Will Alcohol Just Plain Kill You?

In the CNN article, they list alcohol as the leading cause of death for people between the ages of 15 and 49.  But those people weren’t keeling over from heart attacks or cancer, they were running off the road. How often is alcohol mentioned in relation to an accident or injury? We all know this, it’s not a surprise. If somebody lights himself on fire or falls down a well, we know to ask if he’d been drinking. Somebody gets in a fight? Alcohol is probably involved. So yes, I absolutely would agree that alcohol is a major problem for the health of otherwise healthy people if we’re looking at their risk of accidental injury leading to death. Let me know if any of you take issue with this assumption.

What was striking about the Lancet’s assessment of alcohol risks is the overwhelming risk for men as opposed to women. Men drinking had three times the risk of dying between 15 and 49 as women. Road accidents and self-harm were leading causes of death, though they also included tuberculosis as an alcohol related death. That seems a little squirrelly to me, a little over eager to lay deaths at alcohol’s door. For comparison, I could say poverty is by far the leading cause of death worldwide, and I’d be right, but a little squirrelly (definitely an overlooked medical research term).

When you get beyond the initial patina of science, these researchers just go ape all over alcohol. Check out this quote from the full article: “does not need to assume zero exposure, the authors present tangible evidence for low-risk drinking recommendations. The level of consumption that minimises an individual’s risk is 0 g of ethanol per week, largely driven by the fact that the estimated protective effects for ischaemic heart disease and diabetes in women are offset by monotonic associations with cancer.” If you just read that and went, “Huh?” that is exactly the right reaction. They just did medicalese for, “Don’t freakin’ drink, OK? Just don’t!”

Remember second-hand smoke? These researchers want us to calculate in second-hand drinking as a possible harm. “Furthermore, the harmful impact of alcohol extends beyond health into families, crime and disorder, and the workplace. Evidence demonstrating the range and magnitude of the harm of alcohol to those other than the drinker is increasingly emerging.” Again, there is no way I’m going to argue, with my family history, that alcohol abuse doesn’t affect families. But calculating that into a person’s health is an entirely new way to consider the health impacts of alcohol. If your parents smoked, they exposed you to second-hand smoke. If they drank, they exposed you to second-hand alcohol? See where I’m having a little trouble? I’m not saying they’re wrong, I’m just seeing a whole new way of deciding health risks emerging from this study.

Given that presentation, it should come as no surprise that,“The conclusions of the study are clear and unambiguous: alcohol is a colossal global health issue and small reductions in health-related harms at low levels of alcohol intake are outweighed by the increased risk of other health-related harms, including cancer.” We’ll get to that cancer piece in a bit, but let me note that the adjective colossal isn’t usually used in medical journal articles. Colossal compared to what? Poverty? Malnutrition? War? Genocide? Lack of drinking water? I have to say all of those are more likely to kill you than a few drinks. So while I understand where they’re coming from, I wish the researchers had just let the data speak for itself. Once you start interpreting it, your biases start showing up and I already know these researchers hate the vine.

Instead of stopping with a conclusion, these researchers also give us a solution. “The solutions are straightforward: increasing taxation creates income for hard-pressed health ministries, and reducing the exposure of children and adolescents to alcohol marketing has no downsides. The outlook is promising: the UK has just embarked on a huge controlled natural experiment with a progressive evidence-based alcohol strategy in place in Scotland, and with similar measures planned in Northern Ireland and Wales, with England as the placebo control.” Now, the way I read that is that the English parliament just raised taxes through the roof on the Scots, the Welsh, and the poor Northern Irish while keeping their own pub tabs low. It sound pretty darn retro, and honestly a bit colonial.

But shouldn’t we ban the demon alcohol altogether? Oh, wait, we tried that. It was this thing called prohibition, and it didn’t work. But…what if we tried it on a worldwide scale? That seems to be the goal of this particular study. Here’s what the conservative Cato Institute says about prohibition and its inevitable failure due to market forces. And here’s what the Harvard Gazette says about the failure of prohibition because of vigilante justice by conservatives.

Regardless of who you believe, not ever drinking didn’t work as a solution. Taxing alcohol, as the study suggests, does seem to lower the misbehavior associated with alcohol in the U.S.. But these behaviors continue, just at a slightly lower rate.

