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Everything posted by Michael569
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Ok i think it's time for a forum break once again 😅
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Alright, well i appreciate the tag.. it was good to refresh a few things in endocrinology i forgot about so i appreciate that 🤜🏻🤛🏻 You can do that more often 😉 I'll leave it here, need to wash that french baguette with some British lard cream
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fair point, words for words. Point stands. Why is temporary inhibition of 5AR (although I think its more like temporary reduction, inhibition indicates 100% loss of function) bad? You tagged me i this for a reason , right? even tho you knew I'd come after you with the hammer beating you for all your mechanistic speculative arguments Yes I agree, excessive soy (such as 1.2 litres of highly concentrated stuff) is a problem. Granted ! Soy in moderation is not a problem - can I get a concession on that? Eating a bunch of soy is NOT the same as being full of oestrogen, my god! Phytoestrogens aren't the same thing as biological oestrogens. That's an alpha and omega difference. Read into it. You're a scientist, you enjoy this shit so read a few clinical overviews of the phytoestrogen evidence. Let the research tell you the story rather than plugging up gaps in your knowledge with pseudoscience. Take it seriously and you'll see that all roads point the same direction. Being full of oestrogen which, I presume, means, your body is producing very high amounts, would either be some kind of genetic disease or a pituitary tumour or maybe even some sort of ovarian dysfunction or testicular tumour. The body doesn't just start pumping out hormones because you ate a tofu. Oh I am sure he has, that and PUFA has to be his favourite topics, that's where they can get lost in the pseudoscientific jungle. well, at least you're not a carnivore so that's good
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delete? Soy doesn't delete anything. You can't just "delete" an enzyme that's coded by your DNA. If what you mean is temporarily reduce function of 5-Alpha Reductase then that's probably a good thing isn't it? But I don't care about mechanisms. Show me the outcome data. Show me the evidence (in humans) that soy products in moderation cause any endocrine problems? For each of those I have a study with 1000s of people showing protective effects. Ray Pete thinking all over again
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All individual case studies , children who were probably fed too much soy by parents. That's obviously a bad idea. I'm more interested in protective effects of soy against chronic disease, some of those meta analyses I listed had over 5,000 - 10,000 participants. No to mention case studies are at the bottom of hierarchy of evidence for a reason. Still....very interesting to see that effect on kids in excess. Good learning lesson for sure dude hypogonadism is a medical diagnosis usually resulting from testicular trauma, testicular cancer or undescended testicles in boys. I think we are throwing around the terms a bit too freely. If what you mean is lower levels of testosterone then I'd want to see that in long term adult studies. good to know! Lots of men do have gnaecomastia who don't eat soy. I mean you see guys with manboobs all the time so clearly there is more going on. Simply being obese is likely a risk factor for it. ok so if that was the case, what would that mean? People who consume soy products become ...what? Look I know you have a great interest in endocrinology and I appreciate you have a good knowledge on it. I would even encourage you to go study something related to it. It is a fascinating subject and it was one of my favourite when I studies as well. But I think that's also become a bit of a barrier because you tend to be overly reductionstic seeing everything through the same lense. Endocrinology is tempting to use as an argument because it involves a lot of terms people don't understand that you can just throw around. But that won't fly here. If you are discussing the science you need to follow the hierarchy of evidence not randomly throw around endocrinology terms and pathways. You have to ask yourself - "if A causes B" then clearly most people who consume A regularly do get B? Do they? What's the evidence? Where is it? If I say a pathways XZY does this and then you say no, there is also pathway ABC that does the opposite. Who is right? How can we tell? That's why you have human outcome data.
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Welcome back! Good to see you around again 👋🏻
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somewhere out there I have some income from it but like yourself, not enough to sustain me. I'm rebranding my entire business now, so I've put a lot of things on hold, but it's almost ready to be published again. @Sandhu cheers!
