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[ { "answer_id": 736, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 6, "selected": true, "text": "<p>Most dentists - for <em>most</em> procedures - aim for a <em>painless</em> experience. If there is reason to keep some pain sensation intact, the dentist will inform you, and ask at appropriate intervals if you can feel pain.</p>\n\n<p>The efficacy of lidocaine and other local anesthetics depends on how closely your nerve distribution comes to the norm (they will inject the environs of the \"normal\" anatomical position of the nerve), how much anesthetic is injected, whether there are local factors which alter the local tissue pH (e.g. presence of an abscess or infection), how quickly it is removed from the site, etc.</p>\n\n<blockquote>\n <p>Is this feedback that the dentist can use to detect issues with the actual work as he goes along, or would the only purpose of reporting it be to try to get him to do something to mitigate it, for the sake of my immediate experience?</p>\n</blockquote>\n\n<p>Local anesthetics prevent pain sensation, but not vibration or pressure, which themselves can be unpleasant. Hypothetically, a dental procedure which should be painless with anesthesia can be carried out equally well whether the patient feels pain or not, so if you are stoic, feeling pain and not telling your dentist will not likely affect the outcome of that procedure. However, informing the dentist helps them to know if your anatomy is different (valuable information for the next time they need to do a similar local or regional block, your response to the anesthetic used (they might try another anesthetic or approach in the future), or if there might be an unseen infection altering the pH (and efficacy) of the anesthetic. Therefore it is probably wise to let your dentist know what you're feeling. They can reassess the situation, then offer you relief of some kind: a painless injection (the second injection into an already partially anesthetized region is truly painless), nitrous oxide (a gas), or other.</p>\n\n<p>I would liken this for most instances to suturing a laceration. There is <em>never</em> a time when I wish the patient to feel pain while I'm addressing the repair. I address what I see. If a patient feels pain, I want to know that and address the situation.</p>\n\n<p>_{<a href=\"http://www.cda-adc.ca/jcda/vol-68/issue-9/546.pdf\">An Update on Local Anesthetics in Dentistry</a>} </p>\n" }, { "answer_id": 1569, "author": "Wad Cheber", "author_id": 838, "author_profile": "https://health.stackexchange.com/users/838", "pm_score": 3, "selected": false, "text": "<p>It can absolutely give the dentist information which will help him identity potential problems. I recently had a root canal. It was a two-visit procedure, and on the first day, he drilled out the nerve fibers, tissue, and pulp, then placed a temporary crown over the tooth. </p>\n\n<p>The second visit was supposed to be a simple matter of removing the temporary crown, filling the tooth, and inserting the permanent crown. When he began to work, it was quite painful. He was shocked, and immediately set about trying to determine the cause of the problem. </p>\n\n<p>He spotted a bit of nerve fiber he had missed the first time, then completed the procedure. </p>\n\n<p>In this case, the fact I was even able to feel pain was an indication that he had overlooked something earlier in the process. If I hadn't told him about the pain, another procedure would have been necessary.</p>\n" } ]

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[ { "answer_id": 778, "author": "Dave Liu", "author_id": 140, "author_profile": "https://health.stackexchange.com/users/140", "pm_score": 4, "selected": true, "text": "<p><strong>Definition:</strong></p>\n\n<blockquote>\n <p>The term \"high fructose corn syrup\" is not a good descriptor of its\n composition, but the term was mandated to distinguish the newly\n developed fructose-containing corn syrup from traditional all-glucose\n corn syrups. Factors that may account for the different effects of\n fructose alone or a mixture of fructose and glucose could be its\n gastrointestinal effects and absorption characteristics. (5)</p>\n</blockquote>\n\n<p><strong>The Problem</strong></p>\n\n<p>Today we have too much access to energy that we don't need. This leads to the problem of obesity when people consume too many calories, pointing towards higher risks of cardiovascular diseases.</p>\n\n<p><strong>The Possible Culprit</strong></p>\n\n<p>High Fructose Corn Syrup (HFCS) contributes to this problem because when consumed, it does not stimulate the pancreas to produce insulin. In animal models, it even induces insulin resistance, leading to diabetes (1).</p>\n\n<blockquote>\n <p>\"the long-term consumption of diets high in fat and fructose is likely\n to lead to increased energy intake, weight gain, and obesity\" (1).</p>\n \n <p>Additionally, when ingested by itself, fructose is poorly absorbed\n from the gastrointestinal tract, and it is almost entirely cleared by\n the liver since it's absorbed through a different system than glucose.\n This puts more work on the liver. (2)</p>\n</blockquote>\n\n<p>Furthermore, HFCS </p>\n\n<blockquote>\n <p>\"did not suppress circulating ghrelin, a major appetite-stimulating\n hormone\" - (2)</p>\n</blockquote>\n\n<p>So even though you're taking in a massive amount of energy and overworking your liver, you don't feel full, which causes you to keep eating and drinking.</p>\n\n<p>For runners and other endurance athletes, this is ideal. They can store up massive amounts of energy without the need to stuff themselves until their stomachs are nearly exploding. For people who burn a massive amount of energy on a regular basis, HFCS comes as a good source for replenishing and preparing that energy for usage, but for everyone else who doesn't burn high levels of calories, this indicates a high influx of potential energy without anywhere to go. </p>\n\n<p><strong>The Counter</strong></p>\n\n<p>This short-term study notes,</p>\n\n<blockquote>\n <p>\"There were no differences in energy or macronutrient intake on day 2.\n The only appetite variable that differed between sweeteners was desire\n to eat\" (4)</p>\n</blockquote>\n\n<p>Another study notes that most of the testing has been done on rats, whereas in humans, </p>\n\n<blockquote>\n <p>for people with insulin resistance, diets\n with 50 grams or more per day (high consumption) may result in\n elevated triglycerides, but there is no effect with normal levels of\n fructose consumption. (5)</p>\n</blockquote>\n\n<p><strong>The Caution</strong></p>\n\n<blockquote>\n <p>Fructose is poorly absorbed from the digestive tract when it is\n consumed alone, but absorption improves when fructose is consumed in\n combination with glucose and amino acids. In addition, the principal\n sweetener in soft drinks in the US, HFCS, is not pure fructose but a\n mixture of fructose (55%) and glucose (45%). HFCS is predominately\n present as HFCS-55 (55% fructose, 41% glucose, and 4% glucose\n polymers) or HFCS-42 (42% fructose, 53% glucose and 5% glucose\n polymers) (5).</p>\n</blockquote>\n\n<p>Studies on humans hasn't been substantial enough to develop hard evidence. In fact, one of the studies indicates that fructose increased appetites while another claimed it inhibited appetite! </p>\n\n<p>If there's one thing that seems highly possible right now, it's that high fructose corn syrup gives energy, whether you need it or not. Since most people don't, that contributes to possible obesity (3).</p>\n\n<p><strong>Sources:</strong> </p>\n\n<p>(1) <a href=\"http://ajcn.nutrition.org/content/76/5/911.full\" rel=\"nofollow\">Fructose, weight gain, and the insulin resistance syndrome</a></p>\n\n<p>(2) <a href=\"http://ajcn.nutrition.org/content/86/4/895.full\" rel=\"nofollow\">How bad is Fructose?</a></p>\n\n<p>(3) <a href=\"http://www.princeton.edu/main/news/archive/S26/91/22K07/\" rel=\"nofollow\">A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain</a></p>\n\n<p>(4) <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17234503\" rel=\"nofollow\">Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women.</a></p>\n\n<p>(5) <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991323/\" rel=\"nofollow\">Health implications of fructose consumption: A review of recent data</a></p>\n" }, { "answer_id": 16850, "author": "unitacx", "author_id": 14222, "author_profile": "https://health.stackexchange.com/users/14222", "pm_score": 0, "selected": false, "text": "<p>Fructose does not stimulate production of incretin, which results in sweeteners with a high fructose content being metabolized differently.</p>\n\n<p>People taking GLP-1 agonists should avoid high levels of fructose, including the obvious - high fructose corn syrup.</p>\n\n<p>ref:\n<a href=\"https://www.physiology.org/doi/pdf/10.1152/ajpendo.00446.2012\" rel=\"nofollow noreferrer\">https://www.physiology.org/doi/pdf/10.1152/ajpendo.00446.2012</a> \nBurmeister, et al., Central glucagon-like peptide 1 receptor-induced anorexia requires glucose\nmetabolism-mediated suppression of AMPK and is impaired by central fructose] Am J Physiol Endocrinol Metab 304: E677–E685, 2013; doi:10.1152/ajpendo.00446.2012 </p>\n" } ]

[ "https://health.stackexchange.com/questions/774", "https://health.stackexchange.com", "https://health.stackexchange.com/users/59/" ]

[ { "answer_id": 784, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 4, "selected": false, "text": "<p>As a pragmatic approach I would suggest the following. Back pain and neck pain are the most common reasons why people seek for massage therapy. Most common reason for back and neck pain are muscle spasms. They are painful which cause more spasm a so a vicious circle is ready. Reason why people suffer from muscle spasm is multifactorial. Static working postures, poor muscle strength or generally bad posture leads to unfavourable muscle strains and spasms.</p>\n\n<p>Massage can be really effective for the treatment of these muscle spasms. Massage relieves tension, boosts the blood flow in muscle and helps to remove lactic acid stored in muscles. However, the spasms will definitely appear again if one does not to anything to treat the fundamental reasons why muscle spasm occurs. As so there is no long term effect with massage therapy.</p>\n\n<p>There are two Cochrane reviews published in this topic <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001929.pub2/abstract\">(1)</a>, <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004871.pub4/abstract\">(2)</a>:</p>\n\n<blockquote>\n <p>Massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001929.pub2/abstract\">(1)</a></p>\n</blockquote>\n\n<p>There is no explicit evidence for the benefits, but what is important is that there is basically no adverse effects related to massage therapy. So in that sense massage can be helpful also for your mind and wellbeing. Exercise and education indicates the same thing I said in the beginning, in addition to relieving the spasms in your back you should also focus on the overall situation, \"why do I have backpain\".</p>\n\n<p>With regard to neck pain the evidence is much more controversial. My personal opinion is that this might be related to etiology of the pain and spasm. Lower back in more common is obese people with poor physical condition <a href=\"http://www.mayoclinic.org/diseases-conditions/back-pain/basics/causes/con-20020797\">(3)</a> whereas neck pain is associated to overuse and bad postures <a href=\"http://www.mayoclinic.org/diseases-conditions/neck-pain/basics/causes/con-20028772\">(4)</a>.</p>\n" }, { "answer_id": 785, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": true, "text": "<p>There are a couple of studies that show massage will help with delayed onset muscle soreness (DOMS) after exercise, but that it doesn't really impact range of motion (ROM) or peak maximal force.</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1250256/\">This study</a> used a small cohort of 5 males, 5 females, doing arm exercises designed to produce DOMS. One arm got massaged, the other didn't. They self reported less DOMS in the massaged muscle, but it showed no impact on ROM or peak force.</p>\n\n<p><a href=\"http://bjsm.bmj.com/content/37/1/72.full\">This study</a> followed a similar path, examining hamstring contractions with a slightly larger group of 18. Each leg was exercised, and only one was massaged with similar results to the first study I cited.</p>\n\n<p>So yes, massage can reduce some of the after effects of intense exercise sessions, it hasn't been proven to actually improve performance.</p>\n" }, { "answer_id": 1931, "author": "Dr. Duncan", "author_id": 1370, "author_profile": "https://health.stackexchange.com/users/1370", "pm_score": 2, "selected": false, "text": "<p>Beyond addressing injuries, or as a treatment, massage has been shown to have many health benefits for otherwise healthy individuals in addition to feeling good.\nHere are some examples of health benefits that have some research to back them up:</p>\n\n<ul>\n<li><a href=\"http://news.uic.edu/massage-therapy-improves-circulation-alleviates-muscle-soreness\" rel=\"nofollow\">Decreasing Blood Pressure and improved circulation</a></li>\n<li><a href=\"http://www6.miami.edu/touch-research/AdultMassage.html\" rel=\"nofollow\">Reduced anxiety</a></li>\n<li><a href=\"http://www.hindawi.com/journals/ecam/2011/561753/abs/\" rel=\"nofollow\">Improved Sleep</a></li>\n<li><a href=\"http://www.sciencedirect.com/science/article/pii/S0273229711000025\" rel=\"nofollow\">Improved interpersonal relationships and feelings of self worth</a> </li>\n<li><a href=\"http://www.sciencedirect.com/science/article/pii/S027322970500033X\" rel=\"nofollow\">Increased alertness and ability to concentrate</a></li>\n</ul>\n\n<p>Many of these benefits can also be gained by other means such as exercise or meditation, but that does not diminish the fact that massage is a means of achieving these benefits.</p>\n" } ]

[ "https://health.stackexchange.com/questions/780", "https://health.stackexchange.com", "https://health.stackexchange.com/users/140/" ]

[ { "answer_id": 794, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 5, "selected": true, "text": "<p>The estimated daily requirement needed to maintain body stores of B12 varies, an estimate being from 2µg to 5µg, more if stores have been depleted in any way. It is estimated that the average person stores about 1 mg (1000 µg) of B12 in their liver, and other smaller amounts elsewhere. The recommended daily allowance assumes a 50% absorption rate of ingested B12.</p>\n\n<p>This is a good question to discuss the limits of medical science. How is the requirement for B12 determined?</p>\n\n<p><em>Longitudinal studies</em> are those that follow people over many years (even decades.) Humans are not subjected to longitudinal studies involving, say, B12 because:</p>\n\n<ul>\n<li>it would be <strong>unethical</strong> to withhold from some subjects a vitamin necessary for health and well-being while providing it to others just to get an exact number (for the sake of scientific curiosity)</li>\n<li>there are ethical issues in involvement of the young (parental consent should not extend to potential harm)</li>\n<li>if participants are paid volunteers, the study introduces a bias in recruitment (more poor people?) This affects the ability to generalize to the total population, because there may be inherent risks of confounding variables</li>\n<li>the cost of such a study would be prohibitive (who will collect the data, control the diets, pay for the food, and determine outcomes, etc.)</li>\n<li>it is impossible to regulate someone's diet for years or decades (one person sneaking out to eat a dozen oysters could ruin the experiment) </li>\n<li>it would be unethical to control someone's diet for decades (what if someone who signed up for the study later became a vegan on moral grounds? They would either be forced to eat meat or drop out of the study) </li>\n<li>longitudinal studies suffer from cumulative attrition - people die of unrelated causes, move to another area, decide to drop out for other reasons, etc.</li>\n<li>(many more problems)</li>\n</ul>\n\n<p>Therefore different study models must be used, which give us less accurate information, such as retrospective studies, animal studies, studies of treatment of pernicious anemia (a result of B12 deficiency), pregnant and lactating vegans, people who have undergone certain bypass procedures, etc. By studying those patients, it can be determined how much B12 is necessary to the first signs of B12 deficiency away (usually apparent in blood).</p>\n\n<p>B12 is a particularly difficult vitamin to pin down because of its\ncomplexity, the fact that it is synthesized by intestinal flora, and the various steps involved in its absorption which might be influenced by age and other factors.</p>\n\n<p>Again, the estimated daily requirement of B12 varies from ~ 2µg to 5µg.</p>\n\n<p>Since there are no known adverse effects of excess B12 intake, it's not unreasonable to take more than the minimum if warranted. However, a recommendation of 500 - 1000 µg/day seems quite unnecessary.</p>\n\n<p>_{<a href=\"http://books.google.com/books?hl=en&amp;lr=&amp;id=p7XwAwAAQBAJ&amp;oi=fnd&amp;pg=PA459&amp;dq=minimum+daily+requirement+of+B12+in+humans&amp;ots=jlX0km_i0w&amp;sig=brLcOBBtgdOWs1mpqUMDDt4Mq20#v=onepage&amp;q&amp;f=false\">Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics (Carl A. Burtis, David E. Bruns, 2014, p 474</a>}</p>\n" }, { "answer_id": 4898, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>Let me address this point mentioned in the question: \"My apothecary person told me 500-1000 µg per day are needed to even start absorbing meaningful quantities by ingestion.\"</p>\n\n<p>This addresses a problem with the way we absorb vitamin B12. As <a href=\"https://en.wikipedia.org/wiki/Vitamin_B12#Enzyme_function\" rel=\"nofollow noreferrer\">explained here</a>, when vitamin B12 is ingested, certain so-called transport proteins are needed to move it to the bloodstream. Now, at any given time you only have an amount of enzymes capable of transporting about 1.5 micrograms. When you take 5 to 50 micrograms, you saturate the capacity of the transport proteins, and you'll get close to the maximum of 1.5 micrograms of vitamin B12 into your body.</p>\n\n<p>However, a small fraction of the vitamin B12, about 1% will pass through the stomach wall without the help of transport proteins. This means that you can evade the 1.5 micrograms per meal absorption limit by taking huge dosages of the order of many hundreds of micrograms. This is useful for people who are deficient, they'll typically have a problem causing vitamin B12 to not be absorbed using the transport proteins. Even if there is no problem here (e.g. in case of malnutrition) with only 1.5 micrograms per day, a deficiency cannot be corrected in a timely manner. High dose supplements or vitamin B12 injections must then be used. </p>\n\n<p>The 200 micrograms prescribed by your doctor thus amounts to an effective dose of 1.5 micrograms plus 1% of 200 micrograms = 3.5 micrograms of vitamin B12 which is within the range of the RDA.</p>\n" } ]

[ "https://health.stackexchange.com/questions/788", "https://health.stackexchange.com", "https://health.stackexchange.com/users/381/" ]

[ { "answer_id": 794, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 5, "selected": true, "text": "<p>The estimated daily requirement needed to maintain body stores of B12 varies, an estimate being from 2µg to 5µg, more if stores have been depleted in any way. It is estimated that the average person stores about 1 mg (1000 µg) of B12 in their liver, and other smaller amounts elsewhere. The recommended daily allowance assumes a 50% absorption rate of ingested B12.</p>\n\n<p>This is a good question to discuss the limits of medical science. How is the requirement for B12 determined?</p>\n\n<p><em>Longitudinal studies</em> are those that follow people over many years (even decades.) Humans are not subjected to longitudinal studies involving, say, B12 because:</p>\n\n<ul>\n<li>it would be <strong>unethical</strong> to withhold from some subjects a vitamin necessary for health and well-being while providing it to others just to get an exact number (for the sake of scientific curiosity)</li>\n<li>there are ethical issues in involvement of the young (parental consent should not extend to potential harm)</li>\n<li>if participants are paid volunteers, the study introduces a bias in recruitment (more poor people?) This affects the ability to generalize to the total population, because there may be inherent risks of confounding variables</li>\n<li>the cost of such a study would be prohibitive (who will collect the data, control the diets, pay for the food, and determine outcomes, etc.)</li>\n<li>it is impossible to regulate someone's diet for years or decades (one person sneaking out to eat a dozen oysters could ruin the experiment) </li>\n<li>it would be unethical to control someone's diet for decades (what if someone who signed up for the study later became a vegan on moral grounds? They would either be forced to eat meat or drop out of the study) </li>\n<li>longitudinal studies suffer from cumulative attrition - people die of unrelated causes, move to another area, decide to drop out for other reasons, etc.</li>\n<li>(many more problems)</li>\n</ul>\n\n<p>Therefore different study models must be used, which give us less accurate information, such as retrospective studies, animal studies, studies of treatment of pernicious anemia (a result of B12 deficiency), pregnant and lactating vegans, people who have undergone certain bypass procedures, etc. By studying those patients, it can be determined how much B12 is necessary to the first signs of B12 deficiency away (usually apparent in blood).</p>\n\n<p>B12 is a particularly difficult vitamin to pin down because of its\ncomplexity, the fact that it is synthesized by intestinal flora, and the various steps involved in its absorption which might be influenced by age and other factors.</p>\n\n<p>Again, the estimated daily requirement of B12 varies from ~ 2µg to 5µg.</p>\n\n<p>Since there are no known adverse effects of excess B12 intake, it's not unreasonable to take more than the minimum if warranted. However, a recommendation of 500 - 1000 µg/day seems quite unnecessary.</p>\n\n<p>_{<a href=\"http://books.google.com/books?hl=en&amp;lr=&amp;id=p7XwAwAAQBAJ&amp;oi=fnd&amp;pg=PA459&amp;dq=minimum+daily+requirement+of+B12+in+humans&amp;ots=jlX0km_i0w&amp;sig=brLcOBBtgdOWs1mpqUMDDt4Mq20#v=onepage&amp;q&amp;f=false\">Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics (Carl A. Burtis, David E. Bruns, 2014, p 474</a>}</p>\n" }, { "answer_id": 4898, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>Let me address this point mentioned in the question: \"My apothecary person told me 500-1000 µg per day are needed to even start absorbing meaningful quantities by ingestion.\"</p>\n\n<p>This addresses a problem with the way we absorb vitamin B12. As <a href=\"https://en.wikipedia.org/wiki/Vitamin_B12#Enzyme_function\" rel=\"nofollow noreferrer\">explained here</a>, when vitamin B12 is ingested, certain so-called transport proteins are needed to move it to the bloodstream. Now, at any given time you only have an amount of enzymes capable of transporting about 1.5 micrograms. When you take 5 to 50 micrograms, you saturate the capacity of the transport proteins, and you'll get close to the maximum of 1.5 micrograms of vitamin B12 into your body.</p>\n\n<p>However, a small fraction of the vitamin B12, about 1% will pass through the stomach wall without the help of transport proteins. This means that you can evade the 1.5 micrograms per meal absorption limit by taking huge dosages of the order of many hundreds of micrograms. This is useful for people who are deficient, they'll typically have a problem causing vitamin B12 to not be absorbed using the transport proteins. Even if there is no problem here (e.g. in case of malnutrition) with only 1.5 micrograms per day, a deficiency cannot be corrected in a timely manner. High dose supplements or vitamin B12 injections must then be used. </p>\n\n<p>The 200 micrograms prescribed by your doctor thus amounts to an effective dose of 1.5 micrograms plus 1% of 200 micrograms = 3.5 micrograms of vitamin B12 which is within the range of the RDA.</p>\n" } ]

[ "https://health.stackexchange.com/questions/789", "https://health.stackexchange.com", "https://health.stackexchange.com/users/403/" ]

[ { "answer_id": 803, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 3, "selected": false, "text": "<p>You seem to be equating food weight with body weight, and they are not directly related.</p>\n\n<p>Yes, if you eat a pound of something, you will immediately weigh one more pound, as your body has not had a chance to digest it and process it as needed. However, that doesn't mean that you will have gained one permanent pound. The body will break down the food, distribute the end result to various places for either use or storage, and get rid of whatever is not digestible.</p>\n\n<p>Weight fluctuates during the day, so the best gauge of your weight is to weigh yourself at the same time every day, under the same conditions. Track that number, and that gives you your true weight.</p>\n\n<p>Also, weight gain/loss is a relationship between how many calories you need to sustain your day to day activities, and how many you eat. If you consistently eat more calories than you need for a day, then you will gain weight. If you consistently eat less, then you will lose weight. The rate at which you do so varies on how big the deficit/surplus is, how efficient your metabolism, type of calories, many factors such as these.</p>\n\n<p>For your main question, 3500 calories per pound of food is very calorie dense. <a href=\"http://ndb.nal.usda.gov/ndb/foods/show/4978?fgcd=&amp;manu=&amp;lfacet=&amp;format=&amp;count=&amp;max=35&amp;offset=&amp;sort=&amp;qlookup=16398\" rel=\"noreferrer\">For example, 1 lb of peanut butter is going to be ~ 2600 calories</a>. The higher the fat content, the closer you get to that mark. If you ate a straight pound of fat, for example, you would get just over 4000 calories. (<a href=\"http://www.ars.usda.gov/SP2UserFiles/Place/80400525/Data/Classics/ah74.pdf\" rel=\"noreferrer\">Using the typically accepted 9 calories per gram of fat, which is also not 100% accurate</a>). So yes, it is possible to get more than 3500 calories in a pound of food.</p>\n" }, { "answer_id": 4604, "author": "Chloe", "author_id": 1089, "author_profile": "https://health.stackexchange.com/users/1089", "pm_score": 1, "selected": false, "text": "<p>Kind of. <a href=\"https://en.wikipedia.org/wiki/Food_energy#Nutrition_labels\" rel=\"nofollow\">Oils/fats/alcohol has 9 calories per gram</a>. <a href=\"https://duckduckgo.com/?q=1+pound+in+grams&amp;ia=answer\" rel=\"nofollow\">1 pound is 453.593 grams</a>. 9 x 454 = 4,086 calories. So eating 1 pound of oil will give you 4000 calories. <a href=\"https://en.wikipedia.org/wiki/Steatorrhea\" rel=\"nofollow\">However, you will be unlikely to keep all that</a> oil <a href=\"https://en.wikipedia.org/wiki/Laxative#Lubricant_agents\" rel=\"nofollow\">in your digestive tract</a>!</p>\n\n<p>Eating <a href=\"https://en.wikipedia.org/wiki/Hygroscopy\" rel=\"nofollow\">hygroscopic foods</a> will also make you 'gain' more than they weight, because they will attract water. Eating <a href=\"https://en.wikipedia.org/wiki/Honey#Hygroscopy_and_fermentation\" rel=\"nofollow\">honey</a> or lots of <a href=\"https://en.wikipedia.org/wiki/Dietary_fiber#Dietary_fiber_and_fecal_weight\" rel=\"nofollow\">fiber will absorb water</a> and 'appear' to gain weight while it's in your intestines, but you'd also have to drink liquids. </p>\n" }, { "answer_id": 23934, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 1, "selected": false, "text": "<p>Any answer to this type of question is going to be constrained by two basic laws of physics, which are conservation of mass and conservation of energy.</p>\n<p>Conservation of mass tells us that any weight you gain or lose is going to be equal to the difference between the mass you take in and the mass you excrete. Furthermore, the body doesn't transmute one chemical element into another, so conservation of mass can be applied separately to every element.</p>\n<p>If you could eat a pound of food and gain more than a pound of body weight, then that additional mass would have to come from some other imbalance between consumption and excretion. But this is pretty implausible because the mass of carbon is conserved by chemical reactions. Carbon is one of the main components of organic matter, so any weight gain is going to require some gain in carbon. Eating food is the only way your body has of bringing in carbon, while it has lots of ways of excreting carbon, including exhaling CO2.</p>\n<p>Of course you can gain or lose body weight by taking in or losing water, which contains no carbon. But this is not a way of doing any long-term change in body weight.</p>\n<p>In terms of energy, the body has some efficiency for digesting food, which depends on factors such as what type of macronutrient you're eating, and how highly processed the food is. This efficiency is very high when you eat fats -- I've seen estimates of 97-100%. If weight gain means storing energy in fat, then at the high end of this range you're simply transporting fat molecules through your mouth and into your tissues. In that case you could gain a pound by drinking a pound of olive oil, but you can't gain <em>more</em> than a pound of fat -- that would violate both conservation of carbon mass and conservation of energy.</p>\n" }, { "answer_id": 23938, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 1, "selected": false, "text": "<p>1 pound of pure fat, for example, <a href=\"https://fdc.nal.usda.gov/fdc-app.html#/food-details/789035/nutrients\" rel=\"nofollow noreferrer\">oil</a>, has 453.6 g x 9 kilocalories, which is 4.082 kilocalories. When metabolized, up to 5% of calories from fat can get lost due to <a href=\"https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/specific-dynamic-action\" rel=\"nofollow noreferrer\">thermic effect of food</a>, so, theorhetically, you could get ~3, 878 calories from one pound of oil, which could be theoretically converted to ~430 g of body fat. Anyway, this does not happen at any given point of time, because some of dietary fats will be quickly burnt for current metabolic needs, before even completely absorbed.</p>\n<p>I'm not aware of any nutrient or food additive that would have more than 9 kcal/g.</p>\n<hr />\n<p>From the perspective of one macronutrient (carbohydrates, proteins, fats and alcohol) promoting the absorption of another macronutrient (and ths calories): unlike in micronutrients (minerals, vitamins), this does not likely happen, because absorption of each macronutrient is independent of each other. Macronutrients can speed up or slow down the absorption of other macronutrients, but this does not likely affect the amount of total macronutrients being absorbed at the end.</p>\n<p>Certain nutrients, for example <a href=\"https://pubmed.ncbi.nlm.nih.gov/20092365/\" rel=\"nofollow noreferrer\">glycerol</a>, can promote temporary retention of water and thus temporary increase body weight (but this has nothing with promoting calorie absorption or retention).</p>\n" } ]

