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  • Colorado Decriminalized Use of Psychedelic Mushrooms: What Are the Health Benefits?
    on November 27, 2022 at 11:48 am

    Psychedelic mushrooms may be a powerful treatment tool for depression, PTSD, and more. James MacDonald/Bloomberg via Getty Images Colorado recently voted to decriminalize psychedelic mushrooms for people at least 21 years old and permit state-regulated “healing centers” where people can experience the drug with supervision. Research on the potential use of psychedelics in mental health treatment is emerging.Experts shared thoughts on the legislation and separated fact from fiction. Marcus Capone was deployed to Iraq and Afghanistan multiple times during his 13 years of service as a U.S. Navy SEAL. Some of his roles included interrogator and a lead breacher in charge of explosives.  When Marcus medically retired in 2013, new battles began: Excessive alcohol use, sleepless nights, depression, and trouble focusing — to name a few. He was diagnosed with PTSD and later traumatic brain injury (TBI) due to his time in combat and injuries sustained playing contact sports. He tried 10 medications, many in the Selective serotonin reuptake inhibitor (SSRI) and Serotonin and norepinephrine reuptake inhibitors (SNRI) families. Neither worked. His wife, Amber, began researching psychedelics. Then in 2017, a trip to — and in — Mexico changed everything.  At, what Marcus terms a “reputable and longstanding retreat in Mexico,” staff administered 5-MeO-DMT, a psychedelic product from in the gland secretions of a toad that is also found in some plants. It has the potential to produce similar mystical experiences as commonly reported with another psychedelic that’s gaining buzz for the treatment of PTSD: psilocybin.  Marcus says his 10-hour journey marked a turning point for him. “This journey showed me the difficult times that I had experienced in my life, and it forced me to face the consequences of my actions and be able to make amends with the situations that I experienced,” he recalled. “When it was over, and I was able to rest, I woke up with a feeling of overwhelming gratitude and joy that I hadn’t been able to experience in over 15 years. I had feelings again. I was excited to live again…I wanted others to experience this.” Marcus and Amber went on to found Veterans Exploring Treatment Solutions (VETS) to provide resources, research, and advocacy for psychedelic therapies in 2019. Now, in Colorado, people under the age of 21 can have a similar experience without leaving the U.S. Earlier this month, voters passed a ballot initiative called Proposition 122 that decriminalized psychedelic mushrooms for people ages 21 and older. It allows for the creation of state-regulated “healing centers” where individuals have supervised experiences with the drug. The initiative will go into effect in 2024, and in 2026, an advisory board can amend the program to add other plant-based psychedelic drugs. Colorado is the second state to develop a regulated system for psilocybin and psilocin, hallucinogenics that some mushrooms contain. Oregon voted to pass a similar measure in 2020. The new initiatives may raise eyebrows, but research on the drug and its potential to aid in mental health treatment, including for PTSD, is emerging. In 2018, the FDA tabbed psilocybin a “breakthrough therapy,” a designation for drugs that show significant improvements over other treatments in early trials. But they are not FDA-approved. What Proposition 122 does The legislation contains two general parts, says Adam Levin, MD, a PGY-3 resident in the department of psychiatry for The Ohio State University College of Medicine. “Firstly, it decriminalizes the personal use, possession, and growth of psilocybin-containing mushrooms and other plant-based psychedelic substances [DMT, ibogaine, and mescaline],” Levin says. “Secondly, it creates a system of services meant to implement and regulate the supervised administration of these substances.” Both are important. The harms of the “War on Drugs,” a term coined by Pres. Richard Nixon, have been well-documented, Levin says.  In 2021, the Associated Press released a 50-year review of federal and state incarceration data that showed that the United States prison population went from 240,593 in 1975 to 1.43 million people in 2019. Of those, 1 in 5 incarcerated individuals’ most serious crime was a drug offense. Racial disparities were stark. Black incarceration rates went from 600 per 100,000 people in 1970 to 1,808 per 100,000 people in 2000. The Latinx prison population jumped from 208 per 100,000 people to 615 per 100,000 people, while whites were — unsurprisingly — the least impacted, going from 103 per 100,000 people to 242.  Research from 2022 indicated people with a history of incarceration make more than 50% less than those without one. The authors also note that it negatively impacted housing and education — two social detriments of health. Decriminalizing psychedelic mushroom possession, use, and growth protects individuals from these outcomes while still providing safe ways to experience the drugs under supervision. What the legislation doesn’t do Levin notes that the new initiative is not a free-for-all legalization of mushrooms, nor will they be sold for recreational use in Colorado like cannabis is. But Levin says there’s still a gray area. “It also does not precisely define what is meant by supervised administration, which leaves many important questions unanswered,” he says. “For example, what might qualify as a ‘healing center’ under this legislation? Who might qualify as a facilitator or healer, and what will be the process for certification?” Levin says these unanswered questions may lead to challenges in practically implementing the legislation as they try to hammer out the details outside of true medical models, where processes, such as certification and qualifications, are more regulated. Mushrooms and mental health: What the research and experts say Decriminalizing mushrooms may do more than keep people mentally healthy. “Legislation opens up doors for the future of research and moving forward to give people more mental health options outside of pharmaceutical drugs,” says Megan Michelena, the co-founder of Zenchronicity, a microdose mentorship program that supports healing with psilocybin. “It allows for individuals to step outside of fear and seek options for living a fuller life. It reduces the stigma around the use of psychedelics to treat mental health,” Michelena added. Though the new legislation may prompt new research, some data have already emerged, creating a crux for Proposition 122 to pass. A small 2022 study of 43 people indicated that psilocybin could reduce depression symptoms and increase “the global integration of the brain’s functional networks.” A small randomized clinical trial of 24 participants with previously treatment-resistant depression published in 2020 suggested that psilocybin-assisted therapy had sustained results in decreasing their symptoms. They noted the drug had a “low potential” for addiction, and more than half were considered in remission of depression by the four-week mark.  A 2016 study indicated that psilocybin could reduce depression and anxiety symptoms in cancer patients for a sustained period of at least six months.  The low risks for adverse effects and addiction don’t surprise Levin. It’s one of the pros of decriminalizing psilocybin, which doesn’t carry the same addiction risks as alcohol but does have harsher penalties for use and possession, despite emerging research pointing to its place in medicine. “This should tell us that the drug laws are not actually geared toward reducing societal or individual harms in any meaningful way,” he says. “To take the viewpoint of a clinician and someone who studies psychoactive drugs, we should strive for a coherent, evidence-based drug policy, and the drug laws as they stand are largely politically and culturally, rather than scientifically, motivated.” But that approach should come down to science, and Levin believes there are drawbacks to the unregulated, unsupervised use of psychedelic mushrooms. “[They] can be considerable, especially without the proper therapeutic container,” Levin says. “In the short term, ingestion of psilocybin causes significant alterations in consciousness, and these can be profoundly disorienting and anxiety-provoking. In the longer term, these experiences can be incredibly powerful, challenging, and potentially destabilizing, especially without the proper therapeutic support and integration.” The future of mushrooms as medicine Michelena hopes other states follow Colorado and Oregon and pass similar initiatives.  “This will de-stigmatize the use of plant medicine for mental health and overall well-being, opening up opportunities for other states to see the benefits,” she says.  New Jersey proposed a similar bill. California activists were hoping to get a similar initiative on the ballot but announced earlier this year they failed to get the necessary signatures.  Levin has a more nuanced hope. “This will de-stigmatize the use of plant medicine for mental health and overall well-being, opening up opportunities for other states to see the benefits,” Levin says. What that means is up for debate — and it’s one worth having, though he’d like to see some regulation. “My hope would be that these initiatives are implemented responsibly and with the scientific evidence in mind,” Levin says. “I also hope that there is some system of collecting data in these states for the purposes of greater scientific understanding and treatment optimization.” Marcus has a similar outlook. “The safe, legal, therapeutic administration of these therapies is my hope for the future of the psychedelic movement,” he says. “Much more research needs to be completed to better understand the safest and most effective ways to utilize them. Being adequately supported with proper sourcing, dosing, set, setting, preparation, and integration tools are paramount in the successful outcomes of psychedelic therapies.”

  • Chris Hemsworth Learned He Has a High Alzheimer’s Risk: What to Know
    on November 27, 2022 at 11:48 am

    Actor Chris Hemsworth revealed that he has learned from a recent genetic test that he has a high Alzheimer’s risk. Photo by Lisa Maree Williams/Getty Images Chris Hemsworth has discovered he may be at a higher risk of developing Alzheimer’s disease.A genetic test revealed that Hemsworth has two copies of the APOE4 gene The APOE4 gene has been connected to an increased risk for Alzheimer’s. Actor Chris Hemsworth announced that the results of a genetic test he took have revealed that he is at higher risk of developing Alzheimer’s disease because he has two copies of the APOE4 gene. The APOE (apolipoprotein E) gene is partially responsible for how brain cells manage fats and stress, and it has 4 known variants. People receive one of the 4 variants of this gene from each parent. Versions 1-3 of the APOE gene each come with their own risk of diminished brain health, but version 4 is associated with the highest risk of all versions. For those who have received 2 copies of the APOE4 gene (one from each parent), like Hemsworth, their risk of developing Alzheimer’s disease is 8 to 10 times greater than the average person. However, people who have 2 copies of the APOE4 gene are very rare. 2021 research from the National Institute on Aging put the percentage of people with two copies at “2 to 3%”. Nevertheless, Hemsworth’s announcement has increased curiosity about genetic testing, with people wondering if they should do the same in order to make better informed choices about their health. Should you consider genetic testing? The first thing to know about the ongoing public conversation surrounding the gene is that it is connected to risk susceptibility and is not what is known as deterministic. This means that while having two copies puts you at a higher risk – as much as tenfold – it doesn’t mean you are automatically going to develop the condition. This is different from conditions like Huntington’s disease, where the chances of you developing the condition if you have the right mutation of the gene are almost certain.  “It’s a big difference between a genetic test that is showing a mutation, which means you will get it regardless. There’s no lifestyle [element]. There’s nothing that activates the genes, like Huntington’s disease or sickle cell anemia. Versus something like Alzheimer’s disease, which is what the [researchers] consider to be multifactorial,” Karen Sullivan, PhD, a board certified neuropsychologist, told Healthline. Advantages of genetic testing One advantage to genetic testing is that it can – under the right circumstances – motivate lifestyle changes that can decrease your risk. Dustin Hines, PhD, co-director of the Hines Group Comprehensive Neuroscience Lab at the University of Nevada -Las Vegas, told Healthline that the debate of whether or not to get genetic testing is a common topic at his dinner table.“This is one of the things we debate, always: would you get one of these 23andMe screens to see what you have and what you don’t have? I would get tested in a second, I think knowledge is power. That’s my personal opinion, though, but it’s a very personal thing, what you want to do with it.” Hines says that it’s helpful to contextualize genes as partially fluid rather than as static entities.  “Not all genes are equally expressed within the lifetime of individuals. So certain things, such as the environment, such as stress, can increase or decrease genes. And actually, recently, we’ve learned that the clinical idea that you’re born with these genes and they’re set in stone is actually not even true. There’s a whole field of epigenetics that’s now showing that your genes can even change within a lifetime.”  The drawbacks of genetic testing Broadly accessible genetic tests like those offered by services such as 23andMe, have shined a spotlight on genetic testing, grabbing headlines and the attention of the mainstream. However, Sullivan says that patients really need to make sure that they are prepared for the answers they may receive, especially when Alzheimer’s is one of the most feared conditions among senior populations. Nevertheless, Sullivan stresses that genetic tests can have value if your support system is there and if you can turn the results into momentum for yourself and others.“What this genetic test allows us to do is, potentially, when someone is 21 years old, look down into the next few decades of their life and [ask], might they be experiencing the most feared disease of humankind. So there’s a huge rush of distress. And I want people to get empathy from that. I want them to understand this is what it might be like to be in those shoes. So, now knowing what you know, how are you going to join our cause to make dementia care better?”

  • E-Cigarettes, Vaping Linked to Increased Risk of Tooth Decay and Cavities
    on November 27, 2022 at 11:48 am

