Side Effects of Multiple Sclerosis Medications
Twelve disease-modifying medications are FDA-approved to treat relapsing forms of multiple sclerosis (MS). Specifically, these drugs help prevent relapses and slow progression of the disease.
The newest disease-modifying medications are called “immunomodulators” because they affect the functioning of your immune system.
“All these therapies highlight the increased choices and options for patients living with MS, and the ability of physicians to select a therapy based on individual characteristics,” says Ari Green, MD, assistant clinical director of the UCSF Multiple Sclerosis Center and director of the UCSF Neurodiagnostics Center in San Francisco.
But all drugs can have adverse side effects, and those associated with MS medications range from mild (such as flu-like symptoms or irritation at an injection site) to serious (such as progressive multifocal leukoencephalopathy [PML], a viral disease in the brain).
One of the challenges of MS treatment is balancing risk and benefit, says Dr. Green. Stronger medications might be more effective at slowing progression of the disease, but they may also be associated with more risks.
Discussing Medication Side Effects With Your Doctor
"A doctor has to have a frank and open discussion to find out what is tolerable for patients," says Green. "Some side effects go away as the body gets used to MS medications, but others, such as irritation where the injection takes place, do not."
Because people experience side effects differently, each individual has to decide which side effects he or she can live with, he adds.
In some cases, what are thought to be drug side effects may actually be MS symptoms. Fatigue and headache, for example, may be either.
Keeping a detailed log of your symptoms can help your doctor determine whether you are experiencing a symptom of multiple sclerosis or a medication side effect.
Make a note of when your symptom began, how long it lasted, what might have triggered it, and whether anything you did eased the symptom.
“The more patients are engaged in keeping track of things, the more they can be positively and appropriately engaged in directing their own care,” says Green. This information can also help your provider select appropriate therapies in the future.
Managing MS Medication Side Effects
Some simple steps can often help you manage the most common side effects of MS medications:
Infection risk Some of the immunomodulatory medications increase your risk of common infections, so it’s important to practice prevention strategies such as washing your hands frequently and limiting your contact with people who are ill.
Flu-like symptoms Fever, chills, achiness, and feeling generally under the weather are not uncommon following interferon beta injections, leading some users to stop the medication. Interferon beta medications include Betaseron, Extavia, Avonex, Rebif, and Plegridy.
According to nurses with expertise in MS care, the following steps can help to manage these side effects:
Staying hydrated
Eating healthfully
Taking medications before sleep
Warming injectable medicines up to body temperature before injecting
You can also take a small dose of Advil, Motrin, or Nuprin (ibuprofen) an hour before and an hour after your injection. Tylenol (acetaminophen), Aleve (naproxen), or Benadryl (diphenhydramine) may also help ease these side effects, Green says.
RELATED: 7 Side Effects of MS Steroid Treatment
Injection-site irritation Applying ice to your injection sites before injections, and a warm compress afterward, can help ease any irritation.
Some people may also benefit from some retraining on the finer points of giving themselves injections, notes Green. This is especially true because most people learn how to give self-injections right after their diagnosis — a period when they’re undoubtedly absorbing lots of information about the disease.
If you’re having trouble injecting your MS medication, speak to your healthcare provider about working with an MS nurse for training in self-injections.
Heart health The medication Gilenya (fingolimod) is known to slow some users’ heart rate within the first six hours after the first dose. Because of this, your doctor may advise you to have your first dose in a clinical setting, where your pulse and blood pressure can be monitored.
Distinguishing Side Effects From Symptoms
The immediate side effects of MS medications may be more apparent once you experience them. Immediate side effects, such as flu-like symptoms and chills, are easy to discern, says Green. Even the muscle aches and pains that can occur immediately after taking disease-modifying MS medications differ from the pain associated with multiple sclerosis.
The one rare medication side effect that might be hard to distinguish from an MS symptom is PML, which has been related to use of the drug Tysabri (natalizumab). PML, however, will progress much more quickly than multiple sclerosis — a good reason to stay on top of your medical checkups.
Ongoing Medication Monitoring
Most of the medications prescribed for MS require regular blood tests to keep track of the treatment’s effect on your body, including your liver.
The drug Lemtrada (alemtuzumab) requires blood and urine monitoring before, during, and for four years after treatment is given to watch for serious autoimmune conditions associated with the drug.
In addition to monitoring for side effects, you and your doctor should monitor for positive effects of drugs as well. Green says that a change in therapy is needed if you are having more than one MS relapse a year, if multiple new brain lesions are seen on your MRI, or if your symptoms are progressing despite treatment. Switching medications is a decision you and your doctor should make together.
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."
Psoriatic Arthritis Types
www.PsoriaticInfo.com
Learn About The Different Types
of Psoriatic Arthritis Today.
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.
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:
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:
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?
Get AS Treatment Info Today
www.Ankylosing-Spondylitis-Info.com
Get Information About A Medication
For AS & Find A Doctor Near You.
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.”
Psoriatic Arthritis
www.PsoriaticInfo.com
Living With PsA Could Mean Living
With Joint Damage. Learn More Now.
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.
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.
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:
Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.
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.
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:
What Is Binge Eating Disorder?
"" style="box-sizing: border-box; margin: 0px auto !important; border: 0px; vertical-align: bottom;">
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:
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:
Some people also display behavioral, emotional, or physical characteristics, such as:
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:
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.
Psoriatic Arthritis
www.PsoriaticInfo.com
Living With PsA Could Mean Living
With Joint Damage. Learn More Now.
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.
“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.
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.
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.
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.
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.”
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
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.
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.”
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.
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.
Psoriatic Arthritis
www.PsoriaticInfo.com
Living With PsA Could Mean Living
With Joint Damage. Learn More Now.
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:
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:
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 factors. These include:
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.
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.
There are three basic types of hearing loss:
RA Signs And Symptoms
www.ratreatment.com
Learn About RA Signs And Symptoms,
And Find A Treatment Option Now.
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:
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.
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:
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.
6 Things I Didn't Know About Depression Until It Happened to Me
If you or a loved one has been diagnosed with depression, these insights from people who are successfully managing their own depression may help you.
Depression can make you feel alone and isolated, but in reality you aren't. Many other people live with depression every day, and you can learn a lot from them. Here, three people diagnosed with depression share insights they’ve gained along the way.
