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I'm a traffic engineer and this sort of thing is more or less my area of expertise. I feel weird posting "I have nothing to add, seems legit" but I feel like if I wrote a blog post like this as a layman I'd like to know I wasn't completely off my rocker. 

My only suggestion would be if the data allows you to also get "serious injuries" - those are a bit less variable than fatalities and will be able to give you a better picture of the trend, because there's also going to be more of them.

I used to do fatal crash investigation, and fatalities can be very random. You hear about horrific car crashes at high speeds where everyone walks away without a scratch. What you don't hear about is the sort of crash I attended once: a tiny, slow crash on a back road at a low speed, where two cars hit each other at a small suburban intersection. Barely any damage to the cars. No sign of the crash on the road or the vicinity (fatal crashes often have damaged vegetation, marks on the road, etc). But one of the passengers was an 84 year old woman and that crash was more than her body could take. If she hadn't been in the car, there would probably have been zero fatalities in that crash. I saw another similar crash with a man in his 80s. 

That was what surprised me the most about doing fatal crash investigation: I was expecting there to be men in their 20s and 30s who were drunk or high. I wasn't expecting the number of suicides but it didn't surprise me. But the number of "old people" who died, I hadn't expected that even though it's so obvious in retrospect. 

But yeah, that sort of thing is why I think "serious injuries" or "hospitalisations" might be a better metric for you: there will be 10-100x more of them so the trend will be less noisy.

Sorry I only just saw this post. I would not classify myself as "in the field", for what it's worth. I would consider "my field" to be traffic engineering, as I have 10+ years experience in that (not including undergrad). My experience in the field of nutrition is less than that (a 3 year undergrad degree).

The main part of my post is a blog post I made aimed at an intelligent lay audience, so I did leave some nuances out. I do not consider the fact that the NRVs are published by a body that doesn't (and with current technology can't) know the "true" RDI to be the major shortfall that you clearly think it is.

Answer by madJan 20, 202310

I mean, you don't? You can look it up but recent advice was something like 10 days after first symptoms is when contagiousness reduces.

Anecdotally, my husband was sick on Friday and took rapid tests on Friday and Saturday (when he was very sick) and got negative. Then on Monday his rapid test was positive (followed by a positive PCR on Tuesday). So he was no doubt contagious on two days when he gave negative tests. 

I have always respected your posts so when I saw your title was about iron deficiencies I was buckled in. You know that old adage, "when the newspaper reports on your area of expertise it's crap, and yet you believe the rest of it" - I always pay special attention to what people I trust/respect say about things I know a lot about, especially when there's a lot of misinformation out there.

I have just completed the requirements for a bachelor's degree in Nutrition with a focus in biochemistry. I am not a dietitian and will freely admit I know less about iron than you do after this lit review. But what you said makes sense and is scientifically grounded and dovetails with the stuff I know "formally". tl;dr I am thrilled to know that I can trust all your future posts.

I did recently write a draft blog post about iron aimed at a general audience as part of an internship, and I think a few of the things I say in there will provide useful context and background. 

And yes, menstruating is definitely the reason why women are recommended more - I found the original paper where that recommendation comes from and that's what they talk about. 

One thing I have to add - 'black stools' are also a common side effect of iron supplementation, as well as constipation, that doesn't mean you have iron toxicity. But taking "chelated iron" avoids that side effect.


Before I start talking about iron, I want to take a step back and talk about two concepts in nutrition that are often not well communicated to the public: the RDI and the EAR.

You’ve probably seen food labels that talk about the “% RDI” of different nutrients, and you might even know that it stands for “recommended dietary intake”. There’s another concept that goes along with it that you won’t find on nutrition labels: the EAR, or “estimated average requirement”. The RDI is the daily intake that will be enough for 97.5% of people, and is used when checking if an individual is consuming enough of a nutrient. The EAR is the intake that will be enough for 50% of people, and is used in nutrition research to check if a population is consuming enough of a nutrient.

