
Rebalancing Dopamine (Without “Dopamine Fasting”)
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Rebalancing Dopamine (Without “Dopamine Fasting”)

This is Dr. Anna Lembke. She’s a professor of psychiatry at Stanford, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic—as well as running her own clinical practice, and serving on the board of an array of state and national addiction-focused organizations.
Today we’re going to look at her work on dopamine management…
Getting off the hedonic treadmill
For any unfamiliar with the term, the “hedonic treadmill” is what happens when we seek pleasure, enjoy the pleasure, the pleasure becomes normalized, and now we need to seek a stronger pleasure to get above our new baseline.
In other words, much like running on a reciprocal treadmill that just gets faster the faster we run.
What Dr. Lembke wants us to know here: pleasure invariably leads to pain
This is not because of some sort of extrinsic moral mandate, nor even in the Buddhist sense. Rather, it is biology.
Pleasure and pain are processed by the same part of the brain, and if we up one, the other will be upped accordingly, to try to keep a balance.
Consequently, if we recklessly seek “highs”, we’re going to hit “lows” soon enough. Whether that’s by drugs, sex, or just dopaminergic habits like social media overuse.
Dr. Lembke’s own poison of choice was trashy romance novels, by the way. But she soon found she needed more, and more, and the same level wasn’t “doing it” for her anymore.
So, should we just give up our pleasures, and do a “dopamine fast”?
Not so fast!
It depends on what they are. Dopamine fasting, per se, does not work. We wrote about this previously:
Short On Dopamine? Science Has The Answer
However, when it comes to our dopaminergic habits, a short period (say, a couple of weeks) of absence of that particular thing can help us re-find our balance, and also, find insight.
Lest that latter sound wishy-washy: this is about realizing how bad an overuse of some dopaminergic activity had become, the better to appreciate it responsibly, going forwards.
So in other words, if your poison is, as in Dr. Lembke’s case, trashy romance novels, you would abstain from them for a couple of weeks, while continuing to enjoy the other pleasures in life uninterrupted.
Substances that create a dependency are a special case
There’s often a popular differentiation between physical addictions (e.g. alcohol) and behavioral addictions (e.g. video games). And that’s fair; physiologically speaking, those may both involve dopamine responses, but are otherwise quite different.
However, there are some substances that are physical addictions that do not create a physical dependence (e.g. sugar), and there are substances that create a physical dependence without being addictive (e.g. many antidepressants)
See also: Addiction and physical dependence are not the same thing
In the case of anything that has created a physical dependence, Dr. Lembke does not recommend trying to go “cold turkey” on that without medical advice and supervision.
Going on the counterattack
Remember what we said about pleasure and pain being processed in the same part of the brain, and each rising to meet the other?
While this mean that seeking pleasure will bring us pain, the inverse is also true.
Don’t worry, she’s not advising us to take up masochism (unless that’s your thing!). But there are very safe healthy ways that we can tip the scales towards pain, ultimately leading to greater happiness.
Cold showers are an example she cites as particularly meritorious.
As a quick aside, we wrote about the other health benefits of these, too:
A Cold Shower A Day Keeps The Doctor Away?
Further reading
Want to know more? You might like her book:
Dopamine Nation: Finding Balance in the Age of Indulgence
Enjoy!
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Finding Geriatric Doctors for Seniors
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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
❝[Can you write about] the availability of geriatric doctors Sometimes I feel my primary isn’t really up on my 70 year old health issues. I would love to find a doctor that understands my issues and is able to explain them to me. Ie; my worsening arthritis in regards to food I eat; in regards to meds vs homeopathic solutions.! Thanks!❞
That’s a great topic, worthy of a main feature! Because in many cases, it’s not just about specialization of skills, but also about empathy, and the gap between studying a condition and living with a condition.
About arthritis, we’re going to do a main feature specifically on that quite soon, but meanwhile, you might like our previous article:
Keep Inflammation At Bay (arthritis being an inflammatory condition)
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What’s the difference between ‘strep throat’ and a sore throat? We’re developing a vaccine for one of them
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
It’s the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.