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This is an interesting case study, haven't seen that one before. I mean the thing that immediately jumps up is "why would someone drink 1.2L of soy milk", right? . But it seems people do so let's play along. The study vs soy isoflavones in soy milk on average In the case study on NCBI they say: The patient had been consuming approximately 1.2 L of soy milk per day for around 3 years until he had stopped June. The estimated isoflavone content of this amount of soy milk was 310 mg/day, according to the nutrition facts label. This is an interesting finding. According to USDA ARS - database source (I'd consider that a reliable source), you have about 7.85mg of soy isoflavones per 100ml of "soy drink" (page 24, line item, 99043). If you multiply this by 12, you will get about 94.2mg of soy isoflavones per 1.2l of soymilk. The study says 310mg in about 1.2L , which works to be about 26 mg of isoflavones per 100 ml. This is about 3 times the amount of isoflavone as a common soy milk (soy drink, item 99043). Immediately, this tells me that what he drank was some sort of concentrated formula like a fortified soy drink or a soy protein or something with added isoflavones. Maybe it was recommended to him for prostate cancer risk...who knows? We don't care. The conclusion is - what this guy was drinking was NOT a soy milk. An whatever it is, it was not supposed to be drank at those volumes. It was stupid and he paid the price. Its like giving your baby 3 times the recommended baby formula every day. Its gonna lead to some weird stuff. So yes, I agree with your conclusion @Schizophonia that at such humongous amounts, soy isoflavones can be some nasty effects on your endocrine system. Too much of a good thing. How much soy isoflavones do you get from diet? Going back to the USDA database, let's say an average soy consumer would eat 200g of tofu per day, 1 teaspoon of miso with soup and 250ml of soy milk with coffee (I'm making these numbers up) 250mg tofu - the values seem to differ but I've picked line item 99529 with 22.05mg per 100g portion. - total (2.5*22) = 55 mg miso - 1 teaspoon - line item 16112, 89mg / 100 mg so say a teaspoon is about 4 grams so you get basically less than 1mg of isoflavones and then soy milk we already talked about 7.85mg * 2 = about 16mg total daily soy intake - 55 + 1 + 16 = 72mg I am also assuming that this person goes up and down right? They don't drink the same thing. Sometimes they drink oat milk. Sometimes they eat tempeh instead of tofu or maybe even chicken or pork if they're not vegan. So let's say they average out at 65mg of isoflavones per day? That means it would take this person between 4-5 days to achieve the same volume of isoflavone as the guy in the study. So I would say that in normal amounts, you're unlikely to see soy having effects on testosterone. But in excess for a long time, such as what this guy did, it may be too aggressive, and your testo might start going down indeed. But it seems to go away once the food is discontinued. It was interesting to see him developing gynaecomastia tho, I wonder if this was from the soy drink or not. I'd like to see more on this. (for anyone who is confused about this) Soy isoflavones, phytoestrogens, oestrogens and hormones - what's the difference Soy contains molecules called phytoestrogens. Phyto - meaning plant and oestrogen being the main mammalian sex hormone in women (and to some degree in men) responsible for sexual maturation, puberty, menstrual cycle, development of secondary sexual characteristics, etc. In men oestrogens play a role in sperm production for example. When looked at under an electron microscope, the molecule of phytoestrogen looks almost exactly like the oestrogen that the human body produces. Phytoestrogens are divided into a few classes such as isoflavones, stilbenes, coumestans etc. For this example we only need to talk about soy isoflavones as those are found in soy. Why is it said that soy is bad and causes cancer? We know from the evidence that certain cancers like breast cancer and ovarian cancer in women are strongly driven by excessive oestrogen in circulation. This is because these tissues have a high concentration of Oestrogen Receptors Alpha, and most biological oestrogens dock into these receptors. In a growing woman, this is desirable. The expression of Oestrogen Receptor Alpha (meaning when oestrogen docks into it) helps cells divide, increases tissue growth, and increases the speed of sexual maturation. It helps a young woman hit puberty, grow breast tissue, trigger the menstrual cycle and prepare for future pregnancy. Where oestrogen starts becoming problematic is when it is very high later on in life such as during 30s 40s and 50s. Because excessive stimulation of Oestrogen Receptors Alpha can stimulate growth of tissue and whenever that happens, the risk of cancer goes up. And because soy isoflavones look like oestrogens, it was thought that if we have more of them in the body, it will be the same as having more biological oestrogen. Which is not true because of ....Oestrogen Receptor Beta It was found that although