Archive for the ‘Hormone Physician’ Category

Breast cancer affects one in eight women in the United States. Its one of the most common cancers in the country, but thanks to preventative screenings and developments in treatment, the disease currently has a five-year relative survival rate of 90 percent. But when you dig into the statistics a bit more, youre presented with a less optimistic outlook. According to the Centers of Disease Control and Prevention (CDC), Black and white women get breast cancer at about the same rate, but breast cancer deaths among Black women are 40 percent higher than white women. (For Asian, Hispanic, and Native American women, the risk of developing and dying from breast cancer is lower than white women.) These are the straight facts, laid out in black and white.

The reasons Black women are more likely to die from breast cancer than white women are complex, but the disparity is, in fact, surmountable. The solutions arent easy or quick, but they do exist. If this is a problem that doesnt need toand shouldntexist, why does it?

As with any cancer, early diagnosis is key to successful treatment, and the fact that white women tend to be diagnosed at an earlier stage of breast cancer than Black women exposes a major problem from the get-go. Its really a matter of the benefit of being screened in a mammogram, which is how we screen for breast cancer, says Nicola Finley, MD, an integrative physician at Canyon Ranch Tucson. Unfortunately, Black women [tend to be] diagnosed for all cancers when theyre at a more advanced stage. This leads to a higher mortality rate, because there are more obstacles and barriers in terms of treatment at a more advanced stage.

Health-care access is a huge driver of this disparity, says Jennifer Sims, PhD, an assistant professor at Jackson State Universitys School of Public Health who wrote an academic paper about health and racial disparity in breast cancer. Black women tend to have limited access to quality health care, and the reason for this is because they tend to have a lower economic status, she explains. Black women are statistically more likely to live in poverty than white women, which not only affects insurance access but also access to transportation, the ability to take time off work, and arrange child careall of which impacts a persons ability to seek care in the first place.

Thus, many Black women are forced to wait to go to the doctor until theres something visibly wrong, says Dipali Sharma, PhD, a professor of oncology at Johns Hopkins University. One of my colleagues and I were discussing this very topic the other day and she told me about a Black women who had a breast tumor that was literally coming through her skin. But she kept waiting and hoping it would just go away on its own because it was difficult for her to take off of work, Dr. Sharma says. Often, by the time Black women come to the clinic, their cancer is already stage three or four. (Research supports this observation.)

New research also suggests once a breast cancer diagnosis is given, Black women face longer delays to starting treatment and longer treatment times than white women. Even among women with low socioeconomic status, we still saw fewer delays among white women, underscoring the disparate experience of Black women, who appear to experience unique barriers, said lead author Marc Emerson, PhD, in a press release about the study. These delays could affect outcomes, since the longer cancer goes untreated, the harder it is to eliminate. More research needs to be done to understand exactly whats contributing to these delays, but the authors theorize that specific financial and transportation barriers could be at play.

Even when Black women are able to get to the doctor, Dr. Sims says they often face medical racism that impacts their care, regardless of social status. In her book, Invisible Visits: Black Middle-Class Women in the American Healthcare System, Tina Sacks, an assistant professor at UC Berkeleys School of Social Welfare, discusses the many challenges Black middle-class women face in trying to get doctors to take their concerns seriously. This can lead to them being less likely to get further medical testing and screenings when theyre needed. To her point, a Journal of Clinical Oncology study found that Black women, regardless of their risk level, are less likely than white women to undergo genetic testing for the BRCA1/2 geneaka the gene associated with breast, ovarian, and pancreatic cancerin large part because physicians are less likely to recommend it to them.

Some doctors see breast cancer as a white womans disease more than a Black womans disease, so they may not screen Black women as often. Jennifer Sims, PhD

As a Black woman, when I see a doctor, I always make sure to present myself in a particular way, says Dr. Sims. Most of the time when a doctor sees me, they see a Black woman and nothing else. I always make sure they know I did my research beforehand so they take me seriously. I tell them Im an assistant professor and have a PhD and studied at Harvard Medical School. In doing so, I tend to be treated differently than my sister, who has the exact same doctor as I do. This is an example of the type of bias most white women will never experience.

Additionally, Dr. Sims says some Black women feel judged by doctors, which affects their interest in seeking care. If someone has had a negative experience with a doctor who made them feeling shamed, judged, or discriminated against in the past, they are less likely to make check-ups and appointments a priority, she says.

Even if the playing field was level, and women of all races had the same access to unbiased health care, Black women would still be at a disadvantage when it comes to their survival. Sandra Luyindula, MD, a primary care physician at Proactive MD, says that Black women are more likely than white women to be diagnosed with triple-negative breast cancer, a subtype of the disease that is linked to a worse prognosis than other subtypes. (It makes up 10 to 15 percent of all breast cancer cases.)Triple-negative breast cancer is two to three times more common in Black women under the age of 60, she says, adding that it is also more aggressive and has a higher likelihood of recurrence than other types of breast cancer.

Sadly, Dr. Luyindula says we still dont know why this type of cancer is more common in Black women. Triple negative breast cancer is certainly being studied, but [researchers] havent figured it out yet, she says. And there arent many treatment options that work for it, either. Dr. Sharma explains that not only is triple-negative breast cancer aggressive, it doesnt respond to hormone therapy or targeted drugs.

There definitely needs to be more therapy options for women with triple-negative breast cancer, Dr. Sims says. There is a new drug that came out this year, Trodelvy, but whats interesting about that particular drug is that the clinical studies didnt actually include many Black women.This is unfathomable to her. Triple-negative breast cancer predominately affects Black women, so why arent they part of the clinical studies?

This shows that racial bias isnt limited to the doctors office; it permeates research institutes and clinical trials as well. Theres this untrue belief that Black women dont want to participate in medical studies, but the truth is, we need to make it easier for them, Dr. Sharma says. For example, at Johns Hopkins, often we give study participants a gift card as an incentive to participate in studies. But when we issued surveys, we learned something that keeps them from participating is the cost of parking, which can be $20 or $25. So something as simple as giving them a free parking sticker can make it easier for people to participate in studies.

Of course, study participants also need transportation, childcare, and the ability to take time off of work. Rather than writing off a population, we really need to ask what can be done to make participating in studies easier, and then do whats necessary to meet the needs, Dr. Sharma says.

More inclusive clinical studies will lead to better treatment outcomes for Black women diagnosed with breast cancer, but that alone is not enough. We need multilayered solutions that match the complexity of the problem.

To start, Dr. Sims says doctors and health-care providers should go through implicit bias training. Some doctors see breast cancer as a white womans disease more than a Black womans disease, so they may not screen Black women as often, even if they are showing the same symptoms as a white woman, she says. A lot of this bias is unconscious. You may think you have no bias toward Black women, or even women in general, and then you take an implicit-bias test and you see that you are biased.

Most of the time when a doctor sees me, they see a Black woman and nothing else. Dr. Jennifer Sims

Patient advocates and, in some cases, interpreters can also benefit Black women navigating a cancer diagnosis, and perhaps improve their survival chances. Dr. Luyindula says that at her practice, all patientsregardless of race or socioeconomic statusare assigned a patient advocate who ensures they have everything they need to continue treatment, including transportation. She adds that patient advocates can also help address a patients concerns about their ability to come to treatment appointments, access to healthy foods, or other health concernsall questions a doctor might not be able to fully answer during a time-pressed appointment. Meanwhile, an interpreter can help patients overcome language barriers to get the answers they need to make decisions about their carewhich can help improve outcomes, too.

More effort needs to be made for breast cancer prevention to be equitable, too. Mammogram screenings, which are the first line of defense again breast cancer, need to be more accessible to more people where theyre at. Dr. Sims says shes seen creative solutions for this problem, like volunteer organizations hosting cancer screenings at predominantly Black churches. Another solution could be free mammogram screenings at various workplaces, so it doesnt require taking time off work to be screened.

These solutions are just a start, but with time they can make a difference. There needs to be creative solutions to meet needs at an individual level because not everyone has the same needs, Dr. Luyindula says. This is a big, multifactorial issue. We need to understand every component to treat this issue as a whole.

Oh hi! You look like someone who loves free workouts, discounts for cult-fave wellness brands, and exclusive Well+Good content. Sign up for Well+, our online community of wellness insiders, and unlock your rewards instantly.

The rest is here:
Black Women Arent More Likely To Get Breast Cancer, but They Are More Likely To Die From It - Well+Good

It was a simple study design. Retrospective and observational, in today's science, a fishing trip for correlation by computer. All the patients with a positive COVID-19 test during March through June of this year from Quest served as the population, which was refined to include only those who had a Vitamin D level drawn in the previous year. A patient's ethnicity was "inferred" from their zip code based upon the 2018 America Community Study, a government study done every five years that reports on the many demographics of our country. 88% of those with positive COVID-19 tests also had a Vitamin D test, so the study group consisted of 192,000 individuals from across the nation.

"There was an association between lower SARS-CoV-2 positivity rates and higher circulating 25(OH)D levels."

The researchers acknowledge the limitation that their population was selected based on how symptomatic they might have been; after all, the request for COVID-19 testing was prompted by some concern on the part of the patient or physician. They also note that inferring ethnicity from zip codes may be problematic. Is this a sufficient mea culpa?

Not really. There is a second selection bias left unstated and more problematic why were these individuals having Vitamin D levels determined? It is not a routine laboratory test. There are a variety of conditions that may result in a deficiency. There are several that have been noted in other settings to be COVID-19 risk factors. They include obesity and its surgical management, chronic kidney disease, immobility that would leave you housebound or in a nursing facility, a higher risk of fractures, and skin color; darker-skinned individuals are less able to produce Vitamin D given similar exposure to the sun. Other recognized causes of Vitamin D deficiency include medications used to treat HIV, epilepsy, and elevated cholesterol. I suspect because the authors do not elucidate that the population under study were those who had a suspected deficiency in Vitamin D, who coincidentally had COVID-19 tests. That changes the denominator and makes the sample size of their population much different.

There are a lot of unanswered questions about Vitamin D. We know that it is essential, but what constitutes deficiency remains a product of consensus. Values in the group that the researchers identified as deficient are in that consensus. But the use of italics in categorizing that level as a "deficiency" is the nuanced signal that the word choice itself is a bit biased. Because physicians have no hard and fast cut-off, estimates of Vitamin D deficiency in the population range from 50% to 100%. The lay press has identified many early symptoms of a possible Vitamin D deficiency, including fatigue, frequent colds, bone, muscle and back pain, hair loss, and depression. When coupled with an inexpensive, non-prescription treatment, you have the setting for screening more low risk than high-risk patients. The CDCreportsthat Vitamin D testing increased 83-fold between 2000 and 2010 among Medicare beneficiaries, an admittedly higher risk group.

This study sheds no additional light or insights. It merely adds to the growing literature that Vitamin D may or may not be involved in, whatever disease you wish to mention.

Source: SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels PLOS DOI: 10.1371/journal.pone.0239252

More:
Can Vitamin D Play a Role in Treating or Preventing COVID-19? - American Council on Science and Health

Updated Results Demonstrate Significant DCCR Exposure Response Relationship

Interim Analysis of Open-Label Extension Data Demonstrate Continued Efficacy

Improvements in Body Composition and Metabolic Measures Support Efficacy of DCCR in Treatment of PWS Symptoms

REDWOOD CITY, Calif., Sept. 30, 2020 (GLOBE NEWSWIRE) -- Soleno Therapeutics, Inc. (Soleno) (NASDAQ: SLNO), a clinical-stage biopharmaceutical company developing novel therapeutics for the treatment of rare diseases, today announced that updated top-line results from the Companys Phase III trial, DESTINY PWS (C601), evaluating once-daily Diazoxide Choline Controlled Release (DCCR) tablets for patients with Prader-Willi Syndrome (PWS), were highlighted in an oral presentation by Jennifer L. Miller, M.D., Professor in the Division of Pediatric Endocrinology at the University of Florida, at the Foundation for Prader-Willi Research Annual Research Symposium.

DESTINY PWS is a randomized, double-blind, placebo-controlled Phase III study of oncedaily oral administration of DCCR in 127 PWS patients conducted at 29 sites in the U.S. and U.K. The objective of the study was to assess the efficacy and safety of DCCR in subjects ages four years and older, with genetically-confirmed PWS. Patients who completed the double-blind study enrolled in study C602, an ongoing open-label, extension study.

Soleno previously announced initial top-line results from DESTINY PWS in June 2020. The study did not meet its primary endpoint of change from baseline in hyperphagia, measured by the total score of a Hyperphagia Questionnaire for Clinical Trials (HQ-CT, 036). However, significant changes were observed in two of three key secondary endpoints, improvement in physician assessed Clinical Global Impression of Improvement score and reduction of body fat mass, in subjects receiving DCCR as compared to placebo. An interim analysis of the subset of patients who completed 13 weeks of treatment on C602 showed a continued improvement in hyperphagia, as well as several other PWS related behaviors.

Key updated results:

The results from this program continue to demonstrate DCCRs beneficial impact on hyperphagia, the predominant symptom of PWS, other behaviors typical of PWS, as well as problems related to body composition, and a safety profile that is well understood, said Dr. Miller, a Principal Investigator in the Soleno study. The sum total of data presented to date suggest that DCCR, if approved, may be a safe and effective treatment option that can address both the behavioral and metabolic components of PWS. I look forward to continued progress in advancing DCCR as the first potentially approved treatment for key unmet needs associated with PWS, a devastating condition with life-threatening comorbidities.

These compelling updated data bolster our confidence in DCCRs safety and efficacy profile in PWS, said Anish Bhatnagar, M.D., Chief Executive Officer of Soleno Therapeutics. We continue to treat patients in study C602, our open-label extension. As we have previously communicated, we expect to meet with the U.S. Food and Drug Administration before year-end to determine next steps and a potential path forward to address the unmet need for a safe and effective treatment option for PWS patients.

DCCR has orphan designation for the treatment of PWS in the U.S. and EU and Fast Track designation from the U.S. Food and Drug Administration.

About PWSThe Prader-Willi Syndrome Association USA estimates that one in 12,000 to 15,000 people in the U.S. have PWS. The hallmark symptom of this disorder is hyperphagia, a chronic feeling of insatiable hunger that severely diminishes the quality of life for PWS patients and their families. Additional characteristics of PWS include behavioral problems, cognitive disabilities, low muscle tone, short stature (when not treated with growth hormone), the accumulation of excess body fat, developmental delays, and incomplete sexual development. Hyperphagia can lead to significant morbidities (e.g., stomach rupture, obesity, diabetes, cardiovascular disease) and mortality (e.g., choking, accidental death due to food seeking behavior). In a global survey conducted by the Foundation for Prader-Willi Research, 96.5% of respondents (parent and caregivers) rated hyperphagia as the most important or a very important symptom to be relieved by a new medicine. There are currently no approved therapies to treat the hyperphagia/appetite, metabolic, cognitive function, or behavioral aspects of the disorder. Diazoxide choline has received Orphan Drug Designation for the treatment of PWS in the U.S. and EU, and Fast Track Designation in the U.S.

About Diazoxide Choline Controlled-Release (DCCR) TabletDiazoxide Choline Controlled-Release tablet is a novel, proprietary extended-release, crystalline salt formulation of diazoxide, which is administered once-daily. The parent molecule, diazoxide, has been used for decades in thousands of patients in a few rare diseases in neonates, infants, children and adults, but has not been approved for use in PWS. Soleno conceived of and established extensive patent protection on the therapeutic use of diazoxide and DCCR in patients with PWS. The DCCR development program is supported by data from five completed Phase I clinical studies in healthy volunteers and three completed Phase II clinical studies, one of which was in PWS patients. In the PWS Phase II study, DCCR showed promise in addressing hyperphagia, the hallmark symptom of PWS, as well as several other symptoms such as aggressive/destructive behaviors, fat mass and other metabolic parameters.

About Soleno Therapeutics, Inc.Soleno is focused on the development and commercialization of novel therapeutics for the treatment of rare diseases. The companys lead candidate, Diazoxide Choline Controlled-Release (DCCR) tablets, a once-daily oral tablet for the treatment of Prader-Willi Syndrome (PWS), is currently being evaluated in a Phase III clinical development program. For more information, please visit http://www.soleno.life.

