Why We’re Called “10almonds”, And Other Questions
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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
❝Avid coffee drinker so very interested in the results Also question Is there something that you could take or eat that would prevent the caffeine from stimulating the kidneys? I tried to drink decaf from morning to night not a good result! Thanks❞
That is a good question! The simple answer is “no” (but keep reading, because all is not lost)
There’s no way (that we yet know of) to proof the kidneys against the stimulating effect of caffeine. This is especially relevant because part of caffeine’s stimulating effect is noradrenergic, and that “ren” in the middle there? It’s about the kidneys. This is just because the adrenal gland is situated next to them (actually, it’s pretty much sitting on top of them), hence the name, but it does mean that the kidneys are about the hardest thing in the body to have not affected by caffeine.
However! The effects of caffeine in general can be softened a little with l-theanine (found in tea, or it can be taken as a supplement). It doesn’t stop it from working, but it makes the curve of the effect a little gentler, and so it can reduce some unwanted side effects.
You can read more about l-theanine here:
❝How to jump start a inactive metabolism and keep it going? THANKYOU❞
The good news is, if you’re alive, your metabolism is active (it never stops!). So, it may just need perking up a little.
As for keeping it going, well, that’s what we’re here for! We’re all in favor of healthy longevity.
We’ll do a main feature soon on what we can do to influence our metabolism in either direction, but to give some quick notes here:
- A lot of our metabolism is influenced by genes and is unalterable (without modifying our genes, anyway)
- Metabolism isn’t just one thing—it’s many. And sometimes, parts of our metabolism can be much quicker or slower than others.
- When people talk about wanting a “faster metabolism”, they’re usually referring to fat-burning, and that’s just a small part of the picture, but we understand that it’s a focal point for many.
There really is enough material for a whole main feature on metabolic tweaks, though, so watch this space!
❝Why the name “10 Almonds?” Is this recommended by the Doctor? A daily dosage? And, if so, why? Thanks! Please answer me…I truly want to know!❞
Almonds are very nutritionally dense, and for example 20g of almonds (so, about 20 almonds) would give a 100% daily dose of zinc, amongst other nutrients.
We also do like to think that we give our readers an easily digestible dose of condensed “nutrition” in the form of health information.
However! That’s not actually the reason at all. It’s a reference to a viral Facebook hoax! There was a post going around that claimed:
❝HEADACHE REMEDY. Eat 10–12 almonds, the equivalent of two aspirins, next time you have a headache❞ ← not true!
It made us think about how much health-related disinformation there was circulating online! So, calling ourselves 10almonds was a bit of a nod to that story, but also a reminder to ourselves:
We must always publish information with good scientific evidence behind it!
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10 Oft-Ignored Symptoms Of Diabetes
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Due in part to its prevalence and manageability, diabetes is often viewed as more of an inconvenience than an existential threat. While very few people in countries with decent healthcare die of diabetes directly (such as by diabetic ketoacidosis, which is very unpleasant, and happens disproportionately in the US where insulin is sold with a 500%–3000% markup in price compared to other countries), many more die of complications arising from comorbidities, and as for what comorbidities come with diabetes, well, it increases your risk for almost everything.
So, while for most people diabetes is by no means a death sentence, it is something that means you’ll now have to watch out for pretty much everything else too. On which note, Dr. Siobhan Deshauer is here with things to be aware of:
More than your waistline
Some of these are early symptoms (even appearing in the prediabetic stage, so can be considered an early warning for diabetes), some are later risks (it’s unlikely you’ll lose your feet from diabetic neuropathy complications before noticing that you are diabetic), but all and any of them are good reason to speak with your doctor sooner rather than later:
- Polyuria: waking up multiple times at night to urinate due to excess glucose spilling into the urine.
- Increased thirst: dehydration from frequent urination leads to excessive thirst, creating a cycle.
- Acanthosis nigricans: dark, velvety patches on areas like the neck, armpits, or groin, signalling insulin resistance.