1. It's Not Your Fault
For the longest time, "I felt like something was wrong with me," says Marisa McPeck-Stringham, 37, a social worker in Ogden, Utah, who blogs about her life, including her depression, as Iron Daisy. She first noticed as a teen that she was sometimes down in the dumps, but she wasn't diagnosed until age 20, she says. Before the diagnosis, she would ask herself: What's wrong with me? She knew she had a good family, a good home, and great parents. "I didn't know it was a mental illness," she says. "I didn't know it was a problem with my brain chemistry."
That reaction is a common one, says Michelle B. Riba, MD, associate director of the University of Michigan Comprehensive Depression Center in Ann Arbor and past president of the American Psychiatric Association. Patients often tell her they think they did something to bring on the depression, and that they could have been stronger.
Dr. Riba tells her patients, "It's a medical condition and has to be treated like a medical condition." Anyone diagnosed with depression must be evaluated to see which treatment or combination might work for them, Riba says.
2. Being Depressed Takes a Lot of Energy
Elizabeth Moon, 70, of Austin, who wrote Crown of Renewal and other books, was diagnosed in the early 1980s. She didn't understand until after she got a diagnosis and was treated how exhausted she had been from trying to keep up with her life. "I didn't realize how long I had been depressed," she says.
"I was active, very physically active," says Moon. "I didn't think of myself as depressed; I didn't realize I was sliding into depression."
RELATED: 5 Things Psychologists Wish Their Patients Would Do
“Not everyone fits the stereotype of sitting on the couch," unable to do anything, she says. "If you’re feeling worthless, like you have no future — even if you appear to be healthy and holding down a full-time job, get checked out.”
"People may not pinpoint [depression symptoms] right away," Riba says of those who get depressed. They may think they’re sleep deprived, for instance, or just have some temporary issues balancing responsibilities.
3. Exercise Has Been Proven to Help With Symptoms
Often, the last thing you want to do if you’re depressed is go out and get some exercise. But those who’ve been there understand the value of exercise, and say it often helps. "If I don't get out and exercise, I have to really watch myself and make sure I’m not sliding," Moon says. "I do much better if I’m active. I have much less chance of sliding into another episode."
RELATED: The Real Monthly Cost of Depression
Exercise ''readjusts our brain chemistry," says McPeck-Stringham. She includes exercise as part of her "self-care" routine. Her workouts also become valuable "me" time, she finds.
And there is good evidence that exercise improves your mental health. A study published in 2014 in JAMA Psychiatry found that exercise does lower your chance of becoming depressed. And in people who already have depression, exercise helps lift depressive symptoms.
4. Writing Helps You Sort Out Your Emotions
Keola Birano, 33, of Hilo, Hawaii, is a full-time writer who also works for his wife's clothing business. Diagnosed at age 19, he soon learned the power of writing — not for his livelihood, but for his depression. First, he wrote a letter to his father and ''without giving it to him," burned it. "It released whatever [negative] feeling I may have held onto," he says.
He has continued writing, both for his blog, Keola Birano Reimagined, and for personal growth. "When you write, it opens up parts of your brain you didn't know were there,'' he says. "I try to do 10 minutes a day on autopilot, to let the feelings out."
5. Managing Depression Is an Ongoing Effort
"It takes a lot of significant work to keep yourself strong," Birano says. "You have to keep working on it. Once you start thinking you have it beat, you set yourself up for failure."
Moon agrees. "I can go downhill in 30 seconds,'' she says. "I've learned to have a plan in place when that happens," she says. Part of her plan is to keep tabs on her mental health before that slide downhill. "At least five times a year, I take the Beck Depression Inventory [a tool used by mental health experts] and see where I am. If I’m coming up [on the score], I need to be very careful. If the score doesn't go back down, I may need meds."
RELATED: 10 Foods I Eat Every Day to Beat Depression
For her, the best approach has been to take medications when needed and then taper off them, she says, but she doesn’t claim this is best for everyone. It’s important to remember that decisions to stop or start medications should always be done in conjunction with your physician.
6. Having a Depression Relapse Doesn’t Mean You Failed
"Right now, I’m in between episodes," Moon says. "I know another one may come and it isn't a disaster when it does come. It doesn't mean you’ll end up committing suicide either."
Figuring out what works for you to stay on an even keel is critical, Moon says. The most important thing for anyone who's depressed? "Recognize when you’re falling off the cliff," she says. Then go get the help you need and deserve.
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.
Psoriatic Arthritis
www.PsoriaticInfo.com
Living With PsA Could Mean Living
With Joint Damage. Learn More Now.
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.
“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.
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.
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.
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.
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.”
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
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.
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.”
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.
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.”
Sleep Apnea May Raise Risk of Depression
People with sleep apnea are at increased risk for depression, but continuous positive airway pressure (CPAP) therapy for their apnea may ease their depression, a new study suggests.
The Australian study included 293 men and women who were newly diagnosed with sleep apnea. Nearly 73 percent had depression when the study began. The worse their apnea, the more severe their depression.
However, after three months, only 4 percent of the 228 apnea patients who used CPAP for an average of at least five hours a night still had clinically significant symptoms of depression.
At the start of the study, 41 patients reported thinking about harming themselves or feeling they would be better off dead. After three months of CPAP therapy, none of them had persistent suicidal thoughts.
The study appears in the September issue of the Journal of Clinical Sleep Medicine.
"Effective treatment of obstructive sleep apnea resulted in substantial improvement in depressive symptoms," including suicidal thoughts, senior study author Dr. David Hillman said in a journal news release. Hillman is a clinical professor at the University of Western Australia and a sleep physician at the Sir Charles Gairdner Hospital in Perth.
RELATED: 6 Things People With Sleep Apnea Wish You Knew
"The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression," he added.
People with symptoms of depression should be screened for sleep apnea by being asked about symptoms such as snoring, breathing pauses while sleeping, disrupted sleep and excessive daytime sleepiness, the researchers said.
Sleep apnea affects at least 25 million American adults. Untreated sleep apnea increases the risk of high blood pressure, heart disease, stroke, type 2 diabetes and depression, according to the American Academy of Sleep Medicine.
Healthy Pizza? It’s Possible With These 5 Recipes.
