"Whereas puberty was an explosion of joy"
?
I don't get why Pfizer didn't pursue the period pain angle. The potential market had to be far larger than ED.
It seems to be pharmaceutical capitalism's equivalent of "That £5 note can't be there or someone would have picked it up".
I was just at a talk about neurodegenerative disorders yesterday. It's true across genders and disorders that physiological signs precede and don't map perfectly to obvious impairment. More than eighty percent of us will die with observable degeneration in our brains. You're more likely to present as "having Alzheimer's" if you have amyloid plaques and some other physiological sign of disease burden. The speaker posited that "normal cognitive decline" was in fact due to these processes. If tests aren't normed by gender then it makes sense that this disconnect would be somewhat bigger for women -- it's just probably not unique to them.
It wasn't intended to be charitable.
It implies that Pfizer subscribes to Chicago economics, and will therefore be cobalt-bombed under Halfordismo.
So I'm saying, heebie, maybe you're being a bit emotional.
8. The prominence of Chicago (see: whatever thread that was) as the hub of the Midwest led to the existence of the UofC and its Economics department. In an alternate reality, Halfordismo requires cobalt-bombing St. Louis.
This came out a few years ago, that the tests we were using to diagnose Alzheimer's were not sensitive enough for women at the early stages. Because women score better than men on cognitive tests and always have.
So this problem is due to a combination of patriarchy and men literally being too stupid.
3-5: I wonder if they thought it would interfere with marketing for their boner drug by getting girl-cooties on it. Viagra had to be a license to print money -- it's a smaller market, but probably one with a much higher price per dose -- and I could imagine thinking that men would be less likely to buy a drug that was associated in their mind with period cramps than one just for boners.
Maybe, but it's pretty common to market the same thing to different markets by sticking a new name on it.
On the article, I read it and got suspicious of the researcher on general principles. Like, the final section of diet advice sounded like Gwyneth Paltrow Goop bullshit, which makes me wonder about the validity of the research.
I do not believe this is a true statement:
And another thing I was surprised to learn that is so bad for women is commercially grown, non-organic foods, whether vegetables and fruits or animal products, which then act like bad estrogens, so they really mess up your hormonal balance to the point that they are putting xenoestrogens -- foreign estrogens -- into your body. They have such an estrogen disrupting effect in the body that the American Endocrine Society clearly labeled them as a health hazard.
Arsenic has been given to chickens as an antibiotic.
She advises against caffeine? I mean, all she says about it is that for some women it's a trigger for night sweats, but it's in the context of this panicky 'menopause will make you lose your mind' article, so the implication is that caffeine has something to do with the mind-losing. And she doesn't reference any research, and I've certainly never heard of any.
So overall I think the whole thing is probably bullshit on some level.
I'm fairly confident caffeine is actually making me lose my mind. Very slowly.
Caffiene has two effects on me, and they are both good things, but there are times when I wish I could only get one of the effects.
Sometimes you want a diuretic and to stay sleepy.
19: Yes, but more frequently the opposite.
I tried looking at the literature on Viagra for period pain yesterday after seeing this quote elsewhere, and it didn't seem like the research matched the quote. There is a study saying it gives twice as much pain relief as a placebo, but as far as I could tell there wasn't anything saying it was better than ibuprofen and furthermore headaches are a common side-affect, so it probably was only if interest to people whose stomach can't handle NSAIDs. What I think this is referring to is later research saying that vaginal administration (instead of a pill) eliminated the side-affects in a very small sample size. But I still don't see anything saying it's better than ibuprofen. And of course the person whose grant got turned down is mad about it, but that's not much evidence either way. But it's not my field and I could well be missing something.
Oh thank god. For a moment there I thought capitalism had failed.
It cannot fail, it can only be failed.
But on the basis of the bullshitty stuff I was bitching about elsewhere in the article, I'd totally believe the Viagra stuff was bullshit too.
I agree with 21. They know about this market. They are not afraid to market things to women. Companies make lots of money by selling period cramp relievers that don't work. If something did work, they would make even more money. And if it's the same molecule as Viagra, they can sell it under a different name and nobody will care. They sell Ibuprofen under the name "Motrin" and market it to women for women's problems and then they also sell it under other names.
So in conclusion it's a shoddy article and we can all unrattle and derage ourselves?
So the doctor can see plaques on the brain, they know these women have Alzheimer's, but they're testing well on cognitive exams.
That's a very odd statement, given how therapies based on the amyloid hypothesis have been faring for the last several decades. I was unaware that there was a clear definition of Alzheimer's that's independent of doing poorly on cognitive exams.