- Skin tags: multiple skin tags in areas of friction may indicate insulin resistance.
- Recurrent Infections: high blood sugar weakens the immune system, making skin infections, UTIs, and yeast infections more common.
- Diabetic stiff hand syndrome: stiffness in hands, limited movement, or a “positive prayer sign” caused by sugar binding to skin and tendon proteins.
- Frozen shoulder and trigger finger: pain and limited movement in the shoulder or fingers, with a snapping sensation when moving inflamed tendons.
- Neuropathy: numbness, tingling, or pain in hands and feet due to nerve and blood vessel damage, often leading to foot deformities like Charcot foot.
- Diabetic foot infections: poor sensation, weakened immune response, and slow healing can result in severe infections and potential amputations.
- Gastroparesis: damage to stomach nerves causes delayed digestion, leading to bloating, nausea, and erratic blood sugar levels.
For more on all of these, plus some visuals of the things like what exactly is a “positive prayer sign”, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Cost of Insulin by Country 2024 ← after the US, the next most expensive country is Chile, at around 1/5 of the price; the cheapest listed is Turkey, at around 1/33 of the price.
Take care!
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Daily, Weekly, Monthly: Habits Against Aging
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Dr. Anil Rajani has advice on restoring/retaining youthfulness. Two out of three of the sections are on skincare specifically, which may seem a vanity, but it’s also worth remembering that our skin is a very large and significant organ, and makes a big difference for the rest of our physical health, as well as our mental health. So, it’s worthwhile to look after it:
The recommendations
Daily: meditation practice
Meditation reduces stress, which reduction in turn protects telomere length, slowing the overall aging process in every living cell of the body.
Weekly: skincare basics
Dr. Rajani recommends a combination of retinol and glycolic acid. The former to accelerate cell turnover, stimulate collagen production, and reduce wrinkles; the latter, to exfoliate dead cells, allowing the retinol to do its job more effectively.
We at 10almonds would like to add: wearing sunscreen with SPF50 is a very good thing to do on any day that your phone’s weather app says the UV index is “moderate” or higher.
Monthly: skincare extras
Here are the real luxuries; spa visits, microneedling (stimulates collagen production), and non-ablative laser therapy. He recommends creating a home spa if possible for monthly skincare treatments, investing in high-quality devices for long-term benefits.
For more on all of these things, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Age & Aging: What Can (And Can’t) We Do About It?
- No-Frills, Evidence-Based Mindfulness
- The Evidence-Based Skincare That Beats Product-Specific Hype
Take care!
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Peas vs Broad Beans – Which is Healthier?
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Our Verdict
When comparing peas to broad beans, we picked the peas.
Why?
Both are great of course, but…
Looking at the macros to start with, peas have more protein and more fiber. The differences aren’t huge, but they are clear.
In terms of vitamins, peas have more of vitamins A, B1, B2, B3, B5, B6, B9, E, K, and choline (some with very large margins, some with small), while broad beans contain a little more vitamin C (the margin is quite narrow though).
When it comes to minerals, peas have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while broad beans have more sodium. So this category wasn’t close.
Adding up the win from each of the categories makes for a clear triple-win for peas.
Easy-peasy!
Want to learn more?
You might like to read:
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I’ve been sick. When can I start exercising again?
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You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache.
You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness.
Exercise can boost your immune system – but not always
Exercise reduces the chance of getting respiratory infections by increasing your immune function and the ability to fight off viruses.
However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory.
A study from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise.
So, we have to be more careful after performing harder exercises than normal.
Can you exercise when you’re sick?
This depends on the severity of your symptoms and the intensity of exercise.
Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever.
Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion.
However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body.
If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time.
If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker.
If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others.
When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine.
I’ve been sick for a few weeks. What has happened to my strength and fitness?
You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs.
It’s true that almost all training benefits are reversible to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise.
To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They found that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of aerobic fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the larger the declines.
In terms of skeletal muscles, upper thigh muscles become smaller by 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest.
