Month: July 2018

  • July 27, 2018

    Is Your Antiperspirant Poisoning You?

    “I stopped using antiperspirant yesterday, y’all.”

    #TopThreeThingsYouDontWantToHearInACompactCarCarryingSixAdultHumans

    Yes, that is one of the many terrible things I’ve inflicted on my family over the years. I explained that my motive was not ice cold revenge for that time (27 years ago) I paid my brother $20 of hard-earned chore money for the GodMode cheat code in Duke Nukem only to have him erase the game two days later. Nope. As heartbreaking as it was, I had recently learned that the active ingredient in antiperspirant, the magic bullet I credit with getting me through some of my most aggressive social anxiety as a teenager, was linked to Alzheimer’s disease.

    As a perpetually anxious perspirer (spellcheck says that’s not a word, but I’m making it a word #IDoWhatIWant), I was beyond reluctant to give up my antiperspirant. It was almost as vital to my survival as coffee. And I am a coffee before people person. Still, the specter of early onset Alzheimer’s weighed more heavily in my (sort of) still functioning brain.

    So I did what I always do and turned to PubMed to investigate. After all, one study doesn’t make it science. Sometimes one study just makes it an accident, or a data analysis error. I hoped.

    Know what I found in PubMed, and what you would find? This terrifying statement:

    … aluminum is a widely recognized neurotoxin that inhibits more than 200 biologically important functions and causes various adverse effects in plants, animals, and humans

    and also this one:

    Aluminum, the most abundant metallic neurotoxin in the biosphere, is an extremely pro-inflammatory, pathological and genotoxic element that is particularly deleterious to the normal homeostatic operation of brain cells.

    These are just the tip of the iceberg. And, they’re from peer reviewed scientific publications. These aren’t my mom’s favorite crunchy granola blog telling you to wear a magnet headband to banish stress dreams. They are scores of scientists talking about aluminum, the thing that snaps your sweat glands shut, as an incredibly powerful, cell killing substance with a special attraction for your brain cells.

    I know what you’re thinking. Is this something I really need to worry about? Wouldn’t there be some kind of warning from the FDA or the CDC by now? No, no there would not. In order for the FDA or CDC to make a pronouncement about the negative health effects of something in widespread use with far-reaching financial implications for stakeholders who make millions of dollars of political contributions, you need to have a smoking gun, four eye-witnesses, DNA evidence, and a time-stamped, live broadcasted video of the substance in question murdering a bunch of people.

    So how can we know whether or not to embrace the nauseating musk of our ancestors who never lived without the possibility of spontaneous pit stains?

    We investigate the science.

    Aluminum Is Elevated In Alzheimer’s Brains… ?

    No, the ellipsis question mark is not a mistake due to my own personal aluminum exposure. It’s a punctuationary embodiment of the disagreement within the scientific community over the years. In 1996, this group of scientists called their paper, “Content of brain aluminum is not elevated in Alzheimer’s disease.” For scientists, that’s the equivalent of, “Obviously aluminum is not involved in Alzheimer’s, you idiots.” But it contrasts starkly with recent findings in the field, likely due to the development of advanced aluminum measurement tools.

    And y’all, that’s something about science that we all have to kind of accept. Sometimes our initial findings are WRONG. They’re wrong, because we had terrible tools or didn’t understand that our results were contaminated. We are always learning new things, and those new things often invalidate older findings. That’s the nature of science. #ItsScienceYall

    Anyway…

    In the publication I initially stumbled across, a group of scientists in England found that, in 60 human brains (an admittedly small sample size) with 700+ tissue samples, the median aluminum content was about 1 microgram of aluminum per gram of brain tissue. In another study of Alzheimer’s only brains, the same research group found what they termed extremely high levels of aluminum – some more than ten times the “normal person” median discovered in their earlier study.

    The sample sizes in both studies were relatively small in light of the almost 7.5 billion people in this world. But, they still begin to demonstrate a correlation between aluminum in the brain and Alzheimer’s. Of course, correlation is not causation. But these aren’t the only data points we have. Let’s take a quick tour of a few others:

    With all that information, it’s not surprising to discover the quote below while scanning the literature:

    However, recent reports concerning sporadic AD and environmental and occupational exposure to aluminium have allowed the conclusion to be drawn that, under certain conditions, it is inevitable that aluminium will contribute towards Alzheimer’s disease.

