Is thunderstorm asthma becoming more common?

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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.

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  • Prozac’s Effect On Neuroplasticity

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    Neuroplasticity is the brain’s ability to change over time, in accordance with our experiences, and what things we practise.

    For example, before the ubiquity of GPS, taxi-drivers tended to get unusually well-developed in areas of the brain associated with memory and spatial reasoning. In contrast, your writer here, a person who does a lot of reading and writing and also uses at least 3+ languages daily, doubtlessly has overdeveloped language centers. A visual artist might develop much better visual centers. And so forth.

    These changes are in large part physical, and very easy to measure (with the right equipment). It’s not hard to see when a certain part of the brain has proportionally more volume than usual, for example.

    So, what does Prozac have to do with it?

    More than a mood-brightener

    Aside from the obvious primary intended effect of antidepressants (i.e., to treat depression by increasing relevant neurotransmitter levels), antidepressants have a bad reputation for side effects.

    For example: How Serious Are Antidepressant Side Effects?

    Some side effects are often exaggerated in popular (mis)understanding, such as: How Much Weight Gain Do Antidepressants Cause? ← the answer being: often less weight than people gain per year when not on antidepressants (although weight gain can happen, especially if one was previously under-eating while depressed)

    When it comes to Prozac (the most well-known brand name for fluoxetine, a selective serotonin reuptake inhibitor (SSRI), which works by increasing serotonin levels in the brain by decreasing the rate at which the brain “loses” serotonin), it’s worth initially noting that while serotonin is mostly associated with happiness, it does other things too; see: Serotonin For More Than Just Happiness

    The study we wrote about in that article found that it’s not just a matter of how much serotonin we have, but also where in the brain in accumulates, and which parts of the brain get prioritized. Sound familiar?

    Recently, researchers (Dr. Ilida Suleymanova et al.) investigated the effects of serotonin on neuroplasticity, and found that indeed fluoxetine (Prozac) does more than boost serotonin—it also reshapes how certain brain cells manage energy and plasticity.

    This happens as quickly as the first two weeks; for example, parvalbumin interneurons in the prefrontal cortex, which normally keep brain activity balanced, became less rigid after two weeks of treatment (which makes further changes much more possible), bearing in mind that since depression is linked to overly rigid brain circuits, this means that fluoxetine can “soften” these networks, allowing rewiring and flexibility.

    • Specifically, mitochondria in these rigidity-inducing braincells got disempowered by reduced expression of energy-production genes (remember, people think of genes as unchangeable, but they can be turned on and off by hormones/neurotransmitters, amongst other things).
    • Even more specifically, genes tied to adaptability were upregulated, and perineuronal nets that restrict plasticity were weakened.

    To read this paper in full, see: Chronic treatment with fluoxetine regulates mitochondrial features and plasticity-associated transcriptomic pathways in parvalbumin-positive interneurons of prefrontal cortex

    This becomes extra important as we age, because neurogenesis (the brain’s ability to produce new brain cells) is an important factor in neuroplasticity.

    Contrary to popular belief, we continue to do this all the way through life, albeit it does usually slow down in older age, but there are things that affect how much this happens, and when.

    To learn more about that, see: Building Your Brain At Every Age

    Finally, if you’ve been considering antidepressants but haven’t been sure if they’d be right for you, then before you rush to your doctor to get a prescription for Prozac, you might want to check out: Antidepressants: Personalization Is Key! ← because it makes a difference which one you pick

    Alternatively, if you don’t love the idea of having to keep taking something, you might consider: Psychedelics: Yes Even Once? ← since a single dose can have a lasting (positive!) effect on cognitive flexibility

    Want to learn more?

    You might like this book we reviewed a little while ago:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Take care!

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  • The Distracted Mind – by Dr. Adam Gazzaley and Dr. Larry Rosen

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    Yes, yes, we know, unplug once in a while. But what else do this highly-qualified pair of neuroscientists have to offer?

    Rather than being a book for the sake of being a book, with lots of fluff and the usual advice about single-tasking, the authors start with a reframe:

    Neurologically speaking, the hit of dopamine we get when looking for information is the exact same as the hit of dopamine that we, a couple of hundred thousand years ago, got when looking for nuts and berries.

    • When we don’t find them, we become stressed, and search more.
    • When we do find them, we are encouraged and search more nearby, and to the other side of nearby, and near around, to find more.

    But in the case of information (be it useful information or celebrity gossip or anything in between), the Internet means that’s always available now.

    So, we jitter around like squirrels, hopping from one to the next to the next.

    A strength of this book is where it goes from there. Specifically, what evidence-based practices will actually keep our squirrel-brain focused… and which are wishful thinking for anyone who lives in this century.

