What Most People Don’t Know About Hearing Aids
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Dr. Juliëtte Sterkens, a doctor of audiology, makes things clearer in this TEDx talk:
The sound of the future
Half of all adults experience hearing loss by the age of 75, and by 85, that goes up to two thirds. Untreated hearing loss leads to depression, social isolation, cognitive decline, and even an increased fall risk.
It’s not just about reduced volume though; Dr. Sterkens points out that for many (like this writer!) it’s more a matter of unequal pitch perception and difficulty in speech clarity. Most hearing aids just amplify sound, and don’t fully restore clarity, especially beyond a short range.
However, technology keeps marching forwards there have been improvements in the move from analog to digital, and today’s bluetooth-enabled hearing aids often do a lot better, especially in the case of things like TV transmitters and clip-on microphones.
Out and about, you might see signs sometimes saying “Hearing Loop Enabled”, and those transmit sound directly to telecoil-equipped hearing aids—venues with public address systems are legally required to provide hearing accommodations like this. Many hearing aids include telecoils, but users often aren’t informed or don’t have them activated, which is unfortunate, because telecoils improve hearing dramatically in loop-enabled venues.
Dr. Sterkens makes a plea for us to, as applicable,
- Activate telecoils and insist on them in new hearing aids.
- Advocate for assistive listening systems in public venues.
- Use available resources like the Hearing Loss Association of America for tools and information.
- Familiarize ourselves with accessibility laws and report non-compliance.
- Aim to make the world more accessible for people with hearing loss through advocacy, technology, and awareness.
For more on all of this, enjoy:
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You might also like to read:
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Vitamin B6 is essential – but too much can be toxic. Here’s what to know to stay safe
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In recent weeks, reports have been circulating about severe reactions in people who’ve taken over-the-counter vitamin B6 supplements.
Vitamin B6 poisoning can injure nerves and lead to symptoms including numbness, tingling and even trouble walking and moving.
In some cases, those affected didn’t know the product contained any vitamin B6.
So what is vitamin B6, where is it found and how much is too much? Here’s what you need to know about this essential nutrient.
Kim Kuperkova/Shutterstock What is vitamin B6?
Vitamin B6 (also known as pyridoxine) is a group of six compounds that share a similar chemical structure.
It is an essential nutrient, meaning we need it for normal body functions, but we can’t produce it ourselves.
Adults aged 19–50 need 1.3mg of vitamin B6 per day. The recommended dose is lower for teens and children, and higher for those aged 51 and over (1.7mg for men and 1.5mg for women) and people who are breastfeeding or pregnant (1.9mg).
Most of us get this in our diet – largely from animal products, including meat, dairy and eggs.
The vitamin is also available in a range of different plant foods, including spinach, kale, bananas and potatoes, so deficiency is rare, even for vegetarians and vegans.
The vitamin B6 we consume in the diet is inactive, meaning the body can’t use it. To activate B6, the liver transforms it into a compound called pyridoxal-5’-phosphate (PLP).
In this form, vitamin B6 helps the body with more than 140 cellular functions, including building and breaking down proteins, producing red blood cells, regulating blood sugar and supporting brain function.
Vitamin B6 is important for overall health and has also been associated with reduced cancer risk and inflammation.
Despite being readily available in the diet, vitamin B6 is also widely included in various supplements, multivitamins and other products, such as Berocca and energy drinks.
Most people get enough vitamin B6 from their diet. Tatjana Baibakova/Shutterstock Should we be worried about toxicity?
Vitamin B6 toxicity is extremely rare. It almost never occurs from dietary intake alone, unless there is a genetic disorders or disease that stops nutrient absorption (such as coeliac disease).
This is because all eight vitamins in the B group are water-soluble. If you consume more of the vitamin than your body needs, it can be excreted readily and harmlessly in your urine.
However, in some rare cases, excessive vitamin B6 accumulates in the blood, resulting in a condition called peripheral neuropathy. We’re still not sure why this occurs in some people but not others.