[ "https://health.stackexchange.com/questions/793", "https://health.stackexchange.com", "https://health.stackexchange.com/users/385/" ]

[ { "answer_id": 805, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 3, "selected": false, "text": "<p>The original 3500 calorie theory comes from a correspondence <a href=\"http://jama.jamanetwork.com/article.aspx?articleid=328550\" rel=\"nofollow noreferrer\">published in 1959, by a Dr. Max Wishnofsky</a>, where he equates it to pounds lost in observed obese patients.</p>\n\n<p>It's further perpetuated by badly applied mathematics. White adipose tissue has the responsibility for energy storage in the body. This tissue is composed of <a href=\"http://www.sportsci.org/encyc/adipose/adipose.html\" rel=\"nofollow noreferrer\">anywhere from 60% to 85% lipid</a> (fat). If you take the commonly accepted 9 calories of energy per gram of fat (Which is also not quite accurate), you get the following formula:</p>\n\n<p>9 (calories/gram) * 454 grams (grams in a pound) * .85 = 3465 calories.</p>\n\n<p>So, the original estimation was that there were 3500 calories in a pound of human fat, so to lose a pound you had to burn 3500 calories. Since this \"makes sense\", it was widely repeated and used, and became entrenched. It is not accurate, and implying that to lose a pound of fat you have to burn exactly 3500 calories is erroneous.</p>\n\n<p>Edit: While researching something else, I came across this article, titled \"<a href=\"http://www.todaysdietitian.com/newarchives/111114p36.shtml\" rel=\"nofollow noreferrer\">Farewell to the 3500 calorie Rule</a>\", on Today's Dietitian website. One paragraph from the article:</p>\n\n<blockquote>\n <p>It's been estimated that the 3,500-calorie rule is cited in more than 35,000 educational weight-loss sites.1 In September, the Journal of the American Medical Association published a patient handout titled Healthy Weight Loss, in which the first sentence states, \"A total of 3,500 calories equals 1 pound of body fat. This means if you decrease (or increase) your intake by 500 calories daily, you will lose (or gain) 1 pound per week.\"2 Undoubtedly, the 3,500-calorie dogma still is being taught even though it's been shown that it simply doesn't work this way. So where did the 3,500-calorie weight-loss wisdom come from? It originated from researcher Max Wishnofsky, MD, in 1958, who calculated that 1 lb of fat stores approximately 3,500 kcal of energy.3 It was appealingly simple, and it stuck.</p>\n</blockquote>\n" }, { "answer_id": 16875, "author": "life-on-mars", "author_id": 14236, "author_profile": "https://health.stackexchange.com/users/14236", "pm_score": 2, "selected": false, "text": "<p>It is, at least, overly simplified.</p>\n\n<p>The average amount of water in adipose tissue is 13%. In addition to that, it also contains approx. 3% protein. The remainder is fat.</p>\n\n<p>Lard, which should have a similar calorific value as human fat, provides ~8980 calories per kg.</p>\n\n<p>To simplify this calculation we assume that 1 kg of protein provides 4000 calories and 1 kg of fat 9000 calories (in other words ratios of 1:4 and 1:9).</p>\n\n<p>The average kilo of adipose tissue (fat tissue) contains 840g fat and 30g protein. Which amounts to a calorific value of 7680 calories per kilo.</p>\n\n<p>Translated into pounds that is 3484 calories per pound, which is pretty close to the number in question.</p>\n\n<p>The problem is that this is based on average values that have wide ranges attached to them.</p>\n\n<p>The water content of fat tissue can vary between ~4 and ~40% and the protein content between ~2 and ~3.5%. </p>\n\n<p>This means the calorific value can vary <strong>between 5540 and 8540 calories per kilo (or 2510 and 3870 per pound)</strong> of fat tissue. </p>\n\n<p>Sadly, it also seems that the water content is lower for those above standard weight. So whoever needs to lose a couple of pounds because of health reasons should rather apply 3900 per pound.</p>\n\n<p>The numbers are based on this <a href=\"https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/expphysiol.1962.sp001589\" rel=\"nofollow noreferrer\">study</a>. It is a bit old but as the numbers are based on actual tissue samples, I doubt they are too far away from the truth. What might have changed is the average. At least in some countries, as obesity rates are much higher than 50 years ago.</p>\n\n<p>Regarding the water content of body fat, try a watermelon test. Replace an intake of 1000 calories with watermelon worth 500 calories. Drink as much water as you usually do. The extra water intake will most likely lead to an increase body weight on the next day, even though your calorific intake was lower. </p>\n\n<p>^{The above-mentioned study refers to: \"THE CHEMICAL COMPOSITION OF ADIPOSE TISSUE OF MAN AND MICE.\" LORETTE W. THOMAS, Department of Physiology, Edinburgh University. (1962)}</p>\n" }, { "answer_id": 29009, "author": "adamaero", "author_id": 11258, "author_profile": "https://health.stackexchange.com/users/11258", "pm_score": 2, "selected": false, "text": "<blockquote>\n<p>Every pound of pure body fat that is metabolized yields approximately 3500 kcals, thus a daily caloric deficit of 500 kcals theoretically results in fat loss of approximately one pound per week if the weight loss comes entirely from body fat [7].</p>\n</blockquote>\n<blockquote>\n<p>However, a static mathematical model does not represent the dynamic physiological adaptations that occur in response to an imposed energy deficit [8]. Metabolic adaptation to dieting has been studied in overweight populations and when observed, reductions in energy expenditure amount to as little as 79 kcal/d [9], to as much as 504 kcal/d beyond what is predicted from weight loss [10].</p>\n</blockquote>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4033492\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4033492</a></p>\n<p>Exploring reference [7], <a href=\"https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC2376744/\" rel=\"nofollow noreferrer\"><em>What is the Required Energy Deficit per unit Weight Loss?</em></a>:</p>\n<blockquote>\n<p>[...] it is now generally acknowledged that this rule of thumb is an oversimplification (1). But under what conditions is this rule of thumb appropriate? In other words, what are the factors that determine the cumulative energy deficit required per unit weight loss?</p>\n</blockquote>\n<p>Note, 3000 kcal = <strong>32.2 MJ per kg</strong>:</p>\n<p><a href=\"https://i.stack.imgur.com/BON1G.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/BON1G.png\" alt=\"The predicted energy density of weight loss expressed as a function of A)initial body fat content or B) initial body weight of women.Data points depict the calculated weight loss energy densities from several published studies in both obese and lean subjects.\" /></a></p>\n<blockquote>\n<p>Figure 1 The predicted energy density of weight loss expressed as a function of A)initial body fat content or B) initial body weight of women.Data points depict the calculated weight loss energy densities from several published studies in both obese and lean subjects.</p>\n</blockquote>\n<p>There is somewhat of a cluster around 3500 calories, slightly below even. (A rule-of-thumb of less calories is better for losing weight since less calories need to be burned.)</p>\n<blockquote>\n<p>The fact that weight loss typically slows over time for a prescribed constant diet (9, 38) suggests that either the energy expenditure decreases with time, or the dietary intervention is relaxed over time, or both.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/797", "https://health.stackexchange.com", "https://health.stackexchange.com/users/385/" ]

[ { "answer_id": 4407, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": -1, "selected": false, "text": "<p>You expel pollutants by coughing and your body cleans lungs every time it has something to clean. \nMonth is not a long period. They are still not clean. Your lungs need to not only clean themselves but also repair damage caused by smoking. </p>\n\n<p><a href=\"http://www.healthline.com/health-slideshow/quit-smoking-timeline\" rel=\"nofollow\">http://www.healthline.com/health-slideshow/quit-smoking-timeline</a></p>\n\n<p>From my personal experience during few days I had strong cough but after that it subsided and for next two months I would cough from time to time (always once in the morning) and expel clear, hard mucus.\nBy the way, please check if lungs repairing is really the cause of your cough. </p>\n\n<p>It might be that you are ill.</p>\n" }, { "answer_id": 12953, "author": "Tami", "author_id": 9814, "author_profile": "https://health.stackexchange.com/users/9814", "pm_score": 1, "selected": false, "text": "<p>It is a misconception that you will start to cough up tar after smoking cessation. I can imagine why you would think that - after all, cigarettes contain tar and that has to have gone into your lungs, so it has to come out, right?<br>\nWhat happens is that you breathe in fine particles with smoking, part of which your body gets rid of in the period after you had that cigarette. Another part settles in your lungs, but it's not going to get out. I'm guessing you're visualizing it as a collection of tar/dust in your lungs which you're going to cough out eventually if you keep coughing up enough. It simply isn't. You get mucus because of irritation/inflammation of the lungs due to smoking.</p>\n\n<p>What you are going to find is that your lung function gets better with time after smoking cessation. The amount of mucus you cough up will likely also get less. <a href=\"http://erj.ersjournals.com/content/23/3/464\" rel=\"nofollow noreferrer\">This review</a> gives some interesting background information about what smoking cessation does to your lungs and body.</p>\n" } ]

[ "https://health.stackexchange.com/questions/814", "https://health.stackexchange.com", "https://health.stackexchange.com/users/395/" ]

[ { "answer_id": 827, "author": "aparente001", "author_id": 402, "author_profile": "https://health.stackexchange.com/users/402", "pm_score": 3, "selected": false, "text": "<p>My experience has been that when I, or someone in my family, gets chilled, this seems to increase the chance of coming down with a cold. I tried searching on google for this, and found <a href=\"http://blogs.discovermagazine.com/d-brief/2015/01/06/\" rel=\"nofollow\">this article</a>, which says:</p>\n\n<blockquote>\n <p>in mouse airway cells, rhinovirus replicates preferentially at nasal cavity temperature due, in part, to a less efficient antiviral defense response of infected cells at cool temperature.</p>\n</blockquote>\n\n<p><a href=\"http://pnas.org/content/112/3/827\" rel=\"nofollow\">Here</a> is the abstract of the study they were talking about.</p>\n" }, { "answer_id": 830, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 5, "selected": true, "text": "<p>This is a pretty old old-wives tale, taking many forms: don't go out into the cold while it's raining, or without a hat, with wet hair, without a warm coat or scarf, without boots, etc., \"or you'll catch your death of cold.\"</p>\n\n<p>The old wive's tale was immortalized by Jane Austin in her book, <em>Pride and Prejudice</em>, when the heroine's sister Jane falls ill after getting a soaking in the rain.</p>\n\n<p>This has been studied extensively. A New York Times article describes one such uncomfortable-sounding study:</p>\n\n<blockquote>\n <p>In the 1950's, Chicago researchers repeated the experiment on a larger scale with several hundred volunteers sitting in their socks and underwear in a 60-degree room before being inoculated with infectious mucus. Others, in coats, hats and gloves, spent two hours in a large freezer. The conclusion: all 253 chilled volunteers caught cold at exactly the same rate as 175 members of a warm control group. </p>\n</blockquote>\n\n<p>In other words, being cold had no effect on <em>catching</em> a cold.</p>\n\n<p>A 1968 experiment studied the effect of (among other methods of chilling) a cold water bath at several stages during and after inoculation with rhinovirus (one of the many viruses responsible for the common cold). No effect.</p>\n\n<p>Yet the studies continue, because anything shown to decrease the incidence of the common cold would be beneficial to the sufferers, as in the US alone, 75 to 100 million physician visits are due to the common cold, and millions of days are lost from school and work.</p>\n\n<p>But what has never been proven is that getting chilled in any way causes one to come down with a cold.</p>\n\n<p>_{<a href=\"http://www.nytimes.com/2003/03/04/science/you-ll-catch-your-death-an-old-wives-tale-well.html\">'You'll Catch Your Death!' An Old Wives' Tale? Well...</a>}<br>\n_{<a href=\"http://www.nejm.org/doi/full/10.1056/nejm196810032791404\">Exposure to Cold Environment and Rhinovirus Common Cold — Failure to Demonstrate Effect</a>}<br>\n_{<a href=\"http://scholar.google.com/scholar?hl=en&amp;q=effect+of+body+temperature+and+rhinovirus+infection&amp;btnG=&amp;as_sdt=1%2C39&amp;as_sdtp=\">Acute cooling of the body surface and the common cold</a>} </p>\n" }, { "answer_id": 845, "author": "Matthew Brown aka Lord Matt", "author_id": 411, "author_profile": "https://health.stackexchange.com/users/411", "pm_score": 3, "selected": false, "text": "<p>This is an old wives tale. Being cold in and off itself will not cause you to catch a cold because a cold is viral. <a href=\"http://io9.com/does-being-cold-make-you-more-susceptible-to-catching-c-510314172\" rel=\"noreferrer\">3</a></p>\n\n<p>However, being cold for a long time can lower your immune response and if your system was already fighting a cold then symptoms may present that were not needed before. This is because your scored an own goal when you lowered your immune response.</p>\n\n<p>So that possible miss-attribution aside (you already had a cold but did not know it) no, being cold will not cause you to become ill... unless you stay so cold that your body starts to shut down.</p>\n\n<p>One study</p>\n\n<blockquote>\n <p>[...] found that the cells stored at 98.6 degrees launched a more robust immune attack than the ones at 91 degrees. <a href=\"http://blogs.discovermagazine.com/d-brief/2015/01/06/catch-cold-being-cold/#more-9526\" rel=\"noreferrer\">1</a> </p>\n</blockquote>\n\n<p>That study was published in the Proceedings of the National Academy of Sciences. <a href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1411030112\" rel=\"noreferrer\">4</a></p>\n\n<blockquote>\n <p>A study at the Common Cold Centre in Cardiff found that people who chilled their feet in cold water for 20 minutes were twice as likely to develop a cold as those who didn't chill their feet. <a href=\"http://www.nhs.uk/Livewell/coldsandflu/Pages/Preventionandcure.aspx\" rel=\"noreferrer\">2</a></p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/815", "https://health.stackexchange.com", "https://health.stackexchange.com/users/394/" ]

[ { "answer_id": 828, "author": "aparente001", "author_id": 402, "author_profile": "https://health.stackexchange.com/users/402", "pm_score": -1, "selected": false, "text": "<p>Here's how poop gets made. In the intestines, some molecules are removed and sent to where they need to go. The leftovers collect and come out as poop. The density of the poop is a function of the degree of moistness. It seems that your poop is moister.</p>\n\n<p>If she has a tendency to a slight bit of constipation, and wishes to remedy this, she could increase her roughage intake, and drink MORE WATER. Reference: <a href=\"http://www.webmd.com/digestive-disorders/understanding-constipation-prevention\" rel=\"nofollow\">http://www.webmd.com/digestive-disorders/understanding-constipation-prevention</a></p>\n" }, { "answer_id": 1012, "author": "cirko", "author_id": 514, "author_profile": "https://health.stackexchange.com/users/514", "pm_score": 3, "selected": false, "text": "<p>Modern evidence-based medicine won't be able to fully answer your question, but there are indications that <a href=\"https://doi.org/10.1099/00222615-13-1-45\" rel=\"nofollow noreferrer\">bacteria, or more exactly, the individual gut flora heavily influence your fecal weight or stool mass</a>. E.g., in obstipated patients, <a href=\"http://physiolgenomics.physiology.org/content/46/18/679\" rel=\"nofollow noreferrer\">other types of gut bacteria were found than in the control group</a>, which still can't tell what is cause and what is effect. <a href=\"http://www.sciencedirect.com/science/article/pii/S1521691813000577\" rel=\"nofollow noreferrer\">Stool transplantation</a> is also an emerging therapy for various diseases (see also <a href=\"http://www.nature.com/nrgastro/journal/v9/n2/full/nrgastro.2011.244.html\" rel=\"nofollow noreferrer\">here</a> and <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073534/\" rel=\"nofollow noreferrer\">here</a>), so while there is no better explanation for your question, I think the difference in composition of gut flora may be a good candidate to explain individual variation.</p>\n" } ]

[ "https://health.stackexchange.com/questions/819", "https://health.stackexchange.com", "https://health.stackexchange.com/users/397/" ]

[ { "answer_id": 864, "author": "KingBOB", "author_id": 415, "author_profile": "https://health.stackexchange.com/users/415", "pm_score": 2, "selected": false, "text": "<p>What you're describing is known as Palpitations.</p>\n\n<p><strong>Palpitations</strong> are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.</p>\n\n<p>Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious. </p>\n\n<p>The following conditions make you more likely to have an abnormal heart rhythm:</p>\n\n<ol>\n<li>Known heart disease at the time the palpitations begin</li>\n<li>Significant risk factors for heart disease</li>\n<li>An abnormal heart valve</li>\n<li>An electrolyte abnormality in your blood</li>\n</ol>\n\n<p><strong>Causes</strong>\nAnxiety, stress, panic attack, or fear, caffeine intake, nicotine intake, cocaine or other illegal drugs.\nHowever, some palpitations are due to an abnormal heart rhythm.</p>\n\n<p><strong>When to call a doctor</strong>\nIf you have never had heart palpitations before, see your health care provider.</p>\n\n<p>Call 911 or your local emergency number if you have:</p>\n\n<ol>\n<li>Loss of alertness (consciousness)</li>\n<li>Chest pain</li>\n<li>Shortness of breath</li>\n<li>Unusual sweating,</li>\n<li>Dizziness or light-headedness</li>\n</ol>\n\n<hr>\n\n<p>Source: <a href=\"http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm\" rel=\"nofollow\">http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm</a></p>\n" }, { "answer_id": 865, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 5, "selected": true, "text": "<blockquote>\n <p>Is it normal for a person to at times feel their heart beat in their chest without actually placing their hand on their chest, while at other times not be able to...? </p>\n</blockquote>\n\n<p>Yes, this is normal.</p>\n\n<p>Normally, people do not feel their heart beating in their chest at rest. It is one of those things similar to breathing - it's happening, but we're not often aware of it (which is good as it might be very distracting otherwise.)</p>\n\n<p>However, an alteration in the steady background of the beating heart is often perceived. Sometimes the alteration is due to increased rate or force of contractions. If so, the sensation of feeling your heart beating (normally under the circumstances) is called <em>physiological palpitations</em> (i.e. normal.) If they are a result of an \"abnormal\" rate or rhythm, the phenomenon is known as \"palpitations\".</p>\n\n<blockquote>\n <p>In normal resting conditions, the activity of the heart is generally not perceived by the individual. However, during or immediately after intense physical activity or emotional stress, it may be quite normal to become aware of one's own heartbeat for brief periods; these sensations are regarded as physiological palpitations, in that they represent the normal or expected response to a certain challenge or activity leading to an increase in the frequency and strength of the contraction of the heart. Outside of such situations, instead, palpitations are perceived as abnormal.² </p>\n</blockquote>\n\n<p>The sensory mechanisms responsible for palpitation are unknown.¹ </p>\n\n<p>What we do know, though, is that if the heart beats faster or more forcefully, we do feel this, both in our chest, and in our necks, as exemplified in the expression, \"my heart rose into my throat.\" We have baroreceptors in major blood vessels in our neck; when more blood is pushed into our arteries by a forceful beat, there is an awareness of increased pressure.</p>\n\n<blockquote>\n <p>Palpitations are a symptom defined as awareness of the heartbeat and are described by patients as a disagreeable sensation of pulsation or movement in the chest and/or adjacent areas.² </p>\n</blockquote>\n\n<p>A more forceful contraction means more blood is pumped in that heart cycle. This can happen if suddenly stressed (e.g. you're speeding and you see a police car pull into your lane behind you); the adrenaline increases both the rate and the force of your heartbeat. </p>\n\n<p>Likewise, when you have a premature ventricular contraction, or PVC. The first beat is early; this allows the next cycle to have a longer \"filling time\", and the resultant more forceful contraction will be felt. Medically speaking:</p>\n\n<blockquote>\n <p>In cases of isolated extrasystoles, the augmented post-extrasystolic beat may be felt in place of, or in addition to, the premature beat.</p>\n</blockquote>\n\n<p>If you have an irregular heartbeat - the weaker ones will not be felt, but the more forceful ones will. This often is perceived as a fluttering in the chest.</p>\n\n<p>Finally, some people are just more sensitive to their heart beat. This also occurs in hypervigilant states.</p>\n\n<p>_{<a href=\"http://www.ncbi.nlm.nih.gov/books/NBK202/\">1 Palpitations</a>}<br>\n_{<a href=\"http://europace.oxfordjournals.org/content/13/7/920\">2 Management of patients with palpitations: a position paper from the European Heart Rhythm Association</a>} </p>\n" } ]

[ "https://health.stackexchange.com/questions/825", "https://health.stackexchange.com", "https://health.stackexchange.com/users/83/" ]

[ { "answer_id": 836, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 5, "selected": true, "text": "<p>If you're saying that you have a low blood pressure and you're seeking to reestablish a phisiological value I would answer you that low blood pressure it's not a disease unless it's really too low, but this is something you should <strong>clarify with your doctor</strong>. Also, if there's a disease, you should first cure the causes instead of lookin for functional foods to use as they were pills (=&quot;I have X, I eat Y for this&quot;). Again this is something to check with doctors.</p>\n<p>If you're asking which foods have the power to increase blood pressure, I would answer: <strong>salt</strong>^{<a href=\"http://hyper.ahajournals.org/content/27/3/481.short\" rel=\"noreferrer\">1</a>}, <strong>liquorice</strong>^{<a href=\"http://europepmc.org/abstract/med/11494093\" rel=\"noreferrer\">2</a>}. Then I suggest you to <a href=\"http://www.webmd.com/heart/understanding-low-blood-pressure-treatment\" rel=\"noreferrer\">check a link</a> that might be useful.</p>\n" }, { "answer_id": 883, "author": "piyush_dev", "author_id": 429, "author_profile": "https://health.stackexchange.com/users/429", "pm_score": -1, "selected": false, "text": "<p><strong>Increase your caffeine intake</strong>-\nCaffeine can cause a short, but dramatic increase in your blood pressure, even if you don't have high blood pressure</p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058543\" rel=\"nofollow\">Reference article</a> </p>\n" } ]

[ "https://health.stackexchange.com/questions/833", "https://health.stackexchange.com", "https://health.stackexchange.com/users/71/" ]

[ { "answer_id": 836, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 5, "selected": true, "text": "<p>If you're saying that you have a low blood pressure and you're seeking to reestablish a phisiological value I would answer you that low blood pressure it's not a disease unless it's really too low, but this is something you should <strong>clarify with your doctor</strong>. Also, if there's a disease, you should first cure the causes instead of lookin for functional foods to use as they were pills (=&quot;I have X, I eat Y for this&quot;). Again this is something to check with doctors.</p>\n<p>If you're asking which foods have the power to increase blood pressure, I would answer: <strong>salt</strong>^{<a href=\"http://hyper.ahajournals.org/content/27/3/481.short\" rel=\"noreferrer\">1</a>}, <strong>liquorice</strong>^{<a href=\"http://europepmc.org/abstract/med/11494093\" rel=\"noreferrer\">2</a>}. Then I suggest you to <a href=\"http://www.webmd.com/heart/understanding-low-blood-pressure-treatment\" rel=\"noreferrer\">check a link</a> that might be useful.</p>\n" }, { "answer_id": 883, "author": "piyush_dev", "author_id": 429, "author_profile": "https://health.stackexchange.com/users/429", "pm_score": -1, "selected": false, "text": "<p><strong>Increase your caffeine intake</strong>-\nCaffeine can cause a short, but dramatic increase in your blood pressure, even if you don't have high blood pressure</p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058543\" rel=\"nofollow\">Reference article</a> </p>\n" } ]

[ "https://health.stackexchange.com/questions/839", "https://health.stackexchange.com", "https://health.stackexchange.com/users/71/" ]

[ { "answer_id": 3305, "author": "jetbackwards", "author_id": 1692, "author_profile": "https://health.stackexchange.com/users/1692", "pm_score": 1, "selected": false, "text": "<p>The reason we use the upper arm is that the arteries at that level have the same pressure of blood as the outflow-tract from the left ventricle (i.e. where the blood leaves your heart).</p>\n\n<p>Because of the weight of the blood, your pressure in the main arteries in your leg is slightly higher and in your head is slightly lower. This effect is more pronounced when sitting upright or standing.</p>\n\n<p>I think that we also measure it there for practicality - for serial measurements to make sense we should measure it in the same place every time, and an arm is much more easy to get to than a thigh (you'd have to take your trousers off every time!).</p>\n\n<p>Measuring pressures at the end of limbs is only useful in very specific conditions (such as peripheral vascular disease).</p>\n" }, { "answer_id": 3306, "author": "rncardio", "author_id": 1477, "author_profile": "https://health.stackexchange.com/users/1477", "pm_score": 2, "selected": false, "text": "<p>Blood pressure is often checked in lower limbs also. BP needs to be checked in all limbs if one is suspecting obstruction in the arteries. Takayasu's arteritis and atherosclerosis are 2 conditions that can result in unequal blood pressure in different limbs due to obstruction of arteries. </p>\n\n<p>In ankle-brachial index test, blood pressure is checked in the arm and at ankle to detect peripheral arterial disease (PAD: <a href=\"http://www.mayoclinic.org/tests-procedures/ankle-brachial-index/basics/definition/prc-20014625\" rel=\"nofollow\">http://www.mayoclinic.org/tests-procedures/ankle-brachial-index/basics/definition/prc-20014625</a> )</p>\n\n<p>Also, if coarctation of aorta (congenital narrowing of great artery in thorax) is supected, pressure in lower limbs will be lower than that in upper limbs.</p>\n\n<p>Aortic regurgitation (incompetence of aortic valve) leads to higher pressure in lower limb than in upper limb due to pressure wave reflection. Here also it is recommended that pressure is recorded in both upper and lower limb. The degree of change in lower limb correlates with severity of regurgitation (Hill's sign).</p>\n\n<p>Initially, blood pressure should be recorded in both upper limbs. If BP difference in 2 arms is more than 15 mm Hg (systolic), tests (e.g. Doppler ultrasound) should be done to rule out obstruction. For following up on treatment of high blood pressure in such cases, higher blood pressure should be taken and controlled with medication. </p>\n\n<p>Blood pressure can also be estimated using finger probes, but their accuracy and reliability is not well established. This will also be subject to diseases of arteries in the arm, forearm and hand. </p>\n\n<p>For checking blood pressure, one needs an area where the artery can be compressed and one needs to listen to the artery distal to this area as the pressure is released. Brachial artery lies in front part of elbow and can be heard over easily. On the other hand, the artery in knee lies posteriorly (behind the knee). </p>\n\n<p>Since arteries to upper limbs come out of aorta much earlier than arteries to lower limbs, the pressure in upper limbs would be much less subject to diseases of aorta or compression on it by masses in thorax or abdomen. This would be main reason to prefer arms over legs, in addition to simple convenience factor. </p>\n" } ]