What will be interesting is looking at the effect of marijuana use vs. alcohol use as the price of marijuana dips below the price of beer in states legalizing marijuana. There are many assumptions about the relative effect of marijuana on violent behavior and driving behaviors that we will see played out in that particular social experiment. What information we do have seems to support the idea that marijuana use replaces some opioid use, making marijuana an odd ally in the opioid epidemic.

Oh, but I promised to look at the data concerning to most of us who don’t drink like we’re fishes. What does alcohol do to our cancer risk? How much damage does a drink a day do? Having looked at the appendix for the study, which is truly awe inspiring in its completeness (remember, data charts for every country in the world), it’s pretty clear that drinking isn’t good for you. But how bad for you is it? Rather than arguing over whether or not you should include different cancers in the analysis of harms from drinking, let’s use the study’s own graph. Here’s the graph they published looking at the worldwide, overall risk from drinking for all health causes and risks.

Weighted relative risk of alcohol for all attributable causes, by standard drinks consumed per day. 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext#seccestitle200

Now, I don’t pretend to be an expert on graph reading. But if you look at that graph, it looks to me like one drink a day isn’t comparable to four drinks a day. And four drinks a day is still way better than 14. If I were looking at this graph, I would say it doesn’t really matter if you have one drink a day. But I’m sure I’ve just irritated everyone by shrugging. Basically, a little drinking won’t hurt you, and it might help to not stress about it (I suspect that’s the whole point of having a drink anyway). On the other hand, if you’ve been forcing down that glass of bitter wine every morning for your health, you can stop now.

What We Know About Coconut Oil (Hint: Not Poisonous).

For those of you who missed the USA Today article, a professor decided that, amid a world awash with animal fats, she needed to single out coconut oil as pure poison. 

I went looking, and here’s what I found: 

In July of 2018, researchers attempted to compare different fats. They did this by combining every study they could find that compared two fats. If one fat was compared against olive oil, and another fat was compared against olive oil, they assumed that the two fats would perform similarly against each other. If you have a question about this logic, so did they, but they were pretty desperate.

No definitive research.

Why? Because, and this is important, almost no research has been done on comparing different fats. So when anyone, no matter what their degrees, and no matter how many letters they have after their name, says anything definitive about comparing fats, they literally don’t know what they are talking about. That means if someone tells you that coconut oil is poison, they are voicing their opinion based on…the fact they personally are allergic to coconut oil? Or maybe they suffer from doctor-as-God-itis and are pontificating from on high without a shred of data to their name.

But let’s take the squished together studies as fact for a minute and see what we might know about vegetable fats. For this discussion, you need to know that HDL is good fat (cleans your pipes) LDL is bad fat (clogs your pipes) and Triglycerides are bad (may lead to diabetes).

Bad fats

If we replace butter with a vegetable oil, how does it do at lowering your LDL (bad fat)? All vegetable fats tested (safflower, sunflower, rapeseed, flaxseed, corn, olive, soybean, palm, and coconut oil) lowered LDL better than butter. Even beef fat lowered LDL compared to butter. Compared to lard, safflower, sunflower, rapeseed, corn, and soybean oils had a pronounced better effect on LDL. Sunflower oil was more effective at reducing LDL compared to olive or palm oils. But the take home for coconut oil lovers is that it is different and better for LDL levels than butter.

Total Cholesterol

What about total cholesterol levels? Replacing butter with safflower, sunflower, rapeseed, flaxseed, corn, olive, soybean, palm, coconut oil, or even beef fat was effective at reducing total cholesterol. Safflower, sunflower, rapeseed, corn, and soybean oil outperformed lard at lowering cholesterol. Most of the same oils (safflower, sunflower, rapeseed, and corn) lowered overall cholesterol better than palm or coconut oils. Safflower, sunflower, and rapeseed oils also outperformed olive oil at lowering overall cholesterol. So the take home for coconut oil lovers is that coconut oil doesn’t raise cholesterol and lowers it compared to animal fats.

Good fats

But what about the good fat, HDL? Replacing safflower oil with sunflower, olive, palm, or coconut oil increases HDL. Sunflower and olive oil were more effective than soybean oil. Beef fat was more effective than safflower or soybean oil. Coconut and palm oils were more effective at raising HDL than corn or soybean oils. So coconut oil is better than most other vegetable oils at raising your HDL good fat. It’s actually the best of all the oils tested at raising your HDL levels.

