Its' not a bad article. I had long ago heard about the hypothesis that women have a more complex immune system so they can carry a pregnancy to term and not reject the baby immediately as something invasive. (And that's a hypothesis that makes sense to me.)
But I would add that we already know that female menstruation impacts certain specific disease processes, such as heart disease. Men get advised to donate blood to lower their risk of heart disease. Women who are still menstruating don't need to do that.
Covid is known to impact the blood significantly. Blood differences between men and women could play a role in difference in outcomes between men and women for this condition.
Women who have been pregnant become chimeras. They get cells from the baby that stay in their system. They also share a blood supply with the baby.
I have a serious and incurable congenital disorder. I'm convinced my two pregnancies were hugely beneficial to my long-term health for a long list of reasons, possibly including having cells still in me from one child who did not inherit the disorder.
So I'm interested in this topic for personal reasons and I've read a bit about such things over the years and I think it's probably hugely more complicated than this article suggests.
> Men get advised to donate blood to lower their risk of heart disease.
I had never heard of that and did not find any article supporting that from a quick search. I found observational studies concluding that men who donate blood are less at risk for heart attacks, but did not control for selection bias (men who choose to or can donate blood are healthier) or for causes associated with the blood donation (e.g. you might discover you have high blood pressure while donating and seek treatment afterwards).
When I was diagnosed with high blood pressure I asked my doctor if I could donate more blood to lower it and she laughed and said your veins are not rigid pipes so it's not that easy.
Depends how they laugh. You can laugh in a good natured way at what should be a logical step but weirdly isn’t because of a non-obvious component of a system. They are funny in a similar way to how a joke is- something about the sudden change in perspective but with an flaw in the logic. But you are right that you need to make it clear you aren’t laughing at them to avoid such confusion.
I see what you mean, but I probably would have laughed at that because it's a really clever solution, not out of scorn. I am guessing a doctor that has spent decade hearing about various blood pressure medications and treatment would have an instant of "That's funny, why can't we just empty them a bit?"
Not a fan of the Socratic method, I see. When I was a child my father would ask me and my siblings "Which is heavier, a pound of feathers or a pound of lead?"
It wasn't a stupid question, it was an enlightening question, and your "stupid" question would not have sparked further discussion if you'd not asked it.
Why do you ask? Oh, for purposes of helpful demonstration. Seems like a question that is stupid by letter but not by spirit.
I do concede that there are dumb questions, of course. Although typically I like to say, there are no dumb questions but there are dumb times to ask questions.
Your answer isn't in weight but I asked how heavy it is, I expect a weight as answer.
Also I just doped a 1KG block of iron on my head from 1mm distance and it didn't hurt me. Then I cold rolled the block of iron into a 4x4m sheet of metal and I was unable to carry it around for more than a few seconds. Your answer is not only useless its also demonstrably wrong.
when doctors laugh at me (I ask a lot of questions like this) I typically show them the underlying scientific article that supports it, and ask them if they've read it.
The doctor laughed at that? Even if wrong that’s a pretty intuitive thing to think. It’s a very reasonable question - as would the inverse (adding more blood to raise pressure).
I doubt it was a "ha-ha you're a stupid idiot" laugh but more of the sort of laugh you'd do when a toddler does something that makes perfect common sense, but violates social norms (like discussing their bowel movements with strangers).
Not exactly my field, but IIRC blood pressure is not a passive result of how much blood is present, but rather is regulated by the body through a series of control networks. Removing blood does not reduce blood pressure (the body recognizes the dip and will adjust, plus more blood is made again quickly) because the problem is not that there is too much blood, but rather that the pressure setpoint is wrong.
Things like atherosclerosis reduce the space available for blood and increase the pressure without the body realizing the setpoint needs to change, thus why pressure increases.
It's a completely reasonable question. Blood pressure is a function of many variables, including vascular resistance, compliance, heart function, and --yes-- blood volume. In fact, one of the treatments for blood pressure, though rarely a first line, is to use a diuretic to reduce fluid volume. As other posters have commented, the body will compensate this to some degree, and it is not a very lasting or well-controlled effect, so the doctor is correct that bloodletting is not the standard of care for hypertension. But a mental experiment on the extreme margins can help address the question intuitively as well: suppose you removed all the blood, or else suppose you 100x-ed the blood supply. Would pressure fall and rise respectively? Of course it would.
Blood pressure is more of a function of resistance to flow than volume (ignoring things like trauma induced hypovolemic shock - aka bleeding out) - which can be from many causes, including vasodilation/constriction, plaque buildup, compartment syndrome, heart issues (bad rhythm, valve issues, etc.), shock, or regulatory dysfunctions indirectly impacting those areas.