soy isoflavones look like oestrogens, they primarily dock to Oestrogen Receptor Beta. Different from Alpha. A docking to this receptor is associated with reduced growth of tumours, reduced inflammation and generally protective effects against cancers. This is also how Tamoxifen, a common medication for Breast Cancer patients, works as well and it is why it is so incredibly effective. Soy isoflavones from tofu, tempeh, soy and miso do exactly the same and this is why they are considered protective. It is why: isoflavones reduce risk of breast cancer isoflavones reduce risk prostate cancer - because soy reduces DHT levels in men and also because of beta receptor stimulation isoflavones reduce risk of lung cancer because Beta receptors are also found in lungs isoflavones reduce risk of gastrointestinal cancers and colorectal cancers Consider that many of these studies are done in Asian populations where soy has been consumed for centuries and cancer development has only increased after introduction of western food Soy and Testosterone This one is a bit more tricky and I need to dance carefully around this topic because there is very little research. Most research on soy is done on women and older men because that's where those effects are very beneficial and where soy can help save lives. Judging from that study shared in this thread it would seem that extremely high amounts of soy isoflavones can start reducing levels of testosterone to critically low. I agree that this is probably happening. But what about in moderate amounts? This is one of the most popularly quoted study 28 Japanese volunteers were fed 60mg of soy isoflavones per day (this correlated with the average intake calculation I made early on for the average person who consumes some soy) Their Sex Hormone Binding Globulin (SHBG) increased Their dihydrotestosterone (DHT) decreased their free testosterone decreased What likely happened here is a cascade of processes. Because isoflavones increased SHBG, this led to reduction in Free Testosterone because SHBG is like a bus for sex hormones, it takes away sex hormones from circulation and stores them safely. This also probably caused reduction in DHT because the more free testosterone you have, the more of it might be converted to DHT. It would seem like a bad thing but consider that high levels of DHT are linked to male pattern baldness and prostate cancer. I would argue having less DHT is a good thing. You could say that although these men lost a little bit of their "peak masculinity" by losing some free testosterone, it was traded for reduced DHT which most sane men would probably want. Unfortunately we don't have any good long term research on regular amounts of soy and levels of testosterone so I'll continue to err on the side of caution but the bits we have seems to indicate protective effects but potentially detrimental in very very high quantities. Soy Sauce One caveat of all this is soy sauce which I don't consider to be a proper soy food. Soy sauce is heavily modified food stripped of the isoflavones with extreme sodium content. So this is one that should be consumed in very very small quantities. CONCLUSION TO THE FULL POST soy contains molecules called soy isoflavones which under microscope look like human oestrogens. It used to be thought that because of this, soy causes cancer because excessive amounts of oestrogen has been linked to breast cancer and other malignancies in women oestrogen is needed for sexual maturation and sexual development but having too much can be problem for women and men humans have two main oestrogen receptors alpha and beta alpha expression - stimulates cell growth, increases cancer risk beta expression - protects from cancer, reduces inflammation, halts cell growth Human oestrogens mainly dock to Oestrogen Receptor Alpha - can be harmful in excess Soy isoflavones mainly dock to Beta (the good ones) health effects of soy roducts consumption of soy linked to reduction of cancers (lung, colorectal, breast, prostate, ovarian) soy has also been linked to reduced risk of osteoporosis and cardiovascular disease soy is a great source of protein and calcium for people who don't eat animal produce potentially negative effects in very high quantities , such as in the study listed where a man drank 1.2 litre of soy concentrate, there is documented negative effect on testosterone and the entire sex hormone system (HPG - Axis). This effects improved once he discontinued effects on testosterone in men in very very high quantities, testosterone is reduced temporarily in normal quantities (ca. 60mg of isoflavones) DHT goes down - DHT is an agressive form of testosterone responsible for sexual development of boys into men. However in older men high DHT is linked to prosatte cancer and baldness. , in older men, high DHT is linked to prostate. So less DHT is a good thing. SHBG goes up. SHBG is a shuttle transporter for sex hormones. This is good because we don't want unbound testosterone circulating around. Very high amounts of free testosterone can lead to higher DHT (conversion from testo to DHT is also defined by genetics and many other things) free