But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?
Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.
Prostock-studio/Shutterstock How are they similar?
It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.
People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.
Thankfully, both types of sore throat usually get better by themselves.
How are they different?
Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).
These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted antibiotic side-effects.
But strep throat is caused by Streptococcus pyogenes bacteria, also known as strep A. Strep throat is most common in school-aged children, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.
In fact, the potential for complications is one key difference between a viral sore throat and strep throat.
Generally, a viral sore throat is very unlikely to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as chronic fatigue syndrome, multiple sclerosis and certain cancers).
But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.
Invasive strep A infections and deaths have been rising in recent years around the world, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.
Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.
The most common example is rheumatic heart disease. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.
Around the world more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.
However, parts of Australia have some of the highest rates of rheumatic heart disease in the world. More than 5,300 Indigenous Australians live with it.
Strep throat is caused by Streptococcus bacteria and can be treated with antibiotics if needed. Kateryna Kon/Shutterstock Why do some people get sicker than others?
We know strep A infections and rheumatic heart disease are more common in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.
However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.
We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.
How about a vaccine for strep A?
There is no strep A vaccine but many groups in Australia, New Zealand and worldwide are working towards one.
For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the Australian Strep A Vaccine Initiative to develop strep A vaccines. There’s also a global consortium working towards the same goal.
Companies such as Vaxcyte and GlaxoSmithKline have also been developing strep A vaccines.
What if I have a sore throat?
Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.
Your GP can examine you, consider running some tests and help you decide if you need antibiotics.
Kim Davis, General paediatrician and paediatric infectious diseases specialist, Murdoch Children’s Research Institute; Alma Fulurija, Immunologist and the Australian Strep A Vaccine Initiative project lead, Telethon Kids Institute, and Myra Hardy, Postdoctoral Researcher, Infection, Immunity and Global Health, Murdoch Children’s Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Heal And Regrow Receding Gums
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝So, I have a topic that I’d love you guys to discuss: green tea. I used to try + drink it years ago but I always got an allergic reaction to it. So the question I’d like answered is: Will I still get the same allergic reaction if I take the capsules ? Also, because it’s caffeinated, will taking it interfere with iron pills, other vitamins + meds ? I read that the health benefits of the decaffeinated tea/capsules are not as great as the caffeinated. Any info would be greatly appreciated !! Thanks much !!❞
I’ll answer this one in the first person as I’ve had a similar issue:
I found long ago that taking any kind of tea (not herbal infusions, but true teas, e.g. green tea, black tea, red tea, etc) on an empty stomach made me want to throw up. The feeling would subside within about half an hour, but I learned it was far better to circumvent it by just not taking tea on an empty stomach.
However! I take an l-theanine supplement when I wake up, to complement my morning coffee, and have never had a problem with that. Of course, my physiology is not your physiology, and this “shouldn’t” be happening to either of us in the first place, so it’s not something there’s a lot of scientific literature about, and we just have to figure out what works for us.
I’d hypothesize that the reason tea causes a problem but the supplement doesn’t, is because the reaction is not to the l-theanine, but rather to the tannins in the tea.
This last Monday I wrote (inspired in part by your query) about l-theanine supplementation, and how it doesn’t require caffeine to unlock its benefits after all, by the way. So that’s that part in order.
I can’t speak for interactions with your other supplements or medications without knowing what they are, but I’m not aware of any known issue, beyond that l-theanine will tend to give a gentler curve to the expression of some neurotransmitters. So, if for example you’re talking anything that affects that (e.g. antidepressants, antipsychotics, ADHD meds, sleepy/wakefulness meds, etc) then checking with your doctor is best.
❝Can you do something on collagen and keep use posted on pineapple, and yes love and look forward to each issue❞
Glad you’re enjoying! We did write a main feature on collagen a little while back! Here it is:
We Are Such Stuff As Fish Are Made Of
As for pineapple, there’s not a lot to keep you posted about! Pineapple’s protein-digesting, DNA-unzipping action is well-established and considered harmless (if your mouth feels weird when you eat pineapple or drink pineapple juice, this is why, by the way) because no meaningful damage was done.
