Can you buy a better health?

Health is not entirely in our own hands. Genetics plays its part, as do accidents, infections, environmental influences and plain bad luck. We cannot negotiate with all of them.

But a surprisingly large part of our health is influenced by what we do repeatedly: how we eat, whether and how we move, how we sleep, how we deal with stress, whether we smoke and how much alcohol we drink.

The difficulty is that these are rather ordinary things. They lack flashing lights, elegant packaging and a monthly subscription.

Buying something is often easier than changing a habit.

Walk into the health section of a pharmacy or a health-food shop and it can feel like entering a jungle. Shelves are filled with vitamins, minerals, powders, oils, herbs, joint remedies and products promising better sleep, sharper concentration, calmer nerves, stronger immunity, younger skin and joints apparently restored to factory condition.

The online jungle is even denser.

I sometimes entertain myself by opening health advertisements on Facebook. This generally leads to a questionnaire about my sleep, stress, digestion, weight, concentration or whatever organ happens to be commercially interesting that day.

I answer the questions, enter my email address and stop before handing over any payment details. By then, however, the machine has learned enough about me to become deeply concerned.

For the following days I receive emails explaining that my results were exceptional, the experts are almost speechless and it is vitally important that I complete my purchase immediately.

My results seem to leave experts speechless with remarkable regularity.

Then comes a special offer, often sent personally by someone with a title such as Head of the Health Assessment Department. The discount may become even larger in the next email, suggesting that the company’s concern for my health increases in direct proportion to my reluctance to buy.

Frequently, the aim appears to be to enrol people in a monthly payment plan. The first month is offered at a spectacular discount, after which the relationship may prove more lasting than some marriages.

The health market has become such a jungle that I have almost certainly forgotten something. What follows is not intended to be a complete catalogue of everything being sold in the name of health. It is simply what stands out most clearly in my mind.

That is probably more than enough to begin with.

Three rather different shelves

Products sold in the name of health belong to several different worlds.

Some are genuine medical devices or treatments developed for a specific purpose. Some may improve comfort, recovery, relaxation or general wellbeing. Others are expensive containers for hope, supported mainly by attractive photographs and testimonials from remarkably energetic people standing on beaches.

The borders are not always obvious.

A blood-pressure monitor is a good example of a useful purchase. High blood pressure often produces no symptoms, home measurements can reveal important patterns, and the results may lead to a clear decision about further assessment or treatment.

It is not a glamorous machine. It does not promise spiritual transformation. It simply gives useful information—which may be why it receives less attention on social media.

The same principle applies to other measurements: know why you are measuring and what you intend to do with the result.

Watches and rings now estimate pulse, sleep, respiratory rate, heart-rate variability and something called “readiness”. Readiness is not a substance circulating in the blood. It is an algorithmic estimate based on several measurements and compared with the person’s usual pattern.

It may help someone notice poor sleep, illness or inadequate recovery, but it is not a diagnosis issued by a small cardiologist living inside the watch.

Continuous glucose monitors measure glucose in the fluid between cells through a tiny sensor placed beneath the skin. Ordinary glucose meters, ketone meters and most portable lactate meters generally require a drop of blood from a finger.

These instruments can be extremely valuable in diabetes and useful in serious athletic training. For everyone else, more information is not necessarily more health.

If a man is measuring glucose, ketones, lactate, sleep stages, skin temperature and readiness before breakfast, he may be an elite athlete—or he may simply have developed a very demanding relationship with his own metabolism.

A measurement without a sensible response is merely a number with a battery.

And then there is biohacking

The word biohacking now covers almost everything from sensible sleep tracking and dietary experiments to cold exposure, red light, continuous glucose monitoring, unusual supplements and machines that look as though they were borrowed from a minor science-fiction film.

At its most reasonable, biohacking simply means observing the body, changing one variable and seeing whether anything improves.

There is nothing particularly strange about that. Physicians, athletes and ordinary people have been doing versions of it for centuries.

At its less reasonable extreme, it can become a full-time occupation in which a perfectly healthy person spends most of the day monitoring whether he is healthy.

A device or experiment is only useful if it answers a meaningful question or helps solve a real problem.

If the experiment helps someone sleep better, move more, reduce pain or improve a meaningful health marker, it may be worthwhile. If it merely produces another graph to worry about, the biological hack may have created a psychological problem.

