The Beautiful Cure – by Dr. Daniel Davis
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This one is not just a book about the history of immunology and a primer on how the immune system works. It is those things too, but it’s more:
Dr. Daniel Davis, a professor of immunology and celebrated researcher in his own right, bids us look at not just what we can do, but also what else we might.
This is not to say that the book is speculative; Dr. Davis deals in data rather than imaginings. He also cautions us against falling prey to sensationalization of the “beautiful cures” that the field of immunology is working towards. What, then, are these “beautiful cures”?
Just like our immune systems (in the plural; by Dr. Davis’ count, primarily talking about our innate and adaptive immune systems) can in principle deal with any biological threat, but in practice don’t always get it right, the same goes for our medicine.
He argues that in principle, we categorically can cure any immune-related disease (including autoimmune diseases, and tangentially, cancer). The theoretical existence of such cures is a mathematically known truth. The practical, contingent existence of them? That’s what takes the actual work.
The style of the book is accessible pop science, with a hard science backbone from start to finish.
Bottom line: if you’d like to know more about immunology, and be inspired with hope and wonder without getting carried away, this is the book for you.
Click here to check out The Beautiful Cure, and learn about these medical marvels!
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A Cold Shower A Day Keeps The Doctor Away?
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A Cold Shower A Day Keeps The Doctor Away?
This is Dutch extreme athlete Wim Hof, also known as “The Iceman”! He’s broken many world records mostly relating to the enduring the cold, for example:
- climbing Mount Kilimanjaro in shorts
- running a half-marathon above the Arctic Circle barefoot
- standing in a container completely covered with ice cubes for more than 112 minutes
You might not want to do yoga in your pyjamas on an iceberg, but you might like…
- better circulatory health
- reduced risk of stroke
- a boosted immune system
- healthier skin
- more energy and alertness
…and things like that. Wim Hof’s method is not just about extreme athletic achievements; most of what he does, the stuff that can benefit the rest of us, is much more prosaic.
The Wim Hof Method
For Wim Hof, three things are key:
- Breathing (See: Wim Hof Method Breathing Exercises)
- Commitment (See: How to Increase Willpower)
- Cold therapy (See: Benefits of Cold Therapy)
Today, we’re going to be focusing on the last one there.
What are the benefits of Cold Therapy?
Once upon a time, we didn’t have central heating, electric blankets, thermal underwear, and hot showers. In fact, once upon a time, we didn’t have houses or clothes. We used to be a lot more used to the elements! And while it’s all well and good to enjoy modern comforts, it has left our bodies lacking practice.
Practice at what? Most notably: vasodilation and vasoconstriction, in response to temperature changes. Either:
- vasodilation, because part of our body needs more blood to keep it warm and nourished, or
- vasoconstriction, because part of our body needs less blood running through it to get cooled down.
Switching between the two gives the blood vessels practice at doing it, and improves vascular muscle tone. If your body doesn’t get that practice, your blood vessels will be sluggish at making the change. This can cause circulation problems, which in turn have a big impact in many other areas of health, including:
- cardiovascular disease
- stroke risk
- mood instability
- nerve damage in extremities
On the flipside, if the blood vessels do get regular practice at dilating and constricting, you might enjoy lower risk of those things, and instead:
- improved immune response
- healthier skin
- better quality sleep
- more energy and alertness
- improved sexual performance/responsiveness
So, how to get that, without getting extreme?
As today’s title suggests, “a cold shower a day” is a great practice.
You don’t have to jump straight in, especially if you think your circulation and vascular responses might be a bit sluggish in the first instance. In fact, Wim Hof recommends:
- Week 1: Thirty seconds of cold water at the end of a warm shower each morning
- Week 2: One minute of cold water at the end of a warm shower each morning
- Week 3: A minute and a half of cold water at the end of a warm shower each morning
- Week 4: Two minutes of cold water at the end of a warm shower each morning
How cold is cold?
The benefits of cold exposure begin at around 16ºC / 60ºF, so in most places, water from the cold water mains is sufficiently cold.
As your body becomes more used to making the quick-change on a vascular level, the cold water will seem less shocking to your system. In other words, on day 30 it won’t hit you like it did on day one.
At that point, you can either continue with your two-minutes daily cold shower, and reap the benefits, or if you’re curious to push it further, that’s where ice baths come in!
Can anyone do it, or are any conditions contraindicated?