Forward-Looking StatementsThis press release contains forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended. All statements other than statements of historical facts contained in this press release are forward-looking statements, including statements regarding timing of any regulatory process or ultimate approvals and determining a path forward for DCCR for the treatment of PWS and the impact of the COVID-19 pandemic on our operations and clinical trial. In some cases, you can identify forward-looking statements by terms such as "may," "will," "should," "expect," "plan," "anticipate," "could," "intend," "target," "project," "contemplates," "believes," "estimates," "predicts," "potential" or "continue" or the negative of these terms or other similar expressions. These forward-looking statements speak only as of the date of this press release and are subject to a number of risks, uncertainties and assumptions, including the risks and uncertainties associated with market conditions, as well as risks and uncertainties inherent in Solenos business, including those described in the company's prior press releases and in the periodic reports it files with the SEC. The events and circumstances reflected in the company's forward-looking statements may not be achieved or occur and actual results could differ materially from those projected in the forward-looking statements. Except as required by applicable law, the company does not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise.

Corporate Contact:Brian RitchieLifeSci Advisors, LLC212-915-2578

Read more from the original source:
Soleno Therapeutics Announces Updated Top-line Results from Phase III Trial of DCCR for Treatment of Prader-Willi Syndrome - GlobeNewswire

The first thought many sexually active people will have when their period is late is that they are pregnant. However, there are many reasons aside from pregnancy that your period may be late, or even missing altogether.

The process of ovulation and menstruation relies on a delicate balance of hormones, and if these hormones are thrown off even a little bit, it can cause you to have a late period.

This article breaks down nine reasons why your period may be late and what's happening biologically behind the scenes.

If you are exclusively breastfeeding your baby, it's common to experience amenorrhea, or, absence of a period.

This is because breastfeeding is associated with high levels of the hormone prolactin, says G. Thomas Ruiz, MD, OB/GYN Lead at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Elevated prolactin levels suppress the secretion of two hormones that are important for the menstrual cycle and ovulation: follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

Some people may not get their period again until they completely stop breastfeeding.

Stress doesn't just affect your mental wellbeing. It can also affect your hormones, throwing off the menstrual cycle.

Ruiz says when you're stressed, you have an increased level of the hormone cortisol also known as the stress hormone. Elevated cortisol will suppress LH secretion, which will in-turn affect ovulation.

Stress can also lower your levels of estrogen and progesterone hormones, which can make your period irregular.

Ruiz says it's not uncommon to experience a missed period in high-stress situations, such as during college final exams.

A consistent sleep schedule keeps your biological schedule consistent too. But when your sleep schedule is thrown off, the secretion of hormones is not as consistent and regular as it usually is, which in turn affects the secretion of reproductive hormones, says Evelyn Mitchell, MD, obstetrician and gynecologist with Keck Medicine of USC.

If your body isn't releasing the hormones associated with menstruation, then you could have a late or missed period.

Furthermore, lack of sleep can contribute to stress, which, again, will lead to an increase in cortisol, which can also affect your period's timing.

Mitchell says that exercising and eating very little can lead to extreme weight loss that can cause a missed or late period.

When losing weight, the brain may not secrete gonadotropin-releasing hormone (GnRH), Mitchell says. GnRH is a hormone that controls the secretion of other hormones released by the pituitary gland, including reproductive hormones like FSH and prolactin.

Because of this, your pituitary gland won't receive a signal that it needs to secrete reproductive hormones, and this will result in having a late or missed period.

Exercising too much is often associated with weight loss, which can lead to a late or missed period.

But even if you're at a consistent weight, excessive exercise, alone, can cause you to miss your period. Case in point, female athletes are more likely to have missed periods than non-athletes.

Just as weight loss can cause you to miss a period, so can weight gain, Mitchell says. Adipose tissue, or body fat, produces estrogen. So when you have excess weight, you have excess estrogen circulating in your body, which can interfere with the hormonal processes in your brain.

"Estrogen can give negative feedback to the brain that tricks the brain into thinking, 'Oh, maybe I don't need to secrete as much of this hormone,' and then that in turn causes a lack of ovulation and lack of periods," says Mitchell.

Additionally, if you are overweight and have chronically high estrogen levels, your brain may not sense increased estrogen production from the ovary when it comes time to ovulate, and then ovulation and menstruation will not occur, says Ruiz.

"Each woman seems to have a critical weight at which they may have trouble ovulating. Not all women with BMI between 30 to 35 will have ovulatory dysfunction. So women will do fine until they get to a BMI of 35, others will start having dysfunction at BMI of 33," says Ruiz.

When an overweight person loses weight and estrogen levels return to a more normal baseline, periods will likely return to normal.

Perimenopause is the time leading up to menopause when your period will completely stop. Usually, perimenopause occurs in your 40s.

When you are perimenopausal, your ovaries are running out of eggs, Ruiz says, and your levels of estrogen may be irregular. The amount of estrogen produced from cycle to cycle might not be enough to trigger ovulation and therefore menstruation.

Additionally, Mitchell says that perimenopause can sometimes prevent the ovaries from responding properly to estrogen, which could also delay menstruation. Though having regular periods is still possible during perimenopause, it may vary month to month because of changing hormone levels.

After a year of no periods, you are considered menopausal.

If you're having a late period and still getting enough sleep, are at a consistent, healthy weight, aren't severely stressed, and aren't premenopausal or breastfeeding, it's time to consider other possibilities like illness.

Some examples of underlying conditions that can affect the menstrual cycle are:

The most common cause for a late period in sexually active people is pregnancy.

When you are pregnant, you will not menstruate. Hormonally, pregnancy results in high levels of the hormone progestin, and high progestin suppresses ovulation, Ruiz says.

Your body will be releasing hormones and undergoing changes to accommodate the growing baby rather than releasing the hormones responsible for ovulating and menstruating.

The occasional late or missed period is normal and can be caused by a number of factors including stress, lack of sleep, overexercising, or significant changes in weight. But if you've missed three or more periods in a row, you have a condition called amenorrhea and should make an appointment with an OB-GYN.

Your doctor can help determine what the cause of your late or missing periods is and make sure that you don't have any underlying conditions, and get you back on track to having normal, regular periods.

Here is the original post:
9 reasons why your period may be late, including stress, changes to sleep schedule, and more - Insider - INSIDER

Editor's Note: We at POPSUGAR recognize that people of many genders and identities have vaginas and uteruses, not just those who are women. For this particular story, we interviewed experts who generally referred to people with vaginas and uteruses as women.

When I was first introduced to the world of intrauterine devices (IUDs), I had decided that I no longer wanted to take birth-control pills and had began looking for alternative birth-control methods that were not susceptible to human error. In my search, I came across the copper IUD called ParaGard: a hormone-free birth-control option that would be implanted in my uterus and stay there for many years, reliably blocking the fertilization of eggs without any further work on my end.

After a few years of having the ParaGard, however, I noticed that my menstrual flow changed to a heavier period with more painful cramps, and although I loved this form of birth control for its efficiency I personally needed to try another option. After talking to my gynecologist, it was decided that the best option for me would be a hormonal IUD (in my case, the Mirena). I had initially avoided the hormonal IUD, thinking that the hormones would change my body in the same the way my birth control pills did. But, due to my family's medical history and my lifelong experience with heavy periods, my doctor highly suggested that I make the switch. So, I did. After doing so, my body experienced much milder side effects than it did with the copper IUD, which solidified the fact that I had finally found the right birth control option for me.

But, it made me wonder what makes these two palm-sized "T" devices different from one another. In my experience, the side effects of each one differ significantly. So, how do we know which one is the right one for us, if at all? I talked to two gynecologists about the copper and hormonal IUDs to uncover more about how and why exactly they differ, and the many similarities they share as well.

According to the experts that spoke to POPSUGAR, the ParaGard (copper IUD) and the Mirena (hormonal IUD) are both intrauterine contraceptive devices that differ mainly in their contraceptive agents. The "ParaGard is a nonhormonal, long-acting reversible contraception (LARC), and the Mirena is a hormonal LARC," said board-Certified OBGYN Dr. Kameelah Phillips, MD IBCLC. According to Planned Parenthood, LARCs (a family of contraceptives that also includes the hormonal contraceptive implant) prevent unwanted pregnancy up to 20 times more effectively than birth control pills, patches, and vaginal rings. "LARCs are the most effective forms of reversible contraception," adds board-certified OBGYN Dr. Kiarra King, MD FACOG.

While the ParaGard's contraceptive agent is the thin copper coil wrapped around the device, the Mirena prevents pregnancy by emitting a small amount of the hormone progestin (similar to the body's naturally occuring hormone, progesterone) slowly overtime. According to Dr. Phillips, "both LARCs offer contraception for several years. The ParaGard for up to 10 years, and the Mirena for up to five years."

"The mechanism used for inserting the devices is slightly different for the physician simply due to the design of each product," explained Dr. King. Although the design of the insertion tool differs slightly, Dr. King assured us that "the patient wouldn't notice any difference."

"Both IUDS are 99 percent effective in preventing unplanned pregnancy," said Dr. Phillips. Our experts shared that both devices have a failure (or unintended pregnancy) rate of less than 1 percent, but differ slightly within that threshold. "The copper IUD's [failure rate] is around 0.8 percent, while the hormonal IUD is around 0.2 percent," explained Dr. King, making the hormonal IUD slightly more effective.

Dr. Phillips said that the ParaGard "is the longest-acting reversible contraception," which makes this particular device a good option for those who want to prevent pregnancy without having to replace the IUD after a few years. Planned Parenthood states that the copper IUD works by making it nearly impossible for the sperm to reach an egg because "sperm doesn't like copper." Dr. Phillips explained that "there is no hormone [in the ParaGard] to alter periods or ovulation," which means that "it can be used by almost anyone, regardless of medical conditions except of course if you have an allergy to copper."

"Outside of the contraceptive benefit," added Dr. King, "the copper IUD is good for 10 years, so there is less need for removal and reinsertion. It also has no hormones, which makes it a great option for women who can't use a hormonal method." Interestingly, a copper IUD can also be used as emergency contraception (in place of the morning-after pill) and is more than 99.9 percent effective if it's put in within 120 hours (five days) of having unprotected sex. Of course, there are other factors to consider when having an IUD inserted, as outlined in this article.

Both experts agree that the primary con of the ParaGard is the potential for it to change one's menstrual flow. "Some women will notice that their periods are heavier and more painful with the copper IUD," shared Dr. King. "This may not happen to everyone," added Dr. Phillips, "but it is important to know that it is possible. Also, sometimes the period can become a little crampy, so it is important to be open to taking pain medication as needed."

Like the ParaGard, the Mirena's primary benefit is its effectiveness in preventing pregnancy, according to our experts. In addition to its long-acting contraceptive benefits, "the levonorgestrel IUD is associated with less painful periods, decreased menstrual flow and, for some women, amenorrhea, which is the complete cessation of menstrual periods," explained Dr. King.

For some, this easing of periods may just be a handy side effect, but for others, it can feel life changing. "The hormonal component of the Mirena can offer women with heavy or painful periods some meaningful relief," said Dr. Phillips. Along with lighter or no periods, "women can notice painful periods and pelvic pain also improve."

At this point, the Mirena probably sounds like the dream contraceptive but, like anything else, there are potental side effects. "The downsides can include occasional spotting and benign cysts on the ovaries," shared Dr. Phillips. Negative side effects may also include "irregular bleeding in the first several weeks to months after insertion, mood changes, breast tenderness, headaches, or skin changes such as acne," added Dr. King.

In addition to the potential side effects for each listed above, Dr. Phillips shared that "all IUDs carry the risk of making a small hole in the uterus and/or getting stuck in the uterus. The risk is very small," Dr. Phillips assured us, but nonetheless, it is important information to know when deciding which birth control option is best for you.

According to Dr. King, "it is very common for women to notice changes in menstrual patterns and flow after an IUD insertion." She added that "generally, with a hormonal device, bleeding may be irregular initially after insertion, but will often become lighter as time goes on, simply due to the effect of the hormone on the uterine lining." On the other hand, since periods can become heavier with the ParaGard, "it is important to monitor your periods if they become heavier with ParaGard," explained Dr. Phillips, as "heavier periods over time can cause anemia."

According to our experts, the main reason why the ParaGard and Mirena differ in duration of effectiveness is because of their contraceptive ingredients. "The Mirena has the hormone essentially infused into the device which is released daily, but will eventually run out," said Dr. King, explaining this is why it's FDA-approved for a maximum of five years after its insertion. The action of the ParaGard's copper coil, on the other hand, "lasts longer than the slow release progesterone that is present in the Mirena," according to Dr. Phillips.

"There is no problem with switching between ParaGard and Mirena," Dr. Phillips said. "Either can be used at different times in your reproductive lifespan." Dr. King seconded this, adding that "it is all dependent on what is best for a woman at a particular point in her life. Some women get their IUD removed and another one reinserted on the same day."

Dr. Phillips said it is first important to "explain to your doctor that you are looking for a long-acting, reversible contraception. From here, they can lead you through the pros and cons of each to see which option may fit you best." During this discussion with your doctor, you should "talk openly and candidly about your goals, health history, and desire for future pregnancy," advised Dr. King.

As far as deciding which option is best for you, "it is important to know all of your contraceptive options to make sure a long-acting reversible option is right for you," said Dr. Phillips. "The next decision point is if you desire a nonhormonal or hormonal option." It's impossible to say which option is best without first knowing your specific medical history. "If you have a history of heavy periods, a levonorgestrel-based IUD system may be ideal for you," said Dr. King. "If you have contraindications to hormonal devices, a copper device may be a better option. Each woman will have reasons as to why a device is best for her, and that's OK."

Follow this link:
My Body Reacted Differently to the Copper vs. the Hormonal IUD, So I Asked 2 Doctors Why - POPSUGAR

Over the past decade, breast surgeon Deanna Attai, MD, has built a reputation as a physician whos active in online patient groups. So its not surprising that she got her idea for her latest study from Twitter. She frequently observed patients with breast cancer posting about their frustrations talking to their oncologists about the downside of taking endocrine therapy. I saw multiple comments along the lines of My oncologist is great, but when it comes to endocrine therapy, every time I try to talk about side effects, the conversation just stops, said Dr Attai, who is assistant clinical professor in the department of surgery at UCLA Health at the David Geffen School of Medicine.

Or patients complained that their doctors had advised them to simply accept common symptoms of weight gain, joint pain, loss of libido, vaginal dryness, or impotence because there werent treatment alternatives. It struck me that this was a topic I hadnt seen written about in this way that addressed this frustration among patients, she said.

So Dr Attai and her team tapped 9 patients who were active in breast cancer social media communities to create a survey for hormone receptorpositive patients about their experiences with endocrine therapy and communication with their health care providers. Whos better qualified to design the questions than the people who are living with the side effects? she said, adding that conventional quality-of-life studies usually dont measure whats meaningful to patients.

Researchers received responses to the anonymous online survey from 2353 women and 54 men. The results, which were published in August 2020 in the Journal of Cancer Survivorship, found that 91% experienced side effects, which prompted about one-third of patients to discontinue therapy. Nearly one-third of respondents reported that they felt their concerns were dismissed or minimized in discussions with their cancer care team. I was surprised that 30 percent felt they were brushed off, said Dr Attai. I thought it would be lower.

This study is important because it gives voice to our experiences, says breast cancer survivor and patient advocacy leader Sue Friedman. Most clinicians are trained to tell patients whats in their best interest and arent always listening to patients concerns, said Friedman, who is executive director of the national nonprofit organization Facing Our Risk of Cancer Empowered (FORCE), which is based in Tampa, Florida. Yet for patients, these side effects can be a big deal. Hormone therapy affects your libido, energy levels, and weight. These are things that are essential to your very well-being, she said, adding that the results send a critical message to drug researchers about the need for new therapies.

Friedman said she hopes the research will prompt oncologists to dedicate more time to discussing side effects with patients as well as take the initiative to broach the topic. Some patients might not feel comfortable bringing us these conversations, especially related to sexual concerns, she said.

Dr Attai added that such empathy could ultimately improve patients drug compliance. I want physicians to understand that our patients might be struggling with these medicines more than they let on, and theyre also struggling with worry about recurrence if they stop early, she said. More than half of respondents suggested that doctors set aside extra time during office visits or perhaps a separate visit via telehealth to educate patients about expected side effects and discuss strategies to manage them. (In the survey, 40% reported that diet and exercise were helpful.) This survey helps us appreciate what a challenging position our patients are in, Dr Attai said.

