Wakefulness, Cognitive Enhancement, AND Improved Mood?

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Old Drug, New Tricks?

Modafinil (also known by brand names including Modalert and Provigil) is a dopamine uptake inhibitor.

What does that mean? It means it won’t put any extra dopamine in your brain, but it will slow down the rate at which your brain removes naturally-occuring dopamine.

The result is that your brain will get to make more use of the dopamine it does have.

(dopamine is a neutrotransmitter that allows you to feel wakeful and happy, and perform complex cognitive tasks)

Modafinil is prescribed for treatment of excessive daytime sleepiness. Often that’s caused by shift work sleep disorder, sleep apnea, restless leg syndrome, or narcolepsy.

Read: Overview of the Clinical Uses, Pharmacology, and Safety of Modafinil

Many studies done on humans (rather than rats) have been military experiments to reduce the effects of sleep deprivation:

Click Here To See A Military Study On Modafinil!

They’ve found modafinil to be helpful, and more effective and more long-lasting than caffeine, without the same “crash” later. This is for two reasons:

1) while caffeine works by blocking adenosine (so you don’t feel how tired you are) and by constricting blood vessels (so you feel more ready-for-action), modafinil works by allowing your brain to accumulate more dopamine (so you’re genuinely more wakeful, and you get to keep the dopamine)

2) the biological half-life of modafinil is 12–15 hours, as opposed to 4–8 hours* for caffeine.

*Note: a lot of sources quote 5–6 hours for caffeine, but this average is misleading. In reality, we are each genetically predetermined to be either a fast caffeine metabolizer (nearer 4 hours) or a slow caffeine metabolizer (nearer 8 hours).

What’s a biological half-life (also called: elimination half-life)?

A substance’s biological half-life is the time it takes for the amount in the body to be reduced by exactly half.

For example: Let’s say you’re a fast caffeine metabolizer and you have a double-espresso (containing 100mg caffeine) at 8am.

By midday, you’ll have 50mg of caffeine left in your body. So far, so simple.

By 4pm you might expect it to be gone, but instead you have 25mg remaining (because the amount halves every four hours).

By 8pm, you have 12.5mg remaining.

When midnight comes and you’re tucking yourself into bed, you still have 6.25mg of caffeine remaining from your morning coffee!

Use as a nootropic

Many healthy people who are not sleep-deprived use modafinil “off-label” as a nootropic (i.e., a cognitive enhancer).

Read: Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: A systematic review

Important Note: modafinil is prescription-controlled, and only FDA-approved for sleep disorders.

To get around this, a lot of perfectly healthy biohackers describe the symptoms of sleep pattern disorder to their doctor, to get a prescription.

We do not recommend lying to your healthcare provider, and nor do we recommend turning to the online “grey market”.

Such websites often use anonymized private doctors to prescribe on an “informed consent” basis, rather than making a full examination. Those websites then dispense the prescribed medicines directly to the patient with no further questions asked (i.e. very questionable practices).

Caveat emptor!

A new mood-brightener?

Modafinil was recently tested head-to-head against Citalapram for the treatment of depression, and scored well:

See its head-to-head scores here!

How does it work? Modafinil does for dopamine what a lot of anti-depressants do for serotonin. Both dopamine and serotonin promote happiness and wakefulness.

This is very promising, especially as modafinil (in most people, at least) has fewer unwanted side-effects than a lot of common anti-depressant medications.

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  • How long does back pain last? And how can learning about pain increase the chance of recovery?

    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.

    Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.

    Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.

    If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:

    • acute – those with back pain that started less than six weeks ago
    • subacute – where it started between six and 12 weeks ago
    • chronic – where it started between three months and one year ago.

    We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.

    Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.

    More pain doesn’t mean a more serious injury

    Most acute back pain episodes are not caused by serious injury or disease.

    There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.

    Factory worker deep-breathes with a sore back
    Your doctor or physio can rule out serious damage.
    DG fotostock/Shutterstock

    Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.

    The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.

    The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.

    Reduce your chance of lasting pain

    Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:

    • understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
    • reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.

    How to reduce your pain sensitivity and learn about pain

    Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.

    Physio helps patient use an exercise strap
    Some programs combine education with gradual increases in movement.
    Halfpoint/Shutterstock

    These programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.

    But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.

    When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.

    Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.

    But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.The Conversation

    Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia

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

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  • Blueberry & Banana Collagen Baked Oats

    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.

    Good news for vegans/vegetarians! While we include an optional tablespoon of collagen powder in this recipe, the whole recipe is already geared around collagen synthesis, so it’s very collagen-boosting even with just the plants, providing collagen’s building blocks of protein, zinc, and vitamins C and D (your miraculous body will use these to assemble the collagen inside you).

    You will need

    • 2 cups oats, whence the protein and zinc
    • 1 cup milk (your preference what kind; we recommend almond for flavor; whether you choose plant or animal though, it should be fortified with vitamin D)
    • 2 bananas, peeled and mashed
    • 4 oz blueberries, whence the vitamin C (frozen is fine) (chopped dried apricots are also a fine substitute if that’s more convenient)
    • 1 oz flaked almonds, whence the protein and zinc
    • 1 tbsp pumpkin seeds, whence the protein and zinc
    • 1 tbsp flax seeds, whence the protein and zinc
    • Optional: 1 tbsp maple syrup
    • Optional: 1 tbsp collagen powder, dissolved in 1 oz hot water

    Method

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

    1) Preheat the oven to 350℉ / 180℃.

