Vitamins and a Surgeon Enter the Chat - Choose the Winner

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Welcome Avatar! Every 3 months or so we usually find a couple of accounts with niche new content. BowTiedVitamins and BowTiedSurgeon are here to compete for $300 worth of BTC (second place gets $100 worth of BTC). In the end they both get something and please vote tomorrow on Twitter for the winner. a

Ditch Your Multivitamin (@BowTiedVitamins)

Supplements often get a bad rap in the health and fitness world. Due to the lack of regulation, there are many low-quality or even harmful products, scams, and marketing gimmicks. However, by using high-quality, targeted supplements, you can help your body reach its full, optimized potential.

Supplements provide essential nutrients to support your overall health. Food today contains fewer nutrients than it did 100 years ago due to mono-cropping and tradeoffs between crop yields and nutrient content. Meanwhile, filtered water and fluoride have contributed to lower mineral intake. Doctors have even vilified salt to the point where many people are now deficient in iodine.

40% of the population falls below the daily requirements for multiple micronutrients. Supplements can help fill in gaps in nutrition or achieve specific goals. Everyone reading this Substack desires to be the best, most optimized version of themselves. What you put into your body greatly impacts how you feel, including supplements.

Why You Should Ditch Your Multivitamin

Many people take multivitamins, thinking they can meet their daily nutrient needs with just one pill. However, multivitamins frequently fall short of expectations. Here’s why you should ditch yours:

1. The Dosages are Wrong

The origins of the modern-day multivitamin go back 75 years, when the Miles Laboratory developed the first One-A-Day based on newly published Recommended Daily Allowances (RDA). However, there is no rationale for combining all the vitamins you can think of into a single pill. In fact, many nutrients compete for absorption in the body, so taking so many nutrients at once may decrease your body’s ability to use them properly.

The dosages in multivitamins aren’t determined by what’s good for you. The truth is, it's all about marketing. Your multivitamin is probably full of the cheapest ingredients, with hardly any expensive ones. Even worse, producers frequently utilize minute quantities of pricey ingredients so that they may list them on the label. It’s a marketing game to make the fattest profit margins possible!

Most customers lack the education necessary to understand the recommended dosage for each nutrient. They simply check the ingredient list to make sure there are enough ingredients to cover all the required bases. Newsflash: it's physically impossible to combine all the essential nutrients in one pill at an adequate dosage. Consumers think they meet their nutritional needs if the label says it contains 100% of the RDA. But the RDA of most nutrients is, at best, the amount needed to prevent a deficiency, not necessarily a therapeutic amount that will help you optimize your health.

For example, according to some studies, as much as 75% of the U.S. population is vitamin D deficient (i.e., blood serum levels below 30 ng/ml). The RDA of vitamin D is 600 IU per day, and most multivitamins contain 1,000 IU. Every 1,000 IU you take will raise vitamin D blood levels by roughly 5 ng/ml, so depending on how deficient you are, neither the RDA nor most multivitamins will get you back to sufficient levels. Meanwhile, the reference range for vitamin D is 30-100 ng/ml. I guarantee you will feel significantly better if your vitamin D levels are 100 instead of 30.

2. The Ingredients are Wrong You

get what you pay for in the supplement world. Supplement manufacturers try to make the fattest profit margins by using cheap, low-quality ingredients. Cheap supplements are often packed with fillers and additives that interfere with your body’s ability to absorb the nutrients in the pill.

The body is a complicated system, and many nutrients rely on and work synergistically with each other. For example, magnesium is essential for proper vitamin D absorption, but many multivitamins are sorely lacking in magnesium. Meanwhile, vitamin K works synergistically with D to clear calcium from the arteries, and again, many multivitamins do not include K at all. Taking vitamin D without vitamin K can lead to heart problems.

The form of the ingredients matters too. Many multivitamins use folic acid, a synthetic form of folate (an essential B vitamin). Your body is very inefficient at utilizing folic acid, and it can even trigger weakness and fatigue, cause certain types of cancer, and mask a vitamin B12 deficiency.

You must choose supplement products in the proper forms (i.e., bioavailable, gentle, etc.) and doses for them to be safe and effective.

3. They Don’t Target Your Needs

Every body is different, and your nutrient needs will vary based on several factors. Multivitamins don’t allow you to personalize your supplement intake to optimize your health.