What is worth putting in the body?

Vitamins and supplements are not one category with one verdict. Their value depends on the person, the diet, the dose and the reason for taking them.

Correcting a genuine deficiency can be extremely important. Taking increasing amounts of everything “just in case” is something else entirely.

The body is not a savings account into which unlimited vitamins can be deposited for retirement.

Vitamin D deserves particular attention in northern countries where sunlight is limited for much of the year. It is important for calcium absorption, bones and muscle function. Calcium also matters, especially when dietary intake is inadequate or osteoporosis is present.

B vitamins are essential for normal metabolism, blood formation and nervous-system function. They can be particularly important when a deficiency exists because of diet, illness, medication or poor absorption.

But more is not necessarily better here either. Prolonged high intake of vitamin B6, for example, can damage sensory nerves.

The correct dose matters just as much as the name on the bottle.

Icelanders also have a long relationship with fish oil and cod-liver oil. Omega-3 fatty acids can be obtained from oily fish or supplements, while cod-liver oil also contains vitamins A and D.

That makes it useful, but it also means that people taking several products should check whether they are unknowingly doubling or tripling their intake of the same vitamins.

Protein supplements can be convenient, particularly for older people who exercise and may otherwise struggle to consume enough protein. Essential amino acids can stimulate muscle protein synthesis, although a good-quality protein source already contains those amino acids.

The isolated product may be useful in certain circumstances, but it does not possess secret knowledge unavailable to fish, eggs, dairy products or whey.

Creatine is one of the better studied sports supplements. Combined with resistance training, it can help strength and muscle performance, and it may be particularly relevant as we grow older and try to preserve muscle mass.

It still requires the resistance training. The powder cannot perform the final repetitions on our behalf.

Collagen has some evidence suggesting possible benefits for joints, tendons or skin, although the degree of benefit varies between individuals and products.

Coenzyme Q10—or CoQ10—was extremely fashionable for a time, and I used it myself. It plays an important role in cellular energy production and may be useful in selected circumstances.

As with most supplements, its value depends on why it is being taken rather than on the size of the promise printed on the container.

The crowded shelf for aching joints

Joint health is one of the largest areas within the supplement market. In Iceland, familiar examples include Liðaktín, Nutrilenk and Benecta.

The products are not identical. They contain different combinations of ingredients and are based on different proposed mechanisms. Depending on the product, these may include glucosamine, chondroitin, MSM, turmeric, herbal extracts or compounds derived from chitin and chitosan.

Many people feel that these products reduce stiffness or discomfort and help them remain active. There is no reason to dismiss their experience simply because not everyone responds in the same way.

Scientific studies of individual ingredients have produced varying results, and the evidence for one ingredient cannot necessarily be used to pass judgement on a branded combination containing several substances. Nor am I attempting to compare or evaluate these individual Icelandic products here.

A reasonable approach is to examine what a product contains, consider possible interactions or allergies, use it consistently for a sensible period and judge whether there is a meaningful improvement in pain, stiffness or function.

The most important result is not whether the container looks scientific. It is whether the person using it can move more comfortably and do more of the things that matter.

Hyaluronic-acid injections into joints—traditionally nicknamed “rooster-comb injections”—and corticosteroid injections belong to a different category. They are medical treatments rather than general nutritional support.

They can be helpful for selected patients, but the diagnosis, the joint involved, the timing and the individual circumstances all matter.

A steroid injection is not a vitamin delivered with greater determination.

Linus Pauling and my relationship with vitamin C

I have taken large doses of vitamin C for many years. I rarely develop colds or influenza, and my belief in vitamin C began when I realised that I had gone several years without either while eating a daily salad thoroughly covered in lemon juice.

This is my personal experience and conviction. I am not advising other people to take the same doses that I do.

Vitamin C is an important antioxidant and protects cells against oxidative damage from free radicals. It is also essential for collagen production and many other normal biological processes.

Linus Pauling strongly promoted high-dose vitamin C. He was one of the great scientific minds of the twentieth century and won two Nobel Prizes.

Two Nobel Prizes do not make every later hypothesis correct, but they do make a man rather difficult to dismiss with a casual shrug.

