Ridged Nails: What Are They Telling You?

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Dr. Yaseen Arsalan, a Doctor of Pharmacy, has advice on the “nutraceutical” side of things:

Onychorrhexis

Sounds like the name of a dinosaur, but it’s actually the condition that creates the vertical ridges that sometimes appear on nails. It’s especially likely in the case of thinner nails, and/or certain nutritional deficiencies. Overuse of certain chemicals (including nail polish remover, hair products that get on your hands a lot, and cleaning fluids) can also cause it. It can also be worsened by various conditions, including eczema, psoriasis, hypothyroidism, anemia, and amyloidosis, but it won’t usually be outright caused by those alone.

There are two main kinds of ridges on nails:

  • Vertical ridges: associated with hypothyroidism, anemia, and aging. Often an indicator of low iron.
  • Horizontal ridges (Beau’s lines): caused by interrupted nail growth, brute force trauma, chemotherapy, acrylic nails, and gel nail polishes. Can also be an indicator of low zinc.

There are an assortment of medical treatments available, which Dr. Arsalan discusses in the video, but for home remedy treatment, he recommends:

  • Nail-strengthening creams (look for coconut oil, shea butter, beeswax, vitamin E)
  • Hydration (this is about overall hydration e.g. water intake)
  • Careful nail trimming (fingernails with a curved shape and toenails straight across)
  • Nail ridge filler (he recommends the brand Barrielle, for not containing formaldehyde or formalin)
  • Moisturization (with cuticle oil or hand creams, because that hydration we talked about earlier is important, and we want it to stay inside the nail)

For more on those things, plus the medical treatments plus other “how to avoid this” measures, enjoy:

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  • HRT: Bioidentical vs Animal

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    HRT: A Tale Of Two Approaches

    In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).

    • A little over a third said “It can be medically beneficial, but has some minor drawbacks”
    • A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
    • Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
    • Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”

    So what does the science say?

    Which HRT?

    One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:

    ❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞

    And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.

    So to quickly clear up any confusion:

    • Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
    • Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.

    There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).

    A quick jumping-off point if you’re interested in that:

    Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer

    this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.

    Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.

    In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.

    Bioidentical hormones are safer: True or False?

    True! This is an open-and-shut case:

    ❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.

    Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞

    Further research since that review has further backed up its findings.

    Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?

    So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.

    HRT can increase the risk of breast cancer: True or False?

    Contingently True, but for most people, there is no significant increase in risk.

    First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.

    There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:

    ❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.

    Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞

    In fewer words:

    • Estradiol by itself: no increased risk of breast cancer
    • Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
    • Estradiol with actual progesterone: back to no increased risk of breast cancer

    Source: Estradiol therapy and breast cancer risk in perimenopausal and postmenopausal women: a systematic review and meta-analysis

    So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!

    However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:

    ❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.

    Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞

    Source: HRT in difficult circumstances: are there any absolute contraindications?

    HRT makes you happier, healthier, and smell nice too: True or False?

    Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.

    The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.

    More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:

    Read more: Skin, hair and beyond: the impact of menopause

    We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.

    HRT does have some drawbacks: True or False?

    True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.

    For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.

    It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.

    If you experience anything more alarming than that, then indeed check with your doctor.

    HRT is a dangerous scam and sham: True or False?

    False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.

    The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.

    As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.

    They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.

    See for example:

    Menopausal Hormone Replacement Therapy and Reduction of All-Cause Mortality and Cardiovascular Disease

    Our apologies, gentlemen

    We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!

    To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space

    Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.

    That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.

    Meanwhile… take care, all!

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  • Feel Better In 5 – by Dr. Rangan Chatterjee

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    We’ve featured Dr. Rangan Chatterjee before, and here’s a great book of his.

    The premise is a realistic twist on a classic, the classic being “such-and-such, in just 5 minutes per day!”

    In this case, Dr. Chatterjee offers many lifestyle interventions that each take just 5 minutes, with the idea that you implement 3 of them per day (your choice which and when), and thus gradually build up healthy habits. Of course, once things take as habits, you’ll start adding in more, and before you know it, half your lifestyle has changed for the better.

    Which, you may be thinking “my lifestyle’s not that bad”, but if you improve the health outcomes of, say, 20 areas of your life by just a few percent each, you know much better health that adds up to? We’ll give you a clue: it doesn’t add up, it compounds, because each improves the other too, for no part of the body works entirely in isolation.

    And Dr. Chatterjee does tackle the body systematically, by the way; interventions for the gut, heart, brain, and so on.

    As for what these interventions look like; it is very varied. One might be a physical exercise; another, a mental exercise; another, a “make this health 5-minute thing in the kitchen”, etc, etc.

    Bottom line: this is the most supremely easy of easy-ins to healthier living, whatever your starting point—because even if you’re doing half of these interventions, chances are you aren’t doing the other half, and the idea is to pick and choose how and when you adopt them in any case, just picking three 5-minute interventions each day with no restrictions. In short, a lot of value to had here when it comes to real changes to one’s serious measurable health.

    Click here to check out Feel Better In 5, and indeed feel better in 5!

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  • Why do I need to get up during the night to wee? Is this normal?

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    It can be normal to wake up once or even twice during the night to wee, especially as we get older.

    One in three adults over 30 makes at least two trips to the bathroom every night.