A multivitamin is often less expensive, but an investment in health and wellness is one of the best you can make. To achieve your full health potential, you should take complete control over your supplement intake and design a personalized regimen for your nutritional insufficiencies and functional health needs.

Sometimes, less is more. You don’t need to take a pill with every nutrient under the sun. What you need is a plan.

Build an Optimized Stack

By optimizing various nutrient levels, we can trigger hormones, neurotransmitters, and DNA to make the entire body function better and target things like fat loss, muscle gain, immunity, brain function, etc.

Multivitamins are better than nothing (in most cases). And in theory, pairing a high-quality multivitamin with good ingredients in proper balance with therapeutic doses of targeted individual supplements like vitamin D, krill oil, magnesium, and creatine would be an ideal solution. But even multivitamins that are considered high quality, like Thorne, still cut corners by including low-quality ingredients like folic acid.

Instead, you should take the time to figure out what nutrients YOU need. This involves regular blood tests (at least annually) to check nutrient levels and ensure your body’s systems are running optimally. If you need some guidance on blood work, check out my previous thread on Twitter. ←Source

Once you know where your deficiencies are, you can build a personalized supplement stack to help you get back on track. It can be as simple or as comprehensive as you want.

Take a Modular Approach

In my view, the best approach to building a supplement stack is a modular one. You want to put together a good base layer for overall health and add various modules targeted at specific goals or conditions. Your add-on modules might target nootropics, immunity, stress/anxiety, testosterone support, etc.

This doesn’t mean that each supplement only fits into one module or has one use, but this approach helps you to understand why you are taking certain things and how it all works together. For instance, you might not want or need a weightlifting module, but you might still include creatine as part of your base layer or nootropics module for the brain-boosting effects. This approach keeps you from just adding things to your stack because your coworker or your mom said it was good and winding up with 20 pills and no goal.

Build Your Base Layer

Let’s put together an excellent Healthy Living protocol as our base layer. These are supplements that almost everyone will benefit from, have multiple uses, and fit into multiple modules. Taken at therapeutic dosages, they will support and optimize your overall health. This is your multivitamin replacement:

• Magnesium – An essential micronutrient, it affects everything from energy to brain function, mood, and sleep

• Vitamin D – It is involved in almost every bodily process, is a building block for sex hormones, boosts immunity, curbs inflammation, and is essential for bone health

• Vitamin K – Works together with D for proper calcium metabolism, which is essential for bone and heart health

• Krill Oil – Omega-3 fatty acids have a powerful effect on brain health, inflammation, energy, mood disorders, and bone and joint health

• Ashwagandha – An ancient Ayurvedic herb that helps the body adapt to and withstand stress

• Creatine – Supports cellular energy function, which helps build lean muscle mass and boosts intelligence, memory, and mood. And no, it won’t make your hair fall out

• B complex – Studies suggest that taking a B complex supplement positively affects immunity, cell metabolism, energy levels, and cognitive function

For most people, this stack will significantly improve how they feel day to day, and it covers some common deficiencies. Others will still have targeted goals or deficiencies that require add-on modules.

Despite the prevalence of chronic disease, we can prolong life and increase the quality of life through a healthy lifestyle, including diet, exercise, and supplementation. Even if you are dialed in on your diet and exercise, the external stressors of life can take a significant toll on your health and well-being. You must have a systematic approach to your biology and how to optimize your health through targeted supplementation.

If you want help building your supplement stack, follow me on Twitter @BowTiedVitamins, where I show you which vitamins and supplements will help you achieve your best everyday health. Disclaimer: Nothing in this post is medical advice. Please consult your doctor before taking any supplements

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How to Plan for Procreation (@BowTied_Surgeon)

Birth control conversations are usually aimed towards women, but it takes two to tango. Everyone should know what options exist and be able to talk intelligently about them with their partner. Having a kid is a big responsibility and everyone involved in caring for new life should have a say in when to create it. The goal of this post is to do a broad overview of all the options out there and give you the information you need to make the best decision for you. Let’s get started!

*For this post failure rate is defined as the percentage of pregnancies that occur over the course of a year. Failure rate is from CDC data.

1. Natural birth control

• Abstinence This is the only 100% foolproof way to avoid pregnancy and STDs. If you are extremely risk averse and this fits into your lifestyle this is a good option. Methods to improve likelihood of abstinence included wearing crocs and not following @BowTiedFawn.