Conclusion?

In summary, coconut oil is not poison. It’s a bit of a mixed bag, but it outperforms animal fats on straight tests for cholesterol and blood lipids. Anyone claiming otherwise needs to have just funded a major study, because we have no evidence justifying any extreme claims about coconut oils.

Nope. Not coconut oil.

What You Should Eat: Why Every Diet Book Is Wrong.

Right before I got diagnosed with colon cancer, I wrote a book on our guts, called Tending Your Internal Garden. In it, I found some pretty exciting things (like you have thousands of unique species living inside you right now). 

But science marches on, and now we have research that shows why diet books and diet experts don’t agree. They are all right, and they are all wrong.

Why? Because you’re unique.

No, seriously. This isn’t a “feel good” moment.

This is an “Oops, that means they don’t know” moment. 

Yep. All the diet experts out there cannot tell you what the best diet is for you because you have a unique ecosystem. Your responses to food are your own. You literally can make yourself sick eating like they tell you to if you ignore yourself. Just because it worked for “buns of steel” diet-guru-of-the-week does not mean it will work for you.

Here’s the TED video detailing how they found this out, with some suggestions about tracking your own blood sugar response (not something most people are going to do). 

But the question on my mind is this: how long until they figure out that all of our drug reactions are unique as well? Will that be an Aha! moment for modern medicine, the moment we realize that the framework of “managing patients” and “following algorithms” is just an icing on what is guesswork based on nothing? Will we start the movement toward individualized care as being not only the only sane model, but the only scientific one as well? I can dream. 

Reversing Diabetes Without Drugs

It can seem with any chronic illness that the road is one way. You can slow the progression using drugs, but there is no way to go back. This feels particularly true with patients who have diabetes. Yet a new study shows that isn’t the case. 

The researchers in this study used a novel new approach called diet, foregoing the usual drugs. They found that diabetes patients, many of whom had been diabetic for years, were able to reverse their diabetes by using a low-calorie diet and dropping about thirty pounds. 

The numbers the researchers saw in these patients were similar to those seen in weight-loss surgery patients. Surgical practices advertise that they can reverse diabetes, but it usually involves a major surgery and the subsequent loss of over a hundred pounds. 

What happened in the low-calorie diet was that diabetic patients were able to reset their insulin levels and increase their body’s ability to process sugar. The question is why this study needed to be done at all. Shouldn’t diet be the first treatment for diabetes? But doctors reach first for drugs now, even in the U.K. You didn’t honestly think this kind of study would ever be done in the U.S., did you? Here’s more for the geeks among us, and here’s the original study abstract for your doctor.

 

The Truth About the Outback Vision Protocol

Here’s the question: if something is amazingly successful, why does it need to saturate the airwaves with advertising?

That’s the problem with the Outback Vision Protocol, which was first sent to me by a patient. The extremely long infomercial-style presentation promised me that two marvelous supplements would cure very serious vision problems. My hearty presenter informed me that these supplements, with the addition of kangaroo meat, are what a keen-eyed group of soldiers use for superhuman vision. They cured his wife’s eye problems and they could cure mine. 

Some of you already can see what’s coming. But if you’re one of the millions of people dealing with macular degeneration, you might keep reading and pull out your credit card. So let me save you the time.  

At long last, the supplements were revealed to me. They were (drumroll please) lutein and zeaxanthin. If I seem underwhelmed, I am. These are not mysterious or new. They’ve been around for decades. In fact, they’ve even been tested for exactly the sort of use that the presenter is making on his infomercial. AREDS 2 tested the use of lutein and zeaxanthin for macular degeneration because researchers saw enough possible benefit. The study was done, and the results are already back. 

“In the AREDS2 trial, adding DHA/EPA or lutein/zeaxanthin to the original formulation (containing beta-carotene) had no additional overall effect on the risk of advanced AMD.” 

So, yes, some supplementation can help with worsening macular degeneration risk, but it’s unsexy stuff  from AREDS 1 like:

  • 500 milligrams (mg) of vitamin C
  • 400 international units of vitamin E
  • 15 mg beta-carotene
  • 80 mg zinc as zinc oxide
  • 2 mg copper as cupric oxide

These were the original ingredients in AREDS 1, which did show benefit in preventing advancing macular degeneration. The Outback people say that AREDS supports their claims, but no one running the AREDS trials would support claiming that any supplement would reverse eye degeneration. 