These numbers are pretty close for most nutrients, but for iron they can be very different. The iron RDI for adult men is 8 mg/day and the EAR is 6 mg/day. Similarly, the RDI for post-menopausal women is 8 mg/day and the EAR is 5 mg/day. So the RDI and EAR are 2-3 mg apart. In comparison, for women who menstruate, the RDI is 18 mg/day and the EAR is 8 mg/day — a 10 mg difference!

To put that in concrete terms, imagine 100 women of childbearing age in a room (and none are pregnant or breastfeeding). 50 of them would be perfectly healthy consuming 8 mg or less of iron a day. 48 would need between 8 mg and 18 mg a day. And two of them would need even more than 18 mg!

So, even though the food labels recommend 18 mg of iron for women in this age range, half of them will have enough iron eating less than half the recommended amount — and 2% will need even more than the recommendation! This is why some people will have low iron levels, and other people who eat almost identical diets will have good levels. There’s a lot of variation in iron needs in this particular group and it comes down to variability in menstrual losses: for example, some women in this age group don’t menstruate at all and some may experience very heavy periods. 

I’ve noticed this in the vegetarian community: a lot of people will say vegetarians don’t need to take iron supplements because their own iron levels are great, citing spinach or some other iron-rich vegetable as the reason for this. A cup of raw spinach contains 0.8 mg of iron, and the RDI is 18 mg. A typical daily “women’s multivitamin” contains around 5 mg of iron, the equivalent of 6 cups of raw spinach, every single day! For comparison, 100g of tofu contains about 3 mg of iron and 100g of beef contains about 3.5 mg of iron. It is most likely that people claiming that they don’t need iron supplements happen to be ‘lucky’ and need lower intakes.

On the subject of vegetarianism, contrary to popular belief, vegetarians and vegans tend to consume about the same amount of iron as people eating a typical western diet and are at similar risk of deficiency (https://academic.oup.com/ajcn/article/70/3/353/4714844 and https://www.mja.com.au/journal/2013/199/4/iron-and-vegetarian-diets ). However, due to the reduced absorption of iron from plant foods (18% is absorbed from a mixed western diet but only 10% from a vegetarian diet), it is recommended that vegetarians consume 80% more iron. 

This is because there are two types of iron: heme iron, from animal sources, and non-heme iron, from plant sources. Heme iron is more easily absorbed, which is why vegetarians need more iron. A misconception about heme and non-heme iron is that all iron in meat is heme, but in fact, more than half of iron in meat is non-heme. So, 100g of beef would contain about 2 mg of non-heme iron and 1.5 mg of heme iron, while 100g of tofu contains 3 mg of non-heme iron. Non-heme iron absorption can be improved by consumption of vitamin C, which is abundant in most vegetarian and vegan diets.

So, where does all that leave us?

The only way to be sure of your iron status is to have a blood test, as I recommended in the previous article [unpublished; basically a much simpler version of the OP]. If your levels are low, you may want to incorporate more iron-rich foods in your diet, and ensure you consume vitamin C around the same time. You may also want to consider a supplement, especially if you have heavy periods. Whatever you do, you should get follow-up blood tests to ensure that it is working.

Iron supplements can often cause dark stools and constipation, so you may want to try several brands to find one that works for you. Some iron supplements contain “chelated iron”, which is more gentle on the stomach. [plug for advertised product removed]. For treatment of deficiencies under appropriate medical supervision, high-dose Ferrograd-C is available from pharmacies [in Australia]—though this contains non-chelated iron. 

Finally, do not take high doses of iron supplements outside of medical supervision: they can be dangerous. 

I'm a straight woman who for whatever reason seems to date a lot of men who have never had a girlfriend before (as I get older it is happening less for obvious reasons) - but these include two men who had never been kissed in their mid-30s. I tend to mostly date "rationalist" type guys.

