Taking A Trip Through The Evidence On Psychedelics
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In Tuesday’s newsletter, we asked you for your opinions on the medicinal use of psychedelics, and got the above-depicted, below-described, set of responses:
- 32% said “This is a good, evidence-based way to treat many brain disorders”
- 32% said “There are some benefits, but they don’t outweigh the risks”
- 20% said “This can help a select few people only; useless for the majority”
- 16% said “This is hippie hogwash and hearsay; wishful thinking at best”
Quite a spread of answers, so what does the science say?
This is hippie hogwash and hearsay; wishful thinking at best! True or False?
False! We’re tackling this one first, because it’s easiest to answer:
There are some moderately-well established [usually moderate] clinical benefits from some psychedelics for some people.
If that sounds like a very guarded statement, it is. Part of this is because “psychedelics” is an umbrella term; perhaps we should have conducted separate polls for psilocybin, MDMA, ayahuasca, LSD, ibogaine, etc, etc.
In fact: maybe we will do separate main features for some of these, as there is a lot to say about each of them separately.
Nevertheless, looking at the spread of research as it stands for psychedelics as a category, the answers are often similar across the board, even when the benefits/risks may differ from drug to drug.
To speak in broad terms, if we were to make a research summary for each drug it would look approximately like this in each case:
- there has been research into this, but not nearly enough, as “the war on drugs” may well have manifestly been lost (the winner of the war being: drugs; still around and more plentiful than ever), but it did really cramp science for a few decades.
- the studies are often small, heterogenous (often using moderately wealthy white student-age population samples), and with a low standard of evidence (i.e. the methodology often has some holes that leave room for reasonable doubt).
- the benefits recorded are often small and transient.
- in their favor, though, the risks are also generally recorded as being quite low, assuming proper safe administration*.
*Illustrative example:
Person A takes MDMA in a club, dances their cares away, has had only alcohol to drink, sweats buckets but they don’t care because they love everyone and they see how we’re all one really and it all makes sense to them and then they pass out from heat exhaustion and dehydration and suffer kidney damage (not to mention a head injury when falling) and are hospitalized and could die;
Person B takes MDMA in a lab, is overwhelmed with a sense of joy and the clarity of how their participation in the study is helping humanity; they want to hug the researcher and express their gratitude; the researcher reminds them to drink some water.
Which is not to say that a lab is the only safe manner of administration; there are many possible setups for supervised usage sites. But it does mean that the risks are often as much environmental as they are risks inherent to the drug itself.
Others are more inherent to the drug itself, such as adverse cardiac events for some drugs (ibogaine is one that definitely needs medical supervision, for example).
For those who’d like to see numbers and clinical examples of the bullet points we gave above, here you go; this is a great (and very readable) overview:
NIH | Evidence Brief: Psychedelic Medications for Mental Health and Substance Use Disorders
Notwithstanding the word “brief” (intended in the sense of: briefing), this is not especially brief and is rather an entire book (available for free, right there!), but we do recommend reading it if you have time.
This can help a select few people only; useless for the majority: True or False?
True, technically, insofar as the evidence points to these drugs being useful for such things as depression, anxiety, PTSD, addiction, etc, and estimates of people who struggle with mental health issues in general is often cited as being 1 in 4, or 1 in 5. Of course, many people may just have moderate anxiety, or a transient period of depression, etc; many, meanwhile, have it worth.
In short: there is a very large minority of people who suffer from mental health issues that, for each issue, there may be one or more psychedelic that could help.
This is a good, evidence-based way to treat many brain disorders: True or False?
True if and only if we’re willing to accept the so far weak evidence that we discussed above. False otherwise, while the jury remains out.
One thing in its favor though is that while the evidence is weak, it’s not contradictory, insofar as the large preponderance of evidence says such therapies probably do work (there aren’t many studies that returned negative results); the evidence is just weak.
When a thousand scientists say “we’re not completely sure, but this looks like it helps; we need to do more research”, then it’s good to believe them on all counts—the positivity and the uncertainty.
This is a very different picture than we saw when looking at, say, ear candling or homeopathy (things that the evidence says simply do not work).
