Author: Seth Roberts

Movie Grosses and Nobel Prizes

Seth Roberts2 Comments

In Edward Jay Epstein’s new piece Gross Misunderstanding, in the Columbia Journalism Review, he writes

By focusing on the box-office race that is spoon-fed to them each week, journalists may entertain their audiences, but they are missing the real story.

Something similar happens with the Nobel Prizes. Journalists print what they are told — Scientists X and Y did beautiful “pure science” about this or that — and thereby miss the real story. In the case of Nobel Prizes in Medicine, the real story is the long-running lack of progress on major diseases (cancer, heart disease, depression, etc.).

Vitamin D3 in Morning Improves Sleep After All (Story 26)

Seth Roberts13 Comments

Adam Clemans (28 years old, about 80 kg, pharmacist, lives in Shanghai) commented on a recent post that Vitamin D3 didn’t seem to improve his sleep (“I can’t say I noticed any improvement in my sleep from Vitamin D”). He took 4000 IU in drop form right after he woke up.

I wrote him for details. I said that since 4000 IU was the lowest dose I found effective, he might want to try a higher dose. Adam answered my questions and said he would try a higher dose. Two weeks later he wrote again:

I started taking 4 drops (8000 IU) of Vitamin D3 1st thing in the morning (up from 2 drops or 4000 IU); my sleep seemed to improve immediately and quite dramatically. I had been struggling with middle-of-the-night awakening for a week or so, but after the change I slept like a brick or a baby (pick your metaphor). I would like to experiment with this more before I say I am sold on it, but for now it seems to be working well.

He’d been doing the higher dose for two weeks. Hard to explain as a placebo effect.

“Must Prescribe Antibiotic, Must Prescribe Antibiotic … “

Seth Roberts7 Comments

Jim Purdy, who often comments here, told me the following story:

Recently, a health professional ordered two tests for infectious bacteria in a small foot wound (I think the tests were for gram negative or gram positive bacteria, or maybe aerobic and anaerobic). Even before the bacterial tests came back, she wanted me to start on antibiotics. Instead I waited. The first results showed a very low level of a harmless bacteria, so I was glad I hadn’t started antibiotics.

When I saw her again, a few weeks later, I asked about the second set of bacterial tests. She claimed that there had only been one test, but I insisted she check again. She left, and came back a few minutes later and said that she had found the second results, and there had been no bacteria.

Surely the health professional knew that antibiotics are overprescribed, that antibiotic resistant bacteria have become a serious problem, that antibiotics are dangerous, and yet she not only failed give the wound a chance to heal on its own, she failed to allow test results to guide what she did. No wonder she forgot about the second test.

Acne Caused By Pasteurized Dairy: How One Person Figured It Out

Seth Roberts9 Comments

A reader of this blog named Tony Mach explains how he figured out that his acne was caused by pasteurized dairy products:

In summer 2010 my health problems got noticeably worse (unrefreshing sleep, strange pains, strange sensations in the skin and other stuff I don’t want to share here :-P ), and I had to do something. Furthermore I was gaining weight, so I was suspecting something along the lines of diabetes or other metabolic problem.

As I was looking into dietary changes, I stumbled over Wolfgang Lutz’s and Robert Atkins’ work. Being an engineer by training, I figured that if blood sugar might be the problem (which, as it turned out, wasn’t the case for me), then reducing carbs might be a solution (stop fueling the problematic sub-system) – so both Lutz and Atkins appealed to me. I thought let’s give it a try. I was a bit frightened about such an radical change of diet – you read all kind of BS – but hey, I felt like I was going to die anyway.

Before the change, I ate a lots of white bread, some milk chocolate and drank lots of milk. First I reduced carbs – like Lutz suggested, I tried to aim for 6 bread units – but within days I noticed that some problems (like the strange pain and skin sensations) diminished right away. The acne cleared up noticeably. So I thought why bother with low-carb, let’s go full no-carb (like Atkins suggests for some month).

And voila, with no-carb everything got better. I started to feel healthy for the first time in my life. I lost over 30 pounds, all health problems either went away or were almost gone, and life started to become enjoyable. This was a period of about two months over with most problems went away, some fast, some slower.

So for over half a year I was focused on the carbs=evil scheme, started eating cheese again (hey, no carbs!), when slowly some of the health problems returned and my weight started to rise again.

