Watch Out For Lipedema
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Lipedema occurs mostly in women, mostly in times of hormonal change, with increasing risk as time goes by (so for example, puberty yields a lower risk than pregnancy, which yields a lower risk than menopause).
Its name literally means “fat swelling”, and can easily be mistaken for obesity or, in its earlier stages, just pain old cellulite.
Cellulite, by the way, is completely harmless and is also not, per se, an indicator of bad health. But if you have it and don’t like it, you can reduce it:
Obesity is more of a complex matter, and one that we’ve covered here:
Lipedema is actively harmful
Lipedema can become a big problem, because lifestyle change does not reduce lipedema fat, the fat is painful, can lead to obesity if one was not already obese, causes gait and joint abnormalities, causes fatigue, can lead to lymphedema (beyond the scope of today’s article—perhaps another time!) and very much psychosocial distress.
Like many conditions that mostly affect women, the science is… Well, here’s a recent example review that was conducted and published:
Fun fact: in Romanian there is an expression “one eye is laughing; the other is crying”, and it seems appropriate here.
Spot the signs
Because it’s most readily mistaken for cellulite in first presentation, let’s look at the differences between them:
- Cellulite is characterized by dimpled, bumpy, or even skin; lipedema is the same but with swelling too.
- Cellulite is a connective tissue condition; lipedema is too (at least in part), but also involves the abnormal accumulation and deposition of fat cells, rather than just pulling some down a bit.
- Cellulite has no additional symptoms; lipedema soon also brings swollen limbs, joint pain, and/or skin that’s “spongy” and easily bruised.
What to do about it
First, get it checked out by a doctor.
If the doctor says it is just cellulite or obesity, ask them what difference(s) they are basing that on, and ask that they confirm in writing having dismissed your concerns (having this will be handy later if it turns out to be lipedema after all).
If it is lipedema, you will want to catch it early; there is no known cure, but advanced symptoms are a lot easier to keep at bay than they are to reverse once they’ve shown up.
Weight maintenance, skin care (including good hydration), and compression therapy have all been shown to help slow the progression.
If it is allowed to progress unhindered, that’s when a lot more fat accumulation and joint pain is likely to occur. Liposuction and surgery are options, but even they are only a temporary solution, and are obviously not fun things to have to go through.
Prevention is, as ever, much better than cure treatment ← because there is no known cure
One last thing
Lipedema’s main risk factor is genetic. The bad news is, there’s not much that can be done about that for now, but the good news is, you can at least get the heads-up about whether you are at increased risk or not, and be especially vigilant if you’re in the increased risk group. See also:
One Test, Many Warnings: The Real Benefit Of Genetic Testing
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From straight to curly, thick to thin: here’s how hormones and chemotherapy can change your hair
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Head hair comes in many colours, shapes and sizes, and hairstyles are often an expression of personal style or cultural identity.
Many different genes determine our hair texture, thickness and colour. But some people’s hair changes around the time of puberty, pregnancy or after chemotherapy.
So, what can cause hair to become curlier, thicker, thinner or grey?
Curly or straight? How hair follicle shape plays a role
Hair is made of keratin, a strong and insoluble protein. Each hair strand grows from its own hair follicle that extends deep into the skin.
Curly hair forms due to asymmetry of both the hair follicle and the keratin in the hair.
Follicles that produce curly hair are asymmetrical and curved and lie at an angle to the surface of the skin. This kinks the hair as it first grows.
The asymmetry of the hair follicle also causes the keratin to bunch up on one side of the hair strand. This pulls parts of the hair strand closer together into a curl, which maintains the curl as the hair continues to grow.
Follicles that are symmetrical, round and perpendicular to the skin surface produce straight hair.
Life changes, hair changes
Our hair undergoes repeated cycles throughout life, with different stages of growth and loss.
Each hair follicle contains stem cells, which multiply and grow into a hair strand.
Head hairs spend most of their time in the growth phase, which can last for several years. This is why head hair can grow so long.
Let’s look at the life of a single hair strand. After the growth phase is a transitional phase of about two weeks, where the hair strand stops growing. This is followed by a resting phase where the hair remains in the follicle for a few months before it naturally falls out.
The hair follicle remains in the skin and the stems cells grow a new hair to repeat the cycle.
Each hair on the scalp is replaced every three to five years.
Hormone changes during and after pregnancy alter the usual hair cycle
Many women notice their hair is thicker during pregnancy.
During pregnancy, high levels of oestrogen, progesterone and prolactin prolong the resting phase of the hair cycle. This means the hair stays in the hair follicle for longer, with less hair loss.