Very large doses can produce side effects and may increase the risk of kidney stones in susceptible people. Anyone considering unusually high doses should therefore make an informed decision rather than simply assuming that a water-soluble vitamin is incapable of causing problems.

My faith in vitamin C remains strong.

It is simply my personal view, not a prescription for everyone else.

Plants are not the opposite of medicine

Herbal medicine should not automatically be dismissed. Many important medicines originated in plants or were developed from plant compounds.

The problem is not that a substance comes from nature. The important questions are what it contains, how much is present, whether the preparation is consistent, what evidence supports it and how it interacts with medicines or disease.

A plant can be therapeutic, ineffective or poisonous. Nature manufactures all three without changing the colour of the label.

Properly trained herbal practitioners should study dosage, preparation, adverse effects and interactions as part of their education, just as other healthcare professionals must understand the substances they recommend.

Herbal preparations can still vary in strength and purity, and combining them with prescription medicines may require care.

“Natural” is a description of origin, not a guarantee of safety—but neither is it a reason to assume that something cannot work.

Machines for light, pressure, pain and optimism

Some health devices have clearly defined uses. Others occupy the broad territory between medical treatment and wellness.

Bright daylight lamps are a good example of technology with a credible purpose. Proper bright-light therapy can help seasonal affective disorder and may be particularly relevant during northern winters. Timing and adequate light intensity matter.

I have more reservations about some other forms of light treatment, largely because I know less about them.

Red and near-infrared light—often called photobiomodulation—has legitimate medical and research applications. That does not automatically confirm every claim made wherever a red light has been installed, but neither should the entire field be dismissed because some of the marketing runs ahead of the evidence.

Radiofrequency treatment is another broad field. Different RF devices are used in rehabilitation, pain treatment, skin tightening and body-contouring procedures. Some applications appear promising, but the relevant question is always what the specific device has actually been designed and shown to do.

TENS is used mainly for pain relief. Bone stimulation is a different field, involving specially designed electrical or electromagnetic devices that may be used in selected cases of delayed bone healing.

Serious technology and ambitious marketing can sometimes live remarkably comfortably in the same machine.

Compression boots have also become popular. Intermittent pneumatic compression has genuine medical uses, and consumer versions may reduce swelling, improve comfort and possibly assist recovery after strenuous exercise.

They may make tired legs feel better. They do not, however, reverse ageing from the ankles upward.

Compression boots should not be used indiscriminately. Anyone with suspected or untreated deep-vein thrombosis, severe arterial disease, decompensated heart failure, an acute skin infection or significant wounds should seek medical advice before using them.

Massage guns and other massage devices can provide temporary relief from muscle soreness or stiffness. They can make good gifts and may be used regularly—at least until the next Christmas introduces a newer machine.

There was a period when almost every Icelandic home seemed to receive a foot spa for Christmas. For a few weeks the nation sat happily with its feet bubbling in warm water.

Most of the machines then began their long migration towards cupboards, garages and storage rooms, where they remain in excellent condition.

Breathing, cold water and modern rituals

Breathing exercises have become enormously popular.

Some forms are perfectly sensible. Slow, controlled breathing can influence our state of arousal and support relaxation, while specific inspiratory-muscle training can strengthen the muscles used for breathing.

At times, however, the surrounding culture can make breathing sound like a recent invention requiring a teacher, a retreat and matching clothing.

When an activity we have performed continuously since birth develops its own vocabulary, hierarchy and ceremonies, I become a little cautious.

One approach I do find interesting comes from Lucas Rockwood, the founder of YOGABODY.com. He divides breathing exercises into three memorable categories.

Water Breathing is intended to create balance.

Whiskey Breathing is intended to promote relaxation and sleep.

Coffee Breathing is intended to increase energy and alertness.

The names may not satisfy every respiratory physiologist, but they make the purpose of each exercise wonderfully easy to remember. Whiskey Breathing also offers the attractive possibility of obtaining some of the relaxation without having to open the bottle.

I had not initially realised that the man most closely associated with modern cold exposure—Wim Hof—also places considerable emphasis on breathing exercises and meditation.

I know too little about his complete method to judge it fairly.

What I do know is that cold-water bathing has become extremely popular. In many Icelandic swimming pools it now seems that every second person visits the cold tub as well as the hot one.

People clearly find something valuable in it, whether that is alertness, wellbeing, personal challenge or simply the pleasure of returning to the hot tub afterwards.