    Bringing original research from their own labs, as well as studies taken from elsewhere, the authors present a science-based toolkit of genuinely useful resources for actual focus.

    Bottom line: if you think you could really optimize your life if you could just get on track and stay on track, this is the book for you.

    Click here to check out The Distracted Mind, and get yours to focus!

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  • The Only Arm Exercises You Need After 60

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    It’s important, but it’s not so complicated that you have to do a lot of things for it:

    Keeping your strength up

    Age-related muscle loss (sarcopenia) starts in our 30s if we’re not careful, but it accelerates sharply after 60, especially without resistance training. This, of course, leads to reduced independence in daily tasks like lifting, carrying, and pushing, and generally is a harbinger of systemic decline (i.e. the rest of your body gives up too).

    However! Research (cited in the video) shows strength can be rebuilt at any age, even into your 80s and 90s.

    First, understand the general idea: use resistance training 2–3 times weekly for about 20 minutes each session, focusing on compound exercises rather than isolated moves, because compound movements strengthen multiple muscle groups more efficiently, and also reflect how we actually use our bodies in day-to-day life.

    Now, settle into a core arm routine:

    • 3 sets of 8–15 controlled repetitions of a dumbbell row to strengthen your arms, shoulders, and back
    • A curl, twist, and press to build your biceps, triceps, shoulders, and rotator cuff
    • A pushing exercise chosen at your level (e.g. wall press, chair press, knee push-up, or full push-up) to strengthen your chest, triceps, and shoulders.

    How to progress safely as you go: do the most challenging variation you can complete with good form for 8–15 reps, progress when you can exceed 15 easily, and take care to move slowly rather than using momentum, prioritizing good form.

    For more on all of this plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    Resistance Is Useful! (Especially As We Get Older)

    Take care!

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  • ADHD… As An Adult?

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    ADHD—not just for kids!

    Consider the following:

    • If a kid has consistent problems paying attention, it’s easy and common to say “Aha, ADHD!”
    • If a young adult has consistent problems paying attention, it’s easy and common to say “Aha, a disinterested ne’er-do-well!”
    • If an older adult has consistent problems paying attention, it’s easy and common to say “Aha, a senior moment!”

    Yet, if we recognize that ADHD is fundamentally a brain difference in children (and we do; there are physiological characteristics that we can test), and we can recognize that as people get older our brains typically have less neuroplasticity (ability to change) than when we are younger rather than less, then… Surely, there are just as many adults with ADHD as kids!

    After all, that rather goes with the linear nature of time and the progressive nature of getting older.

    So why do kids get diagnoses so much more often than adults?

    Parents—and schools—can find children’s ADHD challenging, and it’s their problem, so they look for an explanation, and ADHD isn’t too difficult to find as a diagnosis.

    Meanwhile, adults with ADHD have usually developed coping mechanisms, have learned to mask and/or compensate for their symptoms, and we expect adults to manage their own problems, so nobody’s rushing to find an explanation on their behalf.

    Additionally, the stigma of neurodivergence—especially something popularly associated with children—isn’t something that many adults will want for themselves.

    But, if you have an ADHD brain, then recognizing that (even if just privately to yourself) can open the door to much better management of your symptoms… and your life.

    So what does ADHD look like in adults?

    ADHD involves a spread of symptoms, and not everyone will have them all, or have them in the same magnitude. However, very commonly most noticeable traits include:

    • Lack of focus (ease of distraction)
      • Conversely: high focus (on the wrong things)
        • To illustrate: someone with ADHD might set out to quickly tidy the sock drawer, and end up Marie Kondo-ing their entire wardrobe… when they were supposed to doing something else
    • Poor time management (especially: tendency to procrastinate)
    • Forgetfulness (of various kinds—for example, forgetting information, and forgetting to do things)

    Want To Take A Quick Test? Click Here ← this one is reputable, and free. No sign in required; the test is right there.

    Wait, where’s the hyperactivity in this Attention Deficit Hyperactivity Disorder?

    It’s often not there. ADHD is simply badly-named. This stems from how a lot of mental health issues are considered by society in terms of how much they affect (and are observable by) other people. Since ADHD was originally noticed in children (in fact being originally called “Hyperkinetic Reaction of Childhood”), it ended up being something like:

    “Oh, your brain has an inconvenient relationship with dopamine and you are driven to try to correct that by shifting attention from boring things to stimulating things? You might have trouble-sitting-still disorder”

    Hmm, this sounds like me (or my loved one); what to do now at the age of __?

