7 Detox Tips From Scientists Who Actually Tried Them

One of the realities of 2014 is that when a baby is born, he or she has already been exposed to toxic chemicals. The evidence is in umbilical cords, which research has confirmed contain pesticides, waste from burning coal and gasoline, and garbage. Even if you try to do everything right (eat organic, buy natural products, live in a cabin in the middle of the woods, etc.), you can’t avoid all of the chemicals that have become pervasive.

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Bruce Lourie and Rick Smith researched the dominance of these chemicals while writing their first book, Slow Death by Rubber Duck: How the Toxic Chemistry of Everyday Life Affects Our Health (2009), which took a look at everyday items, including canned food, pajamas, Tupperware, and rubber ducks, that put toxins into our bodies. Their readers bombarded them with a simple question: If all this stuff is inside us, how do we get it out?

So the two authors, armed with Smith’s PhD in biology and collective decades working in the environmental field (Smith's the executive director of the Broadbent Institute and Lourie is the president of the Ivey Foundation), went out again to determine what actually worked to get toxins out of the body. Through a series of self-designed experiments on themselves and others, they take readers through their journey in Toxin Toxout: Getting Harmful Chemicals Out of Our Bodies and Our World.

Here are some key facts they learned about what actually matters when it comes to detoxing:

1. Chemicals are everywhere, but you don’t have to worry about all of them.Not all chemicals are actually going to damage us, Laurie said, and people have different tolerance to chemicals (though you may find that out the hard way). Some chemicals are disappearing from our lives (DDT, dioxin, lead) because of awareness of their dangers. “I joke sometimes that I’m a worrier, and I carry around a worry list with me,” Smith said. “In the book, we tried to come up with a short worry list.” The list included phthalates, BPA, pesticides, methyl paraben, triclosan, sodium lauryl sulphatel, and metals that can be harmful when they accumulate, such as aluminum, tin, and mercury. Yes, that’s still a long (and confusing) list, but there are some simple ways to avoid or eliminate them.

 

 

2. Avoid some toxins by shopping natural. Chemicals don’t just get into our bodies through what we eat — they come in through what we slather on our skin, what furniture we sit on, and what we breathe. While reporting for the book, Smith measured his urine before and after simply sitting and breathing in a new Chevy Tahoe for eight hours, and found that doing so had elevated his body's levels of four chemicals from the worry list. So shop smart (and roll down the windows when driving). “When you’re making a purchase, be it a cosmetic, a shampoo, or a new sofa, ask ‘Is this the most natural thing I could buy?’” Lourie said. Read ingredient labels and look up the ones you can’t pronounce. Do your research and check out eco-certifications before making big purchases like sofas or cars to see which, like the Tahoe, are made with dangerous chemicals. 

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3. Organic is actually better, if you want to avoid pesticides. Recent research — particularly one study from Stanford that concluded organic produce doesn’t have more nutrients — has ignored the intended benefit of going organic, Smith and Lourie argue. Organic farming isn’t necessarily meant to yield more nutrient-dense food. It’s meant to make food that won’t contain excessive pesticides. (Yes, it may have traces of pesticides, because almost everything does. Remember the umbilical cords?) Smith and Laurie asked nine kids who hadn’t eaten organic before to eat an all-organic diet for five days while giving urine samples. The urine samples showed the switch yielded a big drop in pesticide levels. “Once people start eating organic food, pesticide reduction occurs in a matter of hours,” Smith said.

 

 

4. It’s better to adjust your habits than to go through a cleanse.  One of the most basic things you can do to get toxins out of your body is to drink more water. Another is to eat less animal fat and more (preferably organic) fruits and vegetables. But is the best way to do that a four-day juice cleanse? Probably not, say Smith and Laurie. "'Cleanse' makes it sound like it’s a special thing,” Lourie said. “If you’re eating more vegetables and drinking plenty of water, and you want to put the vegetables in the water, that’s a good thing to do. Just don’t be mistaken that if you do that for four days out of the year, you’re going to be detoxing your body — it doesn’t work that way.” It’s much better to incorporate fruits, veggies, and water into your daily diet.

5. Embrace sweat — and saunas. Toxins enter your body through what you eat, breathe and touch, and they go out the same way, through breath, digested food and drink, and sweat. While exhaling and urinating are pretty non-negotiable, a lot of us are engaged in a war against sweat. “We’re really confused as to what clean smells like,” Jessa Blades, an eco-blogger, tells the authors in the book.Antiperspirants and some deodorants prevent us from sweating out toxins while using toxic metals to keep the sweat in, a “double toxic whammy” Smith said. Lourie even admitted that he’s stopped using deodorant. Even if you change or quit your antiperspirant, you should try to sweat more, too. You can do this by exercising more or by using saunas to “detox through heavy sweating,” Lourie said. You’ll also end up drinking more water, which is good for eliminating toxins.

6. Be wary of fat. Fat holds on to toxins, which is part of the reason chemicals like DDT still hang around our systems. So if you’re eating lots of animal fat, you’re also eating the chemicals that the animal fat is holding. Then, you’re probably also putting on weight and thus adding fat to your body, which will hold on to those chemicals. “It’s a positive feedback loop,” Lourie said. In fact, if you’re worried about toxins and you’re overweight, losing that extra body fat should be the first step toward reducing the toxins in your body.

7. Push companies to do the right thing, and support regulation of toxins.“Only part of the solution to this problem is being a more careful consumer,” Smith said. ‘The other part is to be a more engaged citizen.” Remember when people learned that Subway bread contained a yoga mat chemical, and took to social media to demand that change? “Never has a company capitulated so quickly,” Smith said. It’s easier than ever to make your voice heard. 

11 Struggles Every New Runner Understands

I've never been one of those people. You know the kind, the ones who wake up in the morning or lace up in the evening and "go for a run."

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I've always been envious of my roommates, who can sneak in a jog with ease and carry on with their day, as if they had done something casually simple like taking the trash out. So, I made a vow to give running another chance. After all, the exercise has been shown to make you happier, reduce your risk for disease and even increase longevity.

While group classes and long walks will probably always be more my speed, I did find that I was enjoying running more than I ever did in the past. However, that doesn't come without a few hiccups. Below are a handful of struggles all new runners can probably relate to.

Getting winded in the first few minutes.

Probably one of the most discouraging elements of getting into a running routine is realizing that you're not as in shape as you thought you were. I continuously find myself doing more walking or jogging than actual running. But just because you need those intermittent breaks doesn't mean you aren't a runner. In fact, research shows that walking intervals during your run can help you maintain your overall pace.

Two words: Sore. Muscles.

The second-day pain is real. If you're experiencing those achy muscles, try one of these post-run remedies. Just make sure you're checking in with your body as you establish your routine. A little soreness is OK, but if the pain is more intense you may have sustained a running-related injury.

 

 

Feeling overwhelmed by the copious amount of races.

Color runs, beer runs, zombie runs, princess half marathons... the list is seriously endless. However, there are some perks to picking a race. Signing up for one helps you set a goal as you get into a routine, plus there's an opportunity to turn it into a social event by participating with your friends.

If your goal is to become a marathon runner (and props to you!), there are also some benefits there: Research shows consistent long-distance running can improve cardiovascular health and lower the risk for other organ disorders, the Wall Street Journal reported.

The jolting agony of waking up at 6 a.m.

My sleepy brain is constantly telling me my bed feels better than running (and often, the bed wins). If you need a little extra motivation, try one of these hacks to help you jumpstart your morning workout.

The boredom.

Part of the reason I never got into a routine in the first place was because the exercise itself seemed extremely dull to me (the treadmill is my arch-nemesis). Once I discovered more running-path options, I started to have more fun. However, that's not to say that I don't get a little bored sometimes — and that's OK.

Note: If you still just can't get excited by the process most of the time, you may want to try a more entertaining workout option instead. Exercise should be engaging, not mind-numbing.

Trying to find your perfect route.

Finding your favorite place to run is like finding a good apartment: It feels elusive until one day you hit the lottery. Whether you're into lush scenery or a skyline, it's important to find the routes that work for you in order to make the exercise entertaining.

The joy of picking out new workout clothes.

Sleek tanks! Compression pants! Neon shoes!

Running toward (multiple) "finish lines."

If you've ever uttered to yourself just one more pole, you're not alone. In fact, picking out an arbitrary finish line on your run can improve your performance. Research shows those who stare at a target in the distance go faster and feel less exertion than those who don't concentrate on anything, The Atlantic reported.

 

 

Bargaining with yourself on your run.

If you run five more blocks, you can binge-watch Scandal when you get home, I tell myself. Chances are I'd probably do it anyway — but at least it encourages me in the moment.

Creating a playlist that will consistently keep you motivated.

No, a simple music-streaming app won't do when your lungs are on fire and your legs feel weak. You need that one specific song that will inspire you to keep going (shout out to all my Shake It Off comrades). If you're looking for a playlist to spice up your run, check out some of these.

Eating Well As You Age

Looking in the mirror for changes as you age? A healthy diet helps to ensure that you'll like the reflection you see. Good nutrition is linked to healthy aging on many levels: It can keep you energized and active as well as fight against slowing metabolism and digestion and the gradual loss of muscle mass and healthy bone as you age.

Making healthy diet choices can help you prevent or better manage chronic conditions such as high blood pressure, high cholesterol, and diabetes. It's never too late to adopt healthier eating habits.

Strategies for Healthy Eating as You Age

Replace old eating habits with these healthy approaches:

  • Eat every three or four hours. “This keeps energy levels high and keeps appetite hormones in check to avoid overeating,” says Kim Larson, RD, of Total Health in Seattle and a spokesperson for the Academy of Nutrition and Dietetics.
  • Eat protein at each meal. Aim for 20 to 30 grams to help maintain muscle mass. Choose fish at least twice a week as a source of high quality protein. Other good sources of protein include lean meat and poultry, eggs, beans, nuts, and seeds.
  • Choose whole grains. Replace refined flour products with whole grains for more nutrients and fiber.
  • Choose low-fat dairy. Cutting out the saturated fat may help lower your risk for heart disease.
  • Learn about portion sizes. You may need to scale back on the serving sizes of foods to control your weight.
  • Choose nutrient-rich whole foods over empty calories. Whole foods are those closest to their natural state. Empty calories are typically processed foods with added salt, sugar, and fat. For example, snack on whole fruit instead of cookies.
  • Eat a “rainbow” of foods. “Eat five to seven servings of fruits and veggies each day to keep antioxidants like vitamins A, C, and E high,” Larson says. Choosing fruits and vegetables of different colors provides your body with a wide range of nutrients. According to research published in the May 2012 issue of the Journal of the American Geriatric Societyexercise coupled with higher fruit and vegetable intake led to longer lives. Fruits and veggies also fill you up with fiber, which cuts down on snacking and helps control weight, Larson says.
  • Choose healthy cooking techniques. Try steaming, baking, roasting, or sautéing food rather than frying it to cut back on fat.
  • Cut down on salt. If you’re over 51, national recommendations are to eat less than 1,500 milligrams of salt per day. Look for low-sodium foods and season your meals with herbs and spices rather than salt.
  • Stay hydrated. “Dehydration can cause irritability, fatigue, confusion, and urinary tract infections,” Larson says. Be sure to drink plenty of water and other non-caffeinated liquids throughout the day.
  • Ask about supplements. You may have changing nutrient needs as you get older and might benefit from vitamins B12 and D, calcium, and omega-3 fatty acid supplements, Larson says. Ask your doctor or a dietitian for guidance.

