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November 9, 2024
Symptoms and Traits of Schizoid Personality Disorder
Medically reviewed by Kathleen Daly, MD
Schizoid personality disorder (ScPD) causes traits like having few social relationships, being extremely detached in social situations, and rarely expressing emotions.
People with schizoid personality disorder can have symptoms that affect four aspects of their lives: social relationships, personality, emotions, and cognition (thinking). ScPD usually begins in late adolescence or early adulthood and is lifelong.
Schizoid Personality Disorder vs. Schizophrenia
As the name may imply, schizoid personality disorder is often related to schizophrenia, and if you have this condition, you are more likely to develop schizophrenia.
Schizoid personality disorder is not the same as schizophrenia because it doesn't include hallucinations or delusions, which are some of the defining symptoms of schizophrenia.
Social Symptoms
Differences in social skills are among the most prominent schizoid personality disorder symptoms. People with this condition:
- Usually show no desire to form close relationships with other people
- Often don't develop close relationships with their relatives
- Typically have no close friends or meaningful community
- Rarely date or get married
- Seldom engage in sexual activity
- Often prefer to spend time alone and engage in solo hobbies
Personality Symptoms
Schizoid personality disorder has profound effects on a person's temperament, moods, body language, and behavior. People with schizoid personality disorder often:
- Appear cold, distant, uncaring, or uninterested in others
- Dislike getting involved in everyday events
- Rarely make eye contact
- Seem highly uncomfortable in social situations
- Speak very little or answer questions with quick and short answers
- Seem unmoved by what others think of them
- Don't notice typical social cues or react emotionally to social situations
Emotional Symptoms
People with schizoid personality disorder seem to experience a lack of emotions or very limited emotional reactions. They may:
- Not react emotionally, even during momentous occasions or when faced with serious challenges
- Have passive responses to significant life events, making them seem directionless or uninterested
- Rarely express anger, even when others incite them
- Seldom show joy or pleasure for physically pleasurable experiences, like having sex, spending time in nature, or playing sports
Cognitive Symptoms
People with schizoid personality disorder experience cognitive symptoms, which affect thinking and thought patterns. This may cause:
- Linear thoughts that progress from one thought to another
- A lack of logical or critical thinking
- Disorganized thought patterns at times
Symptoms in Children
There's little information about how schizoid personality disorder looks in children. Personality disorder symptoms generally develop by the time a child reaches adolescence or early adulthood. That's why mental health professionals don't diagnose someone with a personality disorder until after they turn 18.
Research suggests that children who have major depressive disorder are more likely to develop a personality disorder later in their life.
Who's at Risk?
Some people may have a higher risk of developing symptoms of schizoid personality disorder. This includes people who:
- Have a family history of schizophrenia or schizotypal personality disorder
- Live with other mental health conditions, such as depression or another personality disorder
Complications of Schizoid Personality Disorder
Schizoid personality disorder is almost always chronic, meaning that it's a lifelong condition. Although the symptoms typically remain throughout your lifetime, treatment may lead to a better and more stable quality of life. People receiving treatment are also less likely to develop comorbidities or complications.
Those who don't receive treatment may develop certain complications, such as:
- Substance use disorder
- Suicidal thoughts
If you are experiencing a crisis, or know someone who is, call or text the National Suicide Prevention Lifeline at 988 for free and confidential support 24/7. You can also visit SpeakingOfSuicide.com/resources for a list of additional resources or call the number below to reach the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline.
When to Contact a Healthcare Provider
Most people with schizoid personality disorder don't seek help, often because of social isolation or because they don't perceive there to be a problem. A healthcare provider or concerned family member usually brings up the disorder and encourages their loved one to seek diagnosis or treatment.
If you are the loved one of someone who has been diagnosed with schizoid personality disorder or who you suspect has it, you should watch for any concerning symptoms. Talk to your loved one and reach out to a healthcare provider immediately if you see signs of:
- Schizophrenia symptoms, such as delusions or hallucinations
- Difficulty taking care of oneself
- Suicidal ideation
- Substance use
Questions To Ask Your Provider
If you have schizoid personality disorder or are the loved one of someone with this diagnosis, consider asking these questions to a healthcare provider to learn more about the condition:
- Could symptoms of schizoid personality disorder mimic the signs of other mental health conditions?
- Which treatment options are available for schizoid personality disorder?
- Are there any symptoms that I should be most concerned about?
- What should I do if my loved one with this condition doesn't want to get help?
A Quick Review
Schizoid personality disorder causes a lack of interest in socializing with others, a cold or aloof personality, and flat or emotionless reactions to significant events. This condition can affect social relationships, personality, emotions, and thinking.
Most people with this condition don't seek support from a healthcare provider. If you're a loved one of someone who may have this personality disorder, keep an eye on their well-being and talk to a healthcare provider about your concerns.
Frequently asked Questions
What is the difference between schizoid and schizotypal personality disorders?
People with schizoid personality disorder have little interest in maintaining social relationships and rarely express emotions.
People with schizotypal personality disorder typically feel discomfort in relationships, and also experience eccentric behaviors, distorted thinking patterns, and often hold strange beliefs.
How common is schizoid personality disorder?
It's difficult to know for sure how common schizoid personality is. Its prevalence is estimated to be as low as 0.9% and as high as 3.1% of the population. More research is needed for accurate rates.
Do people with symptoms of schizoid personality disorder seek treatment?
People with schizoid personality disorder rarely seek treatment. This is partly because of their chronic social isolation or because they may not be concerned with their way of being.
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November 9, 2024
What Causes Congestive Heart Failure?
Medically reviewed by Anisha Shah, MD
Congestive heart failure (CHF) occurs when your heart muscles become damaged and can't pump enough oxygen-rich blood to the rest of your organs. Several underlying health conditions can raise your risk of CHF, such as high blood pressure, coronary artery disease, and diabetes.
This condition affects more than 6 million adults in the United States, so knowing what can cause CHF can help you understand how to prevent it from developing.
High Blood Pressure
One common cause of congestive heart failure is the thickening or stiffening of the heart's walls. This often occurs due to uncontrolled hypertension (high blood pressure), which narrows the arteries (blood vessels in the heart). As the arteries become narrower and less flexible, it becomes harder for blood to circulate, worsening heart function.
Coronary Artery Disease
Coronary artery disease (CAD) occurs when plaque, a buildup of cholesterol and other substances, forms in the walls of the arteries around the heart. This reduces blood flow and greatly increases the risk of a heart attack. Reduced blood flow from CAD can weaken the heart over time, potentially leading to CHF.
Heart Valve Problems
Heart valve disease occurs when one or more of your heart's four valves—tricuspid, pulmonary, mitral, or aortic—don't function properly. These valves help to keep blood flowing in the right direction. Problems arise when the valves don't open or close fully, affecting blood flow and putting strain on the heart. Advanced heart valve disease can lead to congestive heart failure.
Heart Rhythm Problems
An arrhythmia is an irregular heartbeat that occurs when the heart's rate or rhythm is abnormal. Heart rhythm problems (like atrial fibrillation) can lead to congestive heart failure because the heart beats too quickly to properly fill with blood before pumping it out to the rest of the body. This ineffective pumping causes blood to back up in the veins that send blood to the lungs. As a result, fluid accumulates in the legs, ankles, and feet, contributing to weight gain related to CHF.
Congenital Heart Defects
Congenital heart defects happen when the heart or blood vessels don't develop properly before birth. These structural problems can range from mild to severe and may affect the heart's ability to pump blood efficiently or lead to improper blood flow. Because the heart's anatomy is altered, it may need to work harder to maintain adequate circulation. Both children and adults living with congenital heart disease are at a higher risk for congestive heart failure.
Obesity
Obesity can contribute to a greater risk of high blood pressure and changes to the heart structures because of fat accumulation around the heart. This can result in a condition known as heart failure with preserved ejection fraction (HFpEF), where the heart has difficulty relaxing and filling with blood. People with HFpEF and obesity may have lower exercise capacity compared to others.
Is Congestive Heart Failure Hereditary?
Genetics can play a role in your risk of developing congestive heart failure. Some heart conditions that increase the risk of CHF, like hypertrophic cardiomyopathy (HCM) or dilated cardiomyopathy (DCM), tend to run in families. These conditions affect your heart muscle's ability to pump blood effectively, which can lead to heart failure over time. If you have a family history of these conditions, you may be at higher risk for CHF.
Your healthcare provider may recommend genetic testing if you have a family history of heart disease. Testing can help to identify any genetic mutations that could increase your risk and help guide treatment options if you develop CHF.
Who Gets Congestive Heart Failure?
Heart failure can affect anyone, but some people are at higher risk than others, such as:
- Adults over the age of 65
- Black communities
- People with underlying health conditions, such as high blood pressure, diabetes, and obesity
Certain groups of people are underrepresented in clinical trials for heart failure. For instance, Black people and Indigenous communities have only been included in a handful of studies that help researchers understand treatment options for heart failure. In a recent review of clinical trials for CHF, many studies did not report information about racial or ethnic background, making it difficult to know how well treatments work across different populations.
Risk Factors
Many factors can increase your risk of developing congestive heart failure, such as:
- Sleep apnea, which can cause low oxygen levels and strain the heart
- Metabolic syndrome, which can raise the risk of heart failure
- Cancer treatments like chemotherapy and radiation, which can harm heart tissue
- Infections like HIV or COVID-19, which can cause inflammation that weakens the heart
- Overactive thyroid, which speeds up your metabolism and can cause your heart to work too hard
- Eating a high-fat diet, which can clog your arteries
- Smoking, which damages your arteries and reduces oxygen to the heart
- Living a sedentary lifestyle, which can contribute to obesity, high blood pressure, and diabetes
A Quick Review
Congestive heart failure occurs when the heart can't pump enough oxygen-rich blood to the body. Heart failure can develop suddenly or gradually due to conditions like high blood pressure, coronary artery disease, diabetes, or heart attack.
Other risk factors include arrhythmias, valve disease, congenital defects, and lifestyle factors such as obesity and smoking. If you have any of these conditions, ask your healthcare provider about what you can do to reduce your risk of CHF.
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November 9, 2024
The 10 Best Ways To Adjust to Daylight Savings Time, According To Sleep Experts
Medically reviewed by Smita Patel, DO
Federal law sets the beginning and ending dates of daylight savings time, which include the second Sunday in March at 2 a.m. and the first Sunday in November at 2 a.m. In March, the clocks "spring forward" or are set forward one hour in honor of daylight savings time, and then in November, the clocks "fall back" or are set back to standard time.
There is a great deal of debate over whether or not daylight savings time is healthy and how it affects the human body, specifically sleep cycles. Daylight savings time—when your clocks spring forward—has also been linked to conditions like nervous system disruptions, inflammation, depression, and heart attacks. Even overall mortality can be affected by daylight savings time.
Though little research connects the return to standard time to health issues, daylight savings can still be stressful to your body. Fortunately, you can take steps to adjust and protect your sleep.
1. Fall Back: Stay Up Later
Some sleep experts recommend staying up a little later the night before the clocks "fall back" and you gain an hour of sleep. This helps your body adjust to the time change and prevents you from waking earlier than you need to. It could also help you maintain your sleep base.
2. Fall Back: Block Early Morning Sunlight
When you get an extra hour of sleep in the fall, you may want to take advantage of that opportunity by using room-darkening shades or even an eye mask for the first few weeks to ensure that the sun doesn't wake you sooner than necessary. In other words, the sun may peak through your blinds at 6:30 a.m. versus 7:30 a.m. If you have children, you may also want to make these adjustments in their rooms.
