Satisfaction Across the Life Span: A Systematic Review and Meta-Analysis
And yet, when it comes to prospects for a new relationship…
- If our remaining life is growing shorter, then it’s definitely too short to spend in an unhappy relationship
- Maybe we really won’t find romance again… And maybe that’s ok, if w’re comfortable making our peace with that and finding joy in the rest of life (this widowed writer (hi, it’s me) plans to remain single now by preference, and her life is very full of purpose and beauty and joy and yes, even love—for family, friends, etc, plus the memory of my wonderful late beloved)
- Nevertheless, the simple fact is: many people do find what they go on to describe as their best relationship yet, late in life ← this study is with a small sample size, but in this case, even anecdotal evidence seems sufficient to make the claim reasonable; probably you personally know someone who has done so. If they can, so can you, if you so wish.
- Adding on to that last point… Later life relationships can also offer numerous significant advantages unique to such (albeit some different challenges too—but with the right person, those challenges are just a fun thing to tackle together). See for example:
An exploratory investigation into dating among later‐life women
And about those later-life relationships that do work? They look like this:
this one looks like the title says it all, but it really doesn’t, and it’s very much worth at least reading the abstract, if not the entire paper—because it talks a lot about the characteristics that make for happy or unhappy relationships, and the effect that those things have on people. It really is very good, and quite an easy read.
See again: Healthy Relationship, Healthy Life
Take care!
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No, you don’t need the ‘Barbie drug’ to tan, whatever TikTok says. Here’s why melanotan-II is so risky
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TikTok and Instagram influencers have been peddling the “Barbie drug” to help you tan.
But melanotan-II, as it’s called officially, is a solution that’s too good to be true. Just like tanning, this unapproved drug has a dark side.
Doctors, researchers and Australia’s drug regulator have been warning about its side effects – from nausea and vomiting to brain swelling and erection problems.
There are also safer ways of getting the tanned look, if that’s what you’re after.
AtlasStudio/Shutterstock What is melanotan-II?
No, it’s not a typo. Melanotan-II is very different from melatonin, which is a hormonal supplement used for insomnia and jet lag.
Melanotan-II is a synthetic version of the naturally ocurring hormone α-melanocyte stimulating hormone. This means the drug mimics the body’s hormone that stimulates production of the pigment melanin. This is what promotes skin darkening or tanning, even in people with little melanin.
Although the drug is promoted as a way of getting a “sunless tan”, it is usually promoted for use with UV exposure, to enhance the effect of UV and kickstart the tanning process.
Melanotan-II is related to, but different from, melanotan-I (afamelanotide), an approved drug used to treat the skin condition erythropoietic protoporphyria.
Melanotan-II is not registered for use with Australia’s Therapeutic Goods Administration (TGA). It is illegal to advertise it to the public or to provide it without a prescription.
However, social media has been driving unlicensed melanotan-II sales, a study published last year confirms.
There are many black market suppliers of melanotan-II injections, tablets and creams. More recently, nasal sprays have become more popular.
What are the risks?
Just like any drug, melanotan-II comes with the risk of side effects, many of which we’ve known about for more than a decade. These include changes in the size and pigmentation of moles, rapid appearance of new moles, flushing to the face, abdominal cramps, nausea, vomiting, chest pain and brain swelling.
It can also cause rhabdomyolysis, a dangerous syndrome where muscle breaks down and releases proteins into the bloodstream that damage the kidneys.
For men, the drug can cause priapism – a painful erection that does not go away and can damage the penis, requiring emergency treatment.
Its use has been linked with melanoma developing from existing moles either during or shortly after using the drug. This is thought to be due to stimulating pigment cells and causing the proliferation of abnormal cells.
Despite reports of melanoma, according to a study of social media posts the drug is often marketed as protecting against skin cancer. In fact, there’s no evidence to show it does this.
Social media posts about melanotan-II rarely mention health risks.
There are no studies on long-term safety of melanotan-II use.
Then there’s the issue of the drug not held to the high safety standards as TGA-approved products. This could result in variability in dose, undeclared ingredients and potential microbial contamination.
Thinking about melanotan-II? The drug can cause a long-lasting painful erection needing urgent medical care. Eugenio Marongiu/Shutterstock The TGA has previously warned consumers to steer clear of the drug due to its “serious side effects that can be very damaging to your health”.
According to an ABC article published earlier this week, the TGA is cracking down on the illegal promotion of the drug on various websites. However, we know banned sellers can pop back up under a different name.
TikTok has banned the hashtags #tanningnasalspray, #melanotan and #melanotan2, but these products continue to be promoted with more generic hashtags, such as #tanning.
Part of a wider trend
Australia has some of the highest rates of skin cancer in the world. The “slip, slop, slap” campaign is a public health success story, with increased awareness of sun safety, a cultural shift and a decline in melanoma in young people.
However, the image of a bronzed beach body remains a beauty standard, especially among some young people.
