Super Gut – by Dr. William Davis

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The 10almonds Team

You may be wondering: what sets this book apart from the other gut health books we’ve reviewed? For this one, mostly it’s depth.

This is the most scientifically dense book we’ve reviewed on gut health, so if you’re put off by that, this might not be one for you. However, you don’t need prior knowledge, as he does explain things as he goes. The advice in this book is not just the usual “gut health 101” stuff, either!

A particular strength of this book is that it looks at a wide variety of gut- and gut-related disorders, and ways certain readers may need to do different things than others, to address those problems on the path to good gut health.

The style, for all its hard science content, is quite sensationalist, and that may take some getting used to for non-Americans. However, it doesn’t affect the content!

Bottom line: if you just want simple basic advice, then probably best to skip this one. However, if you are sincerely serious about gut health (or just like reading this sort of thing because learning is satisfying), then this book is packed with relevant and detailed information.

Click here to check out Super Gut, and get to know and improve yours!

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Recommended

  • The Things You Can See Only When You Slow Down – by Haemin Sunim
  • Cold Weather Health Risks
    Cold weather can be good for your health, but persistent cold poses risks like hypothermia, skin issues, heart problems, weakened immune system, and increased risk of falling.

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  • Heal Your Stressed Brain

    The 10almonds Team

    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.

    Rochelle Walsh, therapist, explains the problem and how to fix it:

    Not all brain damage is from the outside

    Long-term stress and burnout cause brain damage; it’s not just a mindset issue—it impacts the brain physiologically. To compound matters, it also increases the risk of neurodegenerative diseases. While the brain can indeed grow new neurons and regenerate itself, chronic stress damages specific regions, and inhibits that.

    There are some effects of chronic stress that can seem positive—the amygdalae and hypothalamus are seen to grow larger and stronger, for instance—but this is, unfortunately, “all the better to stress you with”. In compensation for this, chronic stress deprioritizes the pre-frontal cortex and hippocampi, so there goes your reasoning and memory.

    This often results in people not managing chronic stress well. Just like a weak heart and lungs might impede the exercise that could make them stronger, the stressed brain is not good at permitting you to do the things that would heal it—preferring to keep you on edge all day, worrying and twitchy, mind racing and body tense. It also tends to lead to autoimmune diseases, due to the increased inflammation (because the body’s threat-detection system as at “jumping at own shadow” levels so it’s deploying every defense it has, including completely inappropriate ones).

    Notwithstanding the “Heal Your Stressed Brain” thumbnail, she doesn’t actually go into this in detail and bids us sign up for her masterclass. We at 10almonds however like to deliver, so you can find useful advice and free resources in our links-drop at the bottom of this article.

    Meanwhile, if you’d like to hear more about the neurological woes described above, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • How To Reduce Your Alzheimer’s Risk

    The 10almonds Team

    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.

    Reduce Your Alzheimer’s Risk

    Alzheimer’s is just one cause of dementia, but it’s a very notable one, not least of all because it’s

    • a) the most common cause of dementia, and
    • b) a measurably terminal disease.

    For that reason we’re focusing on Alzheimer’s today, although most of the advice will go for avoiding dementia in general.

    First, some things not everyone knows about Alzheimer’s:

    • Alzheimer’s is a terminal disease.
    • People who get a diagnosis at age 60 are typically given 4–8 years to live.
      • Some soldier on for as many as 20, but those are rare outliers.
    • Alzheimer’s begins 20 years or more before other symptoms start to develop.
      • This makes this information very relevant for younger people approaching 40, for example.
    • Alzheimer’s accounts for 60–80% of dementia, and affects around 6% of people over 60.
      • By the age of 65, that figure is 10%. By the age of 70, however, the percentage is still about the same—this is because of the mortality rate preventing the accumulation of Alzheimer’s patients over time.

