“I discuss melatonin’s effects on sleep & its safety with research up to 2015; I segue into the general benefits of sleep and the severely disrupted sleep of the modern Western world, the cost of melatonin use and the benefit (eg. enforcing regular bedtimes), followed by a basic cost-benefit analysis of melatonin concluding that the net profit is large enough to be worth giving it a try barring unusual conditions or very pessimistic safety estimates.”-Gwern Branwen, “Melatonin.” gwern.net. 14 February 2015.
Blue Zones is a good place to start. However, if I were to give advice to my younger self, I’d focus on:
- Sleep: Get a full night’s sleep and take a midday nap for a total of eight hours.
- Food: Limit eating to four consecutive hours a day. Eat mostly plants. Drink powdered psyllium and water to stave off hunger feelings in the off hours.
- Exercise: Walk/run for 16,000 steps a day or 8 miles, incorporating a full range of movement. Include some weight-bearing activity or physical training twice a week.
- Social: Cultivate a social environment for flourishing among family, friends and your larger social circle. Be a positive, creative person and look for the same in others. Relentlessly prune relationships that are predominantly negative.
- Being & Doing: Find something to do that leaves the world slightly better than you found it and promotes good sleeping, eating, exercise and social habits. The Buddhist idea of the Noble Eightfold Path is a useful model of how to be and what to do.
“So why did they get such different results from so many earlier studies? In their response to Kripke, they offer a clear answer:
They adjusted for three hundred confounders.
This is a totally unreasonable number of confounders to adjust for. I’ve never seen any other study do anything even close. Most other papers in this area have adjusted for ten or twenty confounders. Kripke’s study adjusted for age, sex, ethnicity, marital status, BMI, alcohol use, smoking, and twelve diseases. Adjusting for nineteen things is impressive. It’s the sort of thing you do when you really want to cover your bases. Adjusting for 300 different confounders is totally above and beyond what anyone would normally consider.
Reading between the lines, one of the P&a co-authors was Robert Glynn, a Harvard professor of statistics who helped develop an algorithm that automatically identifies massive numbers of confounders to form a ‘propensity score’, then adjusts for it. The P&a study was one of the first applications of the algorithm on a controversial medical question. It looks like this study was partly intended to test it out. And it got the opposite result from almost every past study in this field.”—Scott Alexander, “More Confounders.” Slate Star Codex. June 24, 2019.
Open question: Are sleep aids bad for you?
Open question: Are confounders one of the central problems of reproducibility in science?
“The point of this book is to persuade you that the benefits of napping, scientifically derived, are so great you should do everything you can to make napping a habit whatever your schedule. As this concise guide makes clear the benefits to nappers are significant: smarter, more productive, healthier. For those who have tried napping without success, this book offers several different methods to try.”
—Kevin Kelly, “Take a Nap! Change Your Life.” Cool Tools.
From the excerpt: “There is no such thing as a bad nap.”
“Over the last 4–5 years, my main hobby has been to get that by hacking my body and mind using a logical, science-based approach…
…People like me will be able to pay for this out of pocket and use off-label prescriptions from private doctors who focus on upgrading and prevention rather than merely healing. Downstream the extra mood, energy, focus, health, willpower and social skills — enhanced over decades — will accrue further and further advantages to people who upgrade themselves, which will lead to a cycle of further concentration of wealth.”
—Serge Faguet, “I’m 32 and spent $200k on biohacking. Became calmer, thinner, extroverted, healthier & happier.” hackernoon.com. September 25, 2017.
N of 1 experimentation is valuable. The problem in this case is he is arguing hockey stick, compounding returns when the more likely scenario is that he’s going to give himself some form of chronic illness over the long-term. You’re only 32. Do you believe 40 years of thyroid supplementation isn’t going to lead to a health problem?
There is useful advice in write-ups such as this one. Thinking about sleep hygiene, eliminating sugar from your diet, intermittent fasting, weight-training built around deadlifts and squats, HITT training for cardio, meditation/cognitive therapy are probably all good ideas.
The place it goes off the rails is with medications and supplements. A low dose of 5mg of lithium is probably alright. If you take ~100-150mg as he is, you better have normal kidney function. Magnesium supplementation is also probably a good idea, since most of us aren’t eating big leafy vegetables at the same rate our ancestors did.
I could even get behind the very occasional therapeutic use of psychoactive compounds such as MDMA, psilocybin mushrooms, LSD, etc. If they were used to to augment a program of meditation and periodic hours in an isolation tank.
But hormone therapy? Playing sorcerer’s apprentice with your hormones strikes me as a singularly bad idea.