Seth's Blog

In a recent post I proposed that we touch our mouths so much to transfer germs from our hands to our immune system. It’s an early warning system. The full sequence is: 1. Hands. 2. Skin around mouth. 3. Tongue (lick lips). 4. Tonsils (immune system). Forewarned is forearmed: exposure to a tiny amount of Germ X makes you much more likely to survive exposure to a large amount of Germ X.

Ants have a similar early-warning system, says a new study described here.

Cremer and her colleagues began by investigating how nestmates encountering an infected ant acted. They infected Lasius neglectus ants with Metarhizium anisopliae, a fungus that sticks to the insects’ outer cuticles and causes infection only after it has worked its way into the body, which takes a day or more. The researchers then placed infected or non-infected ants in a box with five nestmates, and watched what happened. . . .  Ants without the spores were groomed at a constant rate over 5 days, while Cremer saw a spike in grooming of the fungus-infected ants in the first day or two of infection, suggesting that the pathogen was prompting a behavior change in the nestmates.

The grooming was protective:

But even though they’d been exposed, only 2 percent of nestmates died from fungal infections, even though half of the initially infected ants, which had been dipped in solvent with M. anisopliae spores, died within 5 days. When ants were exposed to a dose of fungus expected to cause a 2 percent death rate, Cremer’s group saw an increase in antifungal activity, suggesting that this low level of infection was indeed enough to stimulate a protective immune response.

Earlier studies had shown what is called “social immunization” (“a protection of naive individuals of a colony after social contact to exposed individuals”) among insects. This study was about how social immunization happens.

After I thought of this explanation of mouth touching, I became much less concerned about contact with sick people. I hadn’t known about social immunization.

A new paper (“Are Prenatal Ultrasound Scans Associated with the Autism Phenotype? Follow-up of a Randomised Controlled Trial” by Yonit K. Stoch, Cori J. Williams, Joanna Granich, Anna M. Hunt, Lou I. Landau, John P. Newnham and Andrew J. O. Whitehouse) takes another look at the results of a randomized trial started in 1989. Half the mothers were given one ultrasound during their pregnancy, the rest got five. This study gave a questionnaire sensitive to autism-like traits to the now-grown-up children. This is potentially more sensitive than binary (yes/no) assessment because the questionnaire has about 50 questions.

Here is the entire abstract:

An existing randomised controlled trial was used to investigate whether multiple ultrasound scans may be associated with the autism phenotype. From 2,834 single pregnancies, 1,415 were selected at random to receive ultrasound imaging and continuous wave Doppler flow studies at five points throughout pregnancy (Intensive) and 1,419 to receive a single imaging scan at 18 weeks (Regular), with further scans only as indicated on clinical grounds. There was no significant difference in the rate of Autism Spectrum Disorder between the Regular (9/1,125, 0.8 %) and Intensive (7/1,167, 0.6 %) groups, nor a difference between groups in the level of autistic-like traits in early adulthood. There is no clear link between the frequency and timing of prenatal ultrasound scans and the autism phenotype.

Parrish Hirasaki pointed out to me that when the study was done the intensity of ultrasounds was eight-fold less than now. Here’s what the paper says about this:

Technological advancements over the past two decades have led to considerable improvements in ultrasonographic capabilities, with corresponding increases in acoustic output.

Did you read that and realize the intensities have increased by a factor of eight? Neither did I. Such a big difference in intensity means the results are not serious evidence — contrary to what the abstract implies — against the idea that sonograms are now causing autism.

More Asked about the failure to make clear the difference in intensity, the corresponding author, Andrew Whitehouse, replied:

The parameters of the ultrasound scans were reported clearly in the Methods section, and we refer to several other articles that include a description of the USS administered in this cohort. We are also very clear in the Discussion when we state that “the current study was not designed to investigate the use of [modern] instruments”.

I disagree. So what if the parameters of the ultrasound scans were reported clearly in the Methods section? That’s not the issue. The issue is failure to make clear the huge intensity difference between the ultrasounds they studied and modern ultrasounds. Saying that “the current study was not designed to investigate the use of [modern] instruments” does not make clear at all (much less “very clear”) how much modern ultrasounds differ from the ultrasounds actually studied. Any study can put caveats like that at the end. Yet few studies are as irrelevant as this one to the question they claim (in the title, abstract and introduction) to help answer.

Is it better to take cod liver oil in the morning than at other times of day? Kim Øyhus’s experience suggests that:

Each mid winter and summer I tend to lose my feeling of when it is day or night, especially if I am in the northern parts of Norway, or if the weather is dark clouds for a long time, which often happens. So sorry, no statistics, just my sense of being unhinged from the diurnal cycle.