Reference

Berkowitz MJ, Thompson CK, Zibecchi LT, et al. How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support. J Cancer Surviv. Published online August 17, 2020. doi:10.1007/s11764-020-00908-5

Follow this link:
How Breast Cancer Patients Really Feel About Endocrine Therapy - Cancer Therapy Advisor

Provided by Prince William County

Christine Doering is an Inova contractor working as an employee wellness coordinator for the Prince William County Office of Risk & Wellness Services, Breast cancer is the second leading cause of death among women in the United States with 250,000 new cases diagnosed every year. Additionally, 2,300 men are diagnosed annually with breast cancer.*

October is Breast Cancer Awareness Month, and the emphasis this year is prevention. For this month what were highlighting is the fact that prevention is getting in and getting your annual mammogram and thats the best prevention, says Doering.**

There are a few additional practices that can help women prevent breast cancer. Doering said, The best ways to avoid getting breast cancer for women are to get regular exercise and keep a healthy weight. Limit your alcohol. Talk to your physician. They might recommend taking hormone replacement as you get into your 50s. You might want to talk about family history before you start taking that. Breastfeed your children if you can. That helps limit the chance of getting breast cancer as you get older.*

In past years, Sentara Health Care sent out mobile testing sites to screen women for breast cancer; however, the mobile testing sites have been preempted this year. According to Doering, With Sentara helping out with the COVID-19 pandemic, Sentara wont be setting up mobile testing sites So were just promoting through Inovas Breast Cancer Center in Fairfax.

Appointments can be madeonline.

Sources:* CDC, Mayo Clinic** CDC, National Breast Cancer Organization

See the article here:
October is Breast Cancer Awareness Month - Prince William Living

Laurie Wang, Staff Illustrator

For remote Yale students, dealing with sleep disruptions due to time zone differences can be a learning challenge.

Meir Kryger, a Yale sleep expert and Yale School of Medicine physician, and Suman Baddam, Assistant Professor of Clinical Child Psychiatry, co-instruct the course The Mystery of Sleep, which explores the relationship between sleep and well-being. Disruptions to sleep schedules can negatively impact attention, memory and cognitive awareness. Kryger said that there are a number of students in his class who study remotely and must battle time differences.

When my class starts, which is 4 oclock in the afternoon, in Taiwan its like 4 oclock in the morning, Kryger said. And the student is actually there wide awake and alert, participating in the class They seem to be asking questions when its appropriate. Even though the schedule is crazy.

Alongside the ways that inconsistent sleep schedules can harm students well-being, Baddam also said blue light can impact circadian rhythms, which raises another concern for Yalies taking virtual classes at late hours. He cited a study that showed that the light from a Kindle is enough to disrupt ones sleep patterns in the evenings.

According to Healthline, circadian rhythms are changes in physical and behavioral patterns that follow a 24-hour cycle. These include the release of hormone melatonin, which makes people sleepy.

Remote students Mehmed Can Olgac 22 and Sena Sugiono 24 are located in Turkey and Indonesia, respectively. Because of the large time difference, Olgac and Sugiono must go to extreme measures to adjust.

I have one class that ends at 1 a.m. in the morning on Mondays, so like by the end of that class Im very exhausted, Olgac said. I dont usually remember the second half of the class.

Not only has Olgac faced difficulty staying awake for classes, he said his home responsibilities also make it more challenging to keep up with schoolwork and remember the commitments he has made. Yet despite the downsides of studying remotely, Sugiono said in an interview with the News that there are also some benefits. Since his schedule is reversed, he can work with no distractions.

Now, Im actually enjoying it because I get to concentrate on my studies in a very quiet and tranquil situation, Sugiono wrote in a text message to the News. Just [because] no one is up [from] 2-4 a.m.

He told the News that he sleeps from 2 p.m. to 8 p.m. local time, while juggling extracurriculars in addition to classes.

As a piece of advice to undergraduates abroad studying remotely, Baddam suggested creating a consistent schedule for oneself to avoid sporadic sleep disturbances.

They should basically have their sleep time for their biological day as a shift worker and just stay up all night for the whole week, he told the News, adding that while its still bad, it is less harmful than constantly changing ones sleep schedule.

He also noted that regularly getting seven to nine hours of sleep a night is something that any undergraduate can do to enhance their learning, even if they think they are doing fine, as its hard to recognize how tired we are.

Kyrger and Baddam teach their Cognitive Science course on Tuesday and Thursday afternoons.

Anna Xu | anna.xu@yale.edu

Simisola Fagbemi | simi.fagbemi@yale.edu

View post:
The schedule is crazy: Sleep science and the impact of online classes - Yale Daily News

By CAPITAL NEWS SERVICE

LANSING Fresh from what was conceivably the most important exam of his life, aspiring physician Sevar Yaldo sat on a Bailey Park bench for some fresh air in East Lansing.

Having spent the majority of the pandemic indoors preparing for the Medical College Admission Test, Yaldo understands and literally studied the psychological importance of getting outdoors during quarantine.

The slightest bit of fresh air can go such a long way in improving his thoughts, relationships and self-esteem, Yaldo said. Whenever I have a chance to not be inside, I will be outside, whether Im walking or running.

We often hear about how crucial it is to eat our greens. But rarely do we talk about the importance of seeing green.

Relationships with nature have diminished in an increasingly artificial world. Depression and obesity are reaching unprecedented levels.

While there are a host of treatments including medication and therapy regimens mitigating such problems may be simpler.

I encourage patients with all kinds of mental health conditions be it anxiety, depression, or whatever else to get outside. Ill suggest that they walk to my office rather than driving there, said Okemos psychologist Pamella Montgomery. By the time they arrive, they always report feeling significantly better.

Montgomery has long advocated spending time outdoors.

I worked and went to graduate school full time with a 30-hour-a week internship on the side, but I still managed to run outdoors. To this day, regardless of the weather, I run outside, Montgomery said. Being outdoors and in nature is crucial to our being. Were creatures that need to interact with nature.

Psychologically, she said, Going outside gets you out of your indoor rut. It makes you stop and think about things, which you dont do sitting in front of the TV or computer.

Paul Smith of Ann Arbor drove about 1 hours to go rock-climbing at Oak Park in Grand Ledge.

This is a sport you cant really do by yourself, which I know is very insane during our COVID times, said Smith, who was with a group of people at the Ledges.

Since the start of the pandemic, Smith said hes spent less time outside. With winter coming, hes trying to get outside more.

In addition to it being physically healthy, being outdoors has a good mental impact, he said. If youre just inside all the time, I definitely find it causes a lot of drain and wear on your emotions.

In the age of COVID-19, getting fresh air takes on new meaning.

Those fortunate enough to be near parks and trails can safely socially distance.

When Craig Dennis needs to kill time, he hits a nature trail in East Lansings Harrison Meadows Park. It gave me a purpose to go out and exercise and feel good, he said.

Outdoor activities are bustling as people have taken to hiking, walking dogs, biking and running because indoor activities remain limited. Dennis said hes seen coronavirus-wary older neighbors get outside more.

Speaking of dogs, one chilly morning in Westland, Kobe, with tongue hanging low was out for a walk with owner Jacquis Smith.

I shortened the time of how much time I spend outside. Ive noticed people arent wearing their mask when they are walking their dogs, but I always have mine on, Smith said,

Michigan State University education professor David Stroupe walks a trail alongside the Red Cedar River on campus.

I try to go in the woods and hear the birds, Stroupe said.

Stroupe was already going on regular walks before COVID 19 but has noticed more animals since the pandemic began. I think theyre more bold.

He doesnt bring technology. Being unplugged makes the walk more enjoyable. Since were on computers a lot now, I try and leave my phone at home, he said.

Green, leafy environments can boost a persons mood, speed up brain activity and improve overall health, according to research from the Department of Psychology at Ottawas Carleton University.

And like an all-natural ventilation system, trees and plants encountered on nature walks produce oxygen and scrub carbon dioxide from the atmosphere.

More sunshine helps. Direct sunlight isnt enough to wipe out COVID-19, the Centers for Disease Control and Prevention says, but can help produce vitamin D to gear up the immune system to fight infectious disease.

Sunlight also causes the brain to produce the hormone serotonin, which can heighten happiness.

On a rainy recent evening, the weather and COVID-19 didnt stop the daily busy world, especially not for Lansing resident Driscilla Tettey, whod been running errands all day.

Ive been spending more time outside now during the pandemicbecause we were social distancing and in isolation. We had to be indoors all the time, and that can take a toll on your mental health, so definitely spending more time outside helped boost my mental health and my overall well-being, Tettey said.

Anne Breton, who has been coming to the Harris Nature Center in Okemos for more than 20 years, said its been a gift to have parks in Meridian Township during this COVID-19 era.

We can walk with friends at a social distance,she said after finishing a birdwatching trip in the park.

Shes seen an uptick in the number of people of all ages using the park and said she hopes some who hadnt been enjoying the outdoors will make that a part of their lives, even after they can again go to movies.

Mckenzie Dickens walks barefoot through rows of plants in the MSU Botanical Gardens. Sitting on the grass, crossing his legs and tucking his dreadlocks into a bandana, he said time outdoors is precious, especially in the face of COVID-19.

Theres a point when watching Netflix gets tiresome.Thankfully, though, Gov. (Gretchen) Whitmer kept state parks open so people can visit them, Dickens said of Michigans early lockdown.

For all the harm this pandemic has caused, maybe it has a silver lining. Maybe it can teach everyone how to be outside again, he said.

And its not only people in Michigan who see a silver lining.

Before the pandemic, getting outdoors wasnt easy for Bernard Crawford, an advertising student at Florida Atlantic University. With more time on his hands, being outside is the new highlight of his day.

On an afternoon stroll in the 90-degree weather along Boca Raton streets, Crawford said hes felt a greater sense of connection with nature and is outdoors much of the day.

Being a full-time student, I never had the chance to get out and enjoy Gods beautiful creation. Im upset I was always inside playing video games before, he said.

This story was reported and written by Kathleen Fitch, Kalah Harris, Anne Hooper, Yue Jiang, Chioma Lewis, Lea Mitchell, Claire Moore, Audrey Porter and Lillian Young, and edited by Jiang and Lewis.

Link:
Engaging with nature and just getting outside help in the age of COVID-19 - Spartan Newsroom

- Study in over 500 patients with node-negative or node-positive disease highlights impact of the test on treatment decisions, reducing potential over- and under-treatment and leading to a 23.5% net reduction in chemotherapy recommendations

- Publication shows that Recurrence Scoreresults do not correlate with clinical pathologic parameters

GENEVA, Oct. 2, 2020 /PRNewswire/ -- Exact Sciences today announced results from a prospective decision impact study1 presented at the virtual European Breast Cancer Conference (EBCC-12), being held October 2-3. The findings are consistent with previous studies and further support the clinical utility of the Oncotype DX Breast Recurrence Score test to optimise chemotherapy recommendations in patients with early-stage, hormone-receptor positive, HER-2 negative breast cancer with or without lymph node involvement.

The study was conducted between 2016 and 2019 in 15 certified breast cancer centers across Germany. The analysis presented at EBCC-12 includes 567 patients 403 with node-negative (N0) disease and 167 with one to three positive nodes. Results showed that treatment recommendations changed for 33.5% of patients based on their Recurrence Score results, and that using the test to guide treatment decisions resulted in a net reduction in chemotherapy recommendations of 23.5%. These changes in treatment recommendations could well have been greater in patients with N0 disease if the decision-making criteria (Recurrence Score groups) based on results from the landmark TAILORx study, which was published2in 2018, had been applied at the time of the study.

"These important results show the value of the Oncotype DX test to best select patients for chemotherapy and to avoid potential over- as well as under-treatment by adding genomic information and not relying only on traditional clinical parameters," said Prof. Dr Marc Thill, lead study author and chief physician of the Clinic for Gynecology and Gynecological Oncology at the Agaplesion Markus Krankenhaus in Frankfurt, Germany. "The use of this test allows us to tailor treatment plans more accurately to suit the needs of individual patients, and to use resources more effectively."

Importantly, the analysis presented at EBCC-12 also revealed a weak correlation between centrally and locally performed Ki67 (a classic prognostic factor) and showed a broad range of Recurrence Score results for patients with grade 2 tumours, suggesting that grade does not predict the Recurrence Score result and that the test can provide relevant information for all patients. These findings are consistent with results from a subset analysis3 of the TAILORx study, which showed that only the Oncotype DX test can assess the expected benefit of chemotherapy, and that clinical and pathological features generally provide only prognostic information.

Evidence from routine clinical practice shows that Recurrence Score results do not correlate with clinical pathologic factors

In addition to the results presented at EBCC-12, a recently published retrospective analysis compared the Recurrence Score result with clinical parameters in 4,695 patients with node-negative or node-positive early-stage breast cancer for whom testing with the Oncotype DX test was performed in routine clinical practice in Germany.4 In this group of patients, 84% had a Recurrence Score result of 0-25, consistent with data from TAILORx.2 The findings highlighted an overall high discordance of 45% between Ki67 and the Recurrence Score result classifications, and showed that a large proportion of patients with clinically high-risk features,such as high Ki-67 or high tumour grade, had low Recurrence Score results, suggesting they would not benefit from additional chemotherapy.

These latest results add to the substantial real-world evidence available for the Oncotype DX test, which reflects its growing adoption, particularly since the publication of TAILORx. This landmark study has positively influenced treatment guidelines and is having an important impact on global reimbursement and standard use of the test. More than 1 million patients around the world have used the test to inform their treatment decision.

About Oncotype DXThe Oncotype DX portfolio of breast, colon and prostate cancer tests applies advanced genomic science to reveal the unique biology of a tumour in order to optimise cancer treatment decisions. In breast cancer, the Oncotype DX Breast Recurrence Score test is the only test that has been shown to predict the likelihood of chemotherapy benefit as well as recurrence in invasive breast cancer. Additionally, the Oncotype DX Breast DCIS Score test predicts the likelihood of recurrence in a pre-invasive form of breast cancer called DCIS. In prostate cancer, the Oncotype DX Genomic Prostate Score test predicts disease aggressiveness and further clarifies the current and future risk of the cancer prior to treatment intervention. With more than 1 million patients tested in more than 90 countries, the Oncotype DX tests have redefined personalised medicine by making genomics a critical part of cancer diagnosis and treatment. To learn more about Oncotype DX tests, visit http://www.OncotypeIQ.com/en

AboutExact Sciences Corp.A leading provider of cancer screening and diagnostic tests, Exact Sciences relentlessly pursues smarter solutions providing the clarity to take life-changing action, earlier. Building on the success of the Cologuardand Oncotype DXtests, Exact Sciences is investing in its product pipeline to take on some of the deadliest cancers and improve patient care. Exact Sciences unites visionary collaborators to help advance the fight against cancer. For more information, please visit the company's website at http://www.exactsciences.com, follow Exact Sciences on Twitter @ExactSciences, or find Exact Scienceson Facebook.

NOTE: Oncotype DX, Breast Recurrence Score, and Recurrence Score are trademarks or registered trademarks of Genomic Health, Inc. Exact Sciences is a trademark or registered trademark of Exact Sciences Corporation. All other trademarks and service marks are the property of their respective owners.

