How extreme heat can affect you—and how you can protect yourself
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Because of climate change, last summer was the hottest in the Northern Hemisphere in 2,000 years—and this summer is expected to be even hotter. The record may continue to be broken: Extreme heat is expected to become even more frequent.
The scorching heat has led to an increase in heat-related deaths in the United States, according to the Department of Health and Human Services, with approximately 2,300 deaths in the summer of 2023. Extreme heat, defined as a period of two to three days with high heat and humidity with temperatures above 90 degrees Fahrenheit, can have serious health consequences, including symptoms like headache, dizziness, loss of consciousness, nausea, and confusion.
As we face more extreme heat, you may be wondering how you can protect yourself and your loved ones. Read on to learn about heat-related illness, who’s most at risk, and more.
What happens when our bodies are exposed to extreme heat?
As our body temperature rises, our bodies attempt to cool down by opening up more blood vessels near the skin to begin sweating. The evaporation of our sweat regulates our body temperature, but it also leads to losing fluids and minerals.
When it’s too humid, sweating alone doesn’t do the trick. The heart must work harder to bring blood around the body. It starts beating faster, which can cause light-headedness, nausea, and headache.
This process can affect our health in different ways, including increasing our risk of hospitalization for heart disease, worsening asthma, and injuring kidneys due to dehydration. It can also result in heat-related illness. Below are some effects of heat on our bodies:
- Heat cramps: Occur when a person loses salt through sweating, which causes painful cramps. Symptoms begin as painful spasms after heavy sweating, usually in the legs or the stomach. Heat cramps can lead to heat exhaustion or heat stroke.
- Heat exhaustion: This occurs when the body loses an excessive amount of water and salt, usually during intense physical activity. Symptoms include irritability, heavy sweating, and weakness, including muscle cramps. Heat exhaustion can lead to heat stroke.
- Heat stroke: This is the most severe heat-related illness. It happens when the body can’t cool down and reaches a temperature of 106 Fahrenheit or higher within 10 to 15 minutes. If the person doesn’t receive emergency treatment, it can cause permanent disability or death. Symptoms include confusion, loss of consciousness, and seizures.
What should I do if someone experiences a heat-related illness?
If you or someone you’re with begins to show signs of heat illness, the Centers for Disease Control and Prevention recommends the following:
- Heat cramps: Stop all physical activity, drink water or a sports drink, move to a cool place, and wait for cramps to go away before resuming activity. If the cramps last more than an hour, you’re on a low-sodium diet, or you have heart problems, get medical help.
- Heat exhaustion: Move the person to a cool place, loosen their clothes, use a cool bath or cloths to try to lower their body temperature, and give them a sip of water. If the person throws up, or if their symptoms last longer than an hour or worsen, get medical help.
- Heat stroke: Call 911 immediately. Then, move the person to a cooler place, use cool cloths or a cool bath to help lower their temperature, and don’t give them anything to drink.
Read more about heat-related illness and what to do in each case.
Who’s more vulnerable to extreme heat?
While everyone can be affected by extreme heat, some people are more at risk, including people of color.
A 2023 KFF report outlined that because of historical residential segregation in the U.S. (known as “redlining”), people of color are more likely to live in areas that experience higher temperatures from rooftops, asphalt, and sidewalks that retain the sun’s heat (known as the “urban heat island effect”). Additionally, communities of color are more likely to live in areas with fewer trees, which act as a canopy and provide shade, making the heat worse and more direct.
Children under 5, adults 65 or over, and pregnant people are also more vulnerable to extreme heat. If you have a chronic health condition like diabetes, heart problems, or a mental health condition, you’re also at higher risk. (Some psychiatric medications, like antidepressants, can also make people more susceptible to heat).
Lastly, anyone exposed to the sun and extreme heat for long periods is also at higher risk. This includes athletes, people who work outdoors, and unhoused people.
What can I do to prevent heat-related illness during a heat wave?
