Gut – by Dr. Giulia Enders
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On account of being an organ (or rather, a system of organs) whose functions are almost entirely autonomic, most of us don’t think about our gut much. We usually know there’s acid in the stomach, and we usually know there are “good and bad” gut bacteria. But what of the rest of what goes on?
For anyone who has a hazy half-remembered knowledge from school, this will serve as not only a reminder, but a distinct upgrade in knowledge.
Dr. Giuliua Enders talks us through not just the processes of what goes on, but, as a medical doctor, also many instances of what can go wrong, for example:
- Why do some people’s bodies mistake nuts for a deadly threat (and consequently, accidentally elevate them to the status of actually becoming a deadly threat)?
- Why are some people lactose-intolerant, and why do food intolerances often pop up later with age?
- Why do constipation and diarrhoea happen?
- Why is it that stress can cause stomach ulcers?
The style of writing is light and easy-reading, and the illustrations are clear too. This is a very accessible book that doesn’t assume prior knowledge, and also doesn’t skimp on the scientific explanations—there’s no dumbing down here.
Bottom line: knowing what goes on in our gut as akin to knowing what goes on under the hood of a car. A lot of the time we don’t need to know, but knowing can make a big difference from time to time, and that’s when you’ll wish you’d learned!
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7 Essential Devices For Hand Arthritis: Regain Control of Your Life
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Dr. Diana Girnita is a double board-certified physician in rheumatology and internal medicine. With a PhD in immunology (on top of her MD), and training at Harvard and top universities, she founded Rheumatologist OnCall, offering integrative medicine to broaden rheumatology access. Here’s what she has to say about things that make life easier:
Get your hands on these…
The seven devices that Dr. Girnita recommends are:
- Hand grip strengthener: helps build grip strength with a spring-loaded mechanism. Regular use can improve strength and reduce pain.
- Finger exerciser: different device; similar principle: it strengthens hand and finger muscles using resistance, enhancing hand function.
- Moisturizing paraffin bath: a heated paraffin wax bath that soothes hands, providing heat therapy and moisturizing the skin.
- Weighted silverware: weighted utensils (knives, forks, spoons) make gripping easier and provide stability for eating.
- Foam tubing grips: foam covers to make kitchen tools, toothbrushes, and hairbrushes easier to grip.
- Electric can-opener: reduces strain in opening cans, making meal preparation more accessible.
- Compression gloves: provide gentle compression to reduce swelling and pain, improving hand flexibility and circulation.
- Door knob cover grips: make it easier to turn doorknobs by providing a larger surface to grip.
- Wider-grip pens: ergonomically designed pens with a larger diameter and softer grip reduce hand strain while writing.
This writer, who does not have arthritis but also does not have anything like the grip strength she used to, also recommends a jar opener like this one.
As a bonus, if you spend a lot of time writing at a computer, an ergonomic split keyboard like this one goes a long way to avoiding carpal tunnel syndrome, and logically must be better for arthritis than a regular keyboard; another excellent thing to have (that again this writer uses and swears by) is an ergonomic vertical mouse like this one (aligns the wrist bones correctly; the “normal” horizontal version is woeful for the carpal bones). These things are both also excellent to help avoid worsening peripheral neuropathy (something that troubles this writer’s wrists if she’s not careful, due to old injuries there).
For more on the seven things otherwise listed above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Avoiding/Managing Rheumatoid Arthritis
- Avoiding/Managing Osteoarthritis
- Managing Chronic Pain (Realistically!)
Take care!
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People on Ozempic may have fewer heart attacks, strokes and addictions – but more nausea, vomiting and stomach pain
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Ozempic and Wegovy are increasingly available in Australia and worldwide to treat type 2 diabetes and obesity.
The dramatic effects of these drugs, known as GLP-1s, on weight loss have sparked huge public interest in this new treatment option.
However, the risks and benefits are still being actively studied.
In a new study in Nature Medicine, researchers from the United States reviewed health data from about 2.4 million people who have type 2 diabetes, including around 216,000 people who used a GLP-1 drug, between 2017 and 2023.
The researchers compared a range of health outcomes when GLP-1s were added to a person’s treatment plan, versus managing their diabetes in other ways, often using glucose-lowering medications.
Overall, they found people who used GLP-1s were less likely to experience 42 health conditions or adverse health events – but more likely to face 19 others.
myskin/Shutterstock What conditions were less common?
