
Water Fluoridation, Atheroma, & More
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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 😎
❝I watched a documentary recently on Fluoride in our drinking water & the dangers of it. Why are we poisoning our water?❞
This is a great question, and it certainly is controversial. It sounds like the documentary you watched was predominantly or entirely negative, but there’s a lot of science to back both sides of this, and it’s not even that the science is contradictory (it’s not). It’s that what differs is people’s opinions about whether benefiting one thing is worth creating a risk to another, and that means looking at:
- What is the risk associated with taking no action (error of omission)?
- What is the risk associated with taking an action (error of commission)?
The whole topic is worth a main feature, but to summarize a few key points:
- Water fluoridation is considered good for the prevention of dental cavities
- Water fluoridation aims to deliver fluoride and doses far below dangerous levels
- This requires working on consumer averages, though
- ”Where do we put the safety margins?” is to some extent a subjective question, in terms of trading off one aspect of health for another
- Too much fluoride can also be bad for the teeth (at least cosmetically, creating little white* spots)
- Detractors of fluoride tend to mostly be worried about neurological harm
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- That said, again this is working on consumer averages, though.
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- A good guide is: watch your teeth! Those white* spots will be “the canary in the coal mine” of more serious harm that could potentially come from higher levels due to overconsumption of fluorine.
*Teeth are not supposed to be pure white. The “Hollywood smile” is a lie. Teeth are supposed to be a slightly off-white, ivory color. Anything whiter than that is adding something else that shouldn’t be there, or stripping something off that should be there.
❝How does your diet change clean out your arteries of the bad cholesterol?❞
There’s good news and bad news here, and they can both be delivered with a one-word reply:
Slowly.
Or rather: what’s being cleaned out is mostly not the LDL (bad) cholesterol, but rather, the result of that.
When our diet is bad for cardiovascular health, our arteries get fatty deposits on their walls. Cholesterol gets stuck here too, but that’s not the main physical problem.
Our body’s natural defenses come into action and try to clean it up, but they (for example macrophages, a kind of white blood cell that consumes invaders and then dies, before being recycled by the next part of the system) often get stuck and become part of the buildup (called atheroma), which can lead to atherosclerosis and (if calcium levels are high) hardening of the arteries, which is the worst end of this.
This can then require medical attention, precisely because the body can’t remove it very well—especially if you are still maintaining a heart-unhealthy diet, thus continuing to add to the mess.
However, if it is not too bad yet, yes, a dietary change alone will reverse this process. Without new material being added to the arterial walls, the body’s continual process of rejuvenation will eventually fix it, given time (free from things making it worse) and resources.
In fact, your arteries can be one of the quickest places for your body to make something better or worse, because the blood is the means by which the body moves most things (good or bad) around the body.
All the more reason to take extra care of it, since everything else depends on it!
You might also like our previous main feature:
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What Your Eyes Say About Your Health (If You Have A Mirror, You Can Do This Now!)
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In an age when doctors are increasingly pressed to get you out of their office quickly and not take the time to do thorough tests, having a good basic knowledge of signs and symptoms of disease has become more important than ever for all of us:
The eyes have it:
Dr. Siobhan Deshauer is back, this time working with Dr. Maria Howard, a Canadian optometrist, who advised behind-the-scenes to ensure the best information about these signs and symptoms and what they tell us:
- Color blindness test: Ishihara color test identifies color blindness; in the version in the video, seeing “74” is normal, “12” indicates red-green color blindness, and no numbers suggest complete color blindness due to genetics or retinal/optic nerve issues.
- Yellow sclera (scleral icterus): yellow sclera indicates high bilirubin from excessive red blood cell breakdown, liver damage, bile duct blockage, or Gilbert syndrome.
- Blue sclera: indicates thin collagen in the sclera, which can be linked to osteogenesis imperfecta, Ehlers-Danlos syndrome, and Marfan syndrome.
- Pink eye: caused by infections, autoimmune diseases, or trauma; persistent symptoms or associated pain/vision changes need medical evaluation.
- Physiologic diplopia (double vision): normal test where fingers appear doubled when focusing on different planes; absence may indicate amblyopia.
- Pinhole test (visual acuity): looking through a small pinhole can determine if glasses are needed for clearer vision.
- Nearsighted vs farsighted: nearsightedness risks retinal tears and night vision issues, while farsightedness increases the risk of glaucoma.
- Eye color and health: brown eyes lower cancer risk but higher cataract risk; light eyes higher cancer risk but lower cataract risk; sudden changes may indicate a condition.