Cold water does not automatically become medicine merely because a charismatic Dutchman gets into it willingly.

I have no wish to frighten anyone away from cold-water treatment. As with most things involving a strong physiological response, people simply need to respect their own health, experience and limitations.

Cold water has existed for considerably longer than the wellness industry.

It has only recently acquired better publicity.

My first serious purchases

For most of my life I have not been particularly interested in buying health gadgets. The first devices that genuinely attracted me were Pulsetto and, later, Lumenate with the Nova glasses.

Pulsetto is worn around the neck and is intended to stimulate the vagus nerve non-invasively. The vagus nerve is an important part of the parasympathetic nervous system—the “rest and digest” side of our physiology—and communication through it influences heart rate, digestion and the body’s response to stress.

When I was studying medicine, a story circulated among students that rubbing the neck before a stressful examination might stimulate the vagus nerve and calm us down.

Whether our anatomical reasoning was entirely precise is another question. We were medical students facing examinations and therefore willing to consider almost any intervention that did not require further reading.

Pulsetto rests on both sides of the larynx and uses controlled electrical stimulation through the skin. Its programmes are intended for such purposes as stress, anxiety, focus or feelings of burnout, sleep and digestive wellbeing.

When I have felt particularly pressured, I have sometimes used several programmes in succession—as if one of the keys must surely fit the lock.

I have repeatedly noticed that I become calmer quite quickly. I cannot say which programme produced the effect, or whether the differences between the programmes are as biologically distinct as their names imply.

I can only describe my experience: I find the device easy to use at home, even while doing something else, and it has worked well for me.

I am therefore comfortable recommending it as a useful aid to relaxation, while recognising that my experience is not the same thing as a large clinical trial.

A journey without mushrooms

In recent years, psychedelic retreats involving psilocybin mushrooms or ayahuasca have attracted considerable interest.

Many participants describe major discoveries about themselves, their childhood, their relationships and occasionally the entire universe.

I am attracted to much in the philosophy and traditions of the Indigenous peoples of North America. Even so, I am not yet ready to place myself in the hands of a South American shaman and begin a ceremonial journey through the rainforest.

Before travelling that far, perhaps we Icelanders should first find out whether our own völvur are still accepting appointments.

I have no personal experience of a true psychedelic state. Psychedelic-assisted therapy is being studied seriously in controlled clinical settings, but I do not know enough about psychedelic retreats to express a strong opinion about them.

My interest in Lumenate and the Nova glasses came partly from the possibility of entering a semi-psychedelic state without taking a psychedelic substance.

I initially used Lumenate through my phone. I now use it in a much more convenient way with the Nova glasses. The system uses carefully patterned light through closed eyelids, together with sound, to create changing colours, shapes and visual sensations.

I am very fond of it.

At times it feels almost as if I am travelling through space. More importantly, it can bring me into deep relaxation, meditation and a form of inward reflection that I find difficult to reach in ordinary daily life.

It is not suitable for everyone. Flickering light can trigger seizures in people with photosensitive epilepsy, so the manufacturer’s safety screening and instructions must be taken seriously.

A journey through space is less appealing if it ends in an ambulance.

So, can we buy better health?

We can buy things that help us measure, treat, train, recover, relax or maintain a useful habit.

We can buy a reliable blood-pressure monitor, appropriate supplements, exercise equipment, professional treatment and occasionally a device that genuinely improves how we feel.

What we cannot buy is the final result in a box.

No supplement replaces a reasonable diet. No recovery device replaces movement. No readiness score replaces sleep. No massage gun builds muscle while resting beside the sofa.

And no questionnaire on Facebook has discovered a health profile so unique that the experts are genuinely unable to speak—although the Head of the Assessment Department may still offer another twenty per cent discount before midnight.

The best purchases are usually those connected to a clear purpose:

What am I trying to improve?

Is there a reasonable basis for believing that this product can help?

Is it safe for me?

How will I know whether it is working?

And what will I do differently because of the result?

Health cannot simply be bought, but money can sometimes purchase useful tools, good professional help and better opportunities to care for ourselves.

Used intelligently, these things may support better health.

Used without thought, they may merely improve the health of the company selling them.

The checkout button is easy.

The daily work still belongs to us.