A drop in hormones a few months after delivery causes increased hair loss. This is due to all the hairs that remained in the resting phase during pregnancy falling out in a fairly synchronised way.
Hair can change around puberty, pregnancy or after chemotherapy
This is related to the genetics of hair shape, which is an example of incomplete dominance.
Incomplete dominance is when there is a middle version of a trait. For hair, we have curly hair and straight hair genes. But when someone has one curly hair gene and one straight hair gene, they can have wavy hair.
Hormonal changes that occur around puberty and pregnancy can affect the function of genes. This can cause the curly hair gene of someone with wavy hair to become more active. This can change their hair from wavy to curly.
Researchers have identified that activating specific genes can change hair in pigs from straight to curly.
Chemotherapy has very visible effects on hair. Chemotherapy kills rapidly dividing cells, including hair follicles, which causes hair loss. Chemotherapy can also have genetic effects that influence hair follicle shape. This can cause hair to regrow with a different shape for the first few cycles of hair regrowth.
Hormonal changes as we age also affect our hair
Throughout life, thyroid hormones are essential for production of keratin. Low levels of thyroid hormones can cause dry and brittle hair.
Oestrogen and androgens also regulate hair growth and loss, particularly as we age.
Balding in males is due to higher levels of androgens. In particular, high dihydrotestosterone (sometimes shortened to DHT), which is produced in the body from testosterone, has a role in male pattern baldness.
Some women experience female pattern hair loss. This is caused by a combination of genetic factors plus lower levels of oestrogen and higher androgens after menopause. The hair follicles become smaller and smaller until they no longer produce hairs.
Reduced function of the cells that produce melanin (the pigment that gives our hair colour) is what causes greying.
Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Food Expiration Dates Don’t Mean What Most People Think They Mean
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Have you ever wondered why rock salt that formed during the Precambrian era has a label on it saying that it expires next month? To take something more delicate, how about eggs that expire next Thursday; isn’t that oddly specific for something that is surely affected by many variables? What matters, and what doesn’t?
Covering their assets
The US in particular wastes huge amounts of food, with 37% of food waste coming from households. Confusion over date labels is a major contributor, accounting for 20% of household food waste. Many people misinterpret these labels, often discarding food that is still safe to eat—which is good for the companies selling the food, because then they get to sell you more.
Date labels were introduced in the 70s with the “open dating” system to indicate optimal freshness, not safety. These dates are often conservative, set by manufacturers to ensure food is consumed at its best quality and encourage repeat purchases. However, many foods remain safe well past their labeled dates, including shelf-stable items like pasta, rice, and canned goods, as well as frozen foods stored properly.
Some foods do pose safety risks, especially meat and dairy products, as well as many grain-based foods, all of which which can harbor harmful bacteria. Infant formula labels are strictly regulated for safety. However, most date labels are not linked to health risks, leading to unnecessary waste.
When it comes down to it, our senses of sight, smell, and taste are more reliable than dates on packaging. Some quick pointers and caveats:
- If it has changed color in some way that’s not associated with a healthily ripening fruit or vegetable, that’s probably bad
- If it is moldy, that’s probably bad (but the degree of badness varies from food to food; see the link beneath today’s video for more on that)
- If a container has developed droplets of water on the inside when it didn’t have those before, that’s probably bad (it means something is respiring, and is thus alive, that probably shouldn’t be)
- If it smells bad, that’s probably bad—however this is not a good safety test, because a bad smell may often mean you are inhaling mold spores, which are not good for your lungs.
- If it tastes different than that food usually does, that’s probably bad (especially if it became bitter, pungent, tangy, sour, or cheesy, and does nor normally taste that way).
Some places have trialled clearer labelling, for example a distinction between “expires” and merely “best before”, but public awareness about the distinction is low. Some places have trialled removing dates entirely, to oblige the consumer to use their own senses instead. This is good for the seller in a different way than household food waste is, because it means the seller will have less in-store waste (because they can still sell something that might previously have been labelled as expired).
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression
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Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”.
Some stress in daily life is unavoidable. But remaining stressed is unhealthy. Chronic stress increases chronic health conditions, including heart disease and stroke and diabetes. It can also lead to burnout or depression.
Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle.
What does the stress cycle look like?
Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by self-help experts but it does have a scientific basis.
The stress cycle is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation.
The stress cycle has three stages:
- stage 1 is perceiving the threat
- stage 2 is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol
- stage 3 is relief, including physiological and psychological relief. This completes the stress cycle.
Different people will respond to stress differently based on their life experiences and genetics.