Volume issues, especially difficulty processing waste/removing excess fluid (renal failure or disfunction), can pop up, but reducing volume as a solution is kind of like taking gas out of your gas tank because your throttle keeps getting stuck and you don't want to run anyone over.
Yeah, it can kinda help maybe (and if you're desperate you should do it), but it isn't really addressing the underlying issue. Sometimes you don't have time or the ability to address the underlying issue, but it shouldn't be the first thing to go to.
Not ridiculous that say excess iron or blood volume could be an issue or help if addressed - just not a high odds thing to be tackling usually.
Quick and dirty search gets me a piece titled Health benefits of blood donation which says (in part):
Studies have shown that, in general, Americans tend to consume more iron on a daily basis than is necessary for good health. Ingestion of quantities of iron beyond a certain quantity can promote formation of free radicals in the body. Free radicals have justly earned their reputation for causing cellular changes which can disrupt normal cell function and increase the risk of certain chronic diseases such as heart disease and cancer. This is more likely to be a problem for men and post menopausal women...
The paragraph you quoted references (but does not cite) studies about the effect of excessive iron consumption, not evidence for a causal link from blood donation to reduced cardiovascular risks.
It seems that there is some correlation between cardiovascular risk and blood donation, but this might just be due to a confounding factor: healthy people tend to donate blood more.
E.g. this study [1]:
Despite the significant difference in QRISK2 parameters between study groups, none of these parameters was correlated to the extent of donation when controlling for age, BMI and smoking status.
Or this one [2]:
No significant associations were found between blood donation and the risk of myocardial infarction in analyses restricted to men with hypercholesterolemia or those who never used antioxidant supplements or aspirin.
The study results do not support the hypothesis that reduced body iron stores lower CHD risk.
Ironically this other Dutch study [3], shows an association (not causal) between frequent blood donation and cardiovascular health in women but not in men.
My recollection is that the inference that men should donate blood to protect their heart health is based at least in part on the fact that women see an increase in heart disease around the time they stop menstruating:
Once women reach the age of 50, about the age of natural menopause, their risk for heart disease increases dramatically.
> Once women reach the age of 50, about the age of natural menopause, their risk for heart disease increases dramatically.
Wouldn't the hormonal changes associated with menopause be a more likely explanation for the increase in heart disease risk than the fact they are no longer losing blood periodically?
The correct answer is probably "both" rather than only one or the other. It's humans that like to create simple explanations and clear cut categories, not nature. Nature gives us egg-laying mammals because nature didn't ask our opinion beforehand.
Aside from the obvious (meat, nuts), fortification of processed foods is more common in the US than other countires, and the FDA has some mandatory fortification rules. Breakfast cereals and flour are required to be fortified with iron, amongst other things.
My wife is a phlebotomist. She often sees men who've been prescribed blood donation to control their iron levels. Unfortunately that blood has to be discarded because of the high iron level.
Thanks for searching, I hope parent would be able to provide further details on that statement.
I got O -ve so I maintained >45 Kgs weight(min required) so I could donate when needed but my bones couldn't take it (Osteoporosis, Achondroplasia) and so now I've reduced my weight to 40 Kgs; It was bummer to hear donating lowers risk of heart disease although I wish it was true as its a win-win for donating blood.
The mother and child's blood supply remain separate throughout the pregnancy. Some mixing can occur during childbirth (which is why Rh- women can have one baby that's fine and the next one gets ill).
True, though this can be suppressed by a series of injections during the first pregnancy: “Rhesus disease is uncommon these days because it can usually be prevented using injections of a medication called anti-D immunoglobulin.” - allowing mothers to safely have more than one child.
I confess I was thrown off by "autoimmunity" as I thought it would be a GOOD thing, my reasoning being that an "Autoimmune Disorder" is a bad thing. But I was wrong! I am happy to have learned this new thing today, which is:
"Autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other body normal constituents."
I’ve never heard the sun thing, interesting - any idea why that might be? Avoiding carbs/sugars seems to help me a bit, I think. Do you have any good links for common triggers, how to spot them, etc? I never seem to ‘learn’ mine because there’s always so many possibilities of what could have triggered a flare.
I don't have an autoimmune disease. But a friend of mine had lyme disease => stomach bleeding => allergies to all the foods (when undigested food gets into your bloodstream, your body reacts to it much the same way as it would a virus).
Both then and now, as some of her allergies are starting to fade, the trick was limited experimentation. Get to a known good state. Spend a week exposing yourself to small, then medium amounts of whatever you want to test. Observe your reaction. Repeat for something different the next week. You can test removing stuff from your diet this way too, but it's hard to identify false negatives: "I didn't get better -- does that mean I'm not allergic to this food, or that there are more triggers I still need to remove?"