Taking 1-2 spoons of cod liver oil in the morning got me back to this rhythm in about 3-5 hours. It even works for fixing my diurnal rhythm after partying to sunrise, but only after a day’s rest.

I have posted many times about the value of taking Vitamin D3 in the morning.

In The Shangri-La Diet I noted that hospital patients given intravenous feeding often lose a lot of weight without hunger. I said this supported my theory that the body fat set point is raised by the smell of food. Without smell, the set point goes down. When your set point goes down you lose weight without becoming hungry.

You should be able achieve the same effect by nose-clipping all your food. A new diet, however, makes smell avoidance considerably more difficult and expensive.

The K-E diet, which boasts promises of shedding 20 pounds in 10 days, is an increasingly popular alternative to ordinary calorie-counting programs. The program has dieters inserting a feeding tube into their nose that runs to the stomach. They’re fed a constant slow drip of protein and fat, mixed with water, which contains zero carbohydrates and totals 800 calories a day. Body fat is burned off through a process called ketosis, which leaves muscle intact, Dr. Oliver Di Pietro of Bay Harbor Islands, Fla., said.

It is a hunger-free, effective way of dieting,” Di Pietro said. “Within a few hours and your hunger and appetite go away completely, so patients are actually not hungry at all for the whole 10 days. That’s what is so amazing about this diet.”

Di Pietro says patients are under a doctor’s supervision, although they’re not hospitalized during the dieting process. Instead, they carry the food solution with them, in a bag, like a purse, keeping the tube in their nose for 10 days straight. . . .

Schnaider said she was never hungry throughout the 10 days she was on the K-E diet, but admits that it still wasn’t easy. “It was emotionally difficult, the 10 days of not eating,” Schnaider said. . . . Although the K-E diet is new to the United States, it has been around for years in Europe. Dr. Di Pietro charges $1,500 for the 10-day plan, and says the before-and-after pictures sell themselves.

I sympathize with the “emotionally difficult.” When I lost 30 pounds in 3 months drinking sugar water, I ate maybe 50% of my usual calorie intake. I was never hungry and that too was bad. The world seemed drab without hunger.

Thanks to Tom George.

A month ago I wrote about Chuck Currie’s discovery that coconut oil cured his foot fungus and seems to be curing his toenail fungus. He put coconut oil on his foot, put it in a plastic bag, and put a sock on it. Then he could walk around or whatever — vastly more convenient than the soaking remedies (e.g., soak your feet in vinegar) many people recommend (which I tried) and incomparably better than the foot fungus and toenail fungus remedies you find in a drugstore (which I tried many times).

For some strange reason I had foot fungus on one foot but not the other — for ten years. I have been doing Chuck’s remedy for a month. Within a few days it was clear it worked.  Now the “good” and “bad” foot are indistinguishable. I am writing this post because I discovered that the plastic bag is unnecessary, making it even more convenient. I put the coconut oil on my feet and then put on socks. It still works. Nothing bad happens to the socks, which I think are a cotton/polyester blend.

I’ve been using Whole Foods house brand (“365″) food grade (‘expeller pressed virgin organic”) coconut oil. A 16-oz jar cost about $8. Maybe it will last 4 months with daily application. (For toenail fungus. My foot fungus is completely gone.) All other commercial foot fungus remedies should quietly disappear…

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.

The new Choosing Wisely campaign is centered on lists of “unnecessary” medical tests and procedures. The hope is that these lists will reduce waste in the health care system. I wondered what “unnecessary” meant so I interviewed Daniel Wolfson, who is Executive Vice President and Chief Operating Officer of the American Board of Internal Medicine, located in Philadelphia.

At the heart of my question was: why these procedures and not others? Each list has five items. How were they chosen? Here is how the five items on the American College of Physicians’ list were selected:

The American College of Physicians (ACP) formed a workgroup of eleven experienced internal medicine physicians with specific skills in the assessment of evidence. . . . The group collaboratively identified and narrowed down screening or diagnostic tests commonly used in clinical situations where they are unlikely to provide high value or improve patient outcomes. The results were further reviewed and narrowed by clinically active ACP staff physicians before being placed for review into a randomly selected internal medicine research panel. Representing 1 percent of ACP members, the panel selected five scenarios that represented the greatest potential for overuse or misuse of a diagnostic test leading to low value care.