3. Fall Back: Stick To Your Routines
During the fall, you may want to stick to your routines despite the change. This is especially true for your evening meal.
Research has found that your circadian rhythm affects your body’s ability to metabolize food. For instance, you produce melatonin at night, which reduces the amount of insulin your body makes. This, in turn, affects blood sugar and digestion.
To keep this process consistent and avoid disrupting your sleep, you may want to stick to your usual dinner time rather than moving it. Likewise, consider keeping your other nightly rituals the same even if you feel sleepy an hour earlier.
4. Fall Back: Manage Your Light Exposure
Consider light exposure to help your body adjust to the time change. One study found that wearing sunglasses in the morning speeds up adjustment to the autumn return to standard time. Taking an evening walk may also help you adjust to the time difference.
5. Spring Forward: Shift Your Sleep Schedule
When March arrives, you may want to start preparing for "spring forward." Consider going to bed 15 minutes earlier each night and moving your wakeup time 15 minutes earlier each morning. This way, when the clocks officially spring forward, your body will adjust more easily to the new time.
6. Spring Forward: Improve Your Sleep Hygiene
Prioritizing quality sleep is always important, especially during daylight savings. Here are some ideas:
- Limit blue light from screens before bed
- Keep a consistent bedtime
- Exercise regularly—but not too close to bedtime
- Limit caffeine and alcohol, especially in the evening
- Manage your stress
Creating a sleep-promoting environment can be helpful. Common strategies include not working in bed, keeping the room cool, and making sure noise and light are minimal.
7. Spring Forward: Push Your Dinner Back Gradually
You may want to adjust your evening meal to ensure your sleep is not disrupted too much. This may mean pushing your dinner to an earlier time by 15 minutes each night before the clocks are set forward an hour. This way, when the time change occurs, there is less of an effect on your body's circadian rhythm, making the adjustment easier.
8. Spring Forward: Reduce Light Exposure in the Evening
Reducing your evening light exposure can help make the transition from standard time to daylight savings time in the spring easier. This may mean staying inside in the evening until your body adjusts and not spending too much time on screens, especially around bedtime.
9. Spring Forward: Get Early Morning Sunlight
Exposure to sunlight can significantly affect and help ease your body into the time change. Even 30 minutes of exposure under bright light, such as a morning walk outside, can significantly reduce the time required to fully adjust to daylight savings time.
10. Spring Forward: Consider a Day Off
Some research has found a significant increase in fatal traffic accidents—up to 30%—on the day daylight savings starts. Researchers have also found a short-term rise in workplace injuries (5.7%), particularly among shift workers who tend to sleep 40 minutes less on average.
Experts recommend taking a day off or reducing the workload when daylight savings begins. This allows your body time to adjust to the time change, especially since it can take one week for your body to adapt.
Fall Back vs. Spring Forward
More than 1.5 billion people in 70 countries around the world observe daylight savings time. In the United States, everyone turns their clocks forward by one hour in the spring and backward by one hour in the fall—except Hawaii and most of Arizona. Puerto Rico, American Samoa, Guam, the Virgin Islands, and the Northern Mariana Islands also do not observe daylight savings time.
Despite this decades-old pattern, not everyone supports this approach. The American Academy of Sleep Medicine (AASM) favors a fixed, year-round time for the nation. Their research suggests that year-round standard time (or what the country is on from November through March) is best for sleep and circadian rhythm and benefits public health and safety.
Lawmakers have attempted to address the consistent clock changing by introducing Senate legislation called the Sunshine Protection Act. Under this proposal, introduced in 2022 and again in 2023, the U.S. would operate on permanent daylight savings time.
Though the Senate approved it, this act was rejected by the House of Representatives in 2022 and was not signed in 2023 either. The premise of the act, if it is ever approved, would result in later sunrises and sunsets from November through March when the U.S. observes standard time. In other words, it would abolish the need for clocks to fall back in November—the opposite of what the AASM recommends.
A Quick Review
Daylight savings time occurs between spring and fall when clocks in most parts of the U.S. are set forward one hour. The remainder of the time—November through March—is considered standard time. Federal law determines the beginning and ending dates of daylight savings time.
Daylight savings time always begins the second Sunday in March at 2 a.m. and ends the first Sunday in November at 2 a.m. Health experts have found that daylight savings time can cause accidents, heart attacks, depression, and more. However, until the government passes legislation, clocks spring forward in March and fall back in November every year.
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November 8, 2024
What Happens When You Add an Extra Serving of Beans to Your Daily Diet? New Study Explains
Fact checked by Nick Blackmer
- New research shows that eating more beans could improve your diet quality.
- The study found that adding more beans to your diet could increase intake of nutrients like fiber, magnesium, and iron while decreasing consumption of sodium, added sugars, and saturated fats.
- Beans can cause some gastrointestinal discomfort, but otherwise, experts say beans are an excellent food to incorporate into your diet.
Beans are a delicious, hearty addition to wintertime soups, salads, and other dishes—and new research shows eating more of them could also significantly improve your diet quality.
Analyzing data from over 44,000 participants, researchers found that increasing bean consumption could boost a person’s Healthy Eating Index (HEI) score, a common measure of how nutritious a person’s diet is.
According to the data, beans help a person “[increase] intake of ‘shortfall’ nutrients like dietary fiber, potassium, magnesium, iron, folate, and choline in the diet, as well as [reduce] consumption of ‘watchout’ nutrients like sodium, added sugars, and solid (or saturated) fats,” study author Joanne Slavin, PhD, RD, professor of food science and nutrition at the University of Minnesota College of Food, Agricultural, and Natural Resource Sciences, told Health.
The research was presented at the Academy of Nutrition and Dietetics Food & Nutrition Conference & Expo in Minneapolis, Minnesota in early October. The study was funded by Cannedbeans.org on behalf of Bush’s Best and the Coalition for the Advancement of Pulses.
Despite the fact that beans are a known source of plant-based protein and other nutrients, as many as 80% of American adults aren’t meeting the recommended intake for legumes such as beans, peas, and lentils.
Here’s what experts had to say about why beans can have such a benefit on diet quality, plus the best ways to increase your bean consumption.
Related: What Is 'Dense Bean Salad'? 5 Things RDs Want You to Know About the Viral TikTok Recipe
The Link Between Eating Beans and Improved Diet
Previous evidence has shown legume intake to be associated with reduced all-cause mortality and heart disease risk, and this latest study may offer deeper understanding into why that is.
This research examined data derived from the National Health and Nutrition Examination Survey (NHANES) between the years of 2001 and 2018. This data came from 23,554 participants between the ages of 19 and 50, and an additional 21,020 participants at or above the age of 51. All of the participants completed a 24-hour dietary recall survey, which researchers then measured against the U.S. Department of Agriculture’s HEI standards.
Specifically, they looked at participants’ bean intake, which included canned or non-canned (including dried) chickpeas, pinto beans, kidney beans, or black beans.
Researchers then determined how intake of ‘shortfall’ nutrients, or those typically under-consumed in American diets, might change if participants added either one or two additional servings of beans (1/2 cup or 1 cup cooked beans, respectively) to their diets. In this study in particular, researchers assessed levels of dietary fiber, potassium, magnesium, iron, folate, and choline.
“This was a dietary pattern modeling study,” Slavin explained. “Through using the NHANES dataset, we could model what improvements could be made by increasing bean consumption to recommended levels.”
Increased bean intake was associated with significant increases in shortfall nutrient intake.
And HEI scores overall also improved. People saw their diet quality improve by 15-16% when they added one serving of beans to their diet, and those scores were 19-20% higher when people added in two servings. These HEI score improvements could likely reduce participants’ risk of chronic disease, including heart disease, stroke, diabetes, and cancer.
In addition to increasing nutrient intake and diet quality, adding more beans to a person’s diet also resulted in increased caloric intake, as well as increased sodium intake.
Despite the study’s results, there are a few limitations to keep in mind. For one, data obtained from 24-hour diet recalls can be inaccurate or biased, since they rely solely on participant memory.
Additionally, “as a modeling study, we didn’t have findings on the effect of consuming too many, or very high amounts of, beans in the diet,” said Slavin.
These limitations—plus the fact that the study was funded by Bush’s Brothers & Company and the Coalition for the Advancement of Pulses—means more research is needed.
Adding More Beans to Your Diet
In spite of its limitations, “this study confirms what most dietitians know: beans are an excellent food to incorporate into your healthy eating plan and will likely promote tangible health benefits such as lowered cholesterol levels, increased fiber intake, and improved blood sugar levels,” Katy Wilbur, RD, LDN, clinical dietitian at the Frances Stern Nutrition Center at Tufts Medical Center, told Health.
Aside from the shortfall nutrients mentioned in the study (fiber, potassium, magnesium, iron, folate, and choline), beans are also a great source of protein, calcium, and phosphorus. They’re a “nutritional powerhouse,” said Wilbur.
“Replacing one serving of animal protein with a serving of beans can increase your fiber intake to aid in both gut and heart health, increase your vitamin and mineral intake, decrease your cholesterol and saturated fat intake, and likely save money on your grocery bill,” she added.
These legumes do pose issues for some people, however. The high fiber content can make beans challenging to digest, leading to gas or bloating, explained Wilbur.
But for those who don’t complain of gastrointestinal discomfort after eating beans, there’s no shortage of ways to enjoy them at home.
Beans are typically purchased either canned or dried—and it actually doesn’t really matter which option you choose.
“While canned beans may have additives and preservatives, such as salt, calcium chloride, sugar, or seasonings, canned and dried beans have very similar nutrition profiles,” Wilbur said. It’s also an added bonus that both options are relatively inexpensive.
“If you’re concerned with the sodium in canned beans, there are low-salt versions available,” Slavin also offered.
Canned and dried beans (once they’re cooked) can be easily added to salads, soups, pasta, rice dishes, chilis, and casseroles.
A couple of easy swaps to increase your bean intake include “snacking on dried chickpeas instead of crackers, or using hummus instead of mayonnaise on your sandwich,” Wilbur recommended.
Related: New Research Shows Eating More of This Pantry Staple Could Help You Reach Weight-Related Goals
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November 8, 2024
What Is Repression—and Why Do You Do It?
Medically reviewed by Dakari Quimby, PhD
Repression is a type of defense mechanism where your mind unconsciously represses or blocks out difficult emotions, memories, and thoughts from your conscious mind.
People who have experienced a traumatic event may have repressed memories or emotions—especially since repression can be a protective response to something emotionally or physically painful. Releasing these emotions is also necessary and can be done through therapy.
Repression Symptoms
Repression is a type of emotional regulation. While protective in nature, repression also has several negative consequences that can affect you physically, emotionally, and behaviorally.
Because some people may not know that they have repressed memories, they may be confused by symptoms like nightmares, flashbacks, and intrusive thoughts. They may also experience mood swings, irritability, and even panic attacks with no understanding of the cause. Additional symptoms of repression include:
- Anxiety
- Depression
- Angry outbursts
- Behavioral changes
- Difficulty talking about feelings
- Headaches
- Dizziness
- Fatigue
- Skin conditions
- Chronic pain
- Abdominal pain
- High blood pressure
Why Do You Repress Yourself?
Repression is a hot topic of debate in psychology, and not everyone agrees on its causes or effects. For this reason, several theories exist on why someone can experience repression.
Cognitive Dissonance Theory
Supporters of this theory suggest that repression occurs to manage cognitive dissonance—or the discomfort that results when your thoughts and behaviors conflict. Repression reduces cognitive dissonance by blocking or pushing these thoughts out of your awareness.
Trauma Theory
Trauma theory is based on the idea that repression occurs to protect people from traumatic memories that could interfere with their normal functioning. Some experts believe the memories will resurface when a person is ready to deal with them.