Cardiometabolic conditions
GLP-1 use was associated with fewer serious cardiovascular and coagulation disorders. This includes deep vein thrombosis, pulmonary embolism, stroke, cardiac arrest, heart failure and myocardial infarction.
Neurological and psychiatric conditions
GLP-1 use was associated with fewer reported substance use disorders or addictions, psychotic disorders and seizures.
Infectious conditions
GLP-1 use was associated with fewer bacterial infections and pneumonia.
What conditions were more common?
Gastrointestinal conditions
Consistent with prior studies, GLP-1 use was associated with gastrointestinal conditions such as nausea, vomiting, gastritis, diverticulitis and abdominal pain.
Other adverse effects
Increased risks were seen for conditions such as low blood pressure, syncope (fainting) and arthritis.
People who took Ozempic were more likely to experience stomach upsets than those who used other type 2 diabetes treatments. Douglas Cliff/Shutterstock How robust is this study?
The study used a large and reputable dataset from the US Department of Veterans Affairs. It’s an observational study, meaning the researchers tracked health outcomes over time without changing anyone’s treatment plan.
A strength of the study is it captures data from more than 2.4 million people across more than six years. This is much longer than what is typically feasible in an intervention study.
Observational studies like this are also thought to be more reflective of the “real world”, because participants aren’t asked to follow instructions to change their behaviour in unnatural or forced ways, as they are in intervention studies.
However, this study cannot say for sure that GLP-1 use was the cause of the change in risk of different health outcomes. Such conclusions can only be confidently made from tightly controlled intervention studies, where researchers actively change or control the treatment or behaviour.
The authors note the data used in this study comes from predominantly older, white men so the findings may not apply to other groups.
Also, the large number of participants means that even very small effects can be detected, but they might not actually make a real difference in overall population health.
Observational studies track outcomes over time, but can’t say what caused the changes. Jacob Lund/Shutterstock Other possible reasons for these links
Beyond the effect of GLP-1 in the body, other factors may explain some of the findings in this study. For example, it’s possible that:
- people who used GLP-1 could be more informed about treatment options and more motivated to manage their own health
- people who used GLP-1 may have received it because their health-care team were motivated to offer the latest treatment options, which could lead to better care in other areas that impact the risk of various health outcomes
- people who used GLP-1 may have been able to do so because they lived in metropolitan centres and could afford the medication, as well as other health-promoting services and products, such as gyms, mental health care, or healthy food delivery services.
Did the authors have any conflicts of interest?
Two of the study’s authors declared they were “uncompensated consultants” for Pfizer, a global pharmaceutical company known for developing a wide range of medicines and vaccines. While Pfizer does not currently make readily available GLP-1s such as Ozempic or Wegovy, they are attempting to develop their own GLP-1s, so may benefit from greater demand for these drugs.
This research was funded by the US Department of Veterans Affairs, a government agency that provides a wide range of services to military veterans.
No other competing interests were reported.
Diabetes vs weight-loss treatments
Overall, this study shows people with type 2 diabetes using GLP-1 medication generally have more positive health outcomes than negative health outcomes.
However, the study didn’t include people without type 2 diabetes. More research is needed to understand the effects of these medications in people without diabetes who are using them for other reasons, including weight loss.
While the findings highlight the therapeutic benefits of GLP-1 medications, they also raise important questions about how to manage the potential risks for those who choose to use this medication.
The findings of this study can help many people, including:
- policymakers looking at ways to make GLP-1 medications more widely available for people with various health conditions
- health professionals who have regular discussions with patients considering GLP-1 use
- individuals considering whether a GLP-1 medication is right for them.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healing Arthritis – by Dr. Susan Blum
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We previously reviewed another book by this author, her Immune System Recovery Plan, and today it’s more specific: healing arthritis
Of course, not all arthritis is rooted in immune dysfunction, but a) all of it is made worse by immune dysfunction and b) rheumatoid arthritis, which is an autoimmune disease, affects 1% of the population.
This book tackles all kinds of arthritis, by focusing on addressing the underlying causes and treating those, and (whether it was the cause or not) reducing inflammation without medication, because that will always help.
The “3 steps” mentioned in the subtitle are three stages of a plan to improve the gut microbiome in such a way that it not only stops worsening your arthritis, but starts making it better.
