
What’s Missing from Medicine – by Dr. Saray Stancic
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Another from the ranks of “doctors who got a serious illness and it completely changed how they view the treatment of serious illness”, Dr. Stancic was diagnosed with multiple sclerosis, and wasn’t impressed with the treatments presented.
Taking an evidence-based lifestyle medicine approach, she was able to not only manage her illness sufficiently to resume her normal activities, but even when so far as to run a marathon, and today boasts a symptom-free, active life.
The subtitular six lifestyle changes are not too shocking, and include a plants-centric diet, good exercise, good sleep, stress management, avoidance of substance abuses, and a fostering of social connections, but the value here is in what she has to say about each, especially the ones that aren’t so self-explanatory and/or can even cause harm if done incorrectly (such as exercise, for example).
The style is on the academic end of pop-science, of the kind that has frequent data tables, lots of statistics, and an extensive bibliography, but is still very readable.
Bottom line: if you are faced with a chronic disease, or even just an increased risk of some chronic disease, or simply like to not take chances, then this is a high-value book for you.
Click here to check out What’s Missing From Medicine, and enjoy chronic good health!
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Outsmart Your Pain – by Dr. Christiane Wolf
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Dr. Wolf is a physician turned mindfulness teacher. As such, and holding an MD as well as a PhD in psychosomatic medicine, she knows her stuff.
A lot of what she teaches is mindfulness-based stress reduction (MBSR), but this book is much more specific than that. It doesn’t promise you won’t continue to experience pain—in all likelihood you will—but it does change the relationship with pain, and this greatly lessens the suffering and misery that comes with it.
For many, the most distressing thing about pain is not the sensation itself, but how crippling it can be—getting in the way of life, preventing enjoyment of other things, and making every day a constant ongoing exhausting battle… And every night, a “how much rest am I actually going to be able to get, and in what condition will I wake up, and how will I get through tomorrow?” stress-fest.
Dr. Wolf helps the reader to navigate through all these challenges and more; minimize the stress, maximize the moments of respite, and keep pain’s interference with life to a minimum. Each chapter addresses different psychological aspects of chronic pain management, and each comes with specific mindfulness meditations to explore the new ideas learned.
The style is personal and profound, while coming from a place of deep professional understanding as well as compassion.
Bottom line: if you’ve been looking for a life-ring to help you reclaim your life, this one could be it; we wholeheartedly recommend it.
Click here to check out Outsmart Your Pain, and recover the beauty and joy of life!
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What is Ryeqo, the recently approved medicine for endometriosis?
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For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.
A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.
Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.
What does Ryeqo do?
Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.
Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.
Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.
All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.
Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).
Is it really new?
The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.
But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.
Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.
In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.
The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.
You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
ShutterstockHow to take it and what not to do
Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.
It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.
Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.
Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.
The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.
It’s costly for now
Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.
While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.
Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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This Is When Your Muscles Are Strongest
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Dr. Karyn Esser is a professor in the Department of Physiology and Aging at the University of Florida, where she’s also the co-director of the University of Florida Older Americans Independence Center, and she has insights to share on when it’s best to exercise:
It’s 4–5pm
Surprise, no clickbait or burying the lede!
This goes regardless of age or sex, but as we get older, it’s common for our circadian rhythm to weaken, which may result in a tendency to fluctuate a bit more.
However, since it’s healthy to keep one’s circadian rhythm as stable as reasonably possible, this is a good reason to try to keep our main exercise focused around that time of day, as it provides a sort of “anchor point” for the rest of our day to attach to, so that our body can know what time it is relative to that.
It’s also the most useful time of day to exercise, because most exercises give benefits proportional to progressive overloading, so training at our peak efficiency time will give the most efficient results. So much for those 5am runs!
On which note: while the title says “strongest” and the thumbnail has dumbbells, this does go for all different types of exercises that have been tested.
For more details on all of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Circadian Rhythm: Far More Than Most People Know
Take care!
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Cauliflower vs Carrot – Which is Healthier?
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Our Verdict
When comparing cauliflower to carrot, we picked the cauliflower.
Why?
In terms of macros, cauliflower has nearly 2x the protein while carrot has nearly 2x the carbs and slightly more fiber; we’re calling it a tie in this category.
When it comes to vitamins, cauliflower has more of vitamins B2, B5, B6, B9, C, K, and choline, while carrot has more of vitamins A, B1, B3, and E. Thus, a 7:4 win for cauliflower here.
In the category of minerals, cauliflower has more iron, magnesium, manganese, phosphorus, selenium, and zinc, while carrot has more calcium, copper, and potassium. So, a 6:3 win for cauliflower here.
In short, for overall nutritional density, adding up the sections makes for a clear win for cauliflower, but of course, enjoy either or (preferably) both; diversity is good!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Fast-Pickled Cucumbers
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Pickled vegetables are great for the gut, and homemade is invariably better than store-bought. But if you don’t have pickling jars big enough for cucumbers, and don’t want to wait a couple of weeks for the results, here’s a great way to do it quickly and easily.
You will need
- 1 large cucumber, sliced
- 2 tbsp apple cider vinegar
- 1½ tbsp salt (do not omit or substitute)
- 3 cloves garlic, whole, peeled
- 3 large sprigs fresh dill
- 2 tsp whole black peppercorns
- ½ tsp crushed red pepper flakes
- 1 bay leaf
Method
(we suggest you read everything at least once before doing anything)
1) Mix the vinegar and salt with 1½ cups of water in a bowl.
2) Assemble the rest of the ingredients, except the cucumber, into a quart-size glass jar with an airtight lid.
3) Add the cucumber slices into the jar.
4) Add the pickling brine that you made, leaving ½” space at the top.
5) Close the lid, and shake well.
6) Refrigerate for 2 days, after which, serve at your leisure:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Our Top 5 Spices: How Much Is Enough For Benefits? ← 3/5 of these spices are in this recipe!
Take care!
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No, your aches and pains don’t get worse in the cold. So why do we think they do?
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It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather.
It’s a common idea, but a myth.
When we looked at the evidence, we found no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains.
So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on.
fongbeerredhot/Shutterstock Weather can be linked to your health
The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures may worsen asthma symptoms. Hot temperatures increase the risk of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease.
Many people are also convinced the weather is linked to their aches and pains. For example, two in every three people with knee, hip or hand osteoarthritis say cold temperatures trigger their symptoms.
Musculoskeletal conditions affect more than seven million Australians. So we set out to find out whether weather is really the culprit behind winter flare-ups.
What we did
Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies.
We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included.
We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry).
Bad back on a cold day? We wanted to know if the weather was really to blame. Pearl PhotoPix/Shutterstock What we found
We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis.
The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain.
In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis.
It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather.
The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions.
Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up.
Why do people blame the weather?
The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain.
For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know prolonged sitting, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your back and knee pain.
Likewise, changes in mood, often experienced in cold weather, trigger increases in both back and knee pain.
So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself.
Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the nocebo effect.
When it’s cold outside, we may be less active. Anna Nass/Shutterstock What to do about winter aches and pains?
It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather).
You can:
- become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool
- lose weight if obese or overweight, as this is linked to lower levels of joint pain and better physical function
- keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep less well in cold rooms
- maintain a healthy diet and avoid smoking or drinking high levels of alcohol. These are among key lifestyle recommendations to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with higher levels of physical function.
Manuela Ferreira, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, George Institute for Global Health and Leticia Deveza, Rheumatologist and Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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