    As a scientist, I’m going to admit that the above statement, though pulled directly from this publication, is an opinion. There is no evidence as yet to indicate a direct causal link between aluminum and Alzheimer’s disease.

    BUT

    Is there enough evidence, combined with the widely accepted fact that aluminum is a neurotoxin, to make this scientist limit aluminum exposure?

    Absolutely yes.

    Limit Your Aluminum Exposure – All The Cool Kids Are Doing It!

    Before I jump in here, let me say it one more time: there is no definitive data indicating that aluminum causes Alzheimer’s disease. There is just a lot of correlation between the two. Because of that correlation, I personally made a choice to limit my aluminum exposure. I want to continue annoying the crap out of my brothers for as long as possible, and that means I need to stay at the top of my game.

    So how can we minimize aluminum exposure?

    According to various  sources, including the European Food Safety Agency, the largest exposure risks come through food, specifically breakfast cereals, pots, pans, aluminum foil, and aluminum cans. I have a bit of a hard time with that due to the fact that aluminum testing of canned drinks reveals a content of between 0.1 and 74 ppm. So… 74/1,000,000 of a canned drink is aluminum. Besides, most aluminum cans are lined with something else we apparently need to worry about. But we’ll talk about that in a later post.

    By my estimation, as well as this publication, the things we really need to avoid are antacids, allergy shots, dialysis, and industrial air, but I also choose to avoid antiperspirants. They carry 25x more aluminum than water and 50% more than a vaccination, and most people use them daily if not multiple times daily.

    If you Google this topic, you’ll probably stumble upon a few articles, some from reputable places, that will tell you there’s nothing to worry about with your antiperspirant. Carry on as usual. None of that aluminum can get through  your skin anyway, silly!

    Spoiler Alert: that’s not true!

    Antiperspirant Can Get Through Your Skin

    The argument against antiperspirant as an aluminum exposure risk hinges on the concept of your skin as a physical barrier. So putting something on your skin couldn’t possibly expose the interior of your body to it, right?

    Have you ever used topical anesthetic or Icy Hot? Do you think that stuff is making your skin numb (or psychotically alternating between hot and cold) through psychokinesis and good intentions? It’s not, I assure you. It is being applied to your skin, passing through it, and getting right down to your nerves, where it prevents them from sending information to your brain. Passing materials through your skin is actually a really common mode of drug delivery. Think about those old school birth control patches, nicotine patches, anti-nausea patches.

    Usually when a scientist or physician is trying to pass a therapeutic substance through the skin, it needs to meet certain criteria (smaller than 500 kD). Not everything will pass through, that’s true. But, it’s actually a well-accepted phenomenon in the dermatology world that many of the substances we believe should not get through the skin do sneak in somehow. Even some that are 100 times larger (or 1000!)  than the aluminum salt found in antiperspirant are known to ninja their way through and exert effects on cells several layers beyond the external skin barrier.

    So, should we trust someone who makes the blanket proclamation that something applied topically can’t possibly get through to your skin simply because skin is a barrier?

    No, y’all, we should not.

    Because that’s kind of like saying, “My kids won’t throw a party while I’m gone this weekend, because they’re supposed to be studying and doing the dishes.”

    I have cleaned up after that party.

    So if you put aluminum on your skin, it is likely that you are putting at least some aluminum in your body. Is it more than the safe level? That’s hard to say. But wouldn’t you rather err on the side of not Alzheimer’s?

    Me too.

    You Don’t Have To Embrace The Musk

    Don’t despair just yet though. Abandoning antiperspirant doesn’t mean you have to embrace agoraphobia. There are options. You just have to (1) ensure you are grabbing something that DOES NOT say ANTIPERSPIRANT. Because if it does, it has aluminum in it. For sure. And then (2) pick something that smells good enough to make you believe it’ll survive your day.

    I’ve tried a lot of different things, and this is what I know. None of these work as well as antiperspirant. That’s just the truth. But, there are a couple that work almost as well and don’t contain ingredients that I think will contribute to any cognitive decline or an inexplicable desire to listen to Nickelback non-stop.

