Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps youâve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine â this is known as gastric emptying. The small intestine has a large surface area and rich blood supply â and this is the primary site of drug absorption.
Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food â such as paracetamol â and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance youâll take it for the duration itâs prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isnât enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water â or with a meal if it upsets your stomach.
A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine âwith foodâ and without, usually use a heavy meal to define âwith foodâ. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Overcoming Poor Posture â by Steven Low & Jarlo Ilano
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Weâve previously reviewed the first-named authorâs excellent âOvercoming Gravityâ, and this time the gymnast-physiotherapist is back with another physio, to deliver us a guide to overcoming poor posture.
They start (after the introductory material youâd expect of any such work) with an examination of the connection between posture and pain, because letâs face it, for most people this is whatâs most important.
The authors also do not expect that we live in a world whereby we can devote a lot of time to dedicated postural practice, so they also cover posture in real life, and practical steps to improve posture in the 23.5 (or more) hours per day that youâre mostly not thinking about it.
Which prompts the question: how do we make the change to our regular posture, when indeed we are mostly not thinking about it, and are not likely to start devoting most of our waking thoughts to it? So, again being mindful residents of the real world, the authors also bring us chapters on changing our habits, and redoing our programming, to overcome poor posture in an actually sustainable and thus meaningful fashion.
There are of course specific exercises to do too, but even there, advice is given on how to select those that are most relevant to you, your life, and your body.
Bottom line: if youâd like to be free from the pain caused by the consequences of poor posture, this book can help a lot!
Click here to check out Overcoming Poor Posture, and overcome poor posture, for good!
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Radical Remission â by Dr. Kelly Turner
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First, what this is not:an autobiographical account of the âI beat cancer and you can tooâ pep-talk style.
What it is: a very readable pop-science book based on the authorâs own PhD research into radical remission.
She knew that a very small percentage of people experience spontaneous radical remission (or quasi-spontaneous, if the remission is attributed to lifestyle changes, and/or some alternative therapy), but a small percentage of people means a large number worldwide, so she travelled the world studying over 1,000 cases of people with late-stage cancer who had either not gone for conventional anticancer drugs, or had and then stopped, and lived to tell the tale.
While she doesnât advocate for any particular alternative therapy, she does report on what things came to her attention. She does advocate for some lifestyle changes.
Perhaps the biggest value this book offers is in its promised â9 key factors that can make a real differenceâ, which are essentially her conclusions from her PhD dissertation.
There isnât room to talk about them here in a way that wouldnât be misleading/unhelpful for a paucity of space, so perhaps weâll do a main feature one of these days.
Bottom line: if you have (or a loved one has) cancer, this is an incredibly sensible book to read. If you donât, then itâs an interesting and thought-provoking book to read.
Click here to check out Radical Remission, and learn about the factors at hand!
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Why is it so shameful to have missing or damaged teeth?
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When your teeth and gums are in good condition, you might not even notice their impact on your day-to-day life. Good oral health helps us chew, taste, swallow, speak and convey emotions.
This means the state of your mouth can affect nutrition, confidence, forming relationships and maintaining overall good health and wellbeing.
People who have missing or damaged teeth, or other oral health issues such as gum disease, know this all too well.
They may not only live with pain that affects their sleep, speech and ability to enjoy certain foods, but often also face discrimination and stigma.
So, why is it so shameful to have missing teeth or gum disease? And what can we do about it?
Natalia Lebedinskaia/Getty The social and psychological impact
Oral health is deeply tied to social status. People who donât have good teeth often face stereotypes about their health, wealth and even their intelligence.
For example, in one 2010 study from the United Kingdom, researchers showed young people photographs of the same person, modified with different levels of tooth decay.
Whenever decayed teeth were visible, participants rated the person lower in intelligence, social skills, confidence, self-esteem and whether they appeared happy â based only on the photo.
These stereotypes can lead to bullying and stigma that scar people for life.
In a recent study with colleagues, we looked at nationally representative data on 4,476 children from the Longitudinal Study of Australian Children.
We found losing teeth to decay or injury was relatively common, affecting one in ten children. These children then had a 42% higher risk of being bullied at school.