Disturbingly, tan lines are trending on TikTok as a sought after summer accessory and the hashtag #sunburnttanlines has millions of views. We’ve also seen a backlash against sunscreen among some young people, again promoted on TikTok.
The Cancer Council is so concerned about the trend towards normalising tanning it has launched the campaign End the Trend.
You have other options
There are options beyond spraying an illegal, unregulated product up your nose, or risking unprotected sun exposure: fake tan.
Fake tan tends to be much safer than melanotan-II and there’s more long-term safety data. It also comes with potential side effects, albeit rare ones, including breathing issues (with spray products) and skin inflammation in some people.
Better still, you can embrace your natural skin tone.
Rose Cairns, Senior Lecturer in Pharmacy, NHMRC Emerging Leadership Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Super Gut – by Dr. William Davis
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You may be wondering: what sets this book apart from the other gut health books we’ve reviewed? For this one, mostly it’s depth.
This is the most scientifically dense book we’ve reviewed on gut health, so if you’re put off by that, this might not be one for you. However, you don’t need prior knowledge, as he does explain things as he goes. The advice in this book is not just the usual “gut health 101” stuff, either!
A particular strength of this book is that it looks at a wide variety of gut- and gut-related disorders, and ways certain readers may need to do different things than others, to address those problems on the path to good gut health.
The style, for all its hard science content, is quite sensationalist, and that may take some getting used to for non-Americans. However, it doesn’t affect the content!
Bottom line: if you just want simple basic advice, then probably best to skip this one. However, if you are sincerely serious about gut health (or just like reading this sort of thing because learning is satisfying), then this book is packed with relevant and detailed information.
Click here to check out Super Gut, and get to know and improve yours!
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Tranquility by Tuesday?
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I Know How She Does It: How Successful Women Make The Most of Their Time
This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…
Laura’s 7 Keys To Productivity
Key One: Plan your weeks on Fridays
You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!
Key Two: Measure what matters
Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.
On which note…
“Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).
Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.
We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:
Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android
Dr. Greger’s Daily Dozen @ Nutrition Facts
Key Three: Figure out 2–3 “anchor” events for the weekend
Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!
Key Four: Tackle the toughest work first
You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.
Here’s one:
“If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”
Top Productivity App “ToDoist” has an option for this, by the way!
Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)
10almonds Tip:
“But what if something’s really important but not as pressing as some less important, but more urgent tasks?”
Simple!
Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.
Repeat each day until the important-but-not-urgent task is done!
The 10almonds Team
Key Five: Use bits of time well
If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!
- Use those few minutes before a meeting/phonecall!
- Use the time you spend waiting for public transport or riding on it!
- Use the time you spent waiting for a family member to finish doing a thing!
All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.
Key Six: Make very short daily to-do lists
By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up
Key Seven: Have a bedtime
Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!
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Pomegranate vs Cherries – Which is Healthier?
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Our Verdict
When comparing pomegranate to cherries, we picked the pomegranate.
Why?
In terms of macros, pomegranate is slightly higher in carbs, and/but 4x higher in fiber. That’s already a good start for pomegranates. Lest we be accused of cherry-picking, though, we’ll mention that pomegranate is also slightly higher in protein and fat, for what it’s worth—which is not a lot. As with most fruits, the protein and fat numbers are low importance next to the carb:fiber ratio.
When it comes to vitamins, pomegranate has more of vitamins B1, B2, B5, B6, B9. E. K, and choline. On the other hand, cherries have more of vitamins A and B3. The two fruits are equal in vitamin C. This all makes for a clear win for pomegranate.
In the category of minerals, pomegranate boasts more copper, magnesium, phosphorus, potassium, selenium, and zinc. In contrast, cherries have slightly more calcium. Another win for pomegranate.
Both of these fruits have beneficial polyphenols, each with a slightly different profile, but neither pressingly better than the other.
In short: as ever with healthy foods, enjoy both—diversity is good! But if you’re going to pick on, we recommend the pomegranate.
Want to learn more?
You might like to read:
- Pomegranate Peel’s Potent Potential ← so don’t throw it away!
- Cherries’ Very Healthy Wealth Of Benefits!
Take care!
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What happens to your vagina as you age?
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The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.
Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.
Here’s what happens to your vagina as you age, whether you notice or not.
Let’s clear up the terminology
We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.
What happens to the vagina as you age?
Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.
Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:
- less vaginal secretions, potentially leading to dryness
- less growth of vagina surface cells resulting in a thinned lining
- alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
- fewer blood vessels around the vagina, which may explain less blood flow after menopause
- a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.
What symptoms can I expect?
Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.
Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.
Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.
Not everyone has the same experience
Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.
In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.
If symptoms bother you
Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.
While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.
In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.
Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.
Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.
Are there other treatments?
New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.
For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.
Where to from here?
The normal ageing process, as well as menopause, both affect the vagina as we age.
Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.
While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.
Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.
Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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