    Want to know more? Read: 2023 Alzheimer’s Disease Facts And Figures Special Report ← this is a very comprehensive downloadablereference, by the way, including a lot of information about diagnosis, treatmentpathways, and earlyinterventions.

    Speaking of diagnosis…

    Know what the symptoms are… and aren’t!

    Forgetting your car keys can be frustrating. Forgetting them frequently can be worrying.

    But: there’s a difference between forgetting your car keys, and forgetting what car keys are used for. The latter is the kind of memory loss that’s more of a red flag for Alzheimer’s.

    Similarly: forgetting someone’s name can be embarrassing. Forgetting someone’s name, asking them, forgetting asking them, asking them again, forgetting again (lather rinse repeat) is more of a red flag for Alzheimer’s.

    There are other symptoms too, some of them less commonly known:

    ❝Difficulty remembering recent conversations, names or events; apathy; and depression are often early symptoms. Communication problems, confusion, poor judgment and behavioral changes may occur next. Difficulty walking, speaking, and swallowing are common in the late stages of the disease❞

    ~ Alzheimer’s Association

    If you or a loved one are experiencing worrying symptoms: when it comes to diagnosis and intervention, sooner is a lot better than later, so do talk to your doctor.

    As for reducing your risk? First, the obvious stuff:

    The usual 5 things that go for almost everything:

    How much do lifestyle changes alone make a difference?

    They make a big difference. This 2022 population-based cohort study (so: huge sample size) looked at people who had 4–5 of the healthy lifestyle factors being studied, vs people who had 0–1 of them. They found:

    ❝A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia.❞

    The numbers of years involved by the way ranged between 3 and 20 years, in terms of life expectancy and years without or with Alzheimer’s, with the average increase of healthy life years being approximately the same as the average increase in years. This is important, because:

    A lot of people think “well if I’m going to go senile, I might as well [unhealthy choice that shortens lifespan]”, but they misunderstand a critical factor:

    The unhealthy choices will reduce their healthy life years, and simply bring the unhealthy ones (and subsequent death) sooner. If you’re going to spend your last few years in ill-health, it’s better to do so at 90 than 50.

    The other thing you may already know… And a thing about it that not everyone considers:

    Keeping cognitively active is important. This much is broadly known by the general public, and to clinicians, this was the fourth “healthy factor” in the list of five (instead of the sleep that we put there, because we were listing the 5 things that go for most preventable health issues).

    Everyone leaps to mention sudoku at this point, so if that’s your thing, great, enjoy it! (This writer personally enjoys chess, which isn’t everyone’s cup of tea; if it yours though, you can come join her on Chess.com and we’ll keep sharp together)

    But the more parts of your mental faculties you keep active, the better. Remember, brainpower (as with many things in health and life) is a matter of “use it or lose it” and this is on a “per skill” basis!

    What this means: doing sudoku (a number-based puzzle game) or chess (great as it may be) won’t help as much for keeping your language skills intact, for example. Given that language skills are one of the most impactful and key faculties to get lost to Alzheimer’s disease, neglecting such would be quite an oversight!

    Some good ways to keep your language skills tip-top:

    • Read—but read something challenging, if possible. It doesn’t have to be Thomas Scanlon’s What We Owe To Each Other, but it should be more challenging than a tabloid, for example. In fact, on the topic of examples:
      • This newsletter is written to be easy to read, while not shying away from complex ideas or hard science. Our mission is literally to “make [well-sourced, science-based] health and productivity crazy simple”.
      • But the academic papers that we link? Those aren’t written to be easy to read. Go read them, or at least the abstracts (in academia, an abstract is essentially an up-front summary, and is usually the first thing you’ll see when you click a link to a study or such). Challenge yourself!
    • Write—compared to reading/listening, producing language is a (related, but) somewhat separate skill. Just ask any foreign language learner which is more challenging: reading or writing!
      • Journaling is great, but writing for others is better (as then you’ll be forced to think more about it)
    • Learn a foreign language—in this case, what matters it that you’re practicing and learning, so in the scale of easy to hard, or doesn’t matter if it’s Esperanto or Arabic. Duolingo is a great free resource that we recommend for this, and they have a wide range of extensive courses these days.

