Seth's Blog

Patrick Tucker, an editor at The Futurist, posted a request on the Quantified Self Forums for “astounding” predictions based on self-quantification. He is writing a book about using data to make predictions.

Here are examples from my self-measurement:

1. Drinking sugar water causes weight loss. The self-quantification was measuring my weight. It began when I found a new way to lose weight, which pushed me to try to explain why it worked. The explanation I came up with — a new theory of weight control — made two predictions that via self-experimentation I found to be true. That gave me faith in the theory. Then the theory suggested a really surprising conclusion, that loss of appetite during a trip to Paris was due to the sugar-sweetened soft drinks I had been drinking. If so, drinking sugar water should cause weight loss. (The nearly-universal belief is that sugar causes weight gain, of course.) I tested this prediction and it was true. More.

2. Seeing faces in the morning improves mood the next day (but not the same day). This is so surprising I’ll spell it out: Seeing faces Monday morning improves my mood on Tuesday but not Monday. For years I measured my sleep trying to reduce early awakening. Finally I figured out that not eating breakfast helped. There was no breakfast during the Stone Age; this led me to take seriously the idea that other non-Stone-Age aspects of my life were also hurting my sleep. That was one reason I decided to watch to watch a certain TV show one morning. It had no immediate effect. However, the next morning I woke up feeling great. Via self-measurement of mood, I determined it was the faces on TV that produced the effect, confirmed the effect many times, and learned what details of the situation (e.g., face size) controlled the effect. More.

3. One-legged standing improves sleep. Via self-measurement I determined that how much I stood during a day controlled how well I slept. If I stood a long time, I slept better. Ten years later I woke one day after having slept much better than usual. The previous day had been unusual in many ways. One of them was so tiny that at first I overlooked it: I had stood on one leg a few times. Just for a few minutes. Yet it turned out that it was the one-legged standing that had improved my sleep. Without the previous work on ordinary standing I would have ignored the one-legged standing — it seemed trivial.

4. Butter is healthy. I found that butter improved how fast I can do arithmetic problems. No doubt it improves brain function measured in other ways. Because the optimum nutrition for the brain will be close to the optimum nutrition for the rest of the body — at least, this is what I believe — I predict that butter will turn out to be healthy for my whole body, not just my brain.

5. Mainstream Vitamin D research is all messed up. Via self-measurement I confirmed Tara Grant’s conclusion that taking Vitamin D3 in the morning (rather than later) improved her sleep. It improved my sleep, too. When I had taken it at other times of day I had noticed nothing. Apparently the timing of Vitamin D — the time of day that you take it — matters enormously. Take it at the right time in the morning: obvious good effect. Take it late in the evening: obvious bad effect. Vitamin D researchers haven’t realized this. They have neither controlled when Vitamin D is taken (in experiments) nor measured when it is taken (in surveys). Because timing matters so much it is as if they have done their research failing to control or measure dose. If you fail to control/measure dose, whatever conclusion you reach (good/no effect/bad) depends entirely on what dose your subjects happened to take. And you have no idea what dose that is.

A friend of mine has been using morning faces therapy to improve his mood — he suffers from bipolar disorder — for 15 years. He is the first person I told about it. I recently asked him how his use of it has changed over the years. He replied:

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

I asked how the therapy has helped him. He replied:

The benefits of the morning faces therapy have been both 1) quantitative and 2) qualitative.

1) I have had bipolar disorder for 27 years. With the therapy, I’ve been medication-free for 6 years, and I was on much reduced doses of medication for about 7 years. So it’s fair to say the therapy has reduced the severity of the illness by around one half. Also, the lithium that I took in part caused kidney disease, whereas, obviously, there are no side effects from looking at faces in the morning.

2) The qualitative difference seems far more important to me. I am basically content with life; I am comfortable in my own skin. I’ve never felt like this before, and life without this is empty.

Note to skeptics: you might think, well, bipolar disorder is known to go in remission, and maturity often brings contentment. But this fails to explain why stopping the treatment brings back both the illness and the essential sadness.

A friend with bipolar disorder writes:

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

I recently came across a 2005 survey, done in Texas, that found people with poor sleep were far more likely to be depressed or anxious than people with better sleep. Huge risk ratios:

People with insomnia . . . were 9.82 and 17.35 times as likely to have clinically significant depression and anxiety [than persons without insomnia.]

Other studies have found similar results. For example, a 1979 survey interviewed the same people twice, one year apart. People who had insomnia both times were 40 times more likely to be newly diagnosed with major depression during the intervening year than those who did not have insomnia at either time.