It's basically the scientific method: form a hypothesis, establish a control, make a modification, observe results. It takes a lot of patience, but if your condition has a big enough impact on your life, is probably worth it. The hardest part is probably getting to a known good state. My friend was able to take an allergy test and err on the side of eliminating foods, to help her get there faster. I don't know what might help you; I'd recommend making a plan with your doctor.
An elimination diet is critical to under standing ones sensitivities.
I once spent a month eating nothing but sweet potatoes
. Best I ever felt. Afterwards I could quickly tell what was an issue. Which was most everything not on strict AIP diet.
The Auto immune protocol diet is an excellent place to start. Focuses on inflammation.
> While "man flu" is a popular term for men getting excuses to complain and play on a computer during a minor infection
I always find it funny how we're supposed to be in an age of fighting sexism but the rise of bizarre gendered stereotypes like this — to the point where articles are getting written about them as if they're real phenomenon! — is baffling. Imagine articles about "woman flu" for the (also stereotypically common) phenomenon of women constantly being sick.
What if I told you that this is literally what feminists mean when they talk about "toxic masculinity" and that pop feminism (i.e. what sells ads/clicks) has barely anything to do with actual feminism?
Toxic masculinity refers to the idea that masculinity is narrowly defined around a number of traits and social expectations that are harmful both towards men and to others. E.g. "man flu" is a thing because it's generally not socially acceptable for men to show vulnerability but men often see illness as an exception to that and thus some men use seemingly minor illnesses as an "excuse" to be vulnerable and dependent. Likewise emotions other than anger are often difficult to express for men but sports (football in the US, the other kind of football in Europe) is an "excuse" to express sadness and emotional proximity between (straight) men.
The point here is that these gendered expectations and behaviors aren't innate but they're upheld by society. Women's liberation was able to overcome a lot of stereotypical expectations for women (though certainly not even most of them) but it wasn't followed by a "men's liberation" doing the same for men, except as a direct response where women's liberation challenged male gender roles. E.g. with women no longer being expected to take care of the home by themselves, household chores like laundry and cooking have become socially acceptable for men.
Pop feminism individualizes these problems by ridiculing men, but the problem isn't individual men, nor men in general really. It's a social problem and much like women's liberation it requires a mass movement to solve. Except most men still aren't aware there's a problem and those who are often don't think it's fixable (much like women who rejected the suffragettes or the later waves of feminism).
Yeah I pretty much agree with you and I fall into this category myself. It's obvious we need a movement like that, but society (as it exists right now) won't even acknowledge the need, let alone would actually tolerate the existence of such a movement. Maybe my grandchildren will be able to live in a world that's kinder to men.
The problem is the oppression of gendered expectations towards men is much more abstract because it is framed as empowerment.
Men aren't supposed to cry or show emotions other than anger except in extreme situations (e.g. birth of a child or death of a close relative or romantic partner) but stoicism is seen as a demonstration of strength and rationality.
Social attitudes for men embrace self-destruction but because men are taught adherence to these ideals is the only valid way to seek affirmation, giving them up feels even more damaging because you have nothing else left. This is why positive role models are important but in order to be effective they need to function as role models in the traditional expectations as well.
I think a good example is Terry Crews, who fits the traditional masculine role model of being an accomplished athlete, actor and father, but also broke the silence on sexual assault against men, as well as being an activist against sexism and expressing emotional depth in his characters. Role models aren't enough but they help normalizing non-conforming gender expressions, reducing the resistance faced by people in the real world.
We won't get rid of archaic gender roles overnight, but fighting sexism, homophobia and transphobia (and racism, but that's a story for another time) goes a long way towards allowing men to express themselves differently without having to fear being told they are "unmanly" because being told your behavior is "girly" or "gay" no longer works as an insult if you don't see these adjectives as signaling something "lesser" than how you want to be seen.
In short, women's liberation was easier because sexism meant women were seen as inferior and demanding to be able to do "things men do" was empowering. Men's liberation is more difficult because we didn't overcome sexism and thus men behaving "like women" is still seen as inferior rather than empowering. A good demonstration is how women rejecting their "empowerment" by embracing femininity are recuperated by conservatism.
My friend, who is a study nurse, told me medical studies are often just done on men and then women are treated as small men when it comes to treatment later.
During college, I participated in medical trials at AstraZeneca as an easy way to make money. They almost exclusively asked for male test subjects.