testosterone slightly reduced (this is mostly not an issue) no evidence on long term reduction of total testosterone levels soy does not turn men into fluffy soyboys who can't get erections. That's a bro science bs and at this point anybody claiming this is just trying to sell you something or is out of touch with the evidence. However men should not be consuming extreme amounts of soy like litres of milk per day or 5 blocks of tofu per day - too much of a good thing can become bad for you. Enjoy your tofu and your steak but don't be a zealot about one or the other. One additional thing I'd say is that there is a lot of testosterone optimisation content out there but anybody selling you testosterone-spiking lifestyle/product/diet should be able to answer the following questions: can you guarantee that my DHT won't be going up can you guarantee that my free testosterone won't be going up? can you guarantee that my risk of prostate cancer isnt going up can you show me the evidence that having more testosterone (above average) gives me some exceptional health benefits? Sorry for a long post but wanted to address this properly. Hope this will help someone.
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Thanks for sharing, i think there is a bit more nuance to this topic but it requires a longer response, i don't have time right now to review the evidence but I'll reply at some point this week.
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You could travel to Europe, for example Eastern Europe where the costs of such tests are probably 10 times cheaper than America. Asia would also be cheaper, maybe Turkey, Thailand, Vietnam. Maybe even northern Africa but I have no idea how it works in the region but certainly you could find clinics in Morocco, Egypt, maybe southern Spain, Gibraltar.
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First of all, congrats on your choice to pursue dietetics degree. It can be an incredibly rewarding career although as you said, there is considerable expense, effort and time it takes to obtain it, not to mention the hospital & clinical experience needed - but when it works, it is beautiful and incredibly satisfying. What you will be up against is basically couple more years of what you're already doing - keep your freelance job to pay bills, food etc and to also fund your career transition. I've gone through a very similar journey to yours, instead my includes a corporate 9-5 career that is funding my side hassle of Nutritional Therapy as well as all my bills, future, mortgage, family etc. . I also had to go to school for couple years to retrain and pay tons of money for education and certification and CPD. I don't think there is one book that can tell you how to life your live to maximise efficiency, there will always be something that feels neglected and its important you make peace with that. Do your best to continue what you do without burning yourself out. When you go overboard, you'll feel it pretty quickly. Whenever I continue burning the midnight oil and squeezing more time to work than I should, I usually end up with a flu or something like that. Immune system gets weakened by the stress. Its a body's way of telling you to slow down. You'll be fine-tuning the process for years, figuring out what works and what doesn't, I don't think any of us can tell you exactly what to do. Some advice I found useful that might help tho: understand where your money is going, analyse your top 40% expenses and identify opportunities for cost reductions where possible. I found that getting one of those online banks as a virtual wallet and then paying all my expenses with it, was a great way to track because they offer amazing expense tracking functionalities . For example if you notice yourself spending too much on restaurants and takeaways, then learning batch cooking will save you a lot of money and also teach you tons of recipes to share with your future patients / clients. Or if there are other major expenses like expensive entertainment subscriptions, video games etc that are not in support of your career transition, those will be worth reconsidering. saying that, you still want to have some fun and joy in life so don't turn into a monk who abandons all pleasures small increments of study time daily are more valuble than large chunks on weekends for example you are likely to advance more if you take 60 minutes a day to study compared to studying 8 hours every Saturday. The repetition of small chunks of information helps you retain that information exponentially. You'll actually progress faster splitting your day into time blocks and identifying slots where you could fit some business/study time. I'm still not great at this and it takes a lot of discipline that I haven't developed yet but whenever I do this, splitting my day into time blocks, I can always fit in some more business / study / research time. This is something I discovered very late, but using something like a paper less writing tablet, like Remarkable 2 can really help you advance your game. Not only can you use it to practice different pathways, remember stuff, draft notes etc but it can