Wednesday, April 26, 2017

Hölloch – Weekend in a Cave

Hölloch is currently the 10th longest cave in the world (it used to be the first). Spending a weekend there was a great experience that I can only recommend. It was also one of the toughest trips I've ever done.


After a short briefing, we left the outer world and entered the underground. My mind wondered about a lot of things:
  • How will we cope with the darkness? Answer from the future: just fine.
  • How will we cope with narrow spaces? Answer from the future: mostly fine.
  • Will we be afraid of getting trapped between rocks? Answer from the future: yes, a few times.
  • Will it be physically demanding? Answer from the future: you bet!
The first 2 hours to the bivouac were easy hiking with occasional ladders and ropes. The corridors were wide and spacious.

First part was exactly like mountain hiking.

Under a the biggest waterfall we've seen in the cave.

We dropped our stuff at the bivouac and went to explore the cave. The corridors were getting smaller and smaller. Up to the bivouac, we were mostly standing upright, but now we appreciated every moment when we could stand up. We crouched, we crawled and everything started to hurt. I've also crashed many times into pointy rocks in the walls.

I didn't have to breathe out to pass through but Dano did.

We saw some of the best cave formations of Hölloch, but it was nothing compared to what you can see in the Slovak public caves.

These get destroyed during floods.

At about 8 PM, our guide asked us if we wanted to continue and I was the only one in the group who said no. Dano later told me that I just said what everyone else was thinking. The guide said that usually only one group per year goes further than us, so we still felt good about our stamina.

In total, we climbed about 1000 altitude meters in 10 hours. When Jakub told me about the trip, I imagined a light cave hiking with an occasional ladder or a rope, but this was some tough shit.

We went to bed but I couldn't fall asleep, because it was too hot. The cave has a stable temperature of 6 degrees Celsius, but it felt too hot in my sleeping bag.

Bivouac with sleeping space, kitchen and eating tables.


We went for a fairly easy walk in the morning, checking out more cave formations.

I was impressed with all the infrastructure they have inside the cave. For example, there is a drinking water system that uses just gravity. Or you can send an SMS from the cave using very very long antennas transmitting long waves that pass through hundreds of meters of rock.

It was time for the local Rutschbahn (slide in German), where you slide on one shoe through a steep corridor. The record for it is around one minute, but we went much slower than that. We still hurt ourselves, though.

Before we exited the cave, we also made a small detour and took a boat over a small lake inside the cave. During rain, the water in the lake can rise up quickly and you can't come back the same way.

At this point I was really tired and really looking forward to the exit. Vladimír was not and he needed to crawl through every little passage that fits a person.

Typical Vladimír.

The end

At home I discovered that I had a lot of bruises on my body and two bleeding wounds on my back. Every one of my muscles hurt, but it was definitely worth it. Caving is hard but beautiful.

Album from merged from multiple cameras is on Google Photos.

Sunday, December 18, 2016

Loptoši™ 2016: Georgia

After a year hiatus, my favorite event Loptoši™ was back with its 6th edition. This time it was only me and my brother Palo in late September.


Approximate itinerary on Furkot:
Note: You should try Furkot when planning your next trip. It’s the best thing since sliced bread GPS navigation.


We planned to hike from Mestia to Mazeri via Guli pass and then go see the Shdugra waterfall on the second day.

The beginning was very steep, but we were very soon rewarded with great views of Caucasus. These were some of the highest peaks I’ve ever seen.

Tetnuldi (4858 m) & Gistola (4860 m)
We continued together with a big Czech group also going to Mazeri. The ground was covered with snow from about 2600 meters altitude.

The descent was very slippery and we had trouble keeping balance with huge backpacks, so we both fell multiple times. After finding a great spot for a tent, we cooked dinner and just stayed in the tent.

I got a text in Georgian on my Georgian SIM and thought it must have been something very important. I sent it to my friend Mike who said that they fixed the sewage system in Zugdidi. That was very useful to know, given that we were camping 100 kilometers from there!


I slept like a baby for about 12 hours. Palo wasn’t so lucky and got a bad night in an old sleeping bag. It was freezing outside and we had plenty of frost inside the tent.

Frost inside the tent

Great morning view of Svaneti Range
We descended to Mazeri, where we left half of our gear and then hiked to Shdugra waterfall.

Shdugra waterfall

Mazeri as seen from Shdugra waterfall


We drove from the mountains to the coast of the Black Sea. It was raining and cold, so there was not much to do. We went to sauna and checked out the local fortress.