As ever, we’re a health and productivity newsletter, not doctors, let alone your doctors. Nothing here is medical advice. However, Wim Hof himself says:
❝Listen to your body, and never force the practices. We advise against doing Wim Hof Method if you are dealing with any of the following:
- Epilepsy
- High blood pressure
- Coronary heart disease
- A history of serious healthy issues like heart failure or stroke
- Pregnancy*
- Childhood*❞
*There is simply not enough science regarding the effects of cold exposure on people who are pregnant, or children. Obviously, we don’t expect this to be remedied anytime soon, because the study insitutions’ ethics boards would (rightly!) hold up the study.
As for the other conditions, and just generally if unsure, consult a doctor.
As you can see, this does mean that a limitation of Cold Therapy is that it appears to be far better as a preventative, since it helps guard against the very conditions that could otherwise become contraindications.
We haven’t peppered today’s main feature with study papers, partly because Wim Hof’s own website has kindly collated a collection of them (with links and summaries!) onto one page:
Further reading: The Science Behind The Wim Hof Method
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Gluten: What’s The Truth?
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Gluten: What’s The Truth?
We asked you for your health-related view of gluten, and got the above spread of results. To put it simply:
Around 60% of voters voted for “Gluten is bad if you have an allergy/sensitivity; otherwise fine”
The rest of the votes were split fairly evenly between the other three options:
- Gluten is bad for everyone and we should avoid it
- Gluten is bad if (and only if) you have Celiac disease
- Gluten is fine for all, and going gluten-free is a modern fad
First, let’s define some terms so that we’re all on the same page:
What is gluten?
Gluten is a category of protein found in wheat, barley, rye, and triticale. As such, it’s not one single compound, but a little umbrella of similar compounds. However, for the sake of not making this article many times longer, we’re going to refer to “gluten” without further specification.
What is Celiac disease?
Celiac disease is an autoimmune disease. Like many autoimmune diseases, we don’t know for sure how/why it occurs, but a combination of genetic and environmental factors have been strongly implicated, with the latter putatively including overexposure to gluten.
It affects about 1% of the world’s population, and people with Celiac disease will tend to respond adversely to gluten, notably by inflammation of the small intestine and destruction of enterocytes (the cells that line the wall of the small intestine). This in turn causes all sorts of other problems, beyond the scope of today’s main feature, but suffice it to say, it’s not pleasant.
What is an allergy/intolerance/sensitivity?
This may seem basic, but a lot of people conflate allergy/intolerance/sensitivity, so:
- An allergy is when the body mistakes a harmless substance for something harmful, and responds inappropriately. This can be mild (e.g. allergic rhinitis, hayfever) or severe (e.g. peanut allergy), and as such, responses can vary from “sniffly nose” to “anaphylactic shock and death”.
- In the case of a wheat allergy (for example), this is usually somewhere between the two, and can for example cause breathing problems after ingesting wheat or inhaling wheat flour.
- An intolerance is when the body fails to correctly process something it should be able to process, and just ejects it half-processed instead.
- A common and easily demonstrable example is lactose intolerance. There isn’t a well-defined analog for gluten, but gluten intolerance is nonetheless a well-reported thing.
- A sensitivity is when none of the above apply, but the body nevertheless experiences unpleasant symptoms after exposure to a substance that should normally be safe.
- In the case of gluten, this is referred to as non-Celiac gluten sensitivity
A word on scientific objectivity: at 10almonds we try to report science as objectively as possible. Sometimes people have strong feelings on a topic, especially if it is polarizing.
Sometimes people with a certain condition feel constantly disbelieved and mocked; sometimes people without a certain condition think others are imagining problems for themselves where there are none.
We can’t diagnose anyone or validate either side of that, but what we can do is report the facts as objectively as science can lay them out.
Gluten is fine for all, and going gluten-free is a modern fad: True or False?
Definitely False, Celiac disease is a real autoimmune disease that cannot be faked, and allergies are also a real thing that people can have, and again can be validated in studies. Even intolerances have scientifically measurable symptoms and can be tested against nocebo.
See for example:
- Epidemiology and clinical presentations of Celiac disease
- Severe forms of food allergy that can precipitate allergic emergencies
- Properties of gluten intolerance: gluten structure, evolution, and pathogenicity
However! It may not be a modern fad, so much as a modern genuine increase in incidence.
Widespread varieties of wheat today contain a lot more gluten than wheat of ages past, and many other molecular changes mean there are other compounds in modern grains that never even existed before.
However, the health-related impact of these (novel proteins and carbohydrates) is currently still speculative, and we are not in the business of speculating, so we’ll leave that as a “this hasn’t been studied enough to comment yet but we recognize it could potentially be a thing” factor.