• Natural Family Planning The couple refrains from having sex while the woman is ovulating. It also helps determine fertility if you are trying to get pregnant. If you want to learn more about how to use this method to improve fertility check out the @BowTiedHeifer substack.

• In ovulation the egg leaves the ovary, it then travels up the Fallopian tube to the uterus. After ovulation, the egg lives for 24 hours. If it is not fertilized by sperm in that time it dies. Sperm can be viable for up to 5 days after ejaculation.

• Mechanisms for calculating fertility

  • Cervical mucous consistency: thin, watery, and stretchy when fertile

  • Basal body temperature: slight increase when fertile

  • Calendar method: Calculating based on menstrual cycle There are apps that can help with the process of tracking a cycle. The one I have used is to track my cycle is Clue.

• Failure rate: 23%

  • Pros: no procedures or hormones

  • Cons: Unreliable for women with irregular cycles and Must abstain from sex periodically

• Lactation as birth control o Infant suckling releases hormones that disrupt the normal hormonal pathway that causes ovulation. This prevents moms from having periods (lactational amenorrhea).

  • Failure rate: 2% for the first 6 months if the mom is breastfeeding exclusively (every 4 hours during the day and 6 hours overnight). This can be difficult for many women. Becoming pregnant less than a year after delivery can be dangerous for the mom so taking precautions is advisable.

  • Combined hormonal birth control should not be taken while breastfeeding.

• Pulling out: When a man ejaculates outside his partner

  • 23% failure rate

2. Barrier Methods

• Male condom

  • A barrier worn over the penis. Usually made of latex, plastic and lambskin are available for those with allergies.

    • Failure rate: 13%

  • Female condom

    • A barrier worn inside the vagina.

    • Failure rate: 21%

  • Diaphragm aka cervical cap

    • A barrier placed inside the vagina and over the cervix

    • Failure rate: 17%

  • Pros and cons are the same for each method:

    • Pros:

      • No procedure or hormones

      • Over the counter

    • Cons:

      • Can break, do not use with oil-based lubricants because these can weaken latex and increase risk of failure

      • One time use

3. Spermicide

A Chemical product designed to kill sperm. There are multiple versions, but a common ingredient is Nonoxynol-9.

• Failure rate: 21%

• Pros:

  • No procedures or hormones

  • Over the counter

• Cons:

  • Nonoxynol-9 is known to cause irritation to genital tissue

  • Irritation decreases the integrity of the skin increasing likelihood of STD transmission

4. Hormonal contraception:

This is the use of hormones to disrupt ovulation and prevent pregnancy. There are multiple delivery methods which I will talk about in more detail. There are two main types of hormonal birth control, combination (both estrogen and progesterone) and progesterone only. The diagram below depicts a normal hormonal menstrual cycle. Simply, estrogen spikes trigger ovulation (follicular phase) and progesterone facilitates endometrial growth (luteal phase). Changing the proportion of these hormones changes fertility.

Combination

• Inhibit release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This prevents the mid-cycle LH surge which initiates ovulation.

• Side effects

  • Early side effects:

    • Nausea, breast tenderness, and headaches can occur in less than 10 % of women

    • Breakthrough bleeding and changes in menstruation

  • Long term side effects:

    • Combined contraceptives trick the body into thinking it is pregnant. Therefore, many of the hormonal changes that result in disrupted homeostasis in pregnancy do the same with hormonal contraception. The same factors that can result in a riskier pregnancy (obesity, diabetes, smoking, age, other risk factors of stroke) make the use of combined contraceptives riskier. Modern versions have less estrogen than early versions. This has reduced the risk of these side effects but not eliminated it.

      • May cause mild elevation in blood pressure usually within normal limits if patient’s blood pressure is normal before starting

      • A 3-5-fold increase in relative risk for venous thromboembolism (A 5 fold increased risk is seen in pregnancy).

      • Normotensive, nonsmokers who use combined contraceptives have a stroke risk of 8.4 per 100,000. This is 2X the risk in the same population that did not use combined contraceptives. The risk of stroke during pregnancy is 30 per 100,000.

      • May effect carbohydrate and lipid metabolism. Of greatest concern for those with preexisting insulin resistance or hyperlipidemia.

      • They do not increase risk of breast cancer de novo. However, existing cancer may be worsened by them.