For many people, pizza tops the list of favorite foods. Not only is the drool-worthy combo of cheese, bread, and sauce satisfying, but it’s one of the easiest meals to pick up (or have delivered) from your local pizzeria. While your favorite slice may be delicious, it can be easy to go overboard on sodium-laden sauce, toppings, and high-calorie crusts. Luckily it’s just as easy — and delicious — to pop a homemade pie into the oven. With a few simple swaps and key ingredients, you can give your favorite comfort food a wholesome makeover without skimping on flavor. So whether you’re craving a fresh-out-of-the-oven slice or just looking for a hassle-free weeknight meal, these five healthy and delicious pies are better than delivery!
9 Allergy Safe Beauty Products
For a hypoallergenic beauty product to plump up your lashes, Van Dyke suggests Almay Thickening Mascara. It's affordable, available at mass-market stores, and a great beauty product to avoid skin allergy reactions. Almay products go through rigorous testing to avoid allergens and irritants and maintain the brand's reputation for hypoallergenic beauty products, says Van Dyke. "It is hard to beat Almay for dermatologist-approved makeup, particularly around the eye," she adds.
Risk of Preemie Birth May Rise for Depressed Parents-to-Be
Treating expectant mothers -- and fathers -- might help prevent early birth, study suggests.
It's known that an expectant mother's mental and emotional health can affect her baby. New research, however, finds that depression in either the father or the mother may be linked to an increased likelihood of preterm birth.
Screening for and treating mental health problems in both parents may help reduce the odds of a preterm delivery, according to study author Dr. Anders Hjern and his colleagues.
"Depressive fathers influence the stress hormone balance in the mother, and depression may also -- but this is more speculative -- have an effect on sperm quality," said Hjern, professor of pediatric epidemiology with the Centre for Health Equity Studies in Stockholm, Sweden.
Hjern and his colleagues analyzed more than 360,000 births in Sweden between 2007 and 2012. They determined parental depression by prescriptions for antidepressants that the expectant parents were taking. The researchers also looked at the parents' outpatient and hospital care. All this information was from 12 months before conception until six months after conception.
Mothers who had either a first bout with depression or recurring depression appeared to have a 30 percent to 40 percent higher risk of delivering a baby moderately preterm -- at 32 to 36 weeks. Full term is 39 to 40 weeks, according to the American Congress of Obstetricians and Gynecologists (ACOG).
For expectant fathers, only those who had "new" depression were linked to a greater risk of a preterm child. (People with new depression had no depression 12 months prior to their diagnosis.) These fathers had a 38 percent higher risk of a very preterm baby, defined as 22 to 31 weeks, the study authors said.
However, the study authors only found an association, and not cause-and-effect proof, that parental depression may affect a child's birth outcome.
RELATED: Should You Have Kids If You’re Depressed?
Preterm birth is a leading cause of infant death. Preemies that survive often face long-term health consequences.
Janet Currie, director of the Center for Health and Wellbeing at Princeton University, said stress can certainly be a culprit in causing early delivery.
"There is quite a bit of literature suggesting that stress could trigger labor," said Currie, who was not involved with the new research. "Possibly paternal depression could also have that effect on the mother, for example, if she is stressed out by a father's health problem, or if a father's depression leads to other stresses like loss of employment or income."
Hjern theorized that the effects of antidepressants and unhealthy factors such as obesity and smoking also may contribute to a greater likelihood of preterm labor.
Some experts recommend that couples planning a family or expecting a child seek advice if they are experiencing irritability, anxiety or a change in mood.
Hjern expressed concern that men are less likely to seek professional help for any mental health problems, suggesting a proactive approach toward targeting the well-being of expectant fathers may be beneficial.
The U.S. Preventive Services Task Force -- a panel of independent health experts -- recently recommended screening all adults, including pregnant and postpartum women, for depression.
ACOG applauded the recommendation, saying "routine screening by physicians is important for ensuring appropriate follow-up and treatment." Treatment might include lifestyle changes, therapy and/or medication, the association said.
"Perinatal depression or depression that occurs during pregnancy or in the first 12 months after delivery is estimated to affect one in seven women, making it one of the most common medical complications associated with pregnancy," ACOG said in a statement.
The new study was published online recently in BJOG: An International Journal of Obstetrics and Gynaecology.
Many Under 40 May Not Need Regular Cholesterol Checks: Study
Many adults under 40 may not need to have routine cholesterol screenings, a new study suggests.
To come to this conclusion, the researchers looked at the real world implications of two conflicting sets of guidelines on cholesterol testing.
One, from the American College of Cardiology/American Heart Association (ACC/AHA), says that all adults older than 20 should have a cholesterol screening. They also suggest a repeat test every four to six years.
The other guidelines come from the U.S. Preventive Services Task Force, a government-funded, independent panel of medical experts. They say many adults can go longer before their first cholesterol test -- until age 35 for men, and age 45 for women.
The exception would be people with a major risk factor for heart problems -- such as high blood pressure, smoking or a family history of early heart disease.
Those patients can start cholesterol testing at age 20, the task force adds.
The new findings support the "more targeted" approach the task force uses, according to lead researcher Dr. Krishna Patel, of Saint Luke's Health System in Kansas City, Mo.
Why? The study, Patel explained, tried to estimate the impact of the two different guidelines in the "real world."
To do that, the researchers used data on 9,600 U.S. adults aged 30 to 49 who were part of a government health study.
The study team found that among nonsmokers with normal blood pressure, very few were at heightened risk of suffering a heart attack in the next 10 years. That means very few would be considered candidates for a cholesterol-lowering statin -- even with elevated LDL (so-called "bad" cholesterol) levels.
"So, screening cholesterol early doesn't bring much actionable information," Patel said. "If we're not going to treat, there's no point in doing it."
The study was published May 15 in the Annals of Internal Medicine.
Others disagreed with Patel's point.
The point of screening younger adults is not so doctors can put them all on statins, said Dr. Neil Stone, one of the authors of the ACC/AHA guidelines.
Instead, there are two central reasons, Stone explained.
One is to spot younger adults who may be heading down a path toward heart disease later in life.
Once they know their LDL is high, they and their doctors can have an "all-important discussion" about diet and lifestyle changes, said Stone, who is also professor of medicine at Northwestern University's Feinberg School of Medicine in Chicago.