During a heat wave, follow these tips to stay cool and protect yourself from heat-related illness:
- Never leave your pets or children inside a car.
- Wear loose, light-colored clothing (dark colors absorb more heat).
- Find shade if you’re outside.
- If you don’t have air conditioning in your home, go to a place where you can cool down, such as a local library, community center, local pool or splash pad, or mall. Check to see if your city has designated cooling centers. (Cities like New York have a list of places.)
- Wear a hat.
- Drink (non-alcoholic) fluids often to stay hydrated—and if you have pets, give them water frequently as well.
- Check on your family members or older neighbors who may be more sensitive to extreme heat.
- Avoid using your stove or oven too often or during the hottest parts of the day.
- Cover your windows with shades to keep the heat out.
What are some resources to prevent heat-related illness?
If you need financial assistance to cool down your home, such as to purchase an air conditioner, apply to the federal government’s Low Income Home Energy Assistance Program.
Before you head outside during a heat wave, use the CDC’s HeatRisk tool: Enter your zip code to find the current heat risk in your area and get tips on what to do to stay safe with each risk level.
During a heat wave, also look for a cooling center in your state using the National Center for Healthy Housing’s list.
Check out the National Weather Service’s for more tips and resources.
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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The FIRST Program: Fighting Insulin Resistance with Strength Training – by Dr. William Shang
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A lot of advice about fighting insulin resistance focuses on diet. And, that’s worthwhile! How we eat does make a huge difference to our insulin responses (as does fasting). But, we expect our regular 10almonds readers either know these things now, or can read one of several very good books we’ve already reviewed about such.
This one’s different: it focuses, as the title promises, on fighting insulin resistance with strength training. And why?
It’s because of the difference that our body composition makes to our metabolism. Now, our body fat percentage is often talked about (or, less usefully but more prevalently, even if woefully misleadingly, our BMI), but Dr. Shang makes the case for it being our musculature that has the biggest impact; because of how it hastens our metabolism, and because of how it is much healthier for the body to store glycogen in muscle tissue, than just cramming whatever it can into the liver and visceral fat. It becomes relevant, then, that there’s a limit to how much glycogen can be stored in muscle tissue, and that limit is how much muscle you have.
This is not, however, 243 pages to say “lift some weights, lazybones”. Rather, he explains the relevant pathophysiology (we will be more likely to adhere to things we understand, than things we do not), and gives practical advice on exercising the different kinds of muscle fibers, arguing that the whole is greater than the sum of its parts, as well as outlining an exercise program for the gym, plus a chapter on no-gym exercises too.
The style is quite dense, which may be offputting for some, but it suffices to take one’s time and read thoughtfully; the end result is worth it.
Bottom line: if you’d like to keep insulin resistance at bay, this book is an excellent extra tool for that.
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Vaping: A Lot Of Hot Air?
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Vaping: A Lot Of Hot Air?
Yesterday, we asked you for your (health-related) opinions on vaping, and got the above-depicted, below-described, set of responses:
- A little over a third of respondents said it’s actually more dangerous than smoking
- A little under a third of respondents said it’s no better nor worse, just different
- A little over 10% of respondents said it’s marginally less harmful, but still very bad
- A little over 10% of respondents said it’s a much healthier alternative to smoking
So what does the science say?
Vaping is basically just steam inhalation, plus the active ingredient of your choice (e.g. nicotine, CBD, THC, etc): True or False?
False! There really are a lot of other chemicals in there.
And “chemicals” per se does not necessarily mean evil green glowing substances that a comicbook villain would market, but there are some unpleasantries in there too:
- Potential harmful health effects of inhaling nicotine-free shisha-pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol
- Inflammatory and Oxidative Responses Induced by Exposure to Commonly Used e-Cigarette Flavoring Chemicals and Flavored e-Liquids without Nicotine
So, the substrate itself can cause irritation, and flavorings (with cinnamaldehyde, the cinnamon flavoring, being one of the worst) can really mess with our body’s inflammatory and oxidative responses.