The style here is on the hard end of pop-science, so if you want something more conversational/personable, then this won’t be so much for you, but if you just want the information and explanation, then this does it just fine, and it has frequent references to the science to back it up, with a reassuringly extensive bibliography.
Bottom line: if you have arthritis and want a book that will help you to get either symptom-free or as close to that as is possible from your current condition (bearing in mind that arthritis is generally degenerative), then this is a great book for that.
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PFAS Exposure & Cancer: The Numbers Are High
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PFAS & Cancer Risk: The Numbers Are High
Image Credits Mount Sinai This is Dr. Maaike van Gerwen. Is that an MD or a PhD, you wonder? It’s both.
She’s also Director of Research in the Department of Otolaryngology at Mount Sinai Hospital in New York, Scientific Director of the Program of Personalized Management of Thyroid Disease, and Member of the Institute for Translational Epidemiology and the Transdisciplinary Center on Early Environmental Exposures.
What does she want us to know?
She’d love for us to know about her latest research published literally today, about the risks associated with PFAS, such as the kind widely found in non-stick cookware:
Per- and polyfluoroalkyl substances (PFAS) exposure and thyroid cancer risk
Dr. van Gerwen and her team tested this several ways, and the very short and simple version of the findings is that per doubling of exposure, there was a 56% increased rate of thyroid cancer diagnosis.
(The rate of exposure was not just guessed based on self-reports; it was measured directly from PFAS levels in the blood of participants)
- PFAS exposure can come from many sources, not just non-stick cookware, but that’s a “biggie” since it transfers directly into food that we consume.
- Same goes for widely-available microwaveable plastic food containers.
- Relatively less dangerous exposures include waterproofed clothing.
To keep it simple and look at the non-stick pans and microwavable plastic containers, doubling exposure might mean using such things every day vs every second day.
Practical take-away: PFAS may be impossible to avoid completely, but even just cutting down on the use of such products is already reducing your cancer risk.
Isn’t it too late, by this point in life? Aren’t they “forever chemicals”?
They’re not truly “forever”, but they do have long half-lives, yes.
See: Can we take the “forever” out of forever chemicals?
The half-lives of PFOS and PFOA in water are 41 years and 92 years, respectively.
In the body, however, because our body is constantly trying to repair itself and eliminate toxins, it’s more like 3–7 years.
That might seem like a long time, and perhaps it is, but the time will pass anyway, so might as well get started now, rather than in 3–7 years time!
Read more: National Academies Report Calls for Testing People With High Exposure to “Forever Chemicals”
What should we use instead?
In place of non-stick cookware, cast iron is fantastic. It’s not everyone’s preference, though, so you might also like to know that ceramic cookware is a fine option that’s functionally non-stick but without needing a non-stick coating. Check for PFAS-free status; they should advertise this.
In place of plastic microwaveable containers, Pyrex (or equivalent) glass dishes (you can get them with lids) are a top-tier option. Ceramic containers (without metallic bits!) are also safely microwaveable.
See also:
Here’s a List of Products with PFAS (& How to Avoid Them)
Take care!
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Your Future Self – by Dr. Hal Herschfield
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How do you want to be, one year from now? Five years from now? Ten years from now?
Now, how would you have answered that same question one, five, ten years ago?
The reality, according to Dr. Hal Herschfield, is that often we go blundering into the future blindly, because we lack empathy with our future self. Our past self, we can have strong feelings about. They could range from compassion to shame, pride to frustration, but we’ll have feelings. Our future self? A mystery.
What he proposes in this book, therefore, is not merely the obvious “start planning now, little habits that add up”, etc, but also to address the underlying behavioral science of why we don’t.
Starting with exercises of empathy for our tomorrow-self (literally tomorrow, i.e. the day after this one), and building a mindset of “paying it forward”—to ourself.
By treating our future self like a loved one, we can find ourselves a lot more motivated to actually do the things that future-us will thank us for.
The real value of this book is in the progressive exercises, because it’s a “muscle” that most people haven’t exercised much. But when we do? What a superpower it becomes!
Bottom line: if you know what you “should” do, but somehow just don’t do it, this book will help connect you to your future self and work as a better team to get there… the way you actually want.
Click here to check out Your Future Self, and start by gifting this book to future-you!