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[ { "answer_id": 888, "author": "Robert Cartaino", "author_id": 29, "author_profile": "https://health.stackexchange.com/users/29", "pm_score": 4, "selected": true, "text": "<p>According to <a href=\"http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm\" rel=\"nofollow noreferrer\">the FDA website</a>, no daily reference value has been established for sugars because no recommendations have been made for the total amount of sugar to eat in a day. </p>\n\n<p>Keep in mind that the sugar values listed do not distinguish between naturally occurring and added sugars because it is not a chemically meaningful distinction. So unlike nutritional information about vitamins, proteins, fats, etc, there really is no level of \"recommended sugar\" that would make a good blanket statement for everyone. </p>\n\n<p>Claims that high consumption of added sugars harmful to your health is an extremely complicated subject. It's not that the sugar itself is inherently harmful due to any of its chemical properties, it's just that added sugar tends to be in products that have extremely high fat and high calorie content and are easy to consume in large quantities.</p>\n\n<p>So saying to avoid foods high in added sugars is good general advice, but labeling products to indicate that you should consume {x} amount of sugar per day was <strong><em>not</em></strong> a piece of nutritional guidance the FDA was prepared to make in that labeling.</p>\n" }, { "answer_id": 25223, "author": "Derek Lee", "author_id": 20868, "author_profile": "https://health.stackexchange.com/users/20868", "pm_score": 2, "selected": false, "text": "<p>It seems that the US Food and Drug Administration (FDA) <a href=\"https://www.fda.gov/food/new-nutrition-facts-label/added-sugars-new-nutrition-facts-label\" rel=\"nofollow noreferrer\">has recently added guidance for &quot;added sugars&quot; as a part of enhancing the existing nutrition facts label</a>.</p>\n<p>They differentiate between &quot;total sugars&quot; and &quot;added sugars&quot; and provide the following regarding %DV for total sugars:</p>\n<blockquote>\n<p>&quot;There is no Daily Value* for total sugars because no recommendation\nhas been made for the total amount to eat in a day.&quot;</p>\n</blockquote>\n<p>As for %DV of added sugars, <a href=\"https://www.fda.gov/media/99059/download\" rel=\"nofollow noreferrer\">they also appear to have a PDF</a> of daily recommended values for food components which suggests for adults and 4 years and older that the daily recommended value is 50g:</p>\n<p><a href=\"https://i.stack.imgur.com/kiHYn.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/kiHYn.png\" alt=\"chart showing daily recommended values for food components\" /></a></p>\n" } ]

[ "https://health.stackexchange.com/questions/886", "https://health.stackexchange.com", "https://health.stackexchange.com/users/435/" ]

[ { "answer_id": 931, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 4, "selected": true, "text": "<p>There are several investigations assessing this issue. In several clinical trials (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16873779\">1</a>, <a href=\"http://ajcn.nutrition.org/content/early/2009/04/01/ajcn.2009.26736H.short\">2</a>) Dr. Barnard has prooved that a low-fat vegan diet can improve serum values of <strong>HbA1c</strong> and requirements for medication of patients affected by type 2 diabetes. The same studies found significant improvements in <strong>plasma lipids</strong> (LDL and total cholesterols), that show decrease of risk factors for cardiovascular disease, often a complication of diabetes and metabolic disorders.</p>\n\n<p>Additionally, clinical trials show that vegan and vegetarian diets promote <strong>weight loss</strong> (<a href=\"http://europepmc.org/abstract/med/9863851\">3</a>, <a href=\"http://www.sciencedirect.com/science/article/pii/S0002934305002792\">4</a>, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19506174\">5</a>) and improved <strong>insulin sensitivity</strong>(<a href=\"http://www.sciencedirect.com/science/article/pii/S0002934305002792\">4</a>, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19506174\">5</a>) being these two important risk factors for type 2 diabetes (<a href=\"http://www.webmd.com/diabetes/risk-factors-for-diabetes\">6</a>).</p>\n\n<p>The reasons of the effectiveness must be found in the fact -among others- that vegetarians and vegans eat less quantities of <strong>total fats</strong>, <strong>saturated fats</strong> and highers amounts of <strong>fiber</strong> and show lower <strong>BMI</strong> (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19562864\">7</a>).</p>\n" }, { "answer_id": 16402, "author": "pizi", "author_id": 13398, "author_profile": "https://health.stackexchange.com/users/13398", "pm_score": 0, "selected": false, "text": "<p>Not only has it been proven that a whole food plant-based diet can reverse diabetes type 2 in many cases, but that it can completely reverse diabetes type 2 in two weeks in some people who've been injecting themselves with insulin for 20 years on a daily basis. Studies where this has been achieved can be found at the following link: <a href=\"https://nutritionfacts.org/video/how-not-to-die-from-diabetes/\" rel=\"nofollow noreferrer\">NutritionFacts</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/893", "https://health.stackexchange.com", "https://health.stackexchange.com/users/120/" ]

[ { "answer_id": 911, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 3, "selected": false, "text": "<p>Despite what the supplement industry would have you believe, unless you are an overweight, older female, the commonly available steroid precursors (or the natural foods that claim to boost them) don't really have any effects on testosterone.</p>\n<p>There are three precursors (Dehydroepiandrosterone or DHEA, A'dione, and A'diol) that are hormones used in endogenous (within the body, i.e. natural) testosterone production. Many of the supplements on the market that claim to boost testosterone do increase the amount of these three hormones, but in most cases, do not lead to concurrent elevations in testosterone. (There is a <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164360/table/T1/\" rel=\"noreferrer\">chart showing a study review with outcomes here</a>).</p>\n<p>As far as the side effects, it's best summarized by the same review paper that produced the above chart:</p>\n<blockquote>\n<p><strong>Side Effects</strong></p>\n<p>Significant reductions in serum HDL cholesterol of 12% and 20% have been observed after A'dione and DHEA supplementation, respectively. Similar changes have been observed after AAS injection and have been associated with the development of cardiovascular disease. Broeder et al administered either A'dione or A'diol (200 mg/d) and observed that both adversely affected HDL-cholesterol levels, low-density lipoprotein (LDL)-to-HDL cholesterol ratios, and coronary heart disease risk. Thus, it is possible that long-term supplementation could have serious side effects similar to those associated with AAS use, such as <strong>suppressed testosterone production, liver dysfunction, cardiovascular disease, testicular atrophy, male-pattern baldness, acne, and aggressive behavior. If the supplements are taken before puberty, premature closing of the epiphysis and stunted growth could occur. In women, precursor-induced increases in testosterone concentrations could cause lowered voice pitch, hirsutism (changes in hair growth patterns, including facial hair), increased abdominal fat accumulation, and general virilization. Furthermore, increases in estrogen concentrations experienced by men could have feminizing effects, including gynecomastia.</strong></p>\n</blockquote>\n<p>In addition to the above, there is no regulation on the supplement industry, so they may contain wildly varying levels of ingredients (Even in the same brand/line), and there have been reports of heavy metal contamination as well as contamination with actual steroid substances.</p>\n<p>Currently, you can really sum up the supplement industry in this way: If it works, it's illegal and should be only used under a doctor's care. If it is safe to use, it probably doesn't work like they claim. Also, while many people do not realize it, if you participate in 5k fun runs, amateur cycling, or any amateur competition where the governing body adheres to USADA (or the local national equivalent) strictures, you can be subject to testing, no matter your competitive level. Many supplements would cause you to test positive if you were selected. You can always get a current list of banned supplements at the <a href=\"http://www.supplement411.org/hrl/\" rel=\"noreferrer\">Supplement 411 site</a>.</p>\n<p>If interested, all of the studies referenced in the above paper are listed with links below the paper writeup itself.</p>\n<p>One caveat: Creatine Monophosphate is a legal supplement that has been proven to do what it says. It doesn't create more muscle, but it does create a bigger pool of energy rich fluid in the muscle to draw from, so that you can work out longer, which in turn will create more muscle.</p>\n" }, { "answer_id": 15679, "author": "The Testosterone Fanatic", "author_id": 13232, "author_profile": "https://health.stackexchange.com/users/13232", "pm_score": 3, "selected": true, "text": "<p>Other than the post and the website you mentioned, here are a few more natural testosterone boosters, some of them being substances, and others being lifestyle changes or things-to-do:</p>\n\n<p>1) In this <a href=\"https://www.researchgate.net/publication/275716515_Pomegranate_juice_intake_enhances_salivary_testosterone_levels_and_improves_mood_and_well_being_in_healthy_men_and_women\" rel=\"nofollow noreferrer\">study</a>, pomegranates were found to increase salivary testosterone levels by an average of 24% (though this was averaged over both men and women, in just men, the increase was ~22%).</p>\n\n<p>2) In this <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26609282\" rel=\"nofollow noreferrer\">study</a>, the Ashwagandha group, in conjunction with resistance training, was able to increase their testosterone by 96.2 ng/dl, compared to the placebo group, that was only able to increase their testosterone levels by 18 ng/dl.</p>\n\n<p>3) In this <a href=\"https://www.physiology.org/doi/abs/10.1152/jappl.1997.82.1.49\" rel=\"nofollow noreferrer\">study</a>, significant correlations were observed between dietary intake and testosterone levels. My interpretation from the correlations in this study was that, in general, higher protein intake and higher polyunsaturated fatty acids (PUFA's) result in lower testosterone levels, while more carbohydrates, higher monounsaturated fatty acids (MUFA's) and saturated fatty acids (SFA's) result in higher testosterone levels.</p>\n\n<p>4) Coming to the more controversial one, in this <a href=\"http://www.abc.net.au/catalyst/chemistryofattraction/download/Oberzaucher_Poster.pdf\" rel=\"nofollow noreferrer\">study</a>, whiffing the pheromone copulin, which is secreted by ovulating females, increased salivary testosterone levels by an average of about 30%, as seen in the graph). Copulins are available on amazon; however, I have been unable to find the exact concentration of copulins used in this study and the time of exposure of the subjects to them, so proceed with your own risk.</p>\n\n<p>5) The safer alternative to the above option, which depending on your circumstances, may or may not be available to you, is sexual intercourse. In this <a href=\"https://link.springer.com/article/10.1007/s10508-010-9711-3/fulltext.html\" rel=\"nofollow noreferrer\">study</a>, participants in a visit to the sex club experienced a 72% increase in testosterone levels. Even the observers experienced an 11% increase as well.</p>\n\n<p>6) In this <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Pituitary-testicular+axis+in+obese+men+during+short-term+fasting.\" rel=\"nofollow noreferrer\">study</a>, a 56 hours fast was observed to increase testosterone levels by 180% in normal non-obese men but not by any percentage in obese men, sadly.</p>\n\n<p>7) In this <a href=\"http://www.ehbonline.org/article/S1090-5138(13)00065-2/fulltext\" rel=\"nofollow noreferrer\">study</a>, men who chopped trees for one hour experienced a 48.6% rise in testosterone levels. I quote from the study: \"A comparison of these results to the relative change in testosterone during a competitive soccer tournament in the same population reveals larger relative changes in testosterone following resource production (tree chopping), compared to competition (soccer).\"</p>\n\n<p>8) In this <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22995464\" rel=\"nofollow noreferrer\">study</a>, ingestion of 3000 mg of Royal Jelly caused an increase in testosterone levels (log testosterone levels in the RJ group was +0.12 ± 0.04 log ng/mL vs. -0.02 ± 0.05 log ng/mL in the placebo group).</p>\n" } ]

[ "https://health.stackexchange.com/questions/906", "https://health.stackexchange.com", "https://health.stackexchange.com/users/77/" ]

[ { "answer_id": 909, "author": "larry909", "author_id": 447, "author_profile": "https://health.stackexchange.com/users/447", "pm_score": -1, "selected": false, "text": "<p>From what I've read, sugar is sugar is sugar.</p>\n<p>Although natural occurring sugar might be somewhat less harmful to your body, the basic effects of sugar on the body, like for people with diabetes, are usually not different, no matter what form the sugar is in.</p>\n<p>Quote from <a href=\"http://authoritynutrition.com/6-healthy-sugars-that-can-kill-you/\" rel=\"nofollow noreferrer\">6 Healthy Sugars That Can Kill You</a></p>\n<blockquote>\n<p>“Sugar scares me.” – <a href=\"http://en.m.wikipedia.org/wiki/Lewis_C._Cantley\" rel=\"nofollow noreferrer\">Dr. Lewis Cantley, Cancer Researcher</a></p>\n<p>....</p>\n<p>All the sugar you eat will go down to your intestine, get broken down into glucose and fructose and eventually reach the liver.</p>\n<p>Your liver does not know (or care) whether the sugar you eat is organic or not.</p>\n</blockquote>\n<p><a href=\"http://mobile.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?referrer=&amp;_r=0\" rel=\"nofollow noreferrer\">Is sugar toxic?</a> - Dr. Lustig</p>\n" }, { "answer_id": 910, "author": "James Jenkins", "author_id": 15, "author_profile": "https://health.stackexchange.com/users/15", "pm_score": -1, "selected": false, "text": "<p>No sugar is harmful in moderation. Eating <a href=\"http://www.health.harvard.edu/blog/eating-too-much-added-sugar-increases-the-risk-of-dying-with-heart-disease-201402067021\" rel=\"nofollow\">too much sugar can be bad</a>. There are several different <a href=\"http://www.sugar.org/all-about-sugar/types-of-sugar/\" rel=\"nofollow\">types of sugar</a>, though.</p>\n\n<p><a href=\"http://foodwatch.com.au/blog/carbs-sugars-and-fibres/item/7-types-of-sugar-which-is-healthier.html\" rel=\"nofollow\">Fructose is metabolized differently to sugar and glucose</a>, which some research suggests can be harmful <a href=\"http://articles.mercola.com/sites/articles/archive/2010/01/02/highfructose-corn-syrup-alters-human-metabolism.aspx\" rel=\"nofollow\">in massive doses</a>**, but when digested as part of your diet of fresh fruits and vegetables, it does not appear to cause problems (<em>Fructose natural occurs in fruit, which is how it gets its name</em>).</p>\n" } ]

[ "https://health.stackexchange.com/questions/908", "https://health.stackexchange.com", "https://health.stackexchange.com/users/446/" ]

[ { "answer_id": 916, "author": "Rana Prathap", "author_id": 37, "author_profile": "https://health.stackexchange.com/users/37", "pm_score": 4, "selected": true, "text": "<p>While trying to measure the blood pressure, the physician is most likely interested in measuring the pressure inside the left ventricle of the heart. So it is necessary that the Sphygmomanometer and the cuff should remain at the level of the heart. If it is above the level of heart, the reading is likely to be low, and if it is below the heart, the reading is likely to be high. Also, the blood pressure varies with the posture of the body in which the measurement is taken. So the blood pressure value that exists in most guidelines (for example JNC 8) is measured in the sitting position. Hence the value we are intenting to measure is the one with the patient is sitting position, back supported, legs uncrossed, and upper arm bared. The diastolic pressure is high in sitting position, and systolic pressure is high in supine position. Not supporting the back will increase diastolic pressure, while sitting cross legged increases systolic pressure. This is due to the inherent mechanisms in the human body to maintain perfusions to certain organs. The detailed biomechanics is beyond the scope of the present discussion though.</p>\n\n<p>Reference : <a href=\"http://www.aafp.org/afp/2005/1001/p1391.html\">New AHA Recommendations for Blood Pressure Measurement</a></p>\n" }, { "answer_id": 31202, "author": "Thomas TJ Checkley", "author_id": 15601, "author_profile": "https://health.stackexchange.com/users/15601", "pm_score": 2, "selected": false, "text": "<p>There are numerous factors that can affect blood pressure from body position (as you mention) to stress or pain. The most important thing one can do is try and take the BP measurement the same way every time. I also think it can be beneficial keeping a journal with some additional information next to the BP. For example, if you are in pain, then make a note of that (e.g., right shoulder hurts today, 5/10); or if you are very fatigued or sick that day, note that as well. I would also always include the time of day.</p>\n<p>Even in medical offices with trained staff, it can be tough to obtain BP measurements that are done 'perfectly.'\nSee this article from Hwang et al. (2018) on the issue <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287289/\" rel=\"nofollow noreferrer\">of mistakes when taking blood pressure readings</a>. That said, here are the guidelines from the ANA on taking BP readings: <a href=\"https://www.ahajournals.org/doi/10.1161/HYP.0000000000000087\" rel=\"nofollow noreferrer\">ANA BP Readings</a>. So, individuals taking home BPs don't need to stress out about being 'perfect.'</p>\n<p>Interestingly, in adults it doesn't seem to matter if you take the BP reading in the right or left arm, just that it is at the level of the right atrium (midpoint of the sternum); however, in children, the recommendation is to take the BP in the right arm. Further, if there is obstructive arterial disease present, then the location where the BP is taken does matter.</p>\n<p>References</p>\n<p>Hwang, K. O., Aigbe, A., Ju, H. H., Jackson, V. C., &amp; Sedlock, E. W. (2018). Barriers to Accurate Blood Pressure Measurement in the Medical Office. Journal of primary care &amp; community health, 9, 2150132718816929. <a href=\"https://doi.org/10.1177/2150132718816929\" rel=\"nofollow noreferrer\">https://doi.org/10.1177/2150132718816929</a></p>\n<p>Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., Myers, M. G., Ogedegbe, G., Schwartz, J. E., Townsend, R. R., Urbina, E. M., Viera, A. J., White, W. B., &amp; Wright, J. T. (2019). Measurement of blood pressure in humans: A scientific statement from the american heart association. Hypertension (Dallas, Tex.: 1979), 73(5), e35–e66. <a href=\"https://doi.org/10.1161/HYP.0000000000000087\" rel=\"nofollow noreferrer\">https://doi.org/10.1161/HYP.0000000000000087</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/912", "https://health.stackexchange.com", "https://health.stackexchange.com/users/71/" ]

[ { "answer_id": 915, "author": "Mark", "author_id": 333, "author_profile": "https://health.stackexchange.com/users/333", "pm_score": 4, "selected": true, "text": "<p>Unless you're doing something stupid like eating polar bear liver, <a href=\"https://en.wikipedia.org/wiki/Hypervitaminosis_A\" rel=\"noreferrer\">hypervitaminosis A</a> is the result of long-term overconsumption: taking one supplement in the morning and one in the evening is no more or less dangerous than taking both at once.</p>\n\n<p>According to the National Institutes of Health, the level of <a href=\"http://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/#h8\" rel=\"noreferrer\">vitamin A overconsumption</a> that presents a long-term risk to a healthy adult depends on the form that the vitamin is consumed in. For pre-formed vitamin A (retinoids), the upper level is about three times the RDA, while for vitamin-A precursors (carotenoids), there is no known toxic effect for overconsumption, though it may raise the lung cancer risk of smoking or working with asbestos.</p>\n" }, { "answer_id": 13148, "author": "user361982", "author_id": 10968, "author_profile": "https://health.stackexchange.com/users/10968", "pm_score": 0, "selected": false, "text": "<p>Most vitamins are best taken with some sort of food to aid in the absorption of the supplement. Taking vitamins throughout the day at different intervals also aids in maintaining proper levels of each supplement. Thus, taking vitamins in smaller dosages throughout the day provides optimal balance.</p>\n\n<p>If you are taking vitamin supplements with no contraindications to any prescriptions and your choice is to take them all at night or not at all, you are not creating a problem by taking them all[enter link description here][1] at once.</p>\n" } ]

[ "https://health.stackexchange.com/questions/913", "https://health.stackexchange.com", "https://health.stackexchange.com/users/462/" ]

[ { "answer_id": 927, "author": "Henry Lahore", "author_id": 459, "author_profile": "https://health.stackexchange.com/users/459", "pm_score": 3, "selected": false, "text": "<p>About 1/4 - it varies with the reflectivity of the surface, and angle of the sun. Detailed study is at <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20199222\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/20199222</a></p>\n" }, { "answer_id": 4284, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 4, "selected": false, "text": "<p>The exact value depends on a lot of things - skin tone, the time of day, latitude, how deep the shade is,... </p>\n\n<p>The study <a href=\"http://www.sciencedirect.com/science/article/pii/S0960076005002220\">Vitamin D effective ultraviolet wavelengths due to scattering in shade</a> found that the UVB radiation at 280–320 nanometers that is needed for vitamin D production dropped to levels at around 50% in a tree shade and under an umbrella. It was much less on a covered veranda - around 11% - and completely absent in a car with closed windows.</p>\n\n<p><a href=\"http://www.bioone.org/doi/10.1667/RR1951.1?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%3Dpubmed&amp;\">Latitudinal Variations over Australia of the Solar UV-Radiation Exposures for Vitamin D₃ in Shade Compared to Full Sun</a> came to similar conclusions (emphasis mine):</p>\n\n<blockquote>\n <p>Using shade for UV_D3 exposures can reduce total UV-radiation exposure by <strong>37% to 58%</strong> compared to full sun UV_D3 exposures. This research indicates that an improved approach to optimize UV-radiation exposures for the production of vitamin D₃ is to use diffuse UV radiation under shade in and around the middle of the day.</p>\n</blockquote>\n\n<p>Since exposure to these wavelengths is what drives vitamin D production, an approximate answer to your question is probably \"around 35 to 55%\". </p>\n" } ]

[ "https://health.stackexchange.com/questions/920", "https://health.stackexchange.com", "https://health.stackexchange.com/users/453/" ]

[ { "answer_id": 943, "author": "John Rennie", "author_id": 474, "author_profile": "https://health.stackexchange.com/users/474", "pm_score": 4, "selected": true, "text": "<p>I can speak from personal experience, and from experience working as a physical chemist peripherally associated with a group researching dental care.</p>\n\n<p>My personal experience is that I have a few lesions that my various dentists over the last couple of decades have decided not to fill because they are not serious and not getting any worse. So a dentist will not necessarily reach for their drill at every opportunity.</p>\n\n<p>My research experience is that at least <em>in vitro</em> enamel can remineralise, but you are talking about incremental improvements and nothing approaching total repair of a cavity. Any major cavity will not repair itself.</p>\n\n<p>It is impossible for you to assess the damage to your teeth because you have neither the skills nor the equipment required. Your dentist has both, and you should respect their judgement. Your dentist should probably not have been impatient with your questions, but bear in mind that by questioning him you are implying he does not know what he is talking about and even the most saintly of dentists will get fed up with this eventually.</p>\n" }, { "answer_id": 16574, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>There are really two different questions posed here:</p>\n\n<blockquote>\n <ol>\n <li>How to stop or even reverse cavities?</li>\n </ol>\n</blockquote>\n\n<p>This is currently only partially possible in the sense of slowing down the further spread and development of caries.<br>\nEliminate acids and sugars from your diet, that includes starches and other cariogenic carbohydrates. Practice impeccable oral hygiene with lots of fluoride toothpaste, interdental cleanig with mouth washes, tooth picks and floss. Drink lots of green tea and milk. All of this – and more, if believe what's floating around the net popularly and mostly falsely – has very limited effects and cannot fully replace a visit to the dentist under any normal circumstances. </p>\n\n<p>Cavities cannot be \"reversed\", that is rebuilt and filled up to a fully working intact tooth. Not with miracle supplements, exotic foods and not even by a dentist, except that a dentist might have suitable substances to fill the cavity.</p>\n\n<p>That answers hypothetically a question with unrealistic goals. </p>\n\n<p>And the real question:</p>\n\n<blockquote>\n <ol start=\"2\">\n <li>What do you in case of a cavity and don't want to go dentist because you fear the side effects of drilling?</li>\n </ol>\n</blockquote>\n\n<p>_{First thing is of course something of the past in this case: try to prevent the cavity from forming in the first place. this is called prophylaxis and includes the usual: limit carbohydrate contact with teeth, practice oral hygiene and visit a dentist, not to let her drill anything, but to remove calculus and get protective lacquer layers. But as this is apparently too late in a case with developed cavities:}</p>\n\n<p>Someone with a cavity who does not want to go to a dentist because of the fear of drilling <em>has</em> to go to the dentist and let her drill and fill. The biggest problem in the scenario presented is <em>not</em> the procedure itself but the anxious anticipation that prevents a necessary and very, very probably best option.</p>\n\n<p>The secret of success is mentioning the anxiety involved and then requesting at least one of the following or even two drugs at once. Most of the time the request will be preempted by an offer:</p>\n\n<ol>\n<li>a large dose of local anaesthetic – for example <a href=\"https://en.wikipedia.org/wiki/Lidocaine\" rel=\"nofollow noreferrer\">Lidocaine</a> – that will prevent any pain from being registered in the brain</li>\n<li>an adequate dose of a one-time anxiety reliever or even a sedative that will make your brain not only dull to the pain but utterly uninterested in the effects for a while that is long enough until the procedure is over</li>\n</ol>\n\n<blockquote>\n <p>Dentists can also prescribe medications such as antibiotics, sedatives, and any other drugs used in patient management.<br>\n _{<a href=\"https://en.wikipedia.org/wiki/Dentistry#Dental_treatment\" rel=\"nofollow noreferrer\">Wikipedia: Dentistry#Dental treatment</a>}</p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005095/\" rel=\"nofollow noreferrer\">Current methods of sedation in dental patients - a systematic review of the literature</a> Med Oral Patol Oral Cir Bucal. 2016 Sep; 21(5): e579–e586.\nPublished online 2016 Jul 31. doi:10.4317/medoral.20981</p>\n\n<p>WebMD: <a href=\"https://www.webmd.com/oral-health/sedation-dentistry-can-you-really-relax-in-the-dentists-chair#1\" rel=\"nofollow noreferrer\">Sedation Dentistry: Can You Really Relax in the Dentist's Chair?</a><br>\n<a href=\"https://www.mouthhealthy.org/en/az-topics/a/anesthesia-and-sedation\" rel=\"nofollow noreferrer\">MouthHealthy, ADA, Anesthesia and Sedation</a><br>\n<a href=\"http://www.ada.org/~/media/ADA/Education%20and%20Careers/Files/anesthesia_use_guidelines.pdf\" rel=\"nofollow noreferrer\">ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists 2016</a><br>\n<a href=\"http://www.sedationdentistry4u.com/\" rel=\"nofollow noreferrer\">SedationDentstry4U</a><br>\nInform yourself before requesting any of that and do not fixate on a specific combination, but discuss this with your dentist. </p>\n" }, { "answer_id": 17053, "author": "JQTaylor", "author_id": 14380, "author_profile": "https://health.stackexchange.com/users/14380", "pm_score": 2, "selected": false, "text": "<p>As I understand it, the current consensus among dentists and scientists is that cavities which have reached the dentin layer are too big to heal using any existing technology, but that carious legions (areas of the tooth that have begun to erode through demineralization) can be remineralized with a lot of methods. Your own saliva contains calcium which regularly remineralizes teeth when conditions are right (mostly that pH is high enough). Almost all toothpastes help remineralize by containing some combination of calcium, phosphorous and/or fluoride.</p>\n\n<p>As has been mentioned by other responses, there is some promising research on repairing teeth with substances like AD drug tidesglusib. None of these treatments, to my knowledge, are ready for non-experimental use. </p>\n\n<p>The reason this problem is so tough is that tooth enamel is not a living structure like much of your bone is. It does not contain any living cells. The pulp in your teeth is alive, and can manufacture a small amount of protective dentin (the intermediate layer) to repair damage from the inside, but hasn't been shown to repair the enamel. Once bacteria have reached the dentin by wearing a cavity all the way through your enamel, there is no easy way to kill that bacteria so it is assumed that it will continue to thrive in the cavity until it reaches the pulp and ultimately destroys the tooth. Fillings are created by removing all the weakened and infected enamel and replacing it with an artificial material to protect the rest of the tooth.</p>\n\n<p>Wikipedia provides references for most of this: <a href=\"https://en.wikipedia.org/wiki/Tooth_decay\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Tooth_decay</a></p>\n\n<p>And here is the information about tidesglusib, which is expected to begin human trials in 2019:\n<a href=\"https://epatientfinder.com/human-trials-regrowing-teeth-expected-start-2019/\" rel=\"nofollow noreferrer\">https://epatientfinder.com/human-trials-regrowing-teeth-expected-start-2019/</a></p>\n\n<p>In answer to your second question, the best thing to do to start out is to get a dental x-ray. This will show you how deep the cavity has penetrated and you may well be able to stop its progress by stepping up your dental care and nutrition, making a filling unnecessary. </p>\n" }, { "answer_id": 17067, "author": "Uniphonic", "author_id": 14354, "author_profile": "https://health.stackexchange.com/users/14354", "pm_score": 1, "selected": false, "text": "<p>There were two questions here, but I'm only going to respond to the one in the headline \"How to stop or even reverse cavities?\" with one possibly helpful ingredient of the puzzle.</p>\n\n<p>Besides the regular brushing advice that dentists have been giving for decades, a more recent discovery is the benefits of <a href=\"https://en.wikipedia.org/wiki/Xylitol\" rel=\"nofollow noreferrer\">xylitol</a> on oral health. Studies have shown that oral products with xylitol in them have been <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/\" rel=\"nofollow noreferrer\">\"observed to be effective in preventing caries\"</a> (cavities). These oral products include xylitol chewing gum, xylitol gummy bear snacks, xylitol mouth rinse, and xylitol toothpaste.</p>\n\n<p>According to a medical article published in 2014, on <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/</a> it says regarding xylitol:</p>\n\n<blockquote>\n <p>\"The predominant modality for xylitol delivery has been chewing gum. Chewing gum accelerates the processes of rinsing away acid and uptake of beneficial calcium phosphate molecules to remineralize tooth enamel.\"</p>\n</blockquote>\n\n<p>It also says:</p>\n\n<blockquote>\n <p>\"A study among Montreal children showed that children who chewed xylitol gum had significantly lower caries progression after 24 months than those who did not use gum. These children exhibited a significantly higher number of reversals of carious lesions than the control group, suggesting that remineralization has occurred.\"</p>\n</blockquote>\n\n<p>It also talks about xylitol syrup:</p>\n\n<blockquote>\n <p>\"Twice-daily administration of xylitol oral syrup at a total daily dose of 8 g was observed to be effective in preventing caries.\"</p>\n</blockquote>\n\n<p>Regarding xylitol toothpaste, it says:</p>\n\n<blockquote>\n <p>\"Toothpaste with xylitol led to a decrease in S. mutans colonies in saliva, the amount of secreted saliva, and the increase of pH value. It has a positive effect on the quality of the oral environment and it would be useful introducing it into prophylactic programmes.\"</p>\n</blockquote>\n\n<p>The study concludes that:</p>\n\n<blockquote>\n <p>\"...more research is needed on the mechanisms of action of xylitol...\"</p>\n</blockquote>\n\n<p>and </p>\n\n<blockquote>\n <p>\"While these issues of xylitol still need to be expanded, the benefits it offers are literally worth salivating over.\"</p>\n</blockquote>\n\n<p>Please read the <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/\" rel=\"nofollow noreferrer\">full article</a> for all the details. </p>\n\n<p>An additional medical article from <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/14700079\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/14700079</a> notes that they did a study where samples were soaked in xylitol solution, and says that:</p>\n\n<blockquote>\n <p>\"These results indicate that xylitol can induce remineralization of deeper layers of demineralized enamel by facilitating Ca2+ movement and accessibility.\"</p>\n</blockquote>\n\n<p>Xylitol is a sugar substitute, with 40% less calories and 75% less carbohydrates (<a href=\"https://xylitol.org/xylitol-uses/nutritional-benefits-of-xylitol/\" rel=\"nofollow noreferrer\">than sugar</a>), that <a href=\"https://xylitol.org/xylitol-artificial-natural/\" rel=\"nofollow noreferrer\">naturally occurs in fruits and vegetables</a>, which doesn't have the <a href=\"https://en.wikipedia.org/wiki/Aspartame#Headaches\" rel=\"nofollow noreferrer\">negative side effects reported from many artificial sweeteners</a>. </p>\n\n<p>Xylitol chewing gum, mints, mouth rinse can be found at many stores but are especially prevalent in many health food stores.</p>\n\n<p>This answer wasn't meant to replace any recommendations from a dentist, and was only intended to point out some newer things to possibly supplement your usual oral care. You should probably consult a dentist, if you think you have a cavity.</p>\n" } ]

