Seth's Blog

• Independent discovery of nose-clipping? Nasal soft strips reduce appetite, according to an infomercial.
• Does it matter how you take Vitamin D? A little bit of research.
• Hypercalcemia (too much calcium in the blood) after patient takes 5500 IU/day Vitamin D3 plus 2000 mg/day calcium.
• Fat Chef. A new TV show on the Food Network. Chefs try to lose weight.
• Kickstarter project: Restaurant guide to San Francisco on a map folded in a new way.
• The acne-diet connection. Dermatologists — the supposed experts — continue to say they aren’t connected.

Thanks to Anne Weiss, Phil Alexander and Dave Lull.

A blog called Adventures in Nutritional Therapy (started March 2011) is about what the author learned while trying to solve her health problems via nutrition and a few other things. She usually assumed her health problems were due to too much or too little of some nutrient. She puts it like this: “using mostly non-prescription, over-the-counter (OTC) supplements and treatments to address depression, brain fog, insomnia, migraines, hypothyroidism, restless legs, carpal tunnel syndrome, and a bunch of other annoyances.” In contrast to what “the American medical establishment” advises. Mostly it is nutritional self-experimentation about a wide range of health problems.

Interesting things I learned from the archives:

1. Question: Did Lance Armstrong take performance-enhancing drugs? I learned that LiveStrong (Armstrong’s site) is a content farm. Now answer that question again.

2. “If you return repeatedly to a conventional doctor with a problem they can’t solve, they will eventually suggest you need antidepressants.”

3.  “When I mentioned [to Dr. CFS] the mild success I’d had with zinc, he said it was in my mind: I wanted it to work and it did. When I pointed out that 70% of the things I tried didn’t work, he changed the subject. Dr. CFS’ lack of basic reasoning skills did nothing to rebuild my confidence in the health care system.” Quite right. I have had the same experience. Most things I tried failed. When something finally worked, it could hardly be a placebo effect. This line of reasoning has been difficult for some supposedly smart people to grasp.

4. A list of things that helped her with depression. “Quit gluten” is number one.

5. Pepsi caused her to get acne. Same here.

6. 100 mg/day of iron caused terrible acne that persisted for weeks after she stopped taking the iron.

7. “In September 2008 I started a journey that serves as a good example of the limits of the American health care system, where you can go through three months, 15 doctor visits, $7,000 in medical tests, three prescriptions and five over-the-counter medications trying to treat your abdominal pain, and after you lose ten pounds due to said pain, you are asked by the “specialists” if you have an eating disorder.” I agree. Also an example of the inability of people within the American health care system to see those limits.  If they recognized that people outside their belief system might have something valuable to contribute, apparently something awful would happen.

8. Acupuncture relieved her sciatica, but not for long. “By the time I left [the acupuncturist's office] the pain was gone, but it crept back during my 30-minute drive home.”

9. Pointing out many wrongs does not equal a right. She praises a talk by Robert Lustig about evil fructose. I am quite sure that fructose (by itself) did not cause the obesity epidemic. For one thing, I lost a lot of weight by drinking it. (Here is an advanced discussion.) In other words, being a good critic of other people’s work (as Lustig may be) doesn’t get you very far. I think it is hard for non-scientists (and even some scientists) to understand that all scientific work has dozens of “flaws”. Pointing out the flaws in this or that is little help, unless those flaws haven’t been noticed. What usually helps isn’t seeing flaws, it is seeing what can be learned.

10. A list of what caused headaches and migraines. One was MSG. Another was Vitamin D3, because it made her Vitamin B1 level too low.

She is a good writer. Mostly I found support for my beliefs: 1. Of the two aspects of self-experimentation (measure, change),  change is more powerful. She does little or no self-tracking  (= keeping records) as far as I could tell, yet has made a lot of progress. She has done a huge amount of trying different things. 2. Nutritional deficiencies cause a lot of problems. 3. Fermented food is overlooked. She never tries it, in spite of major digestive problems. She does try probiotics. 4. American health care is exceedingly messed-up. As she puts it, “the American medical establishment has no interest in this approach [which often helped her] and, when they do deign to discuss it, don’t know what the #%@! they’re talking about.” 5. “Over the years I’ve found accounts of personal experiences to be very helpful.” I agree. Her blog and mine are full of them.

Thanks to Alexandra Carmichael.

More Her latest post mentions me (“The fella after my own heart is Seth Roberts, who after ten years of experimenting . . . “). I was unaware of that when I wrote the above.

In November, at Quantified Self Europe, Martha Rotter, who lives in Ireland, gave a talk about how she cured her acne by self-experimentation. She summarizes her talk like this (slides here):

When I moved to Ire­land [from Seattle] in 2007, I began to have skin prob­lems. It began gradu­ally and I attrib­uted it to the move, to stress, to late nights drink­ing with developers and cli­ents, to travel, to whatever excuses I could think of. The stress was mul­ti­plied by the anxi­ety of being embar­rassed about how my face looked, but also because my new job in Ire­land involved me being on stage in front of large audi­ences con­stantly, often sev­eral times a week. A year later my skin was per­petu­ally inflamed, red, full of sores and very pain­ful. When one spot would go away, two more would spring up in its place. It was a tough time. I cried a lot.