Muscle strength declines more than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest.
This is why it feels harder to do the same exercises after resting for even five days.
But in bed rest studies, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants.
How to ease back into exercise
Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow.
Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level.
If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.
Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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HRT: Bioidentical vs Animal
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HRT: A Tale Of Two Approaches
In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).
- A little over a third said “It can be medically beneficial, but has some minor drawbacks”
- A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
- Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
- Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”
So what does the science say?
Which HRT?
One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:
❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞
And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.
So to quickly clear up any confusion:
- Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
- Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.
There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).
A quick jumping-off point if you’re interested in that:
Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer
this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.
Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.
In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.
Bioidentical hormones are safer: True or False?
True! This is an open-and-shut case:
❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.
Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞
Further research since that review has further backed up its findings.
Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?
So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.
HRT can increase the risk of breast cancer: True or False?
Contingently True, but for most people, there is no significant increase in risk.
First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.
There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:
❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.
Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞
In fewer words:
- Estradiol by itself: no increased risk of breast cancer
- Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
- Estradiol with actual progesterone: back to no increased risk of breast cancer
So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!
However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:
❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.
Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞
Source: HRT in difficult circumstances: are there any absolute contraindications?
HRT makes you happier, healthier, and smell nice too: True or False?
Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.
The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.
More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:
Read more: Skin, hair and beyond: the impact of menopause
We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.
HRT does have some drawbacks: True or False?
True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.
For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.
It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.
If you experience anything more alarming than that, then indeed check with your doctor.
HRT is a dangerous scam and sham: True or False?
False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.
The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.
As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.
They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.
See for example:
Our apologies, gentlemen
We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!
To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space
Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.
That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.
Meanwhile… take care, all!
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Horse Sedative Use Among Humans Spreads in Deadly Mixture of ‘Tranq’ and Fentanyl
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TREASURE ISLAND, Fla. — Andrew McClave Jr. loved to lift weights. The 6-foot-4-inch bartender resembled a bodybuilder and once posed for a photo flexing his muscles with former pro wrestler Hulk Hogan.
“He was extremely dedicated to it,” said his father, Andrew McClave Sr., “to the point where it was almost like he missed his medication if he didn’t go.”
But the hobby took its toll. According to a police report, a friend told the Treasure Island Police Department that McClave, 36, suffered from back problems and took unprescribed pills to reduce the pain.
In late 2022, the friend discovered McClave in bed. He had no pulse. A medical examiner determined he had a fatal amount of fentanyl, cocaine, and xylazine, a veterinary tranquilizer used to sedate horses, in his system, an autopsy report said. Heart disease was listed as a contributing factor.
McClave is among more than 260 people across Florida who died in one year from accidental overdoses involving xylazine, according to a Tampa Bay Times analysis of medical examiner data from 2022, the first year state officials began tracking the substance. Numbers for 2023 haven’t been published.
The death toll reflects xylazine’s spread into the nation’s illicit drug supply. Federal regulators approved the tranquilizer for animals in the early 1970s and it’s used to sedate horses for procedures like oral exams and colic treatment, said Todd Holbrook, an equine medicine specialist at the University of Florida. Reports of people using xylazine emerged in Philadelphia, then the drug spread south and west.
What’s not clear is exactly what role the sedative plays in overdose deaths, because the Florida data shows no one fatally overdosed on xylazine alone. The painkiller fentanyl was partly to blame in all but two cases in which the veterinary drug was included as a cause of death, according to the Times analysis. Cocaine or alcohol played roles in the cases in which fentanyl was not involved.
Fentanyl is generally the “800-pound gorilla,” according to Lewis Nelson, chair of the emergency medicine department at Rutgers New Jersey Medical School, and xylazine may increase the risk of overdose, though not substantially.
But xylazine appears to complicate the response to opioid overdoses when they do happen and makes it harder to save people. Xylazine can slow breathing to dangerous levels, according to federal health officials, and it doesn’t respond to the overdose reversal drug naloxone, often known by the brand name Narcan. Part of the problem is that many people may not know they are taking the horse tranquilizer when they use other drugs, so they aren’t aware of the additional risks.