    1. Primal Pit Paste | Jasmine
      This stuff smells nice, and works pretty well. The essential oils can irritate your skin if applied directly after shaving though.
    2. Schmidt’s Deodorant Stick | Rose + Vanilla
      I can’t smell the vanilla in this at all, which is great, because I wouldn’t be a fan of smelling baked goods all day. But, it is hands down my favorite for scent, efficacy, and low tendency to irritate skin. And that’s saying a lot for someone who sweats as much as me (from all the cardio, y’all).
    3. Tom’s of Maine | Unscented
      I have a love hate relationship with Tom’s deodorant. I love it because it’s super kind to skin. I hate it because it always ends up smelling weirdly like lemongrass, no matter which flavor I buy. Still, I keep some on the shelf for days when my skin is feeling extra stabby.

    One last thing – if you absolutely can’t survive without antiperspirant, and it’s so life altering that even a causal relationship with Alzheimer’s wouldn’t sway you, that’s cool. You do you. But maybe try to alternate. Don’t wear antiperspirant every day. Do what you can to limit the amount of high aluminum content you’re slathering all over your skin.

    And I know this post isn’t about antacids, but y’all, don’t eat them like candy. It seems like that’s a terrible idea. OR, know what makes a great antacid? Blue Bell Homemade Vanilla Ice Cream.

    That’s not science though. Unless we do a study on it…

    Aight – that’s it for me today. If you’ve tried life without antiperspirants or have a great zero aluminum deodorant, please share that awesome info in the comments!

    Photo by Becca Matimba on Unsplash

  • July 1, 2018

    Are Female Doctors Better?

    Female doctors are better than their male counterparts under some circumstances, at least according to a study currently making the media rounds.

    No, seriously. According to science.

    Alright, don’t harpoon me for being an angry, militant feminist just yet. Let’s talk about this study first, and then you can be the judge.

    First, a little context.

    Women Are At Higher Risk Of Death After Cardiac Events

    This is a real thing, y’all. Women were twice as likely to to die after hospitalization for a heart attack in this study (from 1996). And the authors noted that women were generally not treated as aggressively as men. I.e. they were half as likely as men to undergo some of the more invasive but lifesaving procedures. <– statistically significant

    Women and elderly people received primary percutaneous coronary intervention – aka lifesaving procedure after heart attack – less often and later than men in this more recent study. <– statistically significant

    In another study, younger women and those with a specific arrhythmia were more likely to develop prehospital cardiogenic shock and less likely to be prescribed “evidence-based treatment at discharge.” <– statistically significant

    This one’s a bit of a head scratcher for me. Women were literally discharged without prescriptions, the same prescriptions that men with similar pathology were given. I honestly can’t imagine what’s responsible for that, but I’m sure some fancy psychologist can figure it out.

    Anyway, my point here is that science supports the idea that women really are at higher risk of death, and, honestly, receiving sub-standard medical care after a cardiac event.

    But that’s not the point of this post.

    Female Doctors (General Internists) Have Lower Readmission And Death Rates

    In unearthing the fact that women are at higher risk than men after cardiac events, researchers wondered what it meant about the treating doctors. What caused this gender disparity? So they did a little digging and looked at WAY more data than I ever want to. Thank goodness these researchers didn’t feel the same way though.

    In 2017 a group of investigators affiliated with Harvard Medical School published data examining a physician’s effect on patient mortality and their likelihood to return to the hospital. They included over 1.5 million individual hospitalizations, 18,000 female doctors, and 39,000 male doctors.

    Patients treated by female doctors were less likely to die (11.07% for female doctors vs. 11.49% for male doctors) and less likely to return to the hospital after treatment (15.02% for women vs. 15.57% for men). Both of these data points were statistically relevant, even though the raw difference was only on the order of 0.5% for both patient death and return to hospital.

    To put these small differences in perspective, the authors calculated the number of patients a female physician would need to treat before preventing one additional death or return to hospital vs. a male physician.

    Number of Patients To Prevent One Death: 233
    Number of Patients to Prevent One Return To Hospital: 182

    So these differences aren’t apparent unless we’re looking at pretty large volumes of patients, but those volumes exist in a lot of hospitals. Meaning that this trend really demands our attention and further investigation, which brings me to the study currently making the rounds.