Overcoming Challenges to Healthy Eating

Eating a healthy diet can be complicated by changes you may face as you age, such as difficulty eating or a limited budget. There are strategies you can try to solve these common challenges:

  • If you've lost your appetite or sense of taste: Try new recipes and flavors — adding spices, herbs, and lemon juice can make foods more appealing. If you take medication, ask your doctor if appetite or taste changes are side effects and if switching to another drug might help.
  • If you have a hard time swallowing or chewing: Choose foods that are moist and easy to eat, such as nutritious soups made with beans and vegetables, Larson says.
  • If affording groceries is difficult: Shop from a list — careful planning can help you make the healthiest and most cost-effective food choices. Use coupons or shop on days when discounts are offered. Buying fruits and veggies when they’re in season and frozen produce in bulk can also help control expenses.
  • If you have trouble preparing meals: Consider buying healthy prepared or semi-prepared meals or at least pre-cut ingredients to cut down on energy-draining prep time.

Larson believes in the importance of enjoying your food. Make healthy-diet changes step by step and have fun experimenting to find new tastes and cooking styles. Eat slowly and pay attention to the experience. “Create a pleasant eatingenvironment," she says. "Sit by a window and enjoy every bite.”

What You Need to Know About Hyperpigmentation

Even small skin traumas like a pimple or bug bite can leave you with complexion-busting dark spots. “This is one of the most common ailments that patients come to see me about,” explains Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “It’s an annoying condition that affects all skin types, but the good news is that it’s fairly easy to treat.”

Find out how Dr. Downie helps patients treat and avoid marks on their complexions.

Everyday Health: What causes hyperpigmentation?

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Jeanine Downie: Any trauma or inflammation to the skin — either from acne, pimples, bug bites, or simply a bump, cut, or scratch — disrupts the surface layers where you have melanin, responsible for skin’s color. As the skin heals, it leaves behind residual pigmentation and dark spots.

 

 

 

EH: Is there anything you can do to prevent it?

JD: Unfortunately, if you’re prone to these dark spots, it’s tough to prevent them. Still, picking or scratching at an irritation will further traumatize the area, so hands off! You’ll also want to be vigilant about wearing sunscreen. As your skin gets darker, so will those hyperpigmented areas — it’s not like a tan is going to even out the color. Obviously, daily sunscreen wear is a must anyway, but this is just one more reason to protect your skin from UV rays.

EH: What steps can you take to treat it?

JD: The sooner you start taking care of your wound, the better it’ll look once healed. I recommend keeping the wound covered, especially if the skin is broken, and applying a topical healing ointment.

 

 

For large cysts or cuts, you may even want to see your dermatologist for a treatment plan. Once the pimple or cut has healed, apply 2% hydroquinone cream, which is available over-the-counter, or 4% hydroquinone, available by prescription from your doctor.

If the topical creams don’t quite do the trick, talk to your dermatologist about chemical peels or laser treatments to completely eliminate more stubborn discoloration.

EH: Is hyperpigmentation more common in people with darker complexions?

JD: No matter your skin color, everyone is susceptible to hyperpigmentation. Still, those with darker complexions seem to hold on to those spots for much longer because they have more melanin in their skin. It also means those hyperpigmented areas are going to be darker and more visible as well. Pregnancy and certain medications can increase your body’s production of melanin, and lead to hyperpigmentation as well.

6 Ways to Prep Your Skin for Summer

Scheduling vacation plans and buying a new swimsuit will mentally prepare you for summer, but your skin may need some help getting ready, too. For gorgeous, smooth skin you'll feel ready to bare, you need to take a few simple steps. Try this head-to-toe refresher to take your skin out of hibernation.

1. Reveal Glowing Skin

Regular exfoliation can be a part of a healthy skin regimen no matter the season; as long as your skin is not sensitive, exfoliation can help you achieve smooth, healthy-looking skin that makes you look more glowing and youthful. “But it must be done with care,” says Doris Day, MD, a dermatologist in New York City. “The goal is to lift off the outer layer of skin cells that are ready to be sloughed off without stripping the skin.”

 

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Brushes, polishing cloths, and scrubs offer easy ways to smooth away rough spots. Rotating cleansing brushes work by physically buffing off the dead skin cells. Exfoliating cloths, microdermabrasion kits, and scrubs with granular ingredients also operate the same way. “For the body, look for a scrub that contains coarse particles that dissolve over time, like sugar, so you don’t irritate the skin,” says Dr. Day.

Products that chemically exfoliate the skin contain ingredients such as glycolic, salicylic, or polyhydroxy acids that cause the skin to shed its outer layer and reveal the newer layer.

2. Remove Hair Without Irritation

If your summer forecast calls for sunny days at the beach or poolside, you may be putting some effort into removing unwanted hair. But once you rip off the wax strip, it’s also important to care for the skin that’s newly exposed to the elements.

Give your skin some time to recover before rolling out your beach towel or getting active outdoors. “I advise clients to stay out of the sun or heat for at least 48 hours after any hair-removal process,” says Cindy Barshop, owner of Completely Bare spas. “Follicles are vulnerable to irritation, and skin may be sensitive due to any heat or friction from lasers, waxing, or shaving.”

Since most of us don’t plan our hair removal that far in advance, buffer your tender skin with an oil-free sunscreen, wait for it to dry (about 5 minutes), and dust on some talc-free baby powder, says Barshop. To prevent ingrown hairs, it’s helpful to wear loose-fitting clothing and use an after-waxing product that contains glycolic and salicylic acids, which team up to prevent dead skin cells from causing bothersome bumps.

 

 

3. Fight UV Rays With Food

All the work you put into making your skin look good won’t be worth it unless you guard it from the sun’s damaging rays, which are strongest during the summer. Surprisingly, you can protect yourself from the inside, too. “In addition to usingsunscreen, eat cooked tomatoes every day if you know you’re going to be in the sun,” says Jessica Wu, MD, assistant clinical professor of dermatology at USC Medical School. According to research, cooked tomatoes are rich in lycopene, an antioxidant that helps fight the effects of UV rays such as redness, swelling, and blistering from sunburn. If you plan to spend a lot of time outdoors, you may benefit from consuming tomato sauce, grilled tomatoes, or even Bloody Marys. “This doesn’t replace sunscreen, but the habit could give you additional protection if you can’t reach your back and miss a spot,” Dr. Wu adds.

4. Clear Up Body Breakouts

It’s no better to have acne on your body than on the face, especially in the heat, when hiding and covering up isn’t an option. The approach to treating acne on the back, chest, and elsewhere on the body is the same as treating facial acne: “Exfoliate regularly, don’t pick, and treat with effective ingredients,” says Day.

Washing with products that contain salicylic acid helps slough off the dead skin cells; a treatment product with micronized benzoyl peroxide can also help by penetrating the skin and killing off the bacteria that cause acne.

If your skin is sensitive, investing in an acne-treating blue light tool may be worth the cost. “You simply wave the light wand over skin for five minutes daily and it helps kill bacteria,” says Leslie Baumann, MD, a dermatologist in Miami. If you have severe body acne, see a dermatologist.

5. Erase Cellulite

First, the good news: Some products may be able to smooth out the undesirable dimples and unevenness of cellulite. The bad news: They won’t get rid of cellulite forever. The smoothing and toning effect, like many good things in life, is fleeting. Still, it may be worth slathering on a toning body lotion to make your skin look and feel tighter for a day at the beach or a special event.

“Products that contain caffeine and theophylline temporarily dehydrate fat cells,” says Dr. Baumann. “However, it’s the massage and the application of the cream that does the work.” The best course of action long-term is to exercise regularly, coupled with targeted massage, suggests Baumann.

Another way to hide cellulite is to apply a fake tan. Take advantage of the newest self-tanners, which have come a long way from the strong-smelling streaky creams or sprays of yesteryear. “There has been so much progress in the formulations — the colors are natural, there’s no streaking, and the scent is so much better,” says Day.

6. Treat Your Feet

If you’ve stuffed your feet inside boots all winter, they probably could use a little TLC for sandal weather. Jump-start your program with a salon pedicure, or if you’re short on time, you can heed Day’s DIY tip, which will help soften feet while you sleep. First, remove thicker skin with a foot file. Apply a rich emollient cream or ointment, then cover the feet in plastic wrap and cotton socks. Leave on overnight. Repeat every day until you achieve smooth skin, then once a week to maintain soft skin.

7 Healthy Habits of the 2016 Presidential Candidates

The New Hampshire primary's in full swing, and if there’s one thing all the presidential hopefuls can agree on, it’s that running for office is the ultimate endurance challenge. They’re canvassing across the country with little time to exercise or sleep, and it doesn’t help that at every stop they’re tempted by unhealthy foods like pizza, pork chops, and pies. So how do the presidential candidates stay healthy and keep their energy levels up during the grueling primary season? Read on to find out!

What Is Guillain-Barré Syndrome?

Guillain-Barré syndrome (GBS) is an illness that can result in muscle weakness or loss of muscle function in parts of the body.

In people with Guillain-Barré syndrome (pronounced GHEE-yan ba-RAY), the body's own immune system attacks the peripheral nervous system.

The peripheral nervous system includes the nerves that connect the brain and spinal cord to the limbs. These nerves help control muscle movement.

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 or 2 out of every 100,000 people develop GBS each year in the United States.

Anyone can get GBS, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS each year.

Causes and Risk Factors

Doctors don't know what causes Guillain-Barré syndrome.

Many people with GBS report a bacterial or viral infection (such as the flu) days or weeks before GBS symptoms start.

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.

Types of GBS

There are several types of Guillain-Barré syndrome, which are characterized by what part of the nerve cell is damaged.

The most common type of GBS is called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

In AIDP, the immune system mistakenly attacks the protective nerve covering that helps transmit nerve signals from the brain to other parts of the body.

Guillain-Barré Syndrome Symptoms

The first symptoms of Guillain-Barré syndrome often include feelings of tingling or weakness in the feet and legs. These feelings may spread to the arms and face.

The chest muscles can also be affected. Up to a quarter of people with GBS experience problems breathing.

In very severe cases, people with GBS may lose all muscle function and movement, becoming temporarily paralyzed.

Signs and symptoms of Guillain-Barré syndrome may include:

  • Pricking or tingling "pins and needles" sensations in the fingers, toes, ankles, or wrists
  • Muscle weakness that starts in the legs and spreads to the upper body
  • Unsteady walking
  • Difficulty with eye or facial movements (blinking, chewing, speaking)
  • Difficulty controlling the bowels or bladder
  • Rapid heart rate
  • Difficulty breathing

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.

Some risk factors for binge eating disorder include:

  • A history of anxiety or depression
  • A history of dieting (especially in unhealthy ways, such as skipping meals or not eating enough food each day)
  • Painful childhood experiences, such as family problems

Symptoms of Binge Eating Disorder

People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.

Binge eating episodes are associated with three or more of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you're not feeling hungry
  • Eating alone, because you feel embarrassed about how much you're eating
  • Feeling extremely disgusted, depressed, or guilty after eating

Some people also display behavioral, emotional, or physical characteristics, such as:

  • Secretive food behaviors, including hoarding, hiding, or stealing food
  • Feelings of anger, anxiety, worthlessness, or shame preceding a binge
  • Feeling disgusted with your body size
  • A strong need to be in control, or perfectionist tendencies

Binge Eating Disorder Treatment

If you have binge eating disorder, you should seek help from a specialist in eating disorders, such as a psychiatrist or psychologist.