- Kayser-Fleischer rings: golden-brown rings around the iris suggest copper buildup from Wilson disease, treatable with chelation therapy.
- Corneal arcus: gray/white ring around the iris indicates cholesterol buildup, normal with aging but concerning in younger individuals, signaling hypercholesterolemia or artery narrowing.
- Limbal rings: dark rings around the iris are generally aesthetic and not health-related.
- Red desaturation test: a difference in red color perception between eyes may indicate optic nerve or retinal issues.
- Eye twitching: often linked to stress, sleep deprivation, or caffeine; persistent twitching or muscle involvement requires medical attention.
- Pupillary reflex: pupil constriction in light; abnormal responses suggest trauma, overdose, or poisoning.
- Cataracts: lens cloudiness due to age, UV exposure, smoking, diabetes, or prednisone; also occurs sometimes in youth due to conditions like diabetes.
- Yellow spots (pinguecula and pterygium): sun damage, wind, and dust exposure cause yellow spots; protect with sunglasses to prevent progression impacting vision.
- Dark spots in the eye: includes freckles, moles (nevi), and melanoma; changes require medical evaluation.
- Hypnotic induction profile: eye roll test assesses susceptibility to hypnosis.
- Floaters: normal clumps in the eye; sudden increases, flashes, or curtain-like effects may signal retinal detachment.
- Retinal detachment: caused by aging-related vitreous shrinkage; treated with lasers, gas bubbles, or retinal buckles.
- Macular degeneration (Amsler grid test): wavy, fuzzy lines or missing vision spots may indicate this condition.
- Giant cell arteritis: no, that’s not a typo: rather it is about blood vessel inflammation that can cause blindness; treated with prednisone, symptoms include headaches and vision changes.
- Near point of convergence: focus test to detect convergence issues common with excessive screen time.
- Blepharitis: eyelid inflammation causing itchiness, burning, or flaky skin; treated with hygiene, antibiotics, or tea tree oil.
- Proptosis (Graves’ disease): bulging eyes due to hyperthyroidism; treatable with medications, radiation, or surgery.
- Ptosis (droopy eyelids): indicates myasthenia gravis, temporarily improved with the ice pack test.
- Night vision issues: caused by retinal problems or high myopia, not typically vitamin A deficiency in developed countries.
- Dry eyes: caused by screen time, smoking, medications, or autoimmune diseases; managed with lubricating drops, reduced screen time, and adjustments.
- Watery eyes: caused by irritation or blocked tear ducts; treated with lubricating drops or surgery.
- Retinoblastoma: rare childhood cancer detectable through flash photography showing one white pupil; early detection enables treatment.
For more on all of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
What Your Hands Can Tell You About Your Health
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Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)
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There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:
Under pressure
When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.
Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower
*10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.
Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.
Dr. Dhand’s advice for patients and families is:
- Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
- Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
- Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.
For more on all of this, enjoy:
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You might also like to read:
The Insider’s Guide To Making Hospital As Comfortable As Possible
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Top 10 Early Warning Signs Of Dementia
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What’s a harmless momentary mind-blank, and what’s a potential warning sign of dementia? Dementia Careblazers, a dementia care organization, has input:
The signs
With the caveat that this is a list of potential warning signs, not a diagnostic tool, the 10 signs are:
- Memory loss: e.g. forgetting important or well-learned information, such as one’s home address
- Challenges in planning or solving problems: e.g. difficulty with tasks such as paying bills (for organizational rather than financial reasons), following recipes, or managing medications
- Difficulty completing familiar tasks: e.g. trouble remembering rules of a familiar game, or directions to a familiar place
- Confusion with place or time: e.g. forgetting where one is, or making mistakes with the date, season, or other time-related details. Note that anyone can be momentarily unsure of today’s date, but if someone thinks it’s 1995, probably something wrong is not quite right. Similarly, being wrong about who is the current national leader is often used as a test, too—assuming countries with enough political stability to not have five different national leaders in the past four years, including one who did not outlast a lettuce *side-eyeing the UK*
- Trouble understanding visual images and spatial relationships: e.g. increased clumsiness, difficulty parking, or bumping into objects
- New problems with speaking or writing: e.g. losing track in conversations, or struggling to find the right words
- Misplacing things: e.g. losing items and being unable to retrace one’s steps to find them
- Decreased or poor judgment: e.g. falling for scams, giving out too much information or money without investigating appropriately first
- Withdrawal from social activities or hobbies: e.g. losing interest in activities one used to enjoy or avoiding social interactions
- Changes in mood and personality: e.g. increased irritability, anxiety, or other noticeable changes in behavior and personality
For more information on each of these, enjoy:
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Want to learn more?