Gluten is bad if (and only if) you have Celiac disease: True or False?
Definitely False; allergies for example are well-evidenced as real; same facts as we discussed/linked just above.
Gluten is bad for everyone and we should avoid it: True or False?
False, tentatively and contingently.
First, as established, there are people with clinically-evidenced Celiac disease, wheat allergy, or similar. Obviously, they should avoid triggering those diseases.
What about the rest of us, and what about those who have non-Celiac gluten sensitivity?
Clinical testing has found that of those reporting non-Celiac gluten sensitivity, nocebo-controlled studies validate that diagnosis in only a minority of cases.
In the following study, for example, only 16% of those reporting symptoms showed them in the trials, and 40% of those also showed a nocebo response (i.e., like placebo, but a bad rather than good effect):
This one, on the other hand, found that positive validations of diagnoses were found to be between 7% and 77%, depending on the trial, with an average of 30%:
Re-challenge Studies in Non-celiac Gluten Sensitivity: A Systematic Review and Meta-Analysis
In other words: non-Celiac gluten sensitivity is a thing, and/but may be over-reported, and/but may be in some part exacerbated by psychosomatic effect.
Note: psychosomatic effect does not mean “imagining it” or “all in your head”. Indeed, the “soma” part of the word “psychosomatic” has to do with its measurable effect on the rest of the body.
For example, while pain can’t be easily objectively measured, other things, like inflammation, definitely can.
As for everyone else? If you’re enjoying your wheat (or similar) products, it’s well-established that they should be wholegrain for the best health impact (fiber, a positive for your health, rather than white flour’s super-fast metabolites padding the liver and causing metabolic problems).
Wheat itself may have other problems, for example FODMAPs, amylase trypsin inhibitors, and wheat germ agglutinins, but that’s “a wheat thing” rather than “a gluten thing”.
That’s beyond the scope of today’s main feature, but you might want to check out today’s featured book!
For a final scientific opinion on this last one, though, here’s what a respected academic journal of gastroenterology has to say:
From coeliac disease to noncoeliac gluten sensitivity; should everyone be gluten-free?
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Early Dementia Screening From Your Blood & More
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.
Dementia is, statistically speaking, the most feared disease in the US. Notwithstanding…
- heart disease killing more
- COVID being more of a lottery
- cancer being the “yes you can modify risk factors but it can come for anyone” life-changing (and often life-ending) disease,
…it’s still dementia that Americans report fearing the most.
And yet… Early dementia screening is seriously underused
It may be a case of a head-in-sand approach to avoid unwanted news, or it could be a case of not knowing what’s available.
So, with that in mind…
How to watch out: first line warning signs
You walk into a room of your house, and suddenly stop: “what did I come in here for?”, you wonder.
A moment later, you’re worrying whether this is a sign of age-related cognitive decline.
The good news: it usually isn’t. In fact, you did that when you were younger, too, you just didn’t pay enough attention at the time to remember it now.
Dementia-related memory loss is less “where did I put my car keys?”, and more “what is this thing for?” (it’s your car keys). Or at a less advanced stage: “whose are these car keys?” (they are yours).
You can read about some of the nuances here:
Is It Dementia? Spot The Signs (Because None Of Us Are Immune) ← If you’d like an objective test of memory and other cognitive impairments, this article also has a link to the industry’s gold standard test (it’s free)
(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)
Tests you can’t do at home
We wrote a little while back about how one kind of blood testing for Alzheimer’s disease works:
The Brain Alarm Signs That Warn Of Dementia
Why “Brain Alarm Signs” if it’s a blood test? Because the blood gets (in very lay terms) bits of broken brain in it. Or more specifically, they tested the blood for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which are bits of the cells from the lining of blood vessels in the brain. These cerebrovascular endothelial extracellular vesicles should not, ideally, be falling off and riding around your bloodstream, and the greater the density of them, the greater likelihood of mild cognitive impairment now, and by extension, dementia later.
It’s not the only blood test available though, see:
Highly accurate blood test for Alzheimer’s disease is similar or superior to clinical cerebrospinal fluid (CSF) tests ← this one checks the ratio of phosporylated-tau217 to non-phosphorylated tau (which is a protein antibody), which equalled or outperformed FDA-approved CSF tests in classifying amyloid-β positron emission topography (PET, as in a PET scan) status, with a confidence interval as high as, or better than, industry standards.
If you don’t like having your blood taken, trust us that you’d find having your cerebrospinal fluid taken even less enjoyable, so this is a very welcome improvement!
