When spring arrives, so do warnings about thunderstorm asthma. But a decade ago, most of us hadn’t heard of it.

So where did thunderstorm asthma come from? Is it a new phenomenon?

In 2016, the world’s most catastrophic thunderstorm asthma event took Melbourne by surprise. An increase in warnings and monitoring is partly a response to this.

But there are also signs climate change may be exacerbating the likelihood of thunderstorm asthma, with more extreme weather, extended pollen seasons and a rise in Australians reporting hay fever.

A landmark catastrophe

The first time many Australians heard of thunderstorm asthma was in November 2016, when a major event rocked Melbourne.

During a late night storm, an estimated 10,000 people were rushed to hospitals with severe asthma attacks. With thousands of calls on emergency lines, ambulances and emergency departments were unprepared to handle the rapid increase in people needing urgent medical care. Tragically, ten of those people died.

This was the most catastrophic thunderstorm asthma event in recorded history and the first time deaths have ever occurred anywhere in the world.

In response, the Victorian Department of Health implemented initiatives, including public awareness campaigns and improvements to health and emergency services, to be ready for future thunderstorm asthma events.

A network of pollen monitoring stations was also set up across the state to gather data that helps to predict future events.

A problem for decades

While this event was unexpected, it wasn’t the first time we’d had thunderstorm asthma in Australia – we’ve actually known about it for decades.

Melbourne reported its first instance of thunderstorm asthma back in 1984, only a year after this phenomenon was first discovered in Birmingham in the United Kingdom.

Thunderstorm asthma has since been reported in other parts of Australia, including Canberra and New South Wales. But it is still most common in Melbourne. Compared to any other city (or country) the gap is significant: over a quarter of all known events worldwide have occurred in Melbourne.

Why Melbourne?

Melbourne’s location makes it a hotspot for these kinds of events. Winds coming from the north of Melbourne tend to be dry and hot as they come from deserts in the centre of Australia, while winds from the south are cooler as they come from the ocean.

When hot and cool air mix above Melbourne, it creates the perfect conditions for thunderstorms to form.

Northern winds also blow a lot of pollen from farmlands into the city, in particular grass pollen. This is not only the most common cause of seasonal hay fever in Melbourne but also a major trigger of thunderstorm asthma.

Why grass pollen?

There’s a particular reason grass pollen is the main culprit behind thunderstorm asthma in Australia. During storms there is a lot of moisture in the air. Grass pollen will absorb this moisture, making it swell up like a water balloon.

If pollen absorbs too much water whilst airborne, it can burst or “rupture,” releasing hundreds of microscopic particles into the air that can be swept by powerful winds.

Normally, when you breathe in pollen it gets stuck in your upper airway – for example, your nose and throat. This is what causes typical hay fever symptoms such as sneezing or runny nose.

But the microscopic particles released from ruptured grass pollen are much smaller and don’t get stuck as easily in the upper airway. Instead, they can travel deep into your airways until they reach your lungs. This may trigger more severe symptoms, such as wheezing or difficulty breathing, even in people with no prior history of asthma.

So who is at risk?

You might think asthma is the biggest risk factor for thunderstorm asthma. In fact, the biggest risk factor is hay fever.

Up to 99% of patients who went to the emergency department during the Melbourne 2016 event had hay fever, while a majority (60%) had no prior diagnosis of asthma.

Every single person hospitalised was allergic to at least one type of grass pollen. All had a sensitivity to ryegrass.

Is thunderstorm asthma becoming more common?

Thunderstorm asthma events are rare, with just 26 events officially recorded worldwide.

However there is evidence these events could become more frequent and severe in coming years, due to climate change. Higher temperatures and pollution could be making plants produce more pollen and pollen seasons last much longer.

Extreme weather events, including thunderstorms, are also expected to become more common and severe.

In addition, there are signs rates that hay fever may be increasing. The number of Australians reporting allergy symptoms have risen from 15% in 2008 to 24% in 2022. Similar trends in other countries has been linked to climate change.

How can I prepare?

Here are three ways you can reduce your risk of thunderstorm asthma:

• stock up on allergy medication and set up an asthma action plan with your GP
• check daily pollen forecasts for the estimated pollen level and risk of a thunderstorm asthma event in your local area
• on days with high pollen or a high risk of thunderstorm asthma, spend less time outside or wear a surgical face mask to reduce your symptoms.

Kira Morgan Hughes, PhD Candidate in Allergy and Asthma, School of Life and Environmental Sciences, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Humans have long been searching for a “magic elixir” to make us smarter, and improve our focus and memory. This includes traditional Chinese medicine used thousands of years ago to improve cognitive function.

