A Cure for Work

Karoshi is the Japanese term for death by overwork. The word first appeared in the second half of the seventies, and the term karojisatsu (suicide due to overwork) emerged shortly thereafter. These are not just individual but social problems. In 2015, the Japanese National Police Agency recorded 2,159 cases of karojisatsu (1), and the figures are trending up (1, 2). 

Karoshi, too, is on the up and up, and it is extending its geographical reach. China has overtaken Japan, and with around 600,000 deaths from overwork per year likely tops the international league tables (3). 

In 2021 the W.H.O. reported an estimated 745,194 deaths and 23.3 million disability-adjusted life years due to overwork world-wide, with an increase between 2000 and 2016 of 42% (4). 

‘No job is worth the risk of stroke or heart disease,’ tweeted Tedros Adhanom Ghebreyesus, the WHO-man and alleged ‘former war criminal’ whose covid policies hugely increased deaths from stroke and heart disease (5), and whose totalitarian W.H.O. Pandemic Preparedness Plan will kill many more (6).

Ted, by the way, is neither a medical doctor nor a scientist. His PhD is in philosophy, derived from a campus ranked 32^nd in the philosophy league table of UK universities (7).

Setting aside the discrepancy between the Chinese and the global data sets (are the Chinese really responsible for 80% of all work-related deaths?), it seems important to try to understand how overwork kills if we wish to develop possible protective strategies.

In an ideal world, the first line of defense would involve a mutually agreed reduction of working hours. In our world, this does not seem to be happening. Forced de-industrialization in Germany and other EU vassal states is liberating many from the drudgery of work altogether, robotics and AI are doing likewise, and those who still have skills to sell are increasingly being pushed into the home-working, hybrid and gig economies where work hours are actually increasing (8). 

We must therefore retreat to the second line, which consists (in my view) of pharmaconutrition.

The big data reveal that most cases of karoshi involve ischemic heart disease and stroke (3, 4). This implicates myocardial damage, endothelial dysfunction and autonomic dysfunction as key links between overwork and an early grave. The data also suggest that it is when you start to work 55 or more hours per week, that the damage starts to accrue.

Overwork has long been associated with hypertension (9, 10), stroke (3, 4), cardiovascular disease (11-13) and diabetes (14), with shift work providing another turn of the screw (14). In this respect overwork might be considered as just another form of chronic stress, which is linked to a similar array of health problems (ie 15, 16) including neuroinflammation-mediated sickness behaviors and, in the longer term, neurodegenerative disease (17-19). (And see below).

The prevailing idea that overwork might, by inducing metabolic and endocrinological shifts and triggering low level general chronic inflammation (15, 16, 20), exacerbate all the above conditions, is a reasonable one. However, there are a significant number of cases of Karoshi where, at autopsy, no obvious pathological signs are found (21).

You are not allowed to run a prospective clinical trial to study this sort of thing yet (memo to self: check with the local ethics committee), so instead, consider the over-worked rat. You can’t ask rats to stay late and finish the filing, but you can force them to swim for extended periods of time. 

Two studies have found that in these damp animals, subtle changes in the heart muscle develop involving interstitial hyperplasia and fibrosis (22, 23). This dysregulation of the local extracellular matrix is known to increase the risk of arrhythmias (24-26) and sudden death (26-28), providing a valuable insight into the dangers of the rat race. 

Here, it seems to me, is a fairly clear connection between Horrible Bosses and karoshi. Accordingly, if you feel that work is harming your health, this finding indicates some logical steps you can take to keep the grim reaper at bay for long enough to enjoy your retirement.

Fibrosis is driven by multiple factors including glycemic stress (29), carbamylative stress (30), and chronic inflammatory stress (31). It therefore makes sense to maintain good blood glucose control, good hydration and an anti-inflammatory metabolism, including measures to rectify colonic dysbiosis, and a broad-spectrum micro- and phytonutrient support program. Once again, it involves the triad of omega 3 HUFA’s, polyphenols and prebiotic fibers.

There are other factors that link overwork with bad health including dysbiosis (32) and immune dysregulation (33), but an adequately designed pharmaconutional approach will alleviate those too. 

A lack of control at work (or anywhere else) appears to be a particularly important stressor (34). This may inter alia inhibit reverse cholesterol transport (35, 36), which would contribute to an increased risk of atheromatous disease; but this too should be neutralized by the above strategy, especially if the said strategy contains olive polyphenols (37, 38). 

There is one more likely cardiovascular (and hepatic) link in the chain. 

Lack of control at work generally entails repeated social defeat, and repeated social defeat elicits unhealthy changes in blood and liver lipids (39).

In pre-clinical models, repeated social defeat also reliably induces neuroinflammation in the hypothalamus and other central sites (40). This is strongly associated with depression (41). Neuroinflammatory stress also predisposes to autonomic dysregulation (42), which likely contributes to the increased risk of cardiac death (43); and, over the longer term, to neurodegenerative disease (ie 44) Even those whose work involves physical activity, and who are likely to be fitter, are not immune to this (45).

As the proposed nutritional program inhibits neuroinflammation, it will likely provide protection against these outcomes. The anti-depressant and anxiolytic effects of Affron^® make it a useful add-on.

There are some folks who should be particularly careful. Those who experienced significant stress in early life are prone to more chronic inflammation in adulthood (34, 46), and are therefore more likely to be vulnerable to overwork (and other stressors). Then there are women.

Women appear to be more sensitive to the pathological effects of psychosocial stress than men, as evidenced by their 10-fold higher incidence of Takotsubo syndrome (47, 48). As more women are working in high-stress positions, more will likely die of work. There is already some evidence of this trend emerging (49).

And then there are all the rest of us. Professor Sir Michael Marmot, a Brit raised in Australia, has amply demonstrated the multiple health risks associated with social inequality and inflicted on those handicapped by poverty, lack of opportunity and loss of control (ie 50-52). 

These are exactly the conditions currently being imposed on us by the degenerate Western political class (53, 54). The results of this are seen in the increasing numbers of people suffering from depression (ie 55, 56) and also in rising deaths of despair (57), although the latter is a predominantly American trend so far.

Marmot and an endogenous Australian, the utilitarian philosopher and bioethicist Peter Singer (58), laid foundations for what might have been something a little closer to an ideal world. In 2024, as skies darken in the West and our public health and happiness continue a long decline, their vision is, in retrospect, a beautiful thing. When the old order breaks we should try to put something better in its place, and could do worse than build on Marmot and Singer’s work.

In the meantime, in our excessively financialized culture, with increasing numbers of workers being priced out of basic housing and abandoned by the political class, hikikomori and quiet quitting seem increasingly justified.

If you labour in the dusk of the West, it might be time to dim the lights (59-61). 

Next week: Loony Toons: an ode to Bugs Bunny.

References:

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