    A new cross-sectional study shows that e-cigarettes or vapes are associated with a higher risk of dental decay and cavities. Abd Latif Mohd Shaafily/EyeEm/Getty Images E-cigarettes, also called vapes, contain potentially harmful chemicals.Although research is emerging, the full implications of how e-cigarettes impact health, particularly oral health, are not yet known.A new cross-sectional study found that the use of e-cigarettes was associated with a higher risk of dental cavities.Although the results are preliminary, the study authors suggest that vaping should be added to dental-medical health questionnaires and included as a factor for increased cavity risk. Electronic cigarettes, or vapes, are battery-powered devices that use a heat source to produce an aerosol from a liquid. The aerosol produced by an e-cigarette is inhaled into the lungs. Vape liquids are available with or without nicotine and can also contain cannabis-derived compounds. Estimates indicate that worldwide, 58.1 million people used vape products in 2018. E-cigarette aerosol contains potentially harmful substances, including nicotine, heavy metals, and flavorings such as diacetyl — a chemical linked to abnormal lung function and lung disease. According to the CDC, more research is needed to understand the health effects of vaping products. Still, a small 2022 case study with four participants found an association between 3–8 years of e-cigarette use and symptomatic chronic lung disease, including small airway fibrosis and constrictive bronchiolitis. The study authors observed an improvement in symptoms among participants who stopped vaping. What’s more, recent research found a link between e-cigarette use and blood vessel damage. In addition, another 2021 study found that e-cigarette users had different oral microbiomes compared to those who do not smoke or vape. The microbes present in people who vape is associated with periodontitis, a severe gum infection that is also common in smokers of traditional cigarettes. Now, a new study from Tufts University School of Dental Medicine found an association between vape use and an increased risk of dental caries, commonly known as cavities. Specifically, people who reported using vapes had a higher risk of developing cavities than those who reported no e-cigarette use. The study was published on Nov. 23 in The Journal of the American Dental Association. Studying vaping and increased cavity risk To assess the associations between vape use and dental cavity risks, the research team collected data from people who attended the dental clinic at Tufts University School of Dental Medicine from January 1, 2019–January 1, 2022. The participants were older than 16 years, had received a diagnosis of cavities, had a Caries Management by Risk Assessment (CAMBRA) record, and responded yes or no to a health questionnaire that asked if they used e-cigarettes. Participants were excluded from the study if they had not had cavities or responded yes to using recreational drugs — unless the drug was delivered through vaping. The research team divided the eligible participants into three age groups: 16–25 years old26–40 years oldolder 40 years old Data from a total of 13,098 participants were included in the study. Among them, 91 reported using e-cigarettes, and 13,007 reported not using e-cigarettes or vapes. The researchers calculated the participant’s cavity risk level using patient records software as low, moderate, or high. Among all the participants who reported no e-cigarette use: 14.5% had a low cavity risk25.9% had a moderate risk59.7% were at high risk Among those who reported using e-cigarettes: 6.6% had a low cavity risk14.3% were at moderate risk79.1% were at high risk Of those who reported no e-cigarette use: 6.3% were aged 16–25 years32.6% were aged 26–40 years61.1% were older than 40 years Of those who reported using vapes: 19.1% were 16–25 years52.9% were 26–40 years27.9% were older than 40 years “This research found that on examining patient records, individuals who reported e-cigarette/vape use had a significantly higher risk of developing dental decay in comparison to those who did not use vapes/e-cigarettes,” Lead study author Dr. Karina Irusa, an assistant professor of comprehensive care at Tufts University School of Dental Medicine, told Healthline. According to the study, the authors suggest that e-cigarettes or vape use should be included in routine dental-medical history questionnaires and listed as one of the factors that increase the risk of cavities. Still, there were limitations to the study. For example: The study was cross-sectional and dependent on patient records.Vape use was self-reported, and the small number of people who reported vape use may have skewed the statistical analysis results.The authors noted that drug use, in general, is associated with poor oral hygiene and increased sugar intake. So, these may be variables.Dental caries risk is influenced by socioeconomic factors, which were not accounted for in the study. Why would vaping increase the risk of cavities? “The current hypothesis is that vaping may cause dry mouth, depriving the oral cavity of its ability to self-cleanse through saliva,” Irusa explained. “We also believe that vaping causes a shift in the oral bacteria favoring the proliferation of the bacteria that cause decay.” Irusa noted, however, that the results of this study are preliminary and limited information exists on how vapes may cause tooth decay. “We are currently in the process of sourcing funding to further investigate the exact mechanism by which e-cigarette/vape use influences the development and propagation of decay,” she said. David Frank, DMD, owner and founder of Walden Dental, told Healthline that most vape products or electronic cigarettes contain nicotine and other harmful chemical byproducts. “When inhaling through a vape pen, your gums and teeth are in the direct line of these dangerous chemicals. Vaping can cause your mouth and gums to dry out, resulting in dry mouth (xerostomia),” Frank explained. “When your mouth is dry, you are at a high risk for tooth decay and gum disease. The bacteria that cause tooth decay like a dry environment because they have an easier time to stick to your teeth resulting in tooth decay and cavities.” Frank noted that in his practice, he’s observed oral health and dental issues in people who report vape use. “We usually see an increase in gingivitis and periodontal disease (significant gum and bone inflammation with associated attachment loss), he said. “Some of these patients require more frequent cleanings to help reduce the level of inflammation in their mouth.” Do cannabis or THC vapes have the same cavity risks? Irusa told Healthline she believes that vapes containing cannabis compounds like THC might also cause an increased risk of tooth decay. “This study was inspired by an initial case series that I had published in 2020 along with 2 other investigators,” Irusa said. “In this case series, we observed 3 patients with severe decay of very atypical patterns that all reported avid use of vapes [or] e-cigarettes with THC-containing liquids. Though we cannot make any definitive statement based on these 3 patients, there may be an association.” What are the risks of tooth decay? Frank explained that once tooth decay results in a cavity, there’s a greater risk of needing continued dental treatment on that tooth over the course of your life. “Any type of dental treatment to a natural tooth will need to be replaced over time if recurrent cavities form around the periphery or underneath the restorations like fillings, crowns, and onlays,” Frank said. “Because vaping results in dry mouth, with [the] introduction of acidic chemicals, its chronic use can lead to an increased risk of forming tooth decay, loss of tooth structure, and the surrounding gums and bone.” What can people who vape do to reduce the risks? In Frank’s practice, he recommends fluoride varnish treatments at the end of cleanings to people who vape, which may help “protect and preserve the enamel from the added acidity insult from vape chemical byproducts like propylene glycol.” Irusa encourages people who vape to visit their dentist regularly to ensure they’re “on an appropriate preventive regimen.” “I would encourage meticulous oral hygiene, which would entail tooth brushing with fluoride-containing toothpaste at least twice a day as well as flossing,” Irusa said. But ultimately, Frank recommends that people should avoid vaping or using any inhaled or mouth-delivered nicotine products. Takeaway Vaping tobacco and cannabis products are increasingly common, despite the health risks. While the full implications of e-cigarette use are not fully understood, emerging research warns of the potential damage to the body. A new study found that e-cigarette use increased the risk of tooth decay and cavities, which may prompt dental hygienists to ask people about vaping. If you vape or smoke cigarettes or other nicotine-containing products and are interested in quitting, the National Cancer Institute and the U.S. Department of Health and Human Services offer resources that can help. You may also wish to talk with your healthcare professional for more guidance.

  • Does Weight Loss Drug Semaglutide Affect How Food Tastes?
    on November 27, 2022 at 11:48 am

    In recent reports, people have anecdotally described changes in how certain foods taste or appeal to them when they’re taking semaglutide. Maskot/Getty Images Semaglutide is a drug that is available for both managing type 2 diabetes and weight management.The drug is sold under the names Rybelsus, Ozempic, and Wegovy.The medication has recently gained a great deal of attention from many on social media for its potential benefits.There have also been recent anecdotal reports of the drug causing changes in the way people taste certain foods and drinks.Experts note that all treatments carry the risk of side effects. Semaglutide is a medication that’s been getting a lot of attention lately on social media and in the news, both for its potential benefits and risks as well as for recent manufacturer shortages. The drug is marketed under the names Rybelsus and Ozempic for blood sugar management in people with type 2 diabetes. Rybelsus is an oral version of semaglutide that a patient takes daily, while Ozempic is an injectable version that’s administered under the skin once a week. A long-acting, injectable form of the drug is also sold under the name Wegovy for weight management in adults with obesity or overweight who have a weight-related condition such as high blood pressure or high cholesterol. “A doctor might prescribe semaglutide for a patient with diabetes who could benefit from a potent blood sugar-lowering agent and simultaneously needs to lose weight and lower cardiovascular risk,” Dr. Caroline Messer, MD, an endocrinologist at Lenox Hill Hospital in New York City, told Healthline. “Similarly, a doctor might prescribe this medication for a patient who is overweight or obese and is perhaps even developing insulin resistance,” she added. Semaglutide is typically combined with dietary adjustments and regular exercise, sometimes with other medications such as metformin. What are the potential risks of taking this drug? Like any medication, semaglutide carries the risk of potential side effects that must be weighed against the potential benefits. Some patients may experience more side effects than others. “The most common side effects are nausea and abdominal distress, which are primarily due to the fact that the medicine slows gastric emptying.  Since food stays longer in the stomach, this can lead to a nausea sensation or indigestion,” Dr. Revital Gorodeski Baskin, MD, director of the Obesity Program a the University Hospitals Diabetes & Obesity Center, told Healthline. “In general, these side effects tends to decrease or remit within a couple of months. Most patients say that they tolerate the side effects,” she added. Other common side effects include reduced appetite, belching, bloating, vomiting, diarrhea, and constipation. Like any medication that reduces blood sugar, semaglutide can also cause low blood sugar episodes. In rare cases, people may develop serious side effects such as pancreatitis, kidney damage, gallbladder damage, or a severe allergic reaction. Research in mice suggests the drug may also raise the risk of thyroid C-cell tumors. “Semaglutide is contraindicated if a person has had a history of pancreatitis as well as personal or family history of medullary thyroid cancer,” said Gorodeski Baskin. If a patient develops side effects that are hard to manage, their doctor may advise changes to their treatment plan. How does semaglutide work? Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA), a class of medication that’s used to treat type 2 diabetes and, in some cases, support weight management. “GLP-1 RAs have been a game changer in the treatment of diabetes and obesity,” Dr. Gregg Faiman, MD, an endocrinologist with University Hospitals in Cleveland, Ohio, told Healthline. GLP-1 RAs mimic GLP-1, a hormone that helps regulate appetite and blood sugar. These medications slow down digestion, increase insulin production, and reduce the release of sugar stored in the liver, which helps curb appetite and lower blood sugar levels. Multiple types of GLP-1 RAs have been developed, among which semaglutide is one of the newest options. Research suggests that semaglutide can help not only lower blood sugar and weight but also reduce the risk of heart disease in people with type 2 diabetes. Does it change how food tastes? In recent reports on social media and in the news, some people have anecdotally described changes in how certain foods taste or appeal to them when they’re taking semaglutide. For example, Insider recently reported a case where a woman lost her taste for coffee, chocolate, ground beef, and her favorite fried-chicken sandwich while taking the medication. In a thread on the social media platform Reddit, posters similarly described favorite foods that had lost their appeal or developed an unwelcome bitter flavor. “Suddenly yesterday, something was…off,” wrote one poster. “[My favorite french fries] tasted bitter to me. They’ve never tasted like that to me before, ever. I may have nearly cried. I love those stupid things, and suddenly they taste like potato-shaped metal chunks.” Messer and Gorodeski Baskin both told Healthline that they have received similar reports from some of their own patients. While such changes may be disconcerting or distressing to some patients, others may find them less troublesome or even helpful for managing food cravings. “I’ve definitely heard that food is less enjoyable and often doesn’t taste the same,” said Messer. “However, relationships with food inevitably improve as food becomes less of an enemy and occupies less of the patient’s head space.” In contrast, Faiman said he hasn’t heard of any patients who have developed changes in their sense of taste or new food aversions while taking semaglutide. He attributes changes in eating habits among people who take the medication to reduced appetite rather than shifting flavors or food aversions. “I have never heard of this complaint for a patient on any form of semaglutide,” he said. “Most say they have a smaller appetite and cannot eat as much as they used to.” A small study from 2020 examined the palatability of food among people taking semaglutide and found no significant difference compared with those taking a placebo. Effect of recent shortages Some patients who’ve received prescriptions for semaglutide have faced challenges accessing the drug in recent months due to high demand and manufacturer shortages. Both Ozempic and Wegovy have been in short supply in the United States and other countries around the world. “Because of the higher than expected demand for Ozempic in particular, there [have been] challenges getting medication,” said Faiman. “These have for the most part now been resolved. In my patients, we were able to give some patients samples.  Others were able to receive their medications from pharmacy but in smaller amounts — monthly instead of quarterly.” Gorodeski Baskin told Healthline that some patients have had to travel to multiple pharmacies to fill their prescriptions for semaglutide. In some cases, she’s had to prescribe another treatment to patients who’ve been unable to access the drug. “In most instances, it has pushed me to prescribe an alternative GLP-1 agonist—and since the alternative is not as good as semaglutide, it has led to frustrations,” she said.

  • High Blood Pressure May Contribute to Neurotic Behavior in Some People
    on November 27, 2022 at 11:48 am

    A new study suggests that high blood pressure may contribute to anxiety and neurotic personality traits. Maskot/Getty Images Recent research suggests that high blood pressure may lead to an increase in neurotic behaviors.High blood pressure (hypertension) is a risk factor for heart attack, stroke, and other health issues. Hypertension was responsible for more than 670,000 deaths in the United States in 2020. Neuroticism is a personality trait characterized by a tendency to experience negative emotions such as anxiety, fear, mental stress, anger, guilt, and depression. Research shows that it is associated with worse health outcomes. “Individuals who score higher in neuroticism tend to be at greater risk of developing chronic disease — including cardiovascular disease and other diseases such as Alzheimer’s disease — and [they] are at an increased risk of premature mortality,” said Angelina Sutin, PhD, a professor in the Department of Behavioral Sciences and Social Medicine at Florida State University in Tallahassee. In addition, “neuroticism is the strongest personality predictor of mental health disorders,” she said, “which can contribute to poor physical health outcomes.” The level of this personality trait in a population can also change over time. For example, one recent study found that neuroticism increased among young people in the United States during the COVID-19 pandemic. While it’s known that neuroticism can increase the risk of poor health outcomes, a new study suggests that, in certain cases, the association can go the other way. Specifically, high diastolic blood pressure is likely to cause neuroticism, suggests the results of a large-scale genetic study recently published in the journal General Psychiatry. How blood pressure is measured Blood pressure is expressed as a measurement with two numbers, one number on top (systolic) and one on the bottom (diastolic). For example, 120/80 mm Hg. Systolic blood pressure represents the pressure in the blood vessels when the heart contracts. In contrast, diastolic is the pressure of the blood vessels between contractions of the heart, when the vessels are relaxed. High blood pressure can increase health risks High blood pressure, also known as hypertension, is a risk factor for heart attack, stroke, and other health problems. This condition was responsible for more than 670,000 deaths in the United States in 2020, according to the Centers for Disease Control and Prevention. While poor diet, lack of physical activity, and high stress levels can influence whether you have high blood pressure, your genes also play a role. How high blood pressure may affect neurotic behaviors The authors of the new study used this fact to examine the association between blood pressure and certain personality traits using a technique called Mendelian randomization. They drew on several large-scale datasets containing genetic data extracted from blood samples provided by people of predominantly European ancestry. Researchers looked at four traits of blood pressure — systolic blood pressure, diastolic blood pressure, pulse pressure, and high blood pressure. They also examined four psychological states — anxiety, depressive symptoms, neuroticism, and subjective well-being. Their analysis showed that diastolic blood pressure had “significant causal effects” on neuroticism but not on anxiety, depressive symptoms, or subjective well-being.  The other blood pressure traits had no association with the four psychological states. The researchers acknowledged certain limitations of their findings. For example, because the genetic data came mainly from people of European ancestry, the results may not apply to other populations. In addition, researchers couldn’t rule out pleiotropy — where one gene might affect both diastolic blood pressure and neuroticism. This could make the link between the two appear stronger. Health impacts of psychological states  More research is needed to fully understand the mechanisms linking blood pressure and psychological states, but the study adds a new twist to that association. “It is intriguing to see that the researchers found evidence supporting a causal direction from blood pressure to neuroticism, but not vice versa,” said Lewina Lee, PhD, assistant professor of psychiatry at Boston University School of Medicine. “I am curious to hear their thoughts on potential mechanisms and explanations for these findings.” However, earlier research has already shown that neuroticism — and related psychological states — can have negative impacts on overall health. For example, two studies — in 2007 and 2013 — linked higher levels of neuroticism to a greater risk of dying from cardiovascular disease. However, Lee said due to the way the studies were designed, participants may have had cardiovascular disease at the start. “So there is insufficient information to say whether neuroticism caused the development of cardiovascular disease,” she said. Other research has examined the health effects of psychological factors closely related to neuroticism. One meta-analysis found a 1.5-fold higher risk of developing cardiovascular disease among people with anxiety compared to those without anxiety. “These results held up even when the analyses were restricted to people who were free of cardiovascular disease at baseline,” said Lee. In addition, research shows that depression is a risk factor for coronary heart disease and increases the risk of dying in people with existing coronary heart disease. Can treating neuroticism improve health outcomes? If neuroticism is linked to poor health outcomes, will treating neuroticism help improve physical health? Sutin said we don’t yet have an answer to that question. “It has just been in recent years that researchers have rigorously tested whether neuroticism can be changed through intervention,” she said, adding, “it can.” Additional research is needed to show whether treatment — which includes medication and cognitive-behavioral therapy (CBT) — can lead to better health outcomes. Lee pointed to research showing that treating neuroticism-related conditions — such as anxiety, depression, and post-traumatic stress disorder (PTSD) — may prevent the recurrence of heart disease. For example, studies show that stress reduction — such as cognitive behavioral therapy and transcendental meditation — can reduce the risk of heart attack, stroke, and other heart-related events in people with existing cardiovascular disease. But she said research on whether treating PTSD can reduce the risk of developing cardiovascular disease has been mixed. Still, “there is a lot of room for more research in this area,” she said. Sutin expects the association between neuroticism and health will go both ways, “such that neuroticism is associated with poor health outcomes, but poor health may also increase neuroticism.” “Disrupting this cycle will be important to improve long-term health and well-being,” she said.