    Waking up from sleep to urinate on a regular basis is called nocturia. It’s one of the most commonly reported bothersome urinary symptoms (others include urgency and poor stream).

    So what causes nocturia, and how can it affect wellbeing?

    A range of causes

    Nocturia can be caused by a variety of medical conditions, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an overactive bladder, or gastrointestinal issues. Other causes include pregnancy, medications and consumption of alcohol or caffeine before bed.

    While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or insomnia, can also cause nocturia.

    When we sleep, an antidiuretic hormone is released that slows down the rate at which our kidneys produce urine. If we lie awake at night, less of this hormone is released, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.

    Stress, anxiety and watching television late into the night are common causes of insomnia.

    A person with their hands in front of their pelvic area in a bathroom.
    Sometimes we need to get up late at night to pee.
    Christian Moro

    Effects of nocturia on daily functioning

    The recommended amount of sleep for adults is between seven and nine hours per night. The more times you have to get up in the night to go to the bathroom, the more this impacts sleep quantity and quality.

    Decreased sleep can result in increased tiredness during the day, poor concentration, forgetfulness, changes in mood and impaired work performance.

    If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.

    In more severe cases, nocturia has been compared to having a similar impact on quality of life as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.

    Nocturia not only upsets sleep, but also increases the risk of falls from moving around in the dark to go to the bathroom.

    Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.

    Can you have a ‘small bladder’?

    It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is smaller relative to your other organs.

    If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.

    If you find you are going to the bathroom quite a lot during the day and evening (more than eight times in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.

    If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.

    There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.

    A happy and healthy bladder

    Here are some tips to maintain a happy and healthy bladder, and reduce the risk you’ll be up at night:

    Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Savor: Mindful Eating, Mindful Life – by Thich Nhat Hanh and Dr. Lilian Cheung

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve talked about mindful eating before at 10almonds, so here’s a book about it. You may wonder how much there is to say!

    As it happens, there’s quite a bit. The authors, a Buddhist monk (Hanh) and a Harvard nutritionist (Dr. Cheung) explore the role of mindful eating in our life.

    There is an expectation that we the reader want to lose weight. If we don’t, those parts of the book will be a “miss” for us, but still contain plenty of other value.

    Most of the same advices can be applied equally to other aspects of health, in any case. A lot of that comes from the book’s Buddhist principles, including the notion that:

    1. We are experiencing suffering
    2. Suffering has a cause
    3. What has a cause can have an end
    4. The way to this end is mindfulness

    As such, the process itself is also mindfulness all the way through:

    1. To be mindful of our suffering (and not let it become background noise to be ignored)
    2. To be mindful of the cause of our suffering (rather than dismissing it as just how things are)
    3. To be mindful of how to address that, and thus end the suffering (rather than despairing in inaction)
    4. To engage mindfully in the process of doing so (and thus not fall into the trap of thinking “job done”)

    And, as for Dr. Cheung? She also has input throughout, with practical advice about the more scientific side of rethinking one’s diet.

    Bottom line: this is an atypical book, and/but perhaps an important one. Certainly, at the very least it may be one to try if more conventional approaches have failed!

    Click here to check out “Savor” on Amazon today, and get mindful!

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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:

    Take care!

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  • Bananas vs Grapes – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing bananas to grapes, we picked the bananas.

    Why?

    In terms of macros, bananas have more fiber and carbs, the ratio of which gives them the (very slightly) lower glycemic index. The difference in GI is marginal enough that it’d be tied on that point alone, but looking at total fiber figures, we say that having nearly 3x the fiber counts for a win here.

    In the category of vitamins, bananas have more of vitamins B2, B3, B5, B6, B7, B9, C, and choline, while grapes have more of vitamins A, B1, E, and K. Thus, an 8:4 win for bananas (and with considerable margins of difference, too).

    When it comes to minerals, bananas have more copper, magnesium, phosphorus, potassium*, selenium, and zinc, while grapes have more calcium and manganese. Thus, a 6:2 win for bananas this time.

    *because of some popular mentions in TV shows, people get hung up on bananas being a good source of potassium. Which they are, but they’re not even in the top 10 of fruits for potassium. Here’s a non-exhaustive list of fruits that have more potassium than bananas, portion for portion:

    1. Honeydew melon
    2. Papaya
    3. Mango
    4. Prunes
    5. Figs
    6. Dates
    7. Nectarine
    8. Cantaloupe melon
    9. Kiwi
    10. Orange

    See also: The Other “Special K”: The Top Micronutrient Deficiency In High Blood Pressure

    It’s worth mentioning polyphenols: black/red grapes do have more abundant polyphenols than bananas, and this is very much a point in their favor; however, we don’t think it’s enough to compensate for bananas beating them in every other category, so we still declare bananas the winner.

    Of course, the solution to this dilemma is to enjoy both!

    Want to learn more?

    You might like to read:

    Can We Drink To Good Health? ← while there are polyphenols such as resveratrol in red wine that per se would boost heart health, there’s so little per glass that you may need 100–1000 glasses per day to get the dosage that provides benefits in mouse studies.

    If you’re not a mouse, you might even need more than that!

    To this end, many people prefer resveratrol supplementation ← link is to an example product on Amazon, but there are plenty more so feel free to shop around 😎

    Enjoy!

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