    2) Mix the oats with 2 cups boiling water; allow to stand for 10–15 minutes, and then drain any excess water.

    3) Mix the mashed bananas with the remaining ingredients except the milk and blueberries, stirring thoroughly.

    4) Add the softened oats, and stir those in thoroughly too.

    5) Add the milk and blueberries, in that order, stirring gently if using fresh blueberries, lest they get crushed.

    6) Pour the mixture into an 8″ square cake tin that you have lined with baking paper, and smooth the top.

    7) Bake for about 40 minutes or until firm and golden brown. Allow to cool; it will firm up more while it does.

    8) Cut into squares or bars, and serve or store for later.

    Enjoy!

    Want to learn more?

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

    We Are Such Stuff As Fish Are Made Of ← our main feature about collagen

    Take care!

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  • An Elegant Defense – by Matt Richtel

    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.

    In a way, Richtel got the best and worst of the publication date lottery. This book, which he’d obviously been working on for however long, was published in March 2020. Yes, that March 2020. So, it obviously got a huge boost in sales that launced it to bestseller status, and/but it doesn’t actually discuss COVID at all.

    What it does discuss, is—as one might expect—the immune system. Or really, the immune systems, plural, several systems working alongside each other. How we got to have such, how our immune functions work, where all the various immune cells come from and what part they play. What pathogens can do to fight and/or confuse (or even co-opt) our immune response, and what modern medicine can do to counteract the pathogens’ anti-countermeasure countermeasures. And how it can still go wrong.

    The “Four Lives” promised in the subtitle are stories, and Richtel explains the immune system through specific people’s specific battles. In particular, a friend of his who had quite a remarkable battle against cancer, which was of course terrible for him, but illustrative for us.

    The style of the book is very readably journalistic. The author is a Pulitzer-winning NYT journalist, and not normally a science writer. Here at 10almonds, “we like big bibliographies and we cannot lie”, and we didn’t get to enjoy that in this case. The book contained no bibliography (nor appropriate inline citations, nor equivalent footnotes). Maybe a future addition will include this.

    Bottom line: there’s a lot of “science for the lay reader” here. While the lack of references is a big oversight, the book does give a very good overview of what both sides (immune response and pathogenic invasion) bring to the battle of your body.

    Click here to check out Elegant Defense, and demystify immunology!

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  • Goji Berries vs Cherries – Which is Healthier?

    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.

    Our Verdict

    When comparing goji berries to cherries, we picked the goji berries.

    Why?

    Looking at the macros first, goji berries have more protein, fiber, and carbs, as well as the lower glycemic index, although cherries are great too. Still, a clear and easy win here.

    In the category of vitamins, goji berries have more of vitamins A and C, while cherries have more of vitamin K; in the other vitamins these two fruits are close enough to equal that variants in what kind of cherry it is will push it slightly one way or the other. However, it’s worth noting that goji berries have 1,991% more vitamin A and 16,033% more vitamin C, while cherries have only 20% more vitamin K. So, all in all, another clear win for goji berries.

    When it comes to minerals, goji berries have more calcium and iron, while cherries have more copper. Again, the margins of difference are very much in goji berries’ favor, with 1,088% more calcium and 2,025% more iron, while cherries have 35% more copper. So, again, a win for goji berries.

    The polyphenol contents of cherries differ far too much to comment here, but as a general rule of thumb, goji berries have more antioxidant powers than cherries, but cherries are also excellent for this.

    In short, enjoy either or both, but goji berries are the more nutritionally dense!

    Want to learn more?

    You might like to read:

    Take care!

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  • Mythbusting The Mask Debate

    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.

    Mythbusting The Mask Debate

    We asked you for your mask policy this respiratory virus season, and got the above-depicted, below-described, set of responses:

    • A little under half of you said you will be masking when practical in indoor public places
    • A little over a fifth of you said you will mask only if you have respiratory virus symptoms
    • A little under a fifth of you said that you will not mask, because you don’t think it helps
    • A much smaller minority of you (7%) said you will go with whatever people around you are doing
    • An equally small minority of you said that you will not mask, because you’re not concerned about infections

    So, what does the science say?

    Wearing a mask reduces the transmission of respiratory viruses: True or False?

    True…with limitations. The limitations include:

    • The type of mask
      • A homemade polyester single-sheet is not the same as an N95 respirator, for instance
    • How well it is fitted
      • It needs to be a physical barrier, so a loose-fitting “going through the motions” fit won’t help
    • The condition of the mask
      • And if applicable, the replaceable filter in the mask
    • What exactly it has to stop
      • What kind of virus, what kind of viral load, what kind of environment, is someone coughing/sneezing, etc

    More details on these things can be found in the link at the end of today’s main feature, as it’s more than we could fit here!