At that point I panicked a bit and made a huge mistake: I thought I can figure this one out too, I have to do something right away. So I trusted what some doctors had written about a pathogen (which I tested for with borderline results), how to cure it (with over the counter medications like Vitamin D and NAC and other stuff) and I thought let’s try this too! The things I took made me worse, but as it was supposed to be a “die off”/”herx” reaction, I wasn’t too alarmed. Turned out that experiment cost me almost an year until I got better again. So for about a year I was not in the mood for big experiments and personal stuff like moving to another city kept me busy.

But slowly I introduced “safe starches” into my diet (like plantains), because I kept reading one should not go too much low-carb. I tried out self-made sourdough rye bread (makes me enormously hungry, so I stopped again) and at one point I thought: What the heck, I’m going to eat ice cream today. Three hours later I got slightly noticeable pimples and local inflammation (I think they are called nodules) and after another roughly 3 hours the acne was prominent.

After that, my suspicion was that milk might be bad for me, but maybe some properly “ripe” cheese like hard cheese (properly digested by bacteria) might be OK. So I waited for the acne inflammation to go away and tried again with a Parmesan cheese. Bingo, acne again, and again in the 3 to 6 hour time frame.

So I didn’t touch milk or dairy again, but now I looked for raw milk cheese, as I read something about it being possibly better. After a while I found raw-milk-cheese, tried it – and got no acne. Tried again, after some time, with another brand – again no acne. Tried cheese from pasteurized milk – acne.

As I still have health problems, I am still in the process of figuring out things. Next up for me is trying to get rid of beef for a week or two, to see if that might be a problem for me.

In summary:
– I was not very systematic in my experiments, and had some lucky moments.
– All the macro-nutrient ratio paradigms are IMHO BS and not applicable for the majority (might make sense if someone has real/major metabolic problems like T1DM, etc.)
– Having said that, in my view some carb foods come with baggage: e.g. cereal grains and (pasteurized) milk
– A quickly reacting, non-dangerous, clearly visible (objective) surrogate health marker (in my case acne) is worth its weight in gold [I agree, canary in coal mine. In this case it isn’t clear what else besides no acne was gained by avoiding pasteurized dairy. — Seth]– With such a marker, one should completely eliminate suspicious foods (in my case *ALL* dairy) and then introduce it again (two or three challenges)
– For me, pasteurized dairy = acne, raw dairy = no acne
– Milk chocolate is dairy [A friend’s mother said, “If I’m ever in jail, bring me some chocolate.” She’ll break out.– Seth]– Some surrogate health markers (e.g. weight) reacted “funky” for me: I changed my diet to no-carb, my weight went down, and without any big changes [in diet or exercise] my weight started to climb again. [Same thing happened to Alex Chernavsky. — Seth]– For most of the health problems that went away, I don’t know exactly what food (Cereal grains? Dairy? Vegetable oils? etc.) caused what problem
– As I felt like I was going to die on my old diet, I am not particular keen on going back full scale to my old diet to see if after one or two month all my old symptoms return, to determine which food caused which symptom… [Better to test the old foods one at a time. — Seth]– Medical science and several MDs helped me diddly squat
– Paleo blogs were much more helpful than the medical community

I can only guess why raw milk and cheese are less harmful than pasteurized milk and cheese. Maybe milk and cheese contain acne-causing chemicals that leak into the blood. Maybe raw milk, which contains bigger entities than pasteurized milk, does a better job of plugging the holes from digestive system to blood.

“The Scale of the Scandal”: Tony Scott’s Suicide Quite Possibly Due to Antidepressant

Seth Roberts10 Comments

As pointed out by dearime, the columnist Peter Hitchens recently made the following comment in The Mail on Sunday:

When I read in August that the talented Hollywood film director Tony Scott had killed himself without any apparent good reason, I was fairly sure that pretty soon we would find that the poor man had been taking ‘antidepressants’. Well, a preliminary autopsy has found ‘therapeutic’ levels of an ‘antidepressant’ in his system. I take no pleasure in being right, but as the scale of this scandal has become clear to me, I have learned to look out for the words ‘antidepressant’ or ‘being treated for depression’ in almost any case of suicide and violent, bizarre behavior. And I generally find it. The science behind these pills is extremely dubious. Their risks are only just beginning to emerge. It is time for an inquiry.

“ Tony Scott Suicide Remains a Mystery After Autopsy,” wrote a Vanity Fair editor. The autopsy found that he had been taking the antidepressant Remeron, whose known side effects include suicide. SSRI’s, of which Remeron is an example, cause suicidal thinking in people who are not depressed.