These stigmatising experiences can lead to feelings of shame, embarrassment and low self-esteem. In some cases, they can mean people are less likely to seek dental care, fearing further humiliation or blame that they have neglected themselves.
Dental care is often out of reach
Tooth decay and gum disease are the most common oral diseases in Australia and can lead to missing teeth. These conditions can occur at any age, from childhood to adulthood, but they usually worsen with age.
Yet the governmentâs Child Dental Benefits Schedule only covers dental care for children aged 17 and under whose parents receive government benefits.
Some states and territories also provide oral care for eligible older adults. But long waiting lists show the public system is stretched.
This means oral health care remains inaccessible and unaffordable for many Australians.
Poor oral health affects everyday life
Arguments for improving oral health almost always focus on preventing other physical health conditions. For example, one large study of 172,630 adults in New South Wales found those with missing teeth or poor oral health were more likely to die from heart disease.
Yet when people canât afford to fix their own oral health issues or their childrenâs, there can be other serious flow-on effects for their day-to-day life and wellbeing, beyond physical health.
Research shows when people are in pain from tooth decay they are more likely to take days off work and school. This can have long-term negative effects, disrupting education and employment.
Parents may also need to take time off work to take children to the dentist or dental hygienist. They often face financial pressures due to high out-of-pocket costs for dental treatments.
Research shows when people canât afford dental treatments they may feel powerless to control their circumstances. As a result, they may choose cheaper treatments, such as having a tooth extracted even when it could have been saved.
There has also been a recent surge in people using superannuation to pay for dental treatments, for largely preventable conditions. This will further entrench financial disadvantage.
So, whatâs the fix?
Research I conducted with colleagues this year found 96% of working-aged adults in Australia believe oral health care is essential.
But there continue to be significant financial barriers in getting required treatment, particularly for people who are unemployed, have low incomes or those with disability.
So, making dental care more affordable and accessible is an important step. This will encourage timely care and make sure check-ups arenât a luxury for those who can afford them.
But while dental visits are important, they canât provide sustainable and long-term protection from oral diseases when the social conditions and behaviours that lead to poor oral health stay the same.
Experiencing stigma because of poor oral health can be highly personal and feel shameful. But the burden to fix this should not be on individuals.
The main causes of oral diseases are behaviours â such as having a lot of sugar, alcohol and tobacco, or poor oral hygiene â and high levels of stress.
We know these behaviours and stress are more common among people who experience social disadvantage.
So we need broader policies that address the social conditions in which people live, work, age and grow â for example, by making access to nutritious food more accessible and affordable.
Reducing disadvantage is the key to addressing both tooth decay and gum disease and the stigma attached to these oral health issues.
Ankur Singh, Chair of Lifespan Oral Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Can You Reverse Gray Hair? A Dermatologist Explains
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Betteridge’s Law of Headlines states “any headline that ends in a question mark can be answered by the word no“âit’s not really a universal truth, but it’s true surprisingly often, and, as board certified dermatologist “The Beauty MD” Dr. Sam Ellis explains, it’s true in this case.
But, all is not lost.
Physiological Factors
Hair color is initially determined by genes and gene expression, instructing the body to color it with melanin (brown and black) and/or pheomelanin (blonde and red). If and when the body produces less of those pigments, our hair will go gray.
Factors that affect if/when our hair will go gray include:
- Genetics: primary determinant, essentially a programmed change
- Age: related to the above, but critically, the probability of going gray in any given year increases with age
- Ethnicity: the level of melanin in our skin is an indicator of how long we are likely to maintain melanin in our hair. Black people with the darkest skintones will thus generally go gray last, whereas white people with the lightest skintones will generally go gray first, and so on for a spectrum between the two.
- Medical conditions: immune conditions such as vitiligo, thyroid disease, and pernicious anemia promote an earlier loss of pigmentation
- Stress: oxidative stress, mainly, so factors like smoking will cause earlier graying. But yes, also chronic emotional stress does lead to oxidative stress too. Interestingly, this seems to be more about norepinephrine than cortisol, though.
