Thanks to Peter Spero and Alex Chernavsky.
In this post, Alexandra Carmichael describes how she recently figured out what caused most of her headaches. She had suffered from frequent headaches for twenty years. One source was dairy. She confirmed this source when eating 1/4 stick of butter gave her a splitting headache. Another source was gluten. She got the idea that gluten might matter from the CureTogether list of migraine treatments. A final source turned out to be Febreze, as I mentioned in an earlier post.
You might marvel that conventional healthcare (e.g., doctors, the Mayo Clinic website, and so on) was no help. Or you might not. In the case of the woman I wrote about for Boing Boing, her conventional doctors actively got in the way of helping her find the source of her migraines. Alexandra takes ibuprofen for her headaches. So conventional healthcare (in this case, the makers of ibuprofen) has managed to profit from every one of her headaches but hasn’t done one useful thing to prevent them. A nasty state of affairs (provide expensive relief of symptoms, ignore prevention and underlying causes, thus ensuring that people continue to get sick and need relief) that is repeated a thousand places in our healthcare system (e.g., in depression, cancer, etc.).
At the First QS Conference, I gave a talk that included the following equation:
progress = resources*knowledge*time*freedom*motivation
I used this equation to explain why mainstream medicine was stagnating, but personal science was not. Personal scientists (individuals trying to improve their own health) seem tiny and insignificant compared to medical school professors with million-dollar grants and large labs. But the visible superiority of medical school professors — they have far more resources and knowledge than personal scientists, not to mention more prestige — masks an enormous hidden inferiority: Personal scientists have far more time, freedom, and motivation than medical school professors. And personal scientists are rapidly gaining more resources and knowledge. This is why, in terms of progress, they are catching up to and surpassing mainstream healthcare.
Alexandra’s story illustrates the pattern. In this case, personal science made progress (it eliminated most of her headaches), mainstream healthcare did not (it eliminated none of them). And the success of personal science depended on increases in resources and increases in knowledge. A new resource that helped Alexandra was a DailyBurn iPhone app that helped her track what she ate. From those records she noticed a curious pattern: that changes in how much dairy she ate caused trouble. Two new sources of knowledge also helped her. The accumulation of knowledge at CureTogether led to her to suspect gluten was one of her triggers. And my story in Boing Boing led to her to suspect that Febreze and other cleaning products were triggers.
I recently heard Tucker Max speak about writing books. He said he had succeeded because he told the truth about himself — including the unpleasant stuff. Most people don’t. That, plus an ability to make it entertaining, was what he could do that other people couldn’t. He was saying that “being yourself” — more precisely, building on how you are different — was the only good place to start. Imitating other people is not a good place to start. Jane Jacobs said the same thing about how cities should develop. She said it was pointless to try to imitate other cities — to imitate them by building a stadium or convention center, for example. Each city should figure out what its unique strengths are — what makes Springfield Springfield — and build on them. Amplify them.
I was pleased to hear Tucker’s remarks because I never hear such stuff said publicly (or privately), except from Jane Jacobs. When I was at Berkeley, now and then I’d tell other professors: It’s a mistake to treat all students in a class the same (by giving them the same assignments, the same tests, etc.). They’re not all the same. They differ greatly. A lot is lost by treating them all alike — a lot of self-esteem, for instance. My colleagues didn’t like hearing this. It was convenient to treat all students the same. And it was status-boosting. My fellow professors worked in a system where the dimension used to gauge success was something they were good at. The notion that there were many other useful ways to excel was undermining. If there is only one measure of success and I am #1 on that measure, I am #1 period. If there are thirty measures of success, all equally valid, and I am #1 on only one of them, my superiority is less clear.
Tucker’s presence at the Ancestral Health Symposium was criticized. Here is an email that the organizers (who include me) received:
One thing neither I nor my attendee friends can explain: Tucker Max as a speaker? Really? His claim to fame is having rough sex with drunk girls and then writing about it. I’m pretty sure the majority of his speaking gigs take place at bars and frat houses. From his own website:
“I get excessively drunk at inappropriate times, disregard social norms, indulge every whim, ignore the consequences of my actions, mock idiots and posers, sleep with more women than is safe or reasonable, and just generally act like a raging dickhead.”