There are several treatments available for BED. Treatment options may include:

 

10 Varicose Veins Myths

If you have ropy, blue blood vessels in your legs, you may think that they’re unsightly but don't cause any overt symptoms. Yet for some people, varicose veins can cause skin damage and, even worse, lead to dangerous blood clots.

They’re incredibly common: Varicose veins affect about one in four U.S. adults, or about 22 million women and 11 million men between ages 40 and 80.

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Your leg veins face an uphill battle as they carry blood from your toes to your heart. Small flaps, or valves, within these vessels prevent blood from getting backed up on this journey, and the pumping action of your leg muscles helps push the blood along. 

But if these valves weaken, blood can pool — primarily in the veins of your legs — increasing pressure in the veins. As a result of this increased pressure, your body tries to widen the veins to compensate, causing them to bulge and thicken, and leading to the characteristic twisted appearance of varicose veins.

 

 

To help you learn the facts about these enlarged veins, we've set the record straight on 10 sometimes confusing pieces of information, including who gets varicose veins and why, health problems they can cause, and treatment options.

Myth 1: Varicose Veins Are Only a Cosmetic Issue

“A lot of people are told by primary care doctors or others that varicose veins are a cosmetic issue only, when oftentimes they can be much more than that,” saysKathleen D. Gibson, MD, a vascular surgeon practicing in Bellevue, Washington.

“A significant percentage of patients with varicose veins will eventually develop symptoms,” says Pablo Sung Yup Kim, MD, assistant professor of surgery at Mount Sinai's Icahn School of Medicine in New York City. “The most common include dull achiness, heaviness, throbbing, cramping, and swelling of the legs.” Other symptoms include severe dryness and itchiness of the skin near varicose veins. People with varicose veins are also at an increased risk for a dangerous type of blood clot known as deep vein thrombosis.

Other not-so-common signs and symptoms, found in less than 10 percent of patients, include bleeding, skin discoloration, skin thickening, and ulcer formation — all due to varicose veins, says Kim. Unfortunately, once you have skin damage, it’s usually permanent.

“It’s very important to seek medical advice if you have varicose veins and experience symptoms — before changes in the skin are irreversible,” he says.

Myth 2: Varicose Veins Are an Inevitable Sign of Aging

Aging definitely worsens varicose veins, though not everyone gets them. “It's a degenerative process that gets worse and more prominent as we age,” says Dr. Gibson. But young people can get varicose veins, too. While the average age of patients treated in Gibson’s practice is 52, she and her colleagues have treated patients as young as 13.

If you've got varicose veins, it may run in your family. “The cause of varicose veins is primarily genetic,” Gibson explains.

Changes in hormone levels also come into play as a risk factor for varicose veins. “Your risk can be made worse, especially by pregnancy,” she adds.

Myth 3: Varicose Veins Are Strictly a Women’s Issue

While varicose veins are more common in women, men get them, too. About one-quarter of adult women have some visible varicose veins, compared to 10 to 15 percent of men.

Steve Hahn, 51, of Kirkland, Washington, first noticed in his twenties that he had varicose veins in his left leg after he sprained his ankle playing basketball. When he injured his knee about 10 years ago, he noticed that the varicose veins had become more extensive.

“After about five years of thinking about it, I finally had them treated,” he says. “Both of my legs felt very heavy all of the time at this point, as opposed to just after walking a golf course or playing tennis or basketball.”

After treatment, Hahn says, “I feel like I have new legs.” The heaviness is gone, as is the ankle swelling, which he didn't know was related to the varicose veins. And as a side benefit, he adds, he looks better in shorts.

Myth 4: Running Can Cause Varicose Veins

Exercise — including running — is usually a good thing for your veins. “Exercise is always good for the circulation,” Kim says. “Walking or running can lead to more calf-muscle pumping and more blood returning to the heart.”

“Being a runner doesn’t cause varicose veins,” adds Gibson, though there's controversy about whether exercise makes them worse or not.” Compression stockings can help prevent blood from pooling in your lower legs during exercise. “For patients who haven't had their varicose veins treated and are running, I recommend compression. When you’re done running and are cooling off, elevate your legs,” she says.

Myth 5: Varicose Veins Are Always Visible

While the varicose veins you notice are right at the surface of the skin, they occur deeper in the body, too, where you can't see them. “It really depends on the makeup of the leg,” Gibson says. “If you've got a lot of fatty tissue between the muscle and the skin, you may not see them. Sometimes surface veins are the tip of the iceberg and there's a lot going on underneath.”

Myth 6: Standing on the Job Causes Varicose Veins

If you have a job that requires you to be on your feet a lot — as a teacher or flight attendant, for example — you may be more bothered by varicose veins. But the jury's still out on whether prolonged standing actually causes varicose veins. “People tend to notice their varicose vein symptoms more when they’re standing or sitting,” Gibson explains.

RELATED: Steer Clear of These 9 Artery and Vein Diseases

Myth 7: Making Lifestyle Changes Won't Help

Your lifestyle does matter, because obesity can worsen varicose veins, and getting down to a healthy weight can help ease symptoms. Becoming more physically active is also helpful. “Wearing compression stockings, doing calf-strengthening exercises, and elevating your legs can all improve or prevent varicose veins,” saysAndrew F. Alexis, MD, MPH, chairman of the dermatology department at Mount Sinai St. Luke's and Mount Sinai Roosevelt in New York City.

Myth 8: Surgery Is Your Only Treatment Option

The only treatment available for varicose veins used to be a type of surgery called stripping, in which the vein is surgically removed from the body. That’s no longer the case. While this procedure is still the most commonly used varicose vein treatment worldwide, according to Gibson, minimally invasive procedures that don't leave scars have become much more popular in the United States.

Endothermal ablation, for example, involves using a needle to deliver heat to your vein, causing it to close and no longer function. While the procedure doesn't leave a scar, it can be painful, and you may have to undergo sedation before being treated. “You have to have a series of injections along the vein to numb it up; otherwise, you wouldn't be able to tolerate the heat,” Gibson explains. You may need to take a day off from work to recover, as well as a few days off from the gym.

Some medications, called sclerosing agents, close a vein by causing irritation. Others are adhesives that seal a vein shut and don’t require the area to be numbed. Gibson and her colleagues have helped develop some of the new technologies and products used in treating varicose veins, including adhesives.

Milder varicose veins can be treated by dermatologists with non-invasive approaches, such as laser therapy and sclerotherapy, says Dr. Alexis. “For more severe cases where symptoms may be involved, seeing a vascular surgeon for surgical treatment options is advised.”

Although treatment for varicose veins means losing some veins, you have plenty of others in your body that can take up the slack, explains Gibson. “The majority of the blood flow in veins in the leg is not on the surface at all; it's in the deep veins within the muscle,” she says. “Those deep veins … are easily able to take over for any veins that we remove on the surface.”

Myth 9: Recovery After Varicose Vein Treatments Is Difficult

 

 

Newer treatments have quicker recovery times. “These procedures can be performed in an office within 20 to 30 minutes with no recovery time. Patients can usually return to work or daily activities on the same day,” Kim says.

Myth 10: Varicose Veins Can Be Cured

Treatments are effective, but they aren't a cure, Gibson says. Sometimes, varicose veins can make a repeat appearance after treatment. “What I tell my patients is it's kind of like weeding a garden,” she says. “We clear them all out, but that doesn't mean there's never going to be another dandelion popping out.”

10 Essential Facts About Ovarian Cancer

Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.

We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.

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Here are 10 essential facts about ovarian cancer that you should know:

1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.

2. You should see your doctor if you experience any of these ovarian cancer symptoms:

  • Vaginal bleeding (especially if you’re past menopause)
  • Abnormal vaginal discharge
  • Pain or pressure in the area below your stomach and between your hip bones
  • Back pain
  • A change in bathroom habits, such as urgently needing to urinate, urinating frequently, or having constipation or diarrhea

It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.

 

 

These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.

3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:

  • Pelvic or abdominal pain
  • Strong urge to urinate or frequent urination
  • Bloating or increased abdominal size
  • Difficulty eating or feeling full early

If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.

4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.

RELATED: Overcoming Ovarian Cancer, Twice

5. Ovarian cancer has several key risk factorsThese include:

  • Women with a family history of ovarian cancer may be at higher risk.
  • Women who have never been pregnant and women who have uninterrupted ovulation due to infertility treatments seem to be at higher risk.
  • Early onset of your period, or having a late menopause, seems to increase risk.
  • Using talcum powder in the genital area may increase risk.
  • Smoking is a risk factor for a type of ovarian cancer known as mucinous ovarian cancer. Quitting smoking seems to reverse the risk back to normal, says Morgan.

6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.

7. Ovarian cancer treatments are evolving and improving all the time.Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.

 

 

8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.

9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.

10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.

How to Prevent Hearing Loss

Do you have trouble following a conversation in a noisy room? Do other people complain that you have the television turned up too loud? If the answer to either of those questions is yes, you may already have some degree of hearing loss.

Hearing loss can start at any age. According to the National Academy on Aging and Society, the number of affected Americans between the ages of 45 and 64 has increased significantly since 1971. But it’s much more common in seniors: Some 40 percent of the 20 million Americans who have hearing loss are 65 or older.

Contrary to popular belief, however, hearing loss is not an inevitable part of aging. Some causes of hearing loss can be prevented, and most types of hearing loss can be helped.

Types and Causes of Hearing Loss

There are three basic types of hearing loss:

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  • Sensorineural hearing loss is caused by damage to the inner ear nerves or the nerves that carry sound to the hearing area of the brain. Once you have this type of nerve damage, the only treatment is a hearing aid. Causes of sensorineural hearing loss include injuries, tumors, infection, certain medications, and excessive noise exposure.
  • Conductive hearing loss is caused by a condition that blocks sound waves from being transferred to the nerves involved in the hearing process. Whereas sensorineural hearing loss usually affects both ears, conductive hearing loss may only affect one ear. Common causes include ear infections, ear wax, ear trauma such as a punctured eardrum, and other diseases that affect the ear canal, the eardrum, or the tiny bones in the middle ear. Unlike sensorineural hearing loss, this type of hearing loss can often be corrected and restored.
  • Mixed hearing loss occurs when someone who has nerve type hearing loss from aging or noise trauma then gets an ear infection or develops a wax impaction, causing their hearing to suddenly get much worse. It’s a combination of sensorineural hearing loss and conductive hearing loss.

Hearing Loss Evaluation

If you are having trouble hearing or develop sudden deafness, you need to get your hearing checked as soon as possible. Sudden deafness is a serious symptom and should be treated as a medical emergency. For many people, though, hearing loss may be gradual and not obvious. Here are seven warning signs to watch out for:

  • You have trouble hearing while on the telephone.
  • You can’t seem to follow a conversation if there is background noise.
  • You struggle to understand women’s or children's voices.
  • People complain that you turn up the TV volume too high.
  • You constantly ask people to repeat themselves.
  • You have a long history of working around loud noises.
  • You notice a ringing, hissing, or roaring sound in your ears.