Right. The tone of the article would make you think that women are badly cognitively damaged in a discontinuous way at menopause, while men just age gradually. But what is actually described is something that you can't measure by cognitive exams.
Indeed. It's "clearly having a problem" which sounds extremely vague.
Women in late middle age, they walk into a room and you can just tell they're a little slow and ditzy, not really on top of things. When those clear deficits don't show up on tests, it just goes to show you how limited testing is.
Does this mean I shouldn't put a jade egg in my urethra?
I would never tell you not to follow your bliss.
26: The speaker I saw yesterday (this person) seemed to be regarding the presence of amyloid deposits as a definitive biomarker for the disease. That doesn't mean they're the cause or an effective target of treatment.
Is testing for amyloid plaques conventional clinical practice yet? This makes it look as if it isn't: https://www.alz.org/alzheimers-dementia/research_progress/earlier-diagnosis
At which point I'm again wondering what the researcher in the article is talking about when she says 'the doctor can see plaques on the brain'. Is she talking about some particular research paper?
Oh, I just looked back at the article. That quote isn't Mosconi, the researcher, it's a question the writer is asking, which gets a sort of implicitly affirmative answer, but not one that commits to saying that patients are actually conventionally getting tested for the presence of plaques.
Being a little slow and ditzy and not really on top of things is just the baseline state for women in late middle age, women in early middle age, men 25-34, retired French people, former service-sector workers in the Midwest and in fact all of humanity.
What I think this is referring to is later research saying that vaginal administration (instead of a pill) eliminated the side-affects in a very small sample size. But I still don't see anything saying it's better than ibuprofen. And of course the person whose grant got turned down is mad about it, but that's not much evidence either way. But it's not my field and I could well be missing something.
But this is consistent with a promising pilot study that couldn't get funding and therefore has never been well-researched.
One might imagine new type of delivery device for such a drug. It would need to small and round, and smooth for comfort; egg-shaped, perhaps. One might even envision a market for high-end luxury devices, carved perhaps of semi-precious stones.
I'm not saying there's nothing there, but "a promising alternative to NSAIDs but which is unlikely to ever become the first line treatment and which has to be administered vaginally" is a far cry from the quote in the article.
Pfizer seems to have a thing with questionable decisions about drug development (and Alzheimer's).
That said, I totally believe that one of the referees for the grant really was a terrible person who said something lazy and sexist in the report. Possibly the grant should have been funded, but the drug companies aren't ignoring a likely success either way.
40 is interesting. I think calling it "questionable" carries a (possibly) unfair connotation, since the decision obviously is very difficult to evaluate without subject expertise which I think neither of us have.
Do pharma companies do joint ventures to mitigate risk, the way oil companies and film studios do?
So much to say about this but am at an airport on a layover. To 33, no, a $1200 scan is not standard practice when a doc can ask you to draw a clock face showing 10:25 and ask you to remember an address as a diagnosis. In some cases, where non-Alz dementia is suspected, a scan can distinguish type and direct treatment. Scans are generally used in clinical trials where plaque burden can be used as a proxy for treatment success . . . except it's a crap proxy and pharma is losing tons of drug development on it.
40/42: I hate to say this, but if there were a legit chance that it could treat Alz, it would have been a goldmine for Pfizer. They must have sliced and diced that data until no hope remained. I suspect they are looking for a partner to investigate at low/no cost to them, but I strongly suspect this was in no way a bad decision on their part. Competitors have lost big on clinical trials that failed; I can't blame them for being cautious about sinking millions into a loser.
Oops, last two are me. To 26, Amyvid scans are diagnostic. I think FDG scans are not. And yes re: plaque theory, especially after the solanezumab/Lily debacle.
I think calling it "questionable" carries a (possibly) unfair connotation, since the decision obviously is very difficult to evaluate without subject expertise which I think neither of us have.
Well, it's the framing of the article, which clearly takes the side of the people portraying it as a bad decision. That may well be a mistake.
I think the article about Pfizer and Alzheimer's is overblown. Pfizer (and most other pharmas) have sunk a lot of money into Alzheimers' and would jump at anything that shows even partial effects, since this is a gold mine. There is a nice discussion about this article here:
I finished the article in 40 and I think ydnew is right. Enbrel costs about as much per year as an apartment in a non-coastal city and isn't covered by many types of insurance, including Medicare. Poor people are not nearly as likely to get it and education/etc are related to delayed onset of dementia and Alzheimer's. The write-up doesn't mention if they they tried to control for economic status, so I'm guessing not. I think they found nothing more than another proof that being poor sucks.