Frus­trated, I went to see my homet­own der­ma­to­lo­gist while I was home for hol­i­days. He told me that a) this was com­pletely nor­mal and b) there was noth­ing I could do but go on anti­bi­ot­ics for a year (in addi­tion to spend­ing a for­tune on creams and pills). I didn’t believe either of those things.

I was not inter­ested in being on an anti­bi­otic for a year, nor was I inter­ested in Accu­tane (my best friend has had it mul­tiple times and it hasn’t had long term res­ults, plus it can be risky). What I was inter­ested in was fig­ur­ing out why this was hap­pen­ing and chan­ging my life to make it stop. I refused to accept my dermatologist’s insist­ence that what you put in your body has no effect on how you look and feel.

I began sys­tem­at­ic­ally cut­ting things out of my diet to see how I reacted. First chicken and soy, based on a recom­mend­a­tion from a food aller­gist. Over the course of a year I cut out sugar, glu­ten, carbs, starches, caf­feine, meat, fish until finally the magical month of Decem­ber 2010 when I cut out dairy. My skin was my own again by New Year’s day this year.

It took a year to fig­ure it out. It was com­pletely worth it. There’s noth­ing wrong with Irish dairy, it just doesn’t work for me. I drink Amer­icanos instead of lattes now, I don’t eat cer­eal; none of that is a huge deal. For what it’s worth, I can drink goat’s milk.

A great example of the power of self-experimentation compared to trusting doctors. One quibble: I’ll be more sure “there’s nothing wrong with Irish dairy” if she finds that American dairy also causes skin problems. The evidence so far (she didn’t have skin problems until she moved to Ireland) suggests that at least for her American dairy (i.e., dairy where she lived in America) is better than Irish dairy. I have heard Irish dairy praised. They sell Irish butter at Beijing stores near me. I won’t be buying it.

At the end of her post she makes a very important point:

Quan­ti­fied Self isn’t for every­one, but every­one should feel they have the power to change things in their body and their life for the better.

I agree. By learning about examples of people who have done just that — such as Martha — we will come closer to having that power. Right now, as far as I can tell, most people feel helpless. They do what doctors or other experts tell them to do, even if it doesn’t work very well.

Long ago, hardly anyone could read. This left them in the grip of those who could. But eventually came mass literacy, when the benefits of reading finally exceeded the costs (e.g., because more books were available at lower prices). Reading is primitive science: if you read about things that happened, it is information gathering. It resembles doing a survey. Nowadays, almost everyone (in rich countries) reads, but almost no one does experimental science. This leaves them in the grip of those who can do experimental science (e.g., drug companies). I think my work and Martha’s work suggest we are close to another turning point, where, for nonscientists, the benefits of doing experiments exceed the costs.

Thanks to Gary Wolf.

Yesterday I wrote how Alexandra Carmichael’s headache story illustrated a large and awful truth about modern healthcare: It happily provides expensive relief of symptoms while ignoring investigation of underlying causes. If we understood underlying causes (e.g., causes of migraines), prevention would be easy. Let people get sick so that we can make money from them. There should be a name for this scam. In law enforcement, it’s called entrapment.

Sensible prevention research would start small. Not by trying to prevent breast cancer, or heart disease, or something like that: They take many years to develop and therefore are hard to study. Sensible prevention research would focus on things that are easy to measure and happen soon after their causative agents. One example is migraines. Migraines happen hours after exposure. The fact that Chemical X causes migraines means it is likely that Chemical X is bad for us, even if it doesn’t cause migraines in everyone. This is the canary-in-a-coal-mine idea. Migraines are the canary.

Acne is another canary. Acne is easy to measure. Figuring out how to prevent it would be a good way to begin prevention research. To prevent acne would be to take the first steps toward preventing many more diseases. A high-school student could do ground-breaking research — research that would improve the lives of hundreds of millions of people — about how to prevent acne but somehow this never happens. In spite of this possibility, grand-prize-winning high-school science projects, from the most brilliant students in the whole country, are always about trivia.

A just-published review in The Lancet reveals once again the unfortunate perspective of medical school professors. The abstract ends with this:

New research is needed into the therapeutic comparative effectiveness and safety of the many products available, and to better understand the natural history, subtypes, and triggers of acne.

Actually, finding out what causes acne is all that’s needed.

To figure out what causes acne (and thereby how to prevent it) three things are necessary: (a) study of environmental causes, such as diet, (b) starting with n=1, and (c) willingness to test many ideas that might be wrong (because it’s far from obvious how to prevent acne). All three of these things are exactly what the current healthcare research system opposes. It opposes prevention research because drug companies don’t fund it. It opposes n=1 studies because they are small and cheap, which is low-status. To do such a study would be like driving a Corolla. It opposes studies that could take indefinitely long because such studies are bad for a researcher’s career. Researchers need a steady stream of publications.

High school students, who aren’t worried about status or number of publications, could make a real contribution here. You don’t need fancy equipment to measure acne.

Thanks to Michael Constans.

Treatment of acne with isotretinoin is associated with suicide attempts, according to a new study. A puzzle is that suicide attempts started to rise before the treatment started. They sharply declined to baseline after treatment stopped.

Acne is an good target for self-experimentation because it is easy to measure and is surely related to diet. My discovery of the value of self-experimentation happened with acne: I discovered that of the two drugs my dermatologist had prescribed, one (benzoyl peroxide) worked, the other (tetracycline) didn’t. I had believed the opposite, that tetracycline worked and benzoyl peroxide didn’t work.