READ MORE: 9 Things Dietitians Wish You Knew About High Cholesterol
The other reason is to catch cases of familial hypercholesterolemia, a genetic condition that causes very high LDL levels (above 190 mg/dL), he said.
People with the condition have a much higher-than-average risk of heart disease, and often develop it at a young age.
Because of that, the condition should be treated with statins, according to the ACC/AHA.
There is "strong and compelling evidence," Stone said, that catching the condition in younger adults makes a difference.
Dr. Paul Ridker, who wrote an editorial accompanying the study, had a similar view.
"Familial hypercholesterolemia is a common disorder, and it's easy to detect," said Ridker, of Brigham and Women's Hospital in Boston. "Why delay something as simple and inexpensive as a cholesterol test?"
Plus, he said, catching even "run-of-the-mill" high LDL is important.
"Knowing about it early in life can be a good motivator to make lifestyle changes," Ridker said.
What if a young adult has healthy LDL levels? Ridker said he'd be "fine" with that patient forgoing further tests until later in life.
For her part, Patel agreed that a one-time check, to catch familial hypercholesterolemia, is a wise move for young adults. But she questioned the value of repeat testing.
According to Stone, the ACC/AHA guidelines say it's "reasonable" to repeat cholesterol testing every four to six years. "It's not mandatory," he noted.
But people's lives, and heart disease risk factors, change as they move through adulthood, Stone said. So, a periodic cholesterol check can be useful when it's done as part of a "global risk assessment" where doctors look at blood pressure, smoking habits and other major risk factors for heart disease.
Motivating younger adults to get those risk factors under control is critical, according to Stone. "We know it's a big deal if you can have optimal risk factor [control] by age 45 or 50," he said.
In the study, very few people were at elevated risk of heart attack -- as long as they didn't smoke or have high blood pressure. ("Elevated" meant a greater than 5 percent chance of having a heart attack in the next 10 years.)
In the absence of those two risk factors, only 0.09 percent of men younger than 40 were at elevated risk of heart attack. And only 0.04 percent of women younger than 50 were.
But smoking, in particular, changed everything: Among male smokers in their 40s, one-half to three-quarters were at elevated risk of a heart attack.
"Smoking had a huge effect," Patel said. Smokers, she stressed, should "definitely" have their cholesterol tested -- and, more importantly, quit the habit.
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.
Why Drinking Tea May Help Prevent and Manage Type 2 Diabetes
Drinking Tea for Diabetes: Green Tea or Black Tea?
When it comes to drinking tea for diabetes, Steinbaum says benefits are tied to all teas, but that green tea is the clear winner. "For one, when you drink green tea for diabetes, you will get a higher level of polyphenols than you would get in black,” she explains. It’s the polyphenols in fruits and vegetables that give them their bright colors. So, having more color means that green tea is richer in polyphenols. “Of the black teas, the more orange the color, the higher the polyphenols,” she adds.
"Green tea is good for people with diabetes because it helps the metabolic system function better."
Suzanne Steinbaum, DO
Besides its color, green tea also contains higher polyphenol levels because it's prepared from unfermented leaves, "so it is really pure,” Steinbaum says. Black tea, on the other hand, is made from leaves that are fully fermented, which robs it of some nutrients. “Plus, some black tea varieties can have two to three times more caffeine than green, which isn’t good in excess,” she says.
Polyphenols: Beyond Drinking Tea for Diabetes
The benefits of tea are clear. But besides tea, a number of foods high in polyphenols also can help prevent and manage type 2 diabetes. “The fruits highest in polyphenols are berries, grapes, apples, and pomegranates — because of their rich color,” Steinbaum says. Broccoli, onions, garlic, tomatoes, eggplant, and spinach are also good sources, as are cranberries, blood oranges, blackberries, blueberries, raspberries, strawberries, rhubarb, lemons, limes, and kiwis. “We know red wine contains resveratrol, which is a polyphenol — the highest concentration is in Bordeaux,” Steinbaum says.
13 Conditions Commonly Mistaken for Multiple Sclerosis
Getting a correct diagnosis of multiple sclerosis (MS) can be a challenge.
No single test can determine a diagnosis conclusively, and not everyone has all of the common symptoms of MS, such as numbness, tingling, pain, fatigue, and heat sensitivity. And to complicate matters, the symptoms you do have may resemble those of some other condition.
To figure out what’s causing possible MS symptoms, doctors look at your medical history, the results of a neurological exam, and an MRI — and sometimes do a spinal tap (also called a lumbar puncture), says Jack Burks, MD, a neurologist and chief medical officer for the Multiple Sclerosis Association of America. "The diagnosis can also require eliminating the possible MS mimicker diseases," he says. That leads to an MS diagnosis by exclusion.
Here are some of the conditions that are sometimes mistaken for multiple sclerosis:
Lyme disease is a bacterial infection transmitted through a tick bite. Early symptoms include fatigue, fever, headaches, and muscle and joint aches. Later symptoms can include numbness and tingling in the hands and feet, as well as cognitive problems such as short-term memory loss and speech issues. If you live in an area that’s known to have Lyme disease or have recently traveled to one, your doctor will want to rule out the possibility, Dr. Burks says.
A migraine is a type of headache that can cause intense pain; throbbing; sensitivity to light, sounds, or smells; nausea and vomiting; blurred vision; and lightheadedness and fainting. A study published online in Neurology in August 2016 found that a migraine was the most common correct diagnosis in study subjects who had definitely or probably been misdiagnosed with MS, occurring in 22 percent of them. That said, headaches — and migraines in particular — do commonly occur with MS, shows a study published in Neurological Sciences in April 2011. And according to a study published in the Journal of Headache Pain in October 2010, they are also significantly associated with other types of pain, as well as with depression.
Migraines can be difficult to diagnose, and doctors use some of the same tools to diagnose the headaches as they do for MS, including taking a medical history and performing a thorough neurological examination.
Conversion and psychogenic disorders are conditions in which psychological stress is converted into a physical problem — such as blindness or paralysis — for which no medical cause can be found. In the Neurology study on MS misdiagnosis, 11 percent of subjects definitely or probably misdiagnosed with MS actually had a conversion or psychogenic disorder.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disease that, like multiple sclerosis, attacks the myelin sheaths — the protective covering of the nerve fibers — of the optic nerves and spinal cord. But unlike MS, it usually spares the brain in its early stages. Symptoms of NMOSD — which include sudden vision loss or pain in one or both eyes, numbness or loss of sensation in the arms and legs, difficulty controlling the bladder and bowels, and uncontrollable vomiting and hiccups — tend to be more severe than symptoms of MS. Treatments for MS are ineffective for and can even worsen NMOSD, so getting an accurate diagnosis is extremely important. A blood test known as the NMO IgG antibody test can help to differentiate between MS and NMOSD.