One of my female friends also wanted to earn money that way, and called them asking why. Their response was essentially that medical trials are very expensive, and men are a cheaper resource. I.e., women have ovaries and a set amount of eggs, and therefore would potentially be more adversely affected by complications from the experimental drugs, so the insurance was a lot more expensive.
When I did med trials, I was told -- where you are in a menstrual cycle matters for measuring the half-life of a given med. Men, lacking those cycles, are easier to wrangle than trying to select for a group of women who fit the study criteria and also happen to be at the same point on their cycle.
Not to dispute what your friend says they were told but I think it's more likely that they want to rule out pregnancies than that they are worried about affecting fertility. Having a test subject sign up unknowingly pregnant or become pregnant during the trial is probably a massive insurance headache even if you have the test subject sign paperwork to reduce liability.
Not to discount your friend's experience, but I haven't seen a recent study for which this is true. Selection criteria aren't secret; they're on clinicaltrials.gov and published in the eventual data used for FDA approval and publication.
I can’t recall seeing a study where only men were allowed to participate, with the exception of male-specific health studies (erectile dysfunction, testosterone replacement therapy, and so on).
In fact, any study that arbitrarily excluded women without good reason would almost certainly be flagged by review boards before being allowed to proceed, and it would struggle to get accepted into journals.
Maybe this was true many decades ago, but it’s certainly not true in recent history.
in my experience, it is still pretty common, depending on the development stage and drug indication. It is not done without good reason. As mentioned elsewhere, there are pleanty of practical reason. The challenge with single sex studies isn't about Journals or IRBs, neither of which care, it is about FDA approval for marketing
It's good when the reasons behind apparent sex differences are investigated. When they are simply taken for given in e.g. provision of healthcare, it can be harmful to people who don't fit the average “male person” or “female person” profile. For instance, people who for whatever reason have hormone levels not typical for the chromosomes they have, people with unusual chromosome configurations, or people with social circumstances unusual for their sex.
Isn’t there some thought that male homosexuality and related conditions may in part be caused by a maternal immune response to a protein important in male fetal brain development?
The TLDR for the article is that it appears to be a combination of chromosomal and hormonal differences that are responsible for observed sex differences in autoimmunity.
Are you asserting that a combination of chromosomal and hormonal differences are also responsible for the observed sex differences in incidence of long COVID? Or are you asserting that autoimmunity is directly involved in long COVID? Or, are you saying something else?
It's an honest question. It's ambiguous what you're saying. Maybe you're saying something interesting, but it's difficult to tell without specifics.
I'm not OP, but I wouldn't be at all surprised if long COVID is an autoimmune reaction or just people that developed autoimmune diseases from having COVID.
Re: the article title: Isn't "autoimmunity" alone the good thing? -- it's what your body does to fight things off. "Why autoimmune diseases are more..." seems like better title. Maybe I'm just not aware of the common verbiage in medical circles but it seems a little sloppy for Nature.
Yep. Automatic, autonomous, all are from auto (self), automatic being "doing by itself", autonomous being "governing itself" (or "self-sufficient"), etc.
Autoimmune diseases/disorders are abnormal immune systems, either being overactive or underactive [1]. It's not generally a good thing and often leads to bad consequences.
Type 1 diabetes, rheumatoid arthritis, Crohn's disease, ulcerative colitis, lupus, multiple sclerosis; a whole grab-bag of fun.
These are also difficult diseases to treat – often involving biologics (large molecules administered by injection or IV). T1D is insulin, obviously, but the first big blockbuster medications in the space were Humira and Remicade, monoclonal antibodies, which are powerful immune-system suppressants but more selective (and therefore, relatively speaking, safer long-term) than systemic steroids like prednisone.
My rule of thumb: if the choices are A) "maybe I'm just not aware of the common verbiage in [technical] circles" that I'm not a part of or B) "a little sloppy for" the multiple layers of experts involved in choosing and approving a title in a flagship science journal, it's very very likely to be A.
But I would add that we already know that female menstruation impacts certain specific disease processes, such as heart disease. Men get advised to donate blood to lower their risk of heart disease. Women who are still menstruating don't need to do that.
Covid is known to impact the blood significantly. Blood differences between men and women could play a role in difference in outcomes between men and women for this condition.
Women who have been pregnant become chimeras. They get cells from the baby that stay in their system. They also share a blood supply with the baby.
I have a serious and incurable congenital disorder. I'm convinced my two pregnancies were hugely beneficial to my long-term health for a long list of reasons, possibly including having cells still in me from one child who did not inherit the disorder.
So I'm interested in this topic for personal reasons and I've read a bit about such things over the years and I think it's probably hugely more complicated than this article suggests.