A simple thing to say about the sleep/mood correlation is that it supports my theory of depression, which says depression is often due to malfunction of two circadian oscillators (one controlled by light, the other by faces). If they are working properly (in sync, with large amplitude) you sleep well and are in a good mood when you are awake. If they are not working properly (e.g., not in sync) then you do not sleep well and are in a bad mood at least part of the time while you are awake. What is called depression (e.g., not wanting to do anything) is actually a good thing in the middle of the night. Not wanting to do anything — being still — is necessary to fall asleep.

A sad and more complicated thing about this correlation is that it is ignored. It is not explained by any theory of depression popular among psychotherapists, such as cognitive-behavioral therapy, not to mention a dozen other explanations of depression (psychoanalytic, etc.) that psychotherapists favor. Nor is it explained by any pharmacological theory of depression. In other words, if you seek treatment for depression within our healthcare system the treatment you will receive will derive from a theory that cannot explain this result. Yet the correlation is so strong it must be telling us something important.

You can read endlessly about the high cost of health care. What if the high cost is not the core problem? What if it is only a symptom of something less obvious? What if health care costs a lot because we have a poor understanding of health and disease (as the failure of popular theories of depression to explain the sleep/mood correlation suggests)? What if we have a poor understanding of health and disease because health research is too concerned with allowing healthcare providers to make money?

In 2007, Jon Cousins started tracking his mood to help NHS psychiatrists decide if he was cyclothymic (a mild form of bipolar disorder). After a few months of tracking, he started sharing his scores with a friend, who expressed concern when his score was low. Jon’s mood sharply improved, apparently because of the sharing. This led him to start Moodscope, a website that makes it easy to track your mood and share the results.

I was curious about the generality of what happened to Jon — how does sharing mood ratings affect other people? In January, Jon kindly posted a short survey about this. More than 100 people replied. (more…)

SAMe is a drug well known to help depression. For example, “a popular dietary supplement called SAMe may help depressed patients who don’t respond to prescription antidepressant treatment, a new study shows.” But there’s something important few people know about SAMe.

While talking to a Seattle woman about how Vitamin D3 first thing in the morning helped her with depression, she told me the following story:

When I was 47, I just wanted to be healthier. I kept gaining weight. I knew what foods are healthy. I just didn’t seem to eat them. A naturopath suggested SAMe. I tried it — Twin Labs SAMe. That was really fabulous for me. For the first time I got a glimpse of what being not depressed was like. Cravings weren’t there any more. Went from a size 24 to a size 14. Lost 70 pounds. I’m 5′ 8″. I didn’t feel deprived. I was eating plenty of food. going to yoga. Feeling really great.

Then Twin Labs discontinued it. It was made in Japan. I tried every other SAMe out there, eight different brands. None of them worked. I gave each of them a month. I tried different dosages.

I started slipping back into depression. Not being able to cope. I was sleeping more. Sugar cravings returned.

[why did Twin Labs stop making it?]

It wasn’t a good seller for them. So fucking wrong. I wrote letters to try to get them to start making it again. I did a campaign. People found pockets of what was left in the country and sent it to me. But it finally ran out.

The moral(s) of the story? 1. So much for word of mouth. You might have thought it would make the good SAMe sell well, better than the bad SAMe. Apparently not. 2. So much for the placebo effect. 3. Clinical studies (e.g., of SAMe) may higher-quality versions of what they are testing than the versions available to the rest of us. 4. So much for quality control in the supplement industry — except maybe in Japan. There can be substantial quality variation among supplements, undetected by the industry. I have to believe the companies selling the useless SAMe didn’t realize it. Surely they thought that good SAMe would be a better product for them than bad SAMe.

This resembles the Vitamin D3 story I have been telling. Tara Grant said she’d heard countless times that Vitamin D is good. She hadn’t heard once that it must be taken in the morning. I’ve heard countless times that SAMe is good. This was the first time I heard about huge quality control issues. In both cases individual self-observation uncovered a crucial truth that an industry had overlooked. They didn’t want to miss it. The Vitamin D Council didn’t want to miss the time-of-day effect. They just did.

This also resembles what I said about ultrasound machines: A lot of them are broken, unbeknownst to their operators and the people (often pregnant women) being scanned. The countless “experts” (doctors) who recommend ultrasound don’t seem to know this.

Which is why personal science (trusting data, not experts) is more valuable than experts want you to think.

• Treasure trove of faces.
• Is the Quantified Self movement a fad? “Does this numerical “self knowledge” make [Gary] Wolf healthier, happier or more effective?”
• Interview with me about personal science by Doc Fermento.
• Junk food in schools not obviously fattening.
• A chemical in miso (genustein) strengthens bones better than bone drugs.