[ "https://health.stackexchange.com/questions/924", "https://health.stackexchange.com", "https://health.stackexchange.com/users/463/" ]

[ { "answer_id": 1007, "author": "Rana Prathap", "author_id": 37, "author_profile": "https://health.stackexchange.com/users/37", "pm_score": 4, "selected": true, "text": "<p>The causes of such pains are called back strains, and may be muscular or ligamentous in origin.</p>\n\n<p>It may be caused by:</p>\n\n<ol>\n<li>Physical exertion</li>\n<li>Fall</li>\n<li>Bending repeatedly</li>\n<li>Lifting heavy objects</li>\n<li>Emotional Stress</li>\n<li>Sitting in improper postures for long periods of time</li>\n</ol>\n\n<p>This happens when a muscle/ligament is overstretched, resulting in the injury of the same. Since spine is essentially supported by a large number of muscles and ligaments, this can happen very easily. If there is an injury, the area around it gets inflamed, and these will lead to spasm of the muscles. Hence the movement of the spine in such conditions will be extremely painful.</p>\n\n<p>The treatment modalities are usually conservative, including rest, NSAIDs, muscle relaxants, and physiotherapy when needed.</p>\n\n<p>References:</p>\n\n<ol>\n<li><p><a href=\"http://www.aafp.org/afp/2000/0315/p1779.html\">Diagnosis and Management of Acute Low Back Pain</a></p></li>\n<li><p><a href=\"http://www.webmd.com/back-pain/guide/low-back-strain\">Low Back Strain - WEBMD</a></p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25314730\">What's causing your lower back pain? The top three causes are sprains and strains, herniated discs, and stenosis</a> (Full text may not be accessible). </p></li>\n</ol>\n" }, { "answer_id": 10414, "author": "Frank Breitling", "author_id": 7600, "author_profile": "https://health.stackexchange.com/users/7600", "pm_score": 1, "selected": false, "text": "<p>According to my understanding and experience sudden back pain can be considered as a sort of <a href=\"https://en.wikipedia.org/wiki/Spasm\" rel=\"nofollow noreferrer\">spasm</a>. As such it cannot be controlled or relaxed intentionally. The patient is also not even aware of the spasm but only of the pain.</p>\n\n<p>However, recent studies have found that an increased intake of magnesium can reduce the back pain. See for example</p>\n\n<p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/anae.12107/abstract\" rel=\"nofollow noreferrer\">A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component</a>.</p>\n\n<p>Magnesium plays an important role in the communication of nerves and the prevention of spasm. Moreover many people need more magnesium than suggested by the recommended daily allowances for various reasons.</p>\n\n<p>This way I understand the result of this study.</p>\n" } ]

[ "https://health.stackexchange.com/questions/941", "https://health.stackexchange.com", "https://health.stackexchange.com/users/474/" ]

[ { "answer_id": 950, "author": "nelomad", "author_id": 479, "author_profile": "https://health.stackexchange.com/users/479", "pm_score": -1, "selected": false, "text": "<p>Anti-fatigue mats will distribute pressure more evenly.</p>\n\n<p>Vitamins A, B6 and B9, as well as copper and iron help produce blood, which, if lacking, can lead to cramps.</p>\n\n<p>Drink water! I read it helps cramps as well.</p>\n\n<p>Stay cool? Don't quote me on that.</p>\n\n<p>Do a warm-up before swimming, then after a cool-down.</p>\n\n<p>Jump around when you wake up. It prevents muscles from tying up.</p>\n\n<p>Stay flex. Stretch often.</p>\n\n<p>And last (and maybe the least) drink pickle juice. And a Gatorade (electrolytes). </p>\n" }, { "answer_id": 960, "author": "P i", "author_id": 476, "author_profile": "https://health.stackexchange.com/users/476", "pm_score": 1, "selected": true, "text": "<p>I think that shoes with good bridge support may be the answer here.</p>\n\n<p>I've been working wearing slippers (one of the many dangers of working at home!).</p>\n\n<p>My guess is that whatever tendon runs the length of the sole was getting put under constant stress.</p>\n\n<p>I've now taken a fortnight away from standing, and I'm using my tennis trainers upon return.</p>\n\n<p>I think a better solution would be if I could find some mat made out of some kind of spongy material that allows the entire foot to sink into it, maybe at a slight angle so the heels are at a higher level than the toes, as I would guess the heel will sink further.</p>\n\n<p>However, I won't accept this (or any other) answer until I am certain my feet are back to a healthy state.</p>\n\n<p>EDIT: June 2016, A HogHeaven anti-fatigue mat has done the job perfectly.</p>\n" } ]

[ "https://health.stackexchange.com/questions/946", "https://health.stackexchange.com", "https://health.stackexchange.com/users/476/" ]

[ { "answer_id": 984, "author": "Mark", "author_id": 333, "author_profile": "https://health.stackexchange.com/users/333", "pm_score": 2, "selected": false, "text": "<p>The 0 to 1 scale is simply a <a href=\"http://en.wikipedia.org/wiki/Visual_acuity#Expression\" rel=\"nofollow\">decimal expression</a> of the 20/20 (Imperial) or 6/6 (metric) measure of visual acuity. It's related to the smallest gap size someone can see on the <a href=\"http://en.wikipedia.org/wiki/Landolt_C\" rel=\"nofollow\">Landolt C chart</a>.</p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Dioptre\" rel=\"nofollow\">Dioptres</a> are not a measure of eyesight quality <em>per se</em>. Rather, they're a measure of the focal length of the lenses needed to bring your eyesight to normal. An <a href=\"http://en.wikipedia.org/wiki/Eyeglass_prescription\" rel=\"nofollow\">eyeglasses prescription</a> might specify two or three such measures to correct various aberrations (eg. \"-5 diopters; -1 diopter @ 180), in such a case, the first one is a spherical correction for distance vision, while the second is a cylindrical correction for <a href=\"http://en.wikipedia.org/wiki/Astigmatism_(eye)\" rel=\"nofollow\">astigmatism</a> and the third (in the rare case that it's present) is a prism correction for <a href=\"http://en.wikipedia.org/wiki/Vergence#Vergence_dysfunction\" rel=\"nofollow\">alignment problems</a>. Eyesight expressed as a single diopter measure refers to the correction needed for distance vision.</p>\n\n<p>Your \"negative integers\" method may be diopters again: a diopter measure can be either positive or negative, depending on what vision problems it's correcting.</p>\n\n<p>I can't find a \"0 to 20+\" scale for visual acuity.</p>\n" }, { "answer_id": 1003, "author": "cirko", "author_id": 514, "author_profile": "https://health.stackexchange.com/users/514", "pm_score": 4, "selected": true, "text": "<p>First of all, one has to distinguish between <a href=\"http://en.wikipedia.org/wiki/Visual_acuity\" rel=\"nofollow noreferrer\"><strong>visual acuity</strong></a> (VA), which is a measure for the maximal possible resolution your eye-brain-system can achieve, and the <a href=\"http://en.wikipedia.org/wiki/Refractive_error\" rel=\"nofollow noreferrer\"><strong>refractive error</strong></a>, which measures the deviation of the optical system of your eye from <em>emmetropy</em> (=perfectly balanced optics, sharp focus on retina without any glasses) in <em>diopters</em> of spheres and cylinders and thus determines what corrective glasses you need to wear in front of your eye in order to achieve your maximum possible visual acuity. </p>\n\n<p>Visual acuity can be measured without corrective glasses, i.e. the \"native\" VA of your eye, or with your best corrective glasses, which then gives you the value of your \"Best-corrected visual acuity\" (BCVA), and only this value is useful for comparison purposes, e.g. for driver's licenses (because errors that <em>can</em> be corrected by glasses also <em>are</em> to be corrected by law, as this is rather easy to do for everybody), and also for scientific evaluation of eye performance.</p>\n\n<p>This also explains a common misconception: When somebody is very near- or farsighted (myope or hyperope), he has to wear glasses with a high (absolute) value of diopters, e.g. -7 dpt. But if he reaches 20/20 vision with his glasses on (again, BCVA), then to an eye doctor, this will matter the most; for the glasses are neglegible in comparison to \"real\" eye diseases which can impair your eye function and lower the BCVA your eye can reach. Many people incorrectly compare their eye functions by comparing the amount of diopters in their glasses, yet this doesn't really say anything about the maximum resolution their eyes have when wearing their best glasses. Refractive errors can be corrected by glasses, contact lenses and laser surgery, but the maximum visual acuity an eye-brain-system is able to achieve can <em>not</em> be altered in any (simple) way.</p>\n\n<p>Now, when visual acuity is measured, a <em>full</em> visual acuity, i.e. \"normal\", or 100%, or any way you'd like to name it, has once simply deliberately been determined by a minimum angle of resolution of 1 arc minute, and the charts that are used for testing it have letters that correspond with this resolution. <a href=\"http://en.wikipedia.org/wiki/Minute_of_arc\" rel=\"nofollow noreferrer\">1 arc minute</a> of resolution corresponds to being able to separate two points with 2,91 cm between them at a distance of 100 m. Now note that this does <em>not</em> necessarily correspond with what most people are able to see; as said previously, the definition of 100% visual acuity was deliberate.\nThe capability to distinguish points with 1 arc minute of space between them has been defined as 20/20 (or 6/6) vision in <a href=\"http://en.wikipedia.org/wiki/Snellen_chart\" rel=\"nofollow noreferrer\">Snellen charts</a>, 1.0 vision in <a href=\"https://www.caa.co.uk/uploadedFiles/CAA/Content/Standard_Content/Medical/Visual/Files/Visual%20Acuity%20Conversion%20Chart.pdf\" rel=\"nofollow noreferrer\">decimal charts (conversion table)</a>, and later 0.0 <a href=\"http://en.wikipedia.org/wiki/LogMAR_chart\" rel=\"nofollow noreferrer\">logMAR</a>, which is the logarithm of the minimum angle of resolution and which has become <a href=\"http://www.icoph.org/dynamic/attachments/resources/icovisualacuity1984.pdf\" rel=\"nofollow noreferrer\">the gold standard in measuring and comparing visual acuity</a> (see p.13 for conversion chart), but is predominantly used for scientific purposes and less in clinical environments. </p>\n\n<p>This is basic knowledge in optics, optometry and ophthalmology. <a href=\"http://en.wikipedia.org/wiki/Visual_acuity\" rel=\"nofollow noreferrer\">Wikipedia</a> describes the correlations between the terms pretty well.</p>\n" } ]

[ "https://health.stackexchange.com/questions/957", "https://health.stackexchange.com", "https://health.stackexchange.com/users/484/" ]

[ { "answer_id": 1031, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 4, "selected": true, "text": "<p>Insulin resistance and obesity are both symptoms of type 2 diabetes, although they also occur at a prediabetic stage, before the diabetes diagnostic criteria are met. <a href=\"http://www.sciencedirect.com/science/article/pii/014067369292814V\" rel=\"noreferrer\">Insulin resistance is highly predictive of diabetes</a>. In the <a href=\"http://www.researchgate.net/profile/Giovanni_Targher/publication/13533291_Prevalence_of_insulin_resistance_in_metabolic_disorders_the_Bruneck_Study/links/00b4951dd5f59ca7d2000000.pdf\" rel=\"noreferrer\">Bruneck study</a>, less than 10% of the insulin resistant subjects had no other metabolic disorder. But still, the exact relationship between insulin resistance and obesity is unclear, as they could</p>\n\n<ul>\n<li>have a common cause, or </li>\n<li>one of them causes the other, or </li>\n<li>be coupled in a positive feedback cycle, or</li>\n<li>all of the above. But we know that they are highly correlated in untreated patients. </li>\n</ul>\n\n<p><img src=\"https://i.stack.imgur.com/JxrsV.gif\" alt=\"enter image description here\"></p>\n\n<p>This is the prevalence of insulin resistance in adolescents from <a href=\"http://care.diabetesjournals.org/content/29/11/2427.full#F1\" rel=\"noreferrer\">NHANES</a>, with white circles denoting normal weight adolescents, black squares denoting overweight adolescents and black circles denoting obese adolescents. </p>\n\n<p>For example, <a href=\"https://class.coursera.org/diabetes-003/\" rel=\"noreferrer\">one of the theories</a> for the progression to diabetes is that the capacity of the body's usual fat depots is overtaxed, leading to having too much fat where it does not belong (e.g. intraabdominal fat deposits), resulting in lipotoxicity and finally diabetes. This would be a potential argument for obesity leading to insulin resistance. A common cause could be searched e.g. in <a href=\"http://www.diapedia.org/metabolism/glp-1-defects-in-diabetes\" rel=\"noreferrer\">reduced incretin secretion</a> or <a href=\"http://www.researchgate.net/profile/Lufen_Chang/publication/11022576_A_central_role_for_JNK_in_obesity_and_insulin_resistance/links/5481cee20cf2941f830a02bd.pdf\" rel=\"noreferrer\">increased JNK activity</a>. But given the difficulty of finding a clear mechanism, and the complexity of the pathways involved, the connection is probably multifactorial. </p>\n\n<p>Weight loss is one of the goals in diabetes management. Exercise and dieting delay the progression of prediabetic stages to diabetes. They reduce both obesity and insulin resistance. So, to answer your question directly, <strong>if you had insulin resistance, and you managed to lose weight, it is very likely that your insulin sensitivity has increased.</strong> </p>\n\n<p>The above assumes that the patient is not taking any metabolic treatment. If he is taking diabetes medications, their effect on insulin sensitivity and weight will be independent. Some medication classes like <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19952301\" rel=\"noreferrer\">GLP 1 agonists</a> will reduce both obesity and insulin related effects, as will <a href=\"http://en.wikipedia.org/wiki/Gastric_bypass_surgery\" rel=\"noreferrer\">bariatric surgery</a>. <a href=\"http://en.wikipedia.org/wiki/Metformin\" rel=\"noreferrer\">Metformin</a> will improve insulin sensitivity without affecting weight much, while <a href=\"http://en.wikipedia.org/wiki/Thiazolidinedione\" rel=\"noreferrer\">the glitazones</a> reduce insulin resistance but lead to weight gain. </p>\n" }, { "answer_id": 9173, "author": "aparente001", "author_id": 402, "author_profile": "https://health.stackexchange.com/users/402", "pm_score": 0, "selected": false, "text": "<p>People who have insulin resistance generally find it more difficult to attain and maintain a healthy weight.</p>\n\n<p>If the person with insulin resistance is overweight (which is often the case), and if s/he succeeds in losing even a small amount of weight, s/he will generally see some immediate improvement in their insulin sensitivity and a lessening of symptoms (such as headache, yucky feeling, foggy feeling).</p>\n\n<p>Reference: <a href=\"https://www.niddk.nih.gov/health-information/diabetes/types/prediabetes-insulin-resistance\" rel=\"nofollow\">https://www.niddk.nih.gov/health-information/diabetes/types/prediabetes-insulin-resistance</a></p>\n\n<p>A low-carb diet helped my insulin resistant son.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1013", "https://health.stackexchange.com", "https://health.stackexchange.com/users/489/" ]

[ { "answer_id": 1015, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 5, "selected": true, "text": "<p>There is no need for any person to learn any drug taxonomy, unless this person is creating or extensively using clinical or pharmacological documentation. I don't doubt that somewhere, a single unified taxonomy of drugs exists, prescribed by some standardization body - and I also don't doubt that it's a major pain to use and as hated by physicians as ICD-10. </p>\n\n<p>For all medical purposes outside of documentation, people use <a href=\"http://www.amazon.de/Women-Fire-Dangerous-Things-Categories/dp/0226468046\">categorization</a> the same way they do it for all other concepts in their life. They put a label on any group they (and hopefully their communication partner) readily recognize. And what they recognize depends on their level of expertise in the field. </p>\n\n<p>This is why you, the patient, will naturally say \"drugs for <a href=\"http://en.wikipedia.org/wiki/Migraine\">migraine</a>\" while talking to a friend of physician. A physician will use categories such as \"<a href=\"http://en.wikipedia.org/wiki/Serotonin_receptor_agonist\">serotonin receptor agonists</a>\". Neither of you two studied a taxonomy tree of drugs before using a correct category name. You knew \"there are migraines\" and derived a proper category name from it. The physician learned about the role of serotonin in the brain, and one chapter of his textbook explained how serotonin is connected to migraine, and another explained how there are drugs which mimic the effects of serotonin by activating the same receptors which are usually activated by serotonin, so they can stop a migraine. </p>\n\n<p>Note that the two categories are not the same, even though they have some overlap. Some serotonin receptor agonists are a type of migraine drugs. But there are migraine drugs which are not serotonin receptor agonists, and there are serotonin receptor agonists which do something other than heal migraine, because they activate a slightly different set of serotonin receptors. But there is no simple way to translate the category \"serotonin receptor agonists\" to layman's terms. It's not even a matter of it resulting from too detailed criteria, and saying that it's good for a layman to learn the more general category above it - because the more general category of \"receptor agonist\" is not easier to understand. <a href=\"http://rads.stackoverflow.com/amzn/click/1591842948\">Experts' taxonomies are not simply more detailed versions of a layman's taxonomy of the same area, they are orthogonal to laymen taxonomies, because they are based on completely different principles.</a> </p>\n\n<p>If what you want is a categorization system reflecting your current knowledge, then you already have it. Talking about \"drugs for fever\" or \"drugs for migraine\" is not wrong in any way. Just say whatever you mean when you need it. There could be a category which you need to talk about but cannot come up with a succinct name for it, such as \"drugs for fever which are safe for toddlers and are taken through the mouth\" - but it is unlikely that it already makes a node in somebody else's standardized taxonomy, you have to describe it. And while your doctor might be inclined to use the description \"pediatric oral antipyretic\" instead, this does not make your label less valid. </p>\n\n<p>If you want to be able to work with a more intricate taxonomy, you'll need more medical knowledge. And that's great - everybody can use knowledge about such an important subject. But in this case, the knowledge comes first. Using the correct taxonomy will come naturally, as a byproduct of your increased knowledge. The other way round does not work. </p>\n\n<p>Of course, it can happen that you come across information which refers to a category you don't understand, for example in the list of interactions of a drug you are taking. But if you want to understand this information, the way is not through some special taxonomy (which cannot be mapped to concepts you already know anyway). If you really need to know what makes a class of drug a \"class\" and not a random collection of drugs, and a source you find does not explain it in terms you understand, you need another source which will try to explain the criteria behind the existing expert's category. I'm sure the users of this site will be happy to help you in this, too. </p>\n" }, { "answer_id": 1407, "author": "Lucky", "author_id": 613, "author_profile": "https://health.stackexchange.com/users/613", "pm_score": 2, "selected": false, "text": "<p>I second rumstscho's answer (except the part about ICD-10 being a major pain to use).</p>\n\n<p>There is a classification system of medicines that is quite detailed and widely used, and it is called:</p>\n\n<h2>Anatomical Therapeutic Chemical (ATC) classification system</h2>\n\n<p>As you can guess from the name it classifies medicines based on: </p>\n\n<ul>\n<li>the organ or system on which they act and</li>\n<li>their therapeutic properties and</li>\n<li>pharmacological properties and</li>\n<li>chemical </li>\n</ul>\n\n<p>How do they take all of these into account? By using a <strong>multilevel</strong> classification system. The classification is paired with a code system, which can be used to search for a medicine on a regulatory agency's website, for instance.</p>\n\n<p>ATC classification system has five levels: </p>\n\n<p><strong>First level</strong> - <a href=\"https://en.wikipedia.org/wiki/Anatomical_Therapeutic_Chemical_Classification_System\" rel=\"nofollow\">anatomical main group</a> (this is a level a layperson can easily understand)</p>\n\n<blockquote>\n <p>A Alimentary tract and metabolism</p>\n \n <p>B Blood and blood forming organs</p>\n \n <p>C Cardiovascular system</p>\n \n <p>D Dermatologicals</p>\n \n <p>G Genito-urinary system and sex hormones</p>\n \n <p>H Systemic hormonal preparations, excluding sex hormones and insulins</p>\n \n <p>J Antiinfectives for systemic use</p>\n \n <p>L Antineoplastic and immunomodulating agents</p>\n \n <p>M Musculo-skeletal system</p>\n \n <p>N Nervous system</p>\n \n <p>P Antiparasitic products, insecticides and repellents</p>\n \n <p>R Respiratory system</p>\n \n <p>S Sensory organs</p>\n \n <p>V Various</p>\n</blockquote>\n\n<p><strong>Second level</strong> - therapeutic main group (this is a level that an informed patient can understand - if you are somewhat familiar with the medical condition/indication the medicine is for, you can understand this level)</p>\n\n<p><strong>Third level</strong> - therapeutic/pharmacological subgroup (this is where things get quite technical; these waters are generally too deep for a layperson)</p>\n\n<p><strong>Fourth level</strong> - chemical/therapeutic/pharmacological subgroup</p>\n\n<p><strong>Fifth level</strong> - the chemical substance</p>\n\n<p>How are medicines included in the system:</p>\n\n<blockquote>\n <p><em>Inclusion and exclusion criteria\n The WHO Collaborating Centre in Oslo establishes new entries in the ATC classification on requests from the users of the system. These include manufacturers, regulatory agencies and researchers. The coverage of the system is not comprehensive. A major reason why a substance is not included is that no request has been received.</em> [...]</p>\n \n <p><em>Complementary, homeopathic and herbal traditional medicinal products are in general not included in the ATC system.</em></p>\n</blockquote>\n\n<p>from: <a href=\"http://www.whocc.no/atc/structure_and_principles/\" rel=\"nofollow\">WHO Collaborating Centre for Drug Statistics Methodology</a></p>\n\n<p>(if you are really interested in this subject, you might find some chapters of <a href=\"http://www.whocc.no/filearchive/publications/1_2013guidelines.pdf\" rel=\"nofollow\">this publication</a> interesting. </p>\n\n<hr>\n\n<p>However, there is no need for you to learn this (or any other classification). If your goal is to gain knowledge on medicines the area you are interested in is <a href=\"https://en.wikipedia.org/wiki/Pharmacology\" rel=\"nofollow\">pharmacology</a> or more precisely <a href=\"https://en.wikipedia.org/wiki/Pharmacodynamics\" rel=\"nofollow\">pharmacodynamics</a>. This is quite a large area, but a real catch for a layperson is that it is an applied science, sou you would need knowledge from physiology, patophysiology and medicinal biochemistry first; and for those you would need cell biology, some anatomy and histology, microbiology, biochemistry (for which you definitely need some chemistry)... This would be a few year's quest and you would still need a curriculum and someone to supervise your learning process to make sure you understand all important concepts correctly. </p>\n\n<p>This doesn't mean that you can't be a well informed, educated patient (or patient's caregiver, family member). You just don't need to learn about all of the major illnesses and medicines. Simply, when (if) a health problem occurs focus your efforts on that specific area. You cannot and should not use the knowledge you gain to self-medicate; it should serve you to communicate better with your health care providers, participate in the decisions, and if necessary consider if it's time to get a second opinion on something.</p>\n\n<hr>\n\n<p>An aside: <a href=\"https://books.google.rs/books?id=s2R-ZYz_iBYC&amp;printsec=frontcover&amp;dq=%22rang+and+dale+pharmacology%22+%22table+of+contents%22&amp;hl=en&amp;sa=X&amp;ei=UhCQVen4JIX5UP66g_AC&amp;redir_esc=y#v=onepage&amp;q=%22rang%20and%20dale%20pharmacology%22%20%22table%20of%20contents%22&amp;f=false\" rel=\"nofollow\">Here is an example</a> of how a book in pharmacology is organised. The lessons about specific medicines start from section 2. You can see that sometimes a cellular/chemical mechanism is used (section 2), and sometimes a whole organ or system of organs (section 3 and 4) or the disease to be treated (section 5 and chapters 43-45 in section 4 e.g.) (whichever is better to explain how a certain medicine works). I do not recommend this book for you (not that it's not good, it's a great one) - because it's designed for grad students of medicine/pharmacy as well as phd students. While it is great because it encourages critical thinking, you can get lost in the quantity of details. I've just used its table of contents as an example how one can go about studying pharmacology. For a layperson I'd say that <strong>starting</strong> with Wikipedia is not a bad thing (articles there are usually well organised), as long as you make sure to check the accuracy of information you find there. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1014", "https://health.stackexchange.com", "https://health.stackexchange.com/users/99/" ]