  • Pregnancy: New Study on How Long a Person Should Wait After a Miscarriage, Abortion
    on November 27, 2022 at 11:48 am

    Experts say there are a number of factors to consider before getting pregnant again after a miscarriage or abortion. d3sign/GettyImages A new study is challenging the current recommendation that a person should wait 6 months after a miscarriage or abortion before getting pregnant again.Researchers say in many cases conceiving 3 months after a pregnancy loss does not increase the risks of an adverse pregnancy outcome.Experts say many factors can go into deciding when to get pregnant again, including physical condition, family support, and age. The World Health Organization (WHO) recommends waiting 6 months before trying for pregnancy after a miscarriage or abortion. The purpose of waiting is to reduce the risk of adverse pregnancy outcomes.  Now, a new study on pregnancy loss and future pregnancy outcomes is challenging that recommendation. In their study, researchers say conceiving within 3 months after pregnancy loss or after induced abortion is not associated with increased risks of adverse pregnancy outcomes.  The researchers analyzed data collected between 2008 and 2016 in Norway. They looked at 49,058 births following a previous miscarriage and 23,707 births following a previous induced abortion. Significance of this pregnancy research  The evidence underlying the WHO recommendation is scarce, says Gizachew A. Tessema and colleagues in their study published in PLOS Medicine. Dr. Mary Jane Minkin, a practicing gynecologist and clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine in Connecticut, agrees. “The World Health Organization’s recommendation is based on some older data from Latin America that had suggested that a pregnancy that followed a miscarriage or induced abortion in less than six months had a higher risk of an adverse outcome, compared to a pregnancy that occurred 6 months or more after the event,” Minkin told Healthline. “The Latin American data had not been overwhelming, but some practitioners based on this older data did recommend that women wait more than six months to conceive again,” she said. The need to revise pregnancy guidelines   “Those WHO recommendations absolutely need to be revised,” says Dr. Holly Puritz, an obstetrician/gynecologist with The Group for Women, a division of Mid-Atlantic Women’s Care in Norfolk, Virginia. “This is truly what all of us have been doing for the last number of years,” she told Healthline. She added the new study supports the real-world recommendations of most obstetricians in this country. Puritz notes that miscarriages are common and so the medical definition of high-risk from recurrent miscarriages is not until somebody has three pregnancy losses. One estimate from the March of Dimes, an organization that works on maternal and child health, suggests miscarriages can occur in 10% to 15% of known cases of pregnancies. Deciding on when to get pregnant again after loss “There is no need to wait an excessive amount of time for women to conceive after a miscarriage or a pregnancy termination,” said Minkin. What’s considered appropriate will differ depending on independent and personal factors. “Most of us do recommend waiting two or so months to give the uterus a chance to recover and for the woman to regain regular menstrual cycle activity,” Minkin said. “And knowing that for many women a pregnancy loss is devastating, we, in general, encourage women to wait until they feel emotionally ready to deal with some of the ordinary hormonal ups and downs that women can experience during the pregnancy,” she added. Puritz said that other personal factors can also impact how long someone may feel they want to wait before trying for pregnancy. This can include family support. Puritz highlights that allowing grief to happen and other people accepting your grief as normal can help in the healing process and in feeling “ready” to try for pregnancy in the future. Minkin adds that she usually encourages a person to stay on prenatal vitamins, which contain folic acid. This can help a person be prepared for the next conception with a decreased risk of having a baby with a neural tube defect. Why not wait the recommended 6 months? There are many reasons why someone may choose to attempt to get pregnant sooner than the 6-month mark.  Age is one of them. “I’ve never said six months and as many women now are older when they are trying to start a family, I think that the six months is an extremely long period,” said Puritz. “Many of us did say three months knowing that there was not strong medical evidence, but giving the patient time to recover mentally and physically and the mental health aspects are somewhat patient-dependent and somewhat in the context if they have children or have had difficulty getting pregnant in the past,” she added.  “The main takeaway from this is that having one miscarriage, although it is very frightening and upsetting to our patients, does not put you in a high-risk category,” Puritz said. 

  • Lung Cancer Screening Dramatically Increases Long-Term Survival Rate
    on November 27, 2022 at 11:48 am

    Experts say lung cancer screening is an important and easy diagnostic test. Weedezign/Getty Images Researchers say early screening significantly improves the 5-year survival rate for lung cancer.Experts note, however, that many people who are at higher risk for lung cancer don’t get screened early.They add that new tests, such as liquid biopsies, are making lung cancer screenings easier. Lung cancer remains the leading cause of cancer death in the United States for both men and women. The rates are declining in the United States, according to the American Cancer Society, because there are fewer smokers, improvements in treatments for non-small cell lung cancer, and earlier screening. Despite that decline, the SEER database of the National Cancer Institute reports that the average lung cancer 5-year survival rate is nearly 23%. A big reason why the survival rate is still so low is that most people still do not get screened. According to the American Lung Association, only 16% of lung cancers are diagnosed at an early stage when it is easier to treat. More than half of people with lung cancer die within one year of being diagnosed. Currently, the only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). The U.S. Preventive Services Task Force recommends annual screenings with LDCT for people between 50 and 80 years old who have a history of heavy smoking, smoke now, or have quit within the past 15 years. Early screening for lung cancer saves lives Diagnosing early-stage lung cancer with low-dose CT screening significantly improves the long-term survival rate, according to a 20-year international study presented today at the annual meeting of the Radiological Society of North America (RSNA). Dr. Claudia Henschke, a professor of radiology and director of the Early Lung and Cardiac Action Program at the Icahn School of Medicine at Mount Sinai in New York and the study’s lead author, told Healthline that “the people who do get screened and detect the cancer early have a far greater chance of surviving.” The key finding of the study, which hasn’t been published yet in a peer-reviewed journal, is that even after a long time interval these participants in the study are not dying of their lung cancer, Henschke said. She noted that the screening process is relatively simple. “Go into the scanner, stay in your street clothes, hold your breath in a single breath hold. That is how easy it is,” Henschke said. “The radiation dose is that of a mammogram or lower, and people have been getting mammograms for many years.” Other lung cancer screening options There are other options now for screening lung cancer, including liquid biopsies, which are blood tests that identify biomarkers in the blood that can tell the doctor if there is cancer in the body. Marty Keiser, the founder and chief executive officer of IVBH, a company that specializes in liquid biopsy and early cancer detection, said there is a need for less invasive lung cancer screening.  “The idea is to more easily and accurately detect lung cancer and place those patients into evidence-based imaging pathways much earlier in the disease state,” Keiser said. “It’s critical that our tests are both highly accurate and easy to administer, but that they also complement and enhance existing standards-of-care — eliminating time, cost, risk and stress, and improving patient outcomes within a clinical setting,” he added. Grail’s Galleri test for lung cancer Dr. Jeff Venstrom is the chief medical officer of GRAIL, whose multi-cancer liquid biopsy test Galleri is now available to consumers. “We know that lung cancers can hide from imaging, and are often aggressive, leading them to shed DNA into the bloodstream early in their natural history,” said Venstrom, who sees blood-based multi-cancer early detection (MCED) tests as complementary to imaging-based modalities for lung cancer screening. “MCED tests like Galleri, which look for this circulating tumor DNA, offer real promise to complement existing low-dose CT screening to find more cancers earlier, especially for non-smokers,” Venstrom told Healthline. “Blood-based MCED tests also avoid radiation exposure and may be more accessible for more people, including those who live in rural communities where access to imaging is limited,” he added. More clinical trials for lung cancer liquid biopsies Guardant, a liquid biopsy company that is currently developing its liquid biopsy for lung cancer and multiple other cancers, moved its lung cancer plans forward in January with a large, focused lung cancer study using blood screening. “We plan on enrolling 9,000 people in that study for high-risk smokers,” Dr. Craig Eagle, the chief medical officer for Guardant, told Healthline. “Ultimately the goal is to provide a test and use data from regulatory trials.” Dr. Scott Lippman, the associate vice chancellor for cancer research at the University of California San Diego, told Healthline that lung cancer screening research is promising. “We all want these early cancer detection tests to work. But we need this to be proven in large, randomized trials,” he said. “To be approved for standard use, it has to show that the benefit is greater than the known harm.”

  • Drinking During Pregnancy May Change Baby’s Brain Structure
    on November 27, 2022 at 11:48 am

    Most experts recommend that women drink no alcohol during pregnancy. Oleg Breslavtsev/Getty Images Researchers say even an occasional drink can alter the brain structure of a developing fetus.Their study is the latest research that indicates that even small amounts of alcohol during pregnancy can affect a baby before it is born.Experts say alcohol during pregnancy can manifest into fetal alcohol syndrome disorders, which can lead to learning and behavioral issues. Even small amounts of alcohol can cause changes to a developing baby’s brain structure. That’s the conclusion of a study presented today at the annual meeting of the Radiological Society of North America (RSNA). For years now, women have heard information about how even the occasional drink while pregnant can harm their infants. For the new study, which hasn’t been published yet in a peer-reviewed journal, researchers used MRI images to evaluate fetal brains in babies exposed to alcohol during their mother’s pregnancy. The scientists reported that even low to moderate alcohol consumption can change the baby’s brain structure and delay brain development. Details on the study on alcohol and babies’ brains The most recent study looked at brain MRIs for 24 fetuses with prenatal alcohol exposure. The mothers were between 22 and 36 weeks pregnant at the time of the MRI and the fetuses were matched 1:1 with healthy fetuses not exposed to alcohol. The scientists determined alcohol use based on surveys completed by the mothers anonymously. Overall, 17 mothers reported drinking relatively infrequently, with an average alcohol consumption of less than one drink per week. Other responses indicated: Three mothers indicated drinking one to three drinks per weekTwo mothers drank four to six weeks per weekOne mother consumed an average of 14 drinks per weekSix mothers reported at least one binge-drinking episode The scientists reported that in fetuses with alcohol exposure: The total maturation score was significantly lowerThe temporal and right superior temporal sulcus, regions of the brain involved in social cognition, audiovisual integration, and language perception and development were affected The researchers say it isn’t clear how these brain changes will affect the babies after birth and won’t know until the children are assessed when older. However, they do assume the changes related to cognitive and behavioral difficulties will continue into childhood. Experts discuss alcohol use during pregnancy “This study provides additional evidence that the ingestion of alcohol affects neural development,” said Dr. G. Thomas Ruiz, the OB/GYN lead at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “The fetal MRI is just the first study to document the neural changes in utero.” “This study strengthens our evidence to counsel pregnant women to avoid alcohol consumption during pregnancy,” Ruiz told Healthline. “We need to determine if there is a critical volume of alcohol that will create a negative impact. It is unlikely that one sip of champagne on Thanksgiving or New Year’s Eve will have the same negative effect on neural development that a daily alcoholic beverage does.”  Many medical experts say that fetal alcohol spectrum disorders (FASD) can lead to learning disabilities, behavioral problems, or speech and language delays. This study concludes that minimal alcohol consumption during pregnancy might cause harm to the unborn child. “I do not believe that occasional alcohol consumption is OK during pregnancy,” Dr. Jessica Auffant, an OB-GYN for Orlando Health Physician Associates in Florida, told Healthline. “Although small amounts may lead to no known consequences, small amounts can cause irreversible fetal changes that we do not know about yet. This study helps confirm this recommendation.” How much alcohol during pregnancy is too much? However, even among the medical community, there isn’t a universal belief that small amounts of alcohol exposure can cause problems. A report issued in 2017 found that “there is no evidence that fetal alcohol spectrum disorder occurs in babies born to women who drink occasionally or moderately during pregnancy.” The researchers here also indicated that only 4% to 5% of children of women who drink heavily are born with FASD. They concluded that “there is no well-accepted scientific evidence that low or moderate levels of alcohol consumption during pregnancy – even in the first few days or weeks after conception- cause FAS or other associated problems.” In 2020, Dr. Howard E. LeWine, wrote in an article for Harvard Health Publishing that “Minimal alcohol use during the first trimester doesn’t appear to increase the risk for high blood pressure complications, or premature birth or low birth weights.” What are fetal alcohol spectrum disorders? Fetal alcohol spectrum disorders are a range of disorders caused by alcohol exposure before birth. The disorders can be mild or severe and can be physical or mental. Alcohol can affect a developing baby before a woman knows she is pregnant, according to the Centers for Disease Control and Prevention (CDC). When a mother drinks alcohol, it enters her blood system and is passed to the baby through the umbilical cord. However, it is never too late to stop drinking if you are pregnant. Because a baby’s brain growth continues throughout the pregnancy, stopping can improve the baby’s health. “We do not know what amount of alcohol is safe and does not pose a risk; therefore should be avoided,” Auffant said. “It is known that alcohol can affect babies at any time during pregnancy, but it is likely more dangerous in the first trimester when the organs develop.” According to the CDC, symptoms of FASD include: Low body weightPoor coordinationHyperactive behaviorDifficulty with attentionPoor memoryDifficulty in school (especially with math)Learning disabilitiesSpeech and language delaysIntellectual disability or low IQPoor reasoning and judgment skillsSleep and sucking problems as a babyVision or hearing problemsProblems with the heart, kidneys, or bonesShorter-than-average heightSmall head sizeAbnormal facial features, such as a smooth ridge between the nose and upper lip “Alcohol consumption mechanisms appear to be layered, with both immediate and long-term effects,” said Dr. Kecia Gaither, the director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, New York. “We do not know what dose of alcohol starts the trail of damage,” Gaither told Healthline. “Given such, physicians, me included, advise patients not to drink alcohol during pregnancy. It is one of the few potential dangers to fetuses where effects can be mitigated simply by not imbibing.”