For example:
- Pineapple’s bromelain action is akin to taking apart a little lego model brick by brick (easy to fix)
- Clastogenic genotoxicity is more like taking a blowtorch to the lego model (less easy to fix)
Fun fact: pineapple is good against inflammation, because of the very same enzyme!
❝I never knew anything about the l- tea. Where can I purchase it?❞
You can get it online quite easily! Here’s an example on Amazon
❝The 3 most important exercises don’t work if you can’t get on the floor. I’m 78, and have knee replacements. What about 3 best chair yoga stretches? Love your articles!❞
Here are six!
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Awakening Your Ikigai – by Dr. Ken Mogi
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It’s been well-established in supercentenarian studies that one of the key factors beyond diet or exercise or suchlike (important as those things definitely are), is having a purpose to one’s life.
Neuroscientist Dr. Ken Mogi explains in this very easy-to-read book, how we can bring ikigai into our lives.
From noticing the details of the small things in life, to reorienting one’s life around what’s most truly most important to us, Dr. Mogi gives us not just a “this is ikigai” exposé, but rather, a practical and readily applicable how-to guide.
Bottom line: if you’ve so far been putting off ikigai as “I’ll get to that”, the time to start is today.
Click here to check out Awakening Your Ikigai, and actually awaken yours!
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Strawberries vs Blackberries – Which is Healthier?
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Our Verdict
When comparing strawberries to blackberries, we picked the blackberries.
Why?
Shocking nobody, both are very healthy options. However, blackberries do come out on top:
In terms of macros, the main thing that sets them apart is that blackberries have more than 2x the fiber. Other differences in macros are also in blackberries’ favor, but only very marginally, so we’ll not distract with those here. The fiber difference is distinctly significant, though.
In the category of vitamins, blackberries lead with more of vitamins A, B2, B3, B5, B9, E, and K, as well as more choline. Meanwhile, strawberries boast more of vitamins B1, B6, and C. So, a 8:2 advantage for blackberries (and some of the margins are very large, such as 9x more choline, 4x more vitamin E, and nearly 18x more vitamin A).
When it comes to minerals, things are not less clear: blackberries have considerably more calcium, copper, iron, magnesium, manganese, and zinc. The two fruits are equal in other minerals that they both contain, and strawberries don’t contain any mineral in greater amounts than blackberries do.
A discussion of these berries’ health benefits would be incomplete without at least mentioning polyphenols, but both of them are equally good sources of such, so there’s no distinction to set one above the other in this category.
As ever, enjoy both, though! Diversity is good.
Want to learn more?
You might like to read:
- Strawberries vs Cherries – Which is Healthier?
- Blackberries vs Blueberries – Which is Healthier?
- Strawberries vs Raspberries – Which is Healthier?
Take care!
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Learn to Age Gracefully
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Live Life in Crescendo – by Stephen Covey and Cynthia Covey-Haller
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Stephen Covey is of course best known for his “7 Habits of Highly Effective People“, while the dozen books he wrote afterwards, not including this one, did not get the same acclaim.
Not including this one, because this one was published posthumously and, notwithstanding the order of the names on the cover, in all likelihood his daughter wrote most of.
And yet! The very spirit of this book is in defiance of 7 Habits being his “early career” magnum opus. We say “early career”, because he was 57 already when that was published, but it was one of his earlier books.
In this work the authors lay out the case for how “your most important work is always ahead of you“, and that it is perfectly possible to “live life in crescendo“, and keep on giving whatever it is that we want to give to the world.
We also learn, mostly through storytelling, of how people are infinitely more important than things, and that it is there that we should put our investments. And that while adversity may not make us stronger, it just means we may need to change our approach, to continue to be productive in whatever way is meaningful to us.
Bottom line: if ever you wonder how your future could live up to your past (in a good way), this is the book to get you thinking.
Click here to check out Live Life in Crescendo, and figure out what your next great work will be!
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