48 before seeing 47, which I also think is right.
You just have to look at the Alz category on Derek's blog to see that the whole amyloid hypothesis is in plenty of trouble:
https://blogs.sciencemag.org/pipeline/archives/category/alzheimers-disease
It's quite strange that we're still using them as an indicator for research purposes when they are being abandoned as a target for drugs on the grounds that getting rid of them doesn't seem to have any effect and people who die without any symptoms have them.
re: 15
She advises against caffeine?
That's usually an indicator of bullshit, for me. Almost any time I read any article with nutritional or exercise advise that strongly advises you to cut out caffeine, I almost immediately discount the author as a bullshitter, or a woo-merchant.
I wonder how many of the people arguing against caffeine on health grounds aren't just LDS
There's a giant LDS building right behind my office. I never noticed it until I moved to this building so I was always wondering where the young men in white shirts were coming from.
Joseph Smith didn't care about caffeine; it was the coffee stains on the crisp white shirts that he abhorred.
Derek Lowe's blog is great!
She advises against caffeine?
Wasn't there a study that just got published that said that coffee is not bad for you? One study participant drank 25 cups a day with no ill effects. "Five cups" was their idea of "a lot," though.
My experience with coffee is that drinking a lot of it eventually burns out your caffeine receptors. I think I passed this milestone when I was still in grad school. The acidity effect never really goes away, though.
"In order to maintain a healthy heart and a healthy blood pressure, people must limit their coffees to fewer than six cups a day," Prof. Hyppönen said. "Based on our data, six was the tipping point where caffeine started to negatively affect cardiovascular risk."
https://www.docwirenews.com/docwire-pick/cardiology-picks/coffee-caffiene-cardiovascular-disease/
I'm sure this is the final word on this topic.
57 That and game 7 of the 2004 ALCS.
I've been at zero caffeine (even chocolate) for about 18 months now to deal with drastically fibrocystic breasts. The surgeon said I could start using caffeine again after menopause, though! Maybe by the time I get there this will have been sorted out.
It is! I don't even have to take my pills (six ibuprofen 3-4 times a day, vitamins D and E and evening primrose oil at night) most days and only a few days a month are painful now. I have only had I think two lumps since getting it under control. I hate having to wear sports bras at all times, but the pain before was almost more than I could stand so it's an okay tradeoff.
Wow. I'm glad there's an accessible solution!
Coffee and pain is worse than no coffee and no pain for me also.
when a doc can ask you to draw a clock face showing 10:25 and ask you to remember an address as a diagnosis
This will get more difficult as millennials age.
I still remember my dad spectacularly failing a mini-mental while still saying, "I think it's a mistake, but people voted for Trump" when asked who the president is.
58. Talk about burying on the lede!
According to the results, there was a nonlinear association between heavy coffee intake (6 or more cups per day) and increased risk for cardiovascular disease. The risk was similar to that seen in participants who didn't drink coffee at all and also those who reported drinking decaffeinated coffee. Participants who drank one to two cups of coffee per day had a comparatively lower risk for cardiovascular disease compared to nondrinkers and heavy coffee drinkers.
There's probably a spurious correlation between not drinking coffee and poor cardiovascular health.
my impression is that coffee/tea is associated with lower risk of Alzheimer's. not sure if pure caffeine is the same. https://www.bmj.com/content/359/bmj.j5024
My doctor also advised me to reduce caffeine (SVTs, basically), but for me somewhere around the 4 - 5 coffee level is fine, in terms of remaining symptom free. So yeah, there can be reasons to moderate it (as per Thorn above), but there's also quite a lot of benefits from moderate coffee intake (also mentioned above), and most of the people who agitate against it in toto are the same people who are for zero alcohol. It's puritanism or some kind of hair shirt thing.
I am actually in this position now. I am definitely losing it in some mild sense; I pause for ages in the middle of sentences trying to find the next word; can't think of words generally; and am having trouble with the basic math needed to cut recipes or increase them by half. this has been fairly sudden onset. I have been to see the memory specialist neurologist and despite my doing perfectly on the ordinary memory test, he has ordered a two hour-long in-depth memory assessment, an MRI (that was fine), a PET scan, and a fucking spinal tap which will require at least one night in the hospital, and in the worst case among his patients, two weeks. my sister says it doesn't hurt as badly as all that but is no fun.