[ { "answer_id": 1051, "author": "michaelpri", "author_id": 26, "author_profile": "https://health.stackexchange.com/users/26", "pm_score": 4, "selected": true, "text": "<p>Ingestion of hydrogen peroxide (H2O2), especially very high strength H2O2, can be very dangerous and can cause some serious health risks and possibly even death. </p>\n\n<p>A United States Food and Drug Administration (FDA) announcement made in 2006^{<a href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108701.htm\">1</a>} says that drinking high strength H2O2, specifically H2O2 of 35%, is extremely dangerous and can cause several serious side effects. \"Ingesting hydrogen peroxide can cause gastrointestinal irritation or ulceration.\" It can also cause other health risks, some of which can be life threatening. </p>\n\n<p>Another article from 2007^{<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658134/\">2</a>} talks about a specific incident in which a 39 year old man accidentally drank 250mL of 35% H2O2. Though the man did not experience the worst possible side effects, he did have to go to the hospital and he did experience damage in his stomach. This is a good example of a real life situation in which H2O2 was consumed, and it did not turn out well. Another real world example^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24692088\">3</a>} turned out much sadder. A 2 year old girl swallowed two sips of 35% H2O2 and died. This happened because of a <a href=\"http://en.wikipedia.org/wiki/Cytotoxicity\">cytotoxic</a> (cell-killing) injury in the tissues and formation of oxygen gas (<a href=\"http://en.wikipedia.org/wiki/Oxygen_toxicity\">oxygen toxicity</a>) caused by the H2O2.</p>\n\n<p>Ingestion of 35% H2O2 is undeniably dangerous, but what about lower concentrations of H2O2, such as 3%? A study from the 1990's^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8667471\">4</a>} studied 670 cases of mostly children being exposed, usually orally, to 3% H2O2. \"Exposure to hydrogen peroxide 3% is usually benign, however, severe gastric injury may occur following small ingestions in children.\" Overall, they found that a majority of the children were not affected by the low concentration H2O2, but there were special cases in which bad outcomes did occur. </p>\n\n<p>Overall, we can see that safeness of drinking H2O2 varies depending on what the concentration is. High concentrations, 35%, are extremely dangerous and should never be consumed, but low concentrations, 3%, present low risks. Now, the question is do the benefits of 3% H2O2 outweigh the risks. </p>\n\n<p>I have been unable to find any reliable sources showing that health benefits of drinking H2O2 of any concentration. Usually, it is used as a topical solution for minor cuts and wounds, not as something to be taken orally. Though the ingestion of 3% H2O2 hasn't been shown to be consistently dangerous, there have been cases of damage in the stomach and other parts of the body.^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16740449\">5</a>} H2O2 poisoning can be very dangerous, even with low concentrations of it, so I would not recommend drinkin H2O2, ever. For more on Hydrogen Peroxide Poisoning, see <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/15298493\">here</a> and <a href=\"http://www.nlm.nih.gov/medlineplus/ency/article/002652.htm\">here</a>.</p>\n\n<hr>\n\n<p>^{[<a href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108701.htm\">1</a>] <a href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108701.htm\">FDA Warns Consumers Against Drinking High-Strength Hydrogen Peroxide for Medicinal Use: Ingestion Can Lead to Serious Health Risks and Death</a>}</p>\n\n<p>^{[<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658134/\">2</a>] <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658134/\">Accidental ingestion of 35% hydrogen peroxide</a>}</p>\n\n<p>^{[<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24692088\">3</a>] <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24692088\">Fatal accidental ingestion of 35 % hydrogen peroxide by a 2-year-old female: case report and literature review</a>}</p>\n\n<p>^{[<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8667471\">4</a>] <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8667471\">Hydrogen peroxide 3% exposures</a>}</p>\n\n<p>^{[<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16740449\">5</a>] <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16740449\">Hemorrhagic gastritis and gas emboli after ingesting 3% hydrogen peroxide</a>}</p>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/15298493\">Hydrogen peroxide poisoning</a>}</p>\n\n<p>^{<a href=\"http://www.nlm.nih.gov/medlineplus/ency/article/002652.htm\">Hydrogen peroxide poisoning</a>}</p>\n" }, { "answer_id": 1220, "author": "jiggunjer", "author_id": 282, "author_profile": "https://health.stackexchange.com/users/282", "pm_score": 2, "selected": false, "text": "<p>According to <a href=\"http://en.wikipedia.org/wiki/Hydrogen_peroxide\" rel=\"nofollow\">Wikipedia</a> this treatment is based on 2 claims: </p>\n\n<ul>\n<li><p>Cells produce hydrogen peroxide as an immune response/damaged tissue response.</p></li>\n<li><p>Pathogens can not survive in oxygen rich environment (recall H2O2 decomposes into H2O and O2)</p></li>\n</ul>\n\n<p>As you may notice the reasoning is rather flawed, even if we assume these two claims to be true. As it turns out though these claims have a weak scientific basis, making the hypothesis for the hydrogen peroxide treatment <strong><em>very</em></strong> far-fetched.</p>\n\n<p>Let's look at the (implied) reasoning:</p>\n\n<p>1) Cells make X to fight disease, so adding X would help fight disease better.<br>\nThere are 2 problems with this. Firstly, a higher concentration of X does not garantee more effectiveness--there may be side-effects to consider too. Secondly, cells may create it locally, whereas by ingesting it or injecting it into the bloodstream X may not reach the important area.</p>\n\n<blockquote>\n <p>Both the effectiveness and safety of hydrogen peroxide therapy is\n disputed by mainstream scientists. Hydrogen peroxide is produced by\n the immune system but in a carefully controlled manner. Cells called\n by phagocytes engulf pathogens and then use hydrogen peroxide to\n destroy them. The peroxide is toxic to both the cell and the pathogen\n and so is kept within a special compartment, called a phagosome.</p>\n</blockquote>\n\n<p>2)Oxygen kills pathogens, so adding oxygen to the cells will kill more pathogens.<br>\nThis claim is complete non-sense. Firstly there is the problem again that the oxygen increase is not local. Secondly this increase may be negligible compared to the normal oxygen levels in the cells.</p>\n\n<blockquote>\n <p>Claims that hydrogen peroxide therapy increase cellular levels of\n oxygen have not been supported. The quantities administered would be\n expected to provide very little additional oxygen compared to that\n available from normal respiration.</p>\n</blockquote>\n\n<p>Lastly and most important, there is no proof that oxygen is lethal to cells capable of respiration. Some cancer cells may even depend on a respiration pathway to generate ATP. So <strong>the claim that oxygen is lethal to all pathogens is false</strong>. This is not surprising as the basis for this claim, the <a href=\"http://en.wikipedia.org/wiki/Warburg_hypothesis\" rel=\"nofollow\">Warburg theory</a>, is also outdated and has been criticized for being a too simplistic view of cancer.</p>\n\n<p>Rather than saying if it is safe, because the context of the question mentions detox, this answer states that <em>there is no reason to drink it</em>.</p>\n\n<blockquote>\n <p>The American Cancer Society states that \"there is no scientific\n evidence that hydrogen peroxide is a safe, effective or useful cancer\n treatment\". The therapy is not approved by the U.S. FDA.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/1019", "https://health.stackexchange.com", "https://health.stackexchange.com/users/545/" ]

[ { "answer_id": 1025, "author": "Khan", "author_id": 498, "author_profile": "https://health.stackexchange.com/users/498", "pm_score": 2, "selected": false, "text": "<p>According to this <a href=\"http://web.archive.org/web/20150225220724/http://discovery.yukozimo.com/who-discovered-brain-cancer/\" rel=\"nofollow noreferrer\">source</a> and <a href=\"https://en.wikipedia.org/wiki/Timeline_of_brain_cancer\" rel=\"nofollow noreferrer\">this</a>, brain cancer was first discovered in 1873 and brain tumor before that. We can't say for sure when the first case of brain tumor occurred because it may have been originated in the prehistoric times. Since no data was recorded in those times, it isn't certain to say when and where the first case of brain tumor occurred.</p>\n\n<blockquote>\n <p>It’s not that hard to answer the question of who discovered brain cancer – this breakthrough is credited to Gupta Longati, a Russian scientist, who discovered the disease in 1873.</p>\n</blockquote>\n" }, { "answer_id": 3499, "author": "Mark Benson", "author_id": 1878, "author_profile": "https://health.stackexchange.com/users/1878", "pm_score": -1, "selected": false, "text": "<p>I have heard it was discovered in 1879. There were some cases before that of people with the same symptoms, but doctors didn't know what it was.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1022", "https://health.stackexchange.com", "https://health.stackexchange.com/users/552/" ]

[ { "answer_id": 1062, "author": "cirko", "author_id": 514, "author_profile": "https://health.stackexchange.com/users/514", "pm_score": 3, "selected": false, "text": "<p>First of all, the 1000-2500 calorie statement <a href=\"https://health.stackexchange.com/questions/981/does-it-become-harder-to-lose-weight-as-you-age/1011#1011\">from the answer to this question</a> is not due to formula inaccuracies (only 0.5% of the variation were attributed to that), but is the <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16280423\" rel=\"nofollow noreferrer\">actual measured BMR in a study within Scottish population</a>.</p>\n\n<p>Second, we know from the above mentioned question in SE that the BMR is dependent, amongst others, of fat-free body mass (FFM), i.e. muscle mass. In the forementioned study, 63% of BMR variation could be attributed to variations in FFM. And we also know that <a href=\"http://link.springer.com/article/10.2165/00007256-200636030-00005\" rel=\"nofollow noreferrer\">diets can lead to a loss of this mass, if they aren't overcompensated by exercise; thus the logical deduction can be made that a diet can lead to BMR decrease, if it's not compensated for</a>, e.g. by exercise or high-protein-intake diets.</p>\n\n<p>I couldn't find any other evidence on direct changes to BMR by a diet, so this connection (diet - FFM decrease - BMR decrease) may just be it for now.</p>\n" }, { "answer_id": 1109, "author": "Atl LED", "author_id": 601, "author_profile": "https://health.stackexchange.com/users/601", "pm_score": 3, "selected": true, "text": "<p>Yes it can. As a general statement, I'm not sure how much it can go down before it's a problem, which is what I think you are asking as your second question. Starving to death might be seen as this taking the BMR close to zero (though I don't think you would get to zero before death).</p>\n\n<p>I think a good reference for this is Peter Emery's review article \"<a href=\"http://www.nature.com/eye/journal/v19/n10/full/6701959a.html#bib14\" rel=\"nofollow\">Metabolic changes in malnutrition</a>.\" There may be more appropriate references when concerning elective reductions in caloric intake, but I suspect the results are <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/1885261\" rel=\"nofollow\">similar</a> on a smaller scale.</p>\n\n<p>There are a few sections of the review that are worth quoting and discussing here:</p>\n\n<p>First the general trend and cause:</p>\n\n<blockquote>\n <p>The basal metabolic rate actually increases during the first few days\n of starvation, under the influence of catecholamines that are secreted\n in response to decreasing blood glucose concentrations. This\n probably reflects the high rate of gluconeogenesis that occurs at this\n time. As fasting progresses, however, metabolic rate decreases as free\n T3 and catecholamine levels decrease and the rate of gluconeogenesis\n decreases.</p>\n</blockquote>\n\n<p>In essence, when you first start to fast (the references<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/2405717?dopt=Abstract&amp;holding=npg\" rel=\"nofollow\"> [1</a>,<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10837292?dopt=Abstract&amp;holding=npg\" rel=\"nofollow\">2] </a>that the review sites are from 1-4 days in this section) the body looks to other sources of energy (<a href=\"https://en.wikipedia.org/wiki/Gluconeogenesis\" rel=\"nofollow\">gluconeogenesis</a>). That is not sustainable over time, and then the BMR begins to drop. How it begins to drop is largely through the lost of lean tissue, with a focus on muscle mass, which is probably a good evolutionary choice over more important systems such as the brain:</p>\n\n<blockquote>\n <p>The response to a less severe degree of food restriction can also be\n seen as a series of adaptive processes with the same priorities, that\n is to maintain the supply of glucose to the brain and to minimise the\n loss of lean tissue. Basal metabolic rate decreases to minimise the\n negative energy balance. This is achieved partly by loss of\n metabolically active tissue, but there is also some evidence that the\n efficiency of energy metabolism increases leading to a decrease in\n energy expenditure per unit cell mass.</p>\n</blockquote>\n\n<p>Again, the <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10365978?dopt=Abstract&amp;holding=npg\" rel=\"nofollow\">referenced review article</a> is also worth a read, especially as it deals with otherwise healthy individuals and people \"dieting\" in the common sense of the word (but in no means the medical). Again body composition and physical activity take a leading role here, but changes in efficiency are certainly noted if not understood. A conclusion reached on efficiency calculation (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10365978?dopt=Abstract&amp;holding=npg\" rel=\"nofollow\">ibid</a>) is also worth quoting:</p>\n\n<blockquote>\n <p>It would thus appear that the generally used indicator of metabolic\n efficiency in humans, that is a reduced oxygen consumption per unit\n fat free mass, is fraught with problems since it does not account for\n variations in contributions from sub-compartments of the fat free mass\n which include those with high metabolism at rest such as brain and\n viscera and those with low metabolism at rest such as muscle mass.</p>\n</blockquote>\n\n<p>When in your life span you start on your low caloric diet can effect the outcome of the diet. A commonly understood example is a shorter stature/smaller skeletal frame will develop under limited nutritional intake. It's probably worth noting that on an evolutionary scale, having too many calories is an exceedingly new problem. In other words, even if we wouldn't see it as preferential in the developed world today, it is probably an adaptive response to lose lean body mass or not develop additional skeletal structure (with goals of efficiency). </p>\n\n<p>I will end returning <a href=\"http://www.nature.com/eye/journal/v19/n10/full/6701959a.html#bib14\" rel=\"nofollow\">Dr. Emery's</a> coverage of the same topic:</p>\n\n<blockquote>\n <p>The main response in chronically malnourished populations is slow\n growth rate, delayed maturity, and small adult stature. Small stature\n can be seen as a successful adaptation to low-energy intake because\n overall basal metabolic rate will be low. However, when metabolic rate\n is adjusted for fat-free mass there is no significant difference\n between those who are most malnourished and those who are well\n nourished. The reason for this is that the main deficit in lean\n tissue mass is in muscle, which has a relatively low metabolic rate,\n while the size of the visceral organs, which are much more\n metabolically active, is much less affected. Hence these changes in\n body composition may cancel out any increase in the efficiency of\n cellular metabolism.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/1037", "https://health.stackexchange.com", "https://health.stackexchange.com/users/489/" ]

[ { "answer_id": 5259, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 4, "selected": false, "text": "<blockquote>\n<p>Remember not to drink too soon before or after a meal as the water will dilute the digestive juices</p>\n</blockquote>\n<p>While that claim might <em>sound</em> reasonable at first, I doubt this has any effect you need to consider for your health. There's several reasons for this:</p>\n<ul>\n<li><p>The stomach normally contains about <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/003883.htm\" rel=\"noreferrer\">20 to 100 milliliters of stomach acid at a pH of around 2 to 3</a>. To change pH by one point, you need to dilute it 1:10. If the stomach contains 50 milliliters at a pH of 2, for example, half a litre is needed to get it up to a pH of 3.</p>\n<p>The effect definitely isn't negligible, but it's less than you might think because stomach acid is a very strong acid. An acid with a pH of 3 or even 4 is still a strong acid, and unlikely to cause problems - the medical condition of <a href=\"http://emedicine.medscape.com/article/170066-overview\" rel=\"noreferrer\">achlorhydria</a> is only diagnosed when the stomach acid pH is greater than 5 in men or 6.8 in women.</p>\n</li>\n<li><p>The stomach is capable of regulating pH if needed - for example, <a href=\"http://m.bja.oxfordjournals.org/content/70/1/6.short\" rel=\"noreferrer\">in a study on preoperative patients</a>, one group was allowed to drink water and one wasn't. The mean water intake was 400 milliliters for the group that was allowed to. The stomach acid in the two groups didn't differ significantly in either volume (which was just 20 milliliters) or acidity.</p>\n</li>\n</ul>\n<blockquote>\n<p>Drink water an hour after the meal to allow the body to absorb the nutrients.</p>\n</blockquote>\n<ul>\n<li><p>Food stays in the stomach for <a href=\"http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/basics/transit.html\" rel=\"noreferrer\">2 to 4 hours</a>, so the recommendation to wait one hour is weird. What's more, food itself contains water and thus does lower the acidity of the stomach - that's normal. Since it can be regulated (see above) it's very doubtful that a bit of water on top is going to screw things up</p>\n</li>\n<li><p>What do these sources think will happen with these nutrients? After the hours in the stomach, there's an additional 3 hours in the small intestine and <strong>30 to 40</strong> hours in the colon for the food. The colon and the stomach do have different roles in digestion, but in general, the digestive tract is pretty good at extracting nutrients from food</p>\n</li>\n</ul>\n<p>As a doctor writes <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/digestion/faq-20058348\" rel=\"noreferrer\">for the Mayo Clinic</a> (yes, I know that link is in your question):</p>\n<blockquote>\n<p>There's no concern that water will dilute the digestive juices or interfere with digestion.</p>\n</blockquote>\n<p>Drink water when you want to drink water. Also, don't trust sites that tell you to drink water to &quot;activate your internal organs&quot; in the morning ;-)</p>\n" }, { "answer_id": 19055, "author": "Prince", "author_id": 6972, "author_profile": "https://health.stackexchange.com/users/6972", "pm_score": -1, "selected": false, "text": "<p>Drinking water during or after a meal actually aids digestion. Water and other liquids help break down food so that your body can absorb the nutrients. Water also softens stools, which helps prevent constipation.</p>\n\n<p>Despite the fact that it aids digestion, it also has its down-side such as the fact that it would slow the digestion process and reduce the body’s ability to produce enough digestive enzymes to digest foods properly. Without proper digestion, a build up of toxic waste can occur no matter what you are eating.</p>\n\n<p>It is important to note that drinking water during a meal would be more beneficial than not drinking while eating if you are not properly hydrated before hand. Eating while dehydrated can cause the body to have a very tough time digesting food.</p>\n\n<p>Based on the information presented, when thinking about how to approach eating meals yourself, there are several tips we can apply. It appears most beneficial to stay hydrated throughout the day and if you must drink while you eat, avoid drinking too much, as well as alcohol and acidic drinks. Drink warm water and drink it sparingly. A small glass will likely not interfere with digestion and by adding a dash of apple cider vinegar or lemon, you can aid in the digestive process further. If you can, you might want to try drinking 30 minutes before and 30 minutes after a meal with no drinking during, see how you feel. If it works for you, then stick with what works, if not, adjust accordingly.</p>\n\n<p><a href=\"http://www.collective-evolution.com/2013/07/02/is-drinking-water-while-eating-good-for-you/\" rel=\"nofollow noreferrer\">http://www.collective-evolution.com/2013/07/02/is-drinking-water-while-eating-good-for-you/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1060", "https://health.stackexchange.com", "https://health.stackexchange.com/users/322/" ]

[ { "answer_id": 1094, "author": "Obfuskater", "author_id": 623, "author_profile": "https://health.stackexchange.com/users/623", "pm_score": -1, "selected": false, "text": "<p>A knee walker (<a href=\"http://rads.stackoverflow.com/amzn/click/B003VMAKVS\" rel=\"nofollow\">http://www.amazon.com/Drive-Medical-Aluminum-Steerable-Alternative/dp/B003VMAKVS</a>) would allow him to ambulate without a wheelchair or crutches. But as JohnP points out, the nature of the lower extremity fracture might make this suggestion impractical.</p>\n" }, { "answer_id": 1423, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": 0, "selected": false, "text": "<p>Walking cast, if the leg break is amenable to same. Lots of examples if you search on that term.</p>\n\n<p><a href=\"https://duckduckgo.com/?q=walking+cast&amp;ia=products\" rel=\"nofollow\">https://duckduckgo.com/?q=walking+cast&amp;ia=products</a></p>\n\n<p>May need a cane to steady himself, so might matter if the breaks are ipsilateral or contralateral.</p>\n" }, { "answer_id": 1994, "author": "Dims", "author_id": 1451, "author_profile": "https://health.stackexchange.com/users/1451", "pm_score": 1, "selected": false, "text": "<p>Bones should be maximally immobilized. It is very painful and dangerous to move otherwise. </p>\n\n<p>It is possible to walk, using only one crutch (I know this by practice). </p>\n\n<p>Probably it is possible to use it on the side opposite to broken collar bone.</p>\n\n<p>Most probably, if we have complex fracture, it will be recommended to use carriage, especially on initial stages of recovery.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1090", "https://health.stackexchange.com", "https://health.stackexchange.com/users/622/" ]

[ { "answer_id": 1094, "author": "Obfuskater", "author_id": 623, "author_profile": "https://health.stackexchange.com/users/623", "pm_score": -1, "selected": false, "text": "<p>A knee walker (<a href=\"http://rads.stackoverflow.com/amzn/click/B003VMAKVS\" rel=\"nofollow\">http://www.amazon.com/Drive-Medical-Aluminum-Steerable-Alternative/dp/B003VMAKVS</a>) would allow him to ambulate without a wheelchair or crutches. But as JohnP points out, the nature of the lower extremity fracture might make this suggestion impractical.</p>\n" }, { "answer_id": 1423, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": 0, "selected": false, "text": "<p>Walking cast, if the leg break is amenable to same. Lots of examples if you search on that term.</p>\n\n<p><a href=\"https://duckduckgo.com/?q=walking+cast&amp;ia=products\" rel=\"nofollow\">https://duckduckgo.com/?q=walking+cast&amp;ia=products</a></p>\n\n<p>May need a cane to steady himself, so might matter if the breaks are ipsilateral or contralateral.</p>\n" }, { "answer_id": 1994, "author": "Dims", "author_id": 1451, "author_profile": "https://health.stackexchange.com/users/1451", "pm_score": 1, "selected": false, "text": "<p>Bones should be maximally immobilized. It is very painful and dangerous to move otherwise. </p>\n\n<p>It is possible to walk, using only one crutch (I know this by practice). </p>\n\n<p>Probably it is possible to use it on the side opposite to broken collar bone.</p>\n\n<p>Most probably, if we have complex fracture, it will be recommended to use carriage, especially on initial stages of recovery.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1091", "https://health.stackexchange.com", "https://health.stackexchange.com/users/165/" ]

[ { "answer_id": 1100, "author": "Susan", "author_id": 165, "author_profile": "https://health.stackexchange.com/users/165", "pm_score": 3, "selected": true, "text": "<p>I summarized the mechanism of hiccups in <a href=\"https://biology.stackexchange.com/q/21865/9268\">a question on biology.SE</a> a few months ago. That may be useful background information for the answer to this question about what interventions work.</p>\n\n<p>Regarding the available data, as usual a <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=23440833\" rel=\"nofollow noreferrer\">Cochrane Review</a> provides the best meta-analysis, and as usual they conclude that there is insufficient evidence for anything. However, in practicality there are <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=8947969\" rel=\"nofollow noreferrer\">decent</a> observational <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=2024799\" rel=\"nofollow noreferrer\">data</a> available.</p>\n\n<p>Because hiccups stem from a reflex arc involving the vagal nerve, physical maneuvers that stimulate the vagus often abort hiccups.</p>\n\n<p>These may include: </p>\n\n<ul>\n<li>Breath holding</li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/6565684\" rel=\"nofollow noreferrer\">Valsalva maneuver</a> (exhaling against a closed glottis)</li>\n<li>Stimulating the nasopharynx or glottis (e.g. gargling cold water; upside down is often (reasonably) recommended to route water up into the nasopharynx where is is more likely to cause vagal stimulation)</li>\n</ul>\n\n<p>If none of these is successful, medications are occasionally used. The oldest and most well-established treatment is <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=13221413\" rel=\"nofollow noreferrer\">chlorpromazine</a> (a.k.a. Thorazine), a first-generation antipsychotic. Although it is approved by the U.S. FDA for treatment of hiccups, even that has only been studied in <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=13221413\" rel=\"nofollow noreferrer\">small case series</a>, mostly in patients with hiccups due to cancer. Other medications that are sometimes used off-label include <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=25069531\" rel=\"nofollow noreferrer\">metoclopramide</a> (a.k.a. Reglan) and <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=7758557\" rel=\"nofollow noreferrer\">baclofen</a>. Although the studies of these medications are small, they do appear to be effective.</p>\n\n<p>Most often, hiccups are benign, often triggered by gastric distention from over-eating or carbonated beverages. However, particularly intractable hiccups have been associated with serious conditions including intracranial problems such as stroke or encephalitis as well as many different kinds of cancer. If hiccups are occurring very frequently or are difficult to resolve, you should consult with a doctor. </p>\n\n<hr>\n\n<p>_{\n<strong>References</strong>\n} <br>\n_{\n<strong>1</strong>. Guelaud C, Similowski T, Bizec JL, Cabane J, Whitelaw WA, Derenne JP. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=7758557\" rel=\"nofollow noreferrer\"><em>Baclofen therapy for chronic hiccup.</em></a> Eur Respir J. 1995 Feb;8(2):235-7.}_{<br>\n<strong>2</strong>. Friedgood CE et al. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=13221413\" rel=\"nofollow noreferrer\"><em>Chlorpromazine (thorazine) in the treatment of intractable hiccups.</em></a> J Am Med Assoc. 1955 Jan 22;157(4):309-10.}_{<br>\n<strong>3</strong>. Friedman NL. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8947969\" rel=\"nofollow noreferrer\"><em>Hiccups: a treatment review.</em></a> Pharmacotherapy. 1996 Nov-Dec;16(6):986-95.}_{\n<strong>4</strong>. Kolodzik PW, Eilers MA. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=2024799\" rel=\"nofollow noreferrer\"><em>Hiccups (singultus): review and approach to management.</em></a> Ann Emerg Med. 1991 May;20(5):565-73.}_{<br>\n<strong>5</strong>. Moretto EN, Wee B, Wiffen PJ, Murchison AG. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=23440833\" rel=\"nofollow noreferrer\">Interventions for treating persistent and intractable hiccups in adults.</a> Cochrane Database Syst Rev. 2013 Jan 31;1.}_{<br>\n<strong>6</strong>. Wang T, Wang D. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=25069531\" rel=\"nofollow noreferrer\"><em>Metoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study.</em></a> Intern Med J. 2014 Dec;44(12a):1205-9.\n}</p>\n" }, { "answer_id": 1118, "author": "Francine DeGrood Taylor", "author_id": 646, "author_profile": "https://health.stackexchange.com/users/646", "pm_score": 2, "selected": false, "text": "<p>I have found a particular combination of actions has worked for me every time, and for all but one of the friends and acquaintances I recommended it to.</p>\n\n<ol>\n<li>Get a glass of water (lukewarm is best)</li>\n<li>Hyperventilate a little (this is so you can hold your breath longer)</li>\n<li>Take a very deep breath and hold it</li>\n<li>Start taking very small swallows of water (not large swallows!)</li>\n<li>Keep doing this for (almost) as long as you can hold your breath</li>\n<li>Let your breath out in an easy, relaxed flow (if you let it out all at once you can re-start your hiccups)</li>\n</ol>\n\n<p>After using it for so many years I can now simulate the underlying physical mechanism without the aids. To me it feels like with each swallow you are pushing down on that muscle between your stomach and esophagus, making it clench and at some point it just gives up and stops clenching. I can just visualize this happening (though I still have to hold my breath) and I can feel the exact moment when the hiccups stop.</p>\n\n<p>Interestingly, after reading @Susan's answer I think it might be the glottis that I feel like I'm putting pressure on. The combination of breath holding and swallowing cause the glottal pressure.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1096", "https://health.stackexchange.com", "https://health.stackexchange.com/users/629/" ]