Lupus is a chronic, autoimmune disorder that, like MS, affects more women than men. It can cause muscle pain, joint swelling, fatigue, and headaches. The hallmark symptom of lupus is a butterfly-shaped rash covering the cheeks and bridge of the nose, but only about half of people with lupus develop this rash. There is no single diagnostic test for lupus, and because its symptoms are similar to those of many other conditions, it is sometimes called “the great imitator.”
Rheumatologists (physicians specializing in diseases of the muscles and joints) typically diagnose lupus based on a number of laboratory tests and the number of symptoms characteristic of lupus that a person has.
A stroke occurs when a portion of the brain stops receiving a steady supply of blood, and consequently doesn't get the oxygen and nutrients it needs to survive. Symptoms of a stroke include loss of vision; loss of feeling in the limbs, usually on one side of the body; difficulty walking; and difficulty speaking — all of which can also be signs of an MS flare. The age of the person experiencing the symptoms may help to pin down the correct diagnosis. "While MS can occur in 70-year-olds, if the person is older, you tend to think of stroke, not MS," Burks says. A stroke requires immediate attention; if you think you’re experiencing a stroke, call 911.
Fibromyalgia and MS have some similar symptoms, including headaches, joint and muscle pain, numbness and tingling of extremities, memory problems, and fatigue. Like MS, fibromyalgia is more common in women than in men. But unlike MS, fibromyalgia does not show up as brain lesions on an MRI.
Sjögren’s syndrome is another autoimmune disorder, and the symptoms of many autoimmune disorders overlap, Burks says. Sjögren’s causes fatigue and musculoskeletal pain and is more common in women than in men. But the telltale signs are dry eyes and dry mouth, which are not associated with MS.
RELATED: The Complex Process of Diagnosing MS
Vasculitis is an inflammation of the blood vessels that can mimic MS, says Kathleen Costello, an adult nurse practitioner and at The Johns Hopkins MS Center in Baltimore and vice president of healthcare access at the National Multiple Sclerosis Society. Depending on the type of vasculitis, symptoms can include joint pain, blurred vision, and numbness, tingling, and weakness in the limbs.
Myasthenia gravis is a chronic autoimmune disease that causes muscle weakness that typically comes and goes, but tends to progress over time. The weakness is caused by a defect in the transmission of nerve impulses to muscles. In many people, the first signs of myasthenia gravis are drooping eyelids and double vision. Like MS, it can also cause difficulty with walking, speaking, chewing, and swallowing. If a doctor suspects myasthenia gravis, a number of tests can help to confirm or rule out the diagnosis.
Sarcoidosis is another inflammatory autoimmune disease that shares some symptoms with MS, including fatigue and decreased vision. But sarcoidosis most commonly affects the lungs, lymph nodes, and skin, causing a cough or wheezing, swollen lymph nodes, and lumps, sores, or areas of discoloration on the skin.
Vitamin B12 deficiency can cause MS-like symptoms such as fatigue, mental confusion, and numbness and tingling in the hands and feet. That's because vitamin B12 plays a role in the metabolism of fatty acids needed to maintain the myelin sheath. Vitamin B12 deficiency can be identified with a simple blood test.
Acute disseminated encephalomyelitis (ADEM) is a severe inflammatory attack affecting the brain and spinal cord. Symptoms include fever, fatigue, headache, nausea, vomiting, vision loss, and difficulty walking. A very rare condition, ADEM typically comes on rapidly, often after a viral or bacterial infection. Children are more likely to have ADEM, while MS is more likely to occur in adults.
6 Detoxifying Vegetable Soup Recipes for the New Year
Bone broth was the hipster darling of 2015 food trends, but if healthy eating is one of your resolutions, just sipping on broth isn’t going to cut it. It’s a new year, and 2016 is all about doubling down on fruits and veggies in the most delicious way possible. Sure, salads pack in a lot of produce, but broth-based soups may be the most satisfying — and warming! — route to healthy eating this winter. If you’ve been mainlining gingerbread and peppermint bark for the past two weeks, a detoxifying veggie soup is the perfect way to usher in a healthier new year, one satisfying slurp at a time. Here are five recipes that’ll give your resolutions staying power all month long:
Many-Veggie Vegetable Soup
We like to think of this dish from Love & Lemons as the “everything but the kitchen sink” of all soup recipes. Here at Everyday Health, we have a strict “no produce left behind” policy, and this is the perfect way to use up all of those death-row veggies in the fridge. Satiating sweet potatoes and carrots pair with lighter veggies like zucchini, tomatoes, and kale to create a hearty, stew-like dish that makes a delicious winter lunch or light supper.
Spiralized Vegan Ramen Soup With Zucchini Noodles
Happiness is when two of your food obsessions (ramen and spiralizing) come together to create a healthy, guilt-free dish. Our friend Ali over at Inspiralized created the ultimate healthy substitute for when you’re jonesing for ramen. This recipe, which swaps noodles for zucchini ribbons, clocks in at 117 calories per serving, which makes it the perfect starter. Or you can make a vegan-friendly meal by adding protein-rich tofu or quinoa — or vegetarian (and a little more authentic!) by serving it with a perfect soft-boiled egg.
Spinach Soup With Rosemary Croutons
Here’s another “easy button” recipe that requires just a few essential ingredients that can be swapped in and out depending on what you have in the fridge. Here, cooked spinach, onion, and potatoes are blended with rosemary to create a vegetable-rich savory slurp, but you could use any green you have on hand (think: kale, arugula, mustard greens) and a variety of herbs (thyme, basil, and tarragon would all do the trick!). Eschewing bread this month? Just skip the croutons.
Carrot Apple Ginger Soup
If you haven’t hit the supermarket for your annual “New Year, New You” shopping spree, check the crisper for these holiday holdovers: carrots, onions, apples, and ginger. This bright, sweet, and spicy soup from Joy the Baker keeps in the fridge for up to four days and freezes like a dream. Your first week of January lunch problem? Solved!