I ask myself, if the study has already been done, why is this David Riley pushing supplements that don’t work? Well, to begin with, he’s not David Riley. It says so on his extensive disclaimer page. Another ad campaign features another name with the same protocol: Bill Campbell’s Outback Vision Protocol. We’ve got pages of fake reviews of the protocol by reviewers like “Jrhonest” who claims to write an honest review but just repastes the same information of the other fake reviews. The only place to get real reviews of the Protocol are on sites like Amazon that work hard to prevent the kind of spamming Campbell has done elsewhere. What does Amazon say? (The book has been pulled from Amazon because of terrible reviews, so the link now goes to German.) Save your money. 

So, before all of you ask me to write a book on vision loss, I’ve already started. Too many of you are in desperate need, and there’s nothing out there that really covers the eye the way I’d like. 

Update June 2018: Well, after months of research, it turns out we don’t have any large scale studies about the eyes. We don’t know whether starting glasses earlier, switching to bifocals, or even if delaying eye surgery will impact your eye health.

We’re also facing a global pandemic of eye disease that still hasn’t made it into the news. I’m talking about young people showing up with eye disease that shouldn’t hit until they are past retirement age. It’s striking Asian countries hardest, but we’re seeing a doubling of eye disease worldwide.

So I had to go back and relearn everything I thought I knew about the eye. I’m afraid I don’t have a definitive book on eye diseases. We just don’t have the big studies we need to say for sure what you should do.

What I have instead is an exploration of why we’re a hundred years behind in the study of the eyes. I’ve simplified the anatomy, optics, and research we do have in a folksy way that will hopefully reach the same people that the Outback folks are trying to get hooked on their program. (Here’s the book.) 

Is there any difference in what I’ve done and what the Outback folks have done? As far as I can tell, the Outback folks have taken the AREDS study, reversed its results, and are running with that study to promote two supplements as a cure-all. I’ve boiled down 225 citations into a simple explanation of how we can improve our eyes, or at least keep them from getting worse. It’s going to be very useful for middle aged duffers like me who are looking to improve their vision. I’m afraid it will be less helpful to those of you in dire need of much more. But it’s at least based in reality. 

I would never claim that my own eye improvements or my studies will magically make you better. But I think I have enough information about the eyes to at least point you in the right direction. 

You can order the book from Smashwords (independent authors’ site), where you can also preview the first chapters for free, or you can get it from Amazon (below).

Update July 2018:

I wanted to share one of the emails I’ve received because I think it is a  relevant concern. I’m also fascinated by the grammatical style, which reminds me of e.e. cummings (a great poet who never used punctuation or capitalization). If you read it that way it’s quite poetic. 

“what a riot

after smashing what’s his name for his bogus claims, you who claim to be the “voice of reason”
have put out an audiotape as well and are just another shill asking for money.

gutsy but iffy on your morals and good intent”

Here’s my response:

Good one! Except that you can sign up for audible, listen to my audio book for free, and then cancel your audible subscription  within the month without paying me a nickel. Please don’t try that with any of the infomercial folks. 
 
If you’d read the number of heartbreaking stories I’ve gotten from really desperate people, you’d write a book as well. I tried to find good studies on things like macular degeneration, but the best I could do is go through the small studies I could find.
 
Again, you’re welcome to not pay me one red cent and do the research yourself. All the studies I referenced in the book are available to read here (free google site). Again, please ask the infomercial folks for the same. 
 
The difference between my information and infomercials is that all my information is free and public. Infomercials claim to have “secret” knowledge you can only get through them. Kevin Trudeau was the king of this, claiming things like chromium picolinate was this secret cure for diabetes (it does help balance some people’s blood sugars). People would write me about the secret, and I’d send them the research.
 
 I’m just charging for the book because I spent the time writing it and  explaining it all. You don’t need me or anyone else if you want to do your own legwork. I’d love for someone to write a book on some of the rarer eye diseases. (Here’s medline to get started). 
 
At the same time, if you know someone who needs the information or the book and can’t afford it, I’ll be glad to send it to them for free. (Update: free copies have gone out to countries including the Philippines, Ghana, and Honduras. Thanks for writing!) 
 
