Seth's Blog

Recently I posted that my work resembles the work of the artist Hong Yi. Her work shows that profitable beautiful art can be made from the cheapest materials; my work shows that non-trivial useful science can be done by anyone. A reader named David commented:

Your work and discoveries, just like Hong’s, are very inspirational. . . . They send a message that every individual has the potential to contribute something to society even with no or limited budget.

This hadn’t occurred to me. It should have. I could have made this point in talks, for example.  Beyond the obvious point, David was saying that the more your personal science could help others, the more likely you would be to do it. The prospect of helping yourself and others will surely be stronger motivation than the prospect of helping only yourself.

How can one person’s personal science help others? This doesn’t happen automatically, it has to be arranged. My Journal of Personal Science and the Make Yourself Healthy Meetup group are two ways of facilitating this. What about other ways?

David’s comment made me think of another way: Acne Club, that is, a high school club for people with acne. The purpose of the club is to promote personal science about acne. Members of the club try to find the causes of their acne, partly by self-experimentation. They meet to share results and ideas (e.g., treatments to try, how to measure acne) and encourage each other. The discovery of two groups of “primitive” people who have no acne suggests that all acne has environmental causes. If a high school group could identify even one environmental cause, it would be a huge contribution to human well-being — especially the well-being of high-school students. I think this is quite possible.

I had acne as a teenager. If you start such a club, I would be happy to help you however I can. For example, I could give advice about measurement and experimental design and could publicize what you learn.

Looking around for evidence connecting glutathione level and acne (it has been proposed that low glutathione causes acne), I found this at acne.org, from a 20-year-old woman:

As a personal choice research and viewing other people’s experiences with supplements is safer than taking my doctor’s advice. My doctor insisted I go on the pill, insisted I get on antibiotics [a common prescription for acne], insisted nothing was wrong with me and even did a hormonal test…said I was “healthy and normal” and to leave the office because my hormones were normal as well as everything from the liver onwards. I stared at him and told him he was wrong: 1. hormone tests will lie if I’m on the pill and 2. I have acne, never had it before in my life and it came about too fast … If acne is a symptom then something is wrong. I personally don’t trust doctors because they generalize [too much] and from personal experiences [where] I’ve been laughed at and dismissed and even told “leaky gut doesn’t exist”. Personal research goes a long way and it’s so great to have communities like this where everyone can help each other out.

This is personal science in the sense of trying to learn from other people’s data. What’s interesting is that she says this. Nobody forced her to. She isn’t try to sell something or look good. Her discovery of the power of “research and viewing other people’s experiences” — better than trusting a doctor — (a) interests her and (b) she thinks will interest acne.org readers. Her own experience certainly supports what she says.

Long ago, it was discovered that the Earth is round. Before the discovery, nobody said that. After the discovery, people discussed it for a while (“Have you heard? The Earth is round.”), maybe a few hundred years. When knowledge of the Earth’s roundness became part of everyone’s belief system, people stopped discussing it.

In other words, this comment suggests that a new truth is coming into being. Her experience is the same as mine with regard to acne: Can’t trust what a doctor says. My dermatologist prescribed two medicines. Studying myself showed that only one of them worked, a possibility my dermatologist seemed to have never considered.

A new study has found that persons with Laron Syndrome (a kind of dwarfism) get almost no acne. Persons with this syndrome, because of a mutation, are insensitive to growth hormone. As a result, they produce much less IGF-1 (insulin-like growth factor) than normal. When given synthetic IGF, they may develop acne; when the dose is reduced, the acne goes away. The authors say: “The findings suggest that an interaction between IGF-1 and androgens is necessary for the development of acne.” This is great progress because people with Laron Syndrome are different from everyone else in just one tiny way (albeit a tiny way with many consequences).

The first important step in understanding the cause of acne was finding two (“primitive”) groups of people with no acne. This suggested that acne has an environmental cause. There were thousands of differences between the lifestyle of those people and “modern” people, so this was just a start. It was hard to know which differences mattered. The Laron Syndrome finding is consistent with the earlier result (no acne in two groups of “primitive” people) because a “Western diet with [its] high intake of hyperglycemic carbohydrates and insulinotropic dairy over-stimulates IIS” (insulin-like/insulin signaling).