 

 

If you think you have any kind of hearing loss, the place to start is with your doctor. Whether your hearing loss is gradual or sudden, your doctor may refer you to an audiologist (a medical specialist in hearing loss) or an otolaryngologist (a medical doctor specializing in disorders of the ear).

 

 

Depending on the cause and type of your hearing loss, treatment may be as simple as removing ear wax or as complicated as reconstructive ear surgery. Sensorineural hearing loss can't be corrected or reversed, but hearing aids and assistive devices can enhance most people’s hearing. For those with profound hearing loss approaching deafness, an electronic hearing device, called a cochlear implant, can even be implanted in the ear.

Tips for Hearing Loss Prevention

One type of hearing loss is 100 percent preventable: that due to noise exposure. Noise is measured in units called decibels: Normal conversation is about 45 decibels, heavy traffic may be about 85 decibels, and a firecracker may be about 120 decibels. Loud noise — anything at or above 85 decibels — can cause damage to the cells in the inner ear that convert sound into signals to the brain. Here are some tips for avoiding noise-induced hearing loss:

  • Minimize your exposure to loud noises that are persistent.
  • Never listen to music through headphones or ear buds with the volume all the way up.
  • Wear ear plugs or protective earmuffs during any activity that exposes you to noise at or above 85 decibels.
  • See your doctor about a baseline hearing test, called an audiogram, to find out if you already have some early hearing loss.

You should also see your doctor if you have any symptoms of ear pain, fullness, or ringing, or if you experience any sudden change in your hearing. These symptoms could be early warnings of preventable hearing loss.

Hearing loss or deafness can have a serious effect on social well-being. It can cut you off from the world around you. Know the causes of hearing loss, and practice hearing loss prevention to preserve the hearing you still have.

Depression Among Doctors: A Growing Problem

Long shifts of on-the-job training, and caring for patients in life-or-death situations, is enough to wear a person down. And it does.

Close to one-third of medical residents (doctors out of medical school and in training) experience depression, according to a new study published online in JAMA. The risk starts on the first day of residency training, when the probability that a doctor will become depressed more than quadruples compared to those not in residency.

“This is remarkable considering how patients often don’t report their depression because of the social stigma that’s attached to it,” says study author Douglas A. Mata, MD, MPH, a resident physician himself at Brigham and Women’s Hospital and a clinical fellow at Harvard Medical School in Boston.

“We also found that the number of depressed residents might be going up — that is, the prevalence of physician depression might be getting worse with time,” adds Dr. Mata. “It’s certainly not getting any better, so we’ve got a public health crisis on our hands that isn’t being talked about enough.”

Depression among doctors in training has been studied extensively over the years, so this study looked at what the research shows as a whole. Mata and his colleagues searched four databases of medical research for all relevant studies from 1963 through September 2015.

They found 31 studies that assessed depression at one point in time, and 23 long-term studies. Together, the studies involved more than 17,500 doctors and showed that 29 percent of them had depression or symptoms of depression. Most of the studies relied on self-reporting, but their methods also differed significantly.

In studies using a nine-question survey to assess depression symptoms, about one in five medical residents (21 percent) had depression. Studies that used another depression measure doubled that, to 43 percent of doctors experiencing depression at some point in their residency.

How Stressful Work Conditions Boost Depression Risk

“Doctor training has a deluge of risk factors for depression,” Mata says. “Many residents spend all their waking hours working like crazy, so their relationships with friends and family go on the back burner, making them feel isolated. Also, constant lack of sleep, combined with ‘time zone changes’ take a toll on the mind and body.”

What Mata means by time zone changes is the effect of being on overnight call every third or fourth night, which is much like taking transatlantic flights twice a week and dealing with the resultant jet lag. Worse, residents must often relocate to new cities each year, where they may lack essential support systems, he says.

“They may have tens of thousands of dollars of debt hanging over their heads as well, since the United States places the financial risks and burdens of training on the students themselves, not on the public health system they’re training to serve,” adds Mata. “To top it all off, they’re responsible for the care of ill patients, and they’re exposed to some mentally traumatic scenarios in the process.”

Is Patient Safety at Risk?

Depression among MDs appears strongly linked to the start of residency training, when the percent of doctors with depression jumped 16 points in the study, putting them at 4.5 times greater risk of depression once residency has begun.

“As clinicians, we’re used to treating others, but we’re often bad at taking care of ourselves,” Mata says. “Doctors need to pay more attention to their own mental well-being, and to that of their colleagues.”

Not doing so could have serious ramifications for patients, points out Victor Fornari, MD, chief of the division of child and adolescent psychiatry at Long Island Jewish Medical Center in Manhasset, New York.

RELATED: 5 Things Psychologists Wish Their Patients Would Do

“Depressive symptoms and depression may interfere with attention and focus,” says Dr. Fornari, who was not involved in the study. “Depression in resident physicians may also interfere with the development of the doctor-patient relationship. Patients may experience their depressed resident physicians as less engaged or less interested in their care.”

And attempting to counteract that impression could potentially make the situation worse, suggests Mata. “The doctors who care the most may overextend themselves to give their patients more empathy, which puts them at a higher risk for depression,” he says.

At the same time, sleep deprivation during residency contributes to depression and possible medical mistakes, he says.

“Sleep deprivation has been linked to a high risk of needle-stick injuries and exposure to bloodborne pathogens,” Mata says. “Depression has also been linked to more medical errors. Depressed doctors report more anxiety about making mistakes, whether or not they actually do.”

How Thanking Your Doctor May Help

While patients should not necessarily worry about their doctors’ health and safety, Mata says, they can help in small ways.

“Just tell your doctors ‘thank you’ and make sure they understand what they mean to you,” he says. “That goes a long way.”

But such kindnesses will not solve a problem that appears to be worsening. The study found that prevalence of depression among residents increased by half a percent each year, though the authors note the rise could relate to increased awareness of depression among docs.

Recognizing the problem is the first step. Residents also need support and mentoring, and modified work hours, which is already occurring in many institutions, Fornari says.

“Part of medical training is encouraging the resident physician to regulate their own self-care in an effort to learn how to manage their stress and ask for assistance with depression,” Fornari says.

Mata would like to see a proactive model rather than the current reactive one, which relies on residents to identify their own depression and seek help. Year-long resilience-based programs that teach coping skills from the first day of residency would be an important measure, he says.

“Widespread depression among doctors will inevitably cause good docs to work fewer hours and even leave the field,” Mata says, adding that the situation may even dissuade people from entering the medical field. “This has broad social implications for the health of our population as a whole.”

Light Box Might Help Nonseasonal Depression, Too

Light therapy, a treatment for a kind of depression known as seasonal affective disorder (SAD), may also benefit nonseasonal depression, a new study indicates.

"The combination of light and an antidepressant seems to work very well for treating nonseasonal depression," said study leader Dr. Raymond Lam, a professor and head of the Mood and Anxiety Disorders Program at the University of British Columbia in Canada.

Depression, a leading cause of disability worldwide, affects one in 20 people, according to background information with the study. Current treatments include psychotherapy and antidepressant medication, but recurrent episodes are common.

Since bright light treatment is used for people whose seasonal depression occurs in the darker months, the researchers hypothesized it might also lift depression that isn't brought on by light deprivation.

Lam and his team randomly assigned 122 adults with major depression not related to seasonal affective disorder to one of four groups. One group got 30 minutes of bright light treatment a day and took a placebo pill, while another used a device that was not light therapy and took the antidepressant fluoxetine (Prozac). A third group took a placebo pill and used a placebo device, while a fourth took Prozac and got light therapy.

The researchers followed the men and women for eight weeks, looking to see how many went into remission -- defined as having normal scores on a widely used depression scale.

"About 60 percent of the patients who got the combination [Prozac plus light] treatment went into remission with their symptoms compared to about 40 percent on light therapy alone," Lam said.

RESEARCH: 12 Ways to Treat Seasonal Depression

The antidepressant alone was not superior to placebo medication. Only about 30 percent of those on placebo medication and sham light treatment had remission, as did just 20 percent of those on Prozac with sham light treatment.

Light therapy alone was better than placebo, but not from a statistically significant point of view, Lam said.

Experts can't say for sure why light therapy works, but for seasonal affective disorder they think it may help correct disturbances in the body's circadian rhythms, or internal clock.

The same may be true for nonseasonal depression, Lam said. "Another theory is that light affects neurotransmitters in the brain such as serotonin [which affects mood]," he said. Or both could play a role, he added.

One limitation of the study, published online Nov. 18 in JAMA Psychiatry, is that patients' natural light exposure was not measured, the researchers said.

Simon Rego is director of psychology training at Montefiore Medical Center and an associate professor at Albert Einstein College of Medicine in New York City. He said the study is the first well-designed comparison of light therapy and the combination of light therapy and antidepressant medications in adults with nonseasonal major depressive disorder.

"In this case, the authors found that the light treatment, whether delivered alone or particularly when delivered in combination with an antidepressant medication, was efficacious in the treatment of nonseasonal [depression] and, just as important, the treatments were well-tolerated by the subjects," Rego said.

"It appears that light therapy, which is already seen as an effective treatment for seasonal affective disorder, may also be appropriate for nonseasonal [depression]," he added.

However, questions remain, Lam said, such as how long the combination treatment should continue.

Light boxes are sold at drugstores and other locations, Lam said, for less than $100 to $300. Some insurance plans cover them, he said.

Recommended treatment involves sitting in front of the fluorescent light box for a half hour daily as soon as possible after waking up. Lam said this can be done while eating breakfast or working on the computer.

The Canadian Institutes of Health Research funded the study. Lam reports serving as a consultant to or receiving honoraria for speaking from various pharmaceutical companies, including Eli Lilly and Co., which makes Prozac.

When’s The Best Time to Exercise?

Ask the Fitness Expert,  Jennifer Bayliss

Q: What’s the best time of day to exercise?

A: The best time of day to exercise is the time that works best for you. Studies go back and forth on this topic and there are benefits in exercising in the morning and later in the day. Ultimately, it comes down to personal preference and lifestyle. Choose a time that helps you make exercise a regular and consistent part of your routine. Here’s why:

It’s all about finding your rhythm.
Ever wonder why some of us are morning people while others are not? This has quite a bit to do with your body’s internal clock, or your circadian rhythms. Circadian rhythms are a daily cycle of sleep and wake cycles. It’s this cycle that regulates physical, mental, and behavioral changes within a 24-hour period. Body temperature, blood pressure, and metabolism are some of the physiological processes that can be affected by your body’s internal clock. These rhythms respond to changes in the environment and can be set and reset. The changes in the environment that can have an effect on circadian rhythms include lightness and darkness, temperatures within the environment, artificial light, the use of an alarm clock to wake, timing of meals, and time of day you exercise. Your personal clock can affect what time of day you prefer to exercise. So, are you a morning person or a night owl?

If you’re a morning person…
It’s a no brainer: You should workout in the AM. Research suggests that those who exercise in the morning tend to be more consistent with their exercise routine. The idea is you’ll get your workout in before any other events or distractions of the day interfere, thus setting yourself up for success. People who exercise earlier in the day generally find they can manage their time better and they feel more energized throughout the day. If you do exercise in the morning, make sure to give yourself a little extra warm-up time to get your body temperature elevated and your muscles warm. Some people have trouble exercising in the morning because of dizziness, fatigue, or lightheadedness experienced when working out on an empty stomach. If that happens to you, try having a small snack, such as a banana or a serving of low-fat yogurt, prior to exercise.