Unfortunately, many people experience multiple and ongoing stressors out of their control, including the cost-of-living crisis, extreme weather events and domestic violence.
Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. Chronic stress and high cortisol can increase inflammation, which damages our brain and other organs.
When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are unhelpful strategies that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an increased stress response.
Stress and the brain
In the brain, chronic high cortisol can shrink the hippocampus. This can impair a person’s memory and their capacity to think and concentrate.
Chronic high cortisol also reduces activity in the prefrontal cortex but increases activity in the amygdala.
The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is goal-directed and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed.
There are five types of activities that can help our brains complete the stress cycle. https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&start=0 It can help to understand how the brain encounters stress.
1. Exercise – its own complete stress cycle
When we exercise we get a short-term spike in cortisol, followed by a healthy reduction in cortisol and adrenaline.
Exercise also increases endorphins and serotonin, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have anti-inflammatory effects.
When you exercise, there is more blood flow to the brain and higher activity in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to relieve feelings of stress.
Exercise can also increase the volume of the hippocampus. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety.
2. Cognitive activities – reduce negative thinking
Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was stronger in people with more negative thinking.
Higher amygdala activity and less rational thinking when you are stressed can lead to distorted thinking such as focusing on negatives and rigid “black-and-white” thinking.
Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called cognitive behaviour therapy.
At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle.
3. Getting creative – a pathway out of ‘flight or fight’
Creative activities can be art, craft, gardening, cooking or other activities such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work.
Such pursuits increase prefrontal cortex activity and promote flow and focus.
Flow is a state of full engagement in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses.
4. Getting social and releasing feel-good hormones
Talking with someone else, physical affection with a person or pet and laughing can all increase oxytocin. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe.
Laughing is also a social activity that activates parts of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases endorphins and serotonin and improves our mood.
5. Self-soothing
Breathing exercises and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the vagus nerves, and reduce cortisol.
A good cry can help too by releasing stress energy and increasing oxytocin and endorphins.
Emotional tears also remove cortisol and the hormone prolactin from the body. Our prior research showed cortisol and prolactin were associated with depression, anxiety and hostility.
Action beats distraction
Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle.
Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing.
Importantly, chronic stress and burnout can also indicate the need for change, such as in our workplaces. However, not all stressful circumstances can be easily changed. Remember help is always available.
If you have concerns about your stress or health, please talk to a doctor.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.
Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong and Susan J. Thomas, Associate professor in Mental Health and Behavioural Science, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Get Well, Stay Well – by Dr. Gemma Newman
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Dr. Gemma Newman is a GP (British equivalent of what in America is called a “family doctor”) who realized she was functioning great as a diagnostic flowchart interpreter and pill dispensary, but not actually doing much of what she got into the job to do: helping people.
Her patients were getting plenty of treatments, but not getting better. Often, they were getting worse. And she knew why: they come in for treatment for one medical problem, when they have six and a half medical problems probably a stack of non-medical problems that contributed to them,
So, this book sets out to do what she tries to do in her office, but often doesn’t have the time: treat the whole person.
In it, she details what areas of life to look at, what things are most likely to contribute to wellness/unwellness (be those things completely in your power or not), and how to—bit by bit—make all the parts better, and keep them that way.
The writing style is conversational, and while it’s heavily informed by her professional competence, there’s no arcane science here; it’s more about the system of bringing everything together harmoniously.
Bottom line: if you think there’s more to wellness than can be represented on an annual physicals chart, then this is the book to help you get/keep on top of things.
Click here to check out Get Well, Stay Well, and do just that!
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The Seven Principles for Making Marriage Work – by Dr. John Gottman
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A lot of relationship advice can seem a little wishy-washy. Hardline clinical work, on the other hand, can seem removed from the complex reality of married life. Dr. Gottman, meanwhile, strikes a perfect balance.
He looks at huge datasets, and he listens to very many couples. He famously isolated four relational factors that predict divorce with 91% accuracy, his “Four Horsemen”:
- Criticism
- Contempt
- Defensiveness
- Stonewalling
He also, as the title of this book promises (and we get a chapter-by-chapter deep-dive on each of them) looks at “Seven principles for making marriage work”. They’re not one-word items, so including them here would take up the rest of our space, and this is a book review not a book summary. However…
Dr. Gottman’s seven principles are, much like his more famous “four horsemen”, deeply rooted in science, while also firmly grounded in the reality of individual couples. Essentially, by listening to very many couples talk about their relationships, and seeing how things panned out with each of them in the long-term, he was able to see what things kept on coming up each time in the couples that worked out. What did they do differently?