Adaptive Forgetting Hypothesis
Some experts believe that repression is an adaptive function that builds resilience and allows people to forget or repress distressing memories. When this occurs, they can focus on current challenges without being weighed down or distracted by past trauma.
False Memories
While some argue that repression can be protective, others are concerned that memories may be distorted over time. People can sometimes confuse real memories with constructed or false ones when exploring repressed memories. Research indicates that people can create false memories based on external factors or when others make suggestions.
Diagnosis
Repression is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the guidebook that helps mental healthcare providers how to diagnose and treat mental health conditions.
The concept of dissociative amnesia is included in the DSM-5-TR. This condition occurs when someone is unable to recall important biographical information. While you may not get an official diagnosis of repression, a mental health provider may look for specific behaviors or tendencies that lead them to believe you are experiencing repression.
Which Treatments Are Available?
If your mental health provider believes you are experiencing repression, they can recommend treatments to help you process past traumas and teach you to express your emotions more freely.
Common treatments include:
- Psychodynamic therapy: This therapy helps you focus on the root cause of your emotional suffering by using self-reflection and self-examination. With the help of a therapist, you may also uncover repressed memories by digging into the unconscious mind.
- Emotionally focused therapy (EFT): EFT helps you improve your communication style and any relationships that your repression is affecting. Through treatment, you can understand why you respond the way you do and how to communicate your thoughts and emotions more effectively.
- Cognitive behavioral therapy (CBT): CBT helps you change negative thought patterns and behaviors to more productive ones. If your therapist believes you have repressed memories, they will help you develop strategies to challenge this way of managing trauma.
How To Prevent Repression
Because repression is an unconscious and involuntary experience, there is no definitive way to prevent it. Some experts argue that repression is not inherently good or bad, so prevention may not be necessary.
Repression sometimes allows you to have a positive attitude without being deterred by your negative experiences. In other situations, repression may negatively affect functioning due to a lack of insight into why you feel or behave the way you do.
The best way to prevent negative consequences from repression is to focus on your ability to express emotions and note if you're experiencing difficulties with communication and relationships. If you are experiencing any mental health concerns that you suspect may be related to repression, talk to your healthcare provider or therapist about your feelings to prevent complications from occurring.
Complications
There is some debate about whether repression can positively or negatively affect people. For this reason, the idea of complications is often subjective. One review found that repression may help improve functioning, with researchers noting that some people with this coping style manage pain better and have a lower risk of depression.
However, research has linked repression to an impaired immune system, so if you tend to get sick frequently, there is a chance that repressed memories may be affecting your physical well-being. Researchers also note that your ability to express your emotions can affect how you heal from illness. Studies show that people who were able to talk about their feelings were more likely to recover from cancer than those who were less expressive.
A Quick Review
Repression is a defense mechanism that occurs when your mind unconsciously blocks out traumatic emotions, memories, and thoughts. Research is mixed on whether repression is good or bad. Some evidence shows that it can have a positive effect on your overall well-being, while other studies find that too much repression can lead to heightened stress and anxiety.
If you suspect that you are dealing with repressed memories, see a mental health provider who can help you work through those thoughts and feelings. They may help you learn more productive ways of adapting to difficult experiences.
Frequently asked Questions
What is the difference between emotional suppression and repression?
While both suppression and repression involve blocking undesirable ideas or impulses, repression is an unconscious response that occurs when you have no memory of a traumatic event, even though you were conscious at the time. Suppression occurs when you consciously choose not to remember the details, push the thoughts or memories away, or refuse to acknowledge them.
What happens if you repress your emotions for too long?
If you have repressed emotions or memories, you may be unaware they exist because your brain is protecting you from past traumas. That said, it is possible to repress emotions to the point where they affect your mental health, cause relationship challenges, and diminish your quality of life.
Is repression a trauma response?
Repression is a defense mechanism to traumatic experiences, but it isn't inherently a trauma response. More common trauma responses include fight, flight, freeze, and fawn.
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November 8, 2024
Struggling to Lose Weight on Obesity Drugs? Here's What You Need to Know
Fact checked by Nick Blackmer
- While taking GLP-1 medications like Ozempic may seem like a guaranteed way to reach your weight loss goals, research shows they don’t work for everyone.
- If you’re still having cravings and haven’t lost at least 5% of your weight in the first 12 weeks, your GLP-1 drug may not be working for you.
- If you suspect your GLP-1 medication is ineffective, experts recommend contacting your healthcare provider to see if you need to switch drugs, up your dosage, or consider other treatment options.
By now, stories of people achieving their weight loss goals while taking Ozempic, Zepbound, or other GLP-1 receptor agonists abound—but that doesn’t mean everyone will shed pounds on these weight management drugs.
In fact, one clinical trial indicated that only about 86% of the more than 800 participants achieved “clinically significant” weight loss after taking semaglutide, sold under the brands Ozempic and Wegovy, for 68 weeks. That means a good portion of users did not.
“Each person responds differently to medications, and the degree of weight loss achieved with treatment can vary based on personal factors,” Priya Jaisinghani, MD, a clinical assistant professor specializing in obesity medicine at the NYU Grossman School of Medicine, told Health.
GLP-1s—prescribed to manage weight for people considered obese or overweight, as well as to control other health conditions—are still relatively new, with the first one was FDA-approved for weight loss in 2014. Scientists are still trying to understand what makes them work better for some people than others.
Here’s what’s known about how GLP-1s help people lose weight, why they sometimes aren't effective, and what to do if yours isn’t working as well as expected.
Related: 7 Mistakes People Make While Taking Weight Loss Drugs, According to Experts
How to Know If Your GLP-1 Is Working
New obesity management medications promote weight loss by mimicking the hormone GLP-1—or both GLP-1 and another hormone, GIP—to stimulate insulin production and slow stomach emptying. This makes people feel fuller faster and continue to feel satiated for longer.
While a doctor should help you assess whether you are truly not responding to your GLP-1 (or your expectations are too high), experts said you might want to pay attention to some red flags.
One indication that your medication isn’t correctly working is if cravings, food noise, and eating control don’t change while taking a GLP-1, Jamy D. Ard, MD, a professor at Wake Forest University School of Medicine who has studied the medications, told Health. “With effective treatment, people who have these symptoms will notice a meaningful improvement in the intensity and frequency of these symptoms,” he said.
Of course, your weight can also give you a clue. As a rule of thumb, you should see a loss of at least 5% of your body weight in the first 12 weeks of starting a GLP-1, Ard noted. “If this isn’t achieved, then we would say the patient does not have a treatment response, and this treatment is not likely to get them to their weight treatment goal,” he said.
But if you’ve lost an expected amount of weight and don’t continue to shed pounds, it could be that your medication is working but that you’ve simply hit a weight loss plateau. At some point, the rate of weight loss slows down and then stops—but your weight should remain steady while on the drug.
“A plateau can occur, but this does not necessarily mean the drug is ineffective,” Fatima Cody Stanford, MD, an obesity medicine scientist at Massachusetts General Hospital Digestive Healthcare Center in Boston, told Health.
Related: Smoothie King Has a New 'GLP-1 Support Menu'—What People on Obesity Drugs Need to Know
Factors Influencing Weight Loss Outcomes
If you and your doctor have determined that your GLP-1 isn’t helping you lose as much weight as expected, there could be several reasons.
One is that your dose may not be high enough, Cody Stanford said. A recent study involving about 3,390 people taking semaglutide or liraglutide, another GLP-1 for obesity, found that participants who took high doses of their drug—1.7 milligrams (mg), 2.0 mg, or 2.4 mg of semaglutide, or 3 mg of liraglutide—lost more weight after a year compared to people taking lower doses.
“Increasing the dose of a GLP-1 can sometimes enhance weight loss or maintain consistent weight loss,” Cody Stanford said. “But this is not guaranteed.”
Aside from dosage, physical factors can play a role. The same study found that people with a higher body mass index lost more weight after a year. Furthermore, people with type 2 diabetes tend to lose less weight on GLP-1s compared to those without it, Jaisinghani noted.
Other barriers to weight loss include lifestyle habits, such as not exercising or routinely eating sugary or fatty foods.
Finally, “medication adherence can influence outcomes,” Cody Stanford added. The drugs are only effective if taken consistently, and people who pause the medication may gain some weight back. GLP-1s can also cause gastrointestinal issues like nausea and vomiting, and some people may discontinue use due to side effects before achieving their weight loss goals.
What to Do If You’re Not Seeing Results
If you’re not reaching your weight loss goals, your doctor may recommend tweaking your dosage and changing your diet and fitness routine.
“Optimizing your medications and lifestyle strategies may be necessary, as weight loss medications work best when combined with lifestyle modifications,” Jaisinghani said.
However, if you’re still not responding to the GLP-1, switching medication may be another option. While research has found that GLP-1s can effectively help people shed pounds, one study from July found that participants who took tirzepatide, sold under the brand names Zepound and Mounjaro, were two times more likely to experience a 10% weight loss and three times more likely to experience 15% weight loss within a year, compared to patients on semaglutide.
If switching medications doesn’t work, underlying genetic or biological factors may make achieving your weight loss goals challenging. In those cases, Vedala said she would suggest alternative weight loss therapies, such as developing a diet and exercise plan. Bariatric surgery, which involves reducing the size of the stomach and making alterations to the small intestine to limit caloric absorption, is also an option for some people.
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November 8, 2024
FDA Plans to Ban Ineffective Cold Medicine Ingredient—How It Will Affect You
Fact checked by Nick Blackmer
- The FDA has proposed removing phenylephrine, a widely used ingredient to treat nasal congestion, from over-the-counter cold medications.
- Last year, an FDA advisory committee concluded that the oral version of the medication is not effective at treating nasal congestion.
- If the proposal is approved and the medication is removed from drugstore shelves, experts say there are still plenty of other over-the-counter medications to treat cold and allergy symptoms.
Phenylephrine, a common ingredient in over-the-counter cold medications like DayQuil, Theraflu, and Sudafed, may soon be banned from drugstore shelves.
On Thursday, the Food and Drug Administration announced its proposal to remove phenylephrine from the approved listed of over-the-counter drugs to treat nasal congestion, citing evidence that the oral version of the medication is ineffective. This proposal comes about a year after an FDA advisory committee concluded that the drug doesn’t work.
The proposal is open for public comment until May 7, 2025—after which the FDA will make its final decision. Until then, companies can continue to make and market oral phenylephrine for nasal congestion, as the proposal is based on the drug’s effectiveness, not on safety concerns.
The FDA’s proposal only applies to orally administered phenylephrine, like in tablets or capsules, and not the nasal spray form.
“It is the FDA’s role to ensure that drugs are safe and effective,” Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research, said in a statement. “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”
Related: Phenylephrine Vs. Pseudoephedrine: What's the Difference Between the 2 Decongestants?
Which Products Contain Phenyleprhine?
Phenylephrine is widely used in cold and allergy medication to treat nasal congestion, as it’s thought to work by reducing swelling of the blood vessels in the nasal passages.
Phenylephrine isn’t always listed on the front of the box, as these products tend to contain multiple ingredients to treat various symptoms, so it’s best to check the active ingredients on the product label.
Brand names of oral phenylephrine products include:
- Children’s Sudafed PE Nasal Decongestant
- PediaCare Children’s Decongestant
- Sudafed PE Congestion
- Suphedrin PE
There are even more combination products of oral phenylephrine plus other drugs. The National Library of Medicine has a full list of medications that include phenylephrine as an active ingredient; some of the most common brands are:
- Alka-Seltzer Plus
- Benadryl
- Excedrin
- Robitussin
- Sudafed PE
- Theraflu
- Tylenol
- Vicks DayQuil/NyQuil
- Various store brands, such as Walgreens, CVS, Target (Up & Up), etc.