If you’re a night owl…
Afternoon or evening exercise can be the perfect way to unwind. Some people find that afternoon or evening workouts are more productive and help relieve some of the stresses of the day. For others, exercise in the morning doesn’t feel good because, when you wake up, your muscles may feel tight and your blood sugars may be low. Afternoon or evening workouts may just seem that much better because you are more alert, your body temperature is naturally elevated, and your muscles are warm and flexible. You also have the added benefit of having had the opportunity to get some food in your system which can help you feel more energized during your workout.

Whether you exercise for weight loss, stress relief, or one of the many other health benefits, it is important to be consistent. Schedule that time for exercise based on what works best for you — morning, noon, or afternoon. Your body’s internal clock will reset itself and your sleep habits and changes to meal times will either fall into place or can be adjusted based on when you decide to work up a sweat!

Do you have a fitness question for us? Leave a comment below!

Jennifer Bayliss is a fitness expert and coach at Everyday Health. She is a certified strength and conditioning specialist through the National Strength and Conditioning Association, a AFAAcertified personal trainer, and holds both an undergraduate and a graduate degree in exercise science.

U.S. Cancer Death Rate Continues to Fall

More Americans are surviving cancer than ever before, but as the population ages, even more will develop the disease.

That's the good and bad news from the 2017 Cancer Progress Report from the American Association for Cancer Research, released Wednesday.

According to the report, the cancer death rate dropped 35 percent among children and 25 percent among adults from 1991 to 2014. That translates to slightly more than 2 million fewer cancer deaths.

On the flip side, new cancer diagnoses are predicted to rise from nearly 1.7 million this year to 2.3 million in 2030, said the association's president, Dr. Michael Caligiuri.

And this year alone, more than 600,000 Americans are predicted to die from cancer, according to the report.

Caligiuri said the increase in cancer cases is simply a consequence of more people living longer. As the report noted, 53 percent of U.S. cancer diagnoses occur among those aged 65 and older, and that population segment is expected to grow from about 49 million in 2016 to just over 74 million in 2030.

"The longer people live, the higher the incidences of cancer are going to be," Caligiuri said.

"The longer you live, the more likely are the chances for serious genetic mutations that cause cancer, and the weaker your system is in repairing your DNA when you do have those genetic changes," he explained.

Dr. Anthony D'Amico is a professor of radiation oncology at Harvard Medical School in Boston. He said, "The most likely explanation for the progress in cancer survival is a combination of advances in cancer treatment coupled with early detection through screening."

The AACR report noted that death rates for many of the most commonly diagnosed cancers in the United States -- including breast, colorectal, lung and prostate cancer -- have been declining for more than a decade. But deaths from other forms of cancer -- brain, liver and uterine cancer -- have been increasing.

RELATED: 'Cancer Pen' Could Help Surgeons Spot Tumor Cells in Seconds

And progress has not benefited every American equally, the researchers noted. Disparities in cancer care continue between whites and blacks, the insured and uninsured, the poor and the elderly.

But there is progress in treatment. Between August 2016 and July 2017, nine new anticancer drugs were approved by the U.S. Food and Drug Administration, the report said. In addition, the FDA approved the use of eight existing drugs for fighting new cancers.

Two of the new drugs are immunotherapeutics, called checkpoint inhibitors. These treatments increase survival and improve the quality of life for patients with many types of cancer.

Progress was also seen in drugs that target specific cancer molecules. In fact, seven of the new drugs do just that, the researchers said.

The FDA also approved a new optical imaging agent to help doctors see brain tumors and more accurately guide their removal.

The keys to more progress in preventing and curing cancer include basic science to understand the biology of cancers, Caligiuri said, then making those findings relevant to cancer treatment through animal and early human trials. Next comes testing on many people to see how safe and effective these new treatments are, he added.

In addition, more studies are needed to better understand the risks for cancer and to develop ways to lower those risks. These include lifestyle changes -- such as not smoking, eating a healthy diet and exercising -- and screening to detect cancer early.

On the cancer prevention side, cigarette smoking declined by nearly 39 percent from 2000 to 2015, which should mean fewer cases of lung cancer in the future, the report said.

The researchers also said that, in the future, nearly all cases of cervical cancer and many cases of oral and anal cancer could be prevented if girls and boys received the human papillomavirus (HPV) vaccine.

Yet, only 63 percent of girls and fewer than 50 percent of boys had received at least one dose of HPV vaccine in 2015, the study reported.

According to D'Amico, "There is still a lot more to do, but we are going in the right direction in terms of discovery, screening and biology."

Cancer is not an inexpensive disease. Direct medical costs in 2014 were nearly $88 billion, the report said. This does not include the indirect costs, such as lost productivity from cancer-related care and death.

Yet the U.S. National Institutes of Health (NIH) received only $30 billion in funding for 2014, Caligiuri said. And of that total, only about $5 billion went to the U.S. National Cancer Institute.

Not surprisingly, Caligiuri believes that both the NIH and the FDA need more money to spend on cancer research and treatment if further progress in the fight against cancer is going to happen.

"The limiting step for more progress against this beast called cancer is funding," Caligiuri said. "The data clearly show that when we have the funding, we can make phenomenal progress."

Low Testosterone and Muscle Mass

Loss of muscle is called muscle wasting, and it’s a late sign of low testosterone. But even before you notice muscle wasting, you may feel weaker and less energetic,” says Ronald Tamler, MD, director of the Mount Sinai Diabetes Center in New York and an associate professor of medicine, endocrinology, diabetes, and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. “Muscle cells have receptors for testosterone called androgen receptors. When testosterone binds to the receptors, muscle fibers are maintained. Without testosterone, maintenance stops and muscle is degraded.”

10 Ways to Fight Chronic RA Pain

The aches and pains of rheumatoid arthritis can be hard to overcome, but these strategies may help in treating chronic pain.

From fatigue to loss of appetite, rheumatoid arthritis (RA) can impact your life in a number of ways, but the most limiting symptom for many people is pain. Because that pain comes in different forms, you may need more than one strategy to relieve it.

“The primary cause of rheumatoid arthritis pain is inflammation that swells joint capsules," says Yousaf Ali, bachelor of medicine and bachelor of surgery, an associate professor of medicine at the Icahn School of Medicine and chief of the division of rheumatology at Mount Sinai West Hospital in New York City. Joint capsules are thin sacs of fluid that surround a joint, providing lubrication for bone movement. In RA, the body's immune system attacks those capsules.

The first goal of pain relief is the control of inflammation, Dr. Ali explains. “Inflammation can cause acute (short-term) pain or longer-lasting smoldering pain," he says. "Chronic erosion of joint tissues over time is another cause of chronic pain. But there are many options for pain relief.”

Getting RA pain under control may take some work. You may find that you'll need to take several drugs — some to slow the joint damage and some to alleviate joint pain. Alternative therapies, like acupuncture, combined with drugs may help you to feel stronger. It may take some time, too. Try the following strategies — with your doctor's supervision — to discover which are most effective for you:

Treatments and Strategies to Help Relieve Chronic RA Pain

1. Inflammation Medication "In the case of RA, all other pain-relief strategies are secondary to controlling inflammation," Ali says. The No. 1 option in the pain relief arsenal is to control inflammation with disease-modifying anti-rheumatic drugs, called DMARDs. These drugs, which work to suppress the body's overactive immune system response, are also used to prevent joint damage and slow the progression of the disease. DMARDs are often prescribed shortly after a diagnosis in order to prevent as much joint damage as possible.

"The most commonly used is the drug methotrexate," he says. It's administered both orally and through injections. Digestive issues, such as nausea and diarrhea, are the most common side effect of DMARDs, and of methotrexate in particular, if taken by mouth. Hair loss, mouth sores, and drowsiness are other potential side effects. Methotrexate, which is taken once a week, can take about five or six weeks to start working, and it may be three to six months before the full effects of the drug are felt; doctors may also combine it with other drugs, including other DMARDs.

"Steroids may be used to bridge the gap during an acute flare," adds Ali. "If flares continue, we can go to triple-drug therapy, or use newer biologic drugs that are more expensive but also effective.” The most common side effect of biologics are infections that may result from their effect on the immune system.

The next tier of pain relief includes these additional approaches:

2. Pain Medication The best drugs for acute pain, Ali says, are nonsteroidal anti-inflammatory drugs, called NSAIDs. Aspirin and ibuprofen belong to this class of drugs, as does a newer type of NSAID called celecoxib. While NSAIDs treat joint pain, research has shown that they don't prevent joint damage. In addition, NSAIDs may irritate the stomach lining and cause kidney damage when used over a long period of time.

"Stronger pain relievers, calledopioids, may be used for severe pain, but we try to avoid them if possible," says Ali. "These drugs must be used cautiously because of the potential to build up tolerance, which can lead to abuse."

3. Diet Although some diets may be touted to help RA symptoms, they aren’t backed by the medical community. “There is no evidence that any special diet will reduce RA pain," Ali says. But there is some evidence that omega-3 fatty acids can help reduce inflammation — and the joint pain that results from it. Omega-3s can be found in cold-water fish and in fish oil supplements. A study published in November 2015 in the Global Journal of Health Sciences found that people who took fish oil supplements were able to reduce the amount of pain medication they needed.

4. Weight Management Maintaining a healthy weight may help you better manage joint pain. A study published in November 2015 in the journal Arthritis Care & Research suggested that significant weight loss can lower the need for medication in people with RA. Among the study participants, 93 percent were using DMARDs before they underwent bariatric surgery, but that dropped to 59 percent a year after surgery.

5. Massage A massage from a therapist (or even one you give yourself) can be a soothing complementary treatment to help reduce muscle and joint pain. A study published in May 2013 in the journal Complementary Therapies in Clinical Practice involved 42 people with RA in their arms who received either light massage or medium massage from a massage therapist once a week for a month. The participants were also taught to do self-massage at home. After a month of treatment, the moderate-pressure massage group had less pain and greater range of motion than the others.

6. Exercise Although you may not feel like being active when you have RA, and it might seem that being active could put stress on your body, gentle exercises can actually help reduce muscle and joint pain, too. “Non-impact or low-impact exercise is a proven way to reduce pain," Ali says. "We recommend walking, swimming, and cycling.” In fact, one of the best exercises you can do for RA is water aerobics in a warm pool because the water buoys your body.

The Arthritis Foundation also notes that yoga is another option to help reduce RA pain, and traditional yoga poses can be modified to your abilities. Yoga may also help improve the coordination and balance that is sometimes impaired when you have the disease. When it comes to exercise, though, it’s also wise to use caution. Talk with your doctor if any workouts are making your pain worse, and, in general, put any exercise plan on hold during an acute flare.

7. Orthoses These are mechanical aids that can help support and protect your joints. Examples include padded insoles for your shoes and splints or braces that keep your joints in proper alignment. You can even get special gloves for hand and finger RA. A physical therapist can help you determine the best orthoses options for you.

8. Heat and Cold Heat helps to relax muscles, while cold helps to dull the sensation of pain. You might find that applying hot packs or ice packs, or alternating between hot and cold, helps reduce your joint pain. Relaxing in a hot bath can also bring relief, as can exercising in a warm pool.