pretty much replace and entire array of notebooks, pens, sheets etc. You can also take notes on downloaded lectures and even download textbooks into it and annotate. If I went to school again, I would definitely be using it daily. Most 9-5 jobs have some "dead hours" daily, time when you don't have work to do (might be different as a freelanceer tho). Meaning if you can do your work efficiently enough, you might be able to squeeze in an extra 30-60 minutes slot to study here and there between your work hours without anyone noticing. Over time this can create a pretty massive compound interest of extra 10-20 hours per months don't neglect yourself - fitness, sleep, spirituality, stress management. All of them sometimes take a temporary hit but important to always stay on the top of them to reasonable degree. With gym, I found full body training helps me save time tremendously compared to 5 days of bodypart splits. with diet, batch cooking is the best way I found so far to save money and time sleep should still be non-negotiable if you notice yourself becoming agitated, sleepless and snappy around people, it is probably an indication that you're going too fast. try not to put too much pressure on yourself to transition asap, this is a very long term game. Having your own health business is tough, the market is massive and marketing with a limited budget that comes from your freelance job is incredibly hard. Pace yourself slowly and try to enjoy the process as you're evolving. Because ultimately there is no goal, there is only the present moment, day by day so make the most of each and don't stress over things that aren't in your immediate control All the best! Hope you'll find a way to make it work, we need more conscious people in the health industry filled with charlatans and quacks.
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Interesting approach. Finding a holistically thinking dentist these days seems pretty rare even in 1st world countries. Its like we are all afraid of the pulling driller but are not quite ready to trust the holistic person yet. I think there is a bridge between holistic and modern dentistry missing. Some sort of integrative approach that leans on to the evidence as well as more alternative practices. Imagine a dentist, who, instead of drilling gives you 6 months to try to remedy the infection yourself, offering specific instructions on diet, antibacterial herbs and cleaning. What a world that would be. And if you can't and the infection spreads, then we drill.
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Depends on what you want to get out of it. With X, same as other platforms, consistency is a key. Daily tweeting, ideally about trending topics related to your business os rewarded more than irregular tweets. If you can post multiple times a day, even better Aim for short and consistent catchy titles, not long elaborate articles, that's more for LinkedIn. Reposting and resharing other people's tweets is what the algorithms reward as well. It's how you start growing network by having your post re shared by bigger accounts... obviously don't expect Elon Musk or Jeff Bezos to reshare so scale accordingly and find accounts that are slightly bigger but not massive. X doesn't like when you pull people away from the platform so it's all about engagement with a particular statement rather than having people, for example, click a link and download something or book a call. You're free to have that in your bio but it should not be the aim. X wants to maximise user's time on the platform so if you work against that rule, your posts won't be seen I think the best way to get started is to observe accounts you aspire towards, who do what you do but are larger. Also spend some time practicing posting for Twitter. Maybe take an interesting article and practice writing about it in 60-100 characters focusing on engagement. Gpt can be pretty good for that to help you practice and give feedback but make sure to pay for premium. Also, maybe this is more long term but don't forget about voice & tone consistency. It's not just about saying something but about how you say it and how consistent you are saying it this way. It's part of your branding - voice & tone guidelines. Throw it into GPT as well and he'll tell you more about it. It is what builds credibility with your audience and what makes your brand recognisable and trustworthy, people like being able to predict your behaviour in a way. Think of successful businesses, podcasters, they all do this in some way and when they don't, you're like "wait, that's weird, why do you say it like that" Good luck
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It seems like there is a learned response there. That's what I meant when I asked if you get agitated at the site of your bed. Because your body associates your bed with adrenergic response. You can break that pattern. Do you work on your bed or do you do other things on it other than sleep (and intimacy) ? What do you think could have led to you getting this response to bed time? Did you use to work on your bed? Or was it your escape place when you were stressed?