Amazon Bean Soup With Winter Squash and Greens
If you’re looking for a vegetarian soup that even the most persnickety carnivore will love, look no further. The United Nations has declared 2016 the “International Year of Pulses” (pulses being beans and legumes to me and you), and for good reason: Beans are cheap, healthy, and environmentally-friendly sources of protein that are packed with fiber and nutrients. We love this wintry mix of beans, carrots, squash, and greens, finished with a squirt of lime. You can easily make this a vegan dish by swapping the butter for heart-healthy olive oil and the chicken stock for a veggie version.
No-Bone Broth
Now that you’ve got five delicious soup ideas, you’ll need some broth. Matt Weingarten, culinary director for Dig Inn, created this No-Bone Broth recipe from kitchen scraps, like apple cores, vegetable peels, and the tops and tails of celery, to create a nutrient-rich, vegan stock that’s a perfect base for any soup recipe.
Loneliness May Fuel Mental Decline in Old Age
Slower deterioration seen in people with more satisfying relationships, researchers say.
Loneliness and depression are linked to an increased risk of mental decline in the elderly, a new study suggests.
Researchers analyzed data from more than 8,300 American adults aged 65 and older who were assessed every two years between 1998 and 2010. Seventeen percent reported loneliness at the beginning of the study, and half of those who were lonely had depression.
Over the course of the study, mental decline was 20 percent faster among the loneliest people than among those who weren't lonely. People who were depressed at the start of the study also had faster mental decline.
However, lower mental function did not lead to worsening loneliness, according to the study scheduled for presentation Monday at the Alzheimer's Association International Conference in Washington, D.C. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.
RELATED: The Health Risks of Loneliness
"Our study suggests that even one or two depressive symptoms -- particularly loneliness -- is associated with an increased rate of cognitive decline over 12 years," study author Dr. Nancy Donovan said in an association news release. She is a geriatric psychiatrist at Brigham and Women's Hospital in Boston and an instructor in psychiatry at Harvard Medical School.
"We found that lonely people decline cognitively at a faster rate than people who report more satisfying social networks and connections. Although loneliness and depression appear closely linked, loneliness may, by itself, have effects on cognitive decline," she explained.
This is important to know for the development of treatments to enhance mental health and quality of life for older adults, she added.
The new study suggested a link between loneliness, depression and heightened risk of mental decline, but it did not prove cause-and-effect.
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."
Psoriatic Arthritis Types
www.PsoriaticInfo.com
Learn About The Different Types
of Psoriatic Arthritis Today.
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.
Antidepressant, Painkiller Combo May Raise Risk of Brain Bleed
Taking both an antidepressant and a painkiller such as ibuprofen or naproxen may increase risk of a brain hemorrhage, a new study suggests.
Korean researchers found that of more than 4 million people prescribed a first-time antidepressant, those who also used nonsteroidal anti-inflammatory drugs (NSAIDs) had a higher risk of intracranial hemorrhage within the next month.
Intracranial hemorrhage refers to bleeding under the skull that can lead to permanent brain damage or death.
The findings, published online July 14 in BMJ, add to a week of bad news on NSAIDs, which include over-the-counter pain relievers such as aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve).
Last Thursday, the U.S. Food and Drug Administration strengthened the warning labels on some NSAIDs, emphasizing that the drugs can raise the risk of heart attack and stroke.
As far as the new link to brain bleeding in antidepressant users, experts stressed that many questions remain unanswered.
And even if the drug combination does elevate the odds, the risk to any one person appears low.
"The incidence of intracranial hemorrhage in people taking antidepressants and NSAIDs was only 5.7 per 1,000 in a year. So about 0.5 percent of people taking these drugs will develop a (hemorrhage) over one year," said Dr. Jill Morrison, a professor of general practice at the University of Glasgow in Scotland.
Still, she said, it's wise for people on antidepressants to be careful about using NSAIDs.
Both types of drug are widely used, and about two-thirds of people with major depression complain of chronic pain, the researchers pointed out.
Make sure an NSAID is the appropriate remedy for what ails you, said Morrison, co-author of an editorial published with the study.
It's known that NSAIDs can cause gastrointestinal bleeding in some people, and studies have suggested the same is true of SSRI antidepressants -- which include widely prescribed drugs such as Paxil, Prozac and Zoloft.
But neither drug class has been clearly linked to intracranial hemorrhage, said Dr. Byung-Joo Park, the senior researcher on the new study.
So Park's team looked at whether the two drug types, used together, might boost the risk.
RELATED: Some Antidepressants Linked to Bleeding Risk With Surgery
The investigators used records from Korea's national health insurance program to find more than 4 million people given a new prescription for an antidepressant between 2009 and 2013. Half were also using an NSAID.
Park's team found that NSAID users were 60 percent more likely to suffer an intracranial hemorrhage within 30 days of starting their antidepressant -- even with age and chronic medical conditions taken into account.
There was no indication that any particular type of antidepressant carried a greater risk than others, said Park, a professor of preventive medicine at Seoul National University College of Medicine.
He agreed that antidepressant users should consult their doctor before taking NSAIDs on their own.
Park also pointed out that the study looked at the risk of brain bleeding within 30 days. So the findings may not apply to people who've been using an antidepressant and an NSAID for a longer period with no problem.
That's an important unanswered question, said Morrison, noting it's possible that the risk of brain bleeding is actually higher for people who used NSAIDs for a prolonged period.
Why would antidepressants have an effect on bleeding? According to Park's team, the drugs can hinder blood cells called platelets from doing their job, which is to promote normal clotting.
Since NSAIDs can also inhibit platelets, combining the two drugs may raise the odds of bleeding, the researchers said.
It's not clear whether there is a safer pain reliever for people on antidepressants, Morrison said. But it's possible that acetaminophen (Tylenol) could fit the bill.
"Acetaminophen does not have the same propensity to cause bleeding problems as NSAIDs do," Morrison said. "So theoretically, this would be safer."
And since this study was conducted in Korea, she added, it's not clear whether the risks would be the same in other racial and ethnic groups. More studies, following people over a longer period, are still needed, Morrison said.
All Diet and Nutrition Articles
The Real Monthly Cost of Depression
Six people reveal how much they spend to treat their depression, how they save money on medications, and more.