We haven’t been linking individual studies so far, because that book we linked above has many, and the number of studies we’d have to list would be:
n = number of kinds of psychedelic drugs x number of conditions to be treated
e.g. how does psilocybin fare for depression, eating disorders, anxiety, addiction, PTSD, this, that, the other; now how does ayahuasca fare for each of those, and so on for each drug and condition; at least 25 or 30 as a baseline number, and we don’t have that room.
But here are a few samples to finish up:
- Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases—A Systematic Review and Meta-Analysis of Clinical Trials
- Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials
- Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin
- Changes in self-rumination and self-compassion mediate the effect of psychedelic experiences on decreases in depression, anxiety, and stress.
- Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies
- Repeated lysergic acid diethylamide (LSD) reverses stress-induced anxiety-like behavior, cortical synaptogenesis deficits and serotonergic neurotransmission decline
In closing…
The general scientific consensus is presently “many of those drugs may ameliorate many of those conditions, but we need a lot more research before we can say for sure”.
On a practical level, an important take-away from this is twofold:
- drugs, even those popularly considered recreational, aren’t ontologically evil, generally do have putative merits, and have been subject to a lot of dramatization/sensationalization, especially by the US government in its famous war on drugs.
- drugs, even those popularly considered beneficial and potentially lifechangingly good, are still capable of doing great harm if mismanaged, so if putting aside “don’t do drugs” as a propaganda of the past, then please do still hold onto “don’t do drugs alone”; trained professional supervision is a must for safety.
Take care!
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The Sugar Alcohol That Reduces BMI!
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Inositol Does-It-Ol’!
First things first, a quick clarification up-front:
Myo-inositol or D-chiro-inositol?
We’re going to be talking about inositol today, which comes in numerous forms, but most importantly:
- Myo-inositol (myo-Ins)
- D-chiro-inositol (D-chiro-Ins)
These are both inositol, (a sugar alcohol!) and for our purposes today, the most relevant form is myo-inositol.
The studies we’ll look at today are either:
- just about myo-inositol, or
- about myo-inositol in the presence of d-chiro-inositol at a 40:1 ratio.
You have both in your body naturally; wherever supplementation is mentioned, it means supplementing with either:
- extra myo-inositol (because that’s the one the body more often needs more of), or
- both, at the 40:1 ratio that we mentioned above (because that’s one way to help balance an imbalanced ratio)
With that in mind…
Inositol against diabetes?
Inositol is known to:
- decrease insulin resistance
- increase insulin sensitivity
- have an important role in cell signaling
- have an important role in metabolism
The first two things there both mean that inositol is good against diabetes. It’s not “take this and you’re cured”, but:
- if you’re pre-diabetic it may help you avoid type 2 diabetes
- if you are diabetic (either type) it can help in the management of your diabetes.
It does this by allowing your body to make better use of insulin (regardless of whether that insulin is from your pancreas or from the pharmacy).
How does it do that? Research is still underway and there’s a lot we don’t know yet, but here’s one way, for example:
❝Evidence showed that inositol phosphates might enhance the browning of white adipocytes and directly improve insulin sensitivity through adipocytes❞
Read: Role of Inositols and Inositol Phosphates in Energy Metabolism
We mentioned its role in metabolism in a bullet-point above, and we didn’t just mean insulin sensitivity! There’s also…
Inositol for thyroid function?
The thyroid is one of the largest endocrine glands in the body, and it controls how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones. So, it working correctly or not can have a big impact on everything from your mood to your weight to your energy levels.
How does inositol affect thyroid function?
- Inositol has an important role in thyroid function and dealing with autoimmune diseases.
- Inositol is essential to produce H2O2 (yes, really) required for the synthesis of thyroid hormones.
- Depletion of inositol may lead to the development of some thyroid diseases, such as hypothyroidism.
- Inositol supplementation seems to help in the management of thyroid diseases.
Read: The Role of Inositol in Thyroid Physiology and in Subclinical Hypothyroidism Management
Inositol for PCOS?
A systematic review published in the Journal of Gynecological Endocrinology noted:
- Inositol can restore spontaneous ovarian activity (and consequently fertility) in most patients with PCOS.