You might also like to read:
Dementia: Spot The Signs (Because None Of Us Are Immune)
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How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise
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.
A growing number of complaints against older doctors has prompted the Medical Board of Australia to announce today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.
The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.
The second would require only general health checks for doctors over 70.
A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their professional code of conduct, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.
PeopleImages.com – Yuri A/Shutterstock Haven’t we moved on from set retirement ages?
It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “still valid in a modern society”.
However, unlike judges, doctors are already required to renew their registration annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct performance assessments if and when they are needed.
What has prompted these proposals?
This latest proposal identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.
Studies of medical competence in ageing doctors show variable results. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.
The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.
In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.
In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.
While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.
It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.
So what distinguishes the two new proposed options?
The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.
Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.
Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.
The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.
In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.
Older surgeons could be independently assessed for dexterity, sight and the ability to give clinical instructions. worradirek/Shutterstock The law tends to prioritise patient safety
All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. That provision basically says patient safety is paramount and trumps all other considerations.
As with legal regimes regulating childcare, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.
Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “punished” for errors in practice.
All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.
Could these proposals amount to age discrimination?
It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.
For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals who are “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.
In broader terms, a licence to practise medicine is often compared to a licence to drive or pilot an aircraft. Despite claims of discrimination, New South Wales law requires older drivers to undergo a medical assessment every year; and similar requirements affect older pilots and air traffic controllers.
Where to from here?
When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.
How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, others have suggested this would only exacerbate shortages in the health-care workforce.
The proposals are open for public comment until October 4.
Christopher Rudge, Law lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthy Homemade Flatbreads
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Our recipes sometimes call for the use of flatbreads, or suggest serving with flatbreads. But we want you to be able to have healthy homemade ones! So here’s a very quick and easy recipe. You’ll probably need to order some of the ingredients in, but it’s worth it, and then if you keep a stock of the ingredients, you can whip these up in minutes anytime you want them.
You will need
- 1 cup garbanzo bean flour, plus more for dusting
- 1 cup quinoa flour
- 2 tbsp ground/milled flaxseed
- 1 tbsp baking powder
- 1 tbsp extra virgin olive oil, plus more for the pan
- ½ tsp MSG, or 1 tsp low-sodium salt, with MSG being the healthier and preferable option
- ½ tsp onion powder
- ½ tsp garlic powder
- ½ tsp dried cumin
- ½ tsp dried thyme
Method
(we suggest you read everything at least once before doing anything)
1) Mix the flaxseed with ⅓ cup of water and set aside for at least 5 minutes.
2) Combine the rest of the ingredients in a big bowl, plus the flax mixtures we just made, and an extra ½ cup of water. Knead this into a dough, adding a touch more water if it becomes necessary, but be sparing with it.
3) Divide the dough into 6 equal portions, shaping each into a ball. Dust a clean surface with the extra garbanzo bean flour, and roll each dough ball into in a thin 6″ circle.
4) Heat a skillet and add some olive oil for frying; when hot enough, place a dough disk in the pan and cook for a few minutes on each side until golden brown. Repeat with the other 5.
5) Serve! If you’re looking for a perfect accompaniment to these, try our Hero Homemade Hummus
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
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Own Your Past Change Your Future – by Dr. John Delony
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This one is exactly what it says on the cover. It’s reminiscent in its premise of the more clinically-presented Tell Yourself A Better Lie (an excellent book, which we reviewed previously) but this time presented in a much more casual fashion.
Dr. Delony favors focusing on telling stories, and indeed this book contains many anecdotes. But also he bids the reader to examine our own stories—those we tell ourselves about ourselves, our past, people around us, and so forth.
To call those things “stories” may create a knee-jerk response of feeling like it is an accusation of dishonesty, but rather, it is acknowledging that experiences are subjective, and our framing of narratives can vary.
As for reframing things and taking control, his five-step-plan for doing such is:
- Acknowledge reality
- Get connected
- Change your thoughts
- Change your actions
- Seek redemption
…which each get a chapter devoted to them in the book.
You may notice that these are very similar to some of the steps in 12-step programs, and also some religious groups and/or self-improvement groups. In other words, this may not be the most original approach, but it is a tried-and-tested one.
Bottom line: if you feel like your life needs an overhaul, but don’t want to wade through a bunch of psychology to do it, then this book could be it for you.
Click here to check out Own Your Past To Change Your Future, and do just that!
Don’t Forget…
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Learn to Age Gracefully
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