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:

❝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:

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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  • The Best Kind Of Fiber For Overall Health?

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    The Fiber Of Good Health

    We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:

    Why You’re Probably Not Getting Enough Fiber (And How To Fix It)

    Fiber’s important for many aspects of health, not least of all the heart:

    What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure

    As well, of course, as being critical for gut health:

    Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)

    But is all fiber “prebiotic fiber”, and/or are some better than others?

    Beta-glucan

    A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:

    • pectin
    • β-glucan
    • wheat dextrin
    • resistant starch
    • cellulose (control)

    As for health metrics, they measured:

    • body weight
    • adiposity
    • indirect calorimetry
    • glucose tolerance
    • gut microbiota
    • metabolites thereof

    What they found was…

    ❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.

    All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞

    ~ Dr. Elizabeth Howard et al.

    If you’d like to read more, the study itself is here:

    Impact of Plant-Based Dietary Fibers on Metabolic Homeostasis in High-Fat Diet Mice via Alterations in the Gut Microbiota and Metabolites

    If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.

    It also acts indirectly as a GLP-1 agonist, by the way:

    The right fiber may help you lose weight

    You may be wondering: what is β-glucan found in?

    It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.

    Is it available as a supplement?

    More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.

    As an aside, cordyceps itself has many other healthful properties too:

    Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.

    Enjoy!

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  • PTSD, But, Well…. Complex.

    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.

    PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.

    These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.

    But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.

    This might have been…

    • childhood emotional neglect
    • a parent with a hair-trigger temper
    • bullying at school
    • extended financial hardship as a young adult
    • “just” being told or shown all too often that your best was never good enough
    • the persistent threat (real or imagined) of doom of some kind
    • the often-reinforced idea that you might lose everything at any moment

    If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.

    How About You? Take The (5mins) Test Here

    Now, we at 10almonds are not doctors or therapists and even if we were, we certainly wouldn’t try to diagnose from afar. But, even if there’s only a partial match, sometimes the same advice can help.

    So what are the symptoms of C-PTSD?

    • A feeling that nothing is safe; we might suddenly lose what we have gained
    • The body keeps the score… And it shows. We may have trouble relaxing, an aversion to exercise for reasons that don’t really add up, or an aversion to being touched.
    • Trouble sleeping, born of nagging sense that to sleep is to be vulnerable to attack, and/or lazy, and/or negligent of our duties
    • Poor self-image, about our body and/or about ourself as a person.
    • We’re often drawn to highly unavailable people—or we are the highly unavailable person to which our complementary C-PTSD sufferers are attracted.
    • We are prone to feelings of rage. Whether we keep a calm lid on it or lose our temper, we know it’s there. We’re angry at the world and at ourselves.
    • We are not quick to trust—we may go through the motions of showing trust, but we’re already half-expecting that trust to have been misplaced.
    • “Hell is other people” has become such a rule of life that we may tend to cloister ourselves away from company.
    • We may try to order our environment around us as a matter of safety, and be easily perturbed by sudden changes being imposed on us, even if ostensibly quite minor or harmless.
    • In a bid to try to find safety, we may throw ourselves into work—whatever that is for us. It could be literally our job, or passion projects, or our family, or community, and in and of itself that’s great! But the motivation is more of an attempt to distract ourselves from The Horrors™.

    “Alright, I scored more of those than I care to admit. What now?”

    A lot of the answer lies in first acknowledging to yourself what happened, to make you feel the way you do now. If you, for example, have an abject hatred of Christmas, what were your childhood Christmases like? If you fear losing money that you’ve accumulated, what underpins that fear? It could be something that directly happened to you, but it also could just be repeated messages you received from your parents, for example.

    It could even be that you had superficially an idyllic perfect childhood. Health, wealth, security, a loving family… and simply a chemical imbalance in your brain made it a special kind of Hell for you that nobody understood, and perhaps you didn’t either.

    Unfortunately, a difficult task now lies ahead: giving love, understanding, compassion, and reassurance to the person for whom you may have the most contempt in the world: yourself.

    If you’d like some help with that, here are some resources:

    ComplexTrauma.org (a lot of very good free resources, with no need for interaction)

    CPTSD Foundation (mostly paid courses and the like)

    Some final words about healing…

    • You are in fact amazing,
    • You can do it, and
    • You deserve it.