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What you need to know about endometriosis
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Endometriosis affects one in 10 people with a uterus who are of reproductive age. This condition occurs when tissue similar to the endometrium—the inner lining of the uterus—grows on organs outside of the uterus, causing severe pain that impacts patients’ quality of life.
Read on to learn more about endometriosis: What it is, how it’s diagnosed and treated, where patients can find support, and more.
What is endometriosis, and what areas of the body can it affect?
The endometrium is the tissue that lines the inside of the uterus and sheds during each menstrual cycle. Endometriosis occurs when endometrial-like tissue grows outside of the uterus.
This tissue can typically grow in the pelvic region and may affect the outside of the uterus, fallopian tubes, ovaries, vagina, bladder, intestines, and rectum. It has also been observed outside of the pelvis on the lungs, spleen, liver, and brain.
What are the symptoms?
Symptoms may include pelvic pain and cramping before or during menstrual periods, heavy menstrual bleeding, bleeding or spotting between periods, pain with bowel movements or urination, pain during or after sex or orgasm, fatigue, nausea, bloating, and infertility.
The pain associated with this condition has been linked to depression, anxiety, and eating disorders. A meta-analysis published in 2019 found that more than two-thirds of patients with endometriosis report psychological stress due to their symptoms.
Who is at risk?
Endometriosis most commonly occurs in people with a uterus between the ages of 25 and 40, but it can also affect pre-pubescent and post-menopausal people. In rare cases, it has been documented in cisgender men.
Scientists still don’t know what causes the endometrial-like tissue to grow, but research shows that people with a family history of endometriosis are at a higher risk of developing the condition. Other risk factors include early menstruation, short menstrual cycles, high estrogen, low body mass, and starting menopause at an older age.
There is no known way to prevent endometriosis.
How does endometriosis affect fertility?
Up to 50 percent of people with endometriosis may struggle to get pregnant. Adhesions and scarring on the fallopian tubes and ovaries as well as changes in hormones and egg quality can contribute to infertility.
Additionally, when patients with this condition are able to conceive, they may face an increased risk of pregnancy complications and adverse pregnancy outcomes.
Treating endometriosis, taking fertility medications, and using assistive reproductive technology like in vitro fertilization can improve fertility outcomes.
How is endometriosis diagnosed, and what challenges do patients face when seeking a diagnosis?
A doctor may perform a pelvic exam and request an ultrasound or MRI. These exams and tests help identify cysts or other unusual tissue that may indicate endometriosis.
Endometriosis can only be confirmed through a surgical laparoscopy (although less-invasive diagnostic tests are currently in development). During the procedure, a surgeon makes a small cut in the patient’s abdomen and inserts a thin scope to check for endometrial-like tissue outside of the uterus. The surgeon may take a biopsy, or a small sample, and send it to a lab.
It takes an average of 10 years for patients to be properly diagnosed with endometriosis. A 2023 U.K. study found that stigma around menstrual health, the normalization of menstrual pain, and a lack of medical training about the condition contribute to delayed diagnoses. Patients also report that health care providers dismiss their pain and attribute their symptoms to psychological factors.
Additionally, endometriosis has typically been studied among white, cisgender populations. Data on the prevalence of endometriosis among people of color and transgender people is limited, so patients in those communities face additional barriers to care.
What treatment options are available?
Treatment for endometriosis depends on its severity. Management options include:
- Over-the-counter pain medication to alleviate pelvic pain
- Hormonal birth control to facilitate lighter, less painful periods
- Hormonal medications such as gonadotropin-releasing hormone (GnRH) or danazol, which stop the production of hormones that cause menstruation
- Progestin therapy, which may stop the growth of endometriosis tissue
- Aromatase inhibitors, which reduce estrogen
In some cases, a doctor may perform a laparoscopic surgery to remove endometrial-like tissue.
Depending on the severity of the patient’s symptoms and scar tissue, some doctors may also recommend a hysterectomy, or the removal of the uterus, to alleviate symptoms. Doctors may also recommend removing the patient’s ovaries, inducing early menopause to potentially improve pain.
Where can people living with endometriosis find support?
Given the documented mental health impacts of endometriosis, patients with this condition may benefit from therapy, as well as support from others living with the same symptoms. Some peer support organizations include:
- Endometriosis Coalition Patient Support Group (virtual)
- MyEndometriosisTeam (virtual)
- Endo Black, Inc. (Washington, D.C.)
- endoQueer (virtual)
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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