9. Acupuncture This Eastern medicine practice, which has been around for centuries, is thought to work by stimulating the body's natural painkillers through the use of fine needles gently placed near nerve endings. “I have found acupuncture to be helpful for some patients, but the pain relief is usually not long-lasting,” says Ali.

10. Transcutaneous Electrical Nerve Stimulation (TENS) TENS is a form of therapy that uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. “TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA,” Ali says. One of the benefits of this treatment is the low occurrence of side effects. If you're interested in trying it for pain relief, talk with your physical therapist.

Remember, you’re not alone — your doctor and specialists can help you find relief from chronic pain. If you’re experiencing more pain than before, or if pain is interfering with your ability to get things done, don’t hesitate to talk to your doctor. Ask your rheumatologist about pain relief options, like exercise, massage, yoga, and acupuncture, but remember that the first priority on your pain relief list should be to get RA inflammation under control.

Bullied Teens at Risk for Later Depression

Getting picked on at age 13 tied to raised odds of poor mental health at 18, U.K. researchers report.

Young teens who are bullied appear to be at higher risk of depression when they reach early adulthood, according to new research.

"We found that teenagers who reported being frequently bullied were twice as likely to be clinically depressed at 18 years," said Lucy Bowes, a researcher at the University of Oxford in England, who led the research.

The researchers found an association, not a definitive cause-and-effect relationship, Bowes said. "In our type of study, we can never be certain that bullying causes depression," she explained. "However, our evidence suggests that this is the case."

To explore the possible link, the investigators used data on nearly 4,000 teens in the Avon Longitudinal Study of Parents and Children, a community-based group born in the United Kingdom. At age 13, all completed a questionnaire about bullying. At 18, they were assessed for depression.

The study found that nearly 700 teens said they had been bullied "often" -- more than once a week -- at age 13. Of those, nearly 15 percent were depressed at age 18. More than 1,440 other teens reported some bullying -- one to three times over a six-month period -- at age 13. Of these, 7 percent were depressed at age 18. In comparison, only 5.5 percent of teens who weren't bullied were depressed at age 18.

RELATED: Living With the Scars of Bullying

Bowes also found the often-bullied teens tended to stay depressed longer than others. For 10 percent of those often-bullied who became depressed, the depression lasted more than two years. By comparison, only 4 percent of the never-bullied group had long-lasting depression.

Among the bullying tactics, name calling was the most common type, experienced by more than one-third of the teens. About one of four had their belongings taken. About 10 percent were hit or beaten up. Most never told a teacher and up to half didn't tell a parent. But up to three-quarters did tell an adult if the bullying was physical, according to the study published in the June 2 online edition of the BMJ.

Bowes noted that other studies have found the same bullying-depression link. If it does prove to be a causative factor, she added, bullying may account for 30 percent of those who develop depression in early adulthood.

In addition, the link held even when factors such as mental and behavioral problems and stressful live events were taken into account, Bowes said.

The research did not look at why bullying might increase the risk of depression or why some teens appear more vulnerable.

The study findings ring true in practice, said Gilda Moreno, a clinical psychologist at Nicklaus Children's Hospital and Baptist Hospital in Miami, who reviewed the findings.

Children who are bullied over time may develop a ''learned helplessness," she said. "It's not having the skills to stand up to the bullying. That's what may lead to the depression."

Because bullied children often don't tell their parents or teachers, Bowes said that parents need to be aware of potential signs. If a child is reluctant to go to school, parents should talk about why and ask about their relationships with friends, she suggested.

Bowes said parents should also believe their child if he or she complains about bullying, and follow up with the school administrators.

Loners are more likely than others to get picked on, Moreno added. Parents can encourage their kids to develop friendships, she said, to foster a kind of core support group.

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Why Some Seniors Lose Their Hearing

Do you have difficulty hearing conversations held in a noisy room? Do you have a harder time picking up women’s voices than men’s? Do you constantly ask others to repeat what they just said? If you answered ‘yes’ to these questions, you may be experiencing hearing loss — especially if you are 65 or older.

About 8.5 percent of adults between the ages of 55 and 64 suffer from hearing loss, according to the National Institute on Deafness and Other Communication Disorders. That number jumps to 25 percent for those 65 to 74, and it doubles to 50 percent for ages 75 and older. After high blood pressure and arthritis, hearing loss is the most common chronic condition affecting senior health.

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What Causes Hearing Loss?

As you age, you are at risk for two types of hearing loss. The most common type of hearing loss in seniors is presbycusis, or age-related hearing loss. A gradual loss of hearing that affects both ears, presbycusis occurs when tiny hairs in the ear, which are necessary for converting sound waves to sound, become damaged or die. Hearing loss from presbycusis is permanent because once these hairs are damaged or die, they are not replaced with new growth.

Related: 11 Early Signs of Dementia

The other type of hearing loss that seniors experience is tinnitus, or ringing in the ears. Tinnitus can be either permanent or temporary.

Risk Factors Related to Hearing Loss

A lifetime of exposure to loud noises such as music, motorcycles, or firecrackers can cause hearing loss in seniors. Noise-related hearing loss often results in tinnitus. Other causes of and risk factors for hearing loss experienced by seniors include:

  • Smoking
  • Allergies, high blood pressure, tumors, or stroke
  • Medications
  • A punctured eardrum
  • Viruses or bacteria
  • Earwax buildup

Your genes may also play a role in presbycusis, as it tends to run in families. Environmental factors like loud music and smoking make it difficult to determine the effect of genetics on age-related hearing loss; however, according to American Family Physician, an estimated 50 percent of age-related hearing loss is inherited.

Men are also more likely than women to develop hearing loss, and they’re more likely to develop it at an earlier age, says American Family Physician.

The Consequences of Hearing Loss

Losing hearing can have a significant effect on other aspects of your wellbeing. Researchers in a 2014 survey of 18,300 adults found that about 12 percent of participants with hearing loss had moderate to severe depression compared with about 5 percent of those with excellent hearing. The survey, which was published in JAMA Otolaryngology Head and Neck Surgery, also noted that women were particularly susceptible to depression related to hearing loss.

Hearing loss also appears to worsen cognitive functioning, according to a study published in the February 2013 issue of JAMA Internal Medicine. Among the nearly 2,000 seniors studied, hearing loss lowered cognitive functioning on some assessments as much as 41 percent more than it did among those without hearing loss.

Hearing Aids and Other Treatment Options

Though you can’t always fully prevent hearing loss, you can take steps to minimize or overcome it. Age-related hearing loss may be prevented or at least lessened by avoiding loud noises.

Because there is no known cure for age-related hearing loss, treatment is generally focused on improving your ability to function day to day. Your doctor may treat you or refer you to a hearing specialist such an otolaryngologist (or ENT, a medical doctor who specializes in the ear, nose, and throat) or an audiologist (a licensed professional who diagnoses and helps manage hearing problems). The cause and extent of your hearing loss will determine the course of treatment.

hearing aid may be one recommendation from your doctor or audiologist. Hearing aids can be beneficial for many, but according to the National Institute on Deafness and Other Communication Disorders, fewer than 30 percent of adults older than 70 who could benefit from a hearing aid have one. Hearing aids have come a long way over the years and are available in a variety of styles. A hearing aid and its battery will either fit behind the ear, on the ear, just inside the ear, or in the ear canal.

Types of hearing aids include:

  • Analog hearing aids that increase the volume of some sounds while lowering the volume of others
  • Digital hearing aids that allow you to determine which sounds to make louder or lower

Using assistive listening devices also can help compensate for hearing loss. These products either amplify sound, such as sound from telephones, televisions, and radio listening systems, or alert the user visually, such as with smoke detectors or alarm clocks.

 

 

Surgery may be another consideration. Cochlear implants are electronic devices with one part surgically implanted in the skin and the other part worn behind or in the ear. Used only for severe hearing loss, implants will not restore normal hearing, but they can make sounds louder. Because of the nature of the implants, they are not without risks — they pose the potential for infection, damage to the facial nerve, and tinnitus.

Speech or lip reading and sign language may be an answer for some seniors with hearing loss. Both of these techniques require training and practice and are generally recommended for those with severe hearing loss.

See your doctor as soon as you think you have a hearing problem. The loss of hearing could be a symptom of another medical condition. Seniors with untreated hearing loss are also more likely to suffer emotionally and socially when they areunable to interact with friends and family members. Left untreated, hearing loss could lead to deafness, and seniors who do not address their hearing loss put their lives at risk if they are unable to hear emergency warnings such as car horns or smoke alarms.

CBT Beats Light Therapy for Seasonal Depression

Cognitive therapy was aimed at 'getting people out of hibernation mode.'

Individuals with seasonal affective disorder (SAD) who participated in 6 weeks of daily cognitive-behavioral therapy (CBT) saw more improvement than those who used light therapy, with the advantage for CBT becoming apparent two winters post-intervention, researchers reported in AJP In Advance.

Two winters after receiving either CBT or light therapy, researchers found that those who received CBT experienced a smaller proportion of recurrence as measured the SIGH-SAD, a primary measure of SAD symptoms, as compared with those who received the light therapy (27.3 percent versus 45.6 percent, respectively), and larger proportion of remissions from SAD as defined by a score of  less then 8 on the Beck Depression Inventory-II (68.3 percent  versus 44.5 percent, respectively), according to Kelly Rohan, PhD, and colleagues from the University of Vermont.

For the study, Rohan and colleagues randomized 177 patients to receive either light therapy on a daily basis for 30 minutes upon waking or to receive CBT-SAD, a type of intervention that delivered psychoeducation, behavioral activation, and cognitive restructuring specifically targeting winter depression symptoms in group therapy sessions twice per week for 6 weeks.

Rohan told MedPage Today that CBT-SAD therapy involved "getting people out of hibernation mode so they approach rather than avoid winter... the activities do not necessarily need to be outdoors or involve communing with snow. They involve anything the person finds enjoyable that can be done in the winter to experience pleasure, rather than withdrawing and socially isolating oneself, which breeds depression." This could involve staying active in one's routines, such as going to the gym, maintaining hobbies, or developing new hobbies to take the place of summer-specific hobbies, or seeing people socially, for instance.

The following winter, researchers contacted study participants in both groups, asking them to resume the treatment they received during the previous winter under their own volition.

Those who received light therapy the previous winter received a letter asking them to resume the daily light therapy upon the onset of the first depressive symptom and those who received CBT-SAD were encouraged to use the skills taught to them the previous winter. Researchers instructed participants in both groups that if recommended strategies were insufficient to relieve symptoms of depression, they should pursue formal treatment, and included contact information for local mental health centers.

RELATED: How to Survive Daylight Saving Time and Shorter Days

Researchers conducted in-person visits in January or February of the first winter following the initial intervention as well as the second winter.

Responses to CBT the first winter after the intervention strongly predicted its effectiveness the following winter. Those who were depression-free the first winter following the intervention were markedly more likely to be depression-free during the second winter compared with those had still shown depression symptoms during the first winter.

In contrast, those who received light therapy who remained depression-free the winter following the intervention were only twice as likely to avoid recurrence during the second winter compared with those without a substantial initial response.

Light therapy has long been used as a treatment for SAD, but one major obstacle to success in treatment includes lack of compliance. In the study, only about a third of subjects reported continuing light therapy at each follow-up, which may have been in part due to study design, according to the authors.