Vaping can cause “popcorn lung”: True or False?
True and False! Popcorn lung is so-called after it came to attention when workers at a popcorn factory came down with it, due to exposure to diacetyl, a chemical used there.
That chemical was at that time also found in most vapes, but has since been banned in many places, including the US, Canada, the EU and the UK.
Vaping is just as bad as smoking: True or False?
False, per se. In fact, it’s recommended as a means of quitting smoking, by the UK’s famously thrifty NHS, that absolutely does not want people to be sick because that costs money:
Of course, the active ingredients (e.g. nicotine, in the assumed case above) will still be the same, mg for mg, as they are for smoking.
Vaping is causing a health crisis amongst “kids nowadays”: True or False?
True—it just happens to be less serious on a case-by-case basis to the risks of smoking.
However, it is worth noting that the perceived harmlessness of vapes is surely a contributing factor in their widespread use amongst young people—decades after actual smoking (thankfully) went out of fashion.
On the other hand, there’s a flipside to this:
Flavored vape restrictions lead to higher cigarette sales
So, it may indeed be the case of “the lesser of two evils”.
Want to know more?
For a more in-depth science-ful exploration than we have room for here…
BMJ | Impact of vaping on respiratory health
Take care!
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The How Not to Die Cookbook – by Dr. Michael Greger
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We’ve previously reviewed Dr. Greger’s “How Not To Die”, which is excellent and/but very science-dense.
This book is different, in that the science is referenced and explained throughout, but the focus is the recipes, and how to prepare delicious healthy food in accordance with the principles laid out in How Not To Die.
It also follows “Dr Greger’s Daily Dozen“, that is to say, the 12 specific things he advises we make sure to have every day, and thus helps us to include them in an easy, no-fuss fashion.
The recipes themselves are by Robin Robertson, and/but with plenty of notes by Dr Greger; they clearly collaborated closely in creating them.
The ingredients are all things one can find in any well-stocked supermarket, so unless you live in a food desert, you can make these things easily.
And yes, the foods are delicious too.
Bottom line: if you’re interested in cooking according to perhaps the most science-based dietary system out there, then this book is a top-tier choice.
Click here to check out The How Not To Die Cookbook, and live well!
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Get The Right Help For Your Pain
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How Much Does It Hurt?
Sometimes, a medical professional will ask us to “rate your pain on a scale of 1–10”.
It can be tempting to avoid rating one’s pain too highly, because if we say “10” then where can we go from there? There is always a way to make pain worse, after all.
But that kind of thinking, however logical, is folly—from a practical point of view. Instead of risking having to give an 11 later, you have now understated your level-10 pain as a “7” and the doctor thinks “ok, I’ll give Tylenol instead of morphine”.
A more useful scale
First, know this:
Zero is not “this is the lowest level of pain I get to”.
Zero is “no pain”.
As for the rest…
- My pain is hardly noticeable.
- I have a low level of pain; I am aware of my pain only when I pay attention to it.
- My pain bothers me, but I can ignore it most of the time.
- I am constantly aware of my pain, but can continue most activities.
- I think about my pain most of the time; I cannot do some of the activities I need to do each day because of the pain.
- I think about my pain all of the time; I give up many activities because of my pain.
- I am in pain all of the time; It keeps me from doing most activities.
- My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.
- My pain is all that I can think about; I can barely move or talk because of my pain.
- I am in bed and I can’t move due to my pain; I need someone to take me to the emergency room because of my pain.
10almonds tip: are you reading this on your phone? Screenshot the above, and keep it for when you need it!
One extra thing to bear in mind…
Medical staff will be more likely to believe a pain is being overstated, on a like-for-like basis, if you are a woman, or not white, or both.
There are some efforts to compensate for this:
A new government inquiry will examine women’s pain and treatment. How and why is it different?