Kvariati must be very pleasant when it's warm and sunny


Google Maps shows two alternatives for the shortest route between Batumi and Akhaltsikhe: 160 km long and 320 km long, both taking about the same time. Feeling adventurous, I chose the shorter alternative through the mountains.

Goats occupying the road

Choose your side

The road was getting worse and worse until it was only mud and no asphalt
The last 60 km took us more than 3 hours and it was very tiring to drive. Too bad it was raining, driving on this bad road could have been compensated with great views of the nearby mountains and valleys. When the bad road ended and we left the mountains, the country suddenly became very dry.

The monastery in Vardzia was spectacular, a labyrinth inside a cliff.

Five monks still live in this mountain

We then drove to Akhaltsikhe. Thanks to an EU grant, the Rabati Castle in Akhaltsikhe was recently reconstructed. Unfortunately, they used concrete almost exclusively, trying to make it look like old stone. It looks nice from afar but fake from very close.

Brothers in Rabati Castle


In the morning, we went for a short hike in Borjomi-Kharagauli National Park. After one hour, the rain stopped and we actually saw a bit of the mountains.

We also visited the Stalin Museum in Gori. Unfortunately, the museum didn’t mention Holodomor in Ukraine or Russian gulags. On our way to Telavi, we passed through Gombori pass during sunset.


We visited the wine museum at Twins Old Cellar. Georgians have a wine-making method that is completely different from the one we use at home (and anywhere else in Europe for that matter). As a result of a different technology, white wine tastes similar to red.

Wine is made in large vessels called kvevri. A person cleans them from the inside.

We arrived to Tbilisi and chilled in the botanical garden for a few hours. In the evening we met up with Achi, cousin of my friend Mike from Stockholm.

Tbilisi during the day

Tbilisi at night

It was great to have someone local show us around. When we asked Achi how to send postcards, we learned that it is very complicated, since the concept of post is fairly new to Georgia. They developed other means of delivering important information, like small ATM-like machines on every corner.

The end

Georgia has a lot to offer: apart from high mountains, beaches and historic sites mentioned in the post, we had a lot of great and cheap food. I will definitely come back.

A selection of my photos is on Flickr. An album merged from our cameras is on Google Photos (if you click on “(i)” in the upper right corner of a photo view, you get to see my captions).

Wednesday, June 22, 2016

Book review: The Simple Path to Wealth by JL Collins

I’ve always recommended JL Collins’ Stock Series to anyone interested in saving, investing and early retirement. JL now took the series and other posts from his blog, polished them and made into a book.

The good

Everything is explained very simply and JL uses a lot of stories. It’s also very short, so you won’t be bored reading it.

You’ll learn the basics about stocks and bonds, how the market works and that a very good investment strategy is actually very simple, with only two index funds. But more importantly, it will give you other crucial advice for this endeavour:
  • There will be times when your portfolio drops 20% within a week and you’ll feel like you’ve made a huge mistake. The solution is simple: treat it as “Sale! Everything 20% off”. The book has a lot of other tricks to make you a calm investor.
  • Chapter III “It has never been about retirement” is the single best short piece I’ve read about the philosophy of saving and early retirement. If you need motivation for saving and investing, this book will give you plenty.
  • I also really like the final chapter on risk. No, you can’t be sure the 4% rule will work forever. You can’t be sure Earth won’t be hit by an asteroid. We live in uncertainty, but having savings can only help you.

The bad

My biggest complaint is the incorrect advice about international investing. To be fair, most investing books are also incorrect, but JL goes too far and recommends only owning American companies. This is on three grounds: high risk, big American companies are global and it’s more expensive.
  • International investing sometimes bears more risk, but this risk has also been rewarded, for example emerging markets over-performed the rest of the world by 2% yearly in the last 40 years.
  • The difference in price these days is about 0.2% in yearly fees between an American and a global fund. That’s a very small price for a much higher diversification.
  • JL says the world is getting more globalized and connected, so having only American companies is enough – you get exposed to all economies anyway. Increased globalization is happening, but the stock markets ignore that. Comparing last 15 years, emerging markets gained 6.4% yearly while developed world gained 3.3% (MSCI World IMI vs. MSCI EM IMI).
Some small complaints:
  • I wish the book used real (=inflation-adjusted) returns. If the index grew 12% yearly when 4% of that was inflation, saying that your wealth grew 12% is very misleading.
  • JL uses a Bell curve to illustrate the variability of stock returns, but Bell curve to me symbolizes lack of variability. In reality, stock returns have a long-tailed distribution and that’s one of the reasons why it’s so easy to underperform the index.
  • I’m curious why JL didn’t mention Betterment (and robo-advisors in general), because he writes about it positively on his blog. In the book, he says multiple times his strategy is about simplicity. However, avoiding Betterment adds 3 times more complexity for an average person.