Said Rohan, "In practice, these data indicate that there are options for treating SAD. If someone is willing not only to use light therapy to alleviate current symptoms, but also to keep using daily light therapy until spring and resume using it each fall/winter season, that is a viable option -- however, if someone is willing to work on their thoughts and behaviors in CBT-SAD over 12 sessions in a winter, that is also an option. Better yet, CBT-SAD is a treatment that might have longer-lasting benefits than light therapy in terms of lower risk for SAD recurrence and less severe symptoms two winters later."

Rohan said she hopes to get rates of depression recurrence even lower following SAD treatment in her next study. "This may involve early fall booster sessions to reinforce use of CBT-SAD skills as the seasons change," she noted, or for those who receive light therapy, a conversation regarding increasing compliance with the daily regimen to offset depression recurrence.

Herbal remedy isn't regulated, and can have side effects and serious drug interactions.

Herbal remedy isn't regulated, and can have side effects and serious drug interactions.

St. John's wort is a popular herbal therapy for depression, but a new Australian study highlights the fact that "natural" does not always equal "safe."

Using reports filed with Australia's drug safety agency, the researchers found that adverse reactions to St. John's wort were similar to those reported for the antidepressant fluoxetine -- better known by the brand name Prozac.

Those side effects included anxiety, panic attacks, dizziness, nausea and spikes in blood pressure, the researchers reported in the July issue of Clinical and Experimental Pharmacology and Physiology.

"It's concerning to see such severe adverse reactions in our population, when people believe they are doing something proactive for their health with little risk," lead researcher Claire Hoban, of the University of Adelaide, said in a university news release.

Research has shown that St. John's wort can help ease mild to moderate depression. But the fact that it works also means there is a risk of side effects, said Dr. Samar McCutcheon, a psychiatrist at Ohio State University Wexner Medical Center in Columbus.

"Even if the bottle says 'natural' or 'herbal,' it still has ingredients that are active in your body," said McCutcheon, who was not involved in the study.

It has long been recognized that St. John's wort can have significant side effects and interact with certain medications, McCutcheon pointed out.

But many consumers may not know that, she noted, largely because dietary supplements are not regulated in the way that drugs are.

"I definitely think this [lack of awareness] is still an issue," McCutcheon said. "People think St. John's wort is safe because they can buy it at a health food store."

In the United States, dietary supplements do not have to be studied for safety and effectiveness before they reach the market.

"Plus," McCutcheon said, "you're relying on companies to make sure these products include the ingredients they're supposed to, and keep out ingredients that they shouldn't."

The situation is similar in Australia, and many consumers there are unaware that supplements are largely unregulated, according to Hoban's team.

RELATED: 7 Supplement Risks Every Woman Should Know About

The researchers based their findings on doctors' reports to Australia's national agency on drug safety. Between 2000 and 2013, there were 84 reports of adverse reactions to St. John's wort, and 447 reports on Prozac.

But since those are voluntary reports, they do not reflect the actual rate of side effects from either therapy, according to the researchers. And, Hoban said, bad reactions to St. John's wort are particularly likely to go unreported, since the herb is often not even considered a drug.

According to McCutcheon, it's important for people with depression symptoms to see a health professional before self-medicating with St. John's wort. "That will help ensure you have the right diagnosis," she said.

If your symptoms are actually part of a different disorder, St. John's wort may be ineffective -- or possibly even risky. For example, McCutcheon said that in people with bipolar disorder, the herb might fuel a manic episode.

But possibly the biggest concern, she said, is the potential for St. John's wort to interact with commonly used medications.

The herb can dampen the effectiveness of birth control pills, blood thinners and heart disease drugs, along with some HIV and cancer drugs, according to the U.S. National Center for Complementary and Integrative Health.

What's more, it can interact with antidepressants. It's not clear exactly how St. John's wort works, McCutcheon said, but it's thought to boost levels of the brain chemical serotonin -- which is how the most commonly used antidepressants work.

"If you use the two together, you run the risk of having too much serotonin," she said. And that raises the risk of a potentially fatal condition called serotonin syndrome, whose symptoms include confusion, tremors, diarrhea and a drop in body temperature.

Some side effects of St. John's wort are caused by the herb itself, such as skin rash that's worsened by sunlight, said Dr. John Reed, director of inpatient services at the University of Maryland's Center for Integrative Medicine in Baltimore.

But the main concern is still its potential for interacting with other medications, he said. "Compared with other herbs, St. John's has more drug interactions," Reed explained. "So if you're using it, don't take other medications unless it's under medical supervision."

He added that anyone on any medication should do some homework before starting an herbal product. "Go online and do a search for drug interactions. Ask your pharmacist or doctor," Reed advised.

"Unfortunately," he said, "this type of information [on drug interactions] doesn't have to be printed on product labels."

The bottom line, according to McCutcheon, is that people with depression should talk to their providers about any supplements they take, or want to take. And those providers, she said, should be willing to have nonjudgmental discussions.

"I want all my patients to be comfortable enough to bring up anything with me," McCutcheon said.

Exposure Therapy: A Surprisingly Effective Treatment for Depression

Exposure therapy isn’t just a treatment for post-traumatic stress disorder. It’s also used to treat anxiety, depression, phobias, and more.

If you’ve experienced a traumatic, life-altering event, you might be surprised to learn that one treatment for such trauma — exposure therapy — involves repeatedly reliving the terrible event.

Sounds more harmful than helpful, right? But people who experience their fears over and over again — with the help of a therapist in exposure therapy — can actually learn to control those fears.

The technique is used to treat a growing list of health conditions that include anxiety, phobias, obsessive compulsive behaviors, long-standing grief, and even depression.

How Exposure Therapy Works

Exposure therapy can seem similar to desensitization. People with PTSD, including combat veterans and rape and assault survivors, may experience nightmares and flashbacks that bring the traumatic event back.

They may also avoid situations that can trigger similar memories and may become upset, tense, or have problems sleeping after the trauma.

Edna B. Foa, PhD, director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania in Philadelphia, explains exposure therapy for PTSD to her patients this way: "We are going to help you talk about the trauma so that you can process and digest it, and make it finished business."

While you won't forget about the trauma entirely, she tells them, ''It’s not going to haunt you all the time."

Dr. Foa reassures her patients that they won't be exposed to dangerous situations. She also tells them, "You are going to find out that you are stronger than you think."

Although exposure therapy is considered a short-term treatment — 8 to 12 sessions is common — people with more severe conditions (and those with obsessive-compulsive behaviors) may need more time.

Exposure Therapy Works for Many Conditions

For PTSD, says Matthew Friedman, MD, PhD, senior adviser for the Department of Veterans Affairs' National Center for PTSD, and professor of psychiatry, pharmacology, and toxicology at Dartmouth College's Geisel School of Medicine in Hanover, New Hampshire, "It’s one of the best treatments we have.” A 2007 report from the Institute of Medicine also found the technique to be effective for PTSD.

Foa published a study in the Journal of Consulting and Clinical Psychology that showed a reduction in depression and PTSD symptoms in female survivors of assault after 9 to 12 sessions.

And a 2014 study in JAMA Psychiatry found that adding exposure therapy to cognitive behavioral therapy (CBT) was more effective at relieving long-standing grief than CBT plus supportive counseling.

Effective, But Different, as a Depression Treatment

While research is still ongoing, some experts believe exposure therapy can be helpful for serious depression, too. Depression and PTSD share common features, like flashbacks and memory flooding, says Adele Hayes, PhD, professor of psychology at the University of Delaware in Newark. But there are some important differences, too.

“With depression, it's not necessarily a trauma, but a whole store of memories associated with being a failure, worthless, and defective," she says. A depressed person’s encounter with a rude clerk at a store may trigger thoughts that seem to back up their fears: that no one likes them, that they are worthless, and so on.

RELATED: 6 Life-Changing Tips From People Living with Depression

In 20 to 24 sessions of exposure therapy, Hayes persuades her patients with depression to reexamine the events that trigger their ''worthless'' messages. Then she asks them to see if they can reinterpret them in a more positive light. Next, she helps them build up what she calls the ''positive emotion system."

But some people with depression may be fearful of having positive emotions, she says. Paradoxically, if they start to have hope, they may begin to fear that things may fall apart again and get more depressed.

Getting Started With Exposure Therapy

"The first few sessions are distressing," says Foa, but the distress of exposure therapy usually lasts for only three or four weeks. Plus, patients usually work their way up to scarier situations by first tackling challenges that are somewhat less scary. For instance, someone with a social phobia or fear of public places may be advised to go to a supermarket during a time when it’s not busy. After that, they may visit the store when it’s more crowded. At first, it's natural to feel upset, Foa says. But "if you stay long enough, the anxiety will go down," she says. "In the beginning, you’re afraid you won't be able to tolerate it, but in the end, you’re a winner."

Homework is an important part of exposure therapy, so you’ll also do exercises outside of your sessions, Dr. Friedman says. This could include listening to a recording of your account of the trauma or performing a task that could trigger memories of the event. At your next visit, you’d talk through your experiences with your therapist.

Before you begin exposure therapy, make sure to get a clear explanation of what to expect from the therapist you’re working with.

To find an exposure therapy specialist, start by asking your family doctor for a referral, or contact organizations like the American Psychological Association or the Association for Behavioral and Cognitive Therapies that can help you locate one. Veterans can contact their local VA clinic for more information.

10 Winter Foods for Depression

1 / 11   Boost Your Mood With Seasonal Bounty
It’s winter, and depending on where you live, it could be very cold and gray, with sunshine in short supply. The winter doldrums plus holiday high anxiety make this season especially stressful and depressing for many people. But you might be able to eat your way to a better mood. Load your plate with these winter foods for depression to lift your spirits.

Moving Just 1 Hour a Week May Curb Depression Risk

Career couch potatoes, take heart: Just one hour a week of any kind of exercise may lower your long-term risk for depression, new research suggests.

The finding comes from a fresh analysis of a Norwegian survey that tracked exercise habits, along with depression and anxiety risk, among nearly 34,000 adults.

After a closer look at the data, a team of British, Australian and Norwegian analysts determined that people who engage in just an hour of exercise per week -- regardless of intensity level -- face a 44 percent lower risk for developing depression over the course of a decade than those who never exercise at all.

"The key finding from this study is that doing even a small amount of regular exercise seems to protect adults against future depression," said study author Samuel Harvey.

"This was not a case of more is better; the vast majority of the mental health benefits of exercise was realized when individuals moved from doing no regular activity to 1 or 2 hours per week," Harvey explained.

"Also, the mental health benefits were there regardless of the intensity of the physical activity," he added. "There is great evidence that there are many physical health benefits to more regular exercise, but the mental health benefits leveled out after 2 hours."

RELATED: 7 Common Myths About Depression

Harvey is an associate professor with the School of Psychiatry at the University of New South Wales, in Sydney, Australia. "The important point here is that any type of physical activity -- even just walking -- had similar levels of mental health benefits," he concluded.

The original survey was launched between 1984 and 1986. In that timeframe, participants (who were about 45 years old, on average) underwent physical exams, and filled out lifestyle and medical questionnaires. Mental health assessments were also completed.

The Norwegian pollsters conducted a follow-up survey between 1995 and 1997 among roughly two-thirds of the original participants.

About 7 percent of those tracked through 1997 had developed depression, while about 9 percent had developed clinical levels of anxiety, the findings showed.