Why Has Phenyleprhine Been Used For So Long If It Doesn’t Work?
Phenylephrine became a popular ingredient in over-the-counter cold medicine in 2006, when the Combat Methamphetamine Epidemic Act was signed into law.
Before then, an effective oral decongestant called pseudoephedrine was the go-to ingredient in these medications. But the law banned over-the-counter sales of cold medicines that contained pseudoephedrine—including the brand name Sudafed—because it was commonly used to make methamphetamine.
Leslie Hendeles, PharmD, professor emeritus at the University of Florida College of Pharmacy, told Health that “phenylephrine can’t be made into methamphetamine, and drug companies, not wanting to lose the market, immediately switched to phenylephrine,” which the FDA deemed safe and effective for treating nasal congestion in the 1970s.
However, in 2007, Hendeles and his colleagues published a paper with research that oral phenylephrine did not treat nasal congestion any more than placebos did. “It turns out, if you go back and analyze the studies that were used, the panel reached a specious conclusion, and the old data does not show that it’s effective either,” Hendeles said.
At the time, the FDA used other research to conclude that oral phenylephrine could still work, but around 2015, several more studies came out that showed the drug was ineffective. These studies had stronger designs than the previous research, with large sample sizes and double-blind methods.
Based on the strength of this new data, in September 2023, the FDA advisory committee concluded that oral phenylephrine did not work in treating nasal congestion.
Related: What Is the Best Cold and Flu Medicine?
What Happens If Phenyleprhine is Banned From Cold Medication?
There are still a wide variety of over-the-counter medications available to treat nasal congestion related to allergies or the common cold. “The FDA removing phenylephrine is not going to deprive any patients,” Hendeles said.
For patients with a common cold, Hendeles recommends nasal spray with phenylephrine. He explained that when phenylephrine is activated in the gut after being swallowed, it doesn’t get effectively absorbed into the blood stream. When the same drug is sprayed into the nose, it can relieve nasal congestion.
Henedeles also recommend oral pseudoephedrine, which is still available for adults age 18 or older without a prescription behind the pharmacy counter.Sterling Elliott, PharmD, a clinical pharmacist and assistant professor of orthopedic surgery at the Northwestern University Feinberg School of Medicine, also recommended oral pseudoephedrine. “To this day, the tried and true oral option remains pseudoephedrine. You can buy it—you simply have to buy it under the controlled conditions,” he told Health. “But it still works great.”
Elliot and Hendeles both cautioned against using nasal sprays too often. Using a nasal decongestant daily for more than a week can cause congestion rebound, making your blood vessels swell and your nose feel even more congested than it was before you sprayed it, Hendeles said.
For people with allergies, Hendeles said there are two major categories of safe, effective products: nasal steroids, like Flonase, and antihistamine nasal spray, like Astepro.
Elliot noted that the proposal has not been finalized yet, and if you have a medication with oral phenylephrine that works for you, there’s no danger in continuing to use it. But if you are looking to switch your medication, the FDA recommends talking to your healthcare provider or pharmacist about other safe, effective ways to treat your symptoms.
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November 8, 2024
Signs and Symptoms of End-Of-Life Kidney Failure
Medically reviewed by Kashif J. Piracha, MD
Kidney failure, or end-stage kidney disease (ESKD), occurs when the kidneys lose their ability to filter waste and excess fluids from the blood. As toxins and fluid build up in the body, other health problems can develop, increasing the risk of life-threatening complications.
About 37 million people in the United States live with kidney disease. Kidney failure is the fifth and final stage of chronic kidney disease. It occurs when the kidneys function less than 15% of normal capacity.
People with ESKD require dialysis or a kidney transplant to survive. For those who opt not to pursue treatments, palliative care and comfort measures can help manage symptoms of end-of-life kidney failure.
Physical Signs of End-Stage Kidney Disease
As kidney function declines, a buildup of waste products in the bloodstream and fluids in the body makes it harder for vital organs to function and for the body to maintain fluid balance. This can cause a variety of physical symptoms, including:
- Urinating (peeing) very little or not at all
- Fatigue or weakness
- Swelling in the arms, legs, feet, and ankles
- Dry and itchy skin or skin color changes
- Muscle cramps
- Nausea and vomiting
- Loss of appetite
- Shortness of breath or foul-smelling breath
- Headaches and back pain
- Insomnia
- Bloody stools
- Nosebleeds
These symptoms of kidney failure may progress gradually at first, and dialysis or kidney transplantation can help reduce or manage symptoms and prolong life.
If you or your loved one opts out of dialysis treatment, these symptoms will become more pronounced in the last days or weeks of life. For example, as fluid builds up, breathing becomes more difficult as the lungs work harder to breathe in oxygen.
Emotional and Psychological Signs of End-Stage Kidney Disease
People nearing the end of life with kidney failure can experience emotional and psychological symptoms as toxins build up in the bloodstream and affect brain function. Initially, people with end-stage kidney disease may experience symptoms like:
- Worsening fatigue
- Apathy
- Difficulty concentrating
- Irritability
As fluid and toxins continue to build up in the body, people with kidney failure may experience new or worsening symptoms, such as:
- Confusion and disorientation
- Anxiety
- Depression
- Loss of interest in activities they previously enjoyed
- Agitation, restlessness, or irritability that may escalate to more severe states of distress
- Delirium, such as hallucinations, paranoia, or extreme confusion
What To Expect in the Final Stages
Without dialysis, people with kidney failure can live days or weeks—depending on their kidneys' remaining function, symptom severity, and overall health.
In the final weeks and days of kidney failure, the kidneys and other vital organs and body systems begin to shut down. Although the timeline can vary, these signs often emerge as the end approaches:
- Fatigue: Very little energy, sleeping more often, or becoming bedbound
- Edema: Worsening swelling in the arms, legs, feet, and ankles
- Dietary changes: Drinking minimal fluids, loss of appetite, and difficulty swallowing
- Confusion: Intensifying mental confusion and shorter periods of alertness
- Itching: Intensely itchy, dry skin
- Breathing changes: Shortness of breath, noisy breathing, or longer spaces between breaths
- Pain: Bone and back pain, headaches
Kidney failure can be challenging for the person with the condition and their loved ones. Spending time with them and supporting them in their end-of-life journey can help them (and you) feel more comfortable. Here's how you can support your loved one in their final days with end-stage kidney disease:
- Physical contact: Hold hands, gently massage them for comfort, and let them know you're there, even if they sleep more than they are awake.
- Create a calming environment: Some people prefer quiet moments with fewer visitors, soft lighting, and soft music at a low volume. This can help your loved one relax and ease discomfort.
- Active listening: If your loved one can still communicate, ask them what they need to feel more comfortable. Listen when they speak, and let them share their thoughts without focusing on your response.
- Be present: Being present is one of the most meaningful gestures you can offer. Your presence can comfort them, whether you talk, read, or sit quietly.
Caring for a loved one with end-stage kidney disease can be emotionally and physically taxing. Remember, you don't have to navigate these challenges alone.
Your loved one's healthcare team, which may include a nephrologist (a doctor specializing in treating kidney diseases), social workers, nurses, and palliative care (end-of-life) specialists, can provide valuable physical and psychosocial support for you and your loved one, which may include:
- Symptom management: Medications can help manage pain, itching, nausea, insomnia, anxiety, and depression to improve quality of life.
- Caregiving support: As your loved one's physical health deteriorates, their healthcare team will provide support with activities of daily living and ensure nursing support is available.
- Emotional support: A palliative care team provides therapies and support for physical, spiritual, and emotional concerns. This may include teaching relaxation techniques and offering talk therapy or massages.
- Respect for wishes: The healthcare team will encourage open communication between the person with kidney failure and family members. They will respect and honor any wishes regarding end-of-life care.
How To Manage the Final Stages
When a loved one decides to forgo or discontinue dialysis for end-stage kidney disease, it can stir up a range of emotions—like sadness, fear, guilt, and worry. These are all valid.
It's common to feel torn between wanting to extend life and the desire to have a good quality of life in the final days. Opting out of dialysis is a deeply personal decision, often made with careful consideration of the physical and emotional toll of ongoing treatment.
Without dialysis, end-of-life care becomes the priority. Hospice and/or palliative care teams work with people experiencing end-stage kidney disease and their family members to help navigate the journey ahead.
Palliative Care
Palliative care can occur at any stage of kidney failure but is especially important in the final stages. This type of care focuses on improving quality of life, relieving symptoms, reducing pain, and addressing emotional, social, and spiritual needs.
A palliative care team includes nephrologists, nurses, social workers, and chaplains, who can offer comprehensive support to someone with end-stage kidney disease and their loved ones.
Hospice Care
Hospice care provides comfort and support during someone's final days or weeks. It focuses on relieving symptoms and enhancing quality of life rather than pursuing curative treatments. Hospice care may occur in the home, a hospice facility, or a hospital setting. Services often include pain management, emotional and spiritual support, and assistance with daily activities.
Where Caregivers Can Find Support
Caring for a loved one with end-stage kidney disease can be a challenge. While caregivers may not experience the condition themselves, watching their loved one's health decline is difficult. It's important to remember that caregivers have support, too. Some resources to consider for seeking guidance include:
- Hospice and palliative care services: Many offer grief counseling, emotional support, and respite care services that allow caregivers to take breaks and ensure their loved one gets professional care.
- Support groups: Local or online support groups allow you to connect with other caregivers going through similar experiences. These groups can provide practical advice, comfort, and understanding during the end-of-life journey.
- Counseling: Professional counselors or therapists can offer one-on-one grief counseling to help caregivers process their emotions during and after the loss of a loved one. Many therapists specialize in end-of-life care and bereavement, offering personalized support.
- Faith-based support: Faith communities often offer emotional support for those with religious or spiritual beliefs. Many places of worship have grief counseling services, prayer groups, or clergy available to help caregivers navigate their experiences.
- Online resources: Numerous online resources, including the National Kidney Foundation, the American Association of Kidney Patients, the National Family Caregiver Support Program, and the Caregivers Action Network, provide support and information to caregivers of people with end-stage kidney disease.
A Quick Review
Kidney failure is a physically and emotionally challenging journey for people living with kidney disease. Kidney failure can cause a variety of symptoms, such as loss of appetite, chronic pain, anxiety, and extreme fatigue. Managing the final stage of kidney disease involves making decisions about end-of-life care.
If you have kidney failure and are discontinuing dialysis or opting out of treatment, knowing what to expect in the days and weeks ahead can help you and your loved ones prepare. Work closely with your healthcare team, who can guide you in making decisions and offer essential support to make your end-of-life journey comfortable.
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November 8, 2024
How To Treat Coronary Artery Disease (CAD)
Medically reviewed by Christopher Lee, MD
Coronary artery disease (CAD) occurs when there's a blockage in the arteries that carry blood and oxygen to the heart muscle. CAD is the most common type of heart disease in the United States and a major contributor to heart attacks and deaths.
While this is a lifelong condition, there are effective treatments that help reduce symptoms, prevent complications, and promote heart health. Treatments often include medications, lifestyle changes, and surgery.
Medications
Cardiologists, or doctors who specialize in heart conditions, are the primary healthcare providers involved in treating coronary artery disease. Your provider may prescribe medications to help reduce symptoms. While medications may always carry the risk of possible side effects, there are several options to choose from.
