The Herbal Supplement That Rivals Prozac

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Flower Power: St. John’s Wort’s Drug-Level Effectiveness

St. John’s wort is a small yellow flower, extract of which can be bought inexpensively off-the-shelf in pretty much any pharmacy in most places.

It’s sold and used as a herbal mood-brightener.

Does it work?

Yes! It’s actually very effective. This is really uncontroversial, so we’ll keep it brief.

The main findings of studies are that St. John’s wort not only gives significant benefits over placebo, but also works about as well as prescription anti-depressants:

A systematic review of St. John’s wort for major depressive disorder

They also found that fewer people stop taking it, compared to how many stop taking antidepressants. It’s not known how much of this is because of its inexpensive, freely-accessible nature, and how much might be because it gave them fewer adverse side effects:

Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis

How does it work?

First and foremost, it’s an SSRI—a selective serotonin reuptake inhibitor. Basically, it doesn’t add serotonin, but it makes whatever serotonin you have, last longer. Same as most prescription antidepressants. It also affects adenosine and GABA pathways, which in lay terms, means it promotes feelings of relaxation, in a similar way to many prescription antianxiety medications.

Mechanism of action of St John’s wort in depression: what is known?

Any problems we should know about?

Yes, definitely. To quote directly from the National Center for Complementary and Integrative Health:

St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as:

  • Antidepressants
  • Birth control pills
  • Cyclosporine, which prevents the body from rejecting transplanted organs
  • Some heart medications, including digoxin and ivabradine
  • Some HIV drugs, including indinavir and nevirapine
  • Some cancer medications, including irinotecan and imatinib
  • Warfarin, an anticoagulant (blood thinner)
  • Certain statins, including simvastatin

Click here for a more comprehensive list of interactions, contraindications, and potential side effects

I’ve read all that, and want to try it!

As ever, we don’t sell it (or anything else), but here’s an example product on Amazon.

Please be safe and do check with your doctor and/or pharmacist, though!

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  • Miss Diagnosis: Anxiety, ADHD, & Women

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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

    ❝Why is ADHD so often misdiagnosed as anxiety in women?❞

    A great question! A short and slightly flippant answer could be “it’s the medical misogyny”:

    Women and Minorities Bear the Brunt of Medical Misdiagnosis

    …and if you’d like to learn more in-depth about this, we recommend this excellent book:

    Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghornyou can read our review here

    However, in this case there is more going on too!

    Part of this is because ADHD is, like many psychiatric issues, a collection of symptoms that may or may not all always be present. Since clinical definitions are decided by clinicians, rather than some special natural law of the universe, sometimes this results in “several small conditions in a trenchcoat”, and if one symptom is or isn’t present, it can make things look quite different:

    What’s The Difference Between ADD and ADHD?

    There are two things at hand here: as in the above example, there’s the presence or absence of hyperactivity, but also, that “attention deficit”?

    It’s often not really a deficit of attention, so much as the attention is going somewhere else—an example of naming psychiatric disorders for how they affect other people, rather than the person in question.

    Sidenote: personality disorders really get the worst of this!

    “You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”

    “You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”

    etc

    In the case of ADHD and anxiety and women, a lot of this comes down to how the redirection of focus is perceived:

    ❝For some time, it has been held that women with ADHD are more likely to internalize symptoms and become anxious and depressed and to suffer emotional dysregulation❞

    ~ Dr. Patricia Quinn

    Source: Attention-deficit/hyperactivity disorder and its comorbidities in women and girls: An evolving picture

    This internalization of symptoms, vs the externalization more generally perceived in boys and men, is more likely to be seen as anxiety.

    Double standards also abound for social reasons, e.g:

    • He is someone who thinks ten steps ahead and covers all bases
    • She is anxious and indecisive and unable to settle on one outcome

    Here’s a very good overview of how this double-standard makes its way into diagnostic processes, along with other built-in biases:

    Miss. Diagnosis: A Systematic Review of ADHD in Adult Women

    Want to learn more?

    We’ve reviewed quite a few books about ADHD, but if we had to pick one to spotlight, we’d recommend this one:

    The Silent Struggle: Taking Charge of ADHD in Adults – by L. William Ross-Child, MLC

    Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!

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  • Easily Digestible Vegetarian Protein Sources

    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.

    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:

    Vegan and Omnivorous High Protein Diets Support Comparable Daily Myofibrillar Protein Synthesis Rates and Skeletal Muscle Hypertrophy in Young Adults

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  • Thinking, Fast and Slow – by Dr. Daniel Kahneman

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    We all try to make the best decisions we can with the information available… Don’t we?

    Yet, somehow, a survival chance of 90% seems better than a mortality rate of 10%, and as it turns out, we as fallible humans are prey to all manner of dubious heuristics.