If you have a chance, could someone please explain this choice of speaker? I’d love to support this conference in the future, and I’m all for challenging social norms, but not those that have to do with basic respect for other people.
I replied:
I wanted Tucker Max to come and went so far as to give up half my presentation time to allow him to speak.
Why did I want him to speak? Because he is a big supporter of paleo, because he had something fresh to say, because he would say it well (and he did), and because he is deeply respected by an audience it is crucial to reach — college students. Sure, some things he writes offend some people. I don’t think that means he doesn’t have something helpful to say.
I don’t think college students respect him so much because he writes about getting raging drunk, etc. I think they respect him because he speaks the truth about subjects where most people don’t speak the truth.
The connection between “being yourself” and speaking the truth about difficult subjects is simple: Being yourself inevitably involves being different and being different inevitably involves some people scorning you. As Tucker said things that caused people to scorn him. As some people scorn my self-experimentation. In a society where being yourself isn’t valued enough, the fear of scorn wins, people self-censor, and, as in the above email, they censor others. Everyone’s loss.
The effect of an educational lifetime of being treated the same — from kindergarten thru college — is that the notion that you are different and have something unique to add becomes less and less plausible to you. Because it becomes implausible, that possibility doesn’t enter into your calculations about what to do with your life — in particular, what job to choose. You begin to think that success = imitation of successful people, when that is misleading. Imitate successful people like you, yes, but most people aren’t like you. I chatted with Tucker after his talk. He said it isn’t enough to be different, you have to act on it, become better and better at exercising your unique talent. I agree. In a better world, you would do this starting young, like 10, and slowly become better so that by the time you needed to make a living you would have substantial skill. But our educational system, by treating everyone the same, or nearly the same, discourages this.
A few days ago, Dominic Andriacchi, a 25-year-old law student living near Detroit, told me that he mentioned some of my self-experimentation (my discovery that postponing breakfast reduced insomnia) in an Amazon ebook (Law School Livin’) he’d just published. He added that something he read in this blog really helped him:
Thank you for introducing me to flaxseed oil. Recently, I re-injured my back (a injury that occurred during college football). While I’ve never seen a doctor for the injury, I did a little internet searching and figured that I had herniated a disk in my lower back. I also had pain in my leg due to, I presume, pressure on the sciatic nerve from the herniated disk.
He re-injured his back pulling a small tree uphill.
Usually, it takes at least a week for the pain to go away. I have trouble sitting, walking, and so forth. That day, because I [had] read the post of Tucker Max’s ankle injury and flaxseed oil, I immediately upped my flaxseed oil to a total of 15 1000mg capsules. The next day, there was nearly no pain at all. I could bend over and touch my toes with only the slightest pain. The day after that, I was back to normal.
Later he added some details:
I took 15 capsules of flaxseed oil [the day of the injury] to see what would happen. There was no immediate benefit that I felt that day, but the next day it was great. Even sitting or the slightest bending can cause a lot of pain, but I was able to bend over and nearly touch my toes. I took another 10 capsules that day as well. The day after that, I was completely pain free. I took more flaxseed oil capsules even though I was experiencing no pain at all. I expected the pain to come back, but it didn’t. From then on, I would just take my normal two flaxseed oil capsules [per day]. I was spacing them out, 5 at a time in between meals.
Right now I am tracking 6 things:
I keep crude measures of my workouts (on scraps of paper). Two more things I want to track:
At the recent Quantified Self Meetup in Mountain View, Fenn Lipkowitz told me that he had started taking a long list of supplements and now felt much better. At last week’s QS Silicon Valley Meetup, he gave a talk about it. The graph above shows “wellness” ratings before and after the change. Here’s what the scale numbers mean:
3 = “i’m hurting, i just want to crawl under my blanket and suffer for a few hours.”
4 = “today sucks, i think i’ll hide and eat some chocolate and read manga.”
5 = “well, i’m here and dont have any excuses, so i guess i’ll go do something.”
6 = “bright eyed and bushy tailed, ready to go do some work”
7 = “why am i writing in my log, i should be out dancing!”