In case you’re curious about how the CSF test works, here you go: NPTX2 in Cerebrospinal Fluid Predicts the Progression From Normal Cognition to Mild Cognitive Impairment ← NPTX2 is a protein biomarker of Alzheimer’s risk
…but again, we really think the blood test is preferable.
Tests beyond the physiological
There are, of course, psychological tests that can be done, including a linguistic analysis of your conversation, compared with a vast database of other people’s conversations, with and without various degrees of cognitive impairment
As Dr. Ioannis Paschalidis explains:
❝We wanted to predict what would happen in the next six years—and we found we can reasonably make that prediction with relatively good confidence and accuracy.
Rather than using acoustic features of speech, like enunciation or speed, the model is just pulling from the content of the interview—the words spoken, how they’re structured.
You can think of the score as the likelihood, the probability, that someone will remain stable or transition to dementia. It had significant predictive ability.
Digital is the new blood. You can collect it, analyze it for what is known today, store it, and reanalyze it for whatever new emerges tomorrow.❞
You can read the full paper here: Prediction of Alzheimer’s disease progression within 6 years using speech: A novel approach leveraging language models
See also: AI: The Doctor That Never Tires?
What if the news isn’t good?
While bad news is never welcome per se, it is preferable to not knowing, insofar as we can then take steps to manage the situation.
You may be wondering: what can be done that I wouldn’t already be doing to minimize my dementia risk in the first place?
And the answer is: yes, do continue those things of course, but there is more to do:
See: Beyond Guarding Against Dementia: When Age’s Brain-Changes Come Knocking
Take care!
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Long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk
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Many women worry hormonal contraceptives have dangerous side-effects including increased cancer risk. But this perception is often out of proportion with the actual risks.
So, what does the research actually say about cancer risk for contraceptive users?
And is your cancer risk different if, instead of the pill, you use long-acting reversible contraceptives? These include intrauterine devices or IUDs (such as Mirena), implants under the skin (such as Implanon), and injections (such as Depo Provera).
Our new study, conducted by the University of Queensland and QIMR Berghofer Medical Research Institute and published by the Journal of the National Cancer Institute, looked at this question.
We found long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk (which is good news) but not necessarily any safer than the pill.
Peakstock/Shutterstock Some hormonal contraceptives take the form of implants under the skin. WiP-Studio/Shutterstock How does the contraceptive pill affect cancer risk?
The International Agency for Research on Cancer, which compiles evidence on cancer causes, has concluded that oral contraceptives have mixed effects on cancer risk.
Using the oral contraceptive pill:
- slightly increases your risk of breast and cervical cancer in the short term, but
- substantially reduces your risk of cancers of the uterus and ovaries in the longer term.
Our earlier work showed the pill was responsible for preventing far more cancers overall than it contributed to.
In previous research we estimated that in 2010, oral contraceptive pill use prevented over 1,300 cases of endometrial and ovarian cancers in Australian women.
It also prevented almost 500 deaths from these cancers in 2013. This is a reduction of around 25% in the deaths that could have occurred that year if women hadn’t taken the pill.
In contrast, we calculated the pill may have contributed to around 15 deaths from breast cancer in 2013, which is less than 0.5% of all breast cancer deaths in that year.
Previous work showed the pill was responsible for preventing far more cancers overall than it contributed to. Image Point Fr What about long-acting reversible contraceptives and cancer risk?
Long-acting reversible contraceptives – which include intrauterine devices or IUDs, implants under the skin, and injections – release progesterone-like hormones.
These are very effective contraceptives that can last from a few months (injections) up to seven years (intrauterine devices).
Notably, they don’t contain the hormone oestrogen, which may be responsible for some of the side-effects of the pill (including perhaps contributing to a higher risk of breast cancer).
Use of these long-acting contraceptives has doubled over the past decade, while the use of the pill has declined. So it’s important to know whether this change could affect cancer risk for Australian women.
Our new study of more than 1 million Australian women investigated whether long-acting, reversible contraceptives affect risk of invasive cancers. We compared the results to the oral contraceptive pill.
We used de-identified health records for Australian women aged 55 and under in 2002.
Among this group, about 176,000 were diagnosed with cancer between 2004 and 2013 when the oldest women were aged 67. We compared hormonal contraceptive use among these women who got cancer to women without cancer.
We found that long-term users of all types of hormonal contraception had around a 70% lower risk of developing endometrial cancer in the years after use. In other words, the risk of developing endometrial cancer is substantially lower among women who took hormonal contraception compared to those who didn’t.