Forward-Looking Statements This news release contains forward-looking statements within the meaning of Section27A of the Securities Act of 1933, as amended, and Section21E of the Securities Exchange Act of 1934, as amended, that are intended to be covered by the "safe harbor" created by those sections. Forward-looking statements, which are based on certain assumptions and describe our future plans, strategies and expectations, can generally be identified by the use of forward-looking terms such as "believe," "expect," "may," "will," "should," "would," "could," "seek," "intend," "plan," "goal," "project," "estimate," "anticipate" or other comparable terms. All statements other than statements of historical facts included in this news release regarding our strategies, prospects, expectations, financial condition, operations, costs, plans and objectives are forward-looking statements. Examples of forward-looking statements include, among others, statements we make regarding expected future operating results, anticipated results of our sales, marketing and patient adherence efforts, expectations concerning payer reimbursement, and the anticipated results of our product development efforts.Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Actual results, conditions and events may differ materially from those indicated in the forward-looking statements. Therefore, you should not rely on any of these forward-looking statements. Important factors that could cause actual results, conditions and events to differ materially from those indicated in the forward-looking statements include, among others, the following: uncertainties associated with the coronavirus (COVID-19) pandemic, including its possible effects on our operations and the demand for our products and services; our ability to efficiently and flexibly manage our business amid uncertainties related to COVID-19; our ability to successfully and profitably market our products and services; the acceptance of our products and services by patients and healthcare providers; our ability to meet demand for our products and services; the willingness of healthcare payers to cover our products and services and adequately reimburse us for such products and services; the amount and nature of competition for our products and services; the effects of the adoption, modification or repeal of any law, rule, order, interpretation or policy relating to the healthcare system, including without limitation as a result of any judicial, executive or legislative action; data protection laws and rules affecting our performance of diagnostic tests, including the Oncotype DX test; the effects of changes in pricing, coverage and reimbursement for our products and services; recommendations, guidelines and quality metrics issued by various organizations such as the American Society of Clinical Oncology, the National Cancer Care Network, the European Society of Medical Oncology, the St Gallen Consensus, and national health technology assessment bodies regarding our products and services; our ability to successfully develop new products and services and assess potential market opportunities; our success establishing and maintaining collaborative, licensing and supplier arrangements; our ability to maintain regulatory approvals and comply with applicable regulations; our ability to manage an international business and our expectations regarding our international expansion and opportunities; the potential effects of foreign currency exchange rate fluctuations and our efforts to hedge such effects; the possibility that the anticipated benefits from our combination with Genomic Health cannot be realized in full or at all or may take longer to realize than expected; the possibility that costs or difficulties related to the integration of Genomic Health's operations will be greater than expected and the possibility of disruptions to our business during integration efforts and strain on management time and resources; the outcome of any litigation, government investigations, enforcement actions or other legal proceedings; and the other risks and uncertainties described in the Risk Factors and in Management's Discussion and Analysis of Financial Condition and Results of Operations sections of our most recently filed Annual Report on Form 10-K and our subsequently filed Quarterly Reports on Form 10-Q. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

1 Thill M, et al. [The REMAR (Rhein-Main-Registry)-Study: Prospective Evaluation of Oncotype DX Assay in Addition to Ki-67 For Adjuvant Treatment Decisions in Early Breast Cancer]. Presented at EBCC-12; October 2, 2020.

2 Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. New Engl J Med. 2018;379:111-121.

3 Sparano JA, Gray RJ, Ravdin PM, et al. Clinical and genomic risk to guide the use of adjuvant therapy for breast cancer. New Engl J Med. 2019;380:2395-2405

4Walter VP, Taran F-A, Wallwiener M, et al. Distribution of the 21-gene breast recurrence score in patients with primary breast cancer in germany. Geburtshilfe und Frauenheilkunde.2020;80:619-627.

Media Contact:

Federico Maiardi+41 79 138 1326fmaiardi@exactsciences.com

Logo - https://mma.prnewswire.com/media/506016/Exact_Sciences_Corporation_Logo.jpg

http://www.exactsciences.com

SOURCE EXACT SCIENCES CORP

See original here:
New Real-World Evidence Further Demonstrates the Clinical Utility of the Oncotype DX Breast Recurrence Score Test, Beyond Clinical Risk Factors, in...

The American Medical Spa Association (AmSpa) has announced the release of a comprehensive new package of forms and consents designed to help medical aesthetic practices prepare for any eventuality and create a culture of safety and compliance.

CHICAGO (PRWEB) October 01, 2020

The American Medical Spa Association (AmSpa) has announced the release of a comprehensive new package of forms and consents designed to help medical aesthetic practices prepare for any eventuality and create a culture of safety and compliance.

"We're so excited to offer a full package of compliance documents to the industry," says AmSpa CEO, Alex R. Thiersch, JD. "We have been working on these documents in conjunction with several of our physician members, as well as our attorney partners at ByrdAdatto. Our goal is to help encourage the industry to become and remain safe and compliant, and this package goes a long way toward accomplishing that. As we say at AmSpa, compliance is cool,' but in order to be compliant, practitioners need access to high-quality, affordable resources that they can use in their practices right away. AmSpa's Forms and Consents Package aims to do precisely that."

Although these forms are very thorough, they must be used only after consulting with both a qualified health care attorney and the practice's medical director. Every practice and every location are different, so there cannot be a "one size fits all" approach to compliance.

The following packages are now available from AmSpa's store:

These packages can be purchased from the AmSpa store (https://www.americanmedspa.org/page/Store).

"We believe that being compliant should not be cost-prohibitive, and we have worked hard to ensure that our members and partners have easy and affordable access to resources that help them operate safely and compliantly," says Thiersch.

For the original version on PRWeb visit: https://www.prweb.com/releases/amspa_releases_comprehensive_forms_and_consents_for_medical_spas/prweb17402211.htm

Originally posted here:
AmSpa Releases Comprehensive Forms and Consents for Medical Spas - Benzinga

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Heres our process.

Every year millions of adults in the United States try to lose weight (1).

Along with exercise, dieting is one of the most common methods used to promote weight loss.

However, not all diets are created equal, which can make it challenging to find a weight loss program thats safe, sustainable, and effective.

The programs featured in this article were selected based on the following criteria:

This article looks at 16 of the best weight loss programs in 2020.

The Mediterranean diet is inspired by the eating patterns of countries like Italy, Spain, and Greece.

A well-rounded Mediterranean diet should include plenty of fruits, vegetables, whole grains, nuts, seeds, proteins, and healthy fats.

Meanwhile, added sugars and foods that have been heavily processed or refined are restricted (2).

Although the diet isnt specifically designed for weight loss, many studies have demonstrated that following the Mediterranean Diet could lead to weight loss (3, 4, 5).

For example, one analysis of 16 studies showed that those who paired the Mediterranean diet with physical activity and calorie restriction lost significantly more weight than those in a control group (6).

Plus, other research suggests that the Mediterranean Diet may help prevent chronic conditions like type 2 diabetes and heart disease (5, 7).

For an easy resource to help get you started on the Mediterranean diet, check out The Complete Mediterranean Cookbook, which features a variety of delicious recipes and in-depth information about the diet.

Shop for The Complete Mediterranean Cookbook online.

Plant-based diets encourage you to eat foods from plants, including fruits, vegetables, nuts, seeds, oils, and legumes.

Unlike vegan or vegetarian diets, most plant-based diets dont eliminate meat or animal products entirely. However, these foods are only enjoyed in moderation and not generally considered to be the main focus of the diet (8).

Plant-based diets are particularly rich in fiber the parts of plant-based foods like fruits, vegetables, and whole grains that are resistant to digestion. Fiber helps keep you full between meals to promote weight loss (9, 10, 11).

According to one review of 12 studies, people who followed a plant-based vegetarian diet lost an average of 4.5 pounds (2 kg) more than those who followed a non-vegetarian diet over 18 weeks (12).

Another review of 32 studies found that plant-based diets were more effective for weight loss, compared with conventional diets, and even led to greater improvements in blood sugar control, cholesterol levels, and inflammation (13).

To learn more about plant-based diets, check out the book The Plant-Based Diet for Beginners by Gabriel Miller, which offers a variety of resources, including recipes and shopping lists.

Shop for The Plant-Based Diet for Beginners by Gabriel Miller online.

Carb-restricted diets are often recommended to help support blood sugar control and increase weight loss among those with type 2 diabetes (14).

There are many types of carb-restricted diets, but most of them involve limiting the consumption of foods that are high in sugar or carbs, such as desserts, candy, bread, and pasta.

Although some carb-restricted diets, such as the Atkins or ketogenic diet, also require significantly reducing your carb consumption to 2050 grams per day, low carb diets are defined as any diet comprising less than 130 grams of carbs per day (15, 16).

One study in 49 people with type 2 diabetes found that a low carb diet was more effective at improving blood sugar levels than a low fat diet. Whats more, it led to reductions in cholesterol and body mass index (BMI) after 3 months (17).

Another study in 124 people with type 2 diabetes found that following a low carb, high fat diet was linked to improved blood sugar control and increased weight loss, compared with a control group (18).

If you want to learn more about carb-restricted diets, you can find valuable resources online, or check out this article to get you started.

Shop for books on carb-restricted diets online.

The Mayo Clinic diet is an eating plan originally developed by experts at the Mayo Clinic, a nonprofit hospital system thats considered to be a leader in medical research.

The Mayo Clinic diet is focused on developing healthy habits like eating breakfast every day, exercising daily, and keeping a food journal.

It also promotes nutritious ingredients, such as fruits, vegetables, whole grains, and healthy fats, while limiting added sugars and saturated fat from full fat dairy and high fat meats.

Although there arent any peer-reviewed studies on the Mayo Clinic diet specifically, studies show that following a diet high in fiber and low in saturated fat may aid weight loss and blood sugar control (19, 20).

Other research suggests that reducing your intake of saturated fat or added sugars may also enhance your bodys ability to use insulin, the hormone thats responsible for carrying sugar from your bloodstream into your cells (21, 22, 23, 24).

You can learn more about the Mayo Clinic diet on the Mayo Clinics website, or find valuable information in books on the topic.

Shop for books on the Mayo Clinic diet online.

Low carb diets involve restricting your intake of carbs, including high carb foods like bread, pasta, and sweets.

Some research suggests that reduced sensitivity to insulin may play a role in the development of polycystic ovary syndrome (PCOS) (25).

As such, low carb diets are often recommended to improve insulin sensitivity and help manage symptoms of PCOS.

One review of eight studies showed that following a low carb diet could help increase weight loss and improve hormone levels in women with PCOS (26).

Whats more, another review of seven studies showed that low carb diets could help balance hormones and improve fertility in women with PCOS (27).

Shop for books on the low carb diet online.

Anti-inflammatory diets emphasize foods rich in nutrients that have been shown to fight inflammation, including antioxidants and omega-3 fatty acids (28).

These diets are rich in foods like fruits, vegetables, nuts, seeds, and fatty fish. They also typically limit processed products, fried foods, and sugar-sweetened beverages.

Studies show that increasing your intake of anti-inflammatory foods like fruits, vegetables, and nuts may be beneficial for weight loss (29, 30, 31).

In addition to promoting weight loss, following an anti-inflammatory diet may help alleviate symptoms of PCOS.

In fact, high levels of inflammation are thought to contribute to symptoms of PCOS and may be associated with increased levels of androgens, or male sex hormones (32).

One study in 100 women with PCOS found that pairing a calorie-restricted, anti-inflammatory diet with regular physical activity for 12 weeks significantly increased weight loss and improved hormone levels, menstrual cycle regularity, blood sugar control, and fertility (33).

Dorothy Calimeris and Lulu Cooks book The Complete Anti-Inflammatory Diet for Beginners is an excellent resource for more information on the anti-inflammatory diet.

Shop for The Complete Anti-Inflammatory Diet for Beginners by Dorothy Calimeris and Lulu Cook online.

The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan intended to promote weight loss, reduce blood pressure levels, and protect against heart disease (34).

The diet promotes nutritious foods like fruits, vegetables, lean proteins, and whole grains.

Meanwhile, red meat and foods high in added sugar, salt, or fat are limited.

According to one review of 13 studies, participants who followed the DASH diet lost more weight and belly fat than those following other calorie-restricted diets for 824 weeks (35).

The DASH diet has likewise been shown to decrease levels of blood pressure, total cholesterol, and LDL (bad) cholesterol all of which are risk factors for heart disease (36, 37).

There are a variety of books and resources on the DASH diet, or you can check out this article to get you started.

Shop for books on the DASH diet online.

The Therapeutic Lifestyle Changes (TLC) diet is a plan developed by the National Cholesterol Education Program to support healthy cholesterol levels.

On the TLC diet, foods high in fat and dietary cholesterol are limited, while foods high in soluble fiber a type of fiber that dissolves in water are encouraged.

The diet also recommends aiming for at least 30 minutes of moderate-intensity exercise daily.

Increasing your intake of soluble fiber and adding more physical activity into your routine are two common strategies for promoting weight loss (38, 39, 40).

Plus, several older studies have even found that the TLC diet can decrease levels of LDL (bad) cholesterol, reduce blood pressure, and enhance immune function (41, 42, 43).

Check out this free guide to the TLC diet online, which is provided by the U.S. Department of Health and Human Services.

Although there are many styles and variations of intermittent fasting, most involve restricting food intake for 1424 hours at a time.

Some research suggests that intermittent fasting may be particularly beneficial for women during menopause (44).

It has been shown to increase weight loss to a similar extent as cutting calories, and it may also help boost fat-burning (45, 46).

Intermittent fasting may likewise reduce insulin resistance and help stabilize blood sugar levels, both of which can be especially beneficial during menopause (47, 48).

Whats more, other research suggests that intermittent fasting may help support mental health during menopause by enhancing self-esteem, as well as reducing stress levels and symptoms of anxiety and depression (44).

Some studies have found that intermittent fasting could affect men and women differently, indicating that women may be more sensitive to the effects of fasting (49, 50).

Therefore, women may benefit from a more relaxed approach to fasting, which could include intermittent fasting just a few times per week, consuming a small number of calories during fasts, or limiting fasting periods to 1416 hours at a time.

Be sure to also follow a healthy and balanced diet during non-fasting periods to maximize the potential benefits.

To learn more about intermittent fasting and how to incorporate it into your daily routine, check out Fast. Feast. Repeat. by Gin Stephens.

Shop for Fast. Feast. Repeat. by Gin Stephens online.

The pescatarian diet is a mostly plant-based diet that includes fish and seafood.

There are several variations of pescatarian diets, but most of them exclude meat and poultry from the diet but include other animal products like fish, eggs, dairy, and honey.

Studies suggest that pescatarians tend to have a lower BMI and improved diet quality, compared with non-vegetarians (51, 52, 53).

The diet may also be particularly beneficial for those with thyroid issues like hypothyroidism, as it encourages the consumption of seafood thats rich in selenium, a mineral thats essential for the production of thyroid hormones (54).

Plus, fish like cod and tuna can help protect against iodine deficiency, another factor that can contribute to thyroid issues (55, 56).

However, keep in mind that this diet may not necessarily be suitable for all thyroid conditions, and those with conditions like Hashimotos or Graves disease may benefit from an individualized dietary pattern tailored to their needs.

Many books can provide more information on the pescatarian diet, along with meal plans and recipes to get you started.

Shop for books on the pescatarian diet online.

The Ornish Diet is a low fat, plant-based eating pattern that promotes nutritious ingredients like fruits, vegetables, whole grains, and legumes.

While weight control is not the primary goal of the Ornish Diet, multiple studies have found that it may be effective for long-term weight loss.

For example, one study in 311 women showed that participants who followed the Ornish Diet for 12 months lost an average of 5 pounds (2.2 kg) (57).

Another small study found that the Ornish Diet was more effective for weight loss than other popular diet plans like Atkins and the ZONE Diet, resulting in 7.5 pounds (3.3 kg) of weight loss after 1 year (58).

Keep in mind that the Ornish Diet restricts fat intake quite a bit and limits the consumption of several healthy foods like nuts, seeds, and oils. Thus, careful planning is necessary to ensure that youre meeting your nutritional needs while following the Ornish Diet.

For more information about the diet, check out UnDo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases by Dean and Annie Ornish.

Shop for UnDo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases by Dean and Annie Ornish online.

Jenny Craig is a popular program that delivers prepackaged, portion-controlled meals to help simplify weight loss.

Jenny Craig may be an especially good fit for many older adults, as its simple, easy to follow, and doesnt require extensive planning or preparation.

Plans are tailored to your specific weight loss goals but typically provide 1,2002,300 calories per day.

One massive review of 39 studies found that Jenny Craig participants experienced nearly 5% more weight loss after 1 year, compared with those in a control group and people who underwent behavioral counseling (59).

In another study in 133 women with overweight, participants who followed Jenny Craig lost an average of 11.5 pounds (5.3 kg) over 12 weeks (60).

You can find more information about Jenny Craig and can get started on the program directly on their website.

The Mediterranean-DASH Intervention for Neurodegenerative Delay, or MIND diet, combines certain aspects of the Mediterranean and DASH diets to help combat mental decline.

On the MIND diet, foods like fruits, vegetables, healthy fats, and whole grains are encouraged, while foods high in saturated or trans fats are limited.

Although research on the effects of the MIND diet for weight control specifically is limited, both the Mediterranean and DASH diets have been associated with increased weight loss (6, 35).

Additionally, studies show that the MIND diet may help preserve brain function with aging and be linked to a lower risk of neurodegenerative disorders like Alzheimers disease (61, 62).

To get started, check out The MIND Diet Plan and Cookbook by Julie Andrews, which provides shopping lists, meal plans, and recipes aimed at promoting better brain health.