Some other resources of ours:
- The 7 Approaches To Pain Management ← a pain specialist discusses the options available
- Managing Chronic Pain (Realistically!) ← when there’s no quick fix, but these things can buy you some hours’ relief at least / stop the pain from getting worse in the moment
- Science-Based Alternative Pain Relief ← for when you’re maxxed out on painkillers, and need something more/different, these are the things the science says will work
Take care!
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How To Really Look After Your Joints
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The Other Ways To Look After Your Joints
When it comes to joint health, most people have two quick go-to items:
- Stretching
- Supplements like omega-3 and glucosamine sulfate
Stretching, and specifically, mobility exercises, are important! We’ll have to do a main feature on these sometime soon. But for today, we’ll just say: yes, gentle daily stretches go a long way, as does just generally moving more.
And, those supplements are not without their merits. For example:
- Effect of omega-3 on painful symptoms of patients with osteoarthritis of the synovial joints: systematic review and meta-analysis
- Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator
Of those, glucosamine sulfate may have an extra benefit in now just alleviating the symptoms, but also slowing the progression of degenerative joint conditions (like arthritis of various kinds). This is something it shares with chondroitin sulfate:
Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis
An unlikely extra use for the humble cucumber…
As it turns out, cucumber extract beats glucosamine and chondroitin by 200%, at 1/135th of the dose.
You read that right, and it’s not a typo. See for yourself:
Reduce inflammation, have happier joints
Joint pain and joint degeneration in general is certainly not just about inflammation; there is physical wear-and-tear too. But combatting inflammation is important, and turmeric, which we’ve done a main feature on before, is a potent helper in this regard:
See also: Keep Inflammation At Bay
(a whole list of tips for, well, keeping inflammation at bay)
About that wear-and-tear…
Your bones and joints are made of stuff, and that stuff needs to be replaced. As we get older, the body typically gets worse at replacing it in a timely and efficient fashion. We can help it do its job, by giving it more of the stuff it needs.
And what stuff is that?
Well, minerals like calcium and phosphorus are important, but a lot is also protein! Specifically, collagen. We did a main feature on this before, which is good, as it’d take us a lot of space to cover all the benefits here:
We Are Such Stuff As Fish Are Made Of
Short version? People take collagen for their skin, but really, its biggest benefit is for our bones and joints!
Wrap up warmly and… No wait, skip that.
If you have arthritis, you may indeed “feel it in your bones” when the weather changes. But the remedy for that is not to try to fight it, but rather, to strengthen your body’s ability to respond to it.
The answer? Cryotherapy, with ice baths ranking top:
- Effects of an Exercise Program and Cold-Water Immersion Recovery in Patients with Rheumatoid Arthritis (RA): Feasibility Study
- Effectiveness of home-based conventional exercise and cryotherapy on daily living activities in patients with knee osteoarthritis: A randomized controlled clinical trial
- Local Cryotherapy, Comparison of Cold Air and Ice Massage on Pain and Handgrip Strength in Patients with Rheumatoid Arthritis
Note that this can be just localized, so for example if the problem joints are your wrists, a washing-up bowl with water and ice will do just nicely.
Note also that, per that last study, a single session will only alleviate the pain, not the disease itself. For that (per the other studies) more sessions are required.
We did a main feature about cryotherapy a while back, and it explains how and why it works:
A Cold Shower A Day Keeps The Doctor Away?
Take care!
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Zuranolone: What to know about the pill for postpartum depression
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In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed.
Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same.
The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available.
On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting.
Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more.
What is zuranolone?
Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days.
How does zuranolone work?
Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.
“Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”
How is it different from other antidepressants?
“What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility.
“It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.”
What are Zurzuvae’s side effects?
According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.
“Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”
She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief.
Can someone breastfeed while taking zuranolone?
It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials).
A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”
Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication.
“A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says.
How much does Zurzuvae cost?
Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind.
Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance.
The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
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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