Medications used to treat CAD include:
- Antiplatelet medications: Bayer (aspirin), Plavix (clopidogrel), Effient (prasugrel), and Brilinta (ticagrelor) are blood thinners. If you have a stent, you'll typically need these medications to help keep it open. After some time, your cardiologist may ask you to stop one of the antiplatelets.
- Statins: Medications such as Lipitor (atorvastatin) or Crestor (rosuvastatin) effectively lower cholesterol and heart disease risk. Serious side effects are rare, but if you experience them, other medications can also help reduce cholesterol.
- Beta-blockers: Lopressor (metoprolol) or Coreg (carvedilol) can help manage chest discomfort from CAD and treat related heart failure. Beta-blockers lower your heart rate, and fatigue is a common side effect.
- Angiotensin-converting enzyme (ACE) inhibitors: These drugs treat hypertension and heart failure associated with CAD by dilating the blood vessels and lowering blood pressure.
Lifestyle Changes
Several lifestyle habits can help lower your chance of developing coronary artery disease and your risk of CAD complications. To keep your heart as healthy as possible, the American Heart Association recommends the following lifestyle habits:
- Avoid smoking
- Avoid secondhand smoke
- Eat a heart-healthy diet rich in fruits, vegetables, fiber, whole grains, fish, and lean meats
- Limit intake of salt, ultra-processed foods, sugary drinks, and alcohol
- Aim for 150 minutes of moderate-intensity exercise per week, such as brisk walking
- Get 7-9 hours of sleep per night
- Monitor your blood sugar, cholesterol, and blood pressure
According to public health guidelines, people with CAD should also receive the flu and COVID-19 vaccines to prevent complications from these respiratory illnesses.
Surgery and Procedures
In addition to medication and lifestyle habits, a cardiologist will sometimes recommend a procedure or surgery to open up a blocked vessel. There are two main options: percutaneous coronary intervention or coronary artery bypass grafting.
Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI) is a minimally invasive procedure to open blocked arteries using a stent. In this procedure, a cardiologist places a catheter in an artery in the wrist or groin. Using contrast dye and X-rays, they can visualize the heart's arteries. They then open a blockage by inflating a balloon and placing a stent to keep the artery open.
Cardiologists often perform PCI as an emergency treatment for a heart attack when a sudden blockage reduces blood flow to the heart. It's also used when people have persistent chronic angina (chest discomfort due to heart blockages) despite medical treatment.
Coronary Artery Bypass Grafting
Coronary artery bypass grafting surgery (CABG) is a surgery in which a cardiac surgeon bypasses the blocked coronary artery. The surgeon sews a piece of artery or vein from elsewhere in the body (e.g., chest, leg, arm) above and below the blockage to create a new route for blood flow. This is a more invasive procedure that carries some risks, and a cardiologist and heart surgeon can help determine if it's an appropriate option for you.
Prognosis and Life Expectancy
Coronary artery disease is a lifelong condition that can increase your risk of heart attack, stroke, and early death. The prognosis and life expectancy of CAD depend on age, symptom severity, underlying conditions, heart function, and overall health status.
In a registry of people who had undergone coronary angiography (a minimally invasive procedure looking at the coronary arteries), the 12-year survival rate of those with normal coronary arteries was 91%. Those with blockages in one vessel had a 74% survival rate, whereas the 12-year survival rate was 50% for people with blockages in three vessels.
Many people with CAD can live long, active, and healthy lives. Treatment and lifestyle habits can help lower the risk of complications and premature death.
Living With and Managing CAD
Coronary artery disease is a very common condition in the United States, but it can affect your daily life by causing symptoms that limit your activity and energy levels. Getting a diagnosis of heart disease isn't easy, and it affects many people's mental health. If you're experiencing mood changes like anxiety and depression as you process your diagnosis, therapy is available to help you cope.
If you have difficulty managing CAD or could use some motivation to make lifestyle changes and adhere to your treatment plan, your healthcare team is available for support. Staying in contact with your providers and leaning on your loved ones is an important part of the treatment journey.
There are also support groups that you can reach out to for help, such as:
Cardiac rehab is also a great way to learn how to safely exercise and get tips on managing CAD. This intensive therapy program includes monitored exercise, education, and counseling to help you live a healthy life with CAD or other heart conditions.
Regardless of which treatments you and your provider choose, living well with CAD is still possible. Following your treatment plan, making necessary lifestyle changes, and asking for support when you need it are essential.
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November 8, 2024
What Is Trench Mouth—and Why Does It Happen?
Medically reviewed by Edmund Khoo, DDS
Trench mouth is a severe, advanced form of gingivitis (gum disease) that causes painful bleeding, lesions, and ulcers between the teeth. Though gingivitis is common, trench mouth is much rarer and occurs due to bacterial overgrowth.
Several treatment options can help reduce symptoms, and treatment aims to prevent the infection from spreading.
Symptoms of Trench Mouth
In its typical form, gingivitis causes bleeding and inflamed gums. Trench mouth, however, is a severe, rapidly advancing form of gingivitis, leading to symptoms in the mouth and other parts of the body.
Oral Symptoms
People with trench mouth experience several sudden symptoms, such as:
- Severe pain in one or more areas of the gums
- Bleeding in the gums
- Swollen gums
- Ulcers or sores in the gum tissue between your teeth
- A thin layer of gray dead tissue around the affected areas
- Yellow, cream-colored, or gray film or "paste" on the gums between the teeth
- Chronic bad breath
Systemic Symptoms
In addition to dental symptoms, trench mouth may also cause systemic (or bodywide) symptoms. These symptoms are more common in advanced cases and may include:
- Fever
- Chills
- Fatigue
- Malaise
- Lethargy
- Swollen lymph nodes
What Causes It?
Trench mouth occurs due to an overgrowth of naturally occurring bacteria in the mouth. When left uncontrolled, the bacteria infect gum tissue, which can lead to inflammation and increase your risk of necrosis—or the breakdown and death of gum tissue.
Several factors, like poor oral hygiene and viral infections, can raise your chances of trench mouth. Trench mouth isn't contagious and can't be spread from person to person.
Risk Factors
Several factors can lead to bacterial overgrowth and raise the risk of developing trench mouth. The most common include:
- Poor oral hygiene
- Inadequate access to dental care
- Human immunodeficiency virus (HIV)
- Diabetes
- Cancer
- Chronic stress
- Lack of sleep
- Gingivitis
- Tobacco and alcohol use
- Malnutrition
- Vitamin C deficiency
Diagnosis
Dentists can diagnose trench mouth based on a visual examination and an assessment of dental history. Your dentist will first rule out other conditions that can cause similar symptoms (such as gingivitis or herpes) and then order several tests to make a proper diagnosis:
- Oral exam: Evaluates affected area by prodding and poking to assess the health of gum tissue and screen for symptoms
- Blood test: Detects underlying conditions that can raise the risk of trench mouth, such as HIV or diabetes
- Gram stain: Scrapes off a tissue sample or collects fluid to detect the type of bacteria causing your symptoms
Your Treatment Options
The treatment goals for trench mouth are to reduce pain and prevent the infection from spreading. If properly managed, most cases of trench mouth are reversible. Serious cases may require surgery if other treatment options are unsuccessful.
Debridement
Debridement involves removing tartar and plaque around the affected gums and teeth using chemicals and an ultrasonic device. Debridement sometimes occurs alongside oxygen therapy, which directs pure oxygen to the affected gum tissue. This treatment can help the gums heal and recover.
Pain Medications
Your dentist may recommend pain medications to help manage any pain you're experiencing. The most common options are nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Aleve (naproxen).
Antiseptic Mouth Wash
Another common treatment is antiseptic mouthwash, such as Paroex Oral Rinse (0.12% chlorhexidine gluconate). This helps combat the bacterial overgrowth that's causing trench mouth. Your dentist will advise you to swish the mouthwash twice daily for about thirty days. Gargling hydrogen peroxide can also help.
Lifestyle Changes
Your dentist may recommend home remedies that help improve the health of your gums and your overall well-being. This includes practicing proper oral hygiene (such as brushing and flossing daily), limiting alcohol and tobacco use, managing stress, getting more sleep, and eating a well-balanced diet.
Oral Antibiotics
When other treatments have not helped reduce your symptoms, your dentist may recommend oral antibiotics to reduce the bacterial overgrowth and improve symptoms. Many dental care providers recommend these options:
- Flagyl (metronidazole)
- Moxatag (amoxicillin)
- Amoxil (penicillin)
- Cleocin (clindamycin)
- Doryx (doxycycline)
- Sumycin (tetracycline)
Dental Maintenance
Once the initial lesions and ulcers have healed, deep cleaning of the teeth above and below the gumline every 3-6 months prevents infection from returning. With scaling, dentists use instruments to scrape off plaque and tartar. They may also perform root planing, numbing your gums and scraping away tartar and plaque at the root of teeth.
Surgery
In severe cases when no treatments are helpful, or you have an advanced stage of trench mouth, surgery may be a good option. The most common is a gingivectomy, where oral surgeons numb the gums and use instruments or lasers to cut away dead gum tissue. An alternative procedure is a gingivoplasty, which reshapes the gums by grafting harvested gum tissue from another part of the mouth.
How To Prevent Trench Mouth
Preventing trench mouth primarily means addressing risk factors and promoting healthy gums. Some tips include:
- Brush your teeth twice a day
- Floss daily
- Change your toothbrush every three months
- Get annual checkups at the dentist
- Avoid or quit smoking
- Manage stress through strategies like meditation, exercise, and journaling
- Aim for at least seven hours of sleep per night
- Eat a well-balanced diet that includes fruits, vegetables, and whole grains
- Limit foods that can damage your teeth, such as hard candy or acidic juices
Are There Complications?
If trench mouth goes untreated, the infection can spread, leading to several more serious oral complications. These may include:
- Necrotizing periodontitis: Causes rapid loss of periodontal tissue (which holds your teeth in place) and leads to the development of thin and gray tissue around your gums
- Necrotizing stomatitis: Occurs as the infection spreads from the gums to the alveolar bone, the part of the jaw that holds in the teeth, which can lead to bone death, ulcers, swelling, and redness in the mouth
- Cancrum oris: Develops when gum and mouth tissues die off, causing destruction inside the mouth and on the face
A Quick Review
Trench mouth is a severe form of gum disease that occurs due to bacterial overgrowth, causing symptoms like pain, bleeding, and sores on and around the gums. Several factors can increase your risk of excess bacteria in the mouth, such as poor oral hygiene, viral infections, and chronic stress.
Treatments can help reduce symptoms in most cases. Your dentist may recommend pain medications, dental therapies, and lifestyle changes to help improve your gum and overall health.
Frequently asked Questions
Is trench mouth contagious?
Trench mouth is not contagious. While viral infections can increase your risk of trench mouth, you cannot spread trench mouth from person to person.
How long can trench mouth last?
Standard treatments can help your symptoms heal within a few days or weeks, but you'll likely need to schedule ongoing dental visits and maintain good oral hygiene to prevent trench mouth from occurring again.
Are gum diseases like trench mouth reversible?
Trench mouth is a severe gum disease, but it is typically reversible with treatment. In severe cases, there may be some loss of gum tissue, which may require surgery. If untreated, the infection can spread to underlying tissues and bone, leading to permanent and irreversible damage.
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November 7, 2024
What Is a ‘Russian Manicure’—And Can It Affect Your Health?
Fact checked by Nick Blackmer
- Russian manicures are trending among celebrities and influencers on TikTok, but dermatologists warn that the technique poses health risks.
- A main feature of Russian manicures is using an electric file to completely remove cuticles, allowing bacteria to enter nails more easily.
- With the risk of bacteria infection and overall nail damage of Russian manicures, experts recommend finding a safer option to keep nails looking beautiful while preserving your health.