  • Acupuncture During Pregnancy May Help Relieve Low Back and Pelvic Pain
    on November 27, 2022 at 11:48 am

    A new meta-analysis shows that acupuncture treatment can improve common pregnancy symptoms such as low back and pelvic pain. Aubrie LeGault/Stocksy United A new meta-analysis shows that acupuncture can improve pain, functional status, and quality of life for pregnant people experiencing lower back and pelvic issues.Health experts state that acupuncture during pregnancy is relatively safe and can treat some common ailments people experience, including low back and pelvic pain.While each individual is different, many people start seeing results from acupuncture after 1 month of treatment. Many pregnant people report lower back and pelvic pain at some point during their pregnancy.  Acupuncture is becoming increasingly popular as a possible treatment for alleviating pain and discomfort, but its efficacy remains up for debate among health experts. A new meta-analysis published on Nov. 21 in BMJ Open examined the impact of acupuncture on pain, functional status, and quality of life for pregnant people with lower back and pelvic discomfort. Researchers investigated 1,040 participants — healthy pregnant people (17–30 weeks gestational age, on average) with lower back and pelvic pain.  Acupuncture was provided by acupuncturists, physical therapists, and midwives. Some received body acupuncture, and others received auricular pressure needles. The studies detailed the acupuncture points that were being treated, needle retaining time, and intervention dose. The analysis shows that acupuncture significantly improved lower back and pelvic pain, functional status, and quality of life. What are the benefits of acupuncture? As a form of Traditional Chinese Medicine (TCM), acupuncture is the practice of inserting thin needles into the body to relieve pain and heal numerous physical, mental, and emotional health conditions. “Acupuncture is predicated on the idea that energy, or qi, flows through our bodies through channels called meridians,” Jamie Bacharach, Dipl.Ac, a licensed medical acupuncturist, told Healthline. “When the flow of qi is disrupted, lacking, or excessive, illness may follow. Acupuncture needles are inserted at various points on the body to manipulate the flow of qi and achieve healing.” There are many different benefits of this form of complementary therapy, which may include: relieving chronic pain managing migraineassisting in the treatment of peripheral neuropathyalleviating nauseaimproving symptoms of rheumatoid arthritis (RA)combating fatigue Acupuncture for low back and pelvic pain during pregnancy Lower back and pelvic pain are common pregnancy symptoms. Bacharach explained that it’s generally caused by the bodily ligaments softening and stretching to prepare for labor, leading to added stress and strain on the back and pelvic joints. Acupuncture relieves this pain by promoting healthy blood flow to the affected areas and potentially relieving stress and anxiety, which could be exacerbating discomfort. “Acupuncture during pregnancy can be very beneficial to relieve some of the common ailments people experience during pregnancy, such as nausea, vomiting, heartburn, constipation, poor circulation, insomnia, as well as anxiety, stress, and depression,” said Dr. Monica Grover, DO, a double board certified in gynecologist and family medicine specialist and medical director at VSPOT. Grover explained that conventional medications can often be a contraindication during pregnancy among those who experience significant pelvic, hip, or back pain associated with sciatica. Many people may turn to acupuncture as an alternative to conventional medicine. In addition, it’s important to understand that effective medical care can take a multidisciplinary approach. “I think it’s important to keep an open mind on various approaches to medical care — holistically, Western medicine, Eastern medicine, and otherwise,” said Dr. Kecia Gaither, MPH, FACOG, a double board certified OB-GYN and maternal fetal medicine specialist and director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx, New York. “Acupuncture’s premise of action is to unblock energy channels within the body effectively. While not specifically known, the proposed mechanism of action is that acupuncture may block or delay the pain signals from being sent to the brain, which reduces or eliminates the sensation of pain.” How many acupuncture treatments before you see results? Bacharach explained that some people may experience the benefits of acupuncture treatment after just one or two sessions. But most people may require three or more sessions to achieve significant results. “In most cases, treatment is more effective when it occurs at least weekly — the less regular the visits, the less effective the treatment will be,” Bacharach said. According to Bacharach, significant results are witnessed within anywhere from 3 to 4 weeks, after which point fewer regular maintenance visits may be scheduled. For instance, during the first trimester, acupuncture can be offered weekly. Then in the second trimester, sessions may be spaced apart every 2-4 weeks, Grover explained. In the third trimester, the sessions can return to weekly treatments.  During the fourth trimester, people can return to having acupuncture between 2–4 weeks postpartum to help with any lingering pregnancy symptoms or any new ones that may arise.   “The results from the procedure are cumulative with effects generally noted within 1–3 months,” Gaither said. “It’s generally recommended to initiate it after the first trimester, certainly to have it performed in the hands of an experienced practitioner — of course, after having a discussion and clearance with one’s healthcare [professional].” Talk with your OB-GYN before trying acupuncture Generally, acupuncture is considered relatively safe during pregnancy.   But there is some concern that it can cause premature labor or even miscarriage, although these concerns have not been shown to have much validity when studied in clinical trials, Grover explained. To be on the safe side, physicians may not clear some pregnant people for acupuncture who’ve shown a prior history of preterm labor or miscarriage or if their current pregnancy is at risk for early labor. In addition, any placental issues, such as placenta previa, may also be a contraindication.   There are also a set of injection sites known as the “forbidden points” that acupuncturists should avoid in a pregnant person, especially prior to 37 weeks. Grover explained that these off-limits points are thought to potentially lead to uterine complications from somatovisceral reflexes as well as the potential of uterine perforation. Recent studies, however, have also negated the dangers of the forbidden points, although they are still practiced in conventional acupuncture therapy.   Takeaway A new meta-analysis shows the positive effects of acupuncture on pain, functional status, and quality of life for pregnant people with low back and pelvic issues. Researchers found significant improvement across the board. Health experts agree that acupuncture during pregnancy can be beneficial for alleviating some of the common issues people experience, including low back and pelvic pain. Results are typically seen after 1 month of treatment, though this may vary from person to person. While acupuncture is considered safe for most pregnancies, it’s important to talk with your OB-GYN beforehand.

  • Drag Race Star Mo Heart: Self-Esteem ‘Starts with You and Finishes with You’
    on November 27, 2022 at 11:48 am

    The “RuPaul’s Drag Race” alum and recording artist reveals how learning to love herself was the key to living her happiest and healthiest life. “I had to learn how to love and affirm myself. That’s when I started to lose weight, that’s when my skin started to clear up, that’s when I took care of myself,” Heart said. Photography courtesy of Studio71 Mo Heart wears many hats. She’s an internationally known drag queen who sashayed to fame on “RuPaul’s Drag Race” and “RuPaul’s Drag Race All Stars,” a recording artist, and the owner of her own eponymous beauty brand, MoBeauty. Despite the glitz and glamour of all this success and the platform and visibility it brings, she says it can be hard to push against some of the entrenched, often toxic “conventional” beauty norms and standards society throws her way. Heart remembers growing up as a ’90s kid, looking up at those Abercrombie & Fitch ads of thin, white models staring back at her. On TV, actors like Pamela Anderson and her co-stars on shows like “Baywatch” were some of the only — and very dominant — examples of a specific kind of filtered sexuality that Heart said she didn’t feel connected to or represented by. The way pop culture and media-driven beauty norms can affect one’s mental health and sense of belonging in the world has been on Heart’s mind a lot lately. She was recently a featured speaker during Advertising Week New York as part of Healthline’s panel on “The Beauty of Intersectionality.” Following the panel, Heart sat down with Healthline to talk about how sometimes, when faced with a lack of representation, you have to “become your own role model.” “You look at yourself, and you don’t tear yourself down. You go, ‘You are beautiful, you are great, you are so smart, you are so strong, you are resilient,'” Heart said. Self-affirming statements like these can go a long way toward protecting one’s mental health from society’s limited view of “beauty,” Heart advised. She said it’s the same advice she wishes she could give to her younger self, too. Representation can affect how someone sees themselves Heart said that no matter who you are, it can be hard to be faced with a steady stream of messaging that you might not be enough. You can fill in the blank yourself for what that might mean: your skin, your body type, your hair, your voice, you name it. “Most people wake up in the morning, look at their phones, and they are already seeing images [on] Instagram, Twitter of what beauty is ‘supposed’ to be, whether through the influencer or the brand,” she explained. “Then, you look at your face, you leave the house, and you keep seeing ads, ads, ads. You go to work, and it’s ads, ads, ads. You’re just surrounded.” Heart said that it’s nearly impossible not to start comparing yourself to these images and thinking, “This is what is wanted, this is what is desired, because if it wasn’t, then you would see the opposite.” It’s a problem for everyone, but especially people who are part of marginalized communities. Heart said that for queer people and People of Color, it is a hurdle to pass every day. For anyone who might not fit into easily categorized boxes set by advertising, social media, and film and TV, you might have to go to great lengths to find the representation that will make you feel seen. Heart recalls working in the mall as a “femme Black kid.” The sense of feeling less than was hard to avoid, Heart said, since there wasn’t one Black face in those ads. If there were, that model or actor would be sandwiched between thin white bodies. “I’d go to the store, and my body didn’t look like that, my hair didn’t look like that, my skin wasn’t like that. A lot of these things begin to weigh you down,” Heart recalled. “Also, there was the fact I was queer, and that was not being celebrated; it was a lot on my feelings. I put on weight, and then there is the way plus-size people are viewed in today’s society. It tears you down over and over and over again.” But some examples were offering positive reinforcement. “I think being a little, femme Black kid, but also one who has vitiligo, which is a skin discoloration disorder when the pigmentation begins to fight itself, so [I had this] very blotchy forehead during the ’90s, where all this beauty affirmation was not there for me,” Heart said. “My mother was the one that really helped instill life into me, because she was a beautiful dark-skinned woman, and even today, dark-skinned women are not celebrated; they are celebrated for being so dark but not for being beautiful. “I’ll never forget there was a Revlon campaign. I was a little kid. My mother came into the living room, and I was saying, ‘This is my girlfriend, that was my girlfriend,’ this and that. ‘She’s pretty, she’s pretty,’ and my mother slid my finger over to the dark-skinned woman and said, ‘She’s pretty too,’” Heart said. How beauty standards affect mental health Heart said it can be hard to push back on some of this messaging. She was lucky in that her mother was there to offer an example to follow of celebrating one’s own unique beauty, embracing it, being proud of it, and being affirmed by it. But she said she knows not everyone has that kind of support, whether in their families or the communities around them. When asked exactly how media beauty standards can affect one’s mental health, Heather Zayde, LCSW, a Brooklyn-based clinical social worker and psychotherapist, said it often comes from who is crafting the messaging. “Modern beauty standards are often based on a Westernized and Eurocentric version of what beauty is, meaning light skin, being tall and thin, high cheekbones, a small nose, etc. These beauty ideals come from colonizing forces, as many non-white and European countries don’t value the same things. This can cause a lot of internalized hatred of one’s body and looks when a person doesn’t fit into these very narrow ideals,” Zayde, who is unaffiliated with any of Heart’s projects, told Healthline.  Zayde said there’s an entire industry put in place to enforce these entrenched standards. “Millions of dollars a year are spent on weight loss diets and beauty products aimed at altering people’s looks to fit into a standardized norm. Feeling as though one doesn’t fit in can lead to depression and anxiety. These Western ideals also lead people to fatphobia, racism, colorism, ageism, and ableism,” Zayde explained. “This can also affect the LGBT+ community in terms of Westernized beauty often coming from a straight, white, male gaze that doesn’t leave space for those who fall outside of those norms,” she added. Heart takes her mother’s lessons, well, to heart. She said you have to “become your own role model” if you feel like there’s no one out there speaking for you and to you. “You have to see the vision and see where you want to end up,” Heart added. “I’m seeing myself whole, happy, loved, complete, beautiful, desired, and affirmed — all of these things.” “I think a lot of us in our 30s are finally starting to heal and be able to be OK with who we are,” said Heart. Photography courtesy of Studio71 How to combat toxic messaging in your life If all these toxic images are constantly around us, how do we push back against their negative influence? “Some of the strategies I recommend are asking yourself: Does this standard of beauty come from within, or is this something I was taught many, many times in my life through advertising, movies, and magazines? Am I viewing myself and others through this standard, and if so, how can I view people differently and in a more welcoming and open-minded way? When I look around the world, how many people actually do fit in with the ‘ideal’ standard of beauty?” Zayde said. You can fight back with your wallet, too. You don’t have to purchase something or buy into a brand that is making you question your own self-worth. “If you are tempted to purchase a product, ask yourself if it’s because the product will make you feel good (like a luxurious skin cream) versus ‘Will this simply make me fit more into a perceived ideal and perhaps harm me?’” Zayde explained. “When considering an eating plan, ‘Will this make me feel healthy and nourished and allow for treats, or is the goal to simply shrink down to the smallest I can be?’” When it comes to TV, you can also turn it off. “If you notice that watching particular shows that value these standards of beauty make you feel bad about yourself, take a break from them and try not to compare yourself to others,” Zayde said. Heart stressed that this can all be easier said than done, especially in the modern age of social media. “We live in a FOMO culture of ‘you’re missing out,’” she said. “I do think that you can step back and take a break, even if it’s just to take 2 hours [away] from social media and going to go do something productive, constructive. Something that fills me instead of drains me or sucks my time away.” “I think you have to step back and put yourself out there, put yourself out in the world,” Heart added. That doesn’t necessarily mean the negative beauty messages are going away. But you’re at least not constantly absorbing them and letting them affect you. Has media really become more inclusive? When reflecting on the beauty messaging of the past, Heart said many of today’s brands actively say, “We need a Black, we need a femme, we need a trans, we need to make sure that we hit our boxes, that we can hit a target.” While those boxes are being checkmarked, Heart said the mainstream market these companies are trying to engage is still, in many ways, the white, middle-class, American “mainstream.” Heart uses the example of “The Bachelor” and how often the more diverse contestants are tokenized and not necessarily put in a position to make great strides for greater media inclusivity. Heart did say in the area of athleisure, you’ll see more “curvy girls” who aren’t just relegated to the “plus-size section” of the store. Some strides are more superficial. Brands are making an attempt, but for many, it’s just surface level, Heart said. “Brands have been slowly incorporating more ages, races, and body types, but the overall rate of inclusion is poor,” Zayde added. “It is my hope that more brands practice inclusion and get really good feedback from consumers that this is incredibly needed. If a brand is trying to make you purchase a product by making you feel bad about yourself, do not support that brand.” Self-affirmation can help combat toxic messaging and boost self-esteem Today, Heart is thriving. In addition to all of her entrepreneurial endeavors, she’s hosting the third season of “The Walk In” on Amazon Prime. When thinking back on where she is now and how far she’s come in her self-acceptance journey, Heart, who is 36, said that she would love to speak to the 12-year-old and 25-year-old versions of herself and say, “You don’t have to go through the same bullshit I went through.” “I think a lot of us in our 30s are finally starting to heal and be able to be OK with who we are, in understanding, ‘You know what? I might not be the most popular in that group, a 10 out of 10, but in this group, I might be a 25!’” she said. “You have to affirm yourself and find love.” Heart said that sometimes you also have to check in with yourself and check in with the friends who are there for you. Sometimes you have to turn to your friend and say, “Girl, I’m going through it!” By affirming yourself and seeking support from those who matter, some of those negative messages and outdated toxic beauty standards seem less monumental. “For me, I had to learn how to love and affirm myself. That’s when I started to lose weight, that’s when my skin started to clear up, that’s when I took care of myself,” Heart said. “I would say it starts with you, and it finishes with you.”