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That's fine that you think that, that wasn't the point of my comment to you. If that is indeed so, as you say, then the OP will learn that by not selling enough books or receiving constructive feedback from the reader. He will then take that feedback and consider incorporating it in his second book if he wishes. But you can't hammer over someone's product like that. I mean you can and nobody in the world will stop you, but people will shut you off if you come across like that and you'll be let wondering "why aren't they taking me seriously, I mean well" and I believe you do mean well but it is also how you say things. Its a common curtesy. Giving feedback and receiving feedback is a form of a skill. Most people can't do either properly. Most people give lousy feedback (or an aggressive one) and they get offended or run away in the face of constructive criticism. I believe you and I can see exactly what you mean, but then if it is so deep, do a proper critique not a surface level bashing. Tell him exactly where you disagree (maybe you should even get a copy of his book just to present your critique fair and square) and present the evidence to support your claims. Otherwise its just "my way or highway" type of critique. If the OP is to learn from your feedback and incorporate it in his future work then it needs to come across professionally, empathetically and respectfully regardless of your personal feelings about it. It is a skill that will be invaluable in professional life. The world won't get over it ,bruh. The world will ignore you and it will cost you potential opportunities, both personally and professionally, if you don't work on adding some softness into the way you deliver your message. I'm not triggered, I don't care, but there is a difference between being radical/liberal and being rude. Its my role as a mod to point these things out. I had to learn some of these things myself upon moving to another country and starting to work in a corporate environment. Its not about what you say but how you say it that matters to people more. Totally fine if you disagree, in that case, I'm happy to drop this conversation.
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mostly just better absorbtion - but I feel this won't be fixed by supplements, there is something else going on. It is really hard to give targeted advice without knowing more but maybe reflect on some of those points and see which of those are low hanging fruit and gradually cross those of the list which do not apply. There are also forms of sleep retraining but you'd have to work with someone on a more one to one basis. Also make sure to speak to AI about it all, describe your experience in the deepest possible detail and let it give you some practical advice
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^
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Sounds like you have a bit of a perfectionist mindset. It can hold you down in life when you can't let go of desire for 100%. There is no need to study all your textbooks couple times just to get above 95% , that's actually pretty counterintuitive. That's a pretty destructive strategy. In the long term, grades are pretty meaningless unless they are consistently awful but any damage you do to your health will follow you like a shadow for life. Try lowering your standards a little bit and refocusing on things that are not urgent but are important. Spend this time learning about things you are likely to need in the future. Think more long term. University is also a time to socialise, bond with others, acquire new skills and start figuring out what you want from life. Put some time into your health as well - exercise, meditate and don't neglect your sleep hygiene. Maybe get yourself a used mountain bike and spend some of that textbook time outdoors instead. Or maybe get a part time internship at an interesting company to start acquiring practical experience. Good luck!