Getting a manicure doesn’t sound like a controversial proposition, but one nail procedure is making waves as a surprisingly contentious option at the salon.
Despite being offered for years by some manicurists, Russian manicures have recently been gaining steam on TikTok as a popular beauty treatment. Users praise the manicure for its no-soak cuticle removal technique, which they say gives them clean-looking, picture-perfect nails. “It’s really giving hand model,” user Alexus said of her post-manicured nails.
However, the procedure has also generated negative buzz on TikTok from dermatologists and others who say the focus on the cuticle comes with noteworthy safety risks. “It’s easy to forget that cuticles actually have a functional purpose,” board-certified dermatologist Courtney Rubin said in a video warning about Russian manicures.
While messages like those certainly raise a red flag, you might be curious about what other skin experts have to say about the beauty treatment—including whether it’s worth skipping due to safety concerns. Here’s a look at the evidence.
Related: Can You Get an Infection From a Dip Powder Manicure?
What Is a Russian Manicure?
To understand the controversy surrounding Russian manicures, it helps to know what the technique entails.
Originating in Eastern Europe, the Russian manicure uses a different method than you may be used to at many U.S. nail salons. One of the main features of the Russian manicure is that it bypasses the usual step of soaking nails in water to soften the cuticle, the layer of translucent skin at the base of the nail. Instead, manicurists skip straight to filing the cuticles while they are dry.
“This technique involves using an electric file to aggressively trim and clean the cuticles, creating a sleek, ‘perfect’ finish around the nail bed,” Hannah Kopelman, DO, a dermatologist of DermOnDemand, told Health.
Russian manicures usually involve the complete removal of the cuticle. “This differs from traditional manicures, where cuticle skin is pushed back after soaking and trimmed with scissors or clippers,” said Brendan Camp, MD, a dermatologist with MDCS Dermatology in New York City.
After cuticle removal, a nail technician typically polishes the nail bed and then applies another coat with your chosen polish. The entire process can take two to three hours.
With the cuticle and skin around the nail bed removed, nails have a larger “canvas” for polish, making them appear longer and more filled-out. TikTokers and celebrities rave that the procedure creates a flawless look and that they are “never going back” to a traditional manicure. Some also claim the technique lasts longer than other manicures, allowing for more time between salon visits.
Are Russian Manicures Safe?
While it’s easy to see the appeal of a Russian manicure’s sleek aesthetic, removing the cuticle has some dermatologists concerned about nail health. That’s because the cuticle’s main purpose is to form a barrier meant to protect your nails and the skin around them from the entry of potentially harmful bacteria.
“The American Academy of Dermatology recommends that cuticles be left alone,” Camp pointed out. “They grow over the root of the nail to protect the nail; compromising the cuticle could set the nail up for injury or infection.”
Some potential infections include onychomycosis, a fungal nail infection, or paronychia, which develops in the skin around the nail, Camp said. A 2022 case study, for example, highlighted a 20-year-old woman who had a Russian manicure and then developed paronychia. She visited the emergency room after experiencing pain, swelling, and pus coming from the area around her nail (she recovered after a course of antibiotics). Kopelman said she’s also seen patients develop cellulitis after the procedure.
An infection that begins in the hands can also spread to the rest of the body. “While it’s not common, there is a real risk of systemic infection,” Kopelman said. “The Russian manicure’s invasive approach can introduce bacteria or fungi into the bloodstream if the protective barrier of the cuticle is compromised.”
However, infections aren’t the only concern with a Russian manicure. The technique might harm your nails themselves. When cuticles are removed so close to the nail bed, Kopelman said, it compromises the structure and integrity of the nail, increasing brittleness and sensitivity. “I often see patients with nails that have become weaker or thinner after frequent Russian manicures,” she said. “Moreover, repeated trauma to the cuticle area can lead to chronic inflammation or even scarring, which affects how the nail grows out in the long term.”
Related: Are Manicures Safe? Experts Recommend Reviewing Health Risks Before Booking an Appointment
Should You Avoid the Russian Manicure?
Camp didn’t suggest that everyone avoid a Russian manicure, but he did note that it’s important to be aware of the risks. If you do opt for one, he encourages selecting a nail technician with plenty of experience.
Kopelman, on the other hand, doesn’t recommend the procedure. “In my professional opinion, it’s best to avoid the Russian manicure or approach it with extreme caution,” she said.
Gentler alternatives like applying cuticle oils can improve the appearance of nails without compromising the skin barrier, Kopelman added. “I remind my patients that there are safe ways to keep nails looking beautiful while preserving the health and integrity of both the nails and the surrounding skin,” she said.
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November 7, 2024
RFK Jr. Claims Fluoride in Drinking Water is ‘Dangerous’—Here’s What the Science Says
Fact checked by Nick Blackmer
- In a recent post on X, Robert F. Kennedy Jr. said fluoride will be removed from America’s drinking water under a Trump presidency, citing its link to health conditions like arthritis, IQ loss, and bone cancer.
- Adding fluoride to drinking water is a decades-long practice in the U.S. to prevent dental cavities, and experts say there are no confirmed health risks of fluoride at a safe level of exposure.
- Still, there is some research showing the toxicity of fluoride at high levels, and reducing its concentration in the water supply may have minimal impact on dental health with the popularity of fluoride toothpaste.
Under a Trump presidency, fluoride will be removed from America’s public water supply, according to Robert F. Kennedy Jr.
The claim comes from a post on X, shared by Kennedy on Saturday, just days before the 2024 presidential election.
“On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water," Kennedy wrote. "Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease. President @realDonaldTrump and First Lady @MELANIATRUMP want to Make America Healthy Again."
In a follow-up post, Kennedy called fluoride a "dangerous neurotoxin."
Water fluoridation, or adding fluoride to drinking water, is a decades-long practice in the U.S.—but Kennedy’s claims have ignited questions about the safety of fluoride in drinking water and what would happen if it were to be removed from the U.S. water supply. Here’s what you need to know.
What Is Fluoride, and Why Is It in Our Drinking Water?
Fluoride is a naturally occurring mineral that can help prevent tooth decay and strengthen bones. Fluoride is often found in water supplies and a variety of dental products, including toothpaste and mouth rinses, to prevent dental cavities.
Almost all water contains some naturally occurring fluoride, but usually not enough to support dental health, so local governments began adding fluoride to water systems in the 1940s. By 2020, over 72% of the total U.S. population, or about 290 million people, received fluoridated water through a community water system.
Water fluoridation is not required by law, and it’s up to state and local governments to decide whether to add fluoride to their water supplies. The U.S. Department of Health and Human Services (HHS) set the optimal fluoride concentration in drinking water at 0.7 milligrams of fluoride per liter of water. While water fluoridation typically involves the addition of fluoride, communities might actually remove fluoride if the natural level is too high.
According to the Centers for Disease Control and Prevention (CDC), drinking fluoridated water reduces cavities by about 25% in children and adults, resulting in less mouth pain, fewer fillings or teeth pulled, and fewer missed days of work and school. It’s worth noting that a Cochrane review published in October 2024 found that the benefit of community water fluoridation on tooth decay has declined since the 1970s, when fluoride toothpaste became more widely available.
Does Fluoride Pose Any Public Health Risks?
Experts say this is a tricky question—research shows that health risks associated with fluoride are based on the level of exposure.
“The science of fluoride is very interesting, because fluoride in small amounts is beneficial whereas fluoride in high doses is toxic,” Athanasios Zavras, DDS, MS, DMSc, Delta Dental of Massachusetts Professor of Public Health and Community Service at Tufts University School of Medicine and chair of the school’s Department of Public Health and Community Service, told Health.
But for now, there are no confirmed health risks of fluoride at optimal levels. “There is no evidence to back up the claims that 0.7 mg/L of fluoride leads to any of the conditions mentioned,” Zavras said.
That said, fluoride has been associated with some adverse health outcomes at higher levels, according to Ashley Malin, PhD, assistant professor of epidemiology at the University of Florida College of Public Health and Health Professions.
Fluoride and Neurodevelopment
Malin primarily studies fluoride’s effect on neurodevelopment, and there is some evidence pointing to a link between the two.
In August, a report by the National Toxicology Program found that higher levels of fluoride exposure—like drinking water with more than 1.5 mg of fluoride per liter (mg/L)—is associated with lower IQ in children.
Most of the studies included in the report were conducted in countries outside the U.S. with higher exposure levels to fluoride. But the report did find that nearly 2 million Americans have water that naturally contains at least 1.5 mg/L of fluoride—the upper limit set by the World Health Organization—and 1 million Americans have tap water naturally fluoridated at 2 mg/L and above.
The report was also cited in a lawsuit brought against the Environmental Protection Agency by a non-governmental organization and other plaintiffs. A federal court in California ruled in favor of the plaintiffs, who claimed the levels of fluoride in U.S. drinking water pose a risk to human health.
Though the court ruling didn’t conclude that the current levels of fluoride in water were dangerous to public health, the EPA must now strengthen its regulations for fluoride in drinking water due to “substantial and scientifically credible evidence establishing that fluoride poses a risk to human health.”
Opponents of the decision, like the American Academy of Pediatrics (AAP), have called into question the validity of the research highlighted in the case, specifically scrutinizing the NTP’s report on the link between fluoridated water and IQ.
“There is nothing about the current decision that changes my confidence in the safety of optimally fluoridated water in the U.S.,” Charlotte W. Lewis, MD, MPH, FAAP, a member of the AAP Section on Oral Health, said in a statement. “Water fluoridation is a public health policy based on a solid foundation of evidence. When new research is published, health experts scrutinize it to make sure it meets high standards for public safety.”
Related: Report: High Fluoride Levels Linked to Lower IQ in Children
Fluoride and Oral Health
One established concern for exposure to high levels of fluoride in young children is dental fluorosis—too much fluoride while teeth are growing can cause teeth discoloration, including white flecks, spots, or lines.
In the U.S., cases of dental fluorosis are mostly mild and cosmetic, meaning it does not affect tooth function and is not painful. Children are no longer at risk of dental fluorosis around age 8, when the enamel of permanent teeth is fully formed.
Fluoride and Other Health Issues
In his post on X, Kennedy also linked fluoride in drinking water to poor bone and joint health—namely bone fractures, bone cancer, and arthritis—as well as thyroid disease.
While high levels of fluoride can weaken bones—in serious cases causing a condition known as skeletal fluorosis—bone cancer has yet to be confidently linked to fluoride exposure. A review from the National Research Council expressed concern over bone cancer risk based on preliminary research and animal studies, but Malin said there have not been rigorous U.S.-based studies on low exposure.
There has been some research that found a link between fluoride exposure and increased risk of bone fracture, Malin said. Most of the studies tested higher levels of fluoride, but a recent Swedish study showed that fluoride exposure at similar levels to the U.S. was associated with an increased risk of major osteoporotic and hip fracture among postmenopausal Swedish women.
As for arthritis, overall, studies of fluoride’s association with increased risk of arthritis have not drawn strong conclusions. One study of residents of Tongyu County in China found that excessive exposure to fluoridated water may increase osteoarthritis risk, but only at levels above the recommended 0.7 mg/L.
Thyroid disease has yet to be strongly connected to fluoride exposure as well. Malin said the association is plausible, and a Canadian study found an increased risk of hypothyroidism in pregnant women with low levels of fluoride exposure from drinking water, but more rigorous studies in the U.S. are needed.
Where Does Added Fluoride in Drinking Water Come From?
The National Sanitation Foundation has approved three chemicals for drinking water fluoridation: hydrofluosilicic acid, sodium fluorosilicate, and sodium fluoride. “These can be byproducts of phosphate fertilizer production,” Malin said, perhaps explaining what Kennedy meant when he called fluoride “industrial waste.”