  • Heart Disease: 'Good' HDL Cholesterol May Not Protect Everyone from a Heart Attack
    on November 27, 2022 at 11:48 am

    Blood tests are a standard way of measuring cholesterol levels in the blood. Victor Torres/Stocksy United Researchers say levels of high-density lipoprotein (HDL), commonly known as “good cholesterol,” can help predict heart disease risk in white adults.However, they say HDL levels are not necessarily an accurate indicator of heart disease risk in Black adults.They say the disparity emphasizes the need for different approaches to heart health for different ethnicities as well as more diverse participation in clinical trials. New research supported by the National Institutes of Health (NIH) says high-density lipoprotein (HDL) – frequently called “good” cholesterol – may not be as good at predicting cardiovascular disease among adults of different ethnicities as once thought.  The study was published today in the Journal of the American College of Cardiology. In it, researchers report that while low levels of HDL still predicted an increased risk of heart attacks or related deaths for white adults, the same wasn’t true for Black adults.    They also found higher HDL cholesterol levels weren’t associated with reduced cardiovascular disease risk for either group.   “The goal was to understand this long-established link that labels HDL as the beneficial cholesterol, and if that’s true for all ethnicities,” said Nathalie Pamir, Ph.D., the study’s senior author and an associate professor of medicine at the Knight Cardiovascular Institute at Oregon Health & Science University in Portland, in a statement.   “It’s been well accepted that low HDL cholesterol levels are detrimental, regardless of race. Our research tested those assumptions,” she added. Details from the cholesterol study Pamir’s team looked at data from 23,901 adults in the United States over a 10-year to-11-year period who enrolled in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS) between 2003 and 2007.  Previous studies influencing accepted ideas about “good” cholesterol levels and heart health were done in the 1970s and 1980s, mostly using white adults. The latest study involved researchers reviewing how cholesterol levels from both Black and white middle-aged adults without heart disease overlapped with cardiovascular events.    Participants shared similar characteristics of age, cholesterol levels, and underlying risk factors for heart disease such as diabetes, high blood pressure, or smoking. During this period, 664 Black adults and 951 white adults experienced a heart attack or heart attack-related death.   Adults with increased levels of low-density lipoprotein (LDL), so-called “bad” cholesterol, and triglycerides in their diets had modestly increased risks for cardiovascular disease, aligning with findings from previous studies.    However, the study was the first to determine lower HDL cholesterol levels only predicted increased cardiovascular disease risk for white adults. It also expands on findings from other studies showing high HDL cholesterol levels are not always associated with reduced cardiovascular events. “What I hope this type of research establishes is the need to revisit the risk-predicting algorithm for cardiovascular disease,” Pamir said. “It could mean that in the future we don’t get a pat on the back by our doctors for having higher HDL cholesterol levels.” The benefits of ‘good’ HDL cholesterol Dr. Yu-Ming Ni, a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California, told Healthline HDL is the “good” cholesterol because HDL particles pick up cholesterol around the body and bring it back to the liver to be processed. “Think of HDL particles as the clean-up crew, whose job is to clean up after the LDL particles, referred to as the ‘bad’ cholesterol,” Ni said. “There seems to be a sweet spot for HDL cholesterol that reduces the risk of bad heart events.” “Too little, and there isn’t enough clean-up going on. Too much might mean the cleaning crew is overwhelmed and unable to do their job of preventing heart disease,” Ni noted. Cholesterol and different ethnicities Ni told Healthline the study suggests that, compared to white Americans, African Americans don’t have a clear “sweet spot” for HDL cholesterol. “Given that African Americans have generally worse cardiovascular outcomes than white Americans, this suggests that other factors may have a greater influence on cardiovascular health, particularly in the presence of other medical conditions such as high blood pressure, diabetes, and obesity,” Ni said.  “This study is useful for understanding population-based management of cardiovascular risk, but clinically, I suspect it will not influence the way I care for patients of African American descent,” Ni added. “HDL is but one of multiple risk factors for cardiovascular disease and treating the whole picture is often more beneficial.” The need for more diverse clinical trials Dr. Jayne Morgan, a cardiologist and the clinical director of the COVID Task Force at Piedmont Hospital/Healthcare in Atlanta, told Healthline the study shows some bigger-picture insight. “It is of paramount importance to have inclusion in clinical trials of everyone,” Morgan said. “This includes all demographics, races, and gender. Without it, there will never be health equity in medicine. The biggest failure of medicine has been the lack of clinical trial diversity.”  Morgan said the Food and Drug Administration (FDA) approves drugs and therapeutics without parallels in the demographic representation in the United States. She compared it to the Tuskegee Experiment, a government-funded experiment observing the effects of syphilis on Black men without telling them about their condition or treating it.  “Blacks and other minorities are prescribed drugs that have scant information on them, but are FDA approved, nevertheless,” Morgan noted. “So often only real-world experience informs on safety and efficacy for minority populations.” The future of cholesterol studies Pamir said researchers are exploring different theories about HDL cholesterol’s role in supporting heart health. One aspect looks at quality over quantity, meaning that instead of having more HDL, the quality of HDL’s function – in picking up and transporting excess cholesterol from the body – may be more important for supporting cardiovascular health.  She said they’re also analyzing hundreds of proteins associated with transporting cholesterol and how varying associations, based on one protein or groups of proteins, may improve cardiovascular health predictions.  The authors also said their findings suggest cardiovascular disease risk calculators using HDL cholesterol could lead to inaccurate predictions for Black adults.    “When it comes to risk factors for heart disease, they cannot be limited to one race or ethnicity,” said Pamir. “They need to apply to everyone.” How to maintain good heart health Veronica Rouse, a registered dietitian who specializes in cardiac nutrition, told Healthline the study doesn’t change dietary guidelines for a healthy heart. “It is still encouraged to lower your LDL cholesterol levels through food, as LDL cholesterol responds to nutrition therapy and is still shown to lower your risk of heart disease,” she said. “One can reduce LDL cholesterol by reducing saturated fat intake, found mainly in fatty meats, lard, shortening, whole dairy products, sweet treats like cookies and cakes, and eliminating trans fats,” Rouse added. Rouse said people should eat heart-healthy foods such as plant protein (soy products, nuts, seeds, beans, and legumes), soluble fiber (avocado, oats, barley, and other whole grains), and healthy fats (extra virgin olive oil, fatty fish and nuts, and seeds).

  • Aerobic Exercise, Especially Running, May Reduce Cancer Risk by 72%
    on November 27, 2022 at 11:48 am

    Experts say running is an exercise that can help reduce cancer risk and recurrence. LeoPatrizi/Getty Images Researchers say high-intensity exercise can help reduce the risk and recurrence of cancer.They say exercise may work by increasing the glucose demand from internal organs and “starving” tumors of this essential fuel.They say running may be the most beneficial exercise, but swimming, cycling, and rowing are also helpful. Will “go for a run, starve a tumor” be the next piece of folk wisdom for people with cancer? A new study published in the journal Cancer Research suggests aerobic exercise could help reduce the risks of certain cancers from developing or recurring. While that finding is far from novel — it’s well established that exercise has protective effects against cancer — researchers from Tel Aviv University in Israel investigated the mechanisms by which aerobic exercise affected tumors and their growth. Exercise and cancer tumors Looking at health data from 2,734 people over a 20-year period, the researchers determined that those who engaged in regular high-intensity aerobic workouts like running had 72% fewer metastatic cancers than those who were sedentary. Then, in the study’s second phase, they monitored mice engaged in aerobic exercise before and after being injected with melanoma cancer cells. What they found was that mice who engaged in regular exercise had fewer metastatic tumors than the sedentary animals. After analyzing protein expression in their mouse model, the researchers observed metabolic changes related to glucose use in the active mice. The researchers said this suggests that exercise was creating glucose demand on internal organs, thus “starving” cancer cells of necessary fuel to proliferate. Expert reacts to study of exercise and cancer “The study provides good evidence that regular aerobic exercise results in reprogramming those metabolic pathways associated with glucose utilization — which they refer to as a ‘metabolic shield,'” said James Hicks, Ph.D., a professor of ecology and evolutionary biology at the University of California Irvine who was not involved in the study. “This exercise-induced ‘reprogramming’ of healthy tissues increases competition for glucose (a primary fuel for cancer cells), thus ‘stealing’ vital energy from cancer cells,” Hicks told Healthline. “It would be interesting to determine if this redistribution is associated with changes in blood flow to tumors since blood flow is delivering glucose to the cells.” “The paper provides insights into the underlying mechanisms of the links between exercise and cancer progression,” he added. “Additional mechanistic studies are needed to determine if the volume of exercise — intensity and duration — can be optimized for a broader population of cancer patients.” Best exercises for people with cancer High-intensity exercise such as running might be an ideal form of exercise for some people, but other exercises like swimming, rowing, and cycling can also provide a similar intensity with less strain on the joints.  High intensity also might not be possible depending on age and other factors. For these people, even moderate exercise still has a protective effect against cancer, Hicks said.  “Hundreds of epidemiological studies, comprised of millions of participants, provide strong evidence that regular, daily activities like brisk walking significantly reduce the risks of many cancers,” he said. “These results show 10 to 20 percent risk reductions for bladder, breast, colon, endometrial, esophageal adenocarcinoma, and renal and gastric cancers. “High-intensity exercise may be challenging for many cancer patients,” he added. “However, moderate exercise levels that will raise your heart rate to 50 to 70 percent of the maximum heart rate are achievable.” Exercise can provide a mental boost There are psychological benefits to exercise on top of the potential medical ones, which can also improve outcomes and quality of life.  “Exercise may well be the singular most proactive and self-empowering way a patient can support their cancer journey,” said Joy Puleo, the director of education at wellness company Balanced Body and a cancer survivor. “All other treatments are medical and require varying levels of expertise,” Puleo told Healthline. “Here, a patient can have a measure of control over self and possible outcomes. It is also a way to include peers and engage their support network.” She suggested picking any aerobic exercise you’d like, as long as you can do it regularly and keep challenging yourself.  “Move. Find an exercise that works for you and use it to challenge ‘the system.’ A good exercise program, regardless of choice, should have elements of challenge associated with it,” Puleo said. “For aerobic work, get on a bike, walk and when you can walk a hill or for a short period, walk faster. A trampoline is a fun way to get the heart rate up and laugh at the same time. My favorite? Go dancing.”