Shop for The MIND Diet Plan and Cookbook by Julie Andrews online.

WW, formerly Weight Watchers, is a diet program that uses a points-based system to promote long-lasting, sustainable weight loss.

More here:
The 16 Best Weight Loss Programs of 2020 - Healthline

The US President and the First Lady had announced that they were quarantining themselves after senior adviser Hope Hicks tested positive.

United States President Donald Trump and First Lady Melania Trump have tested positive for coronavirus. "We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!" the US President tweeted on Friday.

Donald Trump had announced about putting himself in quarantine in a tweet late Thursday night after his close aide Hope Hicks was tested positive with COVID-19. Hicks, 31, is the closest aid of the president to have tested positive with coronavirus. She had travelled with the president on Air Force One early this week.

"Hope Hicks, who has been working so hard without even taking a small break, has just tested positive for COVID-19. Terrible! The First Lady and I are waiting for our test results. In the meantime, we will begin our quarantine process!" Trump said in his tweet.

Trump, in an interview to Fox News, on Thursday night said he and the First Lady spend a lot of time with her.

In the middle of the election campaign, Trump has been travelling a lot in particular in the battleground States. "I just went out with a test and the First Lady just went out with a test also. So, whether we quarantine or whether we have it, I don't know," he said.

In a statement, Judd Deere, the Deputy White House Press Secretary said that the President takes the health and safety of himself and everyone who works in support of him and the American people very seriously.

White House Operations collaborates with the Physician to the President and the White House Military Office to ensure all plans and procedures incorporate current CDC guidance and best practices for limiting COVID-19 exposure to the greatest extent possible both on complex and when the President is travelling," Deere said.

Several White House staffers have tested positive with COVID-19 in recent months, including the National Security Advisor Robert O'Brien and Katie Miller, Vice President Mike Pence's press secretary.

With PTI inputs

Read the original:
Donald Trump and Melania test positive for coronavirus - The News Minute

Monoclonal antibodies that stop the coronavirus from spreading in the body are among promising strategies for averting severe illness from Covid-19 before vaccines arrive, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.Antibody-based medications, other blood products from recovered patients and antivirals are being investigated as early treatments, Fauci said. The aim is to prevent patients from developing the serious lung damage for which Gilead Sciences Inc.s remdesivir and the anti-inflammatory drug dexamethasone are administered.We are focusing very heavily now on treatment of early infection and, or prevention of infection, Fauci told the Journal of the American Medical Association in an interview Friday. And thats the bridge to the vaccine.Immunization against SARS-CoV-2 could begin in the U.S. in November or December, Fauci said, though it will probably take until at least the third quarter of 2021 for enough Americans to have been protected against the pandemic virus to significantly diminish its threat. Fauci said 100 million doses of vaccine may be produced by December, with all six companies supplying the U.S. slated to have made 700 million doses by next April.

With no vaccines yet proven to prevent Covid-19, health authorities must continue to push for new treatments and measures to stop the coronavirus from spreading, said Robert Chip Schooley, a professor of medicine at the University of California, San Diego, who is studying more potent versions of an existing antiviral.

Optimally, wed have an oral antiviral drug you can give to more people earlier in the course of the illness, Schooley said. Vaccines might not be 100% effective, which is better than nothing, but were still going to have to rely on drugs and behavioral modifications for a long time to come.

Blockbuster studies published by the journal Science on Thursday showed about 14% of critical Covid-19 patients have impaired levels of a substance called interferon that helps orchestrate the bodys defense against viral pathogens.

Read More: Covid Doctors Find a Turning Point in Life-Threatening Cases

The finding opens up new strategies for identifying high-risk patients and treating them with interferon infusions or, in some cases, removing interferon-blocking antibodies from their blood in a procedure called plasmapheresis.

Interferon, which is already being studied in dozens of clinical trials, might improve the effectiveness of antiviral drugs if they are administered early in an infection, according to Stanley Perlman, a professor of microbiology and immunology at the University of Iowa in Iowa City, who has studied coronaviruses for 38 years.

Infusions of coronavirus-neutralizing antibodies may also reduce the amount of virus in patients early in an infection, preventing an immune overreaction thats behind most life-threatening cases, said Thomas File, an infectious diseases physician in Akron, Ohio, and president of the Infectious Diseases Society of America.

Monoclonal antibodies, a product made by cloning an antibody captured from the blood of a patient who recovered from Covid-19, could also be given to high-risk patients in nursing homes as a preventative treatment, Fauci said. Ely Lilly & Co.s experimental antibody LY-CoV555 showed some hopeful signs in a trial among out-patients, the company said on Sept. 16.

"What I do is like military intelligence."

We have some cautious optimism that monoclonal antibodies may be an important therapeutic for early disease, Fauci said Sept. 10 in an online briefing for Massachusetts General Hospital staff. We need something to keep people out of the hospital.

Read the rest here:
Early Covid treatments could be a bridge to vaccine - Times of India

There's nothing more satisfying than downing a glass of cool water when your throat is seemingly on fire. But if you find yourself unable to quench that urgent sense of thirst whether you've worked your way through eight or eighteen cups of water in a given day there may be a larger issue at hand. Feeling super thirsty is totally normal if you've just powered your way through a long workout, have spent the day outside under a hot sun, or are working on upkeep around the house (dehydration can manifest itself in cramps or fatigue as well). But endless thirst isn't something that anyone should be living with in the long run.

Many people sip on water throughout the day, thinking they're sufficiently hydrated; but for the majority, the simplest explanation for feeling thirsty is just that they're not drinking enough. "You want to aim for half of your body weight in ounces of water each day," says Stefani Sassos, MS, RD, CDN, the Good Housekeeping Institute's registered dietitian, highlighting a rule of thumb that most can stick to. "If you weigh 160 pounds, as an example, you'll want to aim for about 80oz based on that math just about 10 cups of water a day. Get from ounces to cups by simply dividing by eight, since 8oz is one cup."

If you find that your water intake is close or even above that recommended benchmark, it's time to consider other factors that have you reaching for your water bottle. Believe it or not, it's a condition all its own: polydipsia. "It's an excessive amount of not only thirst but drinking, and it indicates a pathology, which is much different than dehydration," says Ron Weiss, M.D., a board-certified internist and assistant professor of clinical medicine at Rutgers' New Jersey Medical School. Your diet may play a role in potentially developing polydipsia or related symptoms, certainly, as can other lifestyle factors; sometimes, thirst may be an indicator of a larger issue that requires a doctor's help. Below, we review nine more common reasons for constantly feeling thirsty, plus expert tips to finally help you quench that thirst.

Reminder: Consult your physician right away if you're experiencing excessive thirst as it could be a signal for an underlying condition.

Let us explain: If you normally have had plenty to drink throughout your routine, but that routine has adapted in some way recently, it may require you to increase the amount of water you consume in a given day. Most often, people don't account for weather changes, new exercise routines, or a change in career and new daily physicality into upping their water intake. In hotter climates where you may sweat more, or if you've recently started playing a new sport or joined a new club, it's crucial to drink more throughout the day, Sassos explains especially for seniors and the elderly.

You may want to reevaluate your water intake if you are experiencing these symptoms regularly:

Especially one that's angled for dramatic weight loss. "In general, low-carb or keto diets put you at greater risk for dehydration. Carbohydrates retain fluids and electrolytes, so when you drastically decrease the amount of carbs in your diet, that results in extra water being removed through your urine or more trips to the bathroom," says Sassos, who has previously declared keto diets as one of the worst diets for many more reasons.

If you're new to a diet where you're drastically reducing or eliminating a food group entirely, it's important to remain focused on how much water you drink every day, because of that risk of low-carb diets leading to dehydration (and if left unchecked, kidney stones or constipation). "The most important thing, regardless of your diet, is to drink according to your thirst and listen to your body," Sassos adds. "You can also look at your urine to gauge your hydration; you want to see a light lemonade or pale straw-type color, which indicates you are properly hydrated."

It's also important to take a closer look at the food you're already eating. Just like your body processes excess glucose, your kidney processes excess salt and redirects it into your urine, which in turns pulls liquids away from your blood. "And then you would pee an excessive amount," Dr. Weiss says, adding that this process can happen in as little as a few hours if you've eaten a high-sodium meal. "Then, your brain would make you feel thirsty, to take back free water."

While it's natural (and good!) to drink lots of water after enjoying a salty meal, if you're frequently eating meals that are overly high in sodium, chronic dehydration may not be the only condition you could battle later on. Overdoing it on sodium can lead to high-blood pressure over time, and may also lead to kidney or heart damage in the long run. The American Heart Association recommends that Americans eat less than 1,500mg of sodium each day, so if you already know you may be doubling or tripling that limit, talking to your primary care provider about a low-sodium diet is a good idea.

Think salt might be the culprit, but aren't sure? Sassos advises doubling down on fruits and vegetables for a couple weeks to see if your frequent thirst disappears. "Fruits and vegetables naturally have a ton of water content and can help you reach your hydration goal without having to down an extra bottle," she says. "Watermelon, celery, and cucumbers are some of my favorites, and all are over 90% water."

We're sure that you've heard that hunger can sometimes be mistaken for thirst, but did you know that the opposite is also true? "Many symptoms of dehydration, like fatigue and dizziness, can feel similar to feelings of hunger," Sassos says. "It's very important to listen to your body and get in touch with your hunger and thirst cues."

If you've downed a few glasses of water and can't get rid of the feeling that you should be drinking more, it might be time to reach for a snack or think about lunch or dinner. "But if you just had a balanced meal or snack reach for a glass of water [first] to see if hydration is what you really need."

It may be due to new medication or because of high-blood pressure (or a myriad of other health reasons), but dry mouth can also be mistaken for thirst. Dr. Weiss points out that caffeine intake, smoking, and over-the-counter antihistamines or cold medicine can aggravate a case of dry mouth. But medical experts at the Mayo Clinic say that those suffering from dry mouth can get some relief by chewing sugar-free gum to stimulate saliva, in addition to sipping water as frequently as possible. There are medications that can help relieve dry mouth if neither of these solutions work.

When it comes to Dr. Weiss's patients, he says that those who have complained of excessive, constant thirst often end up having complications related to diabetes. Mostly, type 2 diabetes, otherwise known as diabetes mellitus in the medical community, as the kidneys are under more stress to absorb excess glucose, Dr. Weiss explains. When the kidney can't keep up, the glucose ends up in your urine, dragging water along with it, making you feel awfully dehydrated. It can happen quite regularly if your diabetes is undiagnosed or undetected.

Diuretic foods (like celery or asparagus) or drinks can work to make you thirsty over time because they encourage more urination than usual. "Diuretics force sodium to be eliminated by your kidneys it's the laws of osmosis, so you lose water in the process, and then your brain signals that you need more water," Dr. Weiss explains. When it comes to diuretic supplements, he says, "It's the physician's job to make sure the patient isn't getting too much diuretic It'd be drying them out, making them thirsty, if they were being overmedicated with diuretics."

Sassos explains that caffeinated beverages are known to be mildly diuretic, and if you are drinking too much coffee or soda over the course of the day, it may trigger innate thirst. "I recommend no more than 400mg of caffeine daily for healthy adults, or less, if you're sensitive to caffeine like I am," she says. Alcohol is also a diuretic and can be equally harmful for your body, especially if you already aren't getting enough water during the day.

Yulia ReznikovGetty Images

Sometimes, you can be drinking TOO much water yes, really! "Overhydration is a real issue, though less common because normal healthy kidneys easily excrete excess water," Sassos says. "It's more common a problem for people who have kidney issues and can't excrete urine normally." If you have any chronic condition that affects your kidney, your doctor may have already spoken to you about adapting your hydration and beverages you should avoid (and if you haven't had that discussion yet, it's time!).

Kidneys aren't the only organ that can influence your thirst and water regulation in your body. Dr. Weiss points out that your thyroid (which also can influence your appetite, temperature, and even your hair) can greatly impact how thirsty you feel if the gland's hormone production is impacted. Hyperthyroidism and other thyroid issues can contribute to period irregularity and anxiety, among other things, all of which influences thirst. The National Institutes of Diabetes and Digestive and Kidney Diseases also report that those with thyroid issues may also be more likely to suffer from type-1 diabetes, anemia, and other conditions, which may be the root cause of raging thirst.

It's much more rare than having issues related to type 2 diabetes, but some individuals may develop a disorder that doctors know as diabetes insipidus, which triggers a sustained imbalance of fluids in your body. "It has to do with an inappropriately high production rate of a hormone called ADH, which stands for antidiuretic hormone, and how it affects your brain overall," Dr. Weiss explains. "What this does is, it forces your kidney to dump water out of your body, beyond what's appropriate; then, this hormone abnormality would force the person to seek water, like with a raging thirst. I've only confirmed it twice in my life, as it's relatively rare."

Those with diabetes insipidus would also be frequently urinating. But you wouldn't be able to confirm the condition unless you discussed the issue and had a full set of blood work done by your provider which hopefully would be in your plans long before you ever were worried about diabetes insipidus.

This content is imported from {embed-name}. You may be able to find the same content in another format, or you may be able to find more information, at their web site.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

Continued here:
Why Am I Always Thirsty? - 9 Health Explanations for Excessive Thirst - GoodHousekeeping.com

Smart exercise company Echelon has teamed with Amazon for a $500 spin bike that only Prime subscribers can buy.

The Echelon Ex-Prime Smart Connect Bike, unveiled Tuesday, allows users to join virtual exercise classes and connect with personal trainers remotely.

The bike can be bought through Amazon Prime only. Echelon had a similar arrangement with Walmart for its Connect Sport bike, which costs $600, though it had an introductory price of $500.

Advertisement

Echelon, which has made connected fitness products since 2017, said Amazon initiated the partnership, and the two companies developed the bike together. It's Amazon's first foray into the connected fitness market.

But the delays caused other problems too. When Peloton announced the price cuts, it said it would automatically refund customers who purchased a bike within the last 30 days or are still waiting for back-orders. Customers who narrowly missed the 30-day window or who waited weeks for their back-ordered purchases took to Twitter to express their anger over the policy. Peloton said owners of its original bike can trade it in for a $700 rebate, and free yoga and toning accessories.

Peloton also came under fire after customers told Business Insider they had to wait weeks, and in some cases months, for the fitness company to make repairs to their broken bikes.

Read the original:
Amazon's first foray into connected fitness is a $500 smart bike made by Echelon that only Prime subscribers c - Business Insider India

You probably think of staying in good health as something thats insanely time consumingthe stuff of extreme diets, expensive gyms or off-and-on cleanses. But the truth is, there are dozens of easy and effective ways you can seriously improve your health in fifteen minutesor even lessper day. These tiny tweaks, many of which are great fun, can help you strengthen your immune system, boost your mood, and prevent serious diseases like cancer, Alzheimers and Parkinsonsand here, we share them exclusively with you. Read on, and to ensure your health and the health of others, dont miss these Sure Signs Youve Already Had Coronavirus.

1

Add a few minutes to each mealtime.

Eat slowly, says Mackenzie Griffith, a Precision Nutrition certified coach. This will give your body time to send you satiety/fullness cues, making you naturally and voluntarily eat less food. Do this by putting down your utensil between bites, talking to the people around you, chewing more thoroughly, or really focusing on the flavors and textures youre experiencingbecome a sommelier of whatever youre eating. Youll find youre more satisfied, dont feel bloated, and naturally start to shed some weight.

2

Go outside.

An effective way for you to ease stress is by literally changing your view, says Dr. Richard Carmona, former Surgeon General of the U.S. and Chief of Health Innovation at Canyon Ranch. Just sitting quietly outside for a few minutes can help. Nature is easy on the eyes and easy on the ears, and by linking yourself to its calmness, you can lower your anxiety and increase brain health.

3

Doit.

Studies have found that having sex on a regular basis can help lower blood pressure, which can decrease your risk of stroke. According to a study published in American Journal of Cardiology, men who had sex at least twice a week were less likely to develop cardiovascular disease compared with men who had sex once a month. Thats likely because sexual activity increases feel-good chemicals in the brain like dopamine and the bonding hormone oxytocin, which can lower high blood pressure, the No. 1 cause of stroke.

Story continues

4

Have exercise snacks.