    Women Treated By Male Physicians Die More Frequently

    than when they are treated by female physicians, according this this recently published study. The authors said, and this is a direct quote:

    female patients treated by male physicians were the least likely to survive an episode of care

    They also noted that patients treated by female doctors, in general, regardless of patient gender, were more likely to survive.

    This study involved 581,845 patient treatment episodes between the years of 1991 and 2010. In other words, this study brings the heat when it comes to sample size and duration. It’s no bubblegum investigation between two fifth graders. Which means there are a LOT of statistics.

    Researchers anaylzed this data six ways from Sunday. This paper has so many statistical references that I had to Google a couple to jog the cob-webby parts of my brain. And those part of my brain do not want to be jogged.

    The moral of the story though: the results are statistically significant. This publication represents another data point indicating that female patients are at higher risk than their male counterparts. Especially if a man treats them instead of a female doctor.

    But wait, there’s more!

    These researchers wanted to draw some conclusions about the root cause of this male/female difference.

    Male Physicians Who Interact More With Women Are Better At Treating Them

    than male physicians who interact less with women. Seriously, this study showed a trend toward decreased risk for women treated by male physicians as those male physicians’ level of interaction with women in general increased.

    Cue the laugh track now. I feel like I’m telling a story about the Rosetta Stone instead of trends in modern healthcare. Because it seems like female doctors have a secret decoder ring, and the men just don’t. It also seems like the decoder ring works with both men and women.

    Also, how funny is it to say – when men interact more with women, they’re better at communicating with them??

    That’s like saying, “It turns out children become better at language after they talk for a few years.”

    Communication Tutors For Med Schools?

    Maybe med schools will start teaching physicians how to communicate with women the way Rice University teaches their engineers how to communicate with humans. True story, as a freshman at Rice, I listened to a representative of the engineering department explain why everyone had to attend workshops put on by the Cain Initiative. Which, despite the name, is not a creepy cult that meets in the basement of Baker Hall, the most gothic dorm on campus.

    It boiled down to this. Engineers are unskilled at communicating with humans. Which puts them at a disadvantage in life, not just in the workplace. Rice wanted to ensure their engineers were good communicators, so they created a team of communications tutors. From freshman year on, all engineering students were taken by the hand, critiqued, coached, and forced to present endlessly.

    And not to brag, but it totally worked. When I came into grad school, I remember several people commenting on the quality of my slides and presentation style*. “You don’t sound like other engineers.” And not just because I talked way too much about Disney movies.

    So, Tracy Voss, maybe you could head over to Baylor and teach them a few things about remedial communication techniques for people who are naturally terrible communicators.

    *Y’all don’t judge Tracy Voss and Rice University on the quality of this blog. You can attribute all shortcomings to the fact that I was raised by wolves and am wildly unapologetic about that.*

    Advocate Assertively

    for yourself and/or your loved ones. That’s the moral of this story.

    Yes, it seems that male physicians communicate poorly with female patients, leading to increased mortality risk for those female patients. You can’t choose a female physician every time you need healthcare. So whether you’re a man or a woman, you need to communicate as clearly as possible any time you’re in need of healthcare. Especially anything urgent involving your heart, lungs, or brain.

    Don’t ever skip over information, even if you think it might not be relevant. And don’t be a hero. I was raised to suck it up and work through the pain. Bleeding hands? Do that bar routine anyway. Soles of your feet black and blue from an aggressive beam crash? You’re still vaulting.

    But I know now, from watching hundreds of cases and hearing about thousands, sucking it up is often bad for you. Now, you don’t need to whine about a paper cut. But, you do need to recognize that pain, even if you can handle it, is telling you something important about your body’s needs. And you need to listen to that, or at least communicate it to a physician. Clearly. And proactively.

    Female Physicians Are Better

    according to these studies anyway. But, that doesn’t mean they’re better scientists, or smarter. None of the studies I’ve mentioned, or the ones they reference say anything about raw talent or intelligence. In fact, they clearly state that we don’t know why female physicians appear to treat their patients more effectively than their male counterparts. Some of them suggest that it does indeed come down to communication.

    But at this point, we don’t know why. We only know that female patients are at a disadvantage when treated by male physicians. And as much as I dislike this data (because it kind of sucks for everyone), it’s still science.

    Do you have any suggestions for improved communication between physicians and patients? Sound off in the comments or send me a message!

    Photo by rawpixel on Unsplash