Peripheral neuropathy occurs when the sensory nerves – those outside our brain and spinal cord that send information to the central nervous system – are damaged and unable to function. This can be caused by a wide range of diseases (and is most well known in type 2 diabetes).
The most common symptoms are numbness and tingling, though in some cases patients may experience difficulty with balance or walking.
We don’t know exactly how excess vitamin B6 causes peripheral neuropathy, but it is thought to interfere with how the neurotransmitter GABA sends signals to the sensory nerves.
Vitamin B6 can cause permanent damage to nerves. Studies have shown symptoms improved when the person stopped taking the supplement, although they didn’t completely resolve.
What is considered excessive? And has this changed?
Toxicity usually occurs only when people take supplements with high doses of B6.
Until 2022, only products with more than 50mg of vitamin B6 were required to display a warning about peripheral neuropathy. But the Therapeutic Goods Administration lowered this and now requires any product containing more than 10mg of vitamin B6 to carry a warning.
The Therapeutic Goods Administration has also halved the daily upper limit of vitamin B6 a product can provide – from 200mg to 100mg.
These changes followed a review by the administration, after receiving 32 reports of peripheral neuropathy in people taking supplements. Two thirds of these people were taking less than 50mg of vitamin B6.
The Therapeutic Goods Administration acknowledges the risk varies between individuals and a lot is unknown. Its review could not identify a minimum dose, duration of use or patient risk factors.
But I thought B vitamins were good for me?
Too much of anything can cause problems.
The updated guidelines are likely to significantly lower the risk of toxicity. They also make consumers more aware of which products contain B6, and the risks.
The Therapeutic Goods Administration will continue to monitor evidence and revise guidelines if necessary.
While vitamin B6 toxicity remains very rare, there are still many questions about why some people get peripheral neuropathy with lower dose supplements.
It could be that some specific vitamin B compounds have a stronger effect, or some people may have genetic vulnerabilities or diseases which put them at higher risk.
So what should I do?
Most people don’t need to actively seek vitamin B6 in supplements.
However, many reports to the Therapeutic Goods Administration were of vitamin B6 being added to supplements labelled as magnesium or zinc – and some weren’t aware they were consuming it.
It is important to always check the label if you are taking a new medicine or supplement, especially if it hasn’t been explicitly prescribed by a health-care professional.
Be particularly cautious if you are taking multiple supplements. While one multivitamin is unlikely to cause an issue, adding a magnesium supplement for cramping, or a zinc supplement for cold and flu symptoms, may cause an excessive vitamin B6 dose over time, and increase your risk.
Importantly, pay attention to symptoms that may indicate peripheral neuropathy, such as pins and needles, numbness, or pain in the feet or hands, if you do change or add a supplement.
Most importantly, if you need advice, you should talk to your doctor, dietitian or pharmacist.
Vasso Apostolopoulos, Distinguished Professor, Professor of Immunology, RMIT University and Jack Feehan, Vice Chancellors Senior Research Fellow in Immunology, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity
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When Michael Adams was researching health insurance options in 2023, he had one very specific requirement: coverage for prosthetic limbs.
Adams, 51, lost his right leg to cancer 40 years ago, and he has worn out more legs than he can count. He picked a gold plan on the Colorado health insurance marketplace that covered prosthetics, including microprocessor-controlled knees like the one he has used for many years. That function adds stability and helps prevent falls.
But when his leg needed replacing last January after about five years of everyday use, his new marketplace health plan wouldn’t authorize it. The roughly $50,000 leg with the electronically controlled knee wasn’t medically necessary, the insurer said, even though Colorado law leaves that determination up to the patient’s doctor, and his has prescribed a version of that leg for many years, starting when he had employer-sponsored coverage.
“The electronic prosthetic knee is life-changing,” said Adams, who lives in Lafayette, Colorado, with his wife and two kids. Without it, “it would be like going back to having a wooden leg like I did when I was a kid.” The microprocessor in the knee responds to different surfaces and inclines, stiffening up if it detects movement that indicates its user is falling.