- Nutrient deficiencies: the body can make a lot of things, but it needs the raw ingredients. Not having the right amounts of important vitamins and minerals will result in a loss of pigmentation (amongst other more serious problems). Vitamins B6, B9, and B12 are talked about in the video, as are iron and zinc. Copper is also needed for some hair colors. Selenium is needed for good hair health in general (but not too much, as an excess of selenium paradoxically causes hair loss), and many related things will stop working properly without adequate magnesium. Hair health will also benefit a lot from plenty of vitamin B7.
So, managing the above factors (where possible; obviously some of the above aren’t things we can influence) will result in maintaining one’s hair pigment for longer. As for texture, by the way, the reason gray hair tends to have a rougher texture is not for the lack of pigment itself, but is due to decreased sebum production. Judicious use of exogenous hair oils (e.g. argan oil, coconut oil, or whatever your preference may be) is a fine way to keep your grays conditioned.
However, once your hair has gone gray, there is no definitive treatment with good evidence for reversing that, at present. Dye it if you want to, or don’t. Many people (including this writer, who has just a couple of streaks of gray herself) find gray hair gives a distinguished look, and such harmless signs of age are a privilege not everyone gets to reach, and thus may be reasonably considered a cause for celebration
For more on all of the above, enjoy:
Click Here If The Embedded Video Doesnât Load Automatically!
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Is it safe to use cake decorating dusts and dyes? 2 experts explain
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Have you ever baked or decorated a birthday cake?
Interest in elaborate cakes is booming, driven by social media trends and television shows such as Is It Cake?.
This means products such as edible glitter and colourful dyes are becoming increasingly common at childrenâs parties and other social events.
But a recent incident, where a young boy from Queensland was hospitalised after inhaling cake decorating powder, has raised concerns about the safety of these products.
And authorities have now announced a nationwide recall of the product in question.
Klaus Vedfelt/Getty What is âcake dustâ?
âCake dustâ refers to many different products used to decorate cakes. This includes edible glitter, metallic-looking powders, coloured dusts that are brushed on to decorations, and liquid colours that are sprayed on to cakes using airbrushes.
These products are made of various substances. Some are a mixture of food colourings and sugar or starch. Some also contain pigments that give them a metallic or glitter-like appearance. These pigments may contain small amounts of aluminium, copper or zinc that, when eaten in large amounts, can be toxic to humans.
Many also contain amorphous silicon dioxide, which helps stop powders from clumping together. This is not to be confused with crystalline silica dust, which has been shown to cause a long-term lung disease called silicosis.
These substances arenât inherently harmful, but can be dangerous if you are exposed to large amounts. However, how you consume them matters. For example, eating tiny amounts on the surface of a cake is very different to inhaling a concentrated cloud of fine powder.
This is because your lungs donât process particles in the same way as your digestive system. Fine particles can travel deep into your airways, where your body then absorbs them. These particles may irritate lung tissue or trigger inflammation in both small and large airways. They may also block airways and reduce oxygen intake.
This can cause persistent coughing, wheezing and shortness of breath. If you have any of these symptoms, or notice your lips turning blue, visit the emergency department immediately.
âNon-toxicâ doesnât mean edible
Some cake decorating products are labelled ânon-toxicâ rather than âedibleâ. You might assume these terms are interchangeable, but they are not.
In the recent Queensland case, the metallic cake dust was reportedly labelled ânon-toxicâ and intended only âfor use on removable partsâ of cakes. However, it was sold next to other edible cake decorating products.
Unfortunately, this is not the first time such dusts have put peopleâs health at risk. Between 2018 and 2019, United States health authorities investigated multiple poisonings linked to metallic âluster dustâ cake decorations. These products contained high levels of metals, including copper and zinc. The child from Queensland inhaled cake dust that also contained these metals.
Are they more harmful to kids?
Yes. This is because children have much smaller airways than adults, which can become blocked or irritated more easily. They also breathe more quickly relative to their body size, meaning they may inhale more potentially toxic substances at a time.
Children are often drawn to these metallic-looking cake products because they appear to be sparkly. They are also more likely to accidentally inhale cake dusts, for example while helping decorate cakes or blowing out candles.
In the Queensland case, the child inhaled about one tablespoon of gold cake dust before he started coughing, became unresponsive and ultimately spent days in an induced coma. Itâs likely the inhaled dust entered the boyâs lungs, where it blocked his airways.