Final verdict

Go read the book, it’s awesome. Now! Yes, there are factual inaccuracies, but you can correct that by reading All About Asset Allocation or A Random Walk Down Wall Street instead. This book excels in things that other books get wrong or ignore—the psychological and philosophical aspects of investing.

Disclaimer: I got an early copy of the book in exchange for review here and on Amazon. I won’t receive any compensation if it sells well, so I didn’t have an incentive for a good review.

Wednesday, April 27, 2016

The importance of F-You money, part 2: How to invest?

When it comes to F-You money, investing and early retirement, I find the philosophical part of it the most fun. It has greatly influenced my personal philosophy, which is apparent in the two most read posts of this blog: one about non-material value and another about thriving during hard times.

Part 1 of this post was also mostly about philosophical advice. Unfortunately, you can’t eat philosophy and eventually you need to invest. I found many investing articles incomplete and books too long, so I’ve written my own. Also, most of the published advice is written for Americans who usually have better offerings and simpler choices, but this post is aimed at Europeans.

I assume basic knowledge of terminology, so you should know what bonds, stocks, ETFs, TER, small-cap, real returns and others are. If not, reading the first few parts of Jim Collins’ stock series and additional googling on Investopedia should help.

The short version

People wanting to invest usually give their money to a bank. The bank loans the money to someone or buys stocks. Bonds (=loans) have real return about 0 to 4% yearly and stocks about 6 to 8% (over the long term, adjusted for inflation). Banks typically charge 1–2% yearly, so your profit is greatly reduced. Lately, it has become very cheap to circumvent the banks via funds traded on stock exchange (ETFs).

You don’t have to have a super-high salary to invest this way. Here’s a simple rule of thumb: calculate 1% of the money you typically save every 3 months and check if it’s higher than broker fees for a single transaction (more on brokers later). With a low-cost broker like Degiro, saving at least 200 € every 3 months fulfills the criterion.

There are 5 steps.
  1. Get an account with a broker trading on the German Xetra exchange or London Stock Exchange. Degiro is a low-cost broker available in many European countries. Unfortunately, Slovakia and Switzerland are not covered, so people living there need to search on their own (I can offer some tips if you reach out to me).
  2. When do you need the money and what is your risk tolerance? Would you risk higher expected growth for more risk? Answers to these questions determine your bonds/stocks ratio. Betterment has some nice charts that should help you find the right ratio.
  3. For the stock portfolio, I recommend one of these 3 global ETFs:
    Accumulating funds reinvest dividends, so you are always fully invested. They might also be more tax-efficient in some countries.
  4. Unfortunately, simple bond investing advice is an oxymoron. When you ask 4 experts, you get 5 different answers and all of them fairly complex. That being said, for a portfolio with more than 60% of stocks, choose a mix of:
    Bond indexes are typically biased towards long-term bonds, which have better yields but also higher risk. If you want lower risk, open a savings account in a bank or search for ETFs with lower risk—short-term government bonds have the lowest risk. Also check out Betterment’s allocation for low-risk portfolios here and here. Bear in mind that you should bias towards Europe instead of USA.
  5. Once or twice a year, rebalance your portfolio. If stocks overperformed bonds, sell some stocks and buy bonds to get back to your bonds/stocks ratio. This reduces volatility.
You can get more fancy and use more ETFs but for a beginner this is more than enough. It puts you ahead of 99% of other people who pay 1–2% in yearly fees instead of 0.1–0.4% for the ETFs above. The small difference in fees makes a huge difference in the long term thanks to exponential growth.

The long version

Read on if you’re fine with a more complex portfolio or want to know why I made the suggestions above.

US estate & gift tax

If you own US stocks, funds or real estate, you are subject to US estate and gift tax. They apply when you give your assets to someone or they inherit your wealth after your death. The tax is 40% and only applies to wealth above $60,000. Since the European offerings are pretty good and they will get even better, I see little reason to invest using US ETFs. An advantage of European offerings are accumulating ETFs, which are forbidden in the US.