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There is no need for this. All you are saying is "this book is not for me". If you can't show some appreciation for someone who has actually produced and shipped a product then don't comment at all. This isn't a constructive feedback. And this level of patronising aggressivity is not necessary either. If you have to use this sort of language then perhaps you aren't as evolved as you think you are. The lack of empathy in your comments is actually quite disgusting
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what's been going on the past couple weeks? New job? change in life environment? breakup? bereavement? any new stressor added to your life? What is the pattern like? Do you fall asleep and then wake up or do you take a long time to fall asleep? How much sleep do you usually get? Insomnia tends to be more emotionally-related rather than biochemically but neither should be rulled out. Some things to look into potentially: are you getting sufficient daylight exposure the first 30-minutes after waking up? how much time on average do you spend in front of screens? (inc. tablets, phones, PC, laptop, TV, LED readers) could you be over caffeinating? (also consider hidden sources like energy drinks, preworkouts, chocolate, green tea, black tea, oolong tea, certain painkillers) are you taking any regular medication that could be contributing to it? (e.g. neurostimulants etc) are you sleeping in bed with someone else? are you making sure your room is ventilated enough? (you might be sensitive to increased concentration of C02 at night - try opening windows or your bedroom doors) is your room too hot/cold/humid/dry do you tend to associate your bed with sleeplessness? Does your body get agitated by the site of your bed? do you have any signs of restlesness? (biting nails, teeth griding at night, restless leg under table, neediness to play with objects, difficulty focusing) do you suffer from anxiety or depression? do you take any meds for it? are you currently undergoing something stressful? (preparing for exams, moving etc) do you tend to eat late at night do you eat enough? do you avoid any food groups? (carbs, fats, sugar etc) when is your first and last meal? (with regards to your bed time and wake up time) do you drink alcohol? how is your phone usage 2 hours prior to bedtime? are you taking any new supplements or herbs? have you ever had your iron checked? thyroid? Potentially unrelated but you could try some magnesium glycinate during the day, start with 100mg. Careful that it doesn't add up to magnesium from other sources you are already taking like multinutrient supplements or targeted formulas.
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That's fair, i haven't considered this to be an option but you might be right
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You know counterintuitively, you see anecdotes from overweight people who went on low carb diets and their cholesterol improved, even their blood sugar went from prediabetes to normal. It is a high protein diet which is excellent for rapid weight loss. And when you lose weight, your cardiometabolic markers generally tend to improve across the board because obesity makes you sick, regardless of what diet got you to it. But then what happens is, say someone followed Keto or Atkins (somewhat similar to carnivore but includes lot of processed meat) they lost 30 pounds, cholesterol got better and at some point they achieve their normal weight and stop losing any further. From that point some evidence shows that people's cardiometabolic markers start rising up again as a result of the diet that originally helped them lose weight because of their dietary consistency - too much saturated fat, too little fibre, too little carbohydrates, insufficient unsaturated fat intake So we're always looking both long term and short term..sometimes people really need to lose weight quickly (for example when a patient is denied cardiac surgery because he is too fat and could die on the table. He gets put on Oezempic (or something similar) , bunch of other cardiac meds and probably a variation of aggressive low carb diet with tons of shakes and meal replacements. He gets the surgery, survives , but the question then is , which way next? We don't want him getting fat again. He had a primary event so he also needs to make sure his LDL is as low as possible (ofcours he'll now be put on statins for life) When looking long term (up to 36 months) the weight loss trials show the following: * 1-12 months - In the short run, low carb diets dominate weight loss studies. Fastest by far. I think on average participants in low carb compared to moderate and high carb are like 4 + kilos ahead on average? (I might be remembering it wrong) I think the most successful one of all is Jenny Craig although its very expensive and ineffective long term. * 12 - 18 months - low carb diets lose effectiveness, lose their lead and moderate carb diets like Mediterranean, Ornish or Vegetarian start catching up (there are nuances to each but that's beyond the point) Also there is a significant attrition in low carb studies at this point, some people start giving up despite losing weight because they are hard to sustain - this was nicely demonstrated by a 2022 Cochrane trial , i can get you the link you like. Having said that, all diets experience attrition but they seem to be heavier in low carb diets for some reason. * 18-36 months - , Results from all studies seem to be matched, meaning none does better or worse for weigh loss. But what happens is some diets also achieved improvements in LDL, HDL and HbA1C (blood sugar) while other diets didn't or some (in ultra low carb groups) even see a rise in LDL despite weight loss. For example we consistently see Mediterranean diet leading to more favourable cholesterol outcomes while we see low carb diets often leading the opposite way in the long term (24-36 mo) That's a very long response to a simple question that has no simple answer 😄 Also it was about a year and half since i did this deep dive so more stuff might have been published with more rigorous controls and new populations. _ Regarding your question about best resources for health optimisation and longevity - I've stopped consuming most nutritional resources at this point because you can just see all that fuckery, marketing and backwards pretzel mental gymnastics people do with studies. But... I'd love if Avi Bitterman published more content but if you want something of ridiculously high quality amd reliability, he is the man. There are some good podcasts and interviews with him on some barbed wire topics like saturated fats and cholesterol but these videos are complex and last for hours and hours. I like Lane Norton although not fan of the drama on Instagram. NutritionMadeSimple is amazing as well. Red Pen Review team is amazing, some of those guys have their own channels, check out their book reviews as well on some of the most popular books in nutrition which are just gold standard of quackery and bullshit https://www.redpenreviews.org/reviews/
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Sounds like healthy eating is something you currently have to pressure yourself towards rather than gravitate towards naturally. If that's the case it could be that subconsciously you still don't value your health enough? or maybe you think you do until your willpower weakens after having whipped yourself to eat healthy for couple day. And so with the mindful "gatekeeper" off duty, you actually slide into your natural desires for junk food because that's what your current default setting is. Its not criticism at all, just something worth thinking about This is actually super super common and something we all probably experience to some degree Its almost the same as wanting to go from no-gym to 5-days a week - gym. Or wanting to go from spending 8 hours a day on social to getting rid of all social media in 24 hours. Doesn't work, the dopaminergic withdrawal is too rapid and too aggressive. Symptoms become unbearable. And so it needs to be tempered of gradually.
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The word "causes" is one we need to dance carefully around but basically you could say that a combination of: high ApoB 100 includes a combination of LDL, LP(a), VLDL low HDL (although pharmacological interventions aimed at reducing secondary event through HDL elevation are much much less effective than those aimed at reducing LDL, hence why the whole "targed LDL, maintain HDL strategy") . So you could say, optimal HDL & LDL helps protect you from the first event but reducing LDL post primary event will basically save your life where increasing HDL at that point does little. elevated blood pressure (potentially anything above 115-120 / 70-80 - depending how much scrutiny you apply to the evidence) high triglycerides high blood sugar (as measured by combination HbA1C, fasted glucose and post prandial glucose & HOMA-IR), high level of central obesity (as measured by a combination of BMI, waist:hip ratio, waist circumference and reliable body fat measurement) smoking alcohol ...are all major contributors to atherosclerosis. And the longer your vascular sytem is exposed to one or more, the higher your risk - you could even say , the more coronary heart disease you get, much earlier in life because in the end atherosclerosis is unavoidable. Its one of the greatest faults of the design of the human cardiovascular system and why treatments aimed at being able to disengage oxidised ApoB from inside the arterial lumen is basically what will make us heart attack-proof. We're not there yet, although some current drugs like PCK-9 inhibitors seem to do that a bit at a cost of side effects and very high price tag but maybe this is where the future of medicine will be. The closes we have to it (naturally) seems to be concentrated punicalagin extract (pomegrenade juice - kuddos to RendHeaven & Jason for bringing this to my attention) and maybe red grapefruit juice). Maybe there are other components but I have not reviewed the data myself yet. What we are at this stage pretty clear on is the pathophysiology of atherosclerosis. The mechanism itself has been explained to the most miniature details and so we can derive a lot of information from that ...and from there we need to make the next step: "what is the best & safest nutritional composition of a person's diet so that the first onset of cardiovascular disease is delayed for as long as possible by minimising the migration of ApoB containing lipoproteins inside the arterial lumen and their binding to proteoglycan structures?." Second question you could ask is: "what is the best & safest nutritional composition of a person's diet so that a healthy blood pressure of 115-120/ 70-80 is maintained and any increments are only result of natural ageing rather than dietary influence" And that is basically what this entire thread is about because we are all coming at this from different ends, with heavier focus on blood lipids than blood pressure but basically it all boils down to the "how"
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I mean, the whole thing probably has 1200+ calories unless that's what you're after 🙂 Some fruit would be nice