      • They can prevent ovarian cancer (odds ratio .72). This is because ovulation is prevented which decreases the number of lifetime ovulations, which in turn is correlated with reduced lifetime risk of ovarian cancer.

      • After stopping it can take time to regain fertility (~ 2-3 months).

    • Types combined hormonal birth control

      • Pill

      • Patch

      • Ring All have a failure rate: 7% The pill needs to be taken every day the patch and ring are only replaced once a month.

      • Pros: No procedure

      • Cons:

        • See side effects above

        • Cannot use while breast feeding

    • Progesterone

      • It primarily works through:

        • Thickening cervical mucus (inhibits sperm)

        • Preventing ovulation but not as reliably as estrogen containing contraceptives.

        • Slowing movement of an egg through the Fallopian tubes and reduces thickness of the endometrium.

        • Side effects

          • Unscheduled bleeding and changes in the menstrual cycle.

          • Avoids the risks of blood clots and hypertension seen in estrogen containing pills

        • Types of Progesterone only systemic birth control

          • The pill ▪ Failure rate: 7%

            • Pros: Can use while breastfeeding and No procedure

            • Cons:

              • See side effects above

              • Must take within the hour of the same time every day or it will lose effectiveness

          • Injection

            • Failure rate: 4 %

            • Pros:

              • Only get once every 3 months

              • Can use while breastfeeding

            • Cons: See side effects above

              • Procedure is involved

          • Subcutaneous implantable device

            • Failure rate: 0.1%

            • Pros: Can use while breastfeeding and Works for 3 years

            • Cons:

              • See side effects above

              • Procedure is involved

5. Intrauterine devices

• The main effect is to prevent binding of the egg to the wall of the uterus (implantation).

• Copper IUD

  • Prevents implantation by interfering with the structure of the uterus. o Causes irritation to the uterine wall, further discouraging implantation.

  • Side effects:

    • Worse bleeding and cramping during periods

    • Pain and cramping after insertion

    • Failure rate: 0.8%

    • Pros: Can last for 10 years before it needs replacement

    • No hormones

      • Cons:

        • See side effects above

        • Procedure for insertion and removal

        • Levonorgestrel IUD o Functions through structural interference like the copper IUD. o Releases small amounts of progesterone to aid in preventing ovulation and thickening secretions. Hormonal effects are localized to the uterus.

        • Side effects:

          • Changes to menstrual patterns

          • Pain and cramping after insertion

          • Failure rate: 0.1%

            • Pros: Can last for 3-6 years depending on the brand

            • No systemic hormone effects

          • Cons: See side effects above

            • Procedure for implantation and removal

6. Permanent Contraception

Only recommended if a couple is positive they don’t want more children.

• Tubal Ligation

  • Woman’s fallopian tubes are tied preventing sperm and eggs from meeting

  • Failure rate: 0.5%

  • Pros

    • One time procedure

  • Cons:

    • This is a large abdominal procedure with a significant recovery time

    • Irreversible

  • Vasectomy

    • This is when a man’s vas deferens (tube that carries semen from the testicle to the penis) is cut

    • Failure rate: 1.5%

    • Pros:

      • One time procedure

      • No effect on male hormone production (common misconception)

    • Cons:

      • This is an open procedure, low risk but painful recovery

      • Irreversible

      • It takes 12 weeks for sperm count to drop to zero after the procedure

And that’s the down and dirty on birth control. This was a lot, I know, but when it comes to making decisions about healthcare, I want you to have ALL the facts. I hope this adds to your life toolbox, giving you control over your life and how you want to live it.

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Quite different in terms of topic and writing style. Starting to realize how far the reach of the jungle goes. Surgeons, Dentists, Doctors, Lawyers, Wall Street, Software, Fitness, Handymen etc. It’s going to be an interesting building process. That said, there can be only one winner so place your vote on twitter when we release the poll tomorrow. Thank you to both Surgeon and Vitamins for their informative contributions!

Just in case it needs to be said, none of this is to be deemed as a recommendation.

The post is meant to be information based and you should always do your own research on any topic.

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Disclaimer: None of this is to be deemed legal or financial advice of any kind. These are *opinions* written by an anonymous group of Ex-Wall Street Tech Bankers and software engineers who moved into affiliate marketing and e-commerce. We’re an advisor for Synapse Protocol and on the JPEG team.

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