According to Harvard Medical School, researchers have found that people who exercise for just 15 minutes a day live, on average, three years longer than those who dont. New research is proving that exercise snacks are great ways to decrease negative health outcomes (high cholesterol, blood sugars, etc) found in many chronic diseases, says Kathryn Hossack, BSc. CAT(C), owner of Integrative Movement and RideWell Performance. These include doing short bursts, like 20 to 30 seconds of moderate activity, like walking up a flight of stairs or jumping jacks, once every hour or two in your day. Its perfect for those who work at a desk.

5

Talk to a friend.

Feelings of loneliness and social isolation can increase a persons risk of having a heart attack, according to a study published in the journal Heart. People who reported poor social relationships had a 29 percent higher risk of coronary disease, and a 32 percent higher risk of stroke, than people who have solid friendships. The reason: Researchers believe loneliness increases chronic stress, a risk factor for ticker trouble. So take time to drop in on, call or text friends or family regularly.

6

Drink some coffee.

A study published in the European Journal of Neurology found that people who consumed caffeine had a significantly lower risk of Alzheimers Disease than non-drinkers. Why? Researchers believe that certain compounds in roasted coffee may prevent the build-up of brain plaque believed to cause Alzheimers and dementia.

RELATED: COVID Mistakes You Should Never Make

7

Eat a handful of nuts.

Several studies have shown that eating nuts like almonds, walnuts, peanuts or hazelnuts can lower LDL (bad) blood cholesterol, while raising HDL (good) cholesterol among several other health benefits. Eating a small amount of different nuts during the day can help your health significantly in the long run, says Nikola Djordjevic, MD, of MedAlertHelp.org. Nuts are rich in vitamins such as magnesium, selenium or copper. Plus, they are great antioxidants and can help fight free radicals in blood which can cause cell damage and lead to a variety of diseases.

8

Add leafy greens to your meal.

Most people say a complete meal is healthy fat, fiber and protein, but they always forget the greens, says Jacquie Smith, a certified integrative nutrition coach in New York City. Leafy greens are the best type of superfood to add to every meal. Theyre packed with antioxidants, B vitamins, Vitamin C and K, and fiber, which aid in digestion and prevent inflammation. This ultimately prevents chronic diseases and illnesses, such as cancer and cardiovascular disease.

9

Eat berries.

According to a study conducted at the Harvard School of Public Health (HSPH) the high flavonoid content in berries, apples and oranges help ward off the disease. Study participants who consumed the most flavonoids were 40 percent less likely to develop Parkinsons Disease.

10

Make a gratitude list every morning.

Take time to write down ten things youre grateful for in your life, no matter how small or basic. It could be your health, your morning coffee, the ability to pay the mortgage (or having paid off your mortgage). That simple exercise has been shown to improve mood. Gratitude focuses on the good and positives in life, says Dr. Catherine Jackson, a licensed clinical psychologist and board-certified neurotherapist based in Chicago. Research suggests the brain literally produces more dopamine, a feel-good neurotransmitter, when gratitude is expressed. A grateful mind will allow you to be less stressed and feel more positive emotions. While thinking about what you are grateful for is good for the brain, studies show writing it down has even greater benefits.

11

Have a glass of orange juice.

Thats one of the top ways the Arthritis Foundation says you can help prevent the debilitating joint disease. Studies have shown that consumption of Vitamin C reduces the risk of developing osteoarthritis.

12

Play video games.

Seriously. Per a study published in the journal Neuroscience, adults who played a lot of action video games sharpened their vision by 20 percent. Action video game play changes the way our brains process visual information, said study co-author Daphne Bavelier, professor of brain and cognitive sciences at the University of Rochester. After just 30 hours, players showed a substantial increase in the spatial resolution of their vision, meaning they could see figures like those on an eye chart more clearly, even when other symbols crowded in.

13

Track your meals.

In a March study published in the journal Obesity, researchers found that people who tracked their mealslogging them on paper or online, with an app like Lose Itfor at least 15 minutes a day were the most successful at losing weight.

14

Get 15 minutes of sun.

Fifteen minutes of sunlight can help naturally boost Vitamin D levels, which help with bone health and immune function and can also keep circadian rhythm in sync, says John M. Martinez, MD, a primary care physician in La Mesa, California. I find the 15 minutes of sun helps with patients that suffer with insomnia for that reason.

15

Meditate for 15 minutes.

A 2018 study published in The Journal of Positive Psychology found that just 15 minutes of meditation can have the same positive effect on your mood and well-being as taking one vacation day.

RELATED: Im an Infectious Disease Doctor and Would Never Touch This

16

Breathe deeply.

Few people pay attention to their breathing. However, bringing attention to your breath for at least ten minutes a day can reduce stress and increase relaxation, says Jackson. Slow, deep and consistently control breathing activates the parasympathetic nervous system, reduces the heart rate and relaxes the mind and the muscles. It also triggers your neuron in the brain to calm you down. In a stressful situation, the brain needs that extra oxygen to help it think clearly in order to solve or calmly get through the problem.

17

Eat beans.

Or legumes, if youre nasty. A study published in the journal Clinical Diabetes found that participants who ate slightly less than one cup of legumes every day for 10 weeks saw significantly decreased systolic and mean arterial blood pressure.

18

Take a short walk.

People who have been diagnosed with type 2 diabetes or insulin resistance can lower their blood glucose level after meals by taking a 15-minute walk, says Nancy Woodbury, MA, MS, RD, LD/N, a registered dietitian nutritionist in Boca Raton, Florida. The contraction of the larger leg muscles drives excess glucose from the bloodstream directly into the muscle cells, independently of the action of insulin secreted the pancreas. If your pancreas doesnt produce enough insulin, or your muscle cells are resistant to the action of insulin, exercising can help you reduce your blood glucose. Moreover, physical activity that builds muscle mass will increase your capacity to either use or store the glucose which is produced from metabolizing foods with carbohydrates, so you can eat more of them.

19

Do plantar fascia stretches.

Your plantar fascia is the tissue that supports your arches. If we arent actively stretching them in the morning, we pose the risk of developing an inflammatory condition called plantar fasciitis, says Dr. Benjamin Tehrani, a podiatrist at Kings Point Foot&Ankle Specialists in Los Angeles. A simple lacrosse ball massage on the plantar sole of the feet will do the trick. Lay on your back and place the lacrosse ball on the heel. Slowly move the ball from the heel to the ball of your foot, being sure to push against the ground with your feet and feel the ball stretching into the fascia. This helps break up scar tissue or any muscle the has become fatigued from either walking or standing too often or from simple wear and tear of our feet. This helps remove lactic acid from foot muscles, allowing our feet to become more energized and ready for the day.

20

Practice relaxation techniques.

In a pilot study at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital and at Beth Israel Deaconess Medical Center in Boston, 48 adults with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) participated in a nine-week program focused on stress reduction and other healthy behaviors that included relaxation training to be practiced at home for 15 to 20 minutes each day. They not only felt better they had fewer gastrointestinal symptoms and researchers found marked positive changes in genes involved with their stomach conditions. The relaxation response reduced the expression of a number of genes directly linked to the key inflammatory processes of IBD. While the mechanisms behind IBS are less well-defined, they most likely involve stress response, which also could be improved by relaxation response practice, said study researcher Towia Libermann, Ph.D.

21

Listen to music.

According to a study published in the Journal of Alzheimers Disease, adults with self-observed cognitive impairment who listened to 12 minutes of music every day for 12 weeks showed a decrease in a cellular biomarker of aging in the blood, as well as improvements in memory, mood, sleep, and cognitive function. Other studies have found that listening to music or playing a musical instrument improves memory in healthy people, too.

RELATED: Dr. Fauci Says You Can Catch COVID This Way After All

22

Go for a walk together.

As a personal fitness coach, Ive been prescribing challenging fat-loss workouts for years, but as an aging personal fitness coach Ive also recently discovered the decidedly un-challenging activity of going for a walk with my wife every night, says personal trainer and nutrition adviser Matt Edwards. At first it was just to burn calories, and you burn a ton of calories walking, but then I started noticing these other cool benefits creeping in: With no TV, work, phone or other distractions calling for our attention, my wife and I talk. Its nice. Really nice. Its quality time that you can unashamedly devote to simply being with your romantic partner, and it can bring you closer together.

He adds: No distractions also mean that youre completely present in the moment, and the emotional benefits of mindfulness, a practice which promotes being fully present, are felt immediately.

23

Cook with whole foods.

Thats the recommendation of Dr. Terry Wahls, a clinical professor at the University of Iowa. Use ingredients, not boxed, processed foods. The industrialized foods are filled with sugar, salt, and food additives that interfere with our microbes in our gut. Food additives and emulsifiers that are common in industrialized food increase the risk of developing leaky gut, or increased intestinal permeability. When a person has leaky gut, inflammation goes up along with a higher risk of autoimmunity and chronic disease. I can make a meal in a skillet with fresh or frozen vegetables and meator a vegetarian source of protein for those who dont eat meatin less than 15 minutes. Doing so will have a profound impact on your health and your familys health today and far into the future.

24

Do a short burst of high-intensity exercise.

Exercise becomes increasingly important as we age, says Anthony Kouri, MD, an orthopedic surgeon at the University of Toledo Medical Center. Many people think that the only way to benefit from exercise is to do it for a long period of time. However, research suggests that high-intensity exercise in short bursts can improve bone mineral density. Osteoporosis is due to low bone mineral density and is a serious health concern, especially for women. It is a factor in up to 90% of hip fractures. It is often asymptomatic, but can lead to devastating injuries at an older age when our bodies are most vulnerable.

He continues: Recent research suggests that women who participate between 1-2 minutes of high-intensity weight bearing activity each day have 4% better bone health than women who do less than 1 minute of physical activity. Furthermore, women who did more than 2 minutes of this type of exercise had 6% better bone health. These activities include running, jogging, dancing, stair climbing, and tennis, among many others.

25

Meditate.

While meditation is not a cure-all, it helps to slow brain aging, acts as an antidepressant and helps improve depression and anxiety, says Jackson. It has been found to increase grey matter in the hippocampus, which is important for learning and memory and decreases brain cell volume in the amygdala, an area of the brain responsible for fear and stress and improves attention and concentration.

RELATED: Worst Things For Your HealthAccording to Doctors

26

Stretch.

Stretching for just 15 minutes a day can have benefits such as better bone and joint health, improved balance, better flexibility, and mobility, says Dr. Thanu Jeyapalan, clinical director of the Yorkville Sports Medicine Clinic in Toronto. Stretching a few minutes a day will do wonders for your health in the long run.

27

Write in a journal.

Journaling for 15 minutes, or 3 full hand-written pages, can really help you get whatever is buzzing around in your mind and put it down in a physical entity, says Carla E. Campos of 15 Minutes of Creativity. While itll initially feel like a strenuous exercise, with time, youll start to feel better and better about putting all your thoughts, unscripted, and with no edits, down on paper.

28

Pause before that second helping.

Wait 15 minutes after you initial plate before you go back for more, says Martise Moore, a running coach in Los Angeles. It may be just enough time to make you feel full and forgo the unneeded calories.

29

Pet your dog.

Thats right. According to Harvard Medical School, a large study showed that dog owners had lower cholesterol and triglyceride levels than non-ownersand those differences werent explainable by diet, smoking, or body mass index (BMI)! Scientists arent sure why. They do believe that dogs calming effect can lower blood pressure, reducing your risk of cardiovascular disease. Two paws up.

30

Design a sleep ritual.

It doesnt have to be anything fancy something as simple as soaking in a bath for 15 minutes before bed, spraying lavender oil on your pillowcases before you lie down, or committing to a short full-body stretch before bedtime can help you sleep better, says Amanda L. Dale, a certified personal trainer and sports nutritionist. And better sleep leads to better appetite control, reduced inflammation, a lessened incidence of depression, and a lowered risk of heart attack and stroke. And to get through this pandemic at your healthiest, dont miss these 35 Places Youre Most Likely to Catch COVID.

See more here:
Doing This for Just Minutes a Day Can Improve Your Health - KYR News

Diabetes is a chronic condition that affects how your body uses insulin. This hormone controls how much blood sugar, also known as glucose, is released into your cells to be used as energy.

Over 34 million people in the US have diabetes, according to the Centers for Disease Control and Prevention (CDC). While there is no cure for diabetes, it can be managed with lifestyle and dietary changes, or medication like insulin.

Here's what you need to know to manage diabetes and lower blood sugar levels.

With all types of diabetes, your body either doesn't produce enough insulin, or isn't able to use insulin effectively.

Insulin is necessary to move blood sugar into your cells, where it is stored and used for energy. Without insulin, a condition called hyperglycemia can occur, where blood sugar builds up in your bloodstream instead of traveling into your cells.

Type 1 diabetes makes up just 10% of all diagnosed diabetes cases in the US, according to the CDC. It is most commonly diagnosed in children, teenagers, and young adults.

Although the cause is unknown, type 1 diabetes may be due to an autoimmune response caused by an infection or other trigger. Your body mistakenly attacks and damages the beta cells in your pancreas that make insulin, so little or no insulin is produced.

There are not many risk factors for type 1 diabetes, though genetics is believed to play a role. The odds of the children of men with type 1 diabetes developing the condition is 1 in 17, according to the American Diabetes Association (ADA). For the children of women with type 1 diabetes, the odds are 1 in 25 if the woman is under the age of 25, or 1 in 100 after the age of 25.

A type 1 diabetes diagnosis requires some important lifestyle changes. You must take insulin every day in order to survive. Your blood sugar level needs to be frequently monitored. It's essential to carefully plan your meals and count carbohydrates.

"This can be a frustrating and tiresome adjustment, but it is crucial that patients educate themselves on how certain foods impact glucose levels," says endocrinologist Rocio Salas-Whalen, MD, of New York Endocrinology.

Type 2 diabetes makes up about 90% of all diagnosed diabetes cases in the US. It is most often diagnosed in adults, but the CDC notes that it is becoming increasingly diagnosed in children and teenagers.

With type 2, your body can produce insulin, but it is not able to use it effectively. This is called insulin resistance, which happens when your liver, muscle, and fat cells don't effectively take in the blood sugar from your blood to use it for energy. As a result, your blood sugar level increases, which can eventually lead to type 2 diabetes.

You are more at risk for type 2 diabetes if you:

In addition to eating a healthy diet, it's very important for people with type 2 diabetes to maintain a healthy weight, Salas-Whalen says, because this can also help them control blood sugar levels.

Pregnant people may develop gestational diabetes, which is caused by the body's inability to produce the extra insulin needed during your pregnancy. Gestational diabetes can put your baby at risk for health problems later in life, such as obesity or type 2 diabetes.

About 7% of pregnant people in the US are diagnosed with gestational diabetes. It usually begins in the middle of your pregnancy, without any symptoms. You should be tested for it between your 24th and 28th weeks of pregnancy. It typically goes away after your baby is born, but you will have a higher risk of developing type 2 diabetes later in life.

If you have gestational diabetes, you'll need to work with your doctor to develop a healthy eating plan, and you should also remain physically active to help keep your blood sugar levels low. If a healthy diet and exercise don't lower your blood sugar levels, you may need to take insulin.

Prediabetes is a condition where your blood sugar levels are elevated, but not yet high enough for a diabetes diagnosis. However, if left untreated, prediabetes can develop into type 2 diabetes.

More than a third of all US adults over 88 million have prediabetes, yet 84% of them don't know they have it, the CDC notes.

With lifestyle changes like a healthy diet, losing weight, and getting regular exercise, it's possible for prediabetes to be reversed or delayed. Your doctor may also prescribe medication to help lower your blood sugar level.

"A prediabetic still has the potential to avoid diabetes, which should be avoided in every possible way," Salas-Whalen says.

The signs of all types of diabetes can include the following:

However, these symptoms develop slowly over time, and it may be difficult to recognize them, especially if you have type 2 diabetes. The signs of type 1 diabetes may be more severe, and can also include nausea or vomiting.

Target blood sugar levels are different for those with diabetes. The follow chart depicts normal blood sugar levels for diabetics and non-diabetics:

Yuqing Liu/Insider

Many people with diabetes with need to learn how to check their blood sugar multiple times a day using a glucose meter or a continuous glucose meter.

"Try not to think of blood sugars as 'good' or 'bad' or as a reflection of how well or bad you are doing," says Shelley Nicholls, DNP, APRN, CDCES, director of patient education at the Diabetes Research Institute. "Having a good understanding of what affects blood sugars and which of them a person can control or influence is the best tool a person with diabetes can have."

To treat diabetes, it is important to lower your blood sugar level and make sure it stays in a healthy range.