This view predicts that if you replace hyperglycemic foods with foods lower in glycemic index acne should be reduced. This study did that and, indeed, acne decreased (compared to a control group) after ten weeks. The study ended after ten weeks. The patient who reduced his/her glycemic index the most saw the greatest decrease in acne. A second study found the same thing: a low-glycemic-index diet reduced acne. It lasted twelve weeks. With longer follow-up, there might have been even more improvement.

Thanks to Paul Nash.

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

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

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

Presumably Dr. Jenny Kim is a good dermatologist because the author of this NPR piece chose to quote her:

UCLA dermatologist Dr. Jenny Kim says many people don’t realize it’s bacteria that cause acne. “Some people say your face is dirty, you need to clean it more, scrub more, don’t eat chocolate, things like that. But really, it’s caused by bacteria and the oil inside the pore allows the bacteria to overpopulate,” Kim says.

If I were to ask Dr. Kim how she knows that acne is “caused by bacteria” I think she’d say “because when you kill the bacteria [with antibiotics] the acne goes away.”  Suppose I then asked: “Is there evidence that the bacteria of people who get acne differ from the bacteria of people who don’t get acne (before the acne)?” What I assume Dr. Kim would answer: “I don’t know.”

There is no such evidence, I’m sure. It is quite plausible that the bacteria of the two groups (with and without acne) are exactly the same, at least before acne. If it turned out, upon investigation, that the bacteria of people who get acne is the same as the bacteria of people who don’t get acne, that would make it much harder to say that acne is caused by bacteria. As far as I can tell, Dr. Kim and apparently all influential dermatologists have not thought even this deeply about it. To do so would be seriously inconvenient, because if acne isn’t caused by bacteria, it would be harder to justify prescribing antibiotics. Which dermatologists have been doing  for decades.

It isn’t just dermatologists. Many doctors believe that H. pylori causes ulcers — wasn’t a Nobel Prize given for discovering that? The evidence for that assertion consisted of: 1. H. pylori found at ulcers. 2. Doctor swallowed billions of H. pylori and didn”t get an ulcer. (Not a typo.) It was enough that he got indigestion or something. 3. Antibiotics cause ulcers to heal. That was enough for the two doctors who made the H. pylori case and the Nobel Prize committee they convinced. The doctors and the committee failed to know or understand that H. pylori infection is very common and almost no one who is infected gets an ulcer. Psychiatric causal reasoning has been even simpler and even more self-serving. We know that depression — a huge problem — is due to “a chemical imbalance”, according to many psychiatrists, because (a) antidepressants work (not very well) and (b) antidepressants change brain chemistry.

Dr. Kim’s false certainty matters because I’m sure most people with acne don’t know what causes it. I didn’t. Dr. Kim’s false certainty and similar statements from other dermatologists make it harder for them to find out.  I wrote about a woman who figured out what caused her acne. It wasn’t easy or obvious.

Thanks to Bryan Castañeda.

Someone named Red Fury made an interesting comment on my Boing Boing article about acne:

I had acne on/off for years. . . . In my mid-thirties, I tried the Retin-A at night, antibiotic gel for day regimen for about 2 years – no effect. . . . Then, I was talking to a co-worker whose daughter was taking ‘modeling classes’ to become a teen model. She casually mentioned her acned daughter had to give up rice, potato chips, and bread, all of which are high-glycemic index foods. My quack-radar went off, and I looked around for something scientific behind that advice. http://www.ajcn.org/content/86…

Huh. I guess those  nutrition-bashing dermatologists actually did a study and published the scientific results in a peer-reviewed journal. . . . My acne disappeared completely as soon as I eliminated rice and potatoes.

He finds a study that supports the casual advice, he follows the advice, his acne disappears. By convincing him to follow the advice, the scientific study helped him get rid of his acne. Which is impressive.

The interesting twist is that the study was published twice, clearly breaking the rules. Bad scientists! Who did something really good.

Several months ago I posted about how Martha Rotter figured out that her acne was caused by cow dairy products. Now a longer version of her story (by me) is on Boing Boing. There is a ton of useful information in the comments. Some examples:

“Dairy is what caused my acne.” Someone replied: “Same here, specifically milk. I switched to soy milk in high school and my moderately-bad acne went away very suddenly. . . . If I eat a lot of cheese at once, like having pizza more than a couple days a week, my backne gets worse and I get acne inside my ears.” (more…)

• 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.