[ { "answer_id": 1102, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 4, "selected": true, "text": "<p>No, this does not alter them, or make them less effective. There are problems with a scant amount of medicine crumbling, as you've noticed.</p>\n\n<p>The only real concern I'd have for anyone doing this is regarding the authorities: for example, while traveling out of the country, it's good to keep your medicines in their original prescription bottles because it supports you're assertion that the medicines are all <em>prescribed</em> to <em>you</em>. In my entire life, I had only one border agent question my medications. So even there, it's rare.</p>\n\n<p>As long as you can tell which pill is which, this is perfectly safe.</p>\n\n<p>One way to decrease crumbling of a pill is to put a piece of cotton in your container, so that when you close it, the pills don't rattle around in your purse. That's the reason many medications come with a cotton ball stuffed into the bottle.</p>\n" }, { "answer_id": 4260, "author": "JKA99", "author_id": 2489, "author_profile": "https://health.stackexchange.com/users/2489", "pm_score": 3, "selected": false, "text": "<p>The integrity of the pills themselves should be fine with a few exceptions. I won't ask you what you take, but note that there are situations where this powder can cause problems. Though, it is rather unlikely.<br>\nThe only thing I will add to this, as a pharmacist, is keeping all your pills in a single container makes identifying them difficult/time consuming for a third party. If you were in a situation where you or a loved/trusted one was unable to list your medications, having them all together makes this situation much more difficult and potentially harmful to you. <br>\nBy law, all prescribed medication marketed and sold within the US are required to have a stamp on them for identification purposes (see: <a href=\"http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=206.7\" rel=\"noreferrer\">FDA's Code of Federal Regulations</a>). If there are many different medications in a single container it is easier for a single pill to be missed in the sorting phase (as many pills are small, white, and round making them look incredibly similar). This could hurt you in the short and long run. Better to get a cheap pill box to separate them at least by what you take each day to cut down on some of this.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1098", "https://health.stackexchange.com", "https://health.stackexchange.com/users/162/" ]

[ { "answer_id": 1142, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 4, "selected": false, "text": "<p>The simpler story is that it is better to eat whole fruit. </p>\n\n<p>The problem with eating smoothies or even drinking fruit juice is that you are increasing the fruit's glycaemic index. For example, an orange has a glycaemic index of 40, while orange juice has a glycaemic index of 50¹. The theory goes that low glycaemic index foods lower the risk of metabolic disorders such as obesity and diabetes and there is indeed epidemiological data which confirms this specifically about fruit and fruit juice: </p>\n\n<blockquote>\n <p>Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk. </p>\n</blockquote>\n\n<p>based on data from 3 studies which followed a total of ~150 000 women and ~35 000 men for 18 to 24 years.². Note that the consumption of fruit juice increases the diabetes risk when compared to baseline, not just when compared to whole fruit. </p>\n\n<p>Seeing that the average person in a Western culture has a higher chance of developing a metabolic disorder than of having difficulties digesting cellulose, we can conclude that, ceteris paribus, fruit is healthier for you than fruit juice. I did not find data on smoothies and purees, they should fall between whole fruit and fruit juice in glycaemic index. </p>\n\n<p>The story gets murkier when we consider your diet as a whole. People are unlikely to eat a whole orange when they are thirsty. So if you are currently drinking orange juice and planning to switch to the same amount of whole oranges and switch to drinking water, this is probably going to be a healthy decision. But if you are going to switch to drinking Coca cola when thirsty, it will likely be worse. While I did not look for data doing this comparison, the glycaemic index of Coca cola is 63¹, and it also contributes many calories without them being paired with micronutrients. </p>\n\n<p>There has been some debate on whether recommending diets based on GI makes sense, see these two 2002 reviews (paywalled): ³ and ⁴. Anecdotally, I'd say that they make sense, as I have seen people lose weight on them without complaining of hunger pangs. </p>\n\n<hr>\n\n<p>¹ <a href=\"http://www.health.harvard.edu/healthy-eating/glycemic_index_and_glycemic_load_for_100_foods\">http://www.health.harvard.edu/healthy-eating/glycemic_index_and_glycemic_load_for_100_foods</a></p>\n\n<p>² <a href=\"http://dx.doi.org/10.1136/bmj.f5001\">http://dx.doi.org/10.1136/bmj.f5001</a></p>\n\n<p>³ <a href=\"http://dx.doi.org/10.1046/j.1467-789X.2002.00079.x\">http://dx.doi.org/10.1046/j.1467-789X.2002.00079.x</a></p>\n\n<p>⁴ <a href=\"http://dx.doi.org/10.1046/j.1467-789X.2002.00080.x\">http://dx.doi.org/10.1046/j.1467-789X.2002.00080.x</a></p>\n" }, { "answer_id": 1454, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": 3, "selected": false, "text": "<p>There is a simpler answer than others on this page.</p>\n\n<p>Drinking the calories associated with 4 oranges can be done in about 5 seconds. This does not give your body's satiety mechanisms time to kick in and diminish your appetite if you are already tanked up on the calories you need for that day.</p>\n\n<p>By contrast, eating the fruit (with peeling-time thrown in) is much slower, and gives your satiety mechanisms a chance to tell you that you don't really need the calories in that 4th orange.</p>\n\n<p>The biggest nutritional danger today is not scurvy or any other vitamin deficiency. It's over-nutrition, i.e. too many calories. By eating the oranges, vs. drinking then, you reduce the danger of over-nutrition. Dr. Daniel Lustwig's editorial in JAMA first opened my eyes to this aspect of juice drinks.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1099", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 1414, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>You should just stick to the new desired sleep routine and then accept that you'll have a jet lag for a some time. You may not sleep well the first few days, but you should force yourself to get up at the scheduled wake-up time. If you want to set your biological clock 6 hours back, then it may take a week before you're fully adapted to the new routine.</p>\n\n<p>Make sure your bedroom is dark during sleeping time. After a few days into the new routine you should exercise, even if due to excessive sleepiness you don't feel like doing so. A potential problem a few days into the new routine can be that you have accumulated a sleep deficit due to not sleeping well a few days, but this will affect your brain far more than your body. If you give in to that by avoiding physical activity, then you may continue to sleep badly and the change to the new routine may take longer.</p>\n\n<p>Of course, if you feel very sleepy, you should not exercise as fanatically as you are used to. Just start slowly (compared to your usual exercise routine), you may feel that during the exercise session the sleepiness goes away and stays away quite some time after you've finished. That's the desired effect, your body is then fully awake, and that allows you to sleep better at night.</p>\n" }, { "answer_id": 1417, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": true, "text": "<p>There are quite a few things you can do to \"reset\" your sleep schedule, as shown by <a href=\"http://www.webmd.com/sleep-disorders/features/reset-sleep-cycle\">this WebMD article</a>. However, be aware that due to your own circadian rhythms, that may not be the optimal pattern for you. Some of the suggestions include:</p>\n\n<ol>\n<li>Bright lights - Use bright lights around you when you first get up.</li>\n<li>Dim lights - Conversely, use dim lights in the evening.</li>\n<li>Don't lay awake - If you tend to lay awake for a while, do something else before you go to bed.</li>\n<li>Time meals - Use your meal times to help your body adapt to when to sleep. If you eat at irregular times, it can throw off your body.</li>\n<li>Limit caffeine intake (Especially later in the day)</li>\n</ol>\n\n<p>There are a few other suggestions in the article, especially relating to travel. One of the other suggestions is supplementing with melatonin, but as can be seen by <a href=\"http://www.ncbi.nlm.nih.gov/books/NBK11941/\">this study review</a>, many of the studies are not very well done, and a few directly refute melatonin being a sleep aid.</p>\n\n<p>If you have trouble adjusting to a more traditional sleep schedule, you may want to look at biphasic sleeping (2, 4 hour sleep shifts) or contact a sleep center for help.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1101", "https://health.stackexchange.com", "https://health.stackexchange.com/users/558/" ]

[ { "answer_id": 1131, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 2, "selected": false, "text": "<p>A vegan diet is based only on vegetal foods. If we analyze the amino acid content of different food protein sources (animal and plant proteins), <strong>lysine</strong> is consistently at a much lower concentration in all major plant-food protein groups than in animal foods (<a href=\"http://www.sciencedirect.com/science/article/pii/S0065242309470070\" rel=\"nofollow\" title=\"biomarkers\">1</a>, <a href=\"http://ajcn.nutrition.org/content/59/5/1203S.short\" rel=\"nofollow\" title=\"young pellet\">2</a>). Lysine is one of the essential amino acids, thus lysine is most likely to be the first limiting amino acid in diets that are based\npredominantly on cereal grains (<a href=\"http://ajcn.nutrition.org/content/59/5/1203S.short\" rel=\"nofollow\" title=\"young pellet\">2</a>).</p>\n\n<p>For this reason the American Dietetic Association, in its 2009 position paper on vegetarian diets, recommends an increase of consumption of <strong>beans and soy products</strong> in order to satisfy the essential amino acids requirements in vegan diets (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19562864\" rel=\"nofollow\" title=\"ADA pos\">3</a>).</p>\n" }, { "answer_id": 16479, "author": "pizi", "author_id": 13398, "author_profile": "https://health.stackexchange.com/users/13398", "pm_score": 2, "selected": false, "text": "<p>All essential amino acids originate from plants (and microbes), and all plant proteins have all essential amino acids. Eating a whole food plant-based diet also known as a proper vegan diet or a proper plant-based diet, one can obtain absolutely all essential amino acids. Furthermore, our body has an amino acid reservoir from which it daily sends about 90 grams of amino acids to combine with amino acids from a meal and synthesize complete protein. (<a href=\"https://nutritionfacts.org/video/the-protein-combining-myth/\" rel=\"nofollow noreferrer\">1</a>) Even a banana has all essential amino acids. (<a href=\"https://tools.myfooddata.com/protein-calculator.php?food1=9040&amp;serv1=100g&amp;food2=0&amp;serv2=0&amp;food3=0&amp;serv3=0&amp;food4=0&amp;serv4=0&amp;food5=0&amp;serv5=0&amp;food6=0&amp;serv6=0&amp;food7=0&amp;serv7=0&amp;food8=0&amp;serv8=0&amp;food9=undefined&amp;serv9=undefined&amp;food10=0&amp;serv10=0\" rel=\"nofollow noreferrer\">2</a>)</p>\n\n<p>Being deficient of essential amino acids on a proper plant-based diet where one daily consumes foods from each category such as whole grains, legumes, fruits, nuts, and green leafy vegetables is unheard of.</p>\n\n<p>People who are deficient in essential amino acids are also deficient in other nutrients and people who are deficient are likely either starving or in war zones.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1106", "https://health.stackexchange.com", "https://health.stackexchange.com/users/120/" ]

[ { "answer_id": 1121, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 2, "selected": false, "text": "<p>There is no standard for calculating \"food volumes\". The nutrition data of all foods is only consistent by weight. Standardized nutrition data labels all give nutrients per 100 g, frequently also adding the nutrient amount calculated for other weights, for example for one unit of packaging, or one piece when the food is in discrete pieces. </p>\n\n<p>When somebody is talking of nutrition units (e.g. calories, grams of carbs, or whatever) per volume, they are probably using some volume conversion formula. But for most foods, there is no really good formula. Food volume changes a lot in preparation, and frequently it's not as predictable as the change in rice volume you describe - if you have chopped walnuts, the final volume depends on how finely they are chopped, and also how they were handled afterwards. Also, volume measurement of foods is imprecise to the point where it's useless (for example, a \"cup\" of flour can be anywhere from 100 to 160 grams for the same type of flour). </p>\n\n<p>The conclusions: 1) there is no way to predict what formula they are using (e.g. whether they are using the average for cooked or raw rice), because there is no standard for that, and 2) even if you happen to use their formula, you can't achieve precision. If you need precision, you'll have to switch to an app which lets you measure your food by weight. </p>\n" }, { "answer_id": 1125, "author": "Random832", "author_id": 657, "author_profile": "https://health.stackexchange.com/users/657", "pm_score": 3, "selected": true, "text": "<p>In the US, <a href=\"http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.12\" rel=\"nofollow\">21 CFR 101</a> provides reference amounts for serving sizes, which are usually followed somewhat closely (I wasn't able to determine if they are required by law) by food manufacturers.</p>\n\n<p>In the specific case of rice, the standard serving size is \"140 g prepared; 45 g dry\" listed in the format \"_ cup(s) (_ g)\".</p>\n\n<p>Usually, the nutritional label on the actual product package (no comment on databases on random websites and apps) will provide information about whether it is referring to prepared or \"raw\" state, or will provide both. The prepared state may include ingredients not provided in the package.</p>\n\n<p>For example, Cheerios has a serving size of \"1 cup (28 g)\", dry, and additionally provides a column with values for \"with 1/2 cup skim milk\".</p>\n\n<p>Kraft Macaroni &amp; Cheese Dinner gives the serving size as \"2.5 oz (70 g / about 1/2 box) (Makes about 1 cup)\", and provides columns for \"as packaged\" and \"as prepared\". Different pictures I found of the nutrition information and directions varied widely as to the calories of the \"as prepared\" column and the amount of butter called for; presumably these will match on any given box.</p>\n\n<p>I wasn't able to find any pictures of real nutrition labels for packages of plain rice.</p>\n\n<p>Google allows you to specify \"raw\" or \"cooked\" when searching for the nutrition information of rice - according to it, 100 grams of cooked long-grain brown rice has 111 calories, and 100 grams of raw long-grain brown rice has 370 calories. When the measure is switched to one cup, the calories are 216 and 684 respectively, with the weights being 195 and 185 grams. So, if your app doesn't say, it should be easy to figure out which numbers track better with how many calories it actually says a cup of rice has.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1119", "https://health.stackexchange.com", "https://health.stackexchange.com/users/647/" ]

[ { "answer_id": 1305, "author": "Victoria Lam", "author_id": 831, "author_profile": "https://health.stackexchange.com/users/831", "pm_score": 1, "selected": false, "text": "<p>I think the biggest issue (already mentioned by Joshua Frank) is our flawed understanding of how nutrition interacts with human health, especially for the long term. If nutrition were as easy as Soylent claims, well, we could take a multivitamin and eat ice cream for the rest of our lives, no problem. But what do you know, it's more complicated than that. We're constantly discovering new nutrients or new roles for nutrients we already knew about. We now know from microbiome- and psychology- related research that we are not simply the sum of what we eat, but also why we eat and how we eat.</p>\n\n<p>You probably won't die from consuming Soylent (people eat more terrible things all the time), but I wouldn't consider it any healthier than, say, Wonderbread with a multivitamin chaser. In the end, I merely consider it another addition to our supermarkets full of highly processed food.</p>\n\n<p>And dude - it's made of people. Gross.</p>\n" }, { "answer_id": 1324, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": 0, "selected": false, "text": "<p>The wisest thing ever said on television was in an old margarine commercial: \"It's not nice to fool Mother Nature.\"</p>\n\n<p>Eating Soylent exclusively, or as a high percentage of food intake, is unwise, and the fact that some people seem to be getting away with it, unscathed, should offer little reassurance. As others have remarked, we have no way of knowing if we know all the essential nutrients Mother Nature wants us to have. And we may not ever know, because nutrient deficiencies can take years or decades to appear. Vitamin B12 and vitamin E are examples of this. </p>\n\n<p>I recall one lecturer talk about a vitamin or mineral deficiency that was discovered by medical science only because a woman had habitually eaten nothing but an egg on toast for 20 years (cannot remember what it was). And then there are other deficiencies that have come to light much more recently, when hyperalimentation solutions lacked something that humans had never before suspected was essential (I'm thinking vanadium, but again am not sure).</p>\n\n<p>On top of this, I would additionally be concerned about the very naive medical reasoning that Soylent's inventor evinces. On this page <a href=\"http://robrhinehart.com/?p=424\" rel=\"nofollow\">http://robrhinehart.com/?p=424</a> he wonders if his family's fondness for tomatoes reflects a salutary effect of lycopene peculiar to his family's genetics. Nothing is impossible, of course, but the unstated assumption, which appears often in Soylent discussions, is that human appetite for specific substances is correlated with the body's need for, or benefit from, those specific substances. Although true for calories (we get hungry when deprived of calories), in general it is balderdash -- go read about pica and cissa. (You'll read, for example, about iron deficiency causing a massive craving for ice, which is, of course, iron-free. Iron deficiency also causes craving for tomato seeds, which are poor in iron; maybe the inventor's family is iron deficient.) And then you can go read about B12 deficiency (called pernicious anemia, because it was uniformly fatal). Those people had aversions to meat, when, in fact, meat was the food richest in the nutrient they were missing.</p>\n\n<p>Life is an exceedingly complex and subtle machine, and it's risky to think that humans can re-engineer macro processes that are built into us at the deepest levels. If you consume a lot of Soylent and get a disease unknown to medical science, I will be very happy, because we will have learned something about metabolism, and minimally sad, because it was a choice you didn't have to make.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1128", "https://health.stackexchange.com", "https://health.stackexchange.com/users/157/" ]

[ { "answer_id": 1132, "author": "Damon", "author_id": 662, "author_profile": "https://health.stackexchange.com/users/662", "pm_score": 1, "selected": false, "text": "<p>The U.S. recommended primary immunization schedule for <strong>Ixiaro</strong>, the Japanese Encephalitis (JE) Virus Vaccine (Inactivated) is one week <strong>prior</strong> to exposure [1]. An adult patient (17 years old or older) may receive a booster after one year of completing the primary series; adolescents and children (less than 17) has not been studied [1].</p>\n\n<p>Treatment for JE involves supportive care only [2]. There is no specific antiviral treatment for JE; ribavirin, interferon alpha-2a was trialed with no success [2].</p>\n\n<p>Nonspecific symptoms appear after a 5 to 15 day incubation period followed by the specific mental status change manifestations [2]. The seasonality of the disease depends on the local area [2].</p>\n\n<p>References:</p>\n\n<ol>\n<li><p>Ixiaro Package Insert. FDA Approved Biologic Products. <a href=\"http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142569.pdf\" rel=\"nofollow\">http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142569.pdf</a> [accessed 6/3/2015.]</p></li>\n<li><p>Japanese encephalitis: Epidemiology, diagnosis, treatment and prevention. UpToDate.com [accessed 6/3/2015.]</p></li>\n</ol>\n" }, { "answer_id": 5224, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 2, "selected": false, "text": "<p><em>Waiting period</em></p>\n\n<p>It's hard to prove some information doesn't exist, but maybe I'll get points for effort ;)</p>\n\n<p>There is a section on \"Post exposure vaccination\" in the (long) World Health Organization <a href=\"http://www.who.int/immunization/sage/6_TBE_backgr_18_Mar_net_apr_2011.pdf\" rel=\"nofollow\">Background Document on Vaccines and Vaccination\nagainst Tick-borne Encephalitis (TBE)</a>. They mention the concern you also cite in your question, but go on to say that there is no evidence for it:</p>\n\n<blockquote>\n <p>Of special concern is the theoretical possibility that post-exposure\n prophylaxis could result in antibody-dependent enhancement of the infection and exacerbation of the disease. Such phenomena have been reported for other flavivirus infections, but not for TBEV.</p>\n</blockquote>\n\n<p>At least, vaccination after exposure will probably not fast enough to prevent an infection (vaccinating after exposure is, for example, <a href=\"http://www.who.int/ith/vaccines/rabies/en/\" rel=\"nofollow\">done for rabies</a>):</p>\n\n<blockquote>\n <p>Since TBE has a relatively short incubation period, even an anamnestic response may not be fast enough to protect the individual following exposure.</p>\n</blockquote>\n\n<p>This information all seems to come from the review <a href=\"http://www.sciencedirect.com/science/article/pii/S0264410X07013497\" rel=\"nofollow\">After a tick bite in a tick-borne encephalitis virus endemic area: Current positions about post-exposure treatment</a>. It is also repeated in the WHO position paper <a href=\"http://www.who.int/immunization/sage/1_TBE_PP_Draft_13_Mar_2011_SAGE_apr_2011.pdf\" rel=\"nofollow\">Vaccines against tick-borne encephalitis</a>. </p>\n\n<p>Neither those studies nor the manufacturer information for <a href=\"https://www.pfizer.de/fileadmin/produktdatenbank/pdf/FSME-IMMUN_Erwachsene_FI_01.pdf\" rel=\"nofollow\">FSME Immun</a> (which might be what you would receive - warning for others: that information is in German) state a waiting period. A good guess would probably be the incubation period for TBE (<a href=\"http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/tickborne-encephalitis\" rel=\"nofollow\">median 8 days</a>).</p>\n\n<p><em>Subsequent vaccinations</em></p>\n\n<p>That part is easier. For the two vaccines usually used in Western Europe, the WHO writes</p>\n\n<blockquote>\n <p>With both vaccines the manufacturers recommend a booster 3 years after completion of the primary series and subsequent boosters at intervals of 5 years (3 year intervals for individuals aged >60 years)</p>\n</blockquote>\n\n<p>See table 6 on page 43 of the <a href=\"http://www.who.int/immunization/sage/6_TBE_backgr_18_Mar_net_apr_2011.pdf\" rel=\"nofollow\">Background Document on Vaccines and Vaccination against Tick-borne Encephalitis (TBE)</a></p>\n\n<p>As for scheduling, even after those 3 or 5 years, <a href=\"http://www.who.int/immunization/TBE_duration_protection.pdf?ua=1\" rel=\"nofollow\">protection is still really good</a> (after 8 years, 90% were still protected), so there's probably no rush and the booster can be taken when convenient.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1130", "https://health.stackexchange.com", "https://health.stackexchange.com/users/193/" ]

[ { "answer_id": 1139, "author": "Dave Liu", "author_id": 140, "author_profile": "https://health.stackexchange.com/users/140", "pm_score": 2, "selected": false, "text": "<p>If they both contain the exact same substance, then powder form may be easier to measure more precisely. However, I cannot find any studies indicating any significant difference between capsule and powder form. </p>\n\n<p>Additionally, I would like to give you <a href=\"http://sciencelife.uchospitals.edu/2014/11/25/do-probiotics-work/\" rel=\"nofollow\">this link</a> containing an interview with Dr. Stefano Guandalini, MD, Section Chief of Pediatric Gastroenterology, Hepatology, and Nutrition and Medical Director of the Celiac Disease Center at the University of Chicago.</p>\n\n<p>He gives a short list of probiotics which \"have been validated through clinical trials and published in peer-reviewed journals to show efficacy\". For the rest, he states, </p>\n\n<blockquote>\n <p>\"Outside of this incredibly short list, however, there is nothing\n else. There is no other probiotic that has been found to be effective\n in rigorous, controlled clinical trials. This is not to say they\n aren’t working, it’s just to say we don’t have any scientific proof\n yet.\" </p>\n</blockquote>\n" }, { "answer_id": 1153, "author": "Lucky", "author_id": 613, "author_profile": "https://health.stackexchange.com/users/613", "pm_score": 4, "selected": true, "text": "<p>I cannot answer your question directly, but explaining some general considerations might help to clarify what would be a sound choosing approach.</p>\n\n<p>When you say:</p>\n\n<blockquote>\n <p><em>In my opinion it is better to use capsule since it will protect the bacteria from the acid environment in the stomach.</em></p>\n</blockquote>\n\n<p>bear in mind that this applies to <strong>gastro-resistant</strong> capsules only:</p>\n\n<blockquote>\n <p><em>Gastro-resistant capsules are delayed-release capsules\n that are intended to resist the gastric fluid and to release\n their active substance or substances in the intestinal fluid.\n Usually they are prepared by filling capsules with granules\n or with particles covered with a gastro-resistant coating or\n in certain cases, by providing hard or soft capsules with a\n gastro-resistant shell (enteric capsules).</em> (<a href=\"http://lib.njutcm.edu.cn/yaodian/ep/EP5.0/07_monographs_on_dosage_forms/Capsules.pdf\" rel=\"nofollow\">Ph.Eur.5.0.</a>)</p>\n</blockquote>\n\n<p>Many manufacturers of probiotics use hard (gelatine) capsules which are not resistant to stomach acid. In fact these two sorts of capsules have to comply with different pharmacopoeial requirements: </p>\n\n<p><em>Gastro-resistant capsules</em>:</p>\n\n<blockquote>\n <p><strong><em>Disintegration</strong>. For capsules with a gastro-resistant shell carry out the test for disintegration [...] use 0.1 M hydrochloric acid as the liquid\n medium and operate the apparatus for 2 h, or other such time as may be authorised, without the discs. Examine the state of the capsules.<strong>The time of resistance to the acid medium</strong> varies according to the formulation of the capsules to be examined. It is typically 2 h to 3 h but even with authorised deviations it <strong>must not be less than 1 h. No capsule shows signs of disintegration or rupture permitting the escape of the contents.</em></strong> (Ph.Eur.5.0)</p>\n</blockquote>\n\n<p>Whereas for <em>hard capsules</em> it says:</p>\n\n<blockquote>\n <p><em>Use water R as the liquid medium. When justified and authorised, 0.1 M hydrochloric acid or artificial gastric juice R may be used as the liquid medium. [...] Operate the apparatus <strong>for 30 min</strong>, unless otherwise justified and authorised and examine the state of the capsules. <strong>The capsules comply with\n the test if all 6 have disintegrated.</em></strong> (Ph.Eur.5.0)</p>\n</blockquote>\n\n<p>Some strains of probiotics are found to be <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151822/#r27\" rel=\"nofollow\">acid resistant</a> which can be enhanced by formulation factors other than gastro-resistant coating. On the other hand, manufacturers of probiotics in gastro-resistant capsules often state (on their websites e.g.) that they deliver more units of probiotic bacteria to the intestines than conventional dosage forms. (It may depend on the strains they use.) Some probiotics can be found in yoghourt which is definitely not gastro-resistant. </p>\n\n<p>Regulatory requirements are much stricter for medicines than for supplements in most countries, so if one is concerned with the sufficient drug delivery and the accuracy of medical claims, it is useful to know that for medicines to be approved for marketing much firmer evidence about these (and other concerns) has to be submitted.</p>\n\n<hr>\n\n<p>Why does powder exist as a dosage form? There may be several reasons to produce and market oral powder as a dosage form: some people have difficulties to swallow capsules, it may depend on manufacturer's production line, powders allow for <strong>individualised</strong> dosage (measuring the dose for a specific patient - but I don't think this would be necessary with probiotics), hygroscopic excipients which are incompatible with capsule shell etc. </p>\n\n<p>The dose you take in powder <strong>is not more precise</strong> - even if it is sold in divided doses (each dose in one bag), because a small amount of powder can always remain on the walls. The precision of measurement is the same at best, if not in favour of the capsules.</p>\n\n<h2>How to chose?</h2>\n\n<p>Here are some of the questions that should be taken into account:</p>\n\n<ol>\n<li>Is the patient allergic/intolerant to any of the formulation's ingredients?</li>\n<li>Is there a form preferred by the patient's physician, for some medical reason?</li>\n<li>Which form is the most convenient one for you?</li>\n<li>Which form is accessible and affordable to you?</li>\n</ol>\n" }, { "answer_id": 11321, "author": "Tammy", "author_id": 8355, "author_profile": "https://health.stackexchange.com/users/8355", "pm_score": 0, "selected": false, "text": "<p>I was told by a gastroenterologist at the IWK children's hospital in Halifax NS ( regarding medications my child had to take - that many things are excreted from our body when taken in capsul form before it gets a chance to work. An example the doctor gave me is when people take Metamucil capsules they do not get the effect bc the capsul goes through the system often before it is effective. The doctor recommended for someone taking Metamucil to take the powder form rather than the capsul. I would think the same idea would affect probiotic capsules. I started opening my capsule and putting the powder on my oatmeal / food and taking it that way. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1133", "https://health.stackexchange.com", "https://health.stackexchange.com/users/99/" ]