Doing this will not only increase your energy, but according to the ADA, each percentage point of A1C lowered reduces the possibility of long-term health complications which could include serious heart, kidney, brain, eye, or foot problems by 40%.

These are some of the best natural ways to lower and manage your blood sugar levels over time:

It's important for people with diabetes to be careful about the foods they eat because they can impact your blood sugar levels."Some foods can worsen diabetes, while other foods can actually improve diabetes control," Salas-Whalen says.

Carbohydrates and fiber especially affect your blood sugar levels in the following ways:

It can be helpful to follow a diet to manage your diabetes, as planning out your meals and snacks will help you control blood sugar levels effectively.

"Every person has different needs, so there is no one diet that is recommended for people with diabetes," Nicholls says. "The best option is to meet with a dietitian to determine individual needs and goals."

Here are some of the best diets for diabetics:

The Mediterranean diet includes plant-based foods, lean meats, and healthy fats.

According to a 2009 study published in Diabetic Medicine, people who strictly followed a Mediterranean diet for three months had lower A1C percentages and lower blood sugar levels after meals than those who followed it less strictly.

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is mainly used to lower blood pressure, but it can also help lower blood sugar.

A 2017 study published in the ADA journal Diabetics Spectrum suggests that the DASH diet can lower insulin resistance and help you lose weight. A 2016 study published in the journal Nutrition found that a DASH diet can also help lower the risk for gestational diabetes by as much as 71%.

This high-fat, low-carb diet limits carbs to 20 to 50 grams daily in an effort to put your body in the metabolic state of ketosis, where you burn fat instead of carbs for fuel.

A 2017 study published in Nutrition & Diabetes found that overweight adults with type 2 diabetes or prediabetes who followed a keto diet had lower A1C levels and lost over 4% more weight after one year than those who followed a moderate-carbohydrate/low-calorie/low-fat diet.

There are also some health risks associated with the keto diet. If you have type 1 diabetes, your lowered blood sugar level may lead to hypoglycemia and serious brain, kidney, or liver complications.

Another issue associated with this diet are "keto flu" symptoms that may include headache, nausea, and vomiting. It's important to consult with your doctor or a registered dietitian before starting a keto diet.

People with type 1 diabetes need to take insulin every day in order to survive. If people with type 2 diabetes are unable to reach their blood sugar target levels with diet and exercise, they may also need medication like insulin or metformin.

People with type 1 diabetes generally need to take three to four doses of insulin every day, according to the ADA. Women with gestational diabetes may need to take insulin daily during their pregnancy if their bodies aren't producing enough of it naturally. Many people with type 2 diabetes may need one dose each day with or without other medications.

Insulin is injected in the fat under your skin using a syringe, insulin pen, or pump. It should be injected in the same area of the body, but not the same place each day. It's best to inject insulin at mealtime so it is more effectively processed in your body.

There are many different types of insulin, and your doctor may even prescribe two or more of the following types:

"The challenge with taking insulin is that it's tough to know precisely how much to take," Nicholls says. The amount is based on factors that may change throughout the day, such as food, exercise, and stress. "So, deciding on what dose of insulin to take is a complicated balancing act."

Taking an extra dose of insulin can also help you lower blood sugar fast if it's an emergency, though you may want to check in with your doctor beforehand.

If you have type 2 diabetes, your doctor may prescribe metformin, a medication that lowers blood sugar by slowing your liver's production of glucose. It is the drug most commonly prescribed to treat type 2 diabetes.

Metformin is available in a liquid, pill, or extended-release tablet. You take it orally at mealtime two to three times a day. The extended-release tablet only needs to be taken once daily.

According to a 2012 scientific review published in Diabetes Care, metformin can effectively reduce A1C levels for people with type 2 diabetes by an average of 1.12%.

Although it's possible to control your diabetes and lower blood sugar levels, there is no specific cure.

"Because of this reality, lifestyle changes must be permanent and not temporary in order to avoid the potential long-term complications of diabetes," Salas-Whalen says.

To develop the best plan of treatment for diabetes, it's important to meet with your doctor for individualized recommendations.

Read the original:
What is diabetes? A comprehensive guide to lower blood sugar and manage the condition - Insider - INSIDER

Paul L. Nguyen, MD, discusses standard and investigational treatment options in high-risk prostate cancer.

Paul L. Nguyen, MD, senior physician and director of Genitourinary Clinical Center for Radiation Oncology at Dana-Farber Cancer Institute, as well as a professor of radiation oncology at Harvard Medical School, discusses standard and investigational treatment options in high-risk prostate cancer.

Typically, patients with high-risk prostate cancer are treated with standard androgen deprivation therapy with a gonadotropin-releasing hormone agonist plus an antiandrogen, Nguyen says. However, novel agents are in development to try to improve upon standard treatment.

For example, enzalutamide (Xtandi) is currently being tested in the randomized phase 3 ENZARAD trial in men with high-risk, localized prostate cancer, says Nguyen. Additionally, the phase 3 ATLAS trial is evaluating apalutamide (Erleada) in patients with high-risk disease who are receiving primary radiation therapy.

Abiraterone acetate (Zytiga) was tested in the STAMPEDE trial, Nguyen adds. Although data from study were published, the field awaits additional follow-up to determine whether patients with node-negative nonmetastatic prostate cancer derived benefit from abiraterone.

Additionally, other studies such as the phase 3 DASL-HiCaP trial, which is evaluating darolutamide (Nubeqa) in very high-risk prostate cancer, and the phase 3 Predict-RT trial, which is evaluating abiraterone plus apalutamide in patients with high genomic risk disease, are ongoing, concludes Nguyen.

Excerpt from:
Dr. Nguyen on Standard and Investigational Treatment Options in High-Risk Prostate Cancer - OncLive

People with diabetes have a more difficult time regulating their blood sugar. Those with type 1 diabetes are not able to produce insulin, the hormone that helps the body convert blood sugar into energy. And those with type 2 diabetes cannot use insulin effectively.

As a result, blood sugar levels are often much higher for people with diabetes, especially in the morning. Here's why.

As your body prepares to wake for the day, it releases glucose stored in the liver to give you the energy you need to get going. However, people with diabetes are not able to utilize this blood sugar, so roughly half of diabetics experience high blood sugars in the morning. This is known as the dawn phenomenon.

If you have diabetes, your doctor will work with you to set a target range for your blood sugars. In general, blood sugar levels between 70 to 130 mg/dl are considered healthy for diabetes.

If your levels are consistently above your target in the morning, and you have not eaten yet, you might be experiencing dawn phenomenon. This is most common in people with type 2 diabetes.

Blood sugars typically peak about 2 to 3 hours before waking and can remain high as you wake up. For most people, that means the early morning hours, but if you have an abnormal sleep schedule you can experience this spike at any time.

"For individuals who work night shifts, the 'dawn' phenomenon may occur at dusk, since it's related to an individual's normal waking time, not the specific time of the day," says Joseph Barrera, MD, an endocrinologist with Mission Hospital in Orange County, California.

The Somogyi effect is a second explanation for high blood sugars in the morning, and this occurs most often in people with type 1 diabetes. It happens when people experience hypoglycemia or low blood sugar during the night. In an attempt to correct that, the body releases more stored glucose, which can then lead to high blood sugars in the morning.

The Somogyi effect is more rare than the dawn phenomenon, but that's mostly because fewer people have type 1 diabetes than type 2 diabetes. When a 2015 study published in Diabetology & Metabolic Syndrome followed 85 people with type 1 diabetes, it found that 82.4% of them had high blood sugars in the morning, and 60% of those were caused by the Somogyi effect, compared with just 12.9% caused by the dawn phenomenon.

To determine if your high blood sugars in the morning are caused by the Somogyi effect, Barrera says you'll need to see your blood sugar levels about 4 to 5 hours before you wake up, which can be done with a continuous glucose monitor.

You should talk to your doctor if you regularly experience high blood sugars in the morning, Barrera says. Your team will make recommendations on changing your treatment regimen that might help you avoid this morning hyperglycemia.

"High blood sugars in the morning can generally be addressed by careful attention to a diet and exercise regimen, and adjustments in diabetic medication by a qualified health professional," Barrera says.

To avoid dawn phenomenon, your doctor might tell you to take these steps:

People who continue to have trouble with the dawn phenomenon might be advised to take insulin before bed, Barrera says. However, this has to be done carefully, so that it doesn't cause the Somogyi effect.

People who experience the dawn phenomenon often find that it gets worse over time. In fact, it's considered an indicator that diabetes is progressing, so it's important to talk to your doctor about treating it.

On the flip side, making the necessary changes to regulate the dawn phenomenon can lower blood sugar over time. In fact, research has found that it can result in a 0.5% decrease in A1C levels a long-term measure of blood sugar which can reduce your risk for health complications from diabetes.

Read the original post:
Why your blood sugar is high in the morning and how to lower it - Insider - INSIDER

From Harper's BAZAAR

Like most of us, Im doing my best to stay healthy right now. Im social distancing and washing my hands almost obsessively. Im trying to eat as many vegetables as possible to ensure I'm getting health-supporting nutrients that I'm not exactly taking in via all the stress baking.

Its also not surprising that Ive been bombarded with news over the past few months about how to bolster my immune system. I cant scroll through my Instagram feed without seeing some influencer bragging about an immune-boosting smoothie or a supplement company promoting pills with elderberry and citrus.

Let's take a step back though. Immunity has a PR problem right now. The whole idea that you can power up your immunity in some quick-fix way overnight (and, you know, avoid a cold or flu...or Covid-19) isn't actually how it works.

Think of immunity like in American football terms: if youre the star quarterback of your life, your immune system is like that super-jacked lineman whose number-one job is to protect you from all directions. And, separately (but still in that sports realm!), just like how strategic leadership can whip a team into shape, you can train your system to more efficiently pick off any opponentbug, virus, germthat comes your way. But that conditioning takes time and dedication.

So, taking a last-minute, reactionary approach to immunity is the opposite of how you should think about it, says Nicole Avena, PhD, visiting professor of health psychology at Princeton University. Immunity is a marathon, not a sprint. Because of that, there isnt any fast and easy way to immediately amplify yours. Youve got to take an all-in, holistic approach if youre going keep your immune system in fighting form, says Avena.

Recalibrating your immunity for the long game comes down to the classic health habits you hear time and time again: sleep, stress reduction, and sweating it out. The key is doing all of these to at least some degree and not expecting one to be the ultimate cure-all. You wont make your immune system healthier in a week by pumping yourself with vitamins because someone close to you is sick, says E. John Wherry, PhD, director of the Institute for Immunology at the University of Pennsylvania. But you absolutely can help your immunity by making certain lifestyle changes.

Photo credit: Akira Kawahata

Nail Your Sleep Routine

Sleepspecifically getting at least seven hours most nightsmight be the Most Important Thing. The best data we have about how to improve immunity is on getting the right amount of good sleep, says Wherry. People who got six hours of shut-eye a night or less for one week were about four times more likely to catch a cold when exposed to a virus compared to those who got more than seven hours, according to a study published in the journal Sleep. (The risk of getting sick was even higher for those who snoozed less than five hours a night.)

Everything you do when youre awakeeating, digesting, working, walking, exercisingprompts your body to release inflammatory cells, says Rita Kachru, MD, section chief of the clinical immunology and allergy division and assistant professor at the David Geffen School of Medicine at UCLA. Sleep gives your body a break from all of that. Dont get hung up on one crappy night of Zs (or give yourself too much praise for one amazing one, for that matter); focusing on long-term, consistent good sleep habits is the way to go. Your building blocks, right here.

Story continues

Photo credit: Hearst Owned

Mara de la Paz Fernndez, PhD, a sleep researcher and assistant professor of neuroscience and behavior at Barnard College of Columbia University

Photo credit: Hearst Owned

Mariana Figueiro, PhD, director of the Lighting Research Center and a professor of architecture at Rensselaer Polytechnic Institute

Photo credit: Hearst Owned

Mikka Knapp, a registered dietitian-nutritionist

Photo credit: Hearst Owned

Rebecca Robbins, PhD, a sleep researcher and co-author of Sleep for Success!

Photo credit: Hearst Owned

Megan Roche, MD, epidemiology researcher and Strava running coach

Photo credit: Akira Kawahata

Its well established that stress prompts the release of cortisol, that fight-or-flight hormone that enables you to run for your life. When cortisol is high, your immune system isnt as active, says Daniel M. Davis, PhD, professor of immunology at the University of Manchester in England; your body sends all of its resources to the thing it thinks is most likely to kill you, and away from other stuff, like your protective network.

Dont stress? Ill just give up now, youre thinking. Stay calm and try this: instead of attempting to eliminate negativity, refine the way you cope (with the genius advice ahead!)which will make the blues more manageable and mitigate that cortisol response, Davis says.

Photo credit: Hearst Owned

Joy Lere, a psychologist

Photo credit: Hearst Owned

Kevin Gilliland, PsyD, a clinical psychologist and executive director of Innovation360

Photo credit: Hearst Owned

Patricia Celan, MD, a psychiatry resident at Dalhousie University in Canada

Photo credit: Hearst Owned

Beatrice Tauber Prior, PsyD, a clinical psychologist

Photo credit: Akira Kawahata

Working out creates inflammation in the body, but its the good kind, says Wherry. Its a little counterintuitive, because exercise actually disrupts your bodys homeostasis, he says. But when your sweat session is finished, your bod goes back to its status quokeeping your immunity on its toes in that brilliant way, he says. Research backs this up: people who exercise regularly develop more T cells (those destroyer white blood cells) than their sedentary peers, a recent study found. It also helps modulate the stress hormone cortisol, which, when raised, leads to inflammatory activity.

Some experts agree that overtraining (you know, that feeling when youve been pushing yourself too hard and youre feeling it) can hinder immunity. So if youre an everyday athlete, moderate exercise on a consistent basis is the end zone to aim for.

Photo credit: Hearst Owned

Jennifer Haythe, MD, a critical care cardiologist at Columbia University Medical Center

Photo credit: Hearst Owned

Lisa Ballehr, DO, an osteopathic physician and Institute for Functional Medicine certified practitioner

Photo credit: Hearst Owned

Ian Braithwaite, MD, an emergency physician at The Royal London Hospital

Photo credit: Hearst Owned

Kym Niles, certified personal trainer

Photo credit: Hearst Owned

Kristen Gasnick, board-certified physical therapist

Photo credit: Hearst Owned

Jenn Randazzo, registered dietitian

You Might Also Like

Excerpt from:
15 health habits experts use to boost their own immunity - Yahoo Lifestyle UK

Image Source: Courtesy of Molly Burke

Molly Burke's YouTube channel is full of fun videos about fashion, beauty, and everyday life. Burke, who has amassed over two million subscribers on the platform and hundreds of thousands of followers on Instagram and TikTok, respectively, also posts informational footage about her blindness some address misconceptions and others discuss steps to making the world more accessible for those who are disabled.

Burke was legally blind from birth but lost the majority of her sight at age 14 due to retinitis pigmentosa, the breakdown of cells in the retina. She was diagnosed with situational depression, short-term depression resulting from a traumatic life event, which differs from clinical depression, after losing her vision. "My situational depression was triggered by my vision loss and the bullying that I was experiencing because of that," Burke told POPSUGAR. "And it led to me dealing with suicidal ideation." Burke attended five different schools growing up in Canada in the hopes of getting the best education for herself as a blind student and to escape that bullying.

"The bullying was a constant throughout my life, but once bullying was coupled with my vision loss, it just all became too much," Burke recalled. Being 14 is an overwhelming time for most newly minted teenagers as it is. "You're getting ready to transition to high school, and you're going through a lot of self-discovery, figuring out your own sense of style, starting to date, having puberty and hormone changes," she said. "So to then also be going blind was very difficult for me."

The journey to recover from her situational depression was exactly that: a journey "with ups and downs," as Burke described it. Working on all facets of health "mind, body, soul" was key. She found spirituality and started seeing a nutritionist "to fuel my body with foods that really built me up and made me strong." She also turned to fitness and yoga, specifically, and she went to therapy, her "safe space," to seek guidance from a psychologist, which lasted until she was 21.

Burke's outlet for her depression a healthy, positive way to express her emotions was writing music, singing, and being in a band, leading her to connect with fellow musicians. "We were a good ol' angsty punk rock band," she added (we both laughed at that). She worked through her depression, too, by learning to embrace herself, "so really exploring my own self, my interests, my likes and dislikes and owning them instead of doing what you're supposed to do to fit in."