    Now for the least obvious things…

    Social contact is important.

    Especially in older age, it’s easy to find oneself with fewer remaining friends and family, and getting out and about can be harder for everyone. Whatever our personal inclinations (some people being more introverted or less social than others), we are fundamentally a social species, and hundreds of thousands of years of evolution have built us around the idea that we will live our lives alongside others of our kind. And when we don’t, we don’t do as well.

    See for example: Associations of Social Isolation and Loneliness With Later Dementia

    If you can’t get out and about easily:

    • Online socialising is still socializing.
    • Online community is still community.
    • Online conversations between friends are still conversations between friends.

    If you don’t have much (or anyone) in the category of friends and family, join Facebook groups related to your interests, for example.

    Berries are surprisingly good

    ^This may read like a headline from 200,000 BCE, but it’s relevant here!

    Particularly recommended are:

    • blueberries
    • blackberries
    • raspberries
    • strawberries
    • cranberries

    We know that many of these berries seem to have a shelf-life of something like 30 minutes from time of purchase, but… Frozen and dried are perfectly good nutritionally, and in many cases, even better nutritionally than fresh.

    Read: Effect of berry-based supplements and foods on cognitive function: a systematic review

    Turmeric’s health benefits appear to include protecting against Alzheimer’s

    Again, this is about risk reduction, and turmeric (also called curcumin, which is not the same as cumin) significantly reduces the build-up of amyloid plaques in the brain. Amyloid plaques are part of the progression of Alzheimer’s.

    See for yourself: Protective Effects of Indian Spice Curcumin Against Amyloid Beta in Alzheimer’s Disease

    If you don’t like it as a spice (and even if you do, you probably don’t want to put it in your food every day), you can easily get it as a supplement in capsule form.

    Lower your homocysteine levels

    Lower our what now? Homocysteine is an amino acid used for making certain proteins, and it’s a risk factor for Alzheimer’s.

    Foods high in folate (and possible other B-vitamins) seem to lower homocysteine levels. Top choices include:

    • Leafy greens
    • Cruciferous vegetables
    • Tomatoes

    Get plenty of lutein

    We did a main feature about specifically this a little while ago, so we’ll not repeat our work here, but lutein is found in, well, the same things we just listed above, and lower levels of lutein are associated with Alzheimer’s disease. It’s not a proven causative factor—we don’t know entirely what causes Alzheimer’s, just a lot of factors that have a high enough correlation that it’d be remiss to ignore them.

    Catch up on our previous article: Brain Food? The Eyes Have It

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  • California Becomes Latest State To Try Capping Health Care Spending

    The 10almonds Team

    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.

    California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending.

    The goal of the agency, established in 2022, is to make care more affordable and accessible while improving health outcomes, especially for the most disadvantaged state residents. That will require a sustained wrestling match with a sprawling, often dysfunctional health system and powerful industry players who have lots of experience fighting one another and the state.

    Can the new agency get insurers, hospitals, and medical groups to collaborate on containing costs even as they jockey for position in the state’s $405 billion health care economy? Can the system be transformed so that financial rewards are tied more to providing quality care than to charging, often exorbitantly, for a seemingly limitless number of services and procedures?

    The jury is out, and it could be for many years.

    California is the ninth state — after Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington — to set annual health spending targets.

    Massachusetts, which started annual spending targets in 2013, was the first state to do so. It’s the only one old enough to have a substantial pre-pandemic track record, and its results are mixed: The annual health spending increases were below the target in three of the first five years and dropped beneath the national average. But more recently, health spending has greatly increased.