With an illness like depression, the cost of treatment often adds up to more than the price of medication alone. Untreated or undertreated depression can break the bank in the form of lost work, lost productivity, and hospital stays.
In fact, depression is estimated to have cost the U.S. economy more than $210 billion in 2010 (including the cost of comorbid, or simultaneously existing, conditions), according to a study published in 2015 in The Journal of Clinical Psychiatry. “The key to managing the cost of depression is managing depression itself,” says health economist Adam Powell, PhD, president of Payer+Provider, a Boston-based consulting firm that works with insurance companies and healthcare providers. “The direct cost American society spends on treating depression is far smaller than the indirect costs spent on its consequences.”
And the personal costs of effectively managing depression can add up, too. In addition to medication, many people with depression pay for therapy, top quality foods, gym memberships, yoga or mindfulness meditation classes, supplements, educational materials, or other goods and services that they feel help them manage the condition.
Here we share what six people with depression spend on the condition — including which costs they must absorb on their own — and how they cut corners to make ends meet.
Susan Hyatt, 56, Corporate Social Responsibility Advisor
Monthly Medication: $70
Additional Monthly Treatments: $420-$470
Net Monthly Out-of-Pocket Costs: $490-$540
Much of what business consultant Susan Hyatt of Denver pays to manage her depression and seasonal affective disorder (SAD) relates to keeping herself productive. And if her strategies to stay productive aren’t effective, she loses income and can’t pay for the things that help her feel and stay better. In addition to her medication — about $70 a month out-of-pocket for Wellbutrin (bupropion) and Oleptro (trazodone) — Hyatt spends about $100 to $150 on supplements and herbs each month, and a little more than $300 for exercise and other lifestyle activities that help keep her motivated to work.
For example, Hyatt, who founded the consulting company Big Purpose Big Impact, walks to Starbucks or another nearby coffee shop every day to work; her tab adds up to $4 to $8 a day. “The noise forces me to have to really concentrate to get anything done, and it works,” Hyatt says. “Once I go home, I can easily slide back into not being very motivated.”
RELATED: 5 Things Psychologists Wish Their Patients Would Do
Too little motivation becomes costly for an entrepreneur. Hyatt’s depression has caused her to miss phone calls about potential work or speaking opportunities on days when she avoids answering her phone. And as she finishes up her long-term contracts, she often finds it exhausting to apply for new ones, costing her potential income. That means she also can’t currently afford massage, acupuncture, and therapy — all of which have helped her manage her illness in the past. “Friends or family who haven’t had issues with depression or SAD may be sympathetic,” she says, “but they often can’t really get their minds around the fact that depression can be debilitating.”
Her best tip: When her Wellbutrin dosage was increased from 300 milligrams (mg) to 450 mg a day, her doctor originally prescribed three 150 mg tablets. But getting one 300 mg bottle and one 150 mg bottle saved her about $35 a month. If your doctor can similarly prescribe a specific dosage that is cheaper, the savings can add up.
Kathryn Goetzke, 44, Nonprofit Founder
Monthly Medication: $0 currently (previously up to $100)
Additional Monthly Treatments: $300-$700
Net Monthly Out-of-Pocket Costs: $300-$700
Kathryn Goetzke, who lives in San Francisco, can easily tick off the ways her depression has cost her: lost productivity, strained relationships, bad decisions, a poorly functioning immune system, and an inability to maintain boundaries. It’s also led to unhealthy habits, such as smoking, alcohol use, and overeating. But after dealing with all these ramifications of the illness, she’s now found that exercise and a healthy diet help her the most in dealing with the condition.
She avoids sugar, eats organic food, makes smoothies, and spends $75 a month on a gym membership, plus another $75 on exercise classes such as Spinning. Not included in her monthly costs is the $600 she paid for a Fisher Wallace Stimulator, an FDA-cleared wearable device that treats anxiety and depression by sending slight electrical pulses to the brain through two nodes that are attached to the temples; Goetzke uses the Stimulator twice a day.
The $150 a month she spends on supplements goes toward 5-HTP, omega-3s, vitamin D, GABA, Dr. Amen’s Serotonin Mood Support, and green powder — a supplement mixture of vitamins, minerals, probiotics, prebiotics, and other ingredients, depending on the manufacturer.
When Goetzke, who is also founder of the International Foundation for Research and Education on Depression (iFred), goes to therapy, it costs about $400 a month.
She emphasizes that depression is treatable, but many people require treatment beyond medication: Therapy is essential, she believes. And while Goetzke no longer needs medication, she would sacrifice anything for it when she did. “There is nothing more important than mental health,” Goetzke says. “I lost my dad to suicide and never want to follow in his footsteps.”
Her best tip: Goetzke has made a lot of changes to cut corners: she finds therapists covered by insurance, does workouts outside instead of taking extra gym classes, borrows books from the library, and quit drinking and smoking. But her biggest tip is to avoid making big decisions while you’re depressed.
“Give it a month to be sure it’s the right decision,” she says. “That’s really helped me avoid making expensive decisions that were more the depression talking than me.”
Maggie White, 34, Stay-At-Home Mom
Monthly Medication: $170
Additional Monthly Treatments: $500-$1,000
Net Monthly Out-of-Pocket Costs: $670-1,700
Although Maggie White, of Downers Grove, Illinois, spends $80 for Pristiq (desvenlafaxine) and $90 for Klonopin (clonazepam) each month, her other costs vary greatly depending on the month. She cares for five young children at home and needs to “keep [herself] as mentally healthy as possible” since her husband travels frequently, and her mental health affects her family, too.
Her therapy adds up to about $50 a month, and the $40 she spends on essential oils is worthwhile because the aromatherapy helps her feel better. When she can afford gym or yoga classes, they’re about $15 each, but most of her additional costs include organic foods and the $175 per month she spends on a range of supplements: vitamin D3, B-complex, B-12, magnesium/calcium, chromium, 80-billion live probiotics, flaxseed oil, potassium, zinc, and vitamin C.
“You cannot put a price on sound mental health,” White says. “If you’re walking around in that black, haunting fog so many of us know, there is no quality of life, no hope, no way to make healthy decisions, or even to know how to surround yourself with healthy people.”