  • Pain Relievers Such as Ibuprofen May Worsen Arthritis Inflammation
    on November 27, 2022 at 11:48 am

    Experts disagree over the long-term benefits of taking pain relievers for arthritis inflammation. Fertnig/Getty Images Researchers say pain relievers such as ibuprofen may not provide long-term benefits for arthritis inflammation.They say the anti-inflammatory drugs may increase internal inflammation, leading to pain and joint stiffness.However, other experts say these medications are effective treatments for pain relief and inflammation reduction. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen products Advil and Motrin, do not provide a long-term benefit when used for joint inflammation, such as in arthritis. That’s according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). In the new study, which hasn’t been published yet in a peer-reviewed journal, researchers evaluated 129 participants with knee arthritis from the Osteoarthritis Initiative cohort. All participants had moderate to severe arthritis and were on NSAID treatment for at least a year between baseline and the four-year follow-up. In addition to the participants, the study included 592 people not treated with NSAIDs as control subjects. All participants in the study initially underwent an MRI of the knee with another exam four years later. The researchers analyzed cartilage thickness and composition. Both are biomarkers for evaluating arthritis progression. The researchers found that NSAID users showed more degenerative changes, including in cartilage thickness. However, the scientists did not consider the changes statistically significant. The researchers did conclude that longtime NSAID usage could be associated with more internal inflammation, leading to increased pain and decreased joint function. Typically, NSAIDs are used for osteoarthritis because of their ability to reduce inflammation, which reduces pain. Depending on the formulation, they can last anywhere from 4 to 24 hours. The downside of taking pain relievers This isn’t the first study that has shown the downside of taking NSAIDs long-term. “Numerous studies show that long-term use of NSAIDs can result in worsening inflammation, increasing pain, and a faster need for joint replacement,” said Dr. Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in California. “The serious side effects of NSAIDs can drive inflammation to the lung, heart, gastrointestinal tract, liver, and kidneys. Chronic use of NSAIDs can lead to joint replacement surgeries and prevent the body’s normal response to healing and can result in rebound inflammation, including worsening osteoarthritis symptoms,” Mikhael told Healthline. Some experts disagree with pain reliever study Not everyone agrees with the conclusions of the study. “This study is very dangerous,” said Dr. Travis Scudday, an orthopedic surgeon with Hoag Orthopedic Institute in Southern California. “It is a classic example of selection bias. It is a retrospective study examining what patients did independently, without any recommended intervention. “The researchers state that the patients who used NSAIDs had more evidence of synovitis or inflammation in the joint at baseline, meaning before NSAID medications,” he told Healthline. “Most likely, the patients with worse inflammation and pain used NSAIDs. In contrast, patients without significant inflammation and pain did not use inflammation.” “This is the same as looking at two groups of people, one with pneumonia and one without.” Scudday continued. “The people with pneumonia received antibiotics and those without pneumonia did not. Then, concluding that antibiotics caused people to have pneumonia since people with pneumonia used antibiotics more frequently.” Dr. Michael Alaia, a sports health orthopedic surgeon and associate professor at New York University, also felt the study used selection bias to develop their conclusions. “This was not a controlled, randomized study. Ideally, they could have included an orthopedic wing of the study,” he told Healthline. What is osteoarthritis? Osteoarthritis is a degenerative joint tissue. It is the most common form of arthritis. It more often affects those over age 50, according to the National Institutes of Health. Researchers aren’t sure what causes or triggers the breakdown of tissues in the joint. It can cause damage to: CartilageTendonsLigamentsSynoviumBoneThe meniscus in the knee Common symptoms of osteoarthritis include: Pain when using the jointJoint stiffnessChanges in the joint that limit movementFeeling like the joint is loose or unstable It most often occurs in the hands, knees, hips, lower back, and neck, although it can also appear in other joints. Treating osteoarthritis with NSAIDs NSAIDs are short-term pain relievers. “NSAIDs are a great way to treat pain associated with osteoarthritis,” Dr. Alexander Gaukhman, an orthopedic surgeon with Baptist Health Orthopedic Care, told Healthline. “The clinical practice guidelines released by the AAOS (American Academy of Orthopedic Surgeons) place NSAIDs as the first line of treatment for patients with osteoarthritis,” he added. The medications help reduce pain and stiffness by reducing inflammation. “NSAIDs do not play a role in preventing joint or cartilage disease,” notes Dr. Ilan Danan, a sports neurologist and pain management specialist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “The direct use of NSAIDs will not increase inflammation.”  “This information, while helpful, will not change my clinical approach,” Danan told Healthline. “As a degenerative disease, moderate to severe joint arthritis will worsen over time, especially over several years. Most important is that patients understand that there are more advanced means of better addressing arthritic pain beyond the long-term use of NSAIDs — both surgical and non-surgical.” Other treatments for osteoarthritis There isn’t a cure for osteoarthritis, but there are ways to treat and manage the condition. According to the Arthritis Foundation, some non-surgical treatments besides NSAIDs include: Analgesics, such as acetaminophen (Tylenol) and opioidsCounterirritants, such as topical agents with capsaicin, menthol, and lidocaineCorticosteroids, prescription medications that can be taken orally or by injectionDrugs such as duloxetine (Cymbalta) and pregabalin (Lyrica) that treat other conditions but help reduce pain and inflammation “Weight loss and physical therapy are beneficial interventions in early stage, mild arthritis,” said Scudday. As a last resort, joint-replacement surgery may be necessary to relieve pain and maintain the person’s quality of life.

  • Nick Jonas Says He had These 4 Common Type 1 Diabetes Signs Before His Diagnosis
    on November 27, 2022 at 11:48 am

    NBC / Contributor/Getty Images Singer Nick Jonas discussed his type 1 diabetes diagnosis in a recent TIkTok video.Jonas talked about the early symptoms of the disease he had before he was diagnosed as a teenager. Type 1 diabetes affects about 1.3 million adults in the U.S. Singer-songwriter Nick Jonas recently posted a short video to raise awareness of early signs of diabetes for World Diabetes Day – it’s a chronic condition he’s lived with since his teens. The entertainer, now 30, said he experienced several signs that something was wrong before being diagnosed with type 1 diabetes at age 13. According to the Centers for Disease Control and Prevention (CDC), in 2019 nearly 29 million people were diagnosed with diabetes – that’s almost 9 percent of the U.S. population. Type 1 diabetes affects about 1.3 million adults in the U.S. Four signs of type 1 diabetes Jonas pointed to four symptoms as they pop up in the video he posted to both Instagram and TikTok: Weight lossExcessive thirstFrequent urinationIrritability “I remember I told my parents that I needed to go to the doctor, something didn’t feel right and they had already seen the significant weight loss and some of the other symptoms so they brought me in,” Jonas said in an interview with an organization he co-founded called Beyond Type 1. “It was there that my pediatrician informed me that I had type 1 diabetes,” he continued. “At first I was devastated, naturally. But I didn’t really have time to be devastated because I had to get right to the hospital. It was the start to a crazy new journey.” Dr. Ricardo Correa, director of the endocrinology, diabetes and metabolism fellowship program at the University of Arizona College of Medicine – Phoenix, told Healthline that type 1 diabetes usually occurs in younger people, although it can show up in adults. About “85% occur in kids between the age of two and 14 years old,” he said of initial diagnoses. Symptoms of type 1 diabetes Correa said children with undiagnosed type 1 diabetes often arrive at the hospital extremely ill because their disease has been untreated. Many times early symptoms of the disease are relatively mild and go unnoticed by parents and caregivers. “These are kids that usually start having some kind of dehydration, they pee a lot, they are thirsty, they eat a lot, but no one notices because they are kids and this is common,” he said. Correa said these children can go into something called diabetic ketoacidosis, or diabetic coma, a potentially life-threatening condition. “Type 1 diabetes, because they have no insulin, they present directly with diabetes ketoacidosis,” he said. Correa explained that those at highest risk for developing type 1 diabetes are children with a genetic predisposition. “So if someone in your family, father, mother, sibling, has type 1 diabetes, not type 2, but type 1, you’re at higher risk,” he said. Additionally, he said that people born with certain types of autoimmune conditions are more predisposed to develop type 1 diabetes. What is type 1 diabetes? Type 1 diabetes is an autoimmune condition, it results when antibodies in the body start to attack the cells that produce insulin. Correa explained this causes the destruction of those cells that produce insulin. “In type 1 diabetes, the problem is that antibodies are destroying the cells that produce insulin and there will be a point where you don’t produce insulin anymore,” said Correa. If you can no longer produce the insulin, the body is unable to use sugar (glucose) for energy. Diabetes increases risk of other health issues “Any type of diabetes, if it’s not controlled, whether type 1 or type 2, they’re at risk of developing kidney problems, meaning that they can go into dialysis, they’re at risk of developing blindness – it’s [type 1 diabetes] the most common cause of blindness in the world.” He added that people with diabetes can also develop neuropathy or nerve damage. “Meaning that they have some pain, mainly in the feet or other kinds of nerve problems,” said Correa. “They’re [also] at high risk of developing cardiovascular outcomes – meaning heart attacks, strokes, because of this [diabetes].” However, he pointed out that this is all in cases where the condition is not controlled. “If the condition is controlled, because you’re using your insulin for type 1 diabetes or medication for type 2,” Correa said. “It’s very unlikely that this will happen. But uncontrolled [type 1 or type 2 diabetes] then yes, it’s most likely that this will happen.” In some people who develop type 1 diabetes, there can be a honeymoon period shortly after being diagnosed, according to JDRF formerly the Juvenile Diabetes Research Foundation. “During what is known as the ‘honeymoon phase,’ people with T1D can experience a period in which they are asymptomatic,” according to the JDRF website. “The honeymoon phase typically lasts a few months to a year post-diagnosis as, with the help of some injected insulin, a patient’s existing beta cells continue to function normally and produce enough insulin for blood-glucose management.” Eventually, the remaining beta cells lose will function. No way to prevent type 1 diabetes Correa noted that there is no way to prevent the development of type 1 diabetes. However, he said that some studies have shown promise by using stem cells in patients with high-risk, or anti-inflammatory medication that decreases the immune system response. “There has even been trial of tuberculosis vaccine to see if that reduces the production of antibodies that would destroy the beta cells,” Correa said. “But nothing at this point has been approved. The bottom line To raise awareness on World Diabetes Day, singer/songwriter Nick Jonas posted a video to social media explaining the four symptoms of type 1 diabetes – a condition he was diagnosed with as a teen. Experts say that when untreated, type 1 diabetes leads to hospitalization with potentially life-threatening diabetic ketoacidosis. They also say that the disease is genetic and so far, can’t be prevented.

  • Lab-Grown Meat Gets One Step Closer to the Grocery Store After FDA Gives OK
    on November 27, 2022 at 11:48 am

    Hernandez & Sorokina/Stocksy This week the FDA said that meat grown in a lab met major safety requirements.Lab-grown meat has gained interest in recent years as food manufacturers try to meet the increasing demand of the growing population. Animal cells are taken from the tissue of an animal and placed in a tightly-controlled lab environment that helps them multiply and grow. We may soon be eating meat that’s grown from animal cells in a laboratory. In an announcement published Wednesday, The Food and Drug Administration (FDA) stated that UPSIDE Foods, a food manufacturer that creates animal meat from cells, met all of the agency’s safety requirements. UPSIDE Foods will need to pass inspection from the United States Department of Agriculture Food Safety and Inspection Service (USDA-FSIS) before the lab-grown meat heads to market. The meat is produced by extracting cells from animals — in this case, poultry — that are then cultivated in a laboratory and grown into food.  Lab-grown meat has gained interest in recent years as food manufacturers try to meet the increasing demand of the growing population.  According to Ian Smith, a research professor at University of California Irvine, Department of Neurobiology and Behavior, lab-grown meat production is still in the early stages and there are many more hurdles that need to be addressed in order to bring an economically-viable product to market.   “This is exciting for the field. The FDA and USDA are collectively the regulatory authorities that are providing oversight to this particular market so the FDA declaring they have no safety concerns is a big stride forward,” Smith told Healthline.  How is lab-grown meat made? After the animal cells are taken from the tissue of an animal, the cells are placed in a tightly-controlled lab environment that helps them multiply and grow. As the cells multiply, they differentiate into various cell types, like muscle, fat, or connective tissue cells.  Once the cells have differentiated into muscle, fat, or tissue, they are harvested and prepared with typical food packaging and processing methods, according to the FDA.  The FDA states that human food made from cultured animal cells must meet the same safety requirements as other foods. When will lab-grown meat be available? Now that UPSIDE Foods has met those safety requirements, the manufacturer is one step closer to beginning commercial production.  UPSIDE will work with the USDA to obtain a grant of inspection and label approval. “This landmark regulatory decision means the FDA accepts our safety conclusion, and UPSIDE’s cultivated chicken will be available following USDA inspection and label approval,” an UPSIDE Foods spokesperson told Healthline.  Dr. Dana Ellis Hunnes, a senior clinical dietitian at UCLA medical center, assistant professor at UCLA Fielding school of public health, and author of Recipe for Survival, expect that it will be a while before lab-grown meat is scalable and affordable for the average person.  “With that said, it is moving in a better direction from a welfare, environmental standpoint, and perhaps even nutritional standpoint if you can add to the ‘meat’ whatever nutritional profile you want,” Hunnes told Healthline. How healthy is lab-grown meat? Scientists are still learning about how the nutritional profile of lab-grown meat compares to regular meat. Hunnes says that lab-grown meat will likely have the same level of amino acids as conventional meat, however, there may be differences in the overall composition of the meat. There’s a chance lab-grown meat may contain lower levels of iron, zinc, and B12, she added.  According to UPSIDE’s spokesperson, their cultivated chicken contains fewer calories and less fat than conventionally-produced chicken. “Ultimately our goal is to offer consumers meat with improved nutrient profiles, but we won’t be there immediately,” the UPSIDE Foods spokesperson said. Advocates also claim that there’s a lower risk that the meat will carry pathogens like E. coli, Salmonella or Campylobacter since the cells are closely monitored in a lab.  Furthermore, because the meat isn’t sourced from animals that are packed close together in incubators, there’s less opportunity for infectious diseases to impact the meat.  Food manufacturers will be able to better control what is in the meat, says Smith.  “There is no need for antibiotic use in lab-grown meat because there is no contamination from the intestinal pathogens of other animals, so in that sense, it would be a little better,” Hunnes said.  That said, it’s too soon to know if and how lab-grown meat might impact our health. Some scientists say no environment is ever perfectly controlled, even in a lab, and “unexpected biological mechanisms” may occur. The main advantage to lab-grown meat is that it will cut back on the use of greenhouse gasses by reducing land use, water use, and emissions. “From an environmental standpoint, this will be far better for the environment — once it is fully scaled up — than raising 100 million or so cattle each year for slaughter,” Hunnes said.  The bottom line: UPSIDE Foods, a manufacturer that produces animal meat from cells in a lab, meets all of the FDA’s safety requirements and is one step closer to bringing lab-grown meat to market. Interest in lab-grown meat has increased as food manufacturers develop innovative solutions to meet the demands of the growing human population. It’s unclear how lab-grown meat stacks up to conventionally-produced meat, but health experts expect the nutritional profile to be similar. 