    In 2022, growth in health care expenditures exceeded Massachusetts’ target by a wide margin. The Health Policy Commission, the state agency established to oversee the spending control efforts, warned that “there are many alarming trends which, if unaddressed, will result in a health care system that is unaffordable.”

    Neighboring Rhode Island, despite a preexisting policy of limiting hospital price increases, exceeded its overall health care spending growth target in 2019, the year it took effect. In 2020 and 2021, spending was largely skewed by the pandemic. In 2022, the spending increase came in at half the state’s target rate. Connecticut and Delaware, by contrast, both overshot their 2022 targets.

    It’s all a work in progress, and California’s agency will, to some extent, be playing it by ear in the face of state policies and demographic realities that require more spending on health care.

    And it will inevitably face pushback from the industry as it confronts unreasonably high prices, unnecessary medical treatments, overuse of high-cost care, administrative waste, and the inflationary concentration of a growing number of hospitals in a small number of hands.

    “If you’re telling an industry we need to slow down spending growth, you’re telling them we need to slow down your revenue growth,” says Michael Bailit, president of Bailit Health, a Massachusetts-based consulting group, who has consulted for various states, including California. “And maybe that’s going to be heard as ‘we have to restrain your margins.’ These are very difficult conversations.”

    Some of California’s most significant health care sectors have voiced disagreement with the fledgling affordability agency, even as they avoid overtly opposing its goals.

    In April, when the affordability office was considering an annual per capita spending growth target of 3%, the California Hospital Association sent it a letter saying hospitals “stand ready to work with” the agency. But the proposed number was far too low, the association argued, because it failed to account for California’s aging population, new investments in Medi-Cal, and other cost pressures.

    The hospital group suggested a spending increase target averaging 5.3% over five years, 2025-29. That’s slightly higher than the 5.2% average annual increase in per capita health spending over the five years from 2015 to 2020.

    Five days after the hospital association sent its letter, the affordability board approved a slightly less aggressive target that starts at 3.5% in 2025 and drops to 3% by 2029. Carmela Coyle, the association’s chief executive, said in a statement that the board’s decision still failed to account for an aging population, the growing need for mental health and addiction treatment, and a labor shortage.

    The California Medical Association, which represents the state’s doctors, expressed similar concerns. The new phased-in target, it said, was “less unreasonable” than the original plan, but the group would “continue to advocate against an artificially low spending target that will have real-life negative impacts on patient access and quality of care.”

    But let’s give the state some credit here. The mission on which it is embarking is very ambitious, and it’s hard to argue with the motivation behind it: to interject some financial reason and provide relief for millions of Californians who forgo needed medical care or nix other important household expenses to afford it.

    Sushmita Morris, a 38-year-old Pasadena resident, was shocked by a bill she received for an outpatient procedure last July at the University of Southern California’s Keck Hospital, following a miscarriage. The procedure lasted all of 30 minutes, Morris says, and when she received a bill from the doctor for slightly over $700, she paid it. But then a bill from the hospital arrived, totaling nearly $9,000, and her share was over $4,600.

    Morris called the Keck billing office multiple times asking for an itemization of the charges but got nowhere. “I got a robotic answer, ‘You have a high-deductible plan,’” she says. “But I should still receive a bill within reason for what was done.” She has refused to pay that bill and expects to hear soon from a collection agency.

    The road to more affordable health care will be long and chock-full of big challenges and unforeseen events that could alter the landscape and require considerable flexibility.

    Some flexibility is built in. For one thing, the state cap on spending increases may not apply to health care institutions, industry segments, or geographic regions that can show their circumstances justify higher spending — for example, older, sicker patients or sharp increases in the cost of labor.

    For those that exceed the limit without such justification, the first step will be a performance improvement plan. If that doesn’t work, at some point — yet to be determined — the affordability office can levy financial penalties up to the full amount by which an organization exceeds the target. But that is unlikely to happen until at least 2030, given the time lag of data collection, followed by conversations with those who exceed the target, and potential improvement plans.