8 = “holy shit, tearing it up, backflipping over ninjas and juggling fire”
He describes the improvement like this:
Things seem really easy now that were serious barriers before. I now sleep 4-6 hours a night instead of 12, and bounce out of bed. I no longer have high dance inertia, I can just start dancing on demand. I can type 143 works per minute vs my maximum of 92 wpm a month ago.
Every morning he takes:
- vinpocetine 10mg
- vitamin-d 125ug
- fish-oil 1g
- piracetam 1600mg
- alpha-gpc 300mg
- choline-bitartrate 500mg
- dmae 260mg
- boswellia 300mg
- curcumin 300mg
- cordyceps-extract 1.2g
- aloha-cordyceps 525mg
- coq10 30mg
- ginkgo-extract 60mg
- tryptophan 500mg
- Flintstones multivitamin B-complex
Here are his explanations for some of these:
vinpocetine – vasodilator derived from periwinkle plant. enhances focus, seems to improve long range vision, seems to cause your eyes to fixate more steadily on what you’re looking at, less saccades.
piracetam – increases communication between two halves of brain; the effects of this vary by person depending on which half of their brain is in control. for me it makes interpersonal relations become more clear, easier to cooperate and understand the motivations and intentions of others. also uses up choline at a faster rate, which is why i also take
alpha-gpc – a high bioavailability form of choline precursor, which is in the form that cells usually generate when they’re self-scavenging in choline-depletion state. it doesn’t go into rebuilding the cell walls, but is used for synthesis of acetylcholine, a neurotransmitter involved in memory and muscle control.
choline-bitartrate – choline is transformed into phosphatidyl choline in order to (re)build cell membranes. this is low oral availability (doesn’t cross blood/brain barrier easily?) but super cheap and tastes good. i have a theory that alzheimers is caused mostly by long-term choline deficiency.
dmae – another choline precursor? aka “deanol” and has been shown to increase the life-span of mice by 50%, possibly through the mechanism of clearing out lipofuscin deposits. cheap, tastes good.
boswellia – no idea, it’s in the cucurmin pills; somewhat aromatic and pungent, like tea tree oil or piperazine.
curcumin – this is straight up turmeric extract. antioxidant and various other bodily health effects.
cordyceps extract – zombie ant brain fungus. look up images of it online, it’s sick. it makes you want to climb up to the top leaf in a tree, clamp your mandibles, and explode spores everywhere. well, not really. but it improves oxygenation, energy, and will kill a viral infection in one day. the extract is prepared by rapidly growing a lot of cordyceps mycelia in a warm fermenter and spray drying the liquid that comes off. this is highly unnatural environment
aloha cordyceps – aloha pharmaceuticals saw the explosion in “farmed” cordyceps and decided it wasn’t natural enough or something, so they recreated the mushroom’s natural environment of tibetan steppes. they grow it up fast and then let it sit for months in the dark in refrigerators with low oxygen. they claim that their process increases the number of good chemicals (cordycepin, uracil, based on HPLC analysis) and reduces the gross things. i can confirm it tastes/smells much better than swanson brand cordyceps extract. i started taking regular cordyceps extract first and can confirm it works as advertised, but maybe aloha is better, so i take that too. i have a friend taking only aloha cordyceps so we’ll see what happens.
At Thursday’s Quantified Self Silicon Valley Meetup (where I gave a talk called QS + Paleo = ?), Alexandra Carmichael introduced herself with the three words “no”, “headache”, and “today”. About five days earlier, she had started having migraine headaches every day. Before that, she hadn’t had a migraine headache in a year. After the headaches began, her husband, having read my Boing Boing story (about a woman whose migraines were mostly from cleaning products), suggested that her headaches might be caused by the Febreze they had just started using. They stopped using it. Because it can linger in carpets, etc., they cleaned their whole apartment with vinegar and baking soda, to get rid of all traces. That’s when Alexandra’s headaches stopped. When they started using Febreze, one of their daughters became very cranky. After they stopped using it and cleaned their apartment, she returned to her usual self.
Other people have found that Febreze gives them migraines. For example, R. Haeckler:
[Febreze] gives me terrible migraines. . . . Whenever I go to someone’s house who uses it I get a headache almost immediately that lasts the rest of the night.
And this woman (“No Febreze EVER. Gives me a headache and makes me dizzy”).