If you still want to use US securities, check out a tax guide by Credit Suisse. Also note that some countries have estate & gift tax treaties with the US, so the rules might be different for you (usually more favorable).

Stock investing

My thesis is that the stock part of a portfolio should be based on market capitalization indexes, containing thousands of stocks in multiple countries ranging from small- to large-cap.

Capitalization-weighted indexes

Stocks for the Long Run lists a lot of strategies that can beat the market, including the January effect. For small-cap stocks, you could have beaten the market by buying in December and selling in late January. The book mentions that the strategy still worked during the 1990s but stopped working since 1994, which is coincidentally the year the book was published. When a simple strategy becomes well-known, people start exploiting it and it soon stops being profitable.

The book also mentions high dividend yield and low P/E ratio as investing strategies that beat the market for decades. Random check showed that high-dividend yield strategy also seems to have stopped working in the last 3 to 5 years. The value premium is still there but there is a big academic debate whether that’s due to higher risk or not.

There are plenty of incorrectly priced instruments at this moment. However, you won’t take advantage of them with a strategy that is easily accessible to a layperson or implemented by tens of publicly accessible funds. Someone else with more money or resources has already beat you to it. I’m only using market capitalization indexes, because then my strategy is the average of all strategies. Yes, I’m only getting the average return, but the average is still very high.

I’ve read few investment books and investment articles but most of them are intellectually dishonest. They spend 300 pages convincing you to not try beating the market and in the end they allocate exactly 5% to emerging markets (EM), when the global market allocates about 13% there (using MSCI’s definition of emerging markets). They don’t explain why 5% is better than 8.647% or any other arbitrary number. In fact, printing the percentage in a book is a mistake in my opinion, since it should be a moving target.

There are valid reasons for not investing exactly 13% in EM, for example because historically they have shown greater risk and higher volatility (which was rewarded with extra 1–2% yearly). If you don’t want to take the risk, allocate less than 13%; if you like risk, allocate more. Betterment is the only place where they do it right in my opinion. It’s an American investment company (robo-advisor), but their ETF portfolios for various risk levels are completely public and you are free to take inspiration.

The 15/30-stock diversification myth

A Random Walk Down Wall Street, probably the most famous investing book, claims that you can achieve great diversification by only picking 15 random US stocks. Interestingly, Burton Malkiel is a coauthor of a paper claiming that this number is much higher now than 40 years ago, but he still hasn’t changed the text of the book in the newer editions (I might be misunderstanding something in the paper too). To be properly dversified, you need to own hundreds or thousands of stocks.

My stock portfolio

My own stock portfolio contains 3 ETFs that span 46 countries from small- to large-cap and contain about 5000 stocks in total. They roughly correspond to the MSCI ACWI IMI index that covers about 99% of the global investable market.
I own them in proportions determined by their global market capitalizations, so small-cap corresponds to 15% of the developed world and emerging markets to 13% of the whole world. The combined expense ratio is about 0.24%. Note that iShares funds participate in security lending, which offset the expenses by 0.04% for the EM fund last year.

Bond investing

While a lot of the stock investing advice applies to bonds, in addition there is a significant currency risk and bonds are more complex with parameters like credit risk and maturity. I understand bond investing less well and it seems the experts are equally confused. My thesis is that I should own multiple currencies, mostly long-term government bonds. Some home bias is fine, especially for low-risk portfolios.

Long-term bonds are more risky but also have higher yields in the long term, so they are fine in a high-risk portfolio. I see little reason to own many corporate bonds when I have a lot of stocks. Finally, owning multiple currencies is a good hedging strategy.

I currently own:
If you want to know more about bonds, Betterment has informative articles with visualizations, for example here, here or here. As for books, in addition to Random Walk and Stocks for the Long Run, you can read Rick Ferri’s All About Asset Allocation.

No REITs (for now)

REITs have a place in a portfolio, since real estate is traditionally underrepresented in stock indexes. The selection of REITs is getting better in Europe, but the fees are still fairly high. I don’t own any REITs at this moment, but I’ll probably take the plunge within a year or two.

No cash

Traditional advice tells you to keep 5 to 10% of your portfolio in cash, but I don’t do that. When you do the math, it’s not worth it. I’ve instead bumped the bond allocation percentage and I only keep twice my monthly spending available.