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  • Practical Optimism – by Dr. Sue Varma

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    We’ve written before about how to get your brain onto a more positive track (without toxic positivity), but there’s a lot more to be said than we can fit into an article, so here’s a whole book packed full with usable advice.

    The subtitle claims “the art, science, and practice of…”, but mostly it’s the science of. If there’s art to be found here, then this reviewer missed it, and as for the practice of, well, that’s down to the reader, of course.

    However, it is easy to use the contents of this book to translate science into practice without difficulty.

    If you’re a fan of acronyms, initialisms, and other mnemonics (such as the rhyming “Name, Claim, Tame, and Reframe”), then you’ll love this book as they come thick and fast throughout, and they contribute to the overall ease of application of the ideas within.

    The writing style is conversational but with enough clinical content that one never forgets who is speaking—not in the egotistical way that some authors do, but rather, just, she has a lot of professional experience to share and it shows.

    Bottom line: if you’d like to be more optimistic without delving into the delusional, this book can really help a lot with that (in measurable ways, no less!).

    Click here to check out Practical Optimism, and brighten up your life!

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  • What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

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    While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.

    Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.

    More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed he has it.

    So, what is type 1.5 diabetes? And how is it diagnosed and treated?

    Pixel-Shot/Shutterstock

    There are several types of diabetes

    Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.

    Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.

    Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.

    Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.

    Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.

    A senior man applying a device to his finger to measure blood sugar levels.
    People with diabetes may need to regularly monitor their blood sugar levels. Dragana Gordic/Shutterstock

    How does type 1.5 diabetes differ from types 1 and 2?

    Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.

    Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.

    Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as obesity and physical inactivity which are more commonly associated with type 2 diabetes.

    What are the symptoms, and how is it treated?

    The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:

    • increased thirst
    • frequent urination
    • fatigue
    • blurred vision
    • unintentional weight loss.

    Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.

    When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.

    A young woman taking a tablet.
    Type 1.5 diabetes might be managed with oral medications, at least initially. Dragana Gordic/Shutterstock

    Type 1.5 diabetes is often misdiagnosed

    Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.

    There are a few possible reasons for this.

    First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.

    Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).

    Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.

    Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.

    We’re still learning about type 1.5

    Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.

    Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.

    A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.

    Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.

    Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

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

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  • Osteoarthritis Of The Knee

    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

    ❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞

    (this was in response to our article about menopausal HRT)

    Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:

    • Those with HRT were significantly less likely to have knee arthritis than those without
    • However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
    • While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.

    We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.

    Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.

    The researchers do mention:

    ❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞

    ~ Dr. Spector et al.

    What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.

    With regard to the timing, the researchers do note:

    ❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.

    These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞

    ~ Ibid.

    You can read the study here:

    Is hormone replacement therapy protective for hand and knee osteoarthritis in women?: The Chingford Study

    On whether it is worth it now…

    Again, do speak with an endocrinologist because your situation may vary, but:

    • hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
    • anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!

    (We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)

    Meanwhile, take care!

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  • Spelt vs Bulgur – Which is Healthier?

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    Our Verdict

    When comparing spelt to bulgur, we picked the spelt.

    Why?

    An argument could be made for bulgur, but we say spelt comes out on top. Speaking of “sorting the wheat from the chaff”, be aware: spelt is a hulled wheat product and bulgur is a cracked wheat product.

    Looking at macros first, it’s not surprising therefore that spelt has proportionally more carbs and bulgur has proportionally more fiber, resulting in a slightly lower glycemic index. That said, for the exact same reason, spelt is proportionally higher in protein. Still, fiber is usually the most health-relevant aspect in the macros category, so we’re going to call this a moderate win for bulgur.

    When it comes to micronutrients, however, spelt is doing a lot better:

    In the category of vitamins, spelt is higher in vitamins A, B1, B2, B3, and E (with the difference in E being 26x more!), while bulgur is higher only in vitamin B9 (and that, only slightly). A clear win for spelt here.

    Nor are the mineral contents less polarized; spelt has more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while bulgur is not higher in any minerals. Another easy win for spelt.

    Adding these up makes a win for spelt, but again we’d urge to not underestimate the importance of fiber. Enjoy both in moderation, unless you are avoiding wheat/gluten in which case don’t, and for almost everyone, mixed whole grains are always going to be best.

    Want to learn more?

    You might like to read:

    Take care!

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