The reason I put out my own audio book immediately is that I realized many people with severe eye issues can’t read well. So for them, I have a free option they can access, understand, and benefit from without paying me a penny. 
 
Thanks for writing,
Christopher Maloney
 
For those of you who still have questions about me, I’d recommend looking over my website: naturopathicmaine.com. Or email me at docmaloneynd@gmail.com. Don’t worry about hurting my feelings, I’ve been through colon cancer and had every swear word sent my way at one time or another. Evidently my trying to help people makes some people very angry. 
 
If you have a specific eye concern, I can tell you if anything in the book will be relevant for you. Don’t be shy, I’d much rather you wrote than wondered and got worse.
 
Thanks for caring enough about your eyes to try to learn about them!
 
If you’re lazy like I am and don’t feel like scrolling back up, remember that you can order the book from Smashwords (independent authors’ site), where you can also preview the first chapters for free, or you can get it from Amazon. Let me be clear that it is an exploration, not a definitive guide and it is written in a folksy way to try and keep your interest. 
 
 

How turmeric and diet can help NF1 patients.

A new study, brought to my attention by another patient, shows wonderful news for both children and adults with NF1. We finally have evidence that this genetic disease can be seriously improved through dietary intervention. It also gives evidence that supplements added to a bad diet won’t help much.

The study followed NF1 patients for six months, on either the Mediterranean or Western diets. Neither diet impacted the rate of neurofibromas. Then the researchers added 1200 mg (three capsules worth) of turmeric to the diets. Adding turmeric to the western diet did nothing. But adding it to the Mediterranean diet caused a slowing in the buildup of neurofibromas.

Having a diet and a single supplement slow the progression of a genetic disease is wonderful. It means that the disease is not genetic in its symptoms, but epigenetic. Epigenetics is the study of how the body turns off and on genes. The diet and the supplement were able to turn off the progression of neurofibromas.

But what is truly startling is that several of the patients experienced a reversal of existing neurofibromas! That’s not just epigenetic, that’s a switching on of other genes that are significantly repairing previous damage. It opens the door to moving NF1 away from the genetic category, into a metabolic disorder that should be addressed from birth.

In my book, Helping Your NF1 Child: A Parent’s Guide To Neurofibromatosis, I argue for this outlook on the illness. But I did not expect to have this kind of evidence that dietary and lifestyle interventions could reverse the disease.

Here’s the full study available for online reading. It is small and preliminary, but very exciting! We need more studies. 

Why Colon Cancer Won’t Be 100% Cured By A Mouse Study.

As someone who’s had colon cancer, I was excited by the Newsmax headline that trumpeted. “3-Step Treatment Cures Colorectal Cancer in Mice” (yes, I use a variety of news sources, NPR to Newsmax). But when they said that this new treatment was 100% cure, I got suspicious. 

When I get suspicious, I go digging. The Newsmax story didn’t give me enough specifics to find the original medical article, but I found it eventually. The original title is a mind-numbing, “Curative Multicycle Radioimmunotherapy Monitored by Quantitative SPECT/CT-Based Theranostics, Using Bispecific Antibody Pretargeting Strategy in Colorectal Cancer.” It makes me wonder if I missed the class in medical school on how to write the most boring headlines imaginable. 

The most exciting word of the headline is “curative.” These mice were cured. But these mice didn’t get colon cancer the normal way (bad lifestyle choices and poor genetics). They had human colon cancer cells xenografted onto them. If that sounds Dr. Frankensteinish, it is. You get a specifically bred mouse that won’t reject the human cells, then you graft on separately grown cancer cells. The result may or not be relevant to even cancer growth in regular mice. A lot of cancer research has moved away from these mice because regular mice give us a better sense of regular cancer growth. But the xenograft can use human cells, that may or may not give us a better sense of how human cancers would respond to a treatment.  

So maybe this is a cure for colon cancer? Well…maybe. How many mice were treated? Ten. How many got better? Ten, but they only assessed nine of the mice under a microscope. The abstract didn’t mention what happened to the tenth mouse. 

Before I sign up for this particular treatment, I think I’ll at least wait for the bigger mouse trial. Call me a skeptic, but I like at least a hundred xenografted Frankenstein mice in my studies before I think about it. Not to mention a primate trial, small experimental human trials on metastatic patients, and finally a large-scale trial of human patients. In other words, we’re years from having this news really be news you can use. 