    Nobel Prize winner Dr. Daniel Kahneman lays out for us two sytems of thought process:

    • Fast, intuitive, emotional
    • Slow, deliberate, logical

    He makes the case for how and why we do need both, but often end up using the wrong one. He notes how the first is required for efficiency, or we would spend all day deciding what socks to wear… The second, meanwhile, is required for high-stakes decisions, but is lazy by nature, and often we don’t engage it when we ought to.

    Over the course of many diverse examples, Dr. Kahneman shows how again and again, the second system is slowly cogitating at the back of the class, while the first system is bouncing up and down with its hand in the air saying “I know! I know!”, even when, in fact, it does not know.

    For a book largely founded in economics (it’s a massive takedown of the notion of the rational consumer), it is not at all dry, and is very readable in style. It’s engaging throughout, and readers far removed from Wall Street will find plenty of ways it relates to our everyday lives.

    Bottom line: if you’d like to avoid making many mistakes in what you’d assumed to be rational decisions, this book is critical reading.

    Click here to check out “Thinking, Fast And Slow”, and enjoy the results of better decisions!

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  • The Better Brain – by Dr. Bonnie Kaplan and Dr. Julia Rucklidge

    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 reviewed books about eating for brain health before, but this is the first time we’ve reviewed one written by clinical psychologists.

    What does that change? Well, it means it less focus on, say, reducing beta amyloid plaques, and more on mental health—which often has a more immediate impact in our life.

    In the category of criticisms, the authors do seem to have a bit of a double-standard. For example, they criticise psychiatrists prescribing drugs that have only undergone 12-week clinical trials, but they cite a single case-study of a 10-year-old boy as evidence for a multivitamin treating his psychosis when antipsychotics didn’t work.

    However, the authors’ actual dietary advice is nonetheless very respectable. Whole foods, nutrients taken in synergistic stacks, cut the sugar, etc.

    Bottom line: if you’d like to learn about the impact good nutrition can have on the brain’s health, ranging from diet itself to dietary supplements, this book presents many avenues to explore.

    Click here to check out “The Better Brain”, and eat for the good health of yours!

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  • The Teenage Brain – by Dr. Frances Jensen

    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 realize that we probably have more grandparents of teenagers than parents of teenagers here, but most of us have at least some teenage relative(s). Which makes this book interesting.

    There are a lot of myths about the teenage brain, and a lot of popular assumptions that usually have some basis in fact but are often misleading.

    Dr. Jensen gives us a strong foundational grounding in the neurophysiology of adolescence, from the obvious-but-often-unclear (such as the role of hormones) to less-known things like the teenage brain’s general lack of myelination. Not just “heightened neuroplasticity” but, if you imagine the brain as an electrical machine, then think of myelin as the insulation between the wires. Little wonder some wires may get crossed sometimes!

    She also talks about such things as the teenage circadian rhythm’s innate differences, the impact of success and failure on the brain, and harder topics such as addiction—and the adolescent cortisol functions that can lead to teenagers needing to seek something to relax in the first place.

    In criticism, we can only say that sometimes the author makes sweeping generalizations without acknowledging such, but that doesn’t detract from what she has to say on the topic of neurophysiology.

    Bottom line: if there’s a teenager in your life whose behavior and/or moods are sometimes baffling to you, and whose mysteries you’d like to unravel, this is a great book.

    Click here to check out the Teenage Brain, and better understand those around you!

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  • Can Saturated Fats Be Healthy?

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    Saturated Fat: What’s The Truth?

    We asked you for your health-related opinion of saturated fat, and got the above-pictured, below-described, set of results.

    • Most recorded votes were for “Saturated fat is good, but only some sources, and/or in moderation”
      • This is an easy one to vote for, because of the “and/or in moderation” part, which tends to be a “safe bet” for most things.
    • Next most popular was “Saturated fat is terrible for the health and should be avoided”
    • About half as many recorded votes were for “I’m not actually sure what makes saturated fat different”, which is a very laudable option to click. Admitting when we don’t know things (and none of us know everything) is a very good first step to learning about them!
    • Fewest recorded votes were for “Saturated fat is the best source of energy; we should get plenty”.

    So, what does the science say?

    First, a bit of physics, chemistry, and biology

    You may be wondering what, exactly, saturated fats are “saturated” with. That’s a fair question, so…

    All fats have a molecular structure made up of carbon, hydrogen, and oxygen atoms. Saturated fats are saturated with hydrogen, and thus have only single bonds between carbon atoms (unsaturated fats have at least one double-bond between carbon atoms).

    The observable effect this has on them, is that fats that are saturated with hydrogen are solid at room temperature, whereas unsaturated fats are liquid at room temperature. Their different properties also make for different interactions inside the human body, including how likely or not they are to (for example) clog arteries.