This is a good example of why n=1 experimentation is so important. The woman I wrote about for Boing Boing (Sarah) figured out, beyond any doubt, that certain cleaning products caused migraines. Yes, Sarah’s results were unusual. They “don’t generalize” to most people in the sense that most people don’t get migraines from cleaning products. But, as Alexandra’s story shows, they were still helpful — they helped Alexandra avoid migraines.
My writing about n=1 experimentation has emphasized learning widely-applicable truths — how to lose weight, sleep better, and so on. But this other use — learn stuff that is true only for you and perhaps a small subset of people (1%?) — is also important. Sarah’s n=1 experimentation doesn’t fit in the standard healthcare system. It was not suggested or encouraged by her doctors. No professor or researcher could write a paper about it — it’s too small. But it made a difference — first, to herself, now, to Alexandra. The results of n=1 experiments can be spread, however, in the new patient communities, such as the ones at PatientsLikeMe, MedHelp, and CureTogether (started by Alexandra and her husband).
When I submitted for publication my long self-experimentation paper, one of the referees decided he would find out if fructose water would help him lose weight (one of my examples). He discovered that fructose water made his fingers ache — he had a sensitivity to fructose he hadn’t known about. In his review, he said that these sorts of individual differences were not an argument against my method but actually favored it: We need n=1 experiments to fully understand human variation in health.
My explanation of the Ten Commandments is that someone at the top (Moses) was trying to convince people at the bottom to join him. People at the bottom were being preyed upon. “Thou shalt not steal” meant, to Moses’s audience, “no one will steal from you — or at least we, your leaders, will discourage it.” At the very beginning of the Code of Hammarabi, another ancient set of rules, it says one purpose of the rules is “so that the strong will not harm the weak”.
I keep seeing this pattern — people at or near the top of the hierarchy making common cause with people on the bottom against people in the middle. I was reminded of it by this story:
One anecdote described a Hu Yaobang [top Chinese leader] visit that Mr. Wen arranged with Guizhou Province villagers — secretly, he wrote, because Hu Yaobang did not trust local leaders to let them speak freely.
In the 1960s, the U.S. civil rights movement gained considerable force and accomplishment when the very top of the government (first, President Kennedy and Attorney General Robert Kennedy, later President Johnson) weighed in on the side of the protesters (bottom) against the various state governments (middle).
The practical value of this alignment of forces is illustrated by How to Walk to School, a book about school reform (which I reviewed here). Two mothers of young children, Jacqueline Edelberg and another woman, wanted to improve their neighborhood schools before it was too late for their own children to benefit. On the face of it, this was impossible. But they found common cause with the principal of a local school (Susan Kurland). It goes unmentioned in the book but my impression, reading between the lines, is that the main thing that happened is that the worst teachers were shamed into leaving, above all by parents sitting in their classrooms. The principal alone could do nothing about terrible teachers; the parents alone could do nothing; together they did a lot. I spoke to Edelberg about this and she agreed with me.
I point out this pattern because it works. Judaism (Moses) still exists; people still read the Old Testament. Even more powerfully, all governments have lists of laws (Hammurabi). Jacqueline Edelberg’s neighborhood school is much better. The next big revolution in human affairs, I believe, will be health care. The current system, in which people pay vast amounts for drugs that barely work, have awful side effects, and leave intact the root cause (e.g., too little dietary omega-3), will be replaced by a much better system. The much better system will be some version of paleo. As Woody Allen predicted, people will come to believe that butter is health food.
How will it happen? I suspect this pattern will be the driving force. People at the top and people at the bottom will put pressure on people in the middle. Self-experimentation, self-quantification, and personal science (which overlap greatly) are tools of people at the bottom. They cost nothing, they are available to all. When you track (quantify and record) your health problem, and show your doctor, via numbers and graphs, that the drug he prescribed didn’t work, that puts pressure on him. When you bring your doctor numbers and graphs that show a paleo solution did work, that puts even more pressure on him. The point, if it isn’t obvious, is that numbers and graphs, based on carefully collected day-after-day data, amplify what one person can do. Not just what they can learn, not just how healthy they can be, but how much they can influence others. And this amplification of influence, which I never discuss, may ultimately be the most important.