Burke was diagnosed with post-traumatic stress disorder (PTSD) after an accident a few weeks following her 20th birthday where she almost broke her neck (she fell off a stage during a soundcheck for one of her speeches). "I was a full-time motivational speaker at the time, so the thing that I did every single day, all day, for a living suddenly became a source of trauma and fear for me," she said. To help heal from her PTSD, she specifically turned to talk therapy and cognitive behavioral therapy.

Also at 20 years old, Burke was diagnosed with generalized anxiety with OCD tendencies. For her anxiety in particular, she copes through breathing techniques and making sure she gets proper nutrition (when her anxiety is triggered, she often has trouble eating, she explained). She went on and off anxiety medication up until recently as well.

Through it all, finding purpose has been a big component for Burke in tending to her mental health. This purpose, to her, is to "educate, motivate, or inspire one person every day with my story." She wants to break barriers for people living with disabilities because, she said, "I realized that I cannot be angry at society's ignorance towards me if I'm not willing to do anything to actively educate society to stop it."

Burke began public speaking when she was little, and she currently speaks on topics such as accessibility, bullying, and the social model of disability. This model of disability, which she learned at age 16 from a special-education teacher, differs from the medical model of disability that essentially tells those who are disabled that they are the problem. "The medical model of disability really puts a lot of the blame or the burden of guilt on the disabled person themselves, when really there's nothing we can do," she explained. "For many of us, it is incurable, and so to add a burden on top of an incurable condition, to feel like it is your fault, is very damaging." The social model says, instead, that it's society that is the problem.

Burke continued, "I think it's very hard to cultivate young, strong, disabled leaders if that's the mindset we build into them versus the social model that completely takes the burden, the guilt, the blame off of us as disabled people and says, 'You know what? It is us as a whole, as a society, that needs to improve and simply become accessible to all needs.'"

When it comes down to it, "the reality is waiting for a cure isn't living. Accepting who you are is living," Burke said. "You can accept who you are by walking away from the medical model and accepting the social model. It's just a far more empowering way to live."

If you are feeling anxious or depressed and need help finding help or resources, the Anxiety and Depression Association of America and the National Alliance on Mental Illness (1-800-950-6264) have resources available. Also, the National Suicide Prevention Lifeline has several resources and a 24/7 lifeline at 1-800-273-8255 (slated to change to 988 in the future).

Visit link:
YouTuber Molly Burke Became Depressed After Losing Her Eyesight Here's How She Coped - POPSUGAR

Building up a tolerance to caffeine may cause you to reach for more over time.

Image Credit: LIVESTRONG.com Creative

These days, caffeine-infused products are everywhere. You can score a buzz from caffeinated chewing gum, water, popcorn, hot sauce, lip balm you name it.

Although the U.S. Food & Drug Administration (FDA) recommends limiting caffeine to 400 milligrams per day (that's four to five cups of coffee, FYI), consumption is on the rise. An April 2019 study in the American Journal of Preventive Medicine confirmed a significant uptick in energy drink intake, and the National Coffee Association reports that 62 percent of Americans have coffee every day, an increase of 5 percent since 2015.

Whether coffee is your lifeblood, you sip mugs of green tea all day long or you're prone to tossing back energy shots when you're working late-night, here's the scoop on whether it's a big deal to surpass the recommended max.

First, How Does Caffeine Affect the Body?

Caffeine is a stimulant that can either be naturally occurring (like in coffee beans or tea leaves) or synthetic (produced artificially and then added to foods and beverages, like energy drinks).

How Caffeine Perks You Up

"Caffeine affects adenosine, a neurochemical that mellows us out," says Jabraan Pasha, MD, physician of internal medicine at the University of Oklahoma College of Medicine. "It blocks the receptors that adenosine attaches to, so your body can't detect adenosine." By suppressing these sleep-inducing chemicals, we feel more awake.

"Keep in mind that people metabolize caffeine differently. One person can feel fine after drinking several cups of coffee, whereas someone else might feel jittery after just one cup."

"Caffeine also triggers your brain to release dopamine, a neurotransmitter that regulates pleasure and reward, and also has a role in alertness," says Nicole Avena, PhD, assistant professor of neuroscience at Mt. Sinai University and author of Why Diets Fail. "In addition to mental stimulation, caffeine slightly increases your heart rate and blood pressure, which is why you get a physical buzz from it."

According to the American Academy of Sleep Medicine, the effects of caffeine peak 30 to 60 minutes after consumption. And a December 2018 study in Risk Management and Healthcare Policy found that caffeine has a half-life of two to 10 hours, which means it takes your body up to 10 hours to digest half of the caffeine you've consumed.

"Keep in mind that people metabolize caffeine differently," Dr. Pasha says. "One person can feel fine after drinking several cups of coffee, whereas someone else might feel jittery after just one cup."

Healthy Benefits of Coffee and Tea

Most people get their daily caffeine from coffee and tea, and in moderation, these drinks are good for you. A November 2017 study in the BMJ confirmed that drinking coffee is linked to lower rates of heart disease, diabetes, stroke, kidney disease, liver disease, Parkinson's, dementia and cancer.

A December 2013 study in Current Pharmaceutical Design found that certain types of caffeinated tea are connected to lower rates of cancer, cardiovascular disease, diabetes and arthritis. It may also benefit your brain. In a May 2019 study in Molecules, older adults who drank tea were determined to have better cognitive function than their peers.

Researchers surmise these health boosts are thanks to high levels of protective antioxidants in coffee and tea. "The caffeine itself doesn't cause these benefits," Avena says. "You get the same positive outcome whether you drink regular coffee or decaf."

What Happens If You Have Too Much Caffeine?

The short answer is that it depends on the amount, how quickly it is consumed and how sensitive you are to caffeine.

"It might make you feel agitated, jittery or light-headed, or make your heart pound," Dr. Pasha says. "Still, for the most part, caffeine from coffee and tea is relatively safe, even in doses slightly above the recommendation."

A severe caffeine overdose, which the FDA estimates might result from rapid ingestion of about 1,200 milligrams of caffeine (that's about five energy shots or 12 cups of coffee), can cause vomiting, diarrhea, disorientation, seizures or a coma.

Tally Up Your Caffeine Load

According to a January 2014 study in Food and Chemical Toxicology, 85 percent of the U.S. population has at least one caffeinated beverage a day, with a mean of 165 milligrams a day. Use this chart to figure out your total. (Keep in mind that most coffee cups and drink bottles contain more than 8 ounces of liquid for example, a Starbucks Venti is 20 ounces.)

1 oz energy shot

215 mg

8 oz brewed coffee

96 mg

1 oz espresso

64 mg

8 oz black tea

47 mg

8 oz energy drink

29 mg

1 oz dark chocolate

23 mg

8 oz green tea

28 mg

8 oz cola

22 mg

8 oz bottled iced tea

19 mg

Source: Mayo Clinic. "Caffeine Content for Coffee, Tea, Soda and More"

4 Times When You Need to Watch Your Caffeine Intake

If you have a bun in the oven, you've probably heard that you should take it easy with the caffeine. According to the American Pregnancy Association, caffeine can raise your blood pressure and heart rate, lead to dehydration and disrupt sleep patterns for you and baby all of which are not recommended during pregnancy.

The American College of Obstetricians and Gynecologists deems less than 200 milligrams per day (two cups of coffee) to be safe during pregnancy, but some studies, including an August 2020 review in the BMJ, have linked caffeine during pregnancy to miscarriage, stillbirth, low birth weight, leukemia and childhood obesity.

2. You Have a Heart Condition

"If you have a condition that results in heart palpitations, such as cardiac arrhythmia, you may want to cut back on caffeine," Dr. Pasha says.

3. You Have Insomnia or Other Sleep Problems

"Some people are really sensitive to caffeine, and it can stick around in your body for eight hours or more," Dr. Pasha says, which can disrupt sleep.

Plus, if you're sleeping poorly at night, you might need more coffee or tea to feel awake in the morning and before you know it, your caffeine intake can snowball.

Finally, if you're taking an iron supplement, steer clear of caffeine an hour before and after popping your pill. "Caffeine blocks iron absorption," Dr. Pasha says.

Caffeine Dependence Is Real

If you've noticed your coffee or tea intake creeping up, then you may have built up a tolerance.

"When caffeine blocks your adenosine receptors, your body responds by creating more receptors to compensate," Dr. Pasha says. "As a result, you require more caffeine in order to feel alert." Now, you're sipping three or four cups when you used to have just two.

Not only do you start drinking more, but you feel crappy if you don't get your caffeine fix. "You might get a headache and feel sluggish or irritable," Avena says.

Luckily, it's reversible. "If you slowly cut back your caffeine intake over the course of a week or so, your body will reduce the number of adenosine receptors," Dr. Pasha says. It's like starting with a clean slate again.

"If you have a super busy period and drink more than the recommended amount of coffee for a couple of days, it is not the end of the world."

Want to Cut Back? Heres How

Try these five ideas to reduce your caffeine intake without feeling blah.

Vitamin B12 deficiency is common, affecting up to 15 percent of the population, according to the National Institutes of Health, and it can lead to fatigue. "If you are relying on caffeine to get yourself going, you might be deficient in B12," Avena says.

Because B12 is present in animal products (like fish, meat, poultry, eggs and dairy), vegans and vegetarians are at risk for deficiency. Same goes for older adults, who may not absorb B12 as easily.

"Eating foods rich in vitamin B12 or taking a supplement can make you feel like you have your energy back," Avena says. (She recommends Frunutta Dynamo B12 Blaze, a sublingual supplement that contains a small amount of caffeine along with B12.) With more pep in your step, you might not reach for the coffee pot as frequently.

B12 is a water-soluble vitamin, which means it's unlikely you'll overdose on it. Still, talk to your doctor before adding a supplement to your diet, to make sure it's right for you.

"Coffee drinking is very ritualistic we become psychologically hooked on having it at a certain time and place," Avena says. "Look at how you can you alter your routine to disrupt the connection to your caffeine habit."

For example, if you always have a mug of coffee first thing every morning, instead drink a big glass of water right when you wake up and delay that initial cup of joe until after breakfast. If you like the feeling of having a warm beverage in hand when you sit at your computer, try switching to decaf or herbal tea.

Make sure you're getting the recommended seven to nine hours of sleep. "When you feel rested, you may find that you need less caffeine," Dr. Pasha says.

"Exercising gives you a surge of endorphins and dopamine that will help you feel energized and can take the place of a caffeine rush," Dr. Pasha says.

Sunlight suppresses melatonin, a natural hormone that makes you feel sleepy. If you open all the shades when you wake up in the morning or take a walk around the block, your coffee cravings might not be as strong.

Even with moderate caffeine consumption, it's smart to follow these guidelines.

1. Skip Energy Drinks and Shots

Super high levels of caffeine in some energy-boosting beverages can cause your mood to yo-yo. You may have supercharged focus and pep at first, and then crash later.

"When you are hit with a bolus of caffeine, it raises your heart rate and increases your blood pressure, making your body work overtime," Avena says. "Instead, nurse a cup coffee; you will have a steady, lower dose of caffeine and won't experience those up and downs."

What's more: "Energy drinks tend to have a lot of added sugar to mask the chemical taste of synthetic caffeine," Avena says. According to the Harvard School of Public Health, a typical energy drink contains around 40 grams of sugar, as much as a can of soda. That blast of sweetness is not great for your body.

2. Avoid Caffeine After Lunch

A November 2013 study in the Journal of Clinical Sleep Medicine found that consuming 400 milligrams of caffeine six hours before bed reduced total sleep by more than one hour. Have your most highly caffeinated beverage early in the day, and then taper off.

3. Don't Forget Sneaky Sources of Caffeine

An ounce of dark chocolate (70 to 85 percent cocoa) has about 23 milligrams of caffeine, while coffee ice cream can have anywhere from 5 to 45 milligrams per serving. Some medications also contain caffeine (for example, the headache medicine Excedrin has 65 milligrams of caffeine per tablet). Remember to count these sources toward your daily intake, and hold off on them in the late afternoon and evening to avoid interfering with sleep.

So, How Bad Is It Really to Have More Than the Daily Recommended Amount of Caffeine?

As long as you stick to coffee or tea (rather than sugary, additive-laden energy drinks), aren't experiencing any negative side effects and aren't pregnant, it's not that bad.

"As a physician, I wouldn't recommend it," Dr. Pasha says, "But at the end of the day, is it dangerous? No."

Also consider whether you are regularly going overboard or if it's an occasional thing.

"If you have a super busy period and drink more than the recommended amount of coffee for a couple of days, it is not the end of the world," Avena says. "On the other hand, if you are drinking too much every day, you might want to cut back. Honestly, though, there are worse things you could be overdoing it on!"

Continued here:
The Effects of Too Much Caffeine on the Body - LIVESTRONG.COM

A recently published report describes the case of an 88-year-old female patient who experienced drug-induced syndrome of inappropriate antidiuretic hormone (SIADH) due to the combination of naproxen and citalopram and highlights the importance of performing medication reconciliation to prevent adverse drug events.

The patient, who had a history of asymptomatic chronic hyponatremia, presented to the emergency department (ED) complaining of generalized body ache. She additionally stated that she had been experiencing nausea, decreased appetite, and malaise the 4 days prior to her presentation.

Her medical history included hypertension, depression, and osteoarthritis for which she was prescribed amlodipine 10mg daily, losartan 50mg daily, citalopram 20mg daily, and naproxen 250mg every 8 hours as needed. The patient noted that she was initiated on naproxen by her primary care physician 2 weeks prior to her presentation as acetaminophen, which she had been taking for more than 5 years, was not providing pain relief any longer.

Upon admission, the patient had a serum sodium of 113 mmol/L, a urine sodium of 120 mmol/L, and urine osmolality of 487 mOsm/kg. It was noted that her sodium level 10 months prior was 129 mmol/L. Based on her physical exam and other laboratory testing (ie, cortisol level, thyroid-stimulating hormone, pro-BNP, creatinine, liver enzymes, serum albumin, cholesterol; all within range), she was diagnosed with SIADH.

The offending agents, citalopram and naproxen, were discontinued and fluid was restricted to 1 L per day. Instead of using hypertonic saline in our case, we decided to start fluid restriction alone at the beginning because of advanced age (which entails higher risk for osmotic demyelination syndrome), chronic hyponatremia, and relatively stable clinical condition, the authors explained.

On day 3 of her stay, the patients serum sodium level remained unchanged since admission and she experienced worsening mental status. She was then initiated on 2g sodium chloride tablets twice daily and her fluid was further restricted. On day 10 of admission, the patients serum sodium was reported to be 131 mmol/L and the sodium chloride tablets were discontinued. She was discharged on day 14 to a subacute rehabilitation center.

After an inpatient psychiatric evaluation determined that an antidepressant was not necessary at the time, the patient was discharged on amlodipine 10mg daily, losartan 100mg daily, and meloxicam 15mg daily. She was advised to continue to limit fluid to 1 L per day.

In our case, laboratory evaluation led to the diagnosis of SIADH, and the history of presenting illness pointed towards a medication adverse effect as the culprit, the study authors stated. They concluded, When faced with hyponatremia in an elderly patient, medication reconciliation should be one of the initials steps in the assessment.

Chiu C, Sarwal A, Munir RA, Widjaja M, Khalid A, Khanna R. Syndrome of inappropriate antidiuretic hormone (SIADH) induced by long-term use of citalopram and short-term use of naproxen. Am J Case Rep. 2020; 21: e926561. doi: 10.12659/AJCR.926561.

Visit link:
Antidepressant, NSAID Identified as Culprits in SIADH Case - Monthly Prescribing Reference

Insulin controls the amount of sugar in your blood by regulating the conversion of glucose into energy, or storage in the liver for further use.

When we eat food, our body takes glucose from food, which leads to a rise in blood sugar levels. This leads to the release of insulin in healthy individuals, which signals your cells to absorb glucose and use it as energy, which in turn reduces your blood sugar level.

People suffering from type 1 or type 2 diabetes need to take insulin injection to facilitate this process. Nearly 24 per cent people suffering from diabetes take insulin.

There are several types of insulin that a person can take but it depends on how well everyone's body utilizes it and what is the type of diet they follow.

People who are resistant to insulin or consume too many carbohydrates, need to take higher doses of insulin.

See the article here:
Different types of insulin and how to use them for diabetes treatment - Times of India