[ { "answer_id": 1177, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": false, "text": "<p>This is a very interesting question. It's also highly speculative, and vague (what does &quot;a doctor... gives them any medicine necessary to protect them from other diseases that might be lurking in their body&quot; mean? Does it mean they treat the symptoms of AIDS (weight loss, diarrhea, etc?) If it does, then the difference between not treating HIV but treating every complication stretches this almost to the point of meaninglessness. If you are postulating treating all diseases, then I do believe this is speculative at best and unanswerable.</p>\n<p>The most likely scenario is that the patient would eventually die (but don't we all?) How he would die is pure speculation.</p>\n<p>Unfortunately, while you can place a patient in a sterile environment,</p>\n<ol>\n<li><p>you can't sterilize a patient</p>\n</li>\n<li><p>it's exceedingly difficult to sterilize food</p>\n</li>\n<li><p>to prevent all possible hospital acquired bacterial infections, they would need a bubble-boy-like unit (very rare and extremely expensive)</p>\n</li>\n<li><p>you can't predict if some previously unknown virus dormant in our bodies will be able to express itself. (See @Fomite's comment.)</p>\n</li>\n</ol>\n<p>The fact that you stipulate treatment for everything but the virus that replicates in certain blood cells associated with immunity is almost an aside if you're going to treat all pathogens.</p>\n<p>Every bacteria and virus he has in his body will go into that sterile environment with him, so it depends what he has going in. When he no longer has enough immune competency to keep these under control, they will take their toll. If you treat him in a sterile environment and give him world-class treatment of all infections (anti-virals would be needed to treat herpesvirus recurrences, like chicken pox and HSV1, HCV, HepBV, or any other number of viruses one can carry, treat the encephalitis that comes with HSV/etc. He has a small chance of possibly outliving the disease, only to die in the 3-5 days after you turn him out, unless you include bone marrow transplant in the treatment as well.</p>\n<p>The progress of HIV to AIDS is variable. Less than 0.5% of patients never develop any sign whatsoever of the infection except for undeniably positive titers. What if your patient is in this small but not-nonexistent subtype? Then there are almost everything in between, with fewer patients on the healthy end than the sick end.</p>\n<p>My best guess: your patient will die of some ultimately unconquerable disease you are treating in the bubble, for example, multi-drug resistant C. diff, Kaposi's sarcoma, Mycobacterium avium-intracellulare, Toxoplasmosis (Up to 50% of the world's human population is estimated to carry Toxoplasma) liver failure from rampant Epstein-Barr, or some other opportunistic infection from something he carried in there but is either devastating or drug resistant.</p>\n<p>You're asking if the virus will just &quot;die&quot; out, effectively curing the patient. That's kind of like letting the heart and lungs die, but keeping the patient alive on a heart-lung bypass machine. That's not a cure, and upon turning it off, the patient will die.</p>\n<p>And that's purely a guess, which, on SE, makes it worthless.</p>\n<p>_{<a href=\"http://jama.jamanetwork.com/article.aspx?articleid=186199\" rel=\"nofollow noreferrer\">Long-term Nonprogressive Disease Among Untreated HIV-Infected Individuals: Clinical Implications of Understanding Immune Control of HIV</a>}</p>\n" }, { "answer_id": 4271, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 3, "selected": false, "text": "<p>In addition to what anongoodnurse wrote about the patient likely dieing, I don't think this scenario would work at all. </p>\n\n<p>HIV doesn't infect all immune cells. It infects <a href=\"https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/hiv-in-your-body/hiv-lifecycle/\" rel=\"noreferrer\">T-cells/CD4 cells</a>, which are used for adaptive immunity. There are two features of HIV infections that make your scenario impossible or almost impossible:</p>\n\n<ol>\n<li>The time between infection of a cell and lysis (death) can be long, <a href=\"http://www.nature.com/ncomms/2015/151020/ncomms9447/full/ncomms9447.html\" rel=\"noreferrer\">and it can even stay dormant</a>. So there can always be cells that are infected and it can take years before the virus emerges from them </li>\n<li>In the meantime, new T-cells are produced by the body, even in patients with HIV, though very slowly. The bone marrow that produces them is still there. </li>\n</ol>\n\n<p>In some people with AIDS, the number of CD4 cells counted in <a href=\"http://www.aids.org/topics/aids-factsheets/aids-background-information/what-is-aids/hiv-testing/cd4-t-cell-tests/\" rel=\"noreferrer\">blood samples actually goes down to 0</a>, which would be as close to your scenario as people can get and it still doesn't make them cured. The \"viral load\" measured in these patients is usually very high. Remember that HIV needs human cells to <em>reproduce</em>, not to <em>survive</em>. It will happily exist in an individual with no CD4 cells. That person can infect others and because the immune system can't replenish the CD4 cells fast enough (and they get infected soon after being produced) the immune system just stays very, very weak. </p>\n\n<p>The stem cell therapy approach to HIV was mentioned in comments, so I'd like to address that. It's not as \"easy\" as just doing a bone marrow transplant. The new cells would just get infected. <a href=\"https://www.cirm.ca.gov/our-progress/disease-information/hivaids-fact-sheet\" rel=\"noreferrer\">The donor has to be immune to HIV</a> (some people are due to a mutation), so the newly produced cells can't be infected by the virus. Unfortunately, the mutation is rare. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1162", "https://health.stackexchange.com", "https://health.stackexchange.com/users/687/" ]

[ { "answer_id": 1165, "author": "Vae_ newbis", "author_id": 536, "author_profile": "https://health.stackexchange.com/users/536", "pm_score": 4, "selected": true, "text": "<p>This is a question that cannot be answered by a simple yes or no.</p>\n\n<p>As a vegetarian for health purposes (who was a vegan for 1 year) I say that the human isn't supposed to be vegetarian, but rather an opportunistic omnivore. The fact that we can eat meat doesn't mean we have to.</p>\n\n<p>Most of people that went from non-vegetarian to vegetarian (no meat, no fish) felt better the following weeks, however the reasons could be numerous and ambiguous:</p>\n\n<ul>\n<li>Maybe they were eating <strong>too much</strong> meat until they stopped ?</li>\n<li>Maybe the meat they were buying was bad quality meat ?</li>\n</ul>\n\n<p>Anyway, most of meat and fish's nutrients we need to live healthy are proven to be in eggs and milk with enough quantities.</p>\n\n<p>Concerning the vegans (no eggs, no milk), the most recurrent problem is about the vitamin B12 that is very hardly obtained in vegan food, it can be found in some mushrooms, but in most cases you'll have to eat 4kg of that a day to fulfill your daily needs. It can also be found in some algaes and supplements like spirulina, but in that form it is nearly impossible for the body to be absorbed. Even though you might feel better the first year of veganism, you might be sick later on, even though some vegans never become sick.</p>\n\n<p>It also depends of the genes of each person. Some African ethnicities have evolved eating a lot of meat per day and still they remain healthier than most of people from Western countries. On the other hand, most Romans from the antiquity were eating less than 1kg of meat per month.</p>\n\n<p>I think that the best way to find how being vegetarian is good for you is to try it out by yourself, pay attention at how you feel, and have regular blood tests.</p>\n\n<p>Reference: <a href=\"http://chriskresser.com/what-everyone-especially-vegetarians-should-know-about-b12-deficiency\" rel=\"noreferrer\">What Everyone (Especially Vegetarians) Should Know About B12 Deficiency</a></p>\n" }, { "answer_id": 1317, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 4, "selected": false, "text": "<p>This subject is very broad and a detailed answer would require to be a whole book. Shortly I can say that vegetarians and vegans have lower rates of <strong>mortality</strong> (both by ischemic heart disease and total) (1-3) and lower incidence rates of <strong>diabetes</strong> (4) and <strong>cancer</strong> (5,6). Vegetarian diets are related to lower <strong>blood pressure</strong> (7,8), lower <strong>body weight</strong> and <strong>Body Mass Index</strong> (BMI) (3,9), lower serum levels of <strong>total and LDL cholesterol</strong> (3) (LDL is \"the bad one\"), lower levels of C-reactive protein (10) (= show a lower lever of chronical inflammation), and higher <strong>insulin sensitivity</strong> (11) (this means they're less prone to diabetes). All this has been found studying people that were already vegetarian or vegan at the moment of the study.</p>\n\n<p>There are also experiments of people <strong>switching</strong> their diet to vegetarian or vegan for medical purpose, say get rid of <strong>diabetes or heart disease</strong>. A review of these successful experiments is <a href=\"https://lacucinadeibriganti.wordpress.com/articoli/diete-vegane-per-la-cura-delle-malattie-cardiovascolari-e-metaboliche/\">here</a>; basically people who switched to a low-fat lof-glycemic index vegan diet showed improvements in body weight, BMI, waist circumference, total and LDL cholesterol, triglycerides, glycemic control, insulin resistance, less need for drugs, reduction of cardiac events, reversal of heart disease. (12-16)</p>\n\n<p>If you want to read more scientific studies on vegetarianism you might also want to check these: 17-21.</p>\n\n<p>Finally I would like to add my personal experience (3 years vegetarian + 8 vegan): I feel better, my mind is more active, I can keep working or studying after lunch, I stopped having terrible pain in the intestine (probably due to putrefaction of meat during digestion) and my blood analysis are perfect.</p>\n\n<h2>References</h2>\n\n<ol>\n<li><p>Chang-Claude J, Frentzel-Beyme R. Dietary and Lifestyle Determinants of Mortality among German Vegetarians. Int J Epidemiol. 1993;22(2):228-236. doi:10.1093/ije/22.2.228.</p></li>\n<li><p>Thorogood M, Mann J, Appleby P, McPherson K. Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters. BMJ. 1994;308(6945):1667-1670. doi:10.1136/bmj.308.6945.1667.</p></li>\n<li><p>Key TJ, Fraser GE, Thorogood M, et al. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999;70(3):516S-524. Available at: <a href=\"http://ajcn.nutrition.org/content/70/3/516s.short\">http://ajcn.nutrition.org/content/70/3/516s.short</a>. Accessed May 15, 2015.</p></li>\n<li><p>Snowdon DA, Phillips RL. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public Health. 1985;75(5):507-512. doi:10.2105/AJPH.75.5.507.</p></li>\n<li><p>Huang T, Yang B, Zheng J, Li G, Wahlqvist ML, Li D. Cardiovascular disease mortality and cancer incidence in vegetarians: a meta-analysis and systematic review. Ann Nutr Metab. 2012;60(4):233-40. doi:10.1159/000337301.</p></li>\n<li><p>Lanou AJ, Svenson B. Reduced cancer risk in vegetarians: an analysis of recent reports. Cancer Manag Res. 2010;3:1-8. doi:10.2147/CMR.S6910.</p></li>\n<li><p>Fu C-H, Yang CCH, Lin C-L, Kuo TBJ. Effects of long-term vegetarian diets on cardiovascular autonomic functions in healthy postmenopausal women. Am J Cardiol. 2006;97(3):380-3. doi:10.1016/j.amjcard.2005.08.057.</p></li>\n<li><p>Appleby PN, Davey GK, Key TJ. Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Public Health Nutr. 2002;5(5):645-54. doi:10.1079/PHN2002332.</p></li>\n<li><p>Spencer EA, Appleby PN, Davey GK, Key TJ. Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans. Int J Obes Relat Metab Disord. 2003;27(6):728-34. doi:10.1038/sj.ijo.0802300.</p></li>\n<li><p>Krajcovicova-Kudlackova M, Blazicek P. C-reactive protein and nutrition. Bratisl Lek Listy. 2005;106(11):345-7. Available at: <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16541618\">http://www.ncbi.nlm.nih.gov/pubmed/16541618</a>. Accessed May 15, 2015.</p></li>\n<li><p>Kuo C-S, Lai N-S, Ho L-T, Lin C-L. Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores. Eur J Clin Nutr. 2004;58(2):312-6. doi:10.1038/sj.ejcn.1601783. </p></li>\n<li><p>Barnard, N. D., Cohen, J., Jenkins, D. J. A., Turner-McGrievy, G., Gloede, L., Green, A., &amp; Ferdowsian, H. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition, 89(5), 1588S–1596S. doi:10.3945/ajcn.2009.26736H</p></li>\n<li><p>Ornish, D., Brown, S. E., Billings, J. H., Scherwitz, L. W., Armstrong, W. T., Ports, T. A., … Brand, R. J. (1990). Can lifestyle changes reverse coronary heart disease? The Lancet, 336(8708), 129–133. doi:10.1016/0140-6736(90)91656-U</p></li>\n<li><p>Esselstyn, C. B. (1999). Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). The American Journal of Cardiology, 84(3), 339–341. doi:10.1016/S0002-9149(99)00290-8</p></li>\n<li><p>Jenkins, D. J. A., Kendall, C. W. C., Marchie, A., Faulkner, D. A., Wong, J. M. W., de Souza, R., … Connelly, P. W. (2003). Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA, 290(4), 502–10. doi:10.1001/jama.290.4.502</p></li>\n<li><p>Jenkins, D. J. A., Kendall, C. W. C., Faulkner, D., Vidgen, E., Trautwein, E. A., Parker, T. L., … Connelly, P. W. (2002). A dietary portfolio approach to cholesterol reduction: combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia. Metabolism: Clinical and Experimental, 51(12), 1596–604. doi:10.1053/meta.2002.35578</p></li>\n<li><p>Craig, Winston, J., Mangels, Ann, R., Craig, W. J., &amp; Mangels, A. R. (2009). Position of the American Dietetic Association: vegetarian diets. Journal of the American Dietetic Association, 109(7), 1266–82. doi:10.1016/j.jada.2009.05.027</p></li>\n<li><p>Ferdowsian, H. R., &amp; Barnard, N. D. (2009). Effects of plant-based diets on plasma lipids. The American Journal of Cardiology, 104(7), 947–56. doi:10.1016/j.amjcard.2009.05.032</p></li>\n<li><p>Jenkins, D. J. A., Kendall, C. W., Marchie, A., Jenkins, A. L., Augustin, L. S., Ludwig, D. S., … Anderson, J. W. (2003). Type 2 diabetes and the vegetarian diet. Am J Clin Nutr, 78(3), 610S–616. Retrieved from <a href=\"http://ajcn.nutrition.org/content/78/3/610S.short\">http://ajcn.nutrition.org/content/78/3/610S.short</a></p></li>\n<li><p>Trapp, C. B., &amp; Barnard, N. D. (2010). Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Current Diabetes Reports, 10(2), 152–8. doi:10.1007/s11892-010-0093-7</p></li>\n<li><p>Trapp, C., &amp; Levin, S. (2012). Preparing to Prescribe Plant-Based Diets for Diabetes Prevention and Treatment. Diabetes Spectrum, 25(1), 38–44. doi:10.2337/diaspect.25.1.38</p></li>\n</ol>\n" }, { "answer_id": 16403, "author": "pizi", "author_id": 13398, "author_profile": "https://health.stackexchange.com/users/13398", "pm_score": 3, "selected": false, "text": "<p>In 2013, as an already healthy athlete, I decided to stop eating meat, eggs, and dairy products and switch to a plant-based diet. Very soon thereafter, I noticed significant positive changes, realized what it truly meant to be a human being, and never looked back again.</p>\n\n<p>Note: Once you access any of the sources below, to see the supporting peer-reviewed articles, click on the sources cited tab.</p>\n\n<p>More energy (<a href=\"https://nutritionfacts.org/video/plant-based-diets-for-improved-mood-and-productivity/\" rel=\"nofollow noreferrer\">1</a>), better athletic performance (<a href=\"https://nutritionfacts.org/video/whole-beets-vs-juice-for-improving-athletic-performance/\" rel=\"nofollow noreferrer\">2</a>), faster muscle recovery (<a href=\"https://nutritionfacts.org/video/enhanced-athletic-recovery-without-undermining-adaptation/\" rel=\"nofollow noreferrer\">3</a>), less inflammation (<a href=\"https://nutritionfacts.org/video/reducing-muscle-fatigue-with-citrus/\" rel=\"nofollow noreferrer\">4</a>) (<a href=\"https://nutritionfacts.org/video/reducing-muscle-soreness-with-berries/\" rel=\"nofollow noreferrer\">5</a>), better and more frequent bowel movement (<a href=\"https://nutritionfacts.org/video/bowel-movement-frequency/\" rel=\"nofollow noreferrer\">6</a>) (<a href=\"https://nutritionfacts.org/video/bowels-of-the-earth/\" rel=\"nofollow noreferrer\">7</a>) (<a href=\"https://nutritionfacts.org/video/how-many-bowel-movements-should-you-have-every-day/\" rel=\"nofollow noreferrer\">8</a>), better blood sugar (<a href=\"https://nutritionfacts.org/video/how-not-to-die-from-diabetes/\" rel=\"nofollow noreferrer\">9</a>), less cholesterol (<a href=\"https://nutritionfacts.org/video/switching-from-beef-to-chicken-fish-may-not-lower-cholesterol/\" rel=\"nofollow noreferrer\">10</a>), lower risk of cancer or better said cancerlet (<a href=\"https://nutritionfacts.org/video/how-not-to-die-from-cancer/\" rel=\"nofollow noreferrer\">11</a>) (12 Latest-evidence based information on cancer can be found in chapter 3 of the book The China Study Revised and Expanded Edition) and much, much more.</p>\n\n<p>A vegetarian diet includes eggs and dairy products which, whether organic or not, still contain the same main components that meat does - cholesterol, high amounts of saturated fat, no fiber, and almost no antioxidants (<a href=\"https://nutritionfacts.org/video/antioxidant-power-of-plant-foods-versus-animal-foods/\" rel=\"nofollow noreferrer\">13</a>). So I only speak in the name of a whole food plant-based diet.</p>\n\n<p>Below is a picture comparing 500 calories of animal foods vs 500 calories of plant foods. Note the animal foods' cholesterol, high amounts of saturated fat, and no fiber. Data sources for the data in the picture:\n• USDA Nutrient Database. <a href=\"http://ndb.nal.usda.gov/ndb/\" rel=\"nofollow noreferrer\">http://ndb.nal.usda.gov/ndb/</a>\n• Holden JM, Eldridge AL, Beecher GR, et al. “Carotenoid content of U.S. foods: an update of the database.” J. Food Comp. Anal. 12 (1999): 169–196.\n• Campbell, T. Colin (2016) Chart 11.2 The China Study. Benbella Books. </p>\n\n<p><a href=\"https://i.stack.imgur.com/oeLjd.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/oeLjd.png\" alt=\"500 calories of plant foods vs 500 calories of animal foods\"></a></p>\n\n<p>Here is a picture that shows the food categories that I strive to consume on a daily basis. Each category, every day. And of course, remember to exercise and manage stress.</p>\n\n<p><a href=\"https://i.stack.imgur.com/ZjrKH.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/ZjrKH.jpg\" alt=\"proper plant-based diet\"></a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1164", "https://health.stackexchange.com", "https://health.stackexchange.com/users/558/" ]

[ { "answer_id": 1175, "author": "jiggunjer", "author_id": 282, "author_profile": "https://health.stackexchange.com/users/282", "pm_score": 4, "selected": true, "text": "<blockquote>\n<p>Thus far, more than 20 different tumor markers have been characterized and are in clinical use... There is no “universal” tumor marker that can detect any type of cancer.</p>\n<p>[L]imitations to the use of tumor markers[:] ...noncancerous conditions can cause the levels of certain tumor markers to increase. ...not everyone with a particular type of cancer will have a higher level of a tumor marker associated with that cancer. ...tumor markers have not been identified for every type of cancer. ...Although an elevated level of a tumor marker may suggest the presence of cancer, this alone is not enough to diagnose cancer. Therefore, measurements of tumor markers are usually combined with other tests, such as biopsies, to diagnose cancer.</p>\n</blockquote>\n<p>From the national Cancer institute (updated 2011) &quot;There is no universal marker for tumors&quot;. Note that marker in that context refers to samples from any source, including blood.</p>\n<p><a href=\"http://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet\" rel=\"nofollow noreferrer\">Tumor Markers</a></p>\n<p>To answer the converse, not all tumors need have unique markers. E.g. AFP is linked to several types of cancer.</p>\n" }, { "answer_id": 4438, "author": "user2663", "author_id": 2663, "author_profile": "https://health.stackexchange.com/users/2663", "pm_score": -1, "selected": false, "text": "<p>Cancer can be detected by some tests (for both men and women) like :</p>\n\n<p><strong>1. Skin test :</strong> In this test you find new growths of skin, sores that do not heal, changes in the size, shape, or color of any moles, or any other changes on the skin.</p>\n\n<p><strong>2. Colon and Rectum test :</strong> This test is done for cancer of the colon and the rectum. </p>\n\n<p><strong>3. Mouth test :</strong> Through this test you can check your mouth for changes in the color of the lips,tongue, or inner cheeks,cracks, sores, white patches, swelling, or bleeding.</p>\n\n<p>Through all these test you can detect cancer in general.</p>\n\n<p>Source :</p>\n\n<p><a href=\"https://www.londonhealthcheck.com/\" rel=\"nofollow\">https://www.londonhealthcheck.com/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1166", "https://health.stackexchange.com", "https://health.stackexchange.com/users/688/" ]

[ { "answer_id": 1225, "author": "StrongBad", "author_id": 55, "author_profile": "https://health.stackexchange.com/users/55", "pm_score": 2, "selected": false, "text": "<p>There is an adage in electrical safety that \"It is not the voltage that kills you, it is the current\". This was investigated at <a href=\"https://skeptics.stackexchange.com/questions/1664/is-it-the-current-that-kills-you-not-the-voltage\">Skeptics.SE</a>. A review of literature regarding electrocution suggests <a href=\"http://hypertextbook.com/facts/2000/JackHsu.shtml\" rel=\"nofollow noreferrer\">0.06 A to 0.07 A is fatal</a>. That said, because of Ohm's law, voltage does play a role. Ohm's law says that V=IR, where V is voltage, I is current, and R is resistance.</p>\n\n<p><a href=\"http://www.allaboutcircuits.com/textbook/direct-current/chpt-3/ohms-law-again/\" rel=\"nofollow noreferrer\">This analysis</a> measured R for the human body under various conditions (dry, damp, and with a metal ring) and calculated the various voltages needed to get lethal currents based on 17 mA across the chest being lethal. With clean dry skin you would need a voltage of 20 kV while with damp skin you need 340 V to kill you. If you are in contact with metal (e.g., wearing a ring), lethal currents can be generated at as low as 17 V. Even in the worst case scenario of a foot immersed in a conductive liquid with a total resistance of 100 Ohm, would mean that you would require 1.7 V to get a lethal current.</p>\n\n<p>With a 2V, 30 mA, AC power supply, under the right (or wrong) conditions, you could deliver an immediately lethal shock in excess of 17 mA across the chest. If we assume 100 Ohm is the lowest possible resistance, despite the 30 mA source, we are limited to 20 mA at 2 V. The exact impact of 20 mA will depend on the frequency of the source (AC and DC are different and 60 Hz AC is different from 10 kHz AC). With 20 mA at 60 Hz, you would probably lose voluntary muscle control and have pain (possibly sever) and would probably begin experiencing difficulty breathing.</p>\n" }, { "answer_id": 25832, "author": "Oskar Zdrojewski", "author_id": 21514, "author_profile": "https://health.stackexchange.com/users/21514", "pm_score": 0, "selected": false, "text": "<p>I'm not an electrician so there might be some inaccuracies here and I couldn't find an exact study about the long-term effects so take it with a grain of salt.</p>\n<p>Frequent damage to tissues can cause cumulative damage. We can extrapolate some data here:\nSome direct 200 mV pulses (0.6 mA) are enough to kill a cell. And 50 mV Pulse is enough to activate a nerve cell.\nThe question is whether the current reaches the cells. It probably varies based on where the current is applied.</p>\n<p>An educated guess is that you need 4 times (any scattering ignored - I'm not an electrician so idk) the voltage required for you to feel the current to actually kill a cell. So maybe around 25-35VAC could cause some minor damage- definitely much higher than 2 VAC.\nOnce you go over that threshold the exposure durations start to matter and could cause scarring if prolonged.</p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/18600343/\" rel=\"nofollow noreferrer\">In vitro currents</a>\n<a href=\"https://www.asc.ohio-state.edu/physics/p616/safety/fatal_current.html\" rel=\"nofollow noreferrer\">Lowest perceptible Current</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1191", "https://health.stackexchange.com", "https://health.stackexchange.com/users/710/" ]