    Some things to consider:

    • If you don’t want medication (there are pros and cons, beyond the scope of today’s article), you might consider an official diagnosis not worth pursuing. That’s fine if so, because…
    • More important than whether or not you meet certain diagnostic criteria, is whether or not the strategies recommended for it might help you.
    • Whether or not you talk to other people about it is entirely up to you. Maybe it’s a stigma you’d rather avoid… Or maybe it’ll help those around you to better understand and support you.
      • Either way, you might want to learn more about ADHD in adults. Today’s article was about recognizing it—we’ll write more about managing it another time!

    In the meantime… We recommended a great book about this a couple of weeks ago; you might want to check it out:

    Click here to see our review of “The Silent Struggle: Taking Charge of ADHD in Adults”!

    Note: the review is at the bottom of that page. You’ll need to scroll past the video (which is also about ADHD) without getting distracted by it and forgetting you were there to see about the book. So:

    1. Click the above link
    2. Scroll straight to the review!

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  • The Brain Circuit That Switches Off Chronic Pain

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    …and other items from this week’s health news:

    Pain’s “off switch”

    Chronic pain is chronic, that is to say, it is characterized by how it keeps on being there. However, in emergency situations, it’s common for the brain to override pain signals (acute or chronic) in order to function sufficiently to deal with the emergency.

    In the case of chronic pain, even outside of emergencies it would be nice for the brain to override those pain signals, in order to function sufficiently to deal with everyday life, not to mention to simply enjoy some respite.

    Scientists now understand how: there are special neurons in the brainstem’s lateral parabrachial nucleus that can suppress chronic pain signals when survival instincts—like hunger, thirst, or fear—take priority. These Y1R neurons (as they are called) act as a biological switchboard, helping the brain decide when to prioritize immediate needs over lingering pain. The key? They noticed that hunger seemed to reduce chronic pain more effectively than over-the-counter painkillers.

    This means two things, in practical terms:

    1. states (like hunger) that the body recognizes as a threat can shut off pain signals—this is obviously not an ideal solution, since it requires creating states the body recognizes as a threat, and those states are usually not good/sustainable ones either
    2. new research can now look for ways to flip the switch on these Y1R neurons biochemically, hopefully creating a new class of painkillers that work more effectively and do not have the same drawbacks as, for example, opioids

    Read in full: Scientists discover brain circuit that can switch off chronic pain

    Related: How Nature Provides Us With A Surprisingly Powerful Painkiller ← this also interrupts the pain signals, albeit in a different way

    Cannabis is extra risky for over-65s

    Cannabis use is increasing in the US, including among those over 65, though research on long-term effects is still limited because of federal restrictions (the “war on drugs” may have done nothing to reduce drug availability, but has hobbled scientific research for decades).

    However, there is still some research, and it’s clear that there are some extra risks for older users, including:

    • older adults metabolize cannabis more slowly than younger ones, leading to longer-lasting highs, dizziness, confusion, and higher fall risk
    • modern cannabis has far higher THC levels than in past decades (up to 35% in plant form and 90% in concentrates), which means that older adults (accustomed to how things used to be) are more likely to overconsume accidentally, with studies showing tripled emergency visits associated with this
    • interactions with medications that are most commonly prescribed to older people—especially blood thinners—can cause further problems too

    …in addition to the risks that are closer to the same for everyone, e.g. increased inflammation, cognitive decline, heart disease, heart attacks, and stroke.

    Read in full: Regular cannabis use poses risks to those over 65, experts caution

    Related: Cannabis Myths vs Reality

    HRT: Immune-booster!

    Immune function drops sharply after the age of about 60—in men and women, largely due to T-cell production slowing down and eventually all-but-stopping.

    For women, there’s usually an additional problem: menopause significantly alters the immune system, leading to more inflammatory white blood cells (monocytes) that are less effective at clearing bacteria and associated with reduced levels of an immune protein essential for fighting infections (it’s called “complement C3”).

    However, women have an extra resource at our disposal to give our aging immune systems a boost!

    Researchers (Dr. Emma Chambers et al.) found that peri- and post-menopausal women using hormone replacement therapy (HRT) had healthier immune profiles, with fewer inflammatory monocytes, higher complement C3 levels, and infection-fighting capacity closer to that of younger women:

    Read in full: Hormone replacement therapy may help restore immunity in menopausal women

    Related: Your Brain On (And Off) Estrogen

    Take care!

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  • 5 types of ‘wellness woo’ that borrow from mainstream medicine

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    What we consider “fringe” or “mainstream” changes over time. That applies to health and medicine too.

    For instance, massage was once considered a fringe therapy but in the 19th century it morphed into what we know today as physiotherapy.