Nowadays, far more than ever before, people can do useful science (collect data, draw conclusions) about their own health. This personal science can produce much better results than expert advice. For example, I found ways to sleep better and raise my mood superior to what sleep and mood experts know. I wonder how others are using this new power. This is why I wrote a story for Boing Boing about a woman (Sarah) who figured out what caused her migraines after conventional doctors failed to help her. She was eventually helped by an expert (a naturopath) but most of the improvement came from self-experimentation showing that cleaning and skin care products caused migraines.
The story got many comments. A surprising number were eerily dismissive. You might think it was a good thing that Sarah got rid of frequent crippling migraines after doctors failed to. Nope: “Anecdotes are not data” (56 likes). The same person also said “data is data”. Both are examples of preventive stupidity. “Big Brother loves you,” replied Mark Frauenfelder, and I agree. Another surprising comment was “Don’t encourage these people” (= people like Sarah). One of the dismissista s came to his senses. “I’d simply like to close with an apology, as on reflection little I’ve posted here has been useful or expansive,” he wrote.
Some comments nicely summed up the main points of the story. “When all you have is a hammer, everything looks like a nail” was a good description of Sarah’s conventional doctors. They acted as if their only tool was the ability to write prescriptions — so every problem called for a prescription. When the first 10 drugs didn’t work, they tried more drugs. When the first 30 drugs didn’t work, they tried more drugs. Surely this is bad medicine, yet, as far as I can tell, that’s what they learn to do.
Some comments asked questions it would have helped if I had anticipated. How could Sarah have tried 50 different migraine drugs and 13 different birth control pills in one year? I wasn’t puzzled by this but details would have clarified things.
Above all, the comments supported my belief that Sarah’s problem was common. Many commenters said they had migraines caused by environmental triggers. Only one said his migraines turned out to be caused by a tumor. In spite of this pattern of causality, the comments also suggested that conventional doctors generally prescribe drugs for migraines. (“They had the prescription typed into the system before I was even finished telling them what was going on.”) It’s like trying to enter a room by breaking through a wall (prescribing a drug) instead of using the door (finding the triggers). It’s as if all they have is a sledgehammer.
Last night I slept unusually well, waking up more rested and with more energy than usual. I slept longer than usual: 7.0 hours versus my usual 5.1 hours (median of the previous 20 days). My rating of how rested I felt was 99.2% (that is, 99.2% of fully rested); the median of the previous 20 days is 98.8%. Because the maximum is 100%, this is really a comparison of 0.8% (this morning) with 1.2% (previous mornings); and the comparison is not adjusted for the number of times I stood on one leg to exhaustion, which improves this rating. During the previous 20 days I often stood on one leg to exhaustion six times; yesterday I only did it four times. Above all, I felt more energy in the morning. This was obvious. I have just started to measure this. At 8 am and 9 am, I rate my energy on a 0-100 scale where 50 = neither sluggish nor energetic/energized, 60 = slightly energetic/energized, 70 = somewhat energetic/energized, and 75 = energetic/energized. My ratings this morning were 73 (8 am) and 74 (9 am). The median of my 9 previous ratings is 62. The energy improvement (73/74 vs 62) is why I am curious. I would like to feel this way every morning.
What caused it? I had not exercised the previous day. My room was no darker than usual. My flaxseed oil intake was no different than usual. I had not eaten more pork fat than usual. However, four things had been different than usual:
1. 2 tablespoons of butter at lunch. In addition to my usual 4 tablespoons per day.
2. 0.5-1 tablespoons of butter at bedtime. Again, in addition the usual 4.
3. 1 tablespoon (15 g) coconut butter at bedtime. Part of a longer study of the effect of coconut butter. Gary Taubes suggested this. I had eaten 1 T coconut butter at bedtime 13 previous days. On the first of those 13 days, I had felt a lot more energetic than usual in the morning. On the remaining days, however, the improvement was less clear. I started measuring how energetic I felt in the morning to study this further. Last night was Friday night. On the previous two nights (Wednesday and Thursday) I had not eaten the coconut butter. Maybe absence of coconut butter followed by resumption of coconut butter is the cause.
4. Fresh air and ambient noise. Following a friend’s suggestion, I opened one of my bedroom windows.
My first question is whether the improvement is repeatable. If so, I will start to vary these four factors.