I said this sounded like a popularity contest. Mr. Wolfson said, no, the recommendations are based on evidence. “Do you know what a randomized trial is?” he asked. What evidence? I said. It’s not on your website.

Yes, it’s there, said Mr. Wolfson. He pointed me to the “sources” at the end of the ACP list. Here is one of those sources:

2011 USPSTF screening for coronary heart disease with electrocardiography (draft) guideline; 2011 AAFP recommendations for preventive services guideline; 2010 ACCF/AHA assessment of cardiovascular risk in asymptomatic adults guideline.

This is evidence? I said. It’s very vague. At this point Mr. Wolfson ended the interview.

So I continue to think it is a popularity contest. Who knows how the doctors on that “randomly selected internal medicine research panel” made their decisions.

I think the Choosing Wisely campaign is worthwhile, in spite of Mr. Wolfson’s implausible claims (he also said the doctors who created these lists were “courageous”).  Here’s what I would say: The items on these lists are things that many doctors in that specialty think are done too often. The lists are like a free second opinion. 

Michael Ellsberg has an excellent article about the American Dietetic Association’s attempts to make it illegal for anyone they haven’t approved to give nutritional advice. In this document, they are frank that this is their goal. After Ellsberg drew attention to it, it was taken down. I look forward to learning why it was taken down.

The Washington State chapter of the ADA, now called the Washington State Academy of Nutrition and Dietetics, is responsible for taking down the document. The organization has this mission statement:

Empowering the people of Washington to improve health with safe, effective and reliable food and nutrition information.

Our Vision:  Optimize the health and well being of Washington State individuals through food & nutrition.

Our Mission:  Empower members to be Washington State’s food and nutrition leaders.

Long ago, in the civil rights or suffrage movements, for example, empowerment meant removal of barriers. This organization preaches empowerment by creation of barriers. Their empowerment is someone else’s disempowerment.

Did you know that magnesium can reduce constipation? I didn’t. Did you know that constipation can cause bleeding under your skull (subarachnoid hemorrhages), which are earth-shatteringly painful? Apparently a lot of doctors who treat subarachnoid hemorrhages don’t know this. Here is a story from Metafilter:

A year after [cancer] chemo ended I had . . . 4 aneurysms (subarachnoid bleeds) in 12 days. These aneurysms (subarachnoid hemorrhages) were serious agony, the most pain I’ve ever experienced. . . . It’s like the World Trade Center falling down in one’s head, involuntary non-stop screaming, passing out from the pain kind of thing. . . . None of the docs could figure out what these aneurysms were from. They all seemed totally mystified. They gave me a very risky test, brain surgery basically, a brain endoscopy that meant putting a probe into my brain. I had to sign papers that it wasn’t their fault I came out a vegetable.

Several lumbar punctures. 2 CT scans then an MRI. Then my neurologist wanted me to do a really risky test, that involved stopping my heart momentarily. . . . The chances of surviving just one of these aneurysms isn’t good: “An estimated 10-15% of patients die before reaching the hospital. Moreover, mortality rate reaches as high as 40% within the first week, and about 50% die in the first 6 months.” So I felt forced to take this dangerous test. . . .

[I] looked at when the aneurysms happened and the relief I experienced in the Emergency Ward when I’d been injected with magnesium. I googled magnesium and realized its help in treating constipation. I’d been constipated for over a year from the chemo and pain meds for the chemo pain. I realized I had these aneurysms after trying to go to the toilet, from straining. The neurologist didn’t want to hear about constipation . . . . None of the docs asked me about constipation. . . .

I self medicated with magnesium citrate, which relieves constipation in a different way than laxatives, it brings water into the colon, which helps the evacuation process a lot. Calcium and magnesium citrates combined, to be exact. And that did the trick, instantly. No more aneurysms. No more dangerous tests. No more brain surgeries.

I wonder if blood tests showed she was magnesium deficient. I also suspect fermented foods would have helped. Chemo causes constipation, I’m guessing, because it kills intestinal microbes, which fermented foods replace.

If you are nickyskye (the author of this) I hope you will contact me, I would like to write more about it and I have some questions.

Thanks to Melissa McEwen.

• A “safe starch” lowers HDL.
• DIY clinical trials
• omega-3 content versus mercury content of fish: a handy guide.
• Predictions of climate models versus reality. I have only seen careful prediction-vs-reality comparisons made by AGW skeptics. Those who believe humans are dangerously warming the planet appear to be silent on this subject.
• UNESCO’s list of “intangible cultural heritage”. I like to think the items on the list are clues to human nature.

Thanks to David Cramer and Nadalal.