Her best tip: With five kids, planning ahead and trimming the fat are the secrets to White’s household money management. Clothes are hand-me-downs or come from The Salvation Army; for food, she plans meals two weeks out and purchases only the exact groceries needed. Not only does the family skip restaurants, movies, and vacations, but they also don’t have cable TV or personal electronic devices. Instead, they watch old VHS tapes.
Lisa Keith, PsyD, Assistant Professor of Special Education
Monthly Medication: $80
Additional Monthly Treatments: $105
Net Monthly Out-of-Pocket Costs: $185
For Dr. Lisa Keith, of Fresno, California, health insurance helps tremendously with medication costs. The $80 she spends monthly on Cymbalta (duloxetine) and Abilify (aripiprazole) would cost closer to $1,000 per month if not for her insurance. In addition to the $30 she spends each month for a gym membership, $25 in co-pays for her psychiatrist, and $50 for multivitamins, iron, calcium and a few other vitamins, the Fresno Pacific University professor invested $150 in a blue light for light therapy.
“I have it good because I work full-time and have benefits,” Keith says, but those without insurance for medications are less fortunate. “I’ve spent tens of thousands of dollars over the years on medications, doctors, therapy … but the worst thing is that depression cost me a marriage. There’s no price on that.”
Her best tip: Find apps that help manage mental health effectively for you. Keith uses Headspace for meditation, Focus@Will for concentrating, and Spotify for custom music playlists.
zxcdsv
7 Dietitian-Approved Pumpkin Spice Foods You'll Love
1 / 8 Healthy Treats to Celebrate the Season
Fall means beautiful foliage, back-to-school time, and, you guessed it, pumpkin spice everything. From lattes to hummus (yes, you read that right), there’s no shortage of pumpkin spice-flavored products on the market. The problem is that many of these foods are laden with fat and sugar. A grande pumpkin spice latte with whipped cream at Starbucks, for example, contains a whopping 50 grams (g) of sugar and 380 calories — enough for a whole meal! Then there’s the pumpkin muffin from Dunkin’ Donuts, which weighs in at 550 calories and 24 g of fat.
The good news is you don’t have to steer clear of foods with pumpkin: They contain even more potassium than bananas, which means they can help lower blood pressure and decrease the risk of stroke and heart disease. Plus, a study published in February 2014 in the International Journal of Clinical Oncology found that consuming foods rich in beta-carotene — like pumpkins — is associated with a decreased risk of colon cancer, and a study published in 2004 showed that it may also reduce risk of prostate cancer.
To help you get into the spirit of the season — without widening your waistline — try these dietitian-approved pumpkin spice treats!
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.
7 Quick Fixes to Look More Attractive
One look at the billion dollar anti-aging industry and it's no surprise we find youth beautiful above all else. But skin isn't the only indicator of it — the size of your eyes is, too. "Women with baby-like features such as large, widely-spaced eyes are typically judged to be most attractive," says Viren Swami, PhD, author of The Psychology of Physical Attraction,who cites cross-cultural study data from African-American, Asian, Hispanic, and Taiwanese participants.
The quickest and easiest way to maximize your eyes is to sketch a line on the top lash line using a smoky shade, and then smudge the shadow with a brush or your fingertip to soften and blend, says Tina Turnbow, a celebrity makeup aritst.
How to Get Glowing Skin When You Have Psoriasis
Carolyn Jacob, MD, director of Chicago Cosmetic Surgery and Dermatology, doesn’t just treat patients with psoriasis — she manages her own. Dr. Jacob has been living with psoriasis since she was 14 years old.
Jacob’s psoriasis primarily affects her scalp and nails, both of which can be tough to hide. “I hated it when I had scalp involvement, which would show flakes on my clothing and itch constantly,” Jacob says.
Psoriatic Arthritis Info
www.PsoriaticInfo.com
Find More Information About Signs &
Symptoms Of Psoriatic Arthritis Now
Embarrassed about her nail psoriasis, Jacob used to paint them a color that would mask her symptoms. The National Psoriasis Foundation says that about half of all people with psoriasis will have symptoms affecting the nails, which can include changes in color, thickening of the nails, separation of the nail, and the formation of pits or holes.
For healthy skin, Jacob knows she has to keep her skin clear and moisturized as much as possible. She uses CeraVe cleanser, available at many drugstores. “It adds ceramides to the skin, which help to rebalance the natural moisturizing factor in your skin,” she says. She follows that up with CeraVe lotion.
Other daily psoriasis treatment tips that Jacob offers her patients and practices herself include:
When Jacob’s psoriasis flares, she turns to a prescription Avène product called Akérat cream because it contains exfoliators and softeners to soothe the skin.
Jacob knows that psoriasis and its treatments are more than just skin deep. She sticks to a healthy, balanced diet to help keep inflammation down and her symptoms in check. She eats salmon and walnuts for the omega-3 fatty acids, which can help reduce inflammation and promote better heart health. Jacob also takes omega-3 supplements for an extra boost. “They are great for inflammatory conditions, especially psoriasis, and they help balance cholesterol levels and improve your skin texture,” she explains. The heart-healthy supplements can prove particularly beneficial since people with psoriasis have a 58 percent greater chance of suffering a major cardiovascular event like a heart attack, according to the National Psoriasis Foundation.
Stress is also a trigger for psoriasis, so Jacob tries to keep it in check, particularly by exercising. With twin toddlers and a busy schedule, she has to make time to work out. How does she fit it in? “I get up early to exercise so it is done for the day,” she says. It’s a prudent strategy that’s backed by a study from the August 2012 issue of Archives of Dermatology, which found that women who engaged in regular vigorous exercise were less likely to develop psoriasis.
Another of Jacob’s secrets: avoiding alcohol. “It makes stress worse and makes psoriasis worse,” she says. The National Psoriasis Foundation notes that alcohol can interfere with psoriasis treatments and causes side effects when combined with many psoriasis medications. Plus, alcohol can change the way you perceive and manage your stress, according to the National Institute on Alcohol Abuse and Alcoholism.
Jacob’s psoriasis is now well controlled with biologic medications, and she says her skin, scalp, and nails stay pretty healthy. Her best advice? Work with your dermatologist to find the right treatment for you.
“The availability of biologic medications was life changing — to not have to deal with other messy medicines that do not work well, to not itch, and to have normal nails is wonderful,” she says. “This type of treatment makes me feel like a normal person again!”