Choosing ETFs

If you want to search for other ETFs than the ones listed in this post, I recommend using justETF which contains all ETFs traded in Europe. You can limit your search by many criteria, including:
  • Distributing versus accumulating: Accumulating ETFs immediately reinvest dividends, so you are always fully invested and it decreases your transaction costs. They might also be more tax-efficient.
  • Tracking error: Total expense ratio (TER) causes an ETFs to perform worse than the underlying index, but there are other factors at play too. I’ve already mentioned security lending and another one is replication method. Many ETFs don’t own the full index but only a subset of it, which introduces an error that can go either way. There are also synthetic ETFs that don’t actually own the underlying securities and do some magic instead, which also introduces tracking error.
  • Replication method: I only use full-replication or sampling ETFs, because I don’t understand synthetic ETFs. Full-replication and sampling ETFs just own the securities from the underlying index, so they are intuitive.
  • Domicile: The most tax-efficient ETFs are domiciled in Ireland or Luxembourg.
  • Cost of buying: Some ETFs are only available on exchanges with higher broker fees or in a currency that you don’t earn. They might also have a high bid-ask spread. All these make buying more expensive. However, since these are one-time costs, I don’t think they are very important. Recurrent fees are much more important.

Tuesday, April 12, 2016

Snow cave in Binntal

I've slept in a snow cave for the first time ever and can only recommend the experience.


We started the trip in Binn and went towards Mässeralp. At Manibode, we took out a probe to measure the snow depth. It was between 1.5 and 2 metres, just about enough for a snow cave. We left our stuff there and started skinning up towards Grosses Schinhorn. Almost immediately, I felt out of power and Vašek and Kubo were too far ahead. I decided to turn back.

Breithorn and Bietschhorn

It turned out to be a good decision. Since it was getting late and we had a snow cave to dig, Kubo and Vašek didn’t reach Grosses Schinhorn anyway and the good snow ended exactly at my turning point.

Back at Manibode, we found a spot with 2 meters of snow where we didn’t need to dig out an entrance corridor, because the wind did it for us. When planning the trip, we estimated 2 hours to dig the snow cave and that’s about how long it took. Next time I’ll bring a snow saw though.

Vašek working on the roof
Me standing at the entrace of our cave
We marked the top of the snow cave with skis to avoid accidental destruction

The cave had 3G internet, despite being in 2000-meter altitude in the middle of nowhere under 1.5 meters of snow. I have no idea how that's possible.

The views towards Aletschhorn (4193 m) from the cave were stunning.

Aletschhorn before sunset

Aletschhorn after sunset

Aletschhorn in the morning


Even with an open entrance, the cave was around 0 degrees Celsius throughout the night. We could have made it warmer, but as Kubo explained to me, you want to err on the freezing side, otherwise you end up very wet from the melting snow and less comfortable than in a freezing but dry cave.

A 5-star hotel at 2000 meters with 3G internet
The night was surprisingly very good. In fact, I got the best sleep in two months (about 10 hours) despite drying wet clothes in my sleeping bag and keeping 3 liters of water warm so that it wouldn’t freeze.

Our plan for the day was to climb Schwarzhorn (3108 m). When we reached the saddle below Fleschhorn, we saw the last part involved too much climbing and as it was getting late, we changed the plans to go to peak 3112m instead. Just like the day before, I felt out of power and too slow, so I stayed below the summit. We had a bus to catch and too little time.

Kubo and Vašek successfully reached the top and had some great views.

Pizzo Cervandone on the right

Vašek at peak 3112 m pointing at Bietschhorn

The downhill ride offered steep skiing in great snow with a spectacular scenery created by fog and the Sun.

We reached the snow cave for the last time, packed things and continued to Binn to catch the bus.

The end

A short selection of my photos is on Flickr and photos from all 3 of us is on Google Photos.

Saturday, March 19, 2016

How I got much better

In the last 18 months, I stopped going to doctors and instead focused on self-experimentation. Many experiments failed, but overall it’s been a big success. Some symptoms are completely gone, some are still alive but few and far between, and some are thriving as well as for the last 15 years.

This post was supposed to be titled Living with histamine intolerance, part 4, but I don’t classify as histamine tolerant anymore. You can read parts 1, 2 and 3 to get better context, though.

Feel free to get inspiration from my experiments but remember that there are risks involved.