    Likewise, Swiss doctor Maximilian Bircher-Benner wasn’t taken seriously when he said we should eat oats and fruit for breakfast. But he was onto something: he invented muesli.

    There has also been traffic in the other direction. Legitimate medical therapies have turned up in the weird health borderland of beauty and “wellness”.

    When untrained or barely trained people use these therapies, they can do real harm.

    Here are five examples of wellness trends that borrow from mainstream medicine.

    SimpleImages/Getty

    1. Ozone therapy

    Ozone (O₃) is a form of oxygen. Ordinary oxygen (O₂), sometimes with ozone added, can be applied to wounds via a bag or sealed chamber to help them heal. It does this by helping the body fight infection and form collagen.

    But “ozone therapy” – the weird, unlicensed version – puts ozone, or ozone and oxygen, directly into the person’s body. It can go in via the lungs, or via intravenous injection, or it can be pumped into the rectum or vagina.

    Practitioners claim it can reduce inflammation, or even treat cancer or HIV/AIDS, despite no evidence for such health benefits.

    It can also cause fatal air embolisms – bubbles of gas in the bloodstream that can block blood flow to vital organs.

    2. Vitamin drips

    If you don’t get enough of a certain vitamin or mineral through your diet, you can take a supplement. But if that doesn’t work, in some cases, you might need to go to hospital or a doctor’s surgery to get a medically supervised infusion that’s delivered into the vein (an IV infusion).

    For instance, iron infusions help people with serious iron deficiencies.

    But celebrity endorsements have helped fuel the rise of “vitamin drips” at wellness centres and therapy lounges. These drips promise all sorts of outcomes, from boosting your immune system, to treating pain or depression.

    IV needles in untrained hands can be dangerous. They can cause phlebitis (inflammation of the vein) and infiltration (when the IV fluid or medication leaks into the surrounding areas). They can also lead to infection.

    And unlike therapeutic vitamin IV infusions administered in hospital, these non-traditional treatments are not regulated by Australia’s Therapeutic Goods Administration. So you might also not be getting the magic IV potion you’re paying for.

    3. Botox

    The bacterium Clostridium botulinum produces a neurotoxin – a poison that affects nerves. For decades, it’s been used therapeutically to treat excess sweating and migraine, among other conditions. Today, we call this neurotoxin Botox.

    Since about the 1990s, health professionals have been injecting it into people’s faces to temporarily paralyse the muscles that cause wrinkles.

    It’s legal, it’s a registered product, and in trained hands it’s safe to use.

    But as of September 2 this year, it’s been wrapped in an extra layer of regulation.

    People who deliver any non-surgical cosmetic procedures – including Botox – will now be required to demonstrate higher skill levels under tougher policies.

    This comes after several cases where nurses allegedly imported injectables from overseas. But these products weren’t registered for use in Australia and may not have been safe to use.

    4. Apheresis

    Apheresis is the process of separating blood into its component parts by spinning it at high speed in a special machine.

    Clinicians use this process to separate out and remove specific molecules or antibodies in some diseases – what’s called “selective apheresis”.

    For example, if a person has very high cholesterol that doesn’t respond to normal treatments, they can undergo lipid apheresis to “wash out” harmful lipoproteins from their blood.

    It’s easy to see how the idea of “washing” your blood could be misunderstood and misapplied.

    English actor Orlando Bloom announced earlier this year that he’d undergone apheresis to remove microplastics from his blood.

    Microplastics in the body are a cause for concern – but there’s no evidence to suggest apheresis can cleanse human blood of them.

    5. Hyperbaric therapy

    When a diver gets “the bends” from too much nitrogen forming in their body, they can be treated in a hyperbaric oxygen chamber, where they receive 100% oxygen in a pressurised chamber.

    But hyperbaric therapy is also touted as a treatment for autism, Alzheimer’s disease, cancer, strokes, and post-traumatic stress disorder.

    There isn’t enough good science to back up any of these claims. There also isn’t enough science to suggest it makes your skin look younger.

    The key message?

    The history of medicine is full of stories about when mainstream forms of medicine have harmed instead of healed.

    Humans have also always wanted to manage their own health. This has been going on for centuries, with both risks and benefits.

    But just because a therapy has been used in a hospital for one reason doesn’t necessarily mean it works in a wellness clinic for another.

    People can be easily convinced by aggressively marketed wellness therapies, which can be magnified by social media and celebrity endorsements.

    However these therapies can come with a lack of evidence to support their wider uses, and they may harm.

    Caveat emptor – let the buyer beware.

    Philippa Martyr, Lecturer, Pharmacology, Women’s Health, School of Biomedical Sciences, The University of Western Australia

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

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