    Note: We’re talking about respiratory viruses in general in this main feature, but most extant up-to-date research is on COVID, so that’s going to appear quite a lot. Remember though, even COVID is not one beast, but many different variants, each with their own properties.

    Nevertheless, the scientific consensus is “it does help, but is not a magical amulet”:

    Wearing a mask is actually unhygienic: True or False?

    False, assuming your mask is clean when you put it on.

    This (the fear of breathing more of one’s own germs in a cyclic fashion) was a point raised by some of those who expressed mask-unfavorable views in response to our poll.

    There have been studies testing this, and they mostly say the same thing, “if it’s clean when you put it on, great, if not, then well yes, that can be a problem”:

    ❝A longer mask usage significantly increased the fungal colony numbers but not the bacterial colony numbers.

    Although most identified microbes were non-pathogenic in humans; Staphylococcus epidermidis, Staphylococcus aureus, and Cladosporium, we found several pathogenic microbes; Bacillus cereus, Staphylococcus saprophyticus, Aspergillus, and Microsporum.

    We also found no associations of mask-attached microbes with the transportation methods or gargling.

    We propose that immunocompromised people should avoid repeated use of masks to prevent microbial infection.❞

    Source: Bacterial and fungal isolation from face masks under the COVID-19 pandemic

    Wearing a mask can mean we don’t get enough oxygen: True or False?

    False, for any masks made-for-purpose (i.e., are by default “breathable”), under normal conditions:

    However, wearing a mask while engaging in strenuous best-effort cardiovascular exercise, will reduce VO₂max. To be clear, you will still have more than enough oxygen to function; it’s not considered a health hazard. However, it will reduce peak athletic performance:

    Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test

    …so if you are worrying about whether the mask will impede you breathing, ask yourself: am I engaging in an activity that requires my peak athletic performance?

    Also: don’t let it get soaked with water, because…

    Writer’s anecdote as an additional caveat: in the earliest days of the COVID pandemic, I had a simple cloth mask on, the one-piece polyester kind that we later learned quite useless. The fit wasn’t perfect either, but one day I was caught in heavy rain (I had left it on while going from one store to another while shopping), and suddenly, it fitted perfectly, as being soaked through caused it to cling beautifully to my face.

    However, I was now effectively being waterboarded. I will say, it was not pleasant, but also I did not die. I did buy a new mask in the next store, though.

    tl;dr = an exception to “no it won’t impede your breathing” is that a mask may indeed impede your breathing if it is made of cloth and literally soaked with water; that is how waterboarding works!

    Want up-to-date information?

    Most of the studies we cited today were from 2022 or 2023, but you can get up-to-date information and guidance from the World Health Organization, who really do not have any agenda besides actual world health, here:

    Coronavirus disease (COVID-19): Masks | Frequently Asked Questions

    At the time of writing this newsletter, the above information was last updated yesterday.

    Take care!

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  • Non-Alcohol Mouthwash vs Alcohol Mouthwash – Which is Healthier?

    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.

    Our Verdict

    When comparing non-alcohol mouthwash to alcohol mouthwash, we picked the alcohol.

    Why?

    Note: this is a contingent choice and is applicable to most, but not all, people.

    In short, there has been some concern about alcohol mouthwashes increasing cancer risk, but research has shown this is only the case if you already have an increased risk of oral cancer (for example if you smoke, and/or have had an oral cancer before).

    For those for whom this is not the case (for example, if you don’t smoke, and/or have no such cancer history), then best science currently shows that alcohol mouthwash does not cause any increased risk.

    What about non-alcohol mouthwashes? Well, they have a different problem; they usually use chlorine-based chemicals like chlorhexidine or cetylpyridinium chloride, which are (exactly as the label promises) exceptionally good at killing oral bacteria.

    (They’d kill us too, at higher doses, hence: swill and spit)

    Unfortunately, much like the rest of our body, our mouth is supposed to have bacteria there and bad things happen when it doesn’t. In the case of our oral microbiome, cleaning it with such powerful antibacterial agents can kill our “good” bacteria along with the bad, which lowers the pH of our saliva (that’s bad; it means it is more acidic), and thus indirectly erodes tooth enamel.

    You can read more about the science of all of the above (with references), here:

    Toothpastes & Mouthwashes: Which Help And Which Harm?

    Summary:

    For most people, alcohol mouthwashes are a good way to avoid the damage that can be done by chlorhexidine in non-alcohol mouthwashes.

    Here are some examples, but there will be plenty in your local supermarket:

    Non-Alcohol, by Colgate | Alcohol, by Listerine

    If you have had oral cancer, or if you smoke, then you may want to seek a third alternative (and also, please, stop smoking if you can).

    Or, really, most people could probably skip mouthwashes, if you’ve good oral care already by other means. See also:

    Toothpastes & Mouthwashes: Which Help And Which Harm?

    (yes, it’s the same link as before, but we’re now drawing your attention to the fact it has information about toothpastes too)

    If you do want other options though, might want to check out:

    Less Common Oral Hygiene Options ← miswak sticks are especially effective

    Take care!

    Don’t Forget…

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