And, that’s the real meat of the book. Science yes, but lots of real-world case studies and examples, from couples that worked and couples that didn’t.
In so doing, he provides a roadmap for couples who are serious about making their marriage the best it can be.
Bottom line: this is a must-have book for couples in general, no matter how good or bad the relationship.
- For some it’ll be a matter of realising “You know what; this isn’t going to work”
- For others, it’ll be a matter of “Ah, relief, this is how we can resolve that!”
- For still yet others, it’ll be a matter of “We’re doing these things right; let’s keep them forefront in our minds and never get complacent!”
- And for everyone who is in a relationship or thinking of getting into one, it’s a top-tier manual.
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Antihistamines’ Generation Gap
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Are You Ready For Allergy Season?
For those of us in the Northern Hemisphere, fall will be upon us soon, and we have a few weeks to be ready for it. A common seasonal ailment is of course seasonal allergies—it’s not serious for most of us, but it can be very annoying, and can disrupt a lot of our normal activities.
Suddenly, a thing that notionally does us no real harm, is making driving dangerous, cooking take three times as long, sex laughable if not off-the-table (so to speak), and the lightest tasks exhausting.
So, what to do about it?
Antihistamines: first generation
Ye olde antihistamines such as diphenhydramine and chlorpheniramine are probably not what to do about it.
They are small molecules that cross the blood-brain barrier and affect histamine receptors in the central nervous system. This will generally get the job done, but there’s a fair bit of neurological friendly-fire going on, and while they will produce drowsiness, the sleep will usually be of poor quality. They also tax the liver rather.
If you are using them and not experiencing unwanted side effects, then don’t let us stop you, but do be aware of the risks.
See also: Long-term use of diphenhydramine ← this is the active ingredient in Benadryl in the US and Canada, but safety regulations in many other countries mean that Benadryl has different, safer active ingredients elsewhere.
Antihistamines: later generations
We’re going to aggregate 2nd gen, 3rd gen, and 4th gen antihistamines here, because otherwise we’ll be writing a history article and we don’t have room for that. But suffice it to say, later generations of antihistamines do not come with the same problems.
Instead of going in all-guns-blazing to the CNS like first-gens, they are more specific in their receptor-targetting, resulting in negligible collateral damage:
Special shout-out to cetirizine and loratadine, which are the drugs behind half the brand names you’ll see on pharmacy shelves around most of the world these days (including many in the US and Canada).
Note that these two are very often discussed in the same sentence, sit next to each other on the shelf, and often have identical price and near-identical packaging. Their effectiveness (usually: moderate) and side effects (usually: low) are similar and comparable, but they are genuinely different drugs that just happen to do more or less the same thing.
This is relevant because if one of them isn’t working for you (and/or is creating an unwanted side effect), you might want to try the other one.
Another honorable mention goes to fexofenadine, for which pretty much all the same as the above goes, though it gets talked about less (and when it does get mentioned, it’s usually by its most popular brand name, Allegra).
Finally, one that’s a little different and also deserving of a special mention is azelastine. It was recently (ish, 2021) moved from being prescription-only to being non-prescription (OTC), and it’s a nasal spray.
It can cause drowsiness, but it’s considered safe and effective for most people. Its main benefit is not really the difference in drug, so much as the difference in the route of administration (nasal rather than oral). Because the drug is in liquid spray form, it can be absorbed through the mucus lining of the nose and get straight to work on blocking the symptoms—in contrast, oral antihistamines usually have to go into your stomach and take their chances there (we say “usually”, because there are some sublingual antihistamines that dissolve under the tongue, but they are less common.)
Better than antihistamines?
Writer’s note: at this point, I was given to wonder: “wait, what was I squirting up my nose last time anyway?”—because, dear readers, at the time I got it I just bought one of every different drug on the shelf, desperate to find something that worked. What worked for me, like magic, when nothing else had, was beclometasone dipropionate, which a) smelled delightfully of flowers, which might just be the brand I got, b) needs replacing now because I got it in March 2023 and it expired July 2024, and c) is not an antihistamine at all.
But, that brings us to the final chapter for today: systemic corticosteroids
They’re not ok for everyone (check with your doctor if unsure), and definitely should not be taken if immunocompromised and/or currently suffering from an infection (including colds, flu, COVID, etc) unless your doctor tells you otherwise (and even then, honestly, double-check).
But! They can work like magic when other things don’t. Unlike antihistamines, which only block the symptoms, systemic corticosteroids tackle the underlying inflammation, which can stop the whole thing in its tracks.
Here’s how they measure up against antihistamines:
❝The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.❞
~ Dr. Robert Puy et al.
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