People who need surgery to replace a joint typically don’t encounter similar coverage roadblocks. In 2021, 1.5 million knee or hip joint replacements were performed in United States hospitals and hospital-owned ambulatory facilities, according to the federal Agency for Healthcare Research and Quality, or AHRQ. The median price for a total hip or knee replacement without complications at top orthopedic hospitals was just over $68,000 in 2020, according to one analysis, though health plans often negotiate lower rates.
To people in the amputee community, the coverage disparity amounts to discrimination.
“Insurance covers a knee replacement if it’s covered with skin, but if it’s covered with plastic, it’s not going to cover it,” said Jeffrey Cain, a family physician and former chair of the board of the Amputee Coalition, an advocacy group. Cain wears two prosthetic legs, having lost his after an airplane accident nearly 30 years ago.
AHIP, a trade group for health plans, said health plans generally provide coverage when the prosthetic is determined to be medically necessary, such as to replace a body part or function for walking and day-to-day activity. In practice, though, prosthetic coverage by private health plans varies tremendously, said Ashlie White, chief strategy and programs officer at the Amputee Coalition. Even though coverage for basic prostheses may be included in a plan, “often insurance companies will put caps on the devices and restrictions on the types of devices approved,” White said.
An estimated 2.3 million people are living with limb loss in the U.S., according to an analysis by Avalere, a health care consulting company. That number is expected to as much as double in coming years as people age and a growing number lose limbs to diabetes, trauma, and other medical problems.
Fewer than half of people with limb loss have been prescribed a prosthesis, according to a report by the AHRQ. Plans may deny coverage for prosthetic limbs by claiming they aren’t medically necessary or are experimental devices, even though microprocessor-controlled knees like Adams’ have been in use for decades.
Cain was instrumental in getting passed a 2000 Colorado law that requires insurers to cover prosthetic arms and legs at parity with Medicare, which requires coverage with a 20% coinsurance payment. Since that measure was enacted, about half of states have passed “insurance fairness” laws that require prosthetic coverage on par with other covered medical services in a plan or laws that require coverage of prostheses that enable people to do sports. But these laws apply only to plans regulated by the state. Over half of people with private coverage are in plans not governed by state law.
The Medicare program’s 80% coverage of prosthetic limbs mirrors its coverage for other services. Still, an October report by the Government Accountability Office found that only 30% of beneficiaries who lost a limb in 2016 received a prosthesis in the following three years.
Cost is a factor for many people.
“No matter your coverage, most people have to pay something on that device,” White said. As a result, “many people will be on a payment plan for their device,” she said. Some may take out loans.
The federal Consumer Financial Protection Bureau has proposed a rule that would prohibit lenders from repossessing medical devices such as wheelchairs and prosthetic limbs if people can’t repay their loans.
“It is a replacement limb,” said White, whose organization has heard of several cases in which lenders have repossessed wheelchairs or prostheses. Repossession is “literally a punishment to the individual.”
Adams ultimately owed a coinsurance payment of about $4,000 for his new leg, which reflected his portion of the insurer’s negotiated rate for the knee and foot portion of the leg but did not include the costly part that fits around his stump, which didn’t need replacing. The insurer approved the prosthetic leg on appeal, claiming it had made an administrative error, Adams said.
“We’re fortunate that we’re able to afford that 20%,” said Adams, who is a self-employed leadership consultant.
Leah Kaplan doesn’t have that financial flexibility. Born without a left hand, she did not have a prosthetic limb until a few years ago.
Growing up, “I didn’t want more reasons to be stared at,” said Kaplan, 32, of her decision not to use a prosthesis. A few years ago, the cycling enthusiast got a prosthetic hand specially designed for use with her bike. That device was covered under the health plan she has through her county government job in Spokane, Washington, helping developmentally disabled people transition from school to work.
But when she tried to get approval for a prosthetic hand to use for everyday activities, her health plan turned her down. The myoelectric hand she requested would respond to electrical impulses in her arm that would move the hand to perform certain actions. Without insurance coverage, the hand would cost her just over $46,000, which she said she can’t afford.