The other advice given here is useful as general advice, but I would advise you to ask for specific advice/feedback about yourself / your dating profile / etc. I'm happy to provide that if you want it, but an appropriate subreddit or facebook group would likely be better. 

You say you spend a lot of time on dating apps "to no avail" - where are you getting blocked? Are you getting no matches? Are you getting matches but the conversations don't lead to dates? Are you going on first dates but not getting second dates? 

Getting no matches implies your standards might be too high or your profile/photos might suck. 

No conversations implies that you might not be engaging women effectively or you might be engaging effectively but not want to seem pushy by asking for a date.

First dates but no second dates might imply anything from you smell bad to you come across weirdly to you're just not going on enough of them. 

Answer by madSep 21, 2022100

Uh, I don't know where to begin. This is like, the entire field of nutrition.

Vitamin D does not need to be obtained from the diet, it is primarily produced in the skin (from cholesterol, which you don't need to eat; your liver produces all you need from any food) after sun exposure. The amount of sun exposure required depends on the time of year, time of day, cloud cover, and amount of skin exposed. VitD can be obtained in the diet but pretty much only from fish and food that has been supplemented. I assume you are now taking high-dose supplements, because the amount in a typical multivitamin isn't enough.

That said, fatigue is associated with iron deficiency, and if you menstruate there is a ~25% chance you aren't eating enough to have optimum levels - look into a blood test. (If you don't menstruate, you're probably fine, but a blood test can't hurt). 

I am like 2 months away from having an undergraduate degree in nutrition, and I'm studying in Australia, so I recommend this website to you: https://www.nrv.gov.au/

It outlines all the nutrients (from carbohydrates/protein/fat to the vitamins and minerals) and gives the recommended dietary intakes for each. It describes the scientific basis for each, with citations. 

This is a calculator you can use to get a 'personalised' recommendation for each nutrient: https://www.nrv.gov.au/nutrients-energy-calc 

EDIT: Thinking about it a bit, is the question you actually meant to ask "what are common nutritional deficiencies that I might not know about"? That depends on many things, but Vitamin D would be #1 on my list. 

Apparently the extent to which Phineas was affected by the injury is exaggerated, see: https://skeptoid.com/episodes/4744

What you are saying in all your comments is perfectly consistent with how I've heard people say about their experience as asexuals. Have a read of asexual literature, maybe post on a few asexual forums with your experiences. 

At the end of the day, I am 100% sure there are people with similar experiences to you who call themselves asexual and also who call themselves allosexual (not asexual). 

At the end of the days, these labels are a personal thing, like deciding how to cut your hair. There's no right or wrong way, just what makes you feel good.

Answer by madDec 22, 202133

My advice is don't stress too much about labels. 

I'm a woman who dates in kink-adjacent circles, and I'm a dommy switch so I have seen a lot of subby guys' profiles. You seem pretty normal, you seem like the sort of guy I date, down to the social awkwardness/lack of experience. I have a goddess kink so your specific fantasy is right up my alley. There are lots of women like me.

I've dated men who have been pretty normal but just didn't enjoy vaginal sex, we still had sex but just not PIV. I've dated men with fetishes who also enjoyed sex. 

If you WANT some labels, the different types of attraction might speak to you:

https://lgbtq.unc.edu/resources/exploring-identities/asexuality-attraction-and-romantic-orientation/ 

As you said about the painting, it may be that you are attracted to women in an aesthetic way. 

The good thing about labels is that people don't generally police them too hard because they're never perfect; I myself identify as straight but it's not a perfect label for me, just very very close. 

If it makes you happy to call yourself asexual or demisexual or whatever, then do it, try it on. You can always change your mind later. Maybe try joining local ace groups and talking about your experience with them, or reading through relevant subreddits.

Why don't you phone around GPs and ask to find one who will give you AZ? My brother is 29 and in Perth and was able to get AZ in early July that way. I'm sure you'll find a doctor who will do it for you, unless you live remote.

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