Thanks to Jim McGuire, Dave Lull and Peter Spero.

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.

At the SLD forums, Anima describes using several  safe cheap treatments to improve his mood and sleep. First, he tried wearing blue blocker (amber) glasses in the evening. They made him fall asleep more easily and reduced or eliminated hypomania. However, he was still depressed. Second, he tried getting twenty minutes of sunlight early in the morning. His mood improved. But he still had trouble synchronizing his sleep/wake cycle with the sun — that is, being awake during the day and asleep at night. He would stay up an hour later every night and wake up an hour later every day, meaning that half the time he was asleep during the day and awake at night. Finally, he tried adjusting when he ate:

I recently found the missing key to this: meal timing.  I saw a talk that Seth gave where he talked about curing his problem with waking too early by skipping breakfast.  My problem was difficulty waking.  I read an article that suggested that our circadian rhythms are not just tied to light, but to food times as well.  I used to eat late at night and never eat breakfast.  I started eating breakfast immediately upon waking (ick) and stopping all food at least 12 hours before I wanted to wake.  Basically, I did what Seth did only opposite.  It worked. . . . I was even able to adjust my cat’s circadian rhythm — he used to wake me up too early for his breakfast — by gradually moving his supper time.

In another post he describes using B vitamins to treat his restless legs syndrome and ADHD:

I have been taking a supplement with all the B vitamins in amounts much higher than typically recommended. I have also been taking Epsom salt baths for magnesium. I have not experienced restless legs AT ALL since starting. This is quite remarkable to me, because it was such a problem. My ADHD is also much improved.

The idea of treating restless legs syndrome with niacin (a B vitamin) came from Dennis Mangan. Anima had noticed that ADHD and restless legs syndrome often occur together.

He makes some reasonable comments about psychiatrists:

Why are psychiatrists still acting like neurological problems exist in isolation, when clearly they are all related? [In the sense that you can use what is known about how to cure Problem X to help you cure Problem Y, if X and Y often occur together.] I used to take Lamictal, Depakote, Adderall and Ambien every day. That doesn’t include all the meds I tried that didn’t work. I’m currently wearing amber glasses at night and taking a B complex, flax oil (SLD-style) and bathing in epsom salts three times a week. My mood is more stable than it was on medication, and my ADHD is controlled about the same. My sleep is much better. My psychiatrist told me that I would be on medication for the rest of my life. When I told him that I was using dark therapy and light therapy and had stopped taking my medication, he told me that I was “playing with fire,” and that I would end up in a mental institution or commit suicide if I didn’t resume my medication, despite the fact that I had stopped taking it for longer than it would be effective. I asked him if he had read the research on dark therapy. He hadn’t, but he assured me that it is pseudoscience. I guess the definition of “pseudoscience” is any treatment that doesn’t make him money. I puckishly asked him if I seemed manic or depressed, and he was forced to admit that I did not.

The ability of this psychiatrist to ignore contradictory evidence in front of him resembles what happened to Reid Kimball. He told a UCSF gastroenterologist that he was successfully managing his Crohn’s with diet. In my experience, Crohn’s can’t be managed with diet, the doctor said at the end of the appointment.

In yesterday’s post I described how searching the medical literature helped me avoid a dangerous surgery with no obvious benefit. The surgeon I consulted, who recommended the surgery, said that published evidence backed her up. I could not find that evidence, however. Others found evidence that contradicted her recommendation.

Among the comments on that post were similar stories: Searching/reading the medical literature had been helpful. Learning what had happened (in research studies) was better than relying on an expert (a doctor). Here is an example:

A little over two years ago, I was “depressed”. My psychiatrist wanted to prescribe an SNRI [serotonin-norepinephrine reuptake inhibitor]. I related, once again, my poor experience with an SSRI and asked for evidence that an SNRI would be any more effective. He said there was evidence that SSRIs [selective serotonin reuptake inhibitors] worked. I pointed out the 2004 meta-analysis that showed no meaningful difference between SSRIs and placebos. Then I asked whether there was any better evidence for SNRIs. Since he wasn’t able to provide any, I told him that since we know that extremely low Vitamin D blood levels, poor diet, no exercise, and no social life can cause depression (all things I had at the time), I’ll try fixing those things first and then resort to drugs if that fails. It did not fail and I quit seeing him.

None of the stories in the comments described the opposite outcome: Knowing the data made things worse.

Are there exceptions? Is it always helpful (or at least not harmful) to know what happened (i.e., know research outcomes)? Has anyone reading this had an experience where knowing health research data was harmful?