Working with her doctor, she has appealed the decision to her insurer and been denied three times. Kaplan said she’s still not sure exactly what the rationale is, except that the insurer has questioned the medical necessity of the prosthetic hand. The next step is to file an appeal with an independent review organization certified by the state insurance commissioner’s office.
A prosthetic hand is not a luxury device, Kaplan said. The prosthetic clinic has ordered the hand and made the customized socket that will fit around the end of her arm. But until insurance coverage is sorted out, she can’t use it.
At this point she feels defeated. “I’ve been waiting for this for so long,” Kaplan said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Maca Root’s Benefits For The Mood And The Ability
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Maca Root: What It Does And Doesn’t Do
Maca root, or Lepidium meyenii, gets thought of as a root vegetable, though it’s in fact a cruciferous vegetable and more closely related to cabbage—notwithstanding that it also gets called “Peruvian ginseng”.
- Nutritionally, it’s full of all manner of nutrients (vitamins, minerals, fiber, and a wide array of phytochemicals)
- Medicinally, it’s long enjoyed traditional use against a wide variety of illnesses, including respiratory infections and inflammatory diseases.
It’s also traditionally an aphrodisiac.
Is it really anti-inflammatory?
Probably not… Unless fermented. This hasn’t been studied deeply, but a 2023 study found that non-fermented and fermented maca root extracts had opposite effects in this regard:
However, this was an in vitro study, so we can’t say for sure that the results will carry over to humans.
Is it really an aphrodisiac?
Actually yes, it seems so. Here’s a study in which 45 women with antidepressant-induced sexual dysfunction found it significantly improved both libido and sexual function:
❝In summary, maca root may alleviate antidepressant-induced sexual dysfunction as women age, particularly in the domain of orgasm❞
~ Dr. Christina Dording et al.
Read in full: A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women
As for men, well these mice (not technically men) found it beneficial too:
Effects of combined extracts of Lepidium meyenii and Allium tuberosum Rottl. on [e-word] dysfunction
(pardon the censorship; we’re trying to avoid people’s spam filters)
It did also improve fertility (and, actually in real men this time):
Does Lepidium meyenii (Maca) improve seminal quality?
Oh, to be in the mood
Here’s an interesting study in which 3g/day yielded significant mood improvement in these 175 (human) subjects:
And yes, it was found to be “well-tolerated” which is scientist-speak for “this appears to be completely safe, but we don’t want to commit ourselves to an absolutist statement and we can’t prove a negative”.
Oh, to have the energy
As it turns out, maca root does also offer benefits in this regard too:
(that’s not an added ingredient; it’s just a relevant chemical that the root naturally contains)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Leek vs Scallions – Which is Healthier?
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Our Verdict
When comparing leek to scallions, we picked the leek.
Why?
In terms of macros, scallions might have a point: scallions have the lower glycemic index, thanks to leek having more carbs for the same amount of fiber. That said, leek already has a low glycemic index, so this is not a big deal.
When it comes to vitamins, leek has more of vitamins B1, B2, B3, B5, B6, B9, E, and choline, while scallions have more of vitamins A, C, and K. Noteworthily, a cup of chopped leek already provides the daily dose of vitamins A and K, and the difference in levels of vitamin C is minimal. All in all, an easy 8:3 win for leeks here, even without taking that into account.
In the category of minerals, leek has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and selenium, while scallions have a little more zinc.
Both of these allium-family plants (i.e., related to garlic) have an abundance of polyphenols, especially kaempferol.
Of course, enjoy whatever goes best with your meal, but if you’re looking for nutritional density, then leek is where it’s at.
Want to learn more?
You might like to read:
The Many Health Benefits Of Garlic
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How Stress Affects Your Body
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Dr. Sharon Bergquist gives us a tour:
Stress, from the inside out
Stress is a natural physical and emotional response to challenges or being overwhelmed. It can be beneficial in short-term situations (e.g. escape from a tiger) but is harmful when prolonged or frequent (e.g. escape the rat-race).