I think it's drug interaction from the SIX psych meds I take, but he says we have to rule out the serious things before attributing the problem to minor ones. I'm not experiencing any menopause symptoms yet, though I guess they could start. he says the ordinary test is likely to fail to catch early stage problems because if you are too smart to begin with you'll ace it regardless, hence the longer one (I can't help regard this as an academic test I might fail.) it's a bit alarming, frankly, though I'm not so worried about it as to refrain from putting all the tests off till august. like most people I think that if I actually got alzheimer's I'd eat a gun at some point, but there's always the worry you'd wait too long. however I really don't think it's anything serious. more like annoying/anxiety inducing.
the main health benefits of coffee are tasting good and keeping you awake and alert when you need to do a thing. (I mean, sometimes it's iced coffee!) or just for when you need to dork around on the loserweb. who cares about cardiac whatever.
Or maybe you have delayed onset rabies from the goddamn feral dog that bit you in Thailand.
re: 73
Absolutely not to trivialise this, but a few years ago, I was utterly convinced of my cognitive decline. My memory seemed to be hopelessly bad and my ability to coordinate multiple competing mental tasks was just destroyed. So, I bought a couple of memory books, and did some tests, and my actual scores were completely out of whack with my perception of where my ability was.
Stress and lack of sleep, combined with depression, were basically the active cause. Once those slightly resolved -- and being honest, it's more like 1 out of 3 got better, the other two got slightly better but are still crap -- my apparent cognitive decline was gone.
Having a small child around really doesn't help any mental ability you have. When C got to age five, it was like having blinders pulled off my brain.
75: that's a good point.
76: likewise. I'm glad you felt better! I think it's probably just stress, I am super stressed-out on a variety of fronts. I would be totally unsurprised if this resolves completely when things get calmer. I even feel I'm a bit better now and am sort of inclined to say no to the spinal tap, but maybe I'm just being a big baby and should be conscientious to make up for my younger blithe lacks of common sense about rabies.
The thing about a spinal tap is that they tell you not to get up for 12 hours afterwards. Believe them. I did so once because I felt well about to pee about four hours after the procedure. About 12 hours after *that* I was taken away from my parents' home on a stretcher, vomiting with the pain of my headache and spent another week in hospital.
The procedure itself didn't hurt exactly, but the combination of pressure and the grating and crunching noise as the needle approached vertebrae was very unpleasant. I think I was being used for training, since I was about 28 at the time and thus robust.
PS to 78: "Can you remember your name, dear? Your NAME? Do you know where you live? Can you remember how you came here? ..."
al - what is the rationale for the spinal tap? I'm not a doctor, but if they're doing an invasive test like that, I'd like to know why first and how doing the test would affect my treatment.
81: I think they're sending the fluid off to the US to be analyzed for the presence of certain proteins? that might indicate early stage dementia? maybe I'm not 1000% clear on the desired result though I see the rationale.
NW: I guess that's why they want me to stay in the hospital.
81: Alameida is correct. Details: https://www.alzinfo.org/articles/spinal-tap-detect-alzheimers-early/
I hope whatever's wrong is easily corrected. For what it's worth, the vast majority of folks with progressive dementia of some kind also have anognosia, meaning that they cannot perceive that anything is wrong. It's not denial, just a strange symptom. Noticing a deficit, in my most definitely non-medical opinion, is less troubling than having someone else notice one.
Why can't Narnia do the tests itself?
Always winter, never spectrometer-mass.
86 made me laugh hard. I'd guess maybe there isn't a lab with regulatory approval yet? The test is new-ish.
Oh, also, MH, the annual US mass spec conference is called ASMS, which most folks pronounce "assmas," which makes yours even more perfect.
I had a very noticeable (to me) cognitive decline in my late teens thanks to psych drugs, so I lean toward that explanation, but it seems wise to get checked more broadly.
husband x noticed it, unfortunately, or I never would have done anything about it at all. well, I noticed it first and said, 'hey do I seem like a moron lately or what' and he said 'yyyy...no darling you're a genius. but you have seemed pretty out of it. in a genius way.' seriously, I'm taking a ton of anti-psychotics and have been for three years; there's no way that's not what's wrong. I see not wanting to experimentally take me off them on the grounds that I might would go loco, so that obvious avenue is forestalled, but still, nothing else is wrong. no harm in checking as long as insurance will pay for it. I have no psychological coverage, so the neurologist has to convince them this is meaningfully normal doctorin' what involves your atchul body and/or maybe superposition of quantum effects rather than something partaking of the jungian collective unconscious or what have you.