    In California, officials, consumer advocates, and health care experts say engagement among all the players, informed by robust and institution-specific data on cost trends, will yield greater transparency and, ultimately, accountability.

    Richard Kronick, a public health professor at the University of California-San Diego and a member of the affordability board, notes there is scant public data about cost trends at specific health care institutions. However, “we will know that in the future,” he says, “and I think that knowing it and having that information in the public will put some pressure on those organizations.”

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    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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    This story can be republished for free (details).

    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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  • The Things You Can See Only When You Slow Down – by Haemin Sunim

  • Super-Nutritious Shchi

    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.

    The 10almonds Team

    Today we have a recipe we’ve mentioned before, but now we have standalone recipe pages for recipes, so here we go. The dish of the day is shchi—which is Russian cabbage soup, which sounds terrible, and looks as bad as it sounds. But it tastes delicious, is an incredible comfort food, and is famous (in Russia, at least) for being something one can eat for many days in a row without getting sick of it.

    It’s also got an amazing nutritional profile, with vitamins A, B, C, D, as well as lots of calcium, magnesium, and iron (amongst other minerals), and a healthy blend of carbohydrates, proteins, and fats, plus an array of anti-inflammatory phytochemicals, and of course, water.

    You will need

    • 1 large white cabbage, shredded
    • 1 cup red lentils
    • ½ lb tomatoes, cut into eighths (as in: halve them, halve the halves, and halve the quarters)
    • ½ lb mushrooms sliced (or halved, if they are baby button mushrooms)
    • 1 large onion, chopped finely
    • 1 tbsp rosemary, chopped finely
    • 1 tbsp thyme, chopped finely
    • 1 tbsp black pepper, coarse ground
    • 1 tsp cumin, ground
    • 1 tsp yeast extract
    • 1 tsp MSG, or 2 tsp low-sodium salt
    • A little parsley for garnishing
    • A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point for caramelizing the onions. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has far too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.

    Note: with regard to the seasonings, the above is a basic starting guide; feel free to add more per your preference—however, we do not recommend adding more cumin (it’ll overpower it) or more salt (there’s enough sodium in here already).

    Method

    (we suggest you read everything at least once before doing anything)

    1) Cook the lentils until soft (a rice cooker is great for this, but a saucepan is fine); be generous with the water; we are making a soup, after all. Set them aside without draining.

    2) Sauté the cabbage, and put it in a big stock pot or similar large pan (not yet on the heat)

    3) Fry the mushrooms, and add them to the big pot (still not yet on the heat)

    4) Use a stick blender to blend the lentils in the water you cooked them in, and then add to the big pot too.

    5) Turn the heat on low, and if necessary, add more water to make it into a rich soup

    6) Add the seasonings (rosemary, thyme, cumin, black pepper, yeast extract, MSG-or-salt) and stir well. Keep the temperature on low; you can just let it simmer now because the next step is going to take a while:

    7) Caramelize the onion (keep an eye on the big pot, stirring occasionally) and set it aside

    8) Fry the tomatoes quickly (we want them cooked, but just barely) and add them to the big pot

    9) Serve! The caramelized onion is a garnish, so put a little on top of each bowl of shchi. Add a little parsley too.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Could my glasses be making my eyesight worse?

    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.

    James Andrew Armitage and Nick Hockley – Deakin University

    So, you got your eyesight tested and found out you need your first pair of glasses. Or you found out you need a stronger pair than the ones you have. You put them on and everything looks crystal clear. But after a few weeks things look blurrier without them than they did before your eye test. What’s going on?

    Some people start to wear spectacles for the first time and perceive their vision is “bad” when they take their glasses off. They incorrectly interpret this as the glasses making their vision worse. Fear of this might make them less likely to wear their glasses.

    But what they are noticing is how much better the world appears through the glasses. They become less tolerant of a blurry world when they remove them.

    Here are some other things you might notice about eyesight and wearing glasses.