Immediate physiological response: cortisol, adrenaline (epinephrine), and norepinephrine are released by the adrenal glands.
The effects this has (non-exhaustive list; we’re just citing what’s in the video here):
- Cortisol impairs blood vessel function, promoting atherosclerosis.
- Adrenaline increases heart rate and blood pressure, leading to hypertension.
- Stress disrupts the brain-gut connection, causing:
- Digestive issues like irritable bowel syndrome and heartburn.
- Changes in gut bacteria composition, potentially affecting overall health.
- Cortisol increases appetite and cravings for energy-dense “comfort foods”.
- This in turn promotes visceral fat storage, which raises the risk of heart disease and insulin resistance.
- Immune-specific effects:
- Stress hormones initially aid in healing and immune defense.
- Chronic stress weakens immune function (by over-working it constantly), increasing susceptibility to infections and slowing recovery.
- Other systemic effects:
- Chronic stress shortens telomeres, which protect chromosomes. Shortened telomeres accelerate cellular aging.
- Chronic stress can also cause acne, hair loss, sexual dysfunction, headaches, muscle tension, fatigue, irritability, and difficulty concentrating.
So, how to manage this? The video says that viewing stressful situations as controllable challenges, rather than insurmountable threats, leads to better short-term performance and long-term health.
Which would be wonderful, except that usually things are stressful precisely because they are not entirely within the field of our control, and the usual advice is to tend to what we can control, and accept what we can’t.
However… That paradigm still leaves out the very big set of “this might be somewhat within our control or it might not; we really don’t know yet; we can probably impact it but what if we don’t do enough, or take the wrong approach and do the wrong thing? And also we have 17 competing stressors, which ones should we prioritize tending to first, and…” and so on.
To that end, we suggest checking out the “Want to learn more?” link we drop below the video today, as it is about managing stress realistically, in a world that, if we’re honest about it, can sometimes be frankly unmanageable.
Meanwhile, enjoy:
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Want to learn more?
You might also like to read:
Heart Health vs Systemic Stress ← this is good in and of itself, and also links to other stress-related resources of ours
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How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)
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Each Monday, we’re going to be bringing you cutting-edge research reviews to not only make your health and productivity crazy simple, but also, constantly up-to-date.
But today, in this special edition, we want to lay out plain and simple how to see through a lot of the tricks used not just by popular news outlets, but even sometimes the research publications themselves.
That way, when we give you health-related science news, you won’t have to take our word for it, because you’ll be able to see whether the studies we cite really support the claims we make.
Of course, we’ll always give you the best, most honest information we have… But the point is that you shouldn’t have to trust us! So, buckle in for today’s special edition, and never have to blindly believe sci-hub (or Snopes!) again.
The above now-famous Tumblr post that became a meme is a popular and obvious example of how statistics can be misleading, either by error or by deliberate spin.
But what sort of mistakes and misrepresentations are we most likely to find in real research?
Spin Bias
Perhaps most common in popular media reporting of science, the Spin Bias hinges on the fact that most people perceive numbers in a very “fuzzy logic” sort of way. Do you?
Try this:
- A million seconds is 11.5 days
- A billion seconds is not weeks, but 13.2 months!
…just kidding, it’s actually nearly thirty-two years.
Did the months figure seem reasonable to you, though? If so, this is the same kind of “human brains don’t do large numbers” problem that occurs when looking at statistics.
Let’s have a look at reporting on statistically unlikely side effects for vaccines, as an example:
- “966 people in the US died after receiving this vaccine!” (So many! So risky!)
- “Fewer than 3 people per million died after receiving this vaccine!” (Hmm, I wonder if it is worth it?)
- “Half of unvaccinated people with this disease die of it” (Oh)
How to check for this: ask yourself “is what’s being described as very common really very common?”. To keep with the spiders theme, there are many (usually outright made-up) stats thrown around on social media about how near the nearest spider is at any given time. Apply this kind of thinking to medical conditions.. If something affects only 1% of the population (So few! What a tiny number!), how far would you have to go to find someone with that condition? The end of your street, perhaps?