    See also: Could fat in your bloodstream cause blood clots?

    Saturated fat is the best source of energy; we should get plenty: True or False?

    False, in any reasonable interpretation, anyway. That is to say, if your idea of “plenty” is under 13g (e.g: two tablespoons of butter, and no saturated fat from other sources, e.g. meat) per day, then yes, by all means feel free to eat plenty. More than that, though, and you might want to consider trimming it down a bit.

    The American Heart Association has this to say:

    ❝When you hear about the latest “diet of the day” or a new or odd-sounding theory about food, consider the source.

    The American Heart Association recommends limiting saturated fats, which are found in butter, cheese, red meat and other animal-based foods, and tropical oils.

    Decades of sound science has proven it can raise your “bad” cholesterol and put you at higher risk for heart disease.❞

    Source: The American Heart Association Diet and Lifestyle Recommendations on Saturated Fat

    The British Heart Foundation has a similar statement:

    ❝Despite what you read in the media, our advice is clear: replace saturated fats with unsaturated fats and avoid trans fats. Saturated fat is the kind of fat found in butter, lard, ghee, fatty meats and cheese. This is linked to an increased risk of heart and circulatory disease❞

    Source: British Heart Foundation: What does fat do and what is saturated fat?

    As for the World Health Organization:

    ❝1. WHO strongly recommends that adults and children reduce saturated fatty acid intake to 10% of total energy intake

    2. WHO suggests further reducing saturated fatty acid intake to less than 10% of total energy intake

    3. WHO strongly recommends replacing saturated fatty acids in the diet with polyunsaturated fatty acids; monounsaturated fatty acids from plant sources; or carbohydrates from foods containing naturally occurring dietary fibre, such as whole grains, vegetables, fruits and pulses.❞

    Source: Saturated fatty acid and trans-fatty acid intake for adults and children: WHO guideline

    Please note, organizations such as the AHA, the BHF, and the WHO are not trying to sell us anything, and just would like us to not die of heart disease, the world’s #1 killer.

    As for “the best source of energy”…

    We evolved to eat (much like our nearest primate cousins) a diet consisting mostly of fruits and other edible plants, with a small supplementary amount of animal-source protein and fats.

    That’s not to say that because we evolved that way we have to eat that way—we are versatile omnivores. But for example, we are certainly not complete carnivores, and would quickly sicken and die if we tried to live on only meat and animal fat (we need more fiber, more carbohydrates, and many micronutrients that we usually get from plants)

    The closest that humans tend to come to doing such is the ketogenic diet, which focuses on a high fat, low carbohydrate imbalance, to promote ketosis, in which the body burns fat for energy.

    The ketogenic diet does work, and/but can cause a lot of health problems if a lot of care is not taken to avoid them.

    See for example: 7 Keto Risks To Keep In Mind

    Saturated fat is terrible for the health and should be avoided: True or False?

    False, if we are talking about “completely”.

    Firstly, it’s practically impossible to cut out all saturated fats, given that most dietary sources of fat are a mix of saturated, unsaturated (mono- and poly-), and trans fats (which are by far the worst, but beyond the scope of today’s main feature).

    Secondly, a lot of research has been conducted and found insignificant or inconclusive results, in cases where saturated fat intake was already within acceptable levels (per the recommendations we mentioned earlier), and then cut down further.

    Rather than fill up the newsletter with individual studies of this kind here’s a high-quality research review, looking at 19 meta-analyses, each of those meta-analyses having looked at many studies:

    Dietary saturated fat and heart disease: a narrative review

    Saturated fat is good, but only some sources, and/or in moderation: True or False?

    True! The moderation part is easy to guess, so let’s take a look at the “but only some sources”.

    We were not able to find any convincing science to argue for health-based reasons to favor plant- or animal-sourced saturated fat. However…

    Not all saturated fats are created equal (there are many kinds), and also many of the foods containing them have additional nutrients, or harmful compounds, that make a big difference to overall health, when compared gram-for-gram in terms of containing the same amount of saturated fat.

    For example:

    1. Palm oil’s saturated fat contains a disproportionate amount of palmitic acid, which raises LDL (“bad” cholesterol) without affecting HDL (“good” cholesterol), thus having an overall heart-harmful effect.
    2. Most animal fats contain a disproportionate amount of stearic acid, which has statistically insignificant effects on LDL and HDL levels, and thus is broadly considered “heart neutral (in moderation!)
    3. Coconut oil’s saturated fat contains a disproportionate amount of lauric acid, which raises total cholesterol, but mostly HDL without affecting LDL, thus having an overall heart-beneficial effect (in moderation!)

    Do you know what’s in the food you eat?

    Test your knowledge with the BHF’s saturated fat quiz!

    Enjoy!

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