  • FDA Oversight of Clinical Trials was 'Grossly Inadequate,' Report Claims
    on November 27, 2022 at 11:48 am

    VICTOR TORRES/Stocksy The FDA is responsible for reviewing data on vaccines, drugs, and medical devices, and deciding whether these products should be approved for use in the United States.A new report in the medical journal BMJ claims that the FDA did not inspect enough clinical trial sites. The FDA has just 89 inspectors for its bioresearch monitoring program. Experts say the Food and Drug Administration’s oversight of clinical trials for new vaccines and drugs is “grossly inadequate,” according to an investigative report released Wednesday by The BMJ. The report documents what experts say is a failure of the FDA to not only inspect clinical trial sites, but also notify the public and scientific journals when it has identified violations at those sites. While some of these problems occurred during the COVID-19 pandemic, when travel restrictions and other measures limited the FDA’s ability to do on-site inspections, experts say the agency’s problems are not new. Limited FDA inspections of clinical trial sites The FDA is responsible for reviewing data on vaccines, drugs, and medical devices, and deciding whether these products should be approved for use in the United States. In addition, the agency conducts announced and unannounced inspections of certain clinical trial sites to verify the accuracy of data from that site, in response to complaints about the site or concerns from the study sponsor, or for other reasons. According to the BMJ report, very few sites involved in testing COVID-19 vaccines or drugs were inspected by the FDA before those products were approved by the agency. For example, nine of 153 Pfizer-BioNTech trial sites, 10 of 99 Moderna trial sites, and five of 73 remdesivir trial sites were inspected, writes investigative journalist Maryanne Demasi, author of the BMJ report. Reducing inspections during the pandemic During the early months of the pandemic, between March and July 2020, the FDA halted routine clinical trial inspections, focusing instead on “mission critical” inspections. One expert interviewed by The BMJ said that instead of cutting back on inspections at this time — when COVID-19 vaccines and drugs were being developed at “warp speed” — the agency should have been ramping up its oversight. FDA says team prioritized COVID-19-related inspections The FDA told Healthline that it “takes its oversight of clinical trials very seriously, and continued in-person inspections in the United States and other countries during the pandemic. “We prioritized inspections for COVID-related products, including vaccines, ensuring FDA-regulated COVID-19 products are able to be used to save American lives,” the agency spokesperson said. In addition, the agency developed new oversight tools to continue its work during the pandemic, including remote site evaluation using live streaming and remote records requests, the spokesperson said. However, one expert told The BMJ that it is not possible to do a thorough inspection remotely, because inspectors need to examine every aspect of the site — such as cleanliness, organization, and staff coordination. Lack of clinical trial site inspections by the FDA is not new. Between 2000 and 2005, the FDA audited fewer than 1% of the country’s clinical trial sites, according to a 2007 report by the Department of Health and Human Services’ Office of the Inspector General. Currently, the FDA has only 89 inspectors for its bioresearch monitoring program, the agency told The BMJ, but has a goal of increasing this to an average of 100 per year. These inspectors are responsible for monitoring thousands of sites in the United States and other countries, the report said. Lack of transparency around inspections Experts who spoke to The BMJ are also concerned about the lack of transparency around the results of inspections, including violations that are uncovered at clinical trial sites. The FDA publishes its inspection reports online, which are available to the public. But The BMJ said these are not comprehensive, and extensive redactions in the reports limits their usefulness. Ana Santos Rutschman, SJD, a professor of law at Villanova University Charles Widger School of Law, agrees that making this information more available would be useful. “A little more transparency would not hurt the agency,” she said. According to the BMJ report, the FDA also doesn’t inform scientific journals when sites participating in a clinical trial published in that journal receive a serious warning. In response, the FDA told The BMJ that it doesn’t monitor all publications that stem from clinical trial data submitted to the agency. Rutschman doesn’t think it is the role of the FDA, as a regulator, to notify scientific journals about problems with clinical trial sites. FDA stuck with limited funding Experts who spoke with The BMJ are divided on whether the FDA has the funding and other resources it needs to oversee all the research that is under its purview, both in the country and abroad. One felt that more funding and staffing would alleviate some of these problems. Another thought that the agency has sufficient funding and staffing to get the job done. According to one of the experts interviewed by The BMJ, the FDA has over 18,000 full-time employees. But Rutschman said this doesn’t mean all of these people are available to do inspections. “The FDA doesn’t just do drug regulation,” she said, “so the actual number of people they have available on the ground [to do inspections] is rather limited.” Rutschman added that there are two questions involved with these discussions about the FDA One is what will it take to change the situation, including funneling more resources to the FDA, she said, because “I think most people think the agency is underfunded.” The second is, given the FDA’s current resources, is what it is doing acceptable? “The situation right now is far from perfect,” she said, “but I think it’s on the reasonable side of things.” “The part [of The BMJ report] that I agree with is that it probably should be easier to find out what has triggered some warning from the agency,” she said.“But I don’t see how you would expect the FDA to be everywhere at the same time. It’s just not possible.”

  • 5 Ways to Feel Less Bloated After Big Holiday Meals
    on November 27, 2022 at 11:48 am

    Do big holiday meals often leave you feeling bloated and uncomfortable? The Good Brigade/Getty Images Holiday feasting can leave you feeling bloated and uncomfortable.Experts share ways to ease your stomach discomfort this holiday season.Knowing your triggers, swapping foods, and limiting alcohol can all help make holiday meals more pleasant. A full and heavy belly can mean great things were just consumed, but it can also mean uncomfortable things are about to happen. For many Americans, that feeling is just par for the course during holiday celebrations. According to research from the Calorie Control Council, a typical Thanksgiving dinner is packed with over 3,000 calories. That’s almost double the recommended calorie intake for adult women based on the 2020-2025 Dietary Guidelines for Americans. And stomachs can only hold so much food before they hit their capacity. For instance, on average, an adult’s stomach is similar in size to a clenched fist. It can hold about 2.5 ounces if it’s empty and expand to hold around 1 quart. As you fill your stomach up to its capacity, doing so can cause discomfort, including indigestion and even nausea. To help banish that overfed, lethargic, bloated feeling, nutrition experts say the following 5 tips can help reduce intestinal discomfort during the holiday season. 1. Recognize your triggers As a guest of a party, you might find yourself at the mercy of what the host is serving, which can mean you might not know exactly what ingredients they are using to prepare their food. However, knowing ahead of time what ingredients trigger discomfort can help eliminate bloat. “Whether it’s dairy, gluten, or some other food, being aware of food intolerances and other triggers is important so you can avoid or limit them in order to prevent digestive issues like bloating,” Michael Hartman, PhD, nutrition expert, told Healthline. He suggested asking the host before the party what they intend on serving and what ingredients are in the food. “The last thing they want is for you to feel unwell,” said Hartman. To identify foods that trigger bloat, Erin Palinski-Wade, registered dietitian and author of Belly Fat Diet For Dummies, recommended keeping a daily food record and looking for patterns. “It is best to track the food you eat, the portions, the timing, emotions at the time (happy, stressed, etc.) as well as any symptoms you feel,” she told Healthline. “This can allow you to look for patterns to identify foods that may cause bloat as well as help you to see if other factors such as stress may be aggravating your symptoms.” 2. Don’t save calories for the party Eating consistently throughout the day can help keep you from over-eating at the party. “Waiting too long in-between meals until you are ravenous can often lead to eating too fast and too much, which can trigger an increase in bloating,” said Palinski-Wade. Instead of “saving” all your calories for a big meal, she said to eat consistent meals and snacks to support digestion throughout the day. “Watch out for foods that may trigger bloat, such as large amounts of cruciferous vegetables at one sitting, eating more fiber than you generally would without building up, or eating meals with large amounts of fats, sodium, and added sugar,” she said. 3. Make food swaps  Whether you’re the host or know what the host will be serving at the party, you can provide alternative options to choose from. “If you’re trying to build a healthy relationship with food, there are simple healthy holiday food swaps you can make,” said Hartman. For instance, if dairy-filled cheese balls and crackers are a typical appetizer at your holiday dinner table, he said to try mixing it up this year with hummus, pita, and fresh veggies. Instead of buttery mashed potatoes, consider switching to a sweet potato alternative. “And, rather than going for a rice dish that’s high in starch, reach for legumes which are rich in potassium, a mineral that helps flush out excess bloat-causing sodium,” Hartman said. Palinski-Wade suggested using milk in replacement of heavy cream to cut the fat in recipes and reduce large amounts of salt by using flavorful spices like cinnamon and nutmeg. If swapping feels overwhelming or like too much work, she said to stick to eating in moderation. Her favorite strategy for doing this at holiday meals is to review all food offerings first before adding them to her plate. “Then build a balanced plate filling 1/3 with produce, 1/3 with lean protein, and the remaining 1/3 with any favorite side dishes,” she said. “This allows you to enjoy all the offerings without overdoing it, which can help reduce bloat.” 4. Add leafy greens to your plate Vegetables like spinach, kale, bok choy, asparagus, and chard have a high-water content and are also low in calories and packed with vitamins, minerals, and fiber. “[They] work well to reduce bloating,” said Hartman. While eating vegetables regularly is a great way to add fiber to the diet, Palinski-Wade cautioned that increasing fiber gradually is the best way to promote healthy bowel movements and reduce bloat. “If you increase your vegetable intake quickly without adjusting to an added fiber intake, this may result in more bloat,” she said. “Also, if you do not increase your water intake as you increase fiber, this can lead to bloat and constipation as well.” She recommended adding an extra half cup of leafy greens every 3 days to slowly increase your intake to improve digestion without the bloat. “Cruciferous vegetables like broccoli can cause more gas as well, so these are often best to enjoy cooked versus raw to lessen the impact on bloat,” said Palinski-Wade. 5. Limit alcoholic drinks  While alcoholic drinks are often part of celebrating the holidays, drinking alcohol after eating heavy meals can make a swollen stomach worse.  “Alcohol is an inflammatory substance that can slow digestion and increase water retention, making you feel lethargic. It can also lead to swelling in the body, which can result in gas, discomfort, and bloating,” said Hartman. To prevent dehydration and up your water intake, Palinski-Wade said to leave visual reminders like setting your water bottle out where you can see it during the day. She also suggested setting an alarm on your phone to encourage you to sip on water or use an app to track your intake. “Spacing water out helps to prevent bloat, but don’t try to chug water all at once since that may increase bloat as well,” she said. To moderate alcohol intake, Palinski-Wade said it’s best to keep to drinking one glass of an alcoholic beverage for women and two glasses for men per day. Plus, for every glass of alcohol you consume, drink at least one glass of water. “During holiday celebrations, try incorporating fun mocktails made with sparkling water and 100% juice as a delicious way to enjoy the celebration without the added bloat the next day,” she said. Her favorite go-to concoction is 1 cup of seltzer water with ¼ cup tart cherry juice and a slice of lime “for an antioxidant-rich drink that looks just like a fancy glass of wine.” Hartman suggested ditching the mulled wine and spiked eggnog and opting for a nonalcoholic cider or punch instead.

  • Type 1 Diabetes: FDA Approves New Drug Teplizumab That Delays Onset
    on November 27, 2022 at 11:48 am

    Federal regulators have approved a new drug for type 1 diabetes that can be used by adults and children 8 years and older. JGI/Tom Grill/Getty Images Federal regulators have approved a new drug teplizumab that can delay the onset of type 1 diabetes by at least 2 years.The drug, which is sold under the brand name Tzeid, is available for adults and children 8 years and older who currently have stage 2 diabetes.The drug is administered by intravenous infusion once a day for 14 consecutive days.Members of the diabetes community say Tzeid has the potential to be a ground-breaking treatment. The Food and Drug Administration has approved a new drug that regulators say can delay the onset of type 1 diabetes. FDA officials said the injectable drug, teplizumab, can postpone the onset of type 1 diabetes by at least 2 years. The drug, known by the brand name Tzield, is available for adults and children 8 years and older who currently have stage 2 type 1 diabetes. It is administered by intravenous infusion once a day for 14 consecutive days. It’s not recommended for people with insulin-dependent stage 3 type 1 diabetes or for people diagnosed with type 2 diabetes. “Today’s approval of a first-in-class therapy adds an important new treatment option for certain at-risk patients,” said Dr. John Sharretts, the director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA’s Center for Drug Evaluation and Research, in a statement. “The drug’s potential to delay clinical diagnosis of type 1 diabetes may provide patients with months to years without the burdens of disease.” FDA officials said Tzield works by binding to certain immune cells. “Tzield may deactivate the immune cells that attack insulin-producing cells while increasing the proportion of cells that help moderate the immune response,” the FDA officials explained. Members of the diabetes community said the new drug could be a game changer. “This approval is a watershed moment for the treatment and prevention of type 1 diabetes,” Dr. Mark Anderson, director of the University of California San Francisco Diabetes Center, told ABC News. “Until now, the only real therapy for patients has been a lifetime of insulin replacement. This new therapy targets and helps to halt the autoimmune process that leads to the loss of insulin.” A long approval process for type 1 diabetes drug In May 2021, an FDA advisory committee recommended teplizumab be approved by the full agency. In June 2022, the FDA opted to delay approval of the drug while its manufacturer, Provention Bio, retooled the medication. “I will say with confidence that years from now, teplizumab will widely be seen as revolutionary, and in fact for some, including myself, I have already seen it in such a light,” Dr. Mark Atkinson, American Diabetes Association Eminent Scholar for Diabetes Research and director of the University of Florida Diabetes Institute, wrote in his testimony to the FDA earlier this year. He called teplizumab the most impactful diabetes breakthrough since home blood glucose meters replaced urine testing. Others agreed. “We know this can have a blockbuster effect on the pre-diagnosed,” said Frank Martin, PhD, the director of research at JDRF, a global research and advocacy organization for type 1 diabetes. What is teplizumab? Teplizumab is an anti-CD3 monoclonal antibody drug that binds to the surface of T-cells in the body and helps suppress the immune system. Similar drugs are being tested for the treatment of other conditions such as Crohn’s disease and ulcerative colitis. FDA officials reported that teplizumab performed well in a recent clinical trial involving 76 people with stage 2 type 1 diabetes After a median follow-up of 51 months, researchers reported that 45% of the 44 people who were given Tzield were later diagnosed with stage 3 type 1 diabetes. That compared with 72% of the 32 people who received a placebo. Researchers noted that the mid-range time between administration of the drug and stage 3 diagnosis was 50 months for people who received Tzaid and 25 months for those who were given a placebo. The most common side effects were decreased levels of certain white blood cells, rashes, and headaches. A ‘Goldilocks’ immune suppressant Teplizumab was born from a long line of drugs created and tested over more than three decades. The idea took root in the labs of Dr. Kevan Herold and Dr. Jeffrey Bluestone at the University of California San Francisco. It was in 1989, when working with cancer patients, that Bluestone realized an anti-CD3 drug could be a key in stopping the progression of type 1 diabetes because of how it helped transplant patients. His theory seemed to hold up in small studies. Since type 1 diabetes manifests when a person’s immune system gets confused and attacks their insulin-producing beta cells rather than protecting them, Bluestone surmised that by creating monoclonal antibodies in a lab that can be introduced into the body of a person on the verge of developing type 1 diabetes, those will bind to the CD3 cells that are attacking the beta cells and stop the attack. Over the years, researchers like Herold and Bluestone, along with companies like Tolerx, worked to find just the right level of anti-CD3 to make that effort a success. Tolerx came close to approval of its drug about 10 years ago, but it did not make it past phase 3 trials with the FDA due to some significant side effects of flu-like symptoms. Other trials fell short as well, which often happens as drug research progresses. Four years ago, Provention Bio picked up the research and pushed it along. They were frustrated with how the medical system handles diagnoses of autoimmune diseases in general, said Ashleigh Palmer, the co-founder and chief executive officer of Provention. “The medical system waits for patients to exhibit symptoms. Very often, by that point, irreversible damage has been done,” Palmer told DiabetesMine. “Can you imagine,” he added, “a system in which a patient with kidney disease presents at the point of dialysis? Insulin therapy is pretty much the same as if we did that. We go right to the [intense and chronic] treatments at the start.” At the point where Provention Bio took over, the global type 1 diabetes screening research collaboration TrialNet was pumping some decent study participant numbers into the project. More than 800 patients have received the treatment in multiple studies to date. With the work done over those past decades, it seemed they had found what Palmer calls the “Goldilocks” formula for the medication. “Not too little immune response alteration and not too much; just the right amount,” he said. A clinical trial experience Katie Killilea of Rhode Island told DiabetesMine that her son entered the Teplizumab trial at Yale in 2013 after she and her son were both tested via TrialNet at her other son’s diabetes camp. Killilea herself was diagnosed shortly after. But her son, who was farther back in the progress toward type 1 diabetes, was able to remain in the study. The challenges, she said, were that her son [along with his dad] had to spend 3 weeks up near Yale, a bit of a bump in the life of a 12-year-old, and a difficult setup for most families. “It gives me hope, but the whole time [in 2013], I felt acutely aware of how difficult the teplizumab trial was for families financially,” she said. “You had to have a parent who could take time off from work, another parent to stay home with the other child or children. It seemed unrealistic for us, and maybe impossible for others to participate,” she said, stressing that these issues need to be worked out.  But the benefits were many, she said.  “Since he had the drug, his blood glucose returned to normal for a while. TrialNet did glucose tolerance tests every 6 months,” she said. And when the time did come that her son developed type 1 diabetes, Killilea found it to be a more manageable transition as opposed to her other son’s previous diagnosis. “Although he was not able to keep type 1 diabetes at bay forever, he did have a very gentle landing and was diagnosed with type 1 diabetes before he needed to use insulin,” she said.