    Lazy eyes?

    Some people sense an increasing reliance on glasses and wonder if their eyes have become “lazy”.

    Our eyes work in much the same way as an auto-focus camera. A flexible lens inside each eye is controlled by muscles that let us focus on objects in the distance (such as a footy scoreboard) by relaxing the muscle to flatten the lens. When the muscle contracts it makes the lens steeper and more powerful to see things that are much closer to us (such as a text message).

    From the age of about 40, the lens in our eye progressively hardens and loses its ability to change shape. Gradually, we lose our capacity to focus on near objects. This is called “presbyopia” and at the moment there are no treatments for this lens hardening.

    Optometrists correct this with prescription glasses that take the load of your natural lens. The lenses allow you to see those up-close images clearly by providing extra refractive power.

    Once we are used to seeing clearly, our tolerance for blurry vision will be lower and we will reach for the glasses to see well again.

    The wrong glasses?

    Wearing old glasses, the wrong prescription (or even someone else’s glasses) won’t allow you to see as well as possible for day-to-day tasks. It could also cause eyestrain and headaches.

    Incorrectly prescribed or dispensed prescription glasses can lead to vision impairment in children as their visual system is still in development.

    But it is more common for kids to develop long-term vision problems as a result of not wearing glasses when they need them.

    By the time children are about 10–12 years of age, wearing incorrect spectacles is less likely to cause their eyes to become lazy or damage vision in the long term, but it is likely to result in blurry or uncomfortable vision during daily wear.

    Registered optometrists in Australia are trained to assess refractive error (whether the eye focuses light into the retina) as well as the different aspects of ocular function (including how the eyes work together, change focus, move around to see objects). All of these help us see clearly and comfortably.

    young child in clinical chair with corrective test lenses on, smiling
    Younger children with progressive vision impairments may need more frequent eye tests. Shutterstock

    What about dirty glasses?

    Dirty or scratched glasses can give you the impression your vision is worse than it actually is. Just like a window, the dirtier your glasses are, the more difficult it is to see clearly through them. Cleaning glasses regularly with a microfibre lens cloth will help.

    While dirty glasses are not commonly associated with eye infections, some research suggests dirty glasses can harbour bacteria with the remote but theoretical potential to cause eye infection.

    To ensure best possible vision, people who wear prescription glasses every day should clean their lenses at least every morning and twice a day where required. Cleaning frames with alcohol wipes can reduce bacterial contamination by 96% – but care should be taken as alcohol can damage some frames, depending on what they are made of.

    When should I get my eyes checked?

    Regular eye exams, starting just before school age, are important for ocular health. Most prescriptions for corrective glasses expire within two years and contact lens prescriptions often expire after a year. So you’ll need an eye check for a new pair every year or so.

    Kids with ocular conditions such as progressive myopia (short-sightedness), strabismus (poor eye alignment), or amblyopia (reduced vision in one eye) will need checks at least every year, but likely more often. Likewise, people over 65 or who have known eye conditions, such as glaucoma, will be recommended more frequent checks.

    older woman positioned for eye testing apparatus
    Eye checks can detect broader health issues. Shutterstock

    An online prescription estimator is no substitute for a full eye examination. If you have a valid prescription then you can order glasses online, but you miss out on the ability to check the fit of the frame or to have them adjusted properly. This is particularly important for multifocal lenses where even a millimetre or two of misalignment can cause uncomfortable or blurry vision.

    Conditions such as diabetes or high blood pressure, can affect the eyes so regular eye checks can also help flag broader health issues. The vast majority of eye conditions can be treated if caught early, highlighting the importance of regular preventative care.

    James Andrew Armitage, Professor of Optometry and Course Director, Deakin University and Nick Hockley, Lecturer in Optometric Clinical Skills, Director Deakin Collaborative Eye Care Clinic, Deakin University

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

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

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    Christian Moro and Charlotte Phelps – Bond University

    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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