Life-style changes that worked


I always wondered why I felt better in the summer and worse in the winter. Each November my ability to exercise rapidly dropped, except when I spent autumn in sunny California and the symptoms were then postponed by two months.

I’ve tried spending every second in the Sun but it was very difficult to do in Sweden. Spending one week under the Arctic Sun didn’t do anything. Two days of kayaking helped a lot, but not as much as 3 hours of full-body sun bathing. Sunlight is the be the best cure against insomnia and bad sleep.

On the other hand, taking vitamin D in winter helps but doesn’t bring the full effect. It’s not so surprising, since sunlight does more to our skin than just vitamin D production and we’re only discovering those effects now.

Dietary changes

Diamine oxidase (DAO) is an enzyme that regulates histamine in our bodies. The only macronutrient increasing DAO concentrations in the intestinal lymph in rats is fat. In another study of rats, MCT oil increased DAO activity 2.5 times in the intestines.

Even though I’m not a rat, I had to try it out. Did it help? Maybe it did, maybe it didn’t. It’s true that my DAO levels are 3 times higher than before, but I have too little data to judge causality. An unexpected side-effect was a big decrease in headaches and migraines. This is perhaps not that surprising, since MCTs boost ketone production and ketogenic diets are therapeutic for a few neurological conditions.

The second big change in my diet was eating nose to tail – eating other parts of animals than just muscles. Organ meats are cheap, easy to cook and super-nutritious. Skin, bones and cartilage are rich in collagen, which seems to be beneficial for many. The nutritional wars concentrate too much on carbohydrates versus fat, while different proteins and amino acids are often ignored. That’s likely a big mistake.

I’ve changed other small things in my diet, but listing them all would need another full post. Luckily for you, someone made a nice infographic and wrote a book about my diet 4 years ago. After I found out about people copying my diet, I read the book and had a lot of Aha! moments. That being said, the book is overconfident at times and I’d be extra careful following their advice to the last word. Also check Scott Alexander’s critical review.


Abdominal pain has been my number one problem for years. I’ve consulted doctors and tried many things, but those brought minor improvements at best. With Lactobacillus plantarum, the pain was gone within hours. Bacillus coagulans was also helpful for better digestion, but I had to take it every day and was later able to achieve a superior effect with glycine-rich foods, so I stopped taking it.

While I swear by L. plantarum, I do believe that probiotics are mostly unnecessary. If you have to take them every day, there is probably a deeper problem that needs addressing.

Intermittent fasting

I’ve previously written about two stressors, cold showers and exercise, helping me cope with various symptoms. At about the same time I’ve started experimenting with another stressor: intermittent fasting. Surprisingly, fasted state is when I have the best focus and productivity. I usually skip breakfast and only eat within an 8–9 hour window, with a big lunch and a big dinner (or two).

Fasting is a stressor that requires caution, but an intuitive approach works well for me. When the body stops telling me “This is uncomfortobale, but I like it” and switches to “Are you trying to kill us?”, it’s time to listen and eat something.


I don’t like using supplements, because I often forget to take them. However, they are a great tool for controlled experiments. For example, I’ve taken pure glycine for two weeks with great results and after that incorporated a lot of collagen into my diet (with the same results).

It’s all just placebo and correlation doesn’t imply causation!

If everything I’ve experienced is a placebo effect, where was it for the previous 4 years? Out of the 50+ lifestyle changes, prescription pills, supplements and probiotics I’ve tried, only about 15 worked. If there was placebo effect, it must have been negligible. However, the good ol’ regression to the mean (patients getting better on their own) definitely played a role. Then again, I’ve tried relying on it many times before and it was never sufficient on its own.

How do I know the interventions listed above helped? Either I’ve done sufficiently many experiments or the effect was so strong it’d be impossible to explain otherwise. For example, after taking nonsteroidal anti-inflammatory drugs (NSAIDs) regularly, strong abdominal pain started. Wikipedia lists gastrointestinal problems as the main adverse effect of NSAIDs and they are also known to disrupt gut flora. Nothing has helped me for years. Then one day I tried Lactobacillus plantarum and the pain was gone within hours. Fixing other stomach problems took another 10 months, but at least the pain was gone. Also, L. plantarum is one of the few probiotics that performs in medical trials on people and in other studies, animals benefited from probiotics after being given NSAIDs.

A true skeptic would say that correlation doesn’t imply causation and that such evidence is not sufficient. Many people don’t believe successful stories and dismiss any kind of evidence, often because it contradicts their beliefs.