Now we have nootropics, also known as smart drugs, brain boosters or cognitive enhancers.

You can buy these gummies, chewing gums, pills and skin patches online, or from supermarkets, pharmacies or petrol stations. You don’t need a prescription or to consult a health professional.

But do nootropics actually boost your brain? Here’s what the science says.

What are nootropics and how do they work?

Romanian psychologist and chemist Cornelius E. Giurgea coined the term nootropics in the early 1970s to describe compounds that may boost memory and learning. The term comes from the Greek words nӧos (thinking) and tropein (guide).

Nootropics may work in the brain by improving transmission of signals between nerve cells, maintaining the health of nerve cells, and helping in energy production. Some nootropics have antioxidant properties and may reduce damage to nerve cells in the brain caused by the accumulation of free radicals.

But how safe and effective are they? Let’s look at four of the most widely used nootropics.

1. Caffeine

You might be surprised to know caffeine is a nootropic. No wonder so many of us start our day with a coffee. It stimulates our nervous system.

Caffeine is rapidly absorbed into the blood and distributed in nearly all human tissues. This includes the brain where it increases our alertness, reaction time and mood, and we feel as if we have more energy.

For caffeine to have these effects, you need to consume 32-300 milligrams in a single dose. That’s equivalent to around two espressos (for the 300mg dose). So, why the wide range? Genetic variations in a particular gene (the CYP1A2 gene) can affect how fast you metabolise caffeine. So this can explain why some people need more caffeine than others to recognise any neurostimulant effect.

Unfortunately too much caffeine can lead to anxiety-like symptoms and panic attacks, sleep disturbances, hallucinations, gut disturbances and heart problems.

So it’s recommended adults drink no more than 400mg caffeine a day, the equivalent of up to three espressos.

2. L-theanine

L-theanine comes as a supplement, chewing gum or in a beverage. It’s also the most common amino acid in green tea.

Consuming L-theanine as a supplement may increase production of alpha waves in the brain. These are associated with increased alertness and perception of calmness.

However, it’s effect on cognitive functioning is still unclear. Various studies including those comparing a single dose with a daily dose for several weeks, and in different populations, show different outcomes.

But taking L-theanine with caffeine as a supplement improved cognitive performance and alertness in one study. Young adults who consumed L-theanine (97mg) plus caffeine (40mg) could more accurately switch between tasks after a single dose, and said they were more alert.

Another study of people who took L-theanine with caffeine at similar doses to the study above found improvements in several cognitive outcomes, including being less susceptible to distraction.

Although pure L-theanine is well tolerated, there are still relatively few human trials to show it works or is safe over a prolonged period of time. Larger and longer studies examining the optimal dose are also needed.

3. Ashwaghanda

Ashwaghanda is a plant extract commonly used in Indian Ayurvedic medicine for improving memory and cognitive function.

In one study, 225-400mg daily for 30 days improved cognitive performance in healthy males. There were significant improvements in cognitive flexibility (the ability to switch tasks), visual memory (recalling an image), reaction time (response to a stimulus) and executive functioning (recognising rules and categories, and managing rapid decision making).

There are similar effects in older adults with mild cognitive impairment.

But we should be cautious about results from studies using Ashwaghanda supplements; the studies are relatively small and only treated participants for a short time.

4. Creatine

Creatine is an organic compound involved in how the body generates energy and is used as a sports supplement. But it also has cognitive effects.

In a review of available evidence, healthy adults aged 66-76 who took creatine supplements had improved short-term memory.

Long-term supplementation may also have benefits. In another study, people with fatigue after COVID took 4g a day of creatine for six months and reported they were better able to concentrate, and were less fatigued. Creatine may reduce brain inflammation and oxidative stress, to improve cognitive performance and reduce fatigue.

Side effects of creatine supplements in studies are rarely reported. But they include weight gain, gastrointestinal upset and changes in the liver and kidneys.

Where to now?

There is good evidence for brain boosting effects of caffeine and creatine. But the jury is still out on the efficacy, optimal dose and safety of most other nootropics.

So until we have more evidence, consult your health professional before taking a nootropic.

But drinking your daily coffee isn’t likely to do much harm. Thank goodness, because for some of us, it is a magic elixir.

Nenad Naumovski, Professor in Food Science and Human Nutrition, University of Canberra; Amanda Bulman, PhD candidate studying the effects of nutrients on sleep, University of Canberra, and Andrew McKune, Professor, Exercise Science, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.