- Myo-inositol is a safe and effective treatment to improve:
- ovarian function
- healthy metabolism
- healthy hormonal balance
While very comprehensive (which is why we included it here), that review’s a little old, so…
Check out this cutting edge (Jan 2023) study whose title says it all:
Inositol for fertility?
Just last year, Mendoza et al published that inositol supplementation, together with antioxidants, vitamins, and minerals, could be an optimal strategy to improve female fertility.
This built from Gambiole and Forte’s work, which laid out how inositol is a safe compound for many issues related to fertility and pregnancy. In particular, several clinical trials demonstrated that:
- inositol can have therapeutic effects in infertile women
- inositol can also be useful as a preventive treatment during pregnancy
- inositol could prevent the onset of neural tube defects
- inositol also reduces the occurrence of gestational diabetes
Due to the safety and efficiency of inositol, it can take the place of many drugs that are contraindicated in pregnancy. Basically: take this, and you’ll need fewer other drugs. Always a win!
Read: Myo-Inositol as a Key Supporter of Fertility and Physiological Gestation
Inositol For Weight Loss
We promised you “this alcohol sugar can reduce your BMI”, and we weren’t making it up!
Zarezadeh et al conducited a very extensive systematic review, and found:
- Oral inositol supplementation has positive effect on BMI reduction.
- Inositol in the form of myo-inositol had the strongest effect on BMI reduction.
- Participants with PCOS and/or who were overweight, experienced the most significant improvement of all.
Want some inositol?
As ever, we don’t sell it (or anything else), but for your convenience, here’s myo-inositol and d-chiro-inositol at a 40:1 ratio, available on Amazon!
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Easily Digestible Vegetarian Protein Sources
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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
❝What could be easily digestible plant sources of protein for a vegetarian. My son is a gym holic and always looking for ways to get his protein from lentils other than eggs. He says to reach his protein requirement for the day, the amount of lentils he has to eat is sometimes heavy on the gut. Would really appreciate if you throw some light on this ❞
Unless one has IBS or similar (or is otherwise unaccustomed to consuming healthy amounts of fiber), lentils shouldn’t be at all problematic for the digestion.
However, the digestive process can still be eased by (speaking specifically for lentils here) blending them (in the water they were cooked in). This thick tasty liquid can then be used as the base of a soup, for example.
Soy is an excellent source of complete protein too. Your son probably knows this because it’s in a lot of body-building supplements as soy protein isolate, but can also be enjoyed as textured soy protein (as in many plant-based meats), or even just soy beans (edamame). Tofu (also made from soy) is very versatile, and again can be blended to form the basis of a creamy sauce.
Mycoproteins (as found in “Quorn” brand products and other meat substitutes) also perform comparably to meat from animals:
Meatless Muscle Growth: Building Muscle Size and Strength on a Mycoprotein-Rich Vegan Diet
See also, for interest:
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What’s Keeping the US From Allowing Better Sunscreens?
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When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”
At issue is not just whether people are using enough sunscreen, but what ingredients are in it.
The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.
Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.
Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.
In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.
“It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”
Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.
Dermatologists Offer Tips on Keeping Skin Safe and Healthy
– Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.
Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.
But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.
“It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.
Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.
“That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”
Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”
Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.
The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.
“It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”
The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.
“Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.
D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.
Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.
D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.
As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.
“The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Less Common Oral Hygiene Options
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Less Common Alternatives For Oral Hygiene!
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
- The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
- The second part was: Flossing, Better (And Easier!)
- The third (and for now at least, final) part will look at some less common alternatives.
Tooth soap
The idea here is simplicity, and brushing with as few ingredients as possible. Soap cleans your teeth the same way it cleans your (sometimes compositionally quite similar—enamel and all) dishes, without damaging them.
We’d love to link to some science here, but alas, it appears to have not yet been done—at least, we couldn’t find any!