Skeptics are right that no evidence is perfect and we can never be completely sure. I admit I didn’t use an identical twin as a control group and I didn’t double-blind my fasting experiments. However, my personal experiments showed that skeptics are as likely to be wrong as the people they criticize. I’m glad I didn’t listen too much to sites like QuackWatch and Science-Based Medicine, otherwise I would probably avoid probiotics, cholesterol and fat for no good reason.

The new skeptic movement reminds me of the disagreement between academic skeptics and Pyrrhonian skeptics 2 millennia ago in Greece. Academic skeptics claimed “Nothing can be known, not even this” while Pyrrhonians viewed them as too dogmatic. I’m siding with Pyrrhonians here and my advice is: be skeptical, especially of skeptics.

This post is getting too long, so let’s take a short break with classical music.

Self-experimentation and its risks

A while back my mom told me to drink a particular herbal tea to alleviate some of my symptoms. I replied with “If this herb was effective, it’d have performed well in scientific trials and doctors would have prescribed it to me.” The statement does make sense, but it involves many strong assumptions and often isn’t true.

As an example, there is a drug called ramelteon, which binds to the melatonin receptors and for all we know it has identical effects to melatonin and performs about the same as melatonin in clinical trials. A monthly supply of melatonin is about $5 while ramelteon costs $100, yet doctors prescribe ramelteon instead of melatonin. Or one time I asked a Swedish gastroenterologist about her opinion on L. plantarum and other probiotics. She told me I know more than her and I should keep trying. This is despite plenty of successful clinical trials, many done on Swedish universities.

The previous two examples were cures that proved themselves in trials. Using fat and MCT oil in particular to increase the production of DAO has only been tested on rats. Perhaps it also works on people, but as far as I know no experiment was done on people, so doctors wouldn’t recommend it.

Medicine seems to miss a lot of treatments, so self-experimentation might be worth it. It does bear a lot of risks, so I evaluated possible adverse effects and monitored my health. For example, I’ve closely monitored my cardiovascular risk factors and they stayed the same or improved. However, I don’t trust these tests completely. A comprehensive heart-disease blood test would include 5–7 different blood values, but despite so many numbers, its predicting power is limited. I believe that there is too much focus on lipoprotein particle size and soon a more important risk factor will be discovered, so I’m not pronouncing myself completely out of risk yet.

Blood tests are tricky to interpret for another reason. Some blood reference intervals are calculated so that exactly 95% people fall inside them and it’s not always clear if sick people are included or not (see here or here). Unfortunately, many doctors don’t know that and would diagnose you sick or healthy solely based on these arbitrary numbers. It reminds me of a TV discussion with someone complaining that poverty in the US has stayed exactly at 20% of the population for the last 100 years. This came as a big surprise, so the moderator asked about their definition of poverty. “It’s the poorest 20% of the population”, the first person said.

So I take blood tests and reference intervals with a grain of salt. Perhaps more important is tracking values over time and comparing them with a younger version of myself.
Disclaimer: While I don't have a lot of trust in medicine and doctors anymore, a world with doctors is much better than a world without them. Doctors are awesome at fixing anything acute or live-threatening. Next time I break my leg into six parts while skiing, I'm sure doctors will do a great job. It's the chronic conditions where my trust disappears.

Further reading

I recommend 3 blogs for anyone interested in health and medicine. And one crazy idea.
I’ve also read other websites and watched a lot of YouTube videos, but it’s a minefield that is very difficult to navigate. Especially nutrition discussions are often worse than politics or gender, with people citing facts out of context, ignoring evidence and sticking to dogmas. For example, many people benefit from vegetarian or low-carb diets and then preach them as the healthiest diets for everyone. Perhaps they are helpful in certain situations, but that doesn’t mean everyone should follow them or that they are safe in the long term. And some people don’t benefit from any diet, so they become radical skeptics and question everything. Usually there is some truth in each dogma, but some people take them too far.

Maybe this post is also full of untrue dogmas, misrepresented scientific findings and without contradicting evidence. Only time will tell. I tried to do my best, though.

Wednesday, December 9, 2015

ELS: latency based load balancer

You might have noticed that the Spotify back-end has been faster by about 0.47 milliseconds in the last 6 months. Read about my new algorithm in two posts:
  1. The first one is simpler, has a lot of pictures, graphs and even three animations.
  2. The second one has all the necessary math.