Lawmakers in Tallahassee made xylazine a Schedule 1 drug like heroin or ecstasy in 2016, and several other states including Pennsylvania, Ohio, and West Virginia have taken action to classify it as a scheduled substance, too. But it’s not prohibited at the federal level. Legislation pending in Congress would criminalize illicit xylazine use nationwide.
The White House in April designated the combination of fentanyl and xylazine, often called “tranq dope,” as an emerging drug threat. A study of 20 states and Washington, D.C., found that overdose deaths attributed to both illicit fentanyl and xylazine exploded from January 2019 to June 2022, jumping from 12 a month to 188.
“We really need to continue to be proactive,” said Amanda Bonham-Lovett, program director of a syringe exchange in St. Petersburg, “and not wait until this is a bigger issue.”
‘A Good Business Model’
There are few definitive answers about why xylazine use has spread — and its impact on people who consume it.
The U.S. Drug Enforcement Administration in September said the tranquilizer is entering the country in several ways, including from China and in fentanyl brought across the southwestern border. The Florida attorney general’s office is prosecuting an Orange County drug trafficking case that involves xylazine from a New Jersey supplier.
Bonham-Lovett, who runs IDEA Exchange Pinellas, the county’s anonymous needle exchange, said some local residents who use drugs are not seeking out xylazine — and don’t know they’re consuming it.
One theory is that dealers are mixing xylazine into fentanyl because it’s cheap and also affects the brain, Nelson said.
“It’s conceivable that if you add a psychoactive agent to the fentanyl, you can put less fentanyl in and still get the same kick,” he said. “It’s a good business model.”
In Florida, men accounted for three-quarters of fatal overdoses involving xylazine, according to the Times analysis. Almost 80% of those who died were white. The median age was 42.
Counties on Florida’s eastern coast saw the highest death tolls. Duval County topped the list with 46 overdoses. Tampa Bay recorded 19 fatalities.
Cocaine was also a cause in more than 80 cases, including McClave’s, the Times found. The DEA in 2018 warned of cocaine laced with fentanyl in Florida.
In McClave’s case, Treasure Island police found what appeared to be marijuana and a small plastic bag with white residue in his room, according to a police report. His family still questions how he took the powerful drugs and is grappling with his death.
He was an avid fisherman, catching snook and grouper in the Gulf of Mexico, said his sister, Ashley McClave. He dreamed of being a charter boat captain.
“I feel like I’ve lost everything,” his sister said. “My son won’t be able to learn how to fish from his uncle.”
Mysterious Wounds
Another vexing challenge for health officials is the link between chronic xylazine use and open wounds.
The wounds are showing up across Tampa Bay, needle exchange leaders said. The telltale sign is blackened, crusty tissue, Bonham-Lovett said. Though the injuries may start small — the size of a dime — they can grow and “take over someone’s whole limb,” she said.
Even those who snort fentanyl, instead of injecting it, can develop them. The phenomenon is unexplained, Nelson said, and is not seen in animals.
IDEA Exchange Pinellas has recorded at least 10 cases since opening last February, Bonham-Lovett said, and has a successful treatment plan. Staffers wash the wounds with soap and water, then dress them.
One person required hospitalization partly due to xylazine’s effects, Bonham-Lovett said. A 31-year-old St. Petersburg woman, who asked not to be named due to concerns over her safety and the stigma of drug use, said she was admitted to St. Anthony’s Hospital in 2023. The woman, who said she uses fentanyl daily, had a years-long staph infection resistant to some antibiotics, and a wound recently spread across half her thigh.
The woman hadn’t heard of xylazine until IDEA Exchange Pinellas told her about the drug. She’s thankful she found out in time to get care.
“I probably would have lost my leg,” she said.
This article was produced in partnership with the Tampa Bay Times.
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.
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