Selection/Sampling Bias
Diabetes disproportionately affects black people, but diabetes research disproportionately focuses on white people with diabetes. There are many possible reasons for this, the most obvious being systemic/institutional racism. For example, advertisements for clinical trial volunteer opportunities might appear more frequently amongst a convenient, nearby, mostly-white student body. The selection bias, therefore, made the study much less reliable.
Alternatively: a researcher is conducting a study on depression, and advertises for research subjects. He struggles to get a large enough sample size, because depressed people are less likely to respond, but eventually gets enough. Little does he know, even the most depressed of his subjects are relatively happy and healthy compared with the silent majority of depressed people who didn’t respond.
See This And Many More Educational Cartoons At Sketchplanations.com!
How to check for this: Does the “method” section of the scientific article describe how they took pains to make sure their sample was representative of the relevant population, and how did they decide what the relevant population was?
Publication Bias
Scientific publications will tend to prioritise statistical significance. Which seems great, right? We want statistically significant studies… don’t we?
We do, but: usually, in science, we consider something “statistically significant” when it hits the magical marker of p=0.05 (in other words, the probability of getting that result is 1/20, and the results are reliably coming back on the right side of that marker).
However, this can result in the clinic stopping testing once p=0.05 is reached, because they want to have their paper published. (“Yay, we’ve reached out magical marker and now our paper will be published”)
So, you can think of publication bias as the tendency for researchers to publish ‘positive’ results.
If it weren’t for publication bias, we would have a lot more studies that say “we tested this, and here are our results, which didn’t help answer our question at all”—which would be bad for the publication, but good for science, because data is data.
To put it in non-numerical terms: this is the same misrepresentation as the technically true phrase “when I misplace something, it’s always in the last place I look for it”—obviously it is, because that’s when you stop looking.
There’s not a good way to check for this, but be sure to check out sample sizes and see that they’re reassuringly large.
Reporting/Detection/Survivorship Bias
There’s a famous example of the rise in “popularity” of left-handedness. Whilst Americans born in ~1910 had a bit under a 3.5% chance of being left handed, those born in ~1950 had a bit under a 12% change.
Why did left-handedness become so much more prevalent all of a sudden, and then plateau at 12%?
Simple, that’s when schools stopped forcing left-handed children to use their right hands instead.
In a similar fashion, countries have generally found that homosexuality became a lot more common once decriminalized. Of course the real incidence almost certainly did not change—it just became more visible to research.
So, these biases are caused when the method of data collection and/or measurement leads to a systematic error in results.
How to check for this: you’ll need to think this through logically, on a case by case basis. Is there a reason that we might not be seeing or hearing from a certain demographic?
And perhaps most common of all…
Confounding Bias
This is the bias that relates to the well-known idea “correlation ≠ causation”.
Everyone has heard the funny examples, such as “ice cream sales cause shark attacks” (in reality, both are more likely to happen in similar places and times; when many people are at the beach, for instance).
How can any research paper possibly screw this one up?
Often they don’t and it’s a case of Spin Bias (see above), but examples that are not so obviously wrong “by common sense” often fly under the radar:
“Horse-riding found to be the sport that most extends longevity”
Should we all take up horse-riding to increase our lifespans? Probably not; the reality is that people who can afford horses can probably afford better than average healthcare, and lead easier, less stressful lives overall. The fact that people with horses typically have wealthier lifestyles than those without, is the confounding variable here.
See This And Many More Educational Cartoons on XKCD.com!
In short, when you look at the scientific research papers cited in the articles you read (you do look at the studies, yes?), watch out for these biases that found their way into the research, and you’ll be able to draw your own conclusions, with well-informed confidence, about what the study actually tells us.
Science shouldn’t be gatekept, and definitely shouldn’t be abused, so the more people who know about these things, the better!
So…would one of your friends benefit from this knowledge? Forward it to them!
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