This case shows the importance of keeping toddlers away from anything they could swallow, or that may settle in their lungs.
It also underscores the need for more research and tighter regulation. Research should focus on what metals, pigments and fine particles are actually in cake decorating products. Companies must make labels clearer and more comprehensive, adding warnings â such as âavoid inhalationâ or âkeep away from childrenâ â if appropriate. Regulators should also reconsider how these products are marketed and sold, particularly if they are commonly used around children.
So, can I still use these products?
Parents and keen bakers can still use cake decorating products safely, by taking some simple precautions.
Check the label
Always check the label on any cake decorating products, to ensure the product is edible and intended for food-related use.
Avoid imports
Some imported products may not meet local food safety standards, meaning their labels may be unclear or inaccurate. And itâs best to avoid buying products sold through overseas online marketplaces, as they are generally less regulated.
Use and store them with care
When using cake decorating products, you should always follow the directions for use and only apply small amounts in well-ventilated areas. Itâs best to keep them away from children, especially if they have allergies or lung conditions such as asthma or cystic fibrosis. Remember to close or secure any open products, and store them where young children wonât reach them.
William Alexander Donald, Professor of Chemistry, UNSW Sydney and Deborah Yates, Conjoint Professor, Medicine & Health, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Procrastination, and how to pay off the to-do list debt
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Procrastination, and how pay off the to-do list debt
Sometimes we procrastinate because we feel overwhelmed by the mountain of things we are supposed to be doing. If you look at your to-do list and it shows 60 overdue items, itâs little wonder if you want to bury your head in the sand!
âWhat difference does it make if I do one of these things now; I will still have 59 which feels as bad as having 60â
So, treat it like you might a financial debt, and make a repayment plan. Now, instead of 60 overdue items today, you have 1/day for the next 60 days, or 2/day for the next 30 days, or 3/day for the next 20 days, etc. Obviously, you may need to work out whether some are greater temporal priorities and if so, bump those to the top of the list. But donât sweat the minutiae; your list doesnât have to be perfectly ordered, just broadly have more urgent things to the top and less urgent things to the bottom.
Note: this repayment plan means having set repayment dates.
Up front, sit down and assign each item a specific calendar date on which you will do that thing.
This is not a deadline! It is your schedule. Youâll not try to do it sooner, and you wonât postpone it for later. You will just do that item on that date.
A productivity app like ToDoist can help with this, but paper is fine too.
Whatâs important here, psychologically, is that each day youâre looking not at 60 things and doing the top item; youâre just looking at todayâs item (only!) and doing it.
Debt Reduction/Cancellation
Much like you might manage a financial debt, you can also look to see if any of your debts could be reduced or cancelled.
We wrote previously about the âGetting Things Doneâ system. Itâs a very good system if you want to do that; if not, no worries, but you might at least want to borrow this one ideaâĤ.
Sort your items into:
Do / Defer / Delegate / Ditch
- Do: if it can be done in under 2 minutes, do it now.
- Defer: defer the item to a specific calendar date (per the repayment plan idea we just talked about)
- Delegate: could this item be done by someone else? Get it off your plate if you reasonably can.
- Ditch: sometimes, itâs ok to realize âyou know what, this isnât that important to me anymoreâ and scratch it from the list.
As a last resort, consider declaring bankruptcy
Towards the end of the dot-com boom, there was a fellow who unintentionally got his 5 minutes of viral fame for âdeclaring email bankruptcyâ.
Basically, he publicly declared that his email backlog had got so far out of hand that he would now not reply to emails from before the declaration.
He pledged to keep on top of new emails only from that point onwards; a fresh start.
We canât comment on whether he then did, but if you need a fresh start, that can be one way to get it!
In closingâĤ
Procrastination is not usually a matter of laziness, itâs usually a matter of overwhelm. Hopefully the above approach will help reframe things, and make things more manageable.
Sometimes procrastination is a matter of perfectionism, and not starting on tasks because we worry we wonât do them well enough, and so we get stuck in a pseudo-preparation rut. If thatâs the case, our previous main feature on perfectionism may help:
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