Two of these fluoride additives have been found to contain heavy metals, Malin said. A 2014 study found arsenic, lead, and aluminum in hydrofluorosilicic acid, and aluminum and barium in sodium fluoride, noting that all of the tested samples contained a “surprising amount of aluminum.”
The study only used a few samples, but Malin also warned that these two chemicals can have a harmful effect when combined with disinfecting agents like chlorine found in plumbing pipes.
“When combined, disinfecting agents can leach lead from lead-bearing plumbing into the community drinking water, and that can increase lead exposure,” Malin said. “Oftentimes, people think that it’s medical grade fluoride, or similar to the naturally occurring fluoride, but these chemicals are, from my perspective, quite different.”
Related: EPA Says Some 9 Million Lines of Lead Pipes Must Be Removed—What This Could Mean For You
What Would Happen if Fluoride Was Removed From the U.S. Water Supply?
The most important and immediate impact would be a significant increase in dental cavities, especially among children.
“Water fluoridation is often referred to as a ‘public health miracle’ because it helps so many across all socioeconomic groups avoid the devastating effects of dental disease,” Zavras said. “Groups that consume high levels of carbohydrates will bear the burden of such increase disproportionately.”
However, Malin said there is evidence suggesting that water fluoridation is no longer essential for preventing tooth decay, with fluoride toothpaste being widely accessible. “It seems that the demonstrated benefit has declined over the years,” Malin added. “There’s more evidence in support of the topical application.”
Fluoride recommendations have been altered before. The HHS initially set the optimal range of water fluoridation at 0.7 to 1.2 mg/L. In 2015, the agency updated its recommendation to the current optimal concentration of 0.7 mg/L due to the increasing amounts of fluoride in food that is processed with fluoridated water. “We need to remember that community drinking water isn’t the only source of fluoride exposure,” Malin added.
Whether Kennedy is in charge of American health initiatives or not, the EPA will have to address the health risks of water fluoridation per the federal court ruling.
“I think it makes sense to further regulate the chemical to mitigate the risk,” Malin said. “Whether that means reducing the concentration or eliminating it from the water supply altogether remains to be determined.”
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November 7, 2024
The 3 Biggest Misconceptions About Pancreatic Cancer—Knowing These Could Save Your Life
Fact checked by Nick Blackmer
- A new survey found that over half of adults under age 50 said they wouldn’t recognize early signs of pancreatic cancer, and a third of respondents believe only older adults are at risk for the disease.
- The rates of early-onset pancreatic cancer cases in people under 50 are actually on the rise, and only 13% of patients survive five years after their diagnosis.
- With the rise in cases and the deadly nature of the disease, experts share the early warning signs of pancreatic cancer and how you can lower your risk.
Many Americans believe misconceptions about pancreatic cancer risk that could be putting their health in danger, according to a new survey.
The new survey, conducted by The Ohio State University, found that 53% of adults under age 50 said they wouldn’t recognize early signs of pancreatic cancer. A third of respondents believe only older adults are at risk for the disease, and 37% think there’s nothing they can do to lower their chance of getting pancreatic cancer.
Just over 1,000 people were polled for the survey, which was conducted in early October.
Pancreatic cancer affects the pancreas, an organ that sits behind the stomach and aids in digestion. It’s considered rare, but pancreatic cancer often has a dire prognosis—the 5-year survival rate for pancreatic cancer is 13%.
However, the general lack of knowledge about pancreatic cancer risk is worrisome, especially given that rates of early-onset cancer—cases in people under 50—are on the rise.
“Pancreatic cancer rates...have been rising by about 1% annually, and we are seeing this disease in people who are in their 40s much more regularly. This is a concerning trend, and one for which research is needed to learn why,” Zobeida Cruz-Monserrate, PhD, co-leader of the Molecular Carcinogenesis and Chemoprevention Program at The Ohio State University Comprehensive Cancer Center—James, said in a press release.
With this increase in cases, here’s what experts had to say about common pancreatic cancer misconceptions, plus the information you need to know to make sure you’re staying on top of your risk.
Related: Why Is Pancreatic Cancer So Deadly?
Spotting Early Warning Signs of Pancreatic Cancer
In the new survey, over half of adults under 50 said they didn’t know early warning signs of pancreatic cancer.
This could be because—unlike other cancers such as breast or skin—the symptoms of pancreatic cancer can be hard to recognize.
Most cases of pancreatic cancer don’t cause any symptoms until the disease is locally advanced or metastatic, meaning the cancer has spread to another part of the body, Marcovalerio Melis, MD, surgical oncologist at Northwell Health Lenox Hill Hospital, told Health.
And by the time those symptoms do show up, they tend to be very non-specific, he said. Signs of pancreatic cancer include abdominal or back pain, weight loss, loss of appetite, diarrhea, nausea, and new-onset diabetes.
“Tumors in the body and tail of the pancreas often cause nonspecific abdominal symptoms, with patients experiencing fatigue and weight loss,” added Timothy Donahue, MD, surgical director of the Agi Hirshberg Center for Pancreatic Diseases at the UCLA Health Jonsson Comprehensive Cancer Center.
In later stages of pancreatic cancer, people might also develop jaundice—yellowing of the skin and eyes—along with dark urine, pale stool, and itchy skin. This jaundice can happen when tumors form in the head of the pancreas, which can block the bile duct, Donahue told Health.
If someone thinks they might be experiencing jaundice, they should seek medical treatment immediately.
But it can be more challenging to decide when to see a healthcare provider if you’re experiencing these more non-specific symptoms.
“Those are symptoms that many people experience at some point during their life,” said Melis. “More often than not, those symptoms are the result of a benign process.”
But if the symptoms last longer than two to three months, people should seek medical attention and bring the issue up with their doctor, he recommended.
Younger People Have a Small, But Rising, Risk of Pancreatic Cancer
According to the survey, about a third of people think that only elderly people are at risk for pancreatic cancer.
The disease is certainly more of a concern for older people—on average, people are 70 at the time of diagnosis. About 90% of cases are diagnosed in people over 55, Melis said, and two-thirds of pancreatic cancer mortalities occur in those aged 65 years and older.
“The disease remains relatively uncommon in individuals under 45,” he explained.
Despite this, there is a concerning trend of younger people getting diagnosed more frequently.
“In the last decade, a greater increase in pancreatic cancer incidence has been observed among younger adults than in the other age groups, especially those aged 15 to 34 years,” said Melis.
Lifestyle factors such as obesity and alcohol use among younger generations, as well as environmental exposures and dietary changes, may all be contributing to this trend, he said.
“With only a minor increase in survival and a rising incidence, it is projected to become the second leading cause of cancer-related deaths in the U.S. within five years,” said Donahue.
Related: Younger Adults Are Being Diagnosed With Cancer More Than Ever Before—Here's What to Know
How to Lower Your Risk of Pancreatic Cancer
Though 37% of people think there’s nothing they can do to lower their risk of pancreatic cancer, experts stress that this isn’t the case.
According to the American Cancer Society, about 10% of pancreatic cancer cases are connected to inherited gene mutations—these include BRCA1, BRCA2, PALB2, and mutations associated with Lynch syndrome and familial atypical multiple mole melanoma syndrome (FAMMM).
People often undergo genetic testing and counseling once they’ve been diagnosed with the disease.
However, aside from these genetic risks, a large proportion of pancreatic cancer cases are connected to risk factors that people can change, Melis said. There are four risk factors in particular to pay attention to:
- Smoking. The risk of developing pancreatic cancer is twice as high in people who smoke as compared to those who don’t. But “the good news is that quitting smoking can significantly decrease the risk, such that 10 to 20 years after smoking cessation, the risk of pancreatic cancer in former smokers returns to that [of] never smokers,” said Melis.
- Diabetes. Having diabetes long-term has been linked to a 1.5- to two-fold increase in the risk of pancreatic cancer. “While not all the forms of diabetes can be prevented, a healthy diet and lifestyle may certainly prevent—and sometimes even revert—the onset of type 2 diabetes,” Melis explained.
- High body mass index (BMI) or weight. “The relative risk of pancreatic cancer in individuals with a BMI [over] 30 kg/m2 is 1.72 compared with individuals with a BMI [under] 23 kg/m2 after controlling for the effects of age, smoking, and diabetes,” Melis said. Because of this, people should do their best to maintain a healthy weight. Plus, with processed foods tied to higher cancer incidence in general, people should also opt for a balanced diet rich in fruits and vegetables, he recommended.
- Alcohol consumption. More research on the connection between alcohol and cancer is still ongoing. However, Melis said growing evidence suggests that alcohol intake, particularly heavy alcohol intake, is associated with pancreatic cancer risk. “Notably, heavy alcohol consumption is also associated with pancreatitis, also a possible risk factor for pancreatic cancer,” he said.
Related: Study: Nearly Half of All Cancer Cases in the U.S. Are Linked to Risk Factors We Can Control
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November 7, 2024
How Long Can You Live With Congestive Heart Failure?
Medically reviewed by Christopher Lee, MD
Congestive heart failure, or heart failure (HF), happens when there is a structural or functional problem with your heart, making it difficult for your heart to pump blood to vital organs. How long you can live with this condition depends on factors such as age, condition stage, and overall health status.
The progression of HF varies by person. Some people's symptoms worsen quickly, while others remain stable for a long time with the right treatment plan. Communicating with your healthcare provider and sticking to your treatment regimen can help slow the progression of HF, enhance your quality of life, and increase your life expectancy.
Factors Affecting Life Expectancy
The life expectancy of someone with heart failure depends on several factors, such as:
- Age: Some older adults may develop HF because of long-standing or uncontrolled high blood pressure or obesity. The heart may be weaker as a result, which can worsen HF.
- Stage at diagnosis: People diagnosed in an earlier stage of HF may live longer than those diagnosed in more advanced stages, where the heart's ability to pump blood is significantly reduced.
- Underlying health conditions: Other medical conditions can put additional strain on the heart. Coronary artery disease, high blood pressure, cardiomyopathy, or an irregular heartbeat often causes HF. Managing these conditions can reduce the likelihood of your HF progressing.
What's the Life Expectancy?
People diagnosed with heart failure often wonder how long they can live with the condition. According to a study on long-term survival after hospitalization for HF in Australia and New Zealand, survival rates vary based on the above factors. The study included more than 283,000 people and found that:
- 48% of participants lived at least three years after hospitalization
- 34% lived for five years
- 17% lived for 10 years
- Younger people (ages 18-54) with HF tended to live longer, usually 10 years or more
- 6% of people aged 85 and older lived for 10 additional years
- Men had shorter life expectancies than women
The researchers also reported that people with HF experience a loss of about seven years in life expectancy compared to people without the condition. For younger people aged 18-54, this loss of life expectancy can be as much as 20.5 years. Early treatment and careful management of other health conditions can help improve these outcomes.
How To Improve Life Expectancy
Your healthcare provider may recommend certain lifestyle changes when managing heart failure. These include regularly monitoring your weight, avoiding or quitting smoking, staying physically active, getting enough rest, and managing stress. These changes can help improve heart function, slow disease progression, and improve your overall quality of life.
Monitor Your Weight Regularly
Your healthcare provider may suggest you weigh yourself daily because quick weight gain can indicate worsening heart failure. For better accuracy, wear the same type of clothing and keep the scale in the same location each time you weigh yourself. Contact your healthcare provider if you gain 2-3 pounds a day for several days, five or more pounds in a week, or for any weight gain your provider requested you contact them about.