The psychiatrist David Healy was the first to emphasize this point. In 2000, after he began this research, he was offered a job at the University of Toronto. In a very unusual move, the job offer was rescinded. Apparently psychiatry professors at the University of Toronto realized that Healy’s research made the psychiatric drug industry look bad.

I don’t think it’s wrong to sell drugs that improve this or that condition (e.g., depression), even if the improvement is slight. I do think it’s wrong to make false claims to induce people to buy the drugs. In the case of depression, the false claim is that depression is due to a “chemical imbalance.” No chemical difference has ever been shown between people who later become depressed and people who don’t later become depressed. This claim, repeated endlessly, makes it harder to do research into what causes depression. If you figured out what caused depression, you could treat it and prevent it much better. This false claim does enormous damage. It delays by many years discovery of effective treatment and prevention of depression, a disease from which hundreds of millions of people now suffer.

This happens in dozens of areas of medicine. Dermatologists say “ acne is caused by bacteria“. Most doctors appear to believe “ulcers are caused by bacteria”. Ear nose and throat surgeons claim that part of the immune system (the tonsils) causes illness. The “scale of the scandal” — medical school professors either (a) don’t understand causality or (b) deceive the rest of us — is great.

Bacteria are Neither Good nor Bad

Seth Roberts15 Comments

Health experts call bacteria “good” and “bad”. Bad bacteria make us sick. Good bacteria help us digest food, and a few other things. Let me propose another view. Any bacteria (i.e., bacterial species) will make us sick if it becomes too numerous — so all bacteria are “bad”. All bacteria protect us against other bacteria — so all bacteria are “good”. The terms “good” and “bad” are misleading. It is like saying a person is inherently rich or poor. Anyone, given a lot of money, becomes rich. Anyone whose money is taken away becomes poor. Low bacterial diversity or reduction of diversity makes it more likely that one bacterial species can overwhelm its competitors, producing sickness. When this happens, to say that the species (e.g., H. pylori) that became numerous “caused” the sickness (e.g., ulcers) is to seriously misunderstand what happened and how to prevent it from happening. We are taught that our immune system protects us from infection. We should be taught that bacterial diversity does the same thing.

The following story, from a reader of this blog, suggested these ideas:

My wife had a lot of problems, visceral fat that wouldn’t go away being one of the most obvious symptoms. Every time I convinced her to try a ketogenic (= very low carb) diet, she would get sick. I went to NYC to see Paul Jaminet speak. He suggested that she likely had some type of gut infection or dysbiosis. Not a bad theory, as she’d undergone prophylactic antibiotic treatment to clear up an H. pylori infection. (Yes, I know, but at the time it seemed like the thing to do.)

She started putting on weight after that, which is typical.

Finally she gave VLC [very low carb] one last try. She wound up getting inflamed lymph nodes in her thighs. Our doctor was wondering if she might have bovine tuberculosis or the bubonic plague, either of which would explain her symptoms. (The nodes were inflamed, black-and-blue, and sensitive. This is a typical symptom of bovine tuberculosis, and the disease spreads from the gut to the body through the bowel. As we consume raw milk, this wasn’t a crazy theory, but there have been no recorded outbreaks in Connecticut for years and years.) All the tests he did for an infection came back negative, but her symptoms clearly suggested she had one.

Finally she went to see a new OB-GYN. His nurse/dietician reaffirmed everything I’d been telling her, and she finally decided to go fully ketogenic. Once again, she got sick, but this time she decided to tough it out. Sure enough, after many weeks she started feeling better, and more importantly, the weight started coming off, and the visceral fat started reducing.

She did a stool test, and (I haven’t seen the results yet) we were told that she had the obesigenic gut biota. So she started an intensive probiotic regimen. This helped her one negative from the ketogenic diet: constipation.

She’s thrilled with the progress she’s seeing, and her few lingering issues after going primal 2.5 years ago seem to be resolving. The constant yeast infections have abated, and she’s planning a new wardrobe, heaven help me.

There are several interesting things here: 1. A very-low-carb diet made her sick. 2. This happened after antibiotic treatment. 3. Tests for infection were negative. 4. If she waited long enough, the low-carb-induced illness abated. 5. Probiotics helped. 6. Fermented foods didn’t help. At the time of Paul Jaminet’s diagnosis, says the reader, they were already eating plenty of fermented food: “Sauerkraut, yogurt, home-made kefir, the whole drill. No effect.”