Dr. Sarno, All THE RAGE, and Chronic Back Pain.

Today, for those of us in the chronic back pain field, Dr. Sarno is a bit of a legend. He has a perpetually best-selling book, multiple celebrity endorsements, and an established place in the NY medical community. When I wrote my own book on chronic back pain, I looked at him as a leader in the field. 

But the movie All The Rage brings that idea into a sharp contrast with the reality of Dr. Sarno’s ideas being largely ignored by his colleagues. Not just ignored, disregarded as foolish. In a world where we cut, inject, and numb with our strongest painkillers, Dr. Sarno’s solution of the mind has no place. His results were disregarded as placebo, and his colleagues did not refer their patients to him because they did not believe what he was doing could work.

In the past year we have had the medical realization that our strongest painkillers are not more effective than lesser, over-the-counter medication. They are also addictive, creating a crisis that kills patients and robs others of their health. Our surgeries are not as effective as advertised, leaving half of those going under the knife still in agony. We have no better solutions, and Dr. Sarno seems all the wiser for seeing the obvious well before the rest of his colleagues.

Is Dr. Sarno’s mind-over-pain the answer? No. But it is half the answer. The half that has been silenced, ignored, and ridiculed. Today we know that a patient’s emotional state before a surgery has as much effect on the pain after the surgery as the best surgical team. We know that chronic pain can appear and continue with or without any visible mechanical problem. And we know that the mind, when used properly, can be more effective at pain management than our most powerful drugs.

All The Rage captures the profoundly personal journey of chronic pain, detailing one family’s issues with chronic pain and their encounters with the enigmatic Dr. Sarno. Through them, we see his own journey, his progression from traditionalist to staunch pioneer in the pain field. All The Rage captures the beginning, the middle, and the end of Dr. Sarno’s career seen through the lens of a filmmaker forced to cross the fourth wall from objective observer to unwilling participant. In so doing, the film becomes as much autobiographical as biographical, giving us an intimate portrait of the true effect of chronic pain on a family. We see the origin, the arc, and the possible resolution of a lifelong dance with pain. By the end, the viewer wants to see more of the family’s journey, but hopes for their sake that no sequel is ever necessary.

If you have experienced chronic pain and wondered if perhaps there was an emotional aspect, Dr. Sarno is here on the screen to squinch up his bushy eyebrows and tell you, “Of course there is a direct relationship.” All the more helpful, now that he has left his practice and gone to that medical classroom in the sky. He passed away in June, 2017, leaving his books, his legacy, and this movie to catalogue his passing. While they did not appreciate him in his life, the medical community may yet learn to use what he left us to help solve the puzzle of intractable pain.

 

All The Rage (Saved by Sarno) from rumur on Vimeo.

A 200% Increase In Powassan Virus In Maine?

Is your inner anxiety not yet up to “impending catastrophe?” Are you not watching enough political media to make your blood boil? Here’s a new threat, possibly lurking in your backyard, Powassan virus!

The earliest mention of Powassan Virus in online medical journals is from 1959,  when it was first named after a town in Ontario where it was found. That 1959 medical article mentions that Powassan had probably been around for decades. So why are we hearing so much about it now?

Well, we’ve just had two cases of Powassan in Maine. By just, I mean that we just had two more cases. Two earlier cases this year were reported in a Bangor Daily article back in April. Those were from around Portland, and these two new ones are from the midcoast region. Bringing our total for the year to four cases.

At the same time, we’re counting hundreds of Lyme cases, so why do we care so much about Powassan? Well, according to the CDC, Maine only had two Powassan cases IN THE PAST TEN YEARS. So the four this year brings our total up to a headline causing,

“Two hundred percent increase in Powassan in Maine!”

Is Powassan a true terror? Yes and no. It’s not new to Maine, and previous surveys have found it widely spread (but not very common) among Maine’s tick populations. We had another notable outbreak at the turn of the Millenium, four cases that included both Maine and Vermont. Checking residents, between 1% and 4% of Mainers likely have antibodies to Powassan.

But Powassan is scary because it’s viral and we don’t have a good treatment. Arguably, we don’t have great treatments for Lyme either, but that’s a whole different issue (a bit more on that later). 