Exercise did not appear to have any impact on anxiety risk. But investigators found that, regardless of gender or activity intensity, regular exercise lasting at least an hour per week was linked to a lower risk for developing depression over time.

The study authors calculated that roughly 12 percent of the depression cases might have been prevented if those who had become depressed had previously routinely engaged in one hour of low-intensity activity a week.

Exercising more than one hour per week did not, however, appear to substantially decrease depression risk even further; the lion's share of the protective impact appeared to max out at the one-hour mark.

But as to how and why such a minimal amount of regular exercise might help stave off depression, the study team wrote that "the bulk of the observed protective effect remains unexplained." And the study did not prove a cause-and-effect relationship between exercise and lower risk of depression.

Harvey and his colleagues reported their observations in the Oct. 3 issue of the American Journal of Psychiatry.

Simon Rego, chief psychologist at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said that "there are probably many mechanisms at play that could explain how this works. But it doesn't have the same effect on anxiety, so we just don't know yet exactly what's happening."

However, Rego added, "What we do know is that what they've identified is a very low bar of entry. We're talking about just an hour of activity a week. And it doesn't have to be vigorous or intense. You don't need to go out to a spin class or sign up for a running club. This could just be getting people who aren't moving much to just increase their daily walking habit. That's all."

So, he explained, "while we don't have all the definitive answers yet, this is a very promising finding because this is something many people may find easy to do."

9 Diet Hacks Nutritionists Use Every Day

1 / 10   Think Like a Nutritionist With These Simple Tips

Whenever we have a diet or nutrition question, we call on a dietitian or nutritionist to lead us in the right direction. Although you may picture them noshing on raw veggies and sipping water all day, they aren’t always perfect — they enjoy dining out, battle the munchies, and love dessert just like the rest of us! The difference is they know the insider tips to shave calories off comfort food favorites, satisfy cravings the healthy way, and pack more nutrition into each meal. Make their tricks second nature and soon you’ll be an expert at keeping the flavor you crave, while slimming down your meals and your waistline

How to Prevent Hearing Loss

Do you have trouble following a conversation in a noisy room? Do other people complain that you have the television turned up too loud? If the answer to either of those questions is yes, you may already have some degree of hearing loss.

Hearing loss can start at any age. According to the National Academy on Aging and Society, the number of affected Americans between the ages of 45 and 64 has increased significantly since 1971. But it’s much more common in seniors: Some 40 percent of the 20 million Americans who have hearing loss are 65 or older.

Contrary to popular belief, however, hearing loss is not an inevitable part of aging. Some causes of hearing loss can be prevented, and most types of hearing loss can be helped.

Types and Causes of Hearing Loss

There are three basic types of hearing loss:

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  • Sensorineural hearing loss is caused by damage to the inner ear nerves or the nerves that carry sound to the hearing area of the brain. Once you have this type of nerve damage, the only treatment is a hearing aid. Causes of sensorineural hearing loss include injuries, tumors, infection, certain medications, and excessive noise exposure.
  • Conductive hearing loss is caused by a condition that blocks sound waves from being transferred to the nerves involved in the hearing process. Whereas sensorineural hearing loss usually affects both ears, conductive hearing loss may only affect one ear. Common causes include ear infections, ear wax, ear trauma such as a punctured eardrum, and other diseases that affect the ear canal, the eardrum, or the tiny bones in the middle ear. Unlike sensorineural hearing loss, this type of hearing loss can often be corrected and restored.
  • Mixed hearing loss occurs when someone who has nerve type hearing loss from aging or noise trauma then gets an ear infection or develops a wax impaction, causing their hearing to suddenly get much worse. It’s a combination of sensorineural hearing loss and conductive hearing loss.

Hearing Loss Evaluation

If you are having trouble hearing or develop sudden deafness, you need to get your hearing checked as soon as possible. Sudden deafness is a serious symptom and should be treated as a medical emergency. For many people, though, hearing loss may be gradual and not obvious. Here are seven warning signs to watch out for:

  • You have trouble hearing while on the telephone.
  • You can’t seem to follow a conversation if there is background noise.
  • You struggle to understand women’s or children's voices.
  • People complain that you turn up the TV volume too high.
  • You constantly ask people to repeat themselves.
  • You have a long history of working around loud noises.
  • You notice a ringing, hissing, or roaring sound in your ears.

 

 

If you think you have any kind of hearing loss, the place to start is with your doctor. Whether your hearing loss is gradual or sudden, your doctor may refer you to an audiologist (a medical specialist in hearing loss) or an otolaryngologist (a medical doctor specializing in disorders of the ear).

 

 

Depending on the cause and type of your hearing loss, treatment may be as simple as removing ear wax or as complicated as reconstructive ear surgery. Sensorineural hearing loss can't be corrected or reversed, but hearing aids and assistive devices can enhance most people’s hearing. For those with profound hearing loss approaching deafness, an electronic hearing device, called a cochlear implant, can even be implanted in the ear.

Tips for Hearing Loss Prevention

One type of hearing loss is 100 percent preventable: that due to noise exposure. Noise is measured in units called decibels: Normal conversation is about 45 decibels, heavy traffic may be about 85 decibels, and a firecracker may be about 120 decibels. Loud noise — anything at or above 85 decibels — can cause damage to the cells in the inner ear that convert sound into signals to the brain. Here are some tips for avoiding noise-induced hearing loss:

  • Minimize your exposure to loud noises that are persistent.
  • Never listen to music through headphones or ear buds with the volume all the way up.
  • Wear ear plugs or protective earmuffs during any activity that exposes you to noise at or above 85 decibels.
  • See your doctor about a baseline hearing test, called an audiogram, to find out if you already have some early hearing loss.

You should also see your doctor if you have any symptoms of ear pain, fullness, or ringing, or if you experience any sudden change in your hearing. These symptoms could be early warnings of preventable hearing loss.

Hearing loss or deafness can have a serious effect on social well-being. It can cut you off from the world around you. Know the causes of hearing loss, and practice hearing loss prevention to preserve the hearing you still have.

What You Need to Know About Hyperpigmentation

Even small skin traumas like a pimple or bug bite can leave you with complexion-busting dark spots. “This is one of the most common ailments that patients come to see me about,” explains Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “It’s an annoying condition that affects all skin types, but the good news is that it’s fairly easy to treat.”

Find out how Dr. Downie helps patients treat and avoid marks on their complexions.

Everyday Health: What causes hyperpigmentation?

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Jeanine Downie: Any trauma or inflammation to the skin — either from acne, pimples, bug bites, or simply a bump, cut, or scratch — disrupts the surface layers where you have melanin, responsible for skin’s color. As the skin heals, it leaves behind residual pigmentation and dark spots.

 

 

 

EH: Is there anything you can do to prevent it?

JD: Unfortunately, if you’re prone to these dark spots, it’s tough to prevent them. Still, picking or scratching at an irritation will further traumatize the area, so hands off! You’ll also want to be vigilant about wearing sunscreen. As your skin gets darker, so will those hyperpigmented areas — it’s not like a tan is going to even out the color. Obviously, daily sunscreen wear is a must anyway, but this is just one more reason to protect your skin from UV rays.

EH: What steps can you take to treat it?

JD: The sooner you start taking care of your wound, the better it’ll look once healed. I recommend keeping the wound covered, especially if the skin is broken, and applying a topical healing ointment.

 

 

For large cysts or cuts, you may even want to see your dermatologist for a treatment plan. Once the pimple or cut has healed, apply 2% hydroquinone cream, which is available over-the-counter, or 4% hydroquinone, available by prescription from your doctor.

If the topical creams don’t quite do the trick, talk to your dermatologist about chemical peels or laser treatments to completely eliminate more stubborn discoloration.

EH: Is hyperpigmentation more common in people with darker complexions?

JD: No matter your skin color, everyone is susceptible to hyperpigmentation. Still, those with darker complexions seem to hold on to those spots for much longer because they have more melanin in their skin. It also means those hyperpigmented areas are going to be darker and more visible as well. Pregnancy and certain medications can increase your body’s production of melanin, and lead to hyperpigmentation as well.

Breast Cancer Awareness Month 2017

October is Breast Cancer Awareness Month, an annual campaign to raise awareness of breast cancer risks, the value of screening and early detection, and treatment options available to women and men who are diagnosed with one of the many forms of breast cancer. More than 249,000 people in the United States are diagnosed with invasive breast cancer every year, and nearly 41,000 die from the disease.

Over the years, a loop of pink ribbon has come to symbolize breast cancer awareness, and today the image of a pink ribbon can be found emblazoned on thousands of products, from apparel to dishware to office supplies. But there's more to awareness than just wearing pink.

What Is Guillain-Barré Syndrome?

Guillain-Barré syndrome (GBS) is an illness that can result in muscle weakness or loss of muscle function in parts of the body.

In people with Guillain-Barré syndrome (pronounced GHEE-yan ba-RAY), the body's own immune system attacks the peripheral nervous system.

The peripheral nervous system includes the nerves that connect the brain and spinal cord to the limbs. These nerves help control muscle movement.

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 or 2 out of every 100,000 people develop GBS each year in the United States.

Anyone can get GBS, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS each year.

Causes and Risk Factors

Doctors don't know what causes Guillain-Barré syndrome.

Many people with GBS report a bacterial or viral infection (such as the flu) days or weeks before GBS symptoms start.

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.

Types of GBS

There are several types of Guillain-Barré syndrome, which are characterized by what part of the nerve cell is damaged.

The most common type of GBS is called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

In AIDP, the immune system mistakenly attacks the protective nerve covering that helps transmit nerve signals from the brain to other parts of the body.

Guillain-Barré Syndrome Symptoms

The first symptoms of Guillain-Barré syndrome often include feelings of tingling or weakness in the feet and legs. These feelings may spread to the arms and face.

The chest muscles can also be affected. Up to a quarter of people with GBS experience problems breathing.

In very severe cases, people with GBS may lose all muscle function and movement, becoming temporarily paralyzed.

Signs and symptoms of Guillain-Barré syndrome may include:

  • Pricking or tingling "pins and needles" sensations in the fingers, toes, ankles, or wrists
  • Muscle weakness that starts in the legs and spreads to the upper body
  • Unsteady walking
  • Difficulty with eye or facial movements (blinking, chewing, speaking)
  • Difficulty controlling the bowels or bladder
  • Rapid heart rate
  • Difficulty breathing

5 Reasons Why Skin Cancer Surgery Isn’t So Scary

Veva Vesper has dealt with more than her fair share of skin cancer in the last 25 years. The 69-year-old Ohio resident has had more than 500 squamous cell carcinomas removed since the late 1980s, when the immunosuppressant medication she was taking for a kidney transplant caused her to develop them all over her body — everywhere from the corner of her eye to her legs. 

While Vesper’s story is unusual, skin cancer is the most common cancer in the United States. In fact, it’s currently estimated that one in five Americans will get skin cancer in his or her lifetime.  

Mike Davis, a 65-year-old retired cop, and like Vesper, a patient at The Skin Cancer Center in Cincinnati, Ohio, has a more familiar story. Earlier this year, he had a basal cell carcinoma removed from his left ear — the side of his face most exposed to UV damage when driving on patrol. 

The buildup of sun exposure over your lifetime puts you at greater risk for developing basal and squamous cell skin carcinomas as you age. Both Vesper and Davis had Mohs surgery, the most effective and precise way to remove the two most common types of skin cancer.