  • 6 Common Dietary Supplements are No Match for Statins in Lowering Cholesterol
    on November 27, 2022 at 11:48 am

    SolStock/Getty Images A new study found that six dietary supplements commonly marketed as a way to lower cholesterol had no significant impact on levels of LDL cholesterol.People in the study who took a low-dose prescription medication known as a statin saw a 35% average drop in their LDL cholesterol levels during that time.The US Preventive Services Task Force recommends statins for adults aged 40 to 75 years with certain risk factors for cardiovascular disease. If you’ve been thinking about trying to lower your cholesterol using over-the-counter dietary supplements instead of a prescription medication, you may want to hold off on that. A new study found that six dietary supplements commonly marketed as a way to lower cholesterol had no significant impact on levels of LDL (low-density lipoprotein) cholesterol, sometimes called “bad” cholesterol, compared to an inactive placebo. The supplements tested in the study over a 28-day period were fish oil, garlic, cinnamon, turmeric, plant sterols, and red yeast rice. In contrast, people in the study who took a low-dose prescription medication known as a statin saw a 35% average drop in their LDL cholesterol levels during that time. “Compared with placebo, the only agent — of those tested in the study — that actually lowered LDL cholesterol was the statin medication,” said Dr. Kershaw Patel, a preventive cardiologist and assistant professor of cardiology at Houston Methodist in Texas. “So the take-home message for me is patients should not waste their money on these dietary supplements in order to lower their LDL cholesterol,” he said. Patel was not involved in the new study, which was published November 6 in the Journal of the American College of Cardiology. The study was funded by AstraZeneca BioPharmaceuticals, manufacturer of Crestor, a brand name version of the statin used in this study. Consumers targeted with supplement marketing Cholesterol is a waxy, fat-like substance made by the liver that circulates in the blood. The body uses cholesterol to make certain hormones and help digest fatty foods.  Animal foods, including meat, poultry, eggs, seafood, and dairy products also contain cholesterol. Having too much LDL cholesterol, along with too many triglycerides, in your blood can increase the risk of heart attack and stroke. The US Preventive Services Task Force recommends statins for adults aged 40 to 75 years with certain risk factors for cardiovascular disease. However, one survey found that only 45% of Americans over 40 years of age who were eligible for a statin actually took this medication. Patel said people may avoid taking a statin because they are concerned about the safety of these prescription medications. What they may not realize, though, is “the safety of dietary supplements are not evaluated with the same rigor as prescription medications,” he added. Dr. Lawrence Appel, a professor of medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research at The Johns Hopkins University in Baltimore, said consumers are also “bombarded with commercials and advertisements telling them to consume these supplements … for really fuzzy reasons.” However, “there’s really no compelling biological rationale why any of these supplements would dramatically lower LDL cholesterol,” he added. “I mean there’s just no basis for it.” Only statin lowered LDL cholesterol In the recent study, 190 people between the ages of 40 and 75 were randomly assigned to take the low-dose rosuvastatin, one of the six dietary supplements or an inactive placebo for 28 days. Those who took the statin saw a 35% decrease in LDL cholesterol compared to the placebo group. People taking the statin also had a larger decrease in total cholesterol and triglycerides than the placebo group. People taking one of the supplements or the placebo, however, saw no significant benefit over the course of the 28 days. In addition, people taking the garlic supplement saw their LDL cholesterol increase by almost 8%. The rates of adverse events were similar for all groups, researchers found. Benefits and risks of statins Statins can cause side effects such as muscle pain, constipation, and diarrhea. However, in 2018 the American Heart Association said in a scientific statement that for people for who statin treatment is recommended, the benefits “greatly outweigh” the risks. Although dietary supplements are sometimes marketed as “natural,” they may not always be safe, especially when people are taking other supplements or medications. In addition, the industry is largely unregulated, so the quality of products and ingredients can vary among manufacturers, said Dr. Efstathia Andrikopoulou, a cardiologist and assistant professor of medicine at the University of Alabama at Birmingham. As a result, “there can be unpredicted drug-to-drug interactions between supplements and other over-the-counter or prescription medications,” she said. In fact, “some of us [physicians] have had patients who developed kidney disease after taking dietary supplements.” Limitations of the study Patel said one of the limitations of the study is that researchers did not follow people longer than 28 days. So it’s unknown if LDL cholesterol levels would drop more in people taking one of the dietary supplements for a longer time. Still, statins typically start to work within about a month, he said, “so I think if we were going to see any change, it would happen during this time.” The Council for Responsible Nutrition, a trade association for the dietary supplement industry, released a statement November 6 in response to the study, saying, “dietary supplements are not intended to be quick fixes and their effects may not be revealed during the course of a study that only spans four weeks, particularly on a multifactorial condition like high cholesterol.” “Even more perplexing is the researchers’ selection of the supplements in the study,” the council said in their statement. “It’s as if the study was set up for misdirection and failure of the supplements. While all the supplements included in the study are well-recognized for their benefits related to heart health, only three are marketed for their cholesterol-lowering benefits.” Some research supports the longer-term impact of certain dietary supplements. One review of previous studies found that people taking krill oil — which contains similar omega-3 fatty acids as fish oil — saw a larger drop in LDL cholesterol when they used this dietary supplement for more than 12 weeks. However, some reviews of previous research have found no effect of fish oil on total or LDL cholesterol levels in people with type 2 diabetes. There were some beneficial changes in HDL cholesterol and triglycerides. Focus on diet quality and medication Patel said one of the problems with waiting longer to lower your cholesterol is that you are exposed to cardiovascular-related risks for a longer period. Statins, though, start lowering LDL cholesterol in as little as a few weeks. Rather than dietary supplements, Patel recommends that people improve their diet quality — which has nothing to do with supplements, he said — and talk to their doctor about taking a cholesterol-lowering medication. Andrikopoulou said the recent study highlights that there is no value in taking these six dietary supplements for improving cholesterol levels. In addition, “this [study] reinforces our already established dietary and lifestyle recommendations that encourage everyone to make sure they get their vitamins and nutrients from consumption of heart-healthy foods, such as minimally processed foods, vegetables, fruits, lean proteins, and whole grains,” she said. In particular, Patel encourages patients to eat a Mediterranean diet, which emphasizes vegetables, fruits, whole grains, beans, and legumes and includes heart-healthy oils such as olive oil. The American Heart Association also recommends DASH, or Dietary Approaches to Stop Hypertension, which allows more dairy products and meat than the Mediterranean diet. Other alternatives are plant-based vegetarian or vegan diets. While there are heart-healthy diets, eating a diet low in cholesterol does not mean you will have low cholesterol and the same is true for high-cholesterol foods. The body regulates how much cholesterol is in the body and will sometimes make more or less depending on how much cholesterol is taken in via diet. With all these diets, it is important to limit the intake of saturated fats, added sugars, and highly processed foods. Andrikopoulou also recommends that people get at least 150 minutes a week of moderate-intensity physical activity.

  • Why Fentanyl Vaccine Could Be a Game Changer for Opioid Epidemic
    on November 27, 2022 at 11:48 am

    Researchers say a fentanyl vaccine showed promise in a clinical trial involving rats. Luis Velasco/Stocksy Researchers say a new vaccine shows promise in blocking fentanyl from entering a person’s brain.They say the vaccine could help reduce overdoses and aid in addiction recovery.Experts, however, point out that the new vaccine has only been tested on rats, so more research is needed on its effectiveness on humans.They also note that people who’ve had the vaccine could switch to other opioids. Researchers say they’ve developed a breakthrough vaccine blocking fentanyl from entering the brain and eliminating its high effect. The researchers said the vaccine could have major implications on helping solve the nation’s opioid crisis.  The study, published in the journal Pharmaceutics, was led by the University of Houston researchers. In it, the team of scientists reports that the vaccine targets the synthetic opioid fentanyl by blocking its ability to enter the brain.  The team said opioid use disorder (OUD) is treatable, but an estimated 80% of people addicted to the drug experience a relapse after treatment  The researchers said in a statement that the vaccine “could not be timelier or more in demand.” “Over 150 people die every day from overdoses of synthetic opioids including fentanyl, which is 50 times stronger than heroin and 100 times stronger than morphine,” the researchers said. “Consumption of about 2 milligrams of fentanyl (the size of two grains of rice) is likely to be fatal depending on a person’s size.”  The vaccine didn’t produce adverse side effects in the rats involved in lab studies, researchers said. The team plans to start clinical trials in humans soon. “Our vaccine is able to generate anti-fentanyl antibodies that bind to the consumed fentanyl and prevent it from entering the brain, allowing it to be eliminated out of the body via the kidneys,” Colin Haile, the study’s lead author and a research associate professor of psychology at the University of Houston and a founding member of the UH Drug Discovery Institute, said in the statement. “Thus, the individual will not feel the euphoric effects and can ‘get back on the wagon’ to sobriety.”  The dangers of fentanyl Fentanyl is especially dangerous because it’s frequently added to street drugs such as cocaine, methamphetamine, and other opioids, such as oxycodone and hydrocodone/acetaminophen pills, and even to counterfeit benzodiazepines like Xanax.   Therefore, people who often don’t know they’re taking fentanyl can die or become addicted to it.   Dr. William Soliman is the founder and chief executive officer of the Accreditation Council for Medical Affairs. He told Healthline there’s currently nothing available comparable to the vaccine.  “It works similarly to other vaccines in that it makes antibodies that recognize a target opioid,” Soliman said. “The anti-fentanyl antibodies are specific to fentanyl and its derivatives and did not cross-react with opioids like morphine, which means that a vaccinated patient could still be treated with other opioids.” How the fentanyl vaccine could be used Jay Evans, a research professor and director of the Center for Translational Medicine at the University of Montana, told Healthline the vaccine could have multiple uses.  “The vaccine could be administered to people with opioid use disorder to help them quit and not relapse while seeking treatment,” Evans said. “The vaccine could also be used to prevent overdose in people at risk of accidental or purposeful exposure to fentanyl.” Dr. Mike Sevilla, a family physician based in Salem, Ohio., told Healthline he’s impressed by not just the vaccine’s apparent ability to prevent an addictive high, but that it could save lives after overdoses. He added the vaccine would streamline the process of recovery for people who are addicted to fentanyl.  “In the past, medication treatment for substance abuse disorders has really relied on patients to follow a strict regimen, which can be challenging,” Sevilla said. “Access to some of these medications to treat addictions can be difficult, depending on where the person lives, their ability to get to the treatment clinic, and other social drivers of health. I believe that a vaccine to potentially treat addictions could be a game changer.” More research on fentanyl vaccine needed Some experts are stopping short of calling the vaccine a breakthrough yet. “Just because we are seeing this breakthrough through an animal-based study does not mean that its efficacy will transfer to humans,” Dr. Emil Tsai, a neuroscientist and founding chief executive officer of biotech developer SyneuRx, told Healthline. “The biological divergence between the species can lead to unreliable results in the transfer.   “That unknown aside, there are a few points within the study that I am dubious about,” Tsai said. “It’s unclear why the results were more effective for male rats than for female rats. In addition, the decision to make this drug only respond to fentanyl does little to combat those who are addicted to opioids, as this leaves the possibility for them to seek out other opioid drugs.” Tsai said the vaccine only addresses one part of recovery.  “It’s important to treat the entire scope of the addiction,” Tsai said. “Relying on biological methods is a piecemeal solution. It does not address the entire problem. Those who are reliant on drugs or alcohol need counseling and mental wellness for healing.” Why people might avoid the fentanyl vaccine Dr. Kelly Johnson-Arbor, a medical toxicologist and director at National Capital Poison Center, told Healthline the vaccine won’t address other opioids and some people may avoid them because of the false stigma associated with vaccines. “Boosters are also likely to be required for the fentanyl vaccine, meaning that vaccinated individuals may not have lifelong immunity to fentanyl overdose, and the duration of action, and safety, of the vaccine in humans must still be evaluated,” Johnson-Arbor said. “The need for vaccine boosters means that vaccinated individuals will need to re-engage with the healthcare system on a regular basis, which can be a challenge for some individuals with opioid use disorder.”  None of which precludes the vaccine being a good idea, Johnson-Arbor said.  “Overall, fentanyl vaccination is a promising advancement in the prevention and treatment of opioid use disorder, but it still requires more careful studies in humans as well as consideration of its acceptance in the current social and political climate of this country,” she said.

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