How can these observations be explained?

With some general ideas. Each bacterial species keeps similar species in check by competing for the same resources (food and location). No two species need exactly the same things but there is plenty of overlap. For example, Species 1 needs Resources A and B, Species 2 needs Resources A and C. They keep each other in check by reducing the supply of A. Suppose C = carbohydrate. By reducing C, a very-low-carb diet reduces the number of Species 2, making more A available. This allows Species 1 to greatly expand. Maybe this expansion kills off Species 2. Armed with vast amounts of A, Species 1 out-competes other competitors. Its numbers greatly increase, causing sickness.

The notion that some bacteria are good and others are bad is absurd because all are safe in small amounts and all will cause sickness in large amounts. If any one person was replicated in millions or billions of copies it would cause enormous damage, waste and disruption, no matter who it was. Suppose I was genetically replicated so that there were hundreds of millions of me. I only like a few singers, such as Michelle Shocked and Cat Power. There would be a huge undersupply of records by those singers and a huge oversupply of other music. The music industry would collapse. I am a certain size. There would be a huge shortage of clothes of my size and a huge oversupply of clothing of other sizes.

The bacterial ecosystem is not self-correcting. It is the opposite: disruptions tend to spread. Suppose you eat too little carbohydrate. This reduces Species 2 (which needs A and C = carbohydrate). This means there is more Resource A for Species 1 (which needs Resources A and B). Species 1 increases. By virtue of increased numbers, it pushes down its competitors for Resource B. These weakened competitors, which also need D, E, and F, begin to lose battles for those resources against other bacteria that need D, E, and F. They decline in number. No longer with substantial competition for what it needs (A and B), Species 1 multiplies unchecked and causes damage until A and B run out. (Which may be why the reader’s wife, after a long illness, got better.) Fever fights infection because bacteria that grow best at one temperature (normal body temperature) do less well against competitors at a higher temperature.

The tests for infection failed to come up positive because they looked for too few bacteria. According to this view, there are thousands of bacteria inside us that can run out of control. You can test for only a tiny fraction of them. Fermented foods failed to help because they did not provide enough diversity.

We have a huge preference for diversity in what we eat. We much prefer a meal with three foods than one food, for example. The usual view is that this preference evolved because we need many nutrients (e.g., many vitamins) to be healthy. Now I wonder. Maybe the protective effect of bacterial diversity was the main reason. If so, taking a multi-vitamin pill is not going do much good, which is what research suggests.

These ideas are obviously supported by evidence that fermented foods improve health and antibiotics harm health, which I’ve covered many times. They are also supported by two recent studies with a different emphasis. One of them found that teenagers who had more biodiversity near home had more bacterial diversity on their skin. (Maybe there are other important drivers of diversity besides fermented foods.) The other found that people with sinusitis had less bacterial diversity in their nose than people without sinusitis and that increasing diversity tended to prevent sinusitis. Someday the 2005 Nobel Prize for “showing” that ulcers are “caused” by H. pylori will seem as medieval as the 1949 Nobel Prize for prefrontal lobotomies.

The practical consequences of this view include: 1. Antibiotics should be a very last resort. When given, they should be followed by treatments that restore bacterial diversity. The reader’s story suggests restoration of diversity may not be easy. Plainly diversity should be tracked after antibiotics. 2. Epidemiological studies should not just ask how did the germs spread? They should also ask why were they allowed to do harm? Why didn’t natural defenses – the immune system and other bacteria – suppress them to harmless levels? To the epidemiological neglect of immune function we can add neglect of this line of defense. 3. There should be convenient ways to measure one’s bacterial diversity so each of us can learn where we are and what makes it go up and down. 4. Researchers should study what makes bacterial diversity go up and down. Here is a recent study about this: old people living in an old-age home, who ate a restricted diet, had less bacterial diversity than people the same age who lived independently and ate more varied foods.. 5. Researchers should learn the correlates of high and low diversity. Take a group of people, measure their bacterial diversity, track their health for six months.

 

 

 

Quantified Self Utopia: What Would It Look Like?

Seth Roberts1 Comment

On the QS forums, Christian Kleineidam asked:

While doing Quantified Self public relations I lately meet the challenge of explaining how our lives are going to change if everything in QS goes the way we want. A lot of what I do in quantified self is about boring details. . . . Let’s imagine a day 20 years in the future and QS is successful. How will that day be different than [now]?