For ovarian cancer, we saw a 50% reduced risk (compared to those who took no hormonal contraception) for women who were long-term users of the hormone-containing IUD.
The risk reduction was not as marked for the implants or injections, however few long-term users of these products developed these cancers in our study.
As the risk of endometrial and ovarian cancers increases with age, it will be important to look at cancer risk in these women as they get older.
What about breast cancer risk?
Our findings suggest that the risk of breast cancer for current users of long-acting contraceptives is similar to users of the pill.
However, the contraceptive injection was only associated with an increase in breast cancer risk after five years of use and there was no longer a higher risk once women stopped using them.
Our results suggested that the risk of breast cancer also reduces after stopping use of the contraceptive implants.
We will need to follow-up the women for longer to determine whether this is also the case for the IUD.
It is worth emphasising that the breast cancer risk associated with all hormonal contraceptives is very small.
About 30 in every 100,000 women aged 20 to 39 years develop breast cancer each year, and any hormonal contraceptive use would only increase this to around 36 cases per 100,000.
What about other cancers?
Our study did not show any consistent relationships between contraceptive use and other cancers types. However, we only at looked at invasive cancers (meaning those that start at a primary site but have the potential to spread to other parts of the body).
A recent French study found that prolonged use of the contraceptive injection increased the risk of meningioma (a type of benign brain tumour).
However, meningiomas are rare, especially in young women. There are around two cases in every 100,000 in women aged 20–39, so the extra number of cases linked to contraceptive injection use was small.
The French study found the hormonal IUD did not increase meningioma risk (and they did not investigate contraceptive implants).
Benefits and side-effects
There are benefits and side-effects for all medicines, including contraceptives, but it is important to know most very serious side-effects are rare.
A conversation with your doctor about the balance of benefits and side-effects for you is always a good place to start.
Susan Jordan, Professor of Epidemiology, The University of Queensland; Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland, and Penny Webb, Distinguished Scientist, Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Coach’s Plan – by Mike Kavanagh
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A sports coach’s job is to prepare a plan, give it to the player(s), and hold them accountable to it. Change the strategy if needs be, call the shots. The job of the player(s) is then to follow those instructions.
If you have trouble keeping yourself accountable, Kavanagh argues that it can be good to separate how you approach things.
Not just “coach yourself”, but put yourself entirely in the coach’s shoes, as though you were a separate person, then switch back, and follow those instructions, trusting in your coach’s guidance.
The book also provides illustrative examples and guides the reader through some potential pitfalls—for example, what happens when morning you doesn’t want to do the things that evening you decided would be best?
The absolute backbone of this method is that it takes away the paralysing self-doubt that can occur when we second-guess ourselves mid-task.
In short, this book will fire up your enthusiasm and give you a reliable fall-back for when your motivation’s flagging.
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Heart Attack: His & Hers (Be Prepared!)
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Heart attack symptoms vary by sex. This is governed by hormones, so if you are for example a postmenopausal woman and not on HRT, your symptoms might be nearer that of men.
The following symptom list is intended as a rough “most likely” guide. You may not get all of the symptoms you “should”. You could get symptoms from the “wrong” category. So don’t sweat the minutiae, but do be aware of…
Symptoms for everyone:
- Jaw, neck, and/or back pain
- Nausea and/or vomiting
- Shortness of breath
- Feeling of impending doom ← heart attack survivors assure us that you’ll know this one if you experience it
Additional symptoms (mostly) just for men:
- Pressure and/or pain in the upper chest
- Discomfort and/or tingling in the arms
- Sudden cold sweat
Additional symptoms (mostly) just for women:
- Pressure and/or pain in the lower chest and/or abdomen
- Feeling of fullness and/or indigestion
- Fatigue, dizziness, possibly fainting
In the event of experiencing symptoms…
Call 911 or your local equivalent.This is not the time to wait to see if it goes away by itself. If unsure, call. Better safe than sorry/dead.
If you are not alone, or if it is someone with you who is having the suspected heart attack, it may be quicker to go to the Emergency Room by car, than wait for an ambulance.
Even if you choose to do that, you should still call 911 anyway, as the responder will be able to instruct you in real-time, not something we can do in a newsletter.
Note that if available, this means three people in the car is ideal:
Driver, patient, and third person on the phone giving information and following instructions.
Emergency situations rarely go entirely by-the-book, but with a little foreknowledge and at least one person with a calm head, preventable deaths can be avoided.
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