Avoid Smoking
Smoking can put a strain on your heart by increasing your heart rate. Smoking can also raise blood pressure and lower oxygen levels, both of which can worsen heart failure symptoms. Avoiding or quitting smoking improves both heart and lung function and reduces the risk of blood clots. It's one of the most impactful steps to improving your health.
Be Physically Active
Regular, moderate exercise, like Zumba classes or brisk walking, can help strengthen your heart. Climbing stairs or gardening are also great options to get your heart stronger.
A person with heart failure needs a workout plan tailored to their heart's capabilities. Work with your healthcare provider to develop an exercise plan that fits your needs. A cardiac rehabilitation program may be more helpful if moderate exercise is too difficult.
Get Enough Rest and Relaxation
Take breaks to rest throughout your day so you avoid overexerting your heart. Elevating your feet or sitting for a while in between household chores can help. You might also sleep better at night by propping your head up with pillows and avoiding heavy meals or caffeine before bed. Rest periods are essential for giving your heart time to recover.
Reduce Stress
Stress can make heart failure symptoms worse. A diagnosis of HF can be stressful and even trigger anxiety, but healthy coping strategies are important to your overall health and well-being.
Avoid using smoking, alcohol, or overeating to cope with stress. Instead, try relaxation techniques like deep breathing, meditation, or yoga. Joining a support group or leaning on your loved ones can also help you manage stress and allow you to handle the challenges of living with HF.
Manage Overall Health
Your healthcare team may recommend other lifestyle changes that can help you live well with your condition, including:
- Limit your fluid intake
- Eat a heart-healthy diet rich in fruits, vegetables, and whole grains
- Monitor blood pressure
- Stay up to date on vaccinations
Living With Congestive Heart Failure
Heart failure can cause symptoms like fatigue and shortness of breath, which may make daily tasks more challenging. Emotional strain from managing the chronic condition can also cause frustration and anxiety. Financial concerns may arise due to medical costs and reduced work capacity. Social isolation is also common, as physical and emotional limitations impact relationships and daily interactions.
Despite these challenges, it's important to know that support is available. Building emotional support through family, friends, or support groups is necessary for people living with HF. Therapy can also often help manage mental health symptoms. Set realistic goals for physical activity and social involvement, as these can foster a sense of control and accomplishment. Your healthcare team is also a good source of information and support.
A Quick Review
Congestive heart failure is a chronic condition that can affect both physical and emotional well-being. While heart failure is a serious condition, your life expectancy varies on factors like your age, stage of diagnosis, and coexisting health conditions.
Lifestyle changes—such as regularly monitoring your weight, staying active, and managing stress—can improve your heart health and overall quality of life. Emotional support from your community is also important as you navigate this condition.
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November 7, 2024
Renal Diet (Kidney Disease Diet) Guide
Medically reviewed by Kierra Brown, RD
Chronic kidney disease (CKD) occurs when the kidneys become damaged and slowly lose their ability to filter waste and excess fluids from the blood, causing a buildup of harmful substances in the body.
As kidney damage progresses, people often experience symptoms like swelling, fatigue, chest pain, dry skin, itching, numbness, headaches, shortness of breath, and weight loss. Without proper treatment, chronic kidney disease can lead to bone disease, anemia, stroke, or heart attack.
People with CKD are often placed on a renal (kidney) diet to slow the progression of the disease, relieve symptoms, and maintain nutrient stores. This specialized diet focuses on controlling the intake of specific minerals to protect the kidneys from further damage and balance electrolyte levels.
Foods To Eat if You Have Chronic Kidney Disease
When following the renal diet, carefully managing your sodium, phosphorus, potassium, and protein intake is essential.
Foods Low in Sodium
Sodium is an essential mineral that helps to maintain fluid balance in the body. However, people with chronic kidney disease should limit sodium intake because excess sodium causes the blood to hold on to more fluids than needed.
Fluid retention increases blood volume, leading to hypertension (high blood pressure). It can cause edema (swelling), shortness of breath, and strain on the heart and kidneys. Further damage may develop as the kidneys work harder to manage the increased fluid load.
Sodium recommendations vary depending on the stage of kidney disease and your individualized health status. A general rule of thumb is to limit your intake to less than 2,300 milligrams daily.
Here are some tips for reducing your sodium intake:
- Season your food with spices, herbs, vinegar, lemon juice, and salt-free seasoning
- Use low-sodium sauces and salad dressings
- Choose unprocessed meats over their processed counterparts
- Choose products labeled "low-sodium" or "sodium-free"
- Select fresh and frozen fruits, vegetables, and protein sources without added seasonings and sauces
- Drain and rinse canned foods that contain added salt
Foods Low in Phosphorus
Phosphorus is a mineral that plays a pivotal role in bone health and energy production. The kidneys help maintain balanced phosphorus levels by filtering extra phosphorus from the blood and excreting it in urine.
Removing excess phosphorous becomes difficult as kidney function declines, leading to phosphorus buildup in people with chronic kidney disease. High phosphorus levels pull calcium out of the bones, weakening bone structure.
Elevated phosphorus levels can also result in harmful calcium deposits in the lungs, eyes, blood vessels, and heart, increasing the risk of heart attack or stroke. Depending on your phosphorus levels, you may be advised to limit phosphorus intake to 800-1,000 milligrams to reduce these complications.
Foods and drinks low in phosphorus include:
- Fresh fruits and vegetables: Apples, berries, grapes, cucumbers, mushrooms
- Dairy alternatives: Unenriched rice milk and almond milk, vegan yogurt and cheese
- Grains: White bread, pasta, rice, corn and rice cereals
- Beverages: Water, coffee, tea, lemonade, drinks without phosphate additives
Foods Low in Potassium
Potassium is vital for proper nerve, muscle, and kidney function. People with chronic kidney disease typically maintain normal blood potassium levels until reaching the later stages of the disease.
As chronic kidney disease progresses, the kidneys may have difficulty getting rid of excess potassium, leading to hyperkalemia—high potassium levels in the blood. Hyperkalemia can cause muscle weakness, paralysis, nausea, hypotension (low blood pressure), irregular heartbeat, and cardiac arrest. People at risk of hyperkalemia should have their blood levels checked regularly.
Foods low in potassium include:
- Fruits: Apples, pears, peaches, berries, grapes, pineapples, plums, watermelon
- Vegetables: Green beans, asparagus, cabbage, cauliflower, zucchini, corn, eggplant, onions, peas
- Grains: White bread, pasta, rice, grits
- Milk alternatives: Rice milk
Adequate Protein
Protein is required to build and maintain the body's tissues and organs, heal wounds, and fight infections. Using protein to carry out these vital functions causes the body to produce waste products that end up in the blood. The kidneys are responsible for removing this waste.
For people with chronic kidney disease, too much protein can increase pressure on the kidneys, leading to further kidney damage. Low-protein diets can ease this pressure and reduce the kidney's workload.
Too little protein can lead to malnutrition, which develops when the body lacks essential nutrients. People on dialysis may need more protein because the treatments remove protein from the blood. Working with a registered dietitian (RD) or registered dietitian nutritionist (RDN) can help ensure you get the right balance of protein to meet your individualized needs.
Here are some general suggestions:
- Eat smaller portions (2-3 ounces) of meat, chicken, and fish
- Keep dairy to a minimum (one-half cup milk or yogurt or one slice of cheese)
- Make plant proteins half of your total protein intake to slow the loss of kidney function
Plant Proteins
Plant protein serving sizes include one-half cup of beans (e.g., black beans, chickpeas), one-quarter cup of nuts and seeds (e.g., almonds, pumpkin seeds), and one-half cup of grains (e.g., barley, buckwheat).
Foods To Avoid
Specific foods to avoid on a renal diet depend on the stage of kidney disease and laboratory test results. People in the early stages are advised to avoid or limit foods high in sodium and protein to reduce kidney strain. In later stages, avoiding foods high in potassium and phosphorus also becomes crucial.
- Salt and salt seasonings: Table, seasoning, garlic, onion, celery, and lite salts, meat tenderizer
- Salty foods: Crackers, potato chips, pretzels, tortilla chips
- Cured foods: Ham, bacon, sauerkraut, pickles
- Luncheon meats: Deli meats, pastrami, sausage, spam, hot dogs
- Processed foods: Canned food, TV dinners, frozen prepared food, fast food
Foods high in protein include:
- Animal sources: Meat, chicken, fish, eggs, dairy
- Plant sources: Beans and legumes, nuts, seeds
Although beans, nuts, and seeds contain protein, plant proteins are gentler on the kidneys than animal proteins. Excess acid can harm the kidneys, and plant proteins produce less acid in the body than animal proteins.
Foods and drinks high in phosphorus include:
- Foods with phosphate additives: Foods containing dicalcium phosphate, disodium phosphate, monosodium phosphate, phosphoric acid, trisodium phosphate
- Dairy products: Milk, cheese, yogurt
- Protein sources: Oyster, beef liver, fish roe, sardines, chicken liver, organ meats, processed meats
- Beverages: Beer, cocoa, drinks with phosphate additives, dark sodas
- Other foods: Chocolate, caramels, oat bran (e.g., oat bran muffins)
Foods high in potassium include:
- Fruits: Bananas, apricots, dates, dried fruits, oranges, orange juice, kiwis, honeydew melons
- Vegetables: Potatoes, beans and legumes, acorn and butternut squash,
artichokes, beets, leafy greens, tomatoes, avocados - Dairy: Milk, yogurt
- Grains: Bran and bran products, wheat germ, brown rice, nuts, beans, whole-wheat bread and pasta
Meal Ideas for Chronic Kidney Disease
Below are several kidney-friendly breakfast, lunch, and dinner ideas to enjoy throughout the week.
Breakfast
- Whole egg or egg white omelet with red peppers, zucchini, garlic, and onion
- Homemade pancakes, scrambled egg whites, and mixed berries
- Chia seed pudding made with almond milk and topped with sliced pears
Lunch
- Mediterranean chickpea salad with cucumbers, red onion, and fresh herbs
- Chicken salad with grapes, apples, and onions paired with white bread
- Fish tacos with a side of roasted corn
Dinner
- Grilled chicken (3 ounces) with rosemary cauliflower mash and garlic asparagus
- Baked Salmon (3 ounces) seasoned with dill with a side of green beans and white rice
- Tofu with vegetable fried rice
Snacks
- Celery and peanut butter
- Plain popcorn
- Berry smoothie made with almond milk
Diets for Chronic Kidney Disease
The diets researched for their effects on kidney disease are the DASH Diet and plant-based diets.
The DASH Diet, short for Dietary Approaches to Stop Hypertension, is an eating plan designed to lower high blood pressure and slow the progression of heart and kidney disease. It emphasizes consuming fruits, vegetables, whole grains, fish, poultry, beans, seeds, nuts, and low-fat dairy products while limiting sodium, added sugar, saturated fat, and red meat.
Plant-based diets focus on an increased intake of fruits, vegetables, whole grains, beans, nuts, and seeds while limiting or excluding animal products. These diets are rich in fiber, vitamins, minerals, and antioxidants that lower disease risk. Studies have shown that plant-based diets can slow or completely stop the progression of kidney disease.
A Quick Review
Chronic kidney disease is characterized by kidney damage that reduces the ability to eliminate excess waste and fluid. People with the condition are advised to adhere to a strict renal diet to prevent further kidney damage and manage symptoms.
Depending on the stage of kidney disease and laboratory test results, dietary restrictions may include limiting sodium, potassium, phosphorus, and protein intake. Healthcare providers and RDs or RDNs adjust these recommendations to meet each person's needs. Regularly monitoring and adjusting the diet is necessary to minimize kidney disease progression and maintain mineral balance.