If you get Powassan, you very likely won’t get symptoms. If you do get symptoms, they feel like the flu and you’ll likely recover. But if you get symptoms and your body doesn’t kick it, there’s very little modern medicine can do for you besides support you. Just like any number of other viruses. 

If it starts to feel vaguely familiar, it should. Powassan is a flavivirus. Yes, like Zika virus. Different subspecies, same family. Powassan’s flaviviral branch includes Russian spring-summer encephalitis, Central European encephalitis, Omsk hemorrhagic fever, Kyasanur Forest disease, and Powassan. Just reading through its close family members, you should get the sense that Powassan is likely coming from a more northern branch of the flavivirus family than Zika.  

Also notice that every one of these viruses has a pretty scary sounding name. Omsk hemorrhagic fever sounds like a reason to never, ever visit Omsk, which Dostoevsky immortalized as “a hateful hellhole” but which likely influenced all his writing since he was imprisoned there. (They now have a museum for him.) 

A large part of the problem of the flaviviruses is that we’re still assigning every member of the flavivirus family a new name. Think about the flu viruses. We had swine flu, avian flu, etc. and they sound much scarier than H1N1, which is another variation of the same family of viruses. All of the flaviviruses should be assigned a number so that we understand that this isn’t a total unknown, this is another member of a well known and widespread set of viruses that has been with humanity for centuries. Public health officials have started the process by labeling the four different strains of Dengue fever (another flavivirus) one through four rather than giving them all different names like the four horsemen of the Apocolypse. 

According to the CDC, “Powassan (POW) virus is transmitted to humans by infected ticks. Approximately 75 cases of POW virus disease were reported in the United States over the past 10 years.” So our four cases of POW will really make the news. Maine, home of the Whoopie pie, the lobster roll, and the obscure tickborne illness. Is this really what we want to be known for? 

So, should we just watch out for ticks to protect ourselves from Powassan? Maybe. I would argue that the flaviviruses are largely misunderstood as only vector-borne diseases. I’ve mapped this out in Zika Virus When You’re Expecting and I talk about focusing on just ticks in Why Chronic Lyme Doesn’t (And Does) Exist. Blood born diseases need to be seen as more widespread and contagious than we’d like to think. 

But, because they are much more widespread, they also may be much less deadly than they would appear from the very few serious cases that get reported. Powassan reports of serious side effects may indicate a spread of the disease in Maine. But the number of symptom-free cases of Powassan will continue to dwarf the number of serious reported cases. 

Should you worry about Powassan? No more than you would about getting a serious flu and not recovering. While this year in Maine we had four hospitalizations from Powassan, we also had 586 hospitalizations for the flu.

For the few of you heedless folk who ignore the Lyme warnings, who’ve still been frolicking in the buff in tick-infested fields, I doubt if the added threat of Powassan will convince you to change your behavior. For those of us who are already avoiding the fields and doing tick checks, don’t let the fear of more rapid transmission of Powassan panic you. Continue doing what you’ve been doing, and take care of yourself if you get sick. As a virus, all of the things you would do to help yourself get better from the flu would apply to Powassan too.   

NYT Article On Salt: A Rhythm And Weight Loss

Salt may not make you thirsty, and it may help with weight loss. 

Yep, those on the conclusions of a NYT article on Russian Cosmonaut studies. Researchers rarely get to put people in isolation and measure all their excretions (what a great job!) so they can be forgiven for missing this particular discovery. 

It turns out that the cosmonauts had twenty-eight-day cycle of salt retention, even if they were on a low salt diet. Because these were men, it’s a new discovery. If they’d been women, everyone would have said, “I knew that.” 

The men also lost weight when they ate lots of salt, and weren’t thirstier overall. Again, this seems miraculous until you remember that iodine reacts with the thyroid to stimulate thyroid function. Lots of salt, lots of thyroid function. But the reason we don’t do tons of salt is because you can’t really control thyroid function well with salt. Sometimes it becomes active (weight loss) sometimes it gets very active (panic attack) and sometimes it desensitizes the body to thyroid (weight gain despite all your best efforts). 

So, while researchers scratch their heads, here’s the take home. Turns out men have a twenty-eight-day cycle too. If he’s cranky and looks bloated, it may really be his time of the month.