You can make your own tooth soap if you are feeling confident, or you might prefer to buy one ready-made (here’s an example product on Amazon, with various flavor options)
Oil pulling
We are getting gradually more scientific now; there is science for this one… But the (scientific) reviews are mixed:
Wooley et al., 2020, conducted a review of extant studies, and concluded:
❝The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene❞
The “Science-Based Medicine” project was less positive in its assessment, and declared that all and any studies that found oil pulling to be effective were a matter of researcher/publication bias. We would note that SBM is a private project and is not without its own biases, but for balance, here is what they had to offer:
A more rounded view seems to be that it is a good method for cleaning your teeth if you don’t have better options available (whereby, “better options” is “almost any other method”).
One final consideration, which the above seemed not to consider, is:
If you have sensitive teeth/gums, oil-pulling is the gentlest way of cleaning them, and getting them back into sufficient order that you can comfortably use other methods.
Want to try it? You can use any food-grade oil (coconut oil or olive oil are common choices).
Chewing stick
Not just any stick—a twig of the Salvadora persica tree. This time, there’s lots of science for it, and it’s uncontroversially effective:
❝A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties.
Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva.
Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush❞
Read in full: A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health
And about the efficacy vs using a toothbrush, here’s an example:
Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health
Want to try the miswak stick? Here’s an example product on Amazon.
Enjoy!
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The Neuroscience of You – by Dr. Chantel Prat
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The insides of people are rarely so standardized as one finds in a medical textbook, and that’s just as true of the brain as it is of any other organ—and often more so.
Our brains all look quite different from each other’s. Of course there are similarities; a wobbly mass of white and grey matter with tiny blood vessels running through. The constituent parts are (usually!) all present and correct. But… what is “correct”?
Dr. Chantel Prat takes us on a tour of the anatomical features that we may have grown or shrunken over the course of our life, according to how we’ve used them, or not. She also looks at what’s going on when it comes to the smaller scale—from the neuronal to the neurochemical.
We learn the truth (and myth) when it comes to left- and right-brainedness, and we learn how whether we saw that dress as black and blue or white and gold, depends on our circadian rhythm (and thus whether we have wired ourselves for perceiving colors more or less often under daylight or artificial light). And lots more.
The style throughout is very accessible, for a book that goes beyond most “how the brain works” books.
Bottom line: if you’re interested in the workings of your brain (as opposed to: a standardized Platonic ideal of what a brain might be), then this book will set you on the right track.
Click here to check out The Neuroscience of You, and learn more about what makes you you!
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4 Practices To Build Self-Worth That Lasts
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Self-worth is internal, based on who you are, not what you do or external validation. It differs from self-esteem, which is more performance-based. High self-worth doesn’t necessarily mean arrogance, but can lead to more confidence and success. Most importantly, it’ll help you to thrive in what’s actually most important to you, rather than being swept along by what other people want.
A stable foundation
A strong sense of self-worth shapes how you handle boundaries, what you believe you deserve, and what you pursue in life. This matters, because life is unpredictable, so having a resilient internal foundation (like a secure “house”) helps you to weather challenges.
- Self-acceptance and compassion:
- Accept both your positive and negative traits with compassion.
- Don’t judge yourself harshly; allow yourself to accept imperfections without guilt or shame.
- Self-trust:
- Trust yourself to make choices that benefit you and create habits that support long-term well-being—especially if those benefits are cumulative!
- Balance self-care with flexibility to enjoy life without being overly rigid.
- Get uncomfortable:
- Growth happens outside your comfort zone. Step into new, challenging experiences to build self-trust.
- However! Small uncomfortable actions lead to greater confidence and a stronger sense of self. Large uncomfortable actions often doing lead anywhere good.
- Separation of tasks:
- Oftentimes we end up overly preoccupying ourselves with things that are not actually our responsibility. Focus instead on tasks that genuinely belong to you, and let go of trying to control others’ perceptions or tasks.
- Seek internal validation, not external praise. Avoid people-pleasing behavior.
Finally, three things to keep in mind:
- Boundaries: respecting your own boundaries strengthens self-worth, avoiding burnout from people-pleasing.
- Validation: self-worth is independent of how others perceive you; focus on your integrity and personal growth.
- Accountability: take responsibility for your actions but recognize that others’ reactions are beyond your control.
For more on all of these things, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Practise Self-Compassion In Your Relationship (But Watch Out!)
Take care!
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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:
- Self-acceptance and compassion: