Testosterone, Tourette’s, and Tickly Throats
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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
❝Could you do a series on mens health? Testosterone boosters. Libido? What works what doesnt? Also could you discuss prostate health and what supplements, meds, foods or protocols work to relieve symptoms of bph❞
We could indeed! We’ll be sure to write more, but while you’re waiting, you might like to read our main feature from a while back:
Too Much Or Too Little Testosterone?
…as it does include a lot about the use of a supplement that helps against Benign Prostatic Hyperplasia, with performance comparable to the most common drug prescribed for such.
And since (like that drug) it’s a 5α-reductase inhibitor (meaning it works by blocking the conversion of testosterone to DHT), this means it helps against prostate problems (and also, incidentally, male pattern hair loss) without reducing overall testosterone levels. In fact, because less testosterone will be converted to DHT, you’ll actually (all other things being equal) end up with slightly higher free testosterone levels.
❝My BMI is fine, but my waist is too big. What do I do about that? I am 5′ 5″ tall and 128 pounds and 72 years old.❞
It’s hard to say without knowing about your lifestyle (and hormones, for that matter)! But, extra weight around the middle in particular is often correlated with high levels of cortisol, so you might find this of benefit:
Lower Your Cortisol! (Here’s Why & How)
❝Is there anything special that might help someone with Tourette’s syndrome?❞
There are of course a lot of different manifestations of Tourette’s syndrome, and some people’s tics may be far more problematic to themselves and/or others, while some may be quite mild and just something to work around.
It’s an interesting topic for sure, so we’ll perhaps do a main feature (probably also covering the related-and-sometimes-overlapping OCD umbrella rather than making it hyperspecific to Tourette’s), but meanwhile, you might consider some of these options:
- Deep Brain Stimulation (DBS)
- Medications/ Pharmacology
- Comprehensive Behavioral Intervention for Tics (CBIT)
- Speech Therapies
❝Natural solutions for osteoarthritis. Eg. Rosehip tea, dandelion root tea. Any others??? What foods should I absolutely leave alone?❞
We’ll do a main feature on arthritis (in both its main forms) someday soon, but meanwhile, we recommend eating for good bone/joint health and against inflammation. To that end, you might like these main features we did on those topics:
- We Are Such Stuff As Fish Are Made Of (collagen for bone and joint health)
- The Bare-Bones Truth About Osteoporosis (eating for bone health generally)
- Keep Inflammation At Bay (dietary tips for minimizing inflammation—also, our all-time most popular article to date!)
Of these, probably the last one is the most critical, and also will have the speediest effects if implemented.
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Figs vs Banana – Which is Healthier?
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Our Verdict
When comparing figs to banana, we picked the banana.
Why?
Both of these fruits have a reputation for being carb-heavy (though their glycemic index is low in both cases because of the fiber), and they both have approximately the same macros across the board. So a tie on macros.
When it comes to vitamins, figs have more of vitamins A, B1, E, and K, while banana has more of vitamins B2, B3, B5, B6, B9, C, and choline. So, a win for banana there.
In the category of minerals, figs have more calcium and iron, while banana has more copper, magnesium, manganese, phosphorus, potassium, and selenium. Another win for banana.
Adding up the section makes for a win for bananas, but by all means, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now
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Move over, COVID and Flu! We have “hybrid viruses” to contend with now
COVID and influenza viruses can be serious, of course, so let’s be clear up front that we’re not being dismissive of those. But, most people are hearing a lot about them, whereas respiratory syncytial virus (RSV) has flown under a lot of radars.
Simply put, until recently it hasn’t been considered much of a threat except to the young, the old, or people with other respiratory illnesses. Only these days, the prevalence of “other respiratory illnesses” is a lot higher than it used to be!
It’s not just a comorbidity
It’s easy to think “well of course if you have more than one illness at once, especially similar ones, that’s going to suck” but it’s a bit more than that; it produces newer, more interesting, hybrid viruses. Here’s a research paper from last year’s “flu season”:
Coinfection by influenza A virus and respiratory syncytial virus produces hybrid virus particles
Best to be aware of this if you’re in the “older” age-range
It’s not just that the older we are, the more likely we are to get it. Critically, the older we are, the more likely we are to be hospitalized by it.
And..the older we are, the less likely we are to come back from hospital if hospitalized by it.
Some years back, the intensive care and mortality rates for people over the age of 65 were 8% and 7%, respectively:
Respiratory syncytial virus infection in elderly and high-risk adults
…but a new study this year has found the rates like to be 2.2x that, i.e. 15% intensive care rate and 18% mortality, respectively:
Want to know more?
Here are some hot-off-the-press news articles on the topic:
- Better awareness of RSV in older adults is needed to reduce hospitalizations
- Is there also a connection between RSV and asthma?
- Respiratory syncytial virus coinfections conspire to worsen disease
And as for what to do…
Same general advice as for COVID and Flu, just, ever-more important:
- Try to keep to well-ventilated places as much as possible
- Get any worrying symptoms checked out quickly
- Mask up when appropriate
- Get your shots as appropriate
See also:
Harvard Health Review | Fall shots: Who’s most vulnerable to RSV, COVID, and the flu, and which shots are the right choice for you to help protect against serious illness and hospitalization?
Stay safe!
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Gut Health for Women – by Aurora Bloom
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First things first: though the title says “For Women”, almost all of it applies to men too—and the things that don’t apply, don’t cause a problem. So if you’re cooking for your family that contains one or more men, this is still great.
Bloom gives us a good, simple, practical introduction to gut health. Her overview also covers gut-related ailments beyond the obvious “tummy hurts”. On which note:
A very valuable section of this book covers dealing with any stomach-upsets that do occur… without harming your trillions of tiny friends (friendly gut microbiota). This alone can make a big difference!
The book does of course also cover the things you’d most expect: things to eat or avoid. But it goes beyond that, looking at optimizing and maintaining your gut health. It’s not just dietary advice here, because the gut affects—and is affected by—other lifestyle factors too. Ranges from mindful eating, to a synchronous sleep schedule, to what kinds of exercise are best to keep your gut ticking over nicely.
There’s also a two-week meal plan, and an extensive appendix of resources, not to mention a lengthy bibliography for sourcing health claims (and suggesting further reading).
In short, a fine and well-written guide to optimizing your gut health and enjoying the benefits.
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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:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- The Counterintuitive Dos and Don’ts of Nail Health
- Regular Nail Polish vs Gel Nail Polish – Which is Healthier?
Take care!
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Statins: His & Hers?
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The Hidden Complexities of Statins and Cardiovascular Disease (CVD)
This is Dr. Barbara Roberts. She’s a cardiologist and the Director of the Women’s Cardiac Center at one of the Brown University Medical School teaching hospitals. She’s an Associate Clinical Professor of Medicine and takes care of patients, teaches medical students, and does clinical research. She specializes in gender-specific aspects of heart disease, and in heart disease prevention.
We previously reviewed Dr. Barbara Roberts’ excellent book “The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs”. It prompted some requests to do a main feature about Statins, so we’re doing it today. It’s under the auspices of “Expert Insights” as we’ll be drawing almost entirely from Dr. Roberts’ work.
So, what are the risks of statins?
According to Dr. Roberts, one of the biggest risks is not just drug side-effects or anything like that, but rather, what they simply won’t treat. This is because statins will lower LDL (bad) cholesterol levels, without necessarily treating the underlying cause.
Imagine you got Covid, and it’s one of the earlier strains that’s more likely deadly than “merely” debilitating.
You’re coughing and your throat feels like you gargled glass.
Your doctor gives you a miracle cough medicine that stops your coughing and makes your throat feel much better.
(Then a few weeks later, you die, because this did absolutely nothing for the underlying problem)
You see the problem?
Are there problematic side-effects too, though?
There can be. But of course, all drugs can have side effects! So that’s not necessarily news, but what’s relevant here is the kind of track these side-effects can lead one down.
For example, Dr. Roberts cites a case in which a woman’s LDL levels were high and she was prescribed simvastatin (Zocor), 20mg/day. Here’s what happened, in sequence:
- She started getting panic attacks. So, her doctor prescribed her sertraline (Zoloft) (a very common SSRI antidepressant) and when that didn’t fix it, paroxetine (Paxil). This didn’t work either… because the problem was not actually her mental health. The panic attacks got worse…
- Then, while exercising, she started noticing progressive arm and leg weakness. Her doctor finally took her off the simvastatin, and temporarily switched to ezetimibe (Zetia), a less powerful nonstatin drug that blocks cholesterol absorption, which change eased her arm and leg problem.
- As the Zetia was a stopgap measure, the doctor put her on atorvastatin (Lipitor). Now she got episodes of severe chest pressure, and a skyrocketing heart rate. She also got tremors and lost her body temperature regulation.
- So the doctor stopped the atorvastatin and tried rosovastatin (Crestor), on which she now suffered exhaustion (we’re not surprised, by this point) and muscle pains in her arms and chest.
- So the doctor stopped the rosovastatin and tried lovastatin (Mevacor), and now she had the same symptoms as before, plus light-headedness.
- So the doctor stopped the lovastatin and tried fluvastatin (Lescol). Same thing happened.
- So he stopped the fluvastatin and tried pravastatin (Pravachol), without improvement.
- So finally he took her off all these statins because the high LDL was less deleterious to her life than all these things.
- She did her own research, and went back to the doctor to ask for cholestyramine (Questran), which is a bile acid sequestrent and nothing to do with statins. She also asked for a long-acting niacin. In high doses, niacin (one of the B-vitamins) raises HDL (good) cholesterol, lowers LDL, and lowers tryglycerides.
- Her own non-statin self-prescription (with her doctor’s signature) worked, and she went back to her life, her work, and took up running.
Quite a treatment journey! Want to know more about the option that actually worked?
Read: Bile Acid Resins or Sequestrants
What are the gender differences you/she mentioned?
Actually mostly sex differences, since this appears to be hormonal (which means that if your hormones change, so will your risk). A lot of this is still pending more research—basically it’s a similar problem in heart disease to one we’ve previously talked about with regard to diabetes. Diabetes disproportionately affects black people, while diabetes research disproportionately focuses on white people.
In this case, most heart disease research has focused on men, with women often not merely going unresearched, but also often undiagnosed and untreated until it’s too late. And the treatments, if prescribed? Assumed to be the same as for men.
Dr. Roberts tells of how medicine is taught:
❝When I was in medical school, my professors took the “bikini approach” to women’s health: women’s health meant breasts and reproductive organs. Otherwise the prototypical patient was presented as a man.❞
There has been some research done with statins and women, though! Just, still not a lot. But we do know for example that some statins can be especially useful for treating women’s atherosclerosis—with a 50% success rate, rather than 31% for men.
For lowering LDL itself, however, it can work but is generally not so hot in women.
Fun fact:
In men:
- High total cholesterol
- High non-HDL cholesterol
- High LDL cholesterol
- Low HDL cholesterol
…are all significantly associated with an increased risk of death from CVD.
In women:
…levels of LDL cholesterol even more than 190 were associated with only a small, statistically insignificant increased risk of dying from CVD.
So…
The fact that women derive less benefit from a medicine that mainly lowers LDL cholesterol, may be because elevated LDL cholesterol is less harmful to women than it is to men.
And also: Treatment and Response to Statins: Gender-related Differences
And for that matter: Women Versus Men: Is There Equal Benefit and Safety from Statins?*
Definitely a case where Betteridge’s Law of Headlines applies!
What should women do to avoid dying of CVD, then?
First, quick reminder of our general disclaimer: we can’t give medical advice and nothing here comprises such. However… One particularly relevant thing we found illuminating in Dr. Roberts’ work was this observation:
The metabolic syndrome is diagnosed if you have three (or more) out of five of the following:
- Abdominal obesity (waist >35″ if a woman or >40″ if a man)
- Fasting blood sugars of 100mg/dl or more
- Fasting triglycerides of 150mg/dl or more
- Blood pressure of 130/85 or higher
- HDL <50 if a woman or <40 if a man
And yet… because these things can be addressed with exercise and a healthy diet, which neither pharmaceutical companies nor insurance companies have a particular stake in, there’s a lot of focus instead on LDL levels (since there are a flock of statins that can be sold be lower them)… Which, Dr. Roberts says, is not nearly as critical for women.
So women end up getting prescribed statins that cause panic attacks and all those things we mentioned earlier… To lower our LDL, which isn’t nearly as big a factor as the other things.
In summary:
Statins do have their place, especially for men. They can, however, mask underlying problems that need treatment—which becomes counterproductive.
When it comes to women, statins are—in broad terms—statistically not as good. They are a little more likely to be helpful specifically in cases of atherosclerosis, whereby they have a 50/50 chance of helping.
For women in particular, it may be worthwhile looking into alternative non-statin drugs, and, for everyone: diet and exercise.
Further reading: How Can I Safely Come Off Statins?
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Nicotine pouches are being marketed to young people on social media. But are they safe, or even legal?
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Flavoured nicotine pouches are being promoted to young people on social media platforms such as TikTok and Instagram.
Although some viral videos have been taken down following a series of reports in The Guardian, clips featuring Australian influencers have claimed nicotine pouches are a safe and effective way to quit vaping. A number of the videos have included links to websites selling these products.
With the rapid rise in youth vaping and the subsequent implementation of several reforms to restrict access to vaping products, it’s not entirely surprising the tobacco industry is introducing more products to maintain its future revenue stream.
The major trans-national tobacco companies, including Philip Morris International and British American Tobacco, all manufacture nicotine pouches. British American Tobacco’s brand of nicotine pouches, Velo, is a leading sponsor of the McLaren Formula 1 team.
But what are nicotine pouches, and are they even legal in Australia?
Like snus, but different
Nicotine pouches are available in many countries around the world, and their sales are increasing rapidly, especially among young people.
Nicotine pouches look a bit like small tea bags and are placed between the lip and gum. They’re typically sold in small, colourful tins of about 15 to 20 pouches. While the pouches don’t contain tobacco, they do contain nicotine that is either extracted from tobacco plants or made synthetically. The pouches come in a wide range of strengths.
As well as nicotine, the pouches commonly contain plant fibres (in place of tobacco, plant fibres serve as a filler and give the pouches shape), sweeteners and flavours. Just like for vaping products, there’s a vast array of pouch flavours available including different varieties of fruit, confectionery, spices and drinks.
The range of appealing flavours, as well as the fact they can be used discreetly, may make nicotine pouches particularity attractive to young people.
Vaping has recently been subject to tighter regulation in Australia.
Aleksandr Yu/ShutterstockUsers absorb the nicotine in their mouths and simply replace the pouch when all the nicotine has been absorbed. Tobacco-free nicotine pouches are a relatively recent product, but similar style products that do contain tobacco, known as snus, have been popular in Scandinavian countries, particularly Sweden, for decades.
Snus and nicotine pouches are however different products. And given snus contains tobacco and nicotine pouches don’t, the products are subject to quite different regulations in Australia.
What does the law say?
Pouches that contain tobacco, like snus, have been banned in Australia since 1991, as part of a consumer product ban on all forms of smokeless tobacco products. This means other smokeless tobacco products such as chewing tobacco, snuff, and dissolvable tobacco sticks or tablets, are also banned from sale in Australia.
Tobacco-free nicotine pouches cannot legally be sold by general retailers, like tobacconists and convenience stores, in Australia either. But the reasons for this are more complex.
In Australia, under the Poisons Standard, nicotine is a prescription-only medicine, with two exceptions. Nicotine can be used in tobacco prepared and packed for smoking, such as cigarettes, roll-your-own tobacco, and cigars, as well as in preparations for therapeutic use as a smoking cessation aid, such as nicotine patches, gum, mouth spray and lozenges.
If a nicotine-containing product does not meet either of these two exceptions, it cannot be legally sold by general retailers. No nicotine pouches have currently been approved by the Therapeutic Goods Administration as a therapeutic aid in smoking cessation, so in short they’re not legal to sell in Australia.
However, nicotine pouches can be legally imported for personal use only if users have a prescription from a medical professional who can assess if the product is appropriate for individual use.
We only have anecdotal reports of nicotine pouch use, not hard data, as these products are very new in Australia. But we do know authorities are increasingly seizing these products from retailers. It’s highly unlikely any young people using nicotine pouches are accessing them through legal channels.
Health concerns
Nicotine exposure may induce effects including dizziness, headache, nausea and abdominal cramps, especially among people who don’t normally smoke or vape.
Although we don’t yet have much evidence on the long term health effects of nicotine pouches, we know nicotine is addictive and harmful to health. For example, it can cause problems in the cardiovascular system (such as heart arrhythmia), particularly at high doses. It may also have negative effects on adolescent brain development.
The nicotine contents of some of the nicotine pouches on the market is alarmingly high. Certain brands offer pouches containing more than 10mg of nicotine, which is similar to a cigarette. According to a World Health Organization (WHO) report, pouches deliver enough nicotine to induce and sustain nicotine addiction.
Pouches are also being marketed as a product to use when it’s not possible to vape or smoke, such as on a plane. So instead of helping a person quit they may be used in addition to smoking and vaping. And importantly, there’s no clear evidence pouches are an effective smoking or vaping cessation aid.
A Velo product display at Dubai airport in October 2022. Nicotine pouches are marketed as safe to use on planes.
Becky FreemanFurther, some nicotine pouches, despite being tobacco-free, still contain tobacco-specific nitrosamines. These compounds can damage DNA, and with long term exposure, can cause cancer.
Overall, there’s limited data on the harms of nicotine pouches because they’ve been on the market for only a short time. But the WHO recommends a cautious approach given their similarities to smokeless tobacco products.
For anyone wanting advice and support to quit smoking or vaping, it’s best to talk to your doctor or pharmacist, or access trusted sources such as Quitline or the iCanQuit website.
Becky Freeman, Associate Professor, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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