Self-measurement has helped me two ways. One is simple and clear. It has helped me be healthy. Via QS, I have found new ways to sleep better, lose weight, be in a better mood, have fewer colds (due to better immune function), reduce inflammation in my body, have better balance, have a better-functioning brain, have better blood sugar, and so on. I am not an expert in any of these areas — I am not a professional sleep researcher, for example. I believe that this will be a large part of the long-term importance of QS: it will help non-experts make useful discoveries about health and it will help spread those discoveries. Non-experts have important advantages over professional researchers. The non-experts (the personal scientists) are only concerned with helping themselves, not with pleasing their colleagues or winning grants, promotions, or prizes; they can take as long as necessary; and they can test “crazy” ideas. In a QS-successful world, many non-experts would make such discoveries and what they learned would reach a wide audience. Lots of people would know about them and take them seriously. As a result, people would be a lot healthier.

Self-measurement has also helped me in a more subtle way. It made me believe I have more power over my health than I thought. This change began when I studied my acne. I did not begin with any agenda, any point I wanted to make, I just wanted to practice experimentation. I counted my pimples (the QS part) and did little experiments. My results showed that one of the drugs my dermatologist had prescribed (tetracycline, an antibiotic) didn’t work. My dermatologist hadn’t said this was possible. Either he had done nothing to learn if worked or he had reached the wrong answer. What stunned me was how easy it had been to find out something important a well-trained experienced expert didn’t know. My dermatologist was not an original thinker. He did what he was told to do by med school professors (antibiotics are a very common treatment for acne). It was the fact that I could improve on their advice that stunned me. I didn’t have a lab. I didn’t have a million-dollar grant. Yet I had learned something important about acne that dermatology professors with labs and grants had failed to learn (antibiotics may not work, be sure to check).

Skepticism about mainstream medicine is helpful, yes, but only a little bit. More useful is finding a better way. For example, it’s useful to point out that antidepressants don’t work well. It’s more useful to find new ways to combat depression. Two years ago, the psychiatrist Daniel Carlat came out with a book called Unhinged that criticized modern psychiatry: too much reliance on pills. No kidding. Carlat recommended more talk therapy, as if that worked so well. As far as I could tell, Carlat had no idea that you need better research to find better solutions and had no idea what better research might be. This is where QS comes in. By encouraging people to study themselves, it encourages study of a vast number of possible depression treatments that will never (or not any time soon) be studied by mainstream researchers. By providing a way to publicize what people learn by doing this, it helps spread encouraging results. In the case of depression, I found that seeing faces in the morning produced an oscillation in my mood (high during the day, low at night). This has obvious consequences for treating depression. This sort of thing will not be studied by mainstream researchers any time soon but it can easily be studied by someone tracking their mood.

In a QS-successful world, many people would have grasped the power that they have to improve their own health. (You can’t just measure yourself, you have to do experiments and choose your treatments wisely, but measuring yourself is a good start.) They would have also grasped the power they have to improve other people’s health because (a) they can test “crazy” solutions mainstream researchers will never test, (b) they can run more realistic tests than mainstream researchers, (c) they can run longer tests than mainstream researchers, and (d) no matter what the results, they can publicize them. In a QS-successful world, there will be a whole ecosystem that supports that sort of thing. Such an ecosystem is beginning to grow, no doubt about it.

The Dark Side of Open Source

Seth Roberts15 Comments

A friend writes:

David [her boyfriend, not his name] learned some of the new languages (Android being one ). He says that any programming involving Open Source software requires wading through undocumented code, sloppily written by guys who de facto require one to email them, asking for technical support.

And without the cooperation of these people, one has no chance in hell of figuring out what the next command syntax should be. And a lot of the guys who wrote the code are reluctant to cooperate, because their knowledge of how their own code is supposed to be written and how to run it is their only job security.

Coding for very simple operations, such as connecting an external camera to an Android cell phone, has been proving impossible. He’s been working on it for 10 days now.

David has tried several flavors of Linux kernels and also several brands of smartphone drivers. But it always comes to the same thing. The software won’t run, and there are maybe one or two wrong characters in 20,000 lines of code that made it break, and you don’t know where to start looking. Because the error message doesn’t tell you anything other than it won’t run.

To be fair, I use R (which is open source) many times every day. It has far fewer bugs than the S-plus software it replaced. That it’s free is a huge plus.