[ { "answer_id": 1576, "author": "Chris Jenks", "author_id": 1003, "author_profile": "https://health.stackexchange.com/users/1003", "pm_score": 2, "selected": false, "text": "<p>Humans are strange among mammals in making dairy products such a large proportion of their adult diet. It reminds me of this amusing quote by Henry David Thoreau:</p>\n\n<blockquote>\n <p>One farmer says to me, 'You cannot live on vegetable food solely, for\n it furnishes nothing to make bones with;' and so he religiously\n devotes a part of his day to supplying his system with the raw\n material of bones; walking all the while he talks behind his oxen,\n which, with vegetable-made bones, jerk him and his lumbering plow\n along in spite of every obstacle.</p>\n</blockquote>\n\n<p>Also, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24351141\" rel=\"nofollow\">this study</a> <em>seems</em> to be saying that vegetables can supply as much calcium as milk:</p>\n\n<blockquote>\n <p>Recent absorption studies in humans with low-oxalate and low-phytate\n vegetables and pulses also showed that contrary to common\n presuppositions, these vegetables with low calcium chelators do have a\n comparable calcium absorbability to milk.</p>\n</blockquote>\n\n<p>But the intake of calcium is just part of the equation - calcium is also lost by excretion, which is what makes oisteoporosis possible. Many studies, such as <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9614169\" rel=\"nofollow\">this one</a> entitled \"Excess dietary protein can adversely affect bone\", report that high consumption of protein in the diet leads to increased excretion of calcium due to the acids formed in the metabolism of protein.</p>\n\n<p>Finally, an <a href=\"https://www.hsph.harvard.edu/nutritionsource/calcium-full-story/\" rel=\"nofollow\">article</a> published on Harvard's own website considers the 1,000-1,200 mg RDA for calcium recommended by the National Academy of Sciences, which were based on short-term studies, and raises them to question based on long-term studies:</p>\n\n<blockquote>\n <p>In particular, these [long term] studies suggest that high calcium\n intake doesn’t actually appear to lower a person’s risk for\n osteoporosis. For example, in the large Harvard studies of male health\n professionals and female nurses, individuals who drank one glass of\n milk (or less) per week were at no greater risk of breaking a hip or\n forearm than were those who drank two or more glasses per week.</p>\n</blockquote>\n\n<p>The article describes several more studies that found no benefit to bone strength from high milk consumption.</p>\n" }, { "answer_id": 1604, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>According to <a href=\"http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S0004-27302006000400014\" rel=\"nofollow\">this review article</a>, adults need a bit more than 1 gram of calcium per day. However, it may be the case that the natural vitamin D levels for the human body should be a lot higher than what is currently the norm, see e.g. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22264449\" rel=\"nofollow\">here</a>. Calcium is absorbed from the gut by both passive and active mechanisms, the active mechanism is vitamin D dependent. If the level of calcium in the blood drops then calcium from bones will be released and simultaneously, the kidneys will produce more calcitriol which then turns on genes in the gut to produce enzymes that help to extract calcium from food.</p>\n\n<p>Besides the total intake per day, what is also relevant is the presence of big gaps in the intake of calcium. Such gaps will prompt the body to extract calcium from the bones and then you're dependent on processes that will eventually put calcium back into the bones. By spreading the intake of calcium over the day, you can prevent bone loss in the event that in your case this mechanism of putting the calcium back doesn't work as well as it should.</p>\n\n<p>Note that there are many sources of calcium that we tend to ignore. Water can contain calcium, e.g. where I live there is 60 mg per liter. That doesn't sound like a lot, but if you drink 3 liters a day, you'll get 180 mg. Bread only contains 10 mg per slice, but if you eat a lot like I do (I don't recommend doing that unless it fits into a well balanced diet for your case) like 15 slices per day, then that's 150 mg of calcium. So, the dry bread plus water alone is already 280 mg.</p>\n\n<p>Then if you eat 500 grams of broccoli at dinner like I did today, you'll get 235 mg of calcium. Potatoes contain 12 mg per 100 gram, I had 1 kg of potatoes for dinner, so I got 120 mg from the potatoes. This means that in total I got more than 600 mg of calcium from sources one normally doesn't bother to consider. However, it must be said that absorption of calcium from such sources isn't as efficient as from dairy products due to oxalates in vegetables, phytic acids in grains and the lack of phosphorous when you drink just plain water.</p>\n\n<p>So, you see that non dairy sources can give you a decent amount of calcium, but you then need to eat a lot (I eat about 4000 kcal per day, which is a lot more than average). The calorie intake of indigenous people who needed to jog for hours every day to chase prey was likely a lot higher than what it is today for the typical office worker, so they may actually have gotten their gram of calcium per day from only non dairy foods and their vitamin D levels were also likely a lot higher than that of the average office worker. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1247", "https://health.stackexchange.com", "https://health.stackexchange.com/users/443/" ]

[ { "answer_id": 1254, "author": "Susan", "author_id": 165, "author_profile": "https://health.stackexchange.com/users/165", "pm_score": 2, "selected": false, "text": "<p>Yes. </p>\n\n<p>This is one of the few areas of <a href=\"http://phprimer.afmc.ca/Part1-TheoryThinkingAboutHealth/Chapter4BasicConceptsInPreventionSurveillanceAndHealthPromotion/Thestagesofprevention\" rel=\"nofollow noreferrer\">primary prevention</a>* where the data are clear. </p>\n\n<p>The (intelligently) skeptical tone of your question suggests to me that you would be (appropriately) wary of drawing conclusions based on <a href=\"https://stats.stackexchange.com/a/13311\">observational data</a> or <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884846/\" rel=\"nofollow noreferrer\">surrogate endpoints</a>. Fortunately, you have asked a question about an area where rigorous data are available showing reductions in the risk of cardiovascular disease and mortality on the basis of randomized, controlled trials.</p>\n\n<p><strong>Cardiovascular events</strong> </p>\n\n<p>In large-scale randomized trials of people with primary hypertension, antihypertensive therapy produces a nearly 50 percent relative risk reduction in the incidence of heart failure, a 30 to 40 percent relative risk reduction in stroke, and a 20 to 25 percent relative risk reduction in myocardial infarction.^1,2,3,4 </p>\n\n<p>The benefits show a consistent \"dose-response\" relationship. That is, larger improvements in blood pressure control are associated with greater decreases in risk. This is an important point, since it adds credibility to the association. This is demonstrated in graphs like this one:</p>\n\n<p><img src=\"https://i.imgur.com/k96ECBL.png\" alt=\"enter image description here\"></p>\n\n<p>_{Image from Reference 1, below: <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386598/\" rel=\"nofollow noreferrer\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386598/</a>} </p>\n\n<p>On the x-axis you see the degree of blood pressure lowering achieved with medications. On the y-axis is “relative risk” (RR). By definition, a null intervention yields RR=1. A relative risk of 0.5 represents a 50% decreased risk, etc. </p>\n\n<p>The graph is showing meta-analysis data, i.e. data compiled from many clinical trials in order to increase statistical power. The basic idea is that each circle is a clinical trial and bigger circles represent “stronger” data (i.e. with lower variance). The regression line shows that there is a linear relationship between the degree of blood pressure lowering and the relative risk reduction (here for a composite endpoint of stroke, myocardial infarction, and heart failure.) This analysis included 31 randomized, placebo-controlled trials, with 190,606 participants. These are strong data. </p>\n\n<p><strong>Mortality data</strong> </p>\n\n<p>In addition to the dramatic reductions in adverse cardiovascular outcomes, blood pressure control has also been shown to reduce mortality. One meta-analysis used data from 42 randomized, controlled studies including nearly 200,000 subjects (Psaty). They found a reduction in cardiovascular disease mortality (RR, 0.81; 95% CI, 0.73-0.92); and total mortality (RR, 0.90; 95% CI, 0.84-0.96). The fact that these relative risk (RR) confidence intervals do not cross 1 demonstrates statistical significance. </p>\n\n<p>Although the RR value of 0.90 is considerably less impressive than the reductions in more specific outcomes (stroke, heart failure, etc), this is expected due to the myriad of other factors affecting mortality. A statistically significant relative risk of 0.90 for <strong>mortality</strong> is actually quite dramatic. One would be challenged to find any other intervention for primary prevention that, in randomized trials, can be shown to decrease overall mortality with this degree of certainty.</p>\n\n<p><strong>Conclusion</strong> </p>\n\n<p>There are many interventions in modern medicine that are of questionable long-term benefit to healthy patients (i.e. primary prevention).** These include cholesterol lowering medications, aspirin, various forms of cancer screening, etc. In most cases, the disease-specific improvements in outcomes are subtle and debated, and randomized data showing a reduction in overall mortality are lacking or inconsistent. The use of blood pressure lowering medications in patients with hypertension falls into a different category. These medications are effective. </p>\n\n<p>_{\n*That is, interventions aimed at preventing disease in <em>healthy</em> people. This is in contrast to <em>secondary</em> prevention, treating people after they have already had an adverse outcome. In general, secondary prevention is a much \"easier\" arena in which to demonstrate benefit because the risk of adverse outcomes is so much higher.\n} </p>\n\n<p>_{\n**Here, I’m considering hypertension, hyperlipidemia to fall within the range of “healthy” because these abnormalities are only problematic if they cause a cardiovascular event of some sort.\n}</p>\n\n<hr>\n\n<p><strong>References</strong> </p>\n\n<ol>\n<li><p>Blood Pressure Lowering Treatment Trialists' Collaboration, Turnbull F, Neal B, Ninomiya T, Algert C, Arima H, Barzi F, Bulpitt C, Chalmers J, Fagard R, Gleason A, Heritier S, Li N, Perkovic V, Woodward M, MacMahon S. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=18480116\" rel=\"nofollow noreferrer\">Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials.</a> BMJ. 2008 May 17;336(7653):1121-3.</p></li>\n<li><p>Law MR, Morris, Wald NJ. <a href=\"http://www.bmj.com/content/338/bmj.b1665\" rel=\"nofollow noreferrer\">Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies.</a> BMJ 2009; 338.</p></li>\n<li><p>Kostis JB, Davis BR, Cutler J, Grimm RH Jr, Berge KG, Cohen JD, Lacy CR, Perry HM Jr, Blaufox MD, Wassertheil-Smoller S, Black HR, Schron E, Berkson DM, Curb JD, Smith WM, McDonald R, Applegate WB. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9218667\" rel=\"nofollow noreferrer\">Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group.</a> JAMA. 1997 Jul 16;278(3):212-6.</p></li>\n<li><p>Gueyffier F, Boutitie F, Boissel JP, Pocock S, Coope J, Cutler J, Ekbom T, Fagard R, Friedman L, Perry M, Prineas R, Schron E. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=9148648\" rel=\"nofollow noreferrer\">Effect of antihypertensive drug treatment on cardiovascular outcomes in women and men. A meta-analysis of individual patient data from randomized, controlled trials. The INDANA Investigators.</a> Ann Intern Med. 1997 May 15;126(10):761-7.</p></li>\n<li><p>Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, Weiss NS. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=12759325\" rel=\"nofollow noreferrer\"><em>Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis.</em></a> JAMA. 2003 May 21;289(19):2534-44.</p></li>\n</ol>\n" }, { "answer_id": 1257, "author": "Joel", "author_id": 765, "author_profile": "https://health.stackexchange.com/users/765", "pm_score": 4, "selected": true, "text": "<p>Yes, mortality benefits for blood pressure medicine have been demonstrated in trials.</p>\n\n<p>Let me just preface this by saying this was much harder to find than I was expecting. Questioning the benefit of blood pressure reduction is medical heresy, so you'd think you wouldn't have trouble finding the data out there.</p>\n\n<p>First of all, let's define the question. We're asking whether treatment of hypertension leads to lower mortality in the setting of a randomized clinical trial. Reading between the lines, I think what we really want to know is whether treatment of isolated hypertension (i.e. in patients that have no strokes, heart failure or other diseases associated with hypertension) leads to lower mortality in a randomized clinical trial. Treating hypertension after a stroke or heart attack is hands down beneficial (see HOPE, PART2, IDNT, NICOLE or PREVENT trials [1-5]). You can't answer the question with this data though, because maybe the drug is really just treating the heart attack or stroke. </p>\n\n<p>To get data specifically on treating hypertension itself, not in the setting of other medical problems, you have to go back to the 1960s. The VA COOP Study Group on Antihypertensive Agents [6,7] trial specifically looked at treating people who just came into the clinic with high blood pressure. Mortality was 5% lower in the treatment group, or, for every 20 people treated for 3.3 years (the average time people were enrolled in the study), 1 person will have their life saved. Honestly, this is a pretty good outcome as far as drugs go, taking aspirin to prevent heart attacks doesn't work nearly as well, for example. The authors collected these numbers on mortality but they didn't test for whether the numbers were likely to have just popped up by chance or not (statistical significance). I crunched them myself with Fisher's exact test and the results were unlikely to have just come up by chance (p value = 0.015) </p>\n\n<p>Some caveats. This study was old (the word negro is used), but it was really well done. They had the patients go through a 2 month run in phase where they had to take pills that turned their urine orange just so they could see whether they took their pills regularly before letting them in the trial. All the patients and the doctors were blinded. They used sealed envelope randomization. Patients were enrolled from eight different sites. Of course, it was done at the VA in the 60s, so every single patient was a man. Also, the patients weren't exactly free of other diseases. For some reason, the authors didn't just say how many patients had strokes or heart attacks in the past. They devised this \"severity score\" to assess how many health problems people had at the start of the trial. The score went from 0-4 and on average the patients were less than 1. I would say most weren't very sick.</p>\n\n<p>Some other trials tried to test blood pressure medicines versus placebo but fell short. The Australian Therapeutic Trial in Mild Hypertension [8] had many fewer events than the VA study so weren't quite able to show statistical significance. The benefits to treatment that they measured in this study were way smaller. Treatment reduced death by .15%. So for every 666 people taking the drug for 1 year, 1 person's life would be saved. They were only able to show this was statistically significant when they looked at the numbers for people actually taking the drug. You want to look at everyone that entered the study in the first place though (intention to treat), because you can always invent scenarios where you get biased results if you don't do this. </p>\n\n<p>There was one other study that looked at this question. The Oslo study [9] also failed to show that treatment actually saved lives when treating patients with just hypertension.</p>\n\n<p>Keep in mind that all of these studies were able to show benefit to treating (fewer strokes, less kidney failure) but mortality was really only lower in the VA trial. My gut tells me that this was because aged American veterans were less healthy to start with then relatively healthy Norwegians and Australians (the population from the other studies). It was less of a needle-in-a-haystack challenge in the VA trial.</p>\n\n<p>Sometime in the 70s or 80s, it seems that doctors all decided that treating hypertension was the way to go no matter how healthy the patient was otherwise so we don't have any more studies. </p>\n\n<p>References</p>\n\n<ol>\n<li>HOPE (Heart Outcomes Prevention Evaluation) Study Investigators.\nEffects of an angiotensin-converting-enzyme inhibitor, ramipril, on\ncardiovascular events in high-risk patients. N Engl J Med 2000; 342:\n145–53.</li>\n<li>MacMahon S, Sharpe N, Gamble G, et al. Randomised, placebocontrolled\ntrial of the angiotensin converting enzyme inhibitor,\nramipril, in patients with coronary or other occlusive vascular disease.\nJ Am Coll Cardiol 2000; 36: 438–43.</li>\n<li>Lewis E, Hunsicker L, Clarke W, et al. Renoprotective effect of the\nangiotensin-receptor antagonist irbesartan in patients with nephropathy\ndue to type 2 diabetes. N Engl J Med 2001; 345: 851–60.</li>\n<li>Dens J, Desmet W, Coussement P, et al. Usefulness of nisoldipine for\nprevention of restenosis after percutaneous transluminal coronary\nangioplasty (results of the NICOLE study). Am J Cardiol 2001; 87:\n28–33.</li>\n<li>Pitt B, Byington R, Furberg C, et al. Effect of amlodipine on the\nprogression of atherosclerosis and the occurrence of clinical events.\nCirculation 2000; 102: 1503–10.</li>\n<li>Effects of Treatment on Morbidity in Hypertension: Results in Patients With Diastolic Blood Pressures Averaging 115 Through 129 mm Hg. JAMA. 1967;202(11):1028-1034. doi:10.1001/jama.1967.03130240070013.</li>\n<li>Effects Morbidity of Treatment on in Hypertension: II. Results in Patients With Diastolic Blood Pressure Averaging 90 Through 114 mm Hg. JAMA. 1970;213(7):1143-1152. doi:10.1001/jama.1970.03170330025003.</li>\n<li>THE AUSTRALIAN THERAPEUTIC TRIAL IN MILD HYPERTENSION: Report by the Management Committee, The Lancet, Volume 315, Issue 8181, 14 June 1980, Pages 1261-1267, ISSN 0140-6736, <a href=\"http://dx.doi.org/10.1016/S0140-6736(80)91730-4\">http://dx.doi.org/10.1016/S0140-6736(80)91730-4</a>.\n(<a href=\"http://www.sciencedirect.com/science/article/pii/S0140673680917304\">http://www.sciencedirect.com/science/article/pii/S0140673680917304</a>)</li>\n<li>Anders Helgeland, Treatment of mild hypertension: A five year controlled drug trial: The Oslo study, The American Journal of Medicine, Volume 69, Issue 5, November 1980, Pages 725-732, ISSN 0002-9343, doi: 10.1016/0002-9343(80)90438-6.</li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/1248", "https://health.stackexchange.com", "https://health.stackexchange.com/users/755/" ]

[ { "answer_id": 2000, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 4, "selected": true, "text": "<p>It is not possible. </p>\n\n<p>The regulation of human body temperature (thermoregulation) is very subtle. Wikipedia article about thermoregulation contains a very nice graph about that mechanism.\n<a href=\"https://i.stack.imgur.com/OgG4H.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/OgG4H.png\" alt=\"enter image description here\"></a></p>\n\n<p>The labels are not described in the text in detail and the reference in the caption does not include this picture. Picture is a work by one JW Dietrich and I also searched PubMed for this guy, but he has no works on this topic. </p>\n\n<p>Another more pragmatic picture is here.</p>\n\n<p><a href=\"https://i.stack.imgur.com/bGim4.jpg\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/bGim4.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>Fever or increased body temperature is almost solely caused by to the production <a href=\"https://en.wikipedia.org/wiki/Fever#Pathophysiology\" rel=\"noreferrer\">prostaglandin E2 (PGE2)</a>. PGE2 acts on the hypothalamus or the thermoregulator of the body and as a result body temperature increases (<a href=\"https://en.wikipedia.org/wiki/Fever#Pathophysiology\" rel=\"noreferrer\">1</a>). PGE2 production is controlled by the immune system. Fever is meant to have a good cause since fever is supposed to help killing the bacteria or viruses causing any illness.</p>\n\n<p>Antipyretics are drugs which interact with PGE2. Basically they suppress the formation of PGE2. In that way they \"treat\" the fever.</p>\n\n<p>As can be seen from the control circuit describing the thermoregulation PGEs has nothing to with this process. Due to this, blocking non existing PGE2 production during normal body temperature has no effect whatsoever which would cause the body temperature to drop. Even it would happen with some mysterious cause, the body rapidly balance the situation as seen above in the figures.</p>\n" }, { "answer_id": 16616, "author": "CowperKettle", "author_id": 2248, "author_profile": "https://health.stackexchange.com/users/2248", "pm_score": 3, "selected": false, "text": "<p>Kudos for finding that study on mice! I also googled a bit for references..</p>\n<p>From &quot;Physiology Secrets&quot; (<a href=\"https://books.google.ru/books?id=a1RchCrwKWsC&amp;lpg=PA315&amp;ots=R_v5D-uOUE&amp;dq=aspirin%20decreases%20normal%20body%20temperature&amp;hl=ru&amp;pg=PA315#v=onepage&amp;q=aspirin%20decreases%20normal%20body%20temperature&amp;f=false\" rel=\"noreferrer\">page 315</a>) by Hershel Raff, published in 2003:</p>\n<blockquote>\n<p><a href=\"https://i.stack.imgur.com/4EqsB.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/4EqsB.png\" alt=\"enter image description here\" /></a></p>\n</blockquote>\n<p>Furthermore, in one other source the author says that aspirin can even induce hyperthermia (elevated body temperature) (&quot;Applied Pharmacology for the Dental Hygienist&quot; by Elena Bablenis Haveles, 2015, <a href=\"https://books.google.ru/books?id=gfYoDgAAQBAJ&amp;lpg=PA606&amp;ots=hvghGZG_-f&amp;dq=aspirin%20decreases%20normal%20body%20temperature&amp;hl=ru&amp;pg=PA606#v=onepage&amp;q&amp;f=false\" rel=\"noreferrer\">page 606</a>):</p>\n<blockquote>\n<p><a href=\"https://i.stack.imgur.com/0VFyq.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/0VFyq.png\" alt=\"enter image description here\" /></a></p>\n</blockquote>\n<p>A research article, detailing research performed on healthy subjects:</p>\n<blockquote>\n<p><a href=\"https://www.wemjournal.org/article/S1080-6032(11)00157-8/pdf\" rel=\"noreferrer\">The Effects of High- and Low-Dose Aspirin on Thermoregulation During and After Acute Cold Exposure</a> (Murray et al., 2011, Wilderness and Environmental Medicine)</p>\n<p>Conclusions. — These data demonstrate that aspirin had no significant effect on the thermal and metabolic responses during acute cold exposure and rewarming.</p>\n</blockquote>\n<p>Figure from the article:</p>\n<blockquote>\n<p><a href=\"https://i.stack.imgur.com/7zfgU.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/7zfgU.png\" alt=\"enter image description here\" /></a></p>\n</blockquote>\n<p>(High-dose aspirin: 650 mg/day for one week; low-dose aspirin: 81 mg/day for one week)</p>\n" } ]

[ "https://health.stackexchange.com/questions/1253", "https://health.stackexchange.com", "https://health.stackexchange.com/users/758/" ]

[ { "answer_id": 1281, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 6, "selected": true, "text": "<p>Assuming the person is not taking anticoagulants, it's actually quite difficult to bleed to death from dismemberment of small members (hands, feet, penis, ears, nose, etc). Even large members such as arms and legs are often survivable because the body is very good at protecting itself from blood loss. For example, transected arteries will spasm and clamp off blood flow, and loss of blood will cause the body to divert blood flow away from the extremities and to the vital organs, thereby slowing the bleeding and allowing it to clot. In fact, the whole shock process can be viewed as a set of defensive measures by the body to ensure survival in the face of serious injury. This was a bitter lesson learned by emergency medicine only fairly recently. The standard practice used to be to infuse hypovolemic patients with fluids to maintain normal blood pressure. The trouble is, a normal blood pressure prevents the body from realizing it has inadequate blood volume and turns off its defensive measures, thus allowing the bleeding to continue unabated. </p>\n\n<p>Left to fend for himself, a healthy adult would almost certainly survive having his penis removed. With modern medical care, that becomes a certainty.</p>\n\n<p>Could he still urinate? Sure, as long as the urethra wasn't blocked. It could become blocked by clotted blood, but eventually the pressure of a full bladder would overcome the blockage.</p>\n" }, { "answer_id": 8820, "author": "Nona", "author_id": 6494, "author_profile": "https://health.stackexchange.com/users/6494", "pm_score": 2, "selected": false, "text": "<p>The problem is there are too many unknowns. First, the speed of clotting varies from person to person. There are lab tests that measure clotting time (e.g. INR), especially useful when a patient takes anticoagulants. One respondent mentioned the absence of anticoagulants, but anticoagulants include substances not specifically prescribed to reduce clotting, such as supplements and even food items that reduce clotting. Further, there are genetic factors (i.e. Factor VIII and others) that modulate clotting time, operating independently of medical intervention/prescribed drugs or anything consumed. Age is another facet in the clotting process, as infants often do not clot quickly. Couple that fact with the smaller quantity of blood in an infant's body and it makes sense why some infants actually die from circumcision related bleeding. An infant may retain his penis after circumcision but still die from operation related blood loss.</p>\n\n<p>Additionally, the penis is different than other appendages and extremities. Besides the difference in tissue composition (smooth muscle vs. skeletal muscle elsewhere), penile arteries dilate more than arteries elsewhere and veins constrict more than veins elsewhere (assuming one has generally healthy blood vessels prior to injury). The unique elasticity of penile blood vessels mean that a traumatic injury like penile amputation is more likely to bleed continuously than many other amputations when taking into account the relative area of tissue amputated and blood vessels severed. Other than the femoral or carotid arteries, which, due to their own unique locations, are more likely to cause death from dissection than severing other arteries, the penis is again unique in that the arteries both inside and leading to it do not always clamp off- sometimes, they remain dilated even after a severing injury.</p>\n\n<p>One of the biggest factors of survival (a somewhat controllable factor) in this case is time. The more time elapses after amputation without subsequent medical intervention, the more likely death becomes. </p>\n\n<p>Death from penile amputation can arise not simply from blood loss but also from related issues such as overall stress and pain. Stress hormones and an inflammatory chemical cascade following such a traumatic injury can overwhelm the heart. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1258", "https://health.stackexchange.com", "https://health.stackexchange.com/users/769/" ]

[ { "answer_id": 7320, "author": "Weezy", "author_id": 5142, "author_profile": "https://health.stackexchange.com/users/5142", "pm_score": 3, "selected": true, "text": "<p>I have suffered from health anxiety for the last couple of years and let me share some of the things I find helpful.</p>\n\n<ol>\n<li><strong>Stay hydrated</strong>: Drinking loads of water instantly relieves the tightness in your throat and definitely helps alleviate anxiety. If you think you're about to have a panic attack start drinking till your stomach is full and think about the movement of water inside you. This will help you alleviate some of the anxiety.</li>\n<li><strong>Take Deep Breaths</strong>: When you get anxious, flight and fight hormones are released into your bloodstream that causes muscle tightness and increased metabolism, elevated heartbeat rate etc. You must start taking deep controlled breaths as soon as you feel anxious. Also by counting backwards from 10 to 1 as you breathe it will help your mind achieve relaxation more quickly</li>\n<li><strong>Hypnosis &amp; Meditation</strong>: This is the long term solution to attack the anxiety itself. There are youtubers like Michael Sealey and Jason Stephenson who have wonderful meditation/hypnosis video guides that will help you learn how to control your anxiety and have a more positive outlook. Don't try to meditate when you're having a panic attack as this may irritate you further. Make it a routine to meditate on a daily basis for at least 40-50 mins. While it may not cure your anxiety it will definitely help you and motivate you to practice more meditation and ease your anxiety.</li>\n</ol>\n\n<p>Remember if your anxiety has a psychological source such as some kind of pain or worry then it may be useful to address those issues first. Ask yourself questions like why am I anxious? Is there a specific reason? Identify the reason and act accordingly. If you have a generalized anxiety disorder then meditation on a daily basis should rid you of anxiety once and for all. </p>\n" }, { "answer_id": 15780, "author": "VaTo", "author_id": 650, "author_profile": "https://health.stackexchange.com/users/650", "pm_score": 0, "selected": false, "text": "<p>For all those people that are suffering for the same cause as me, I would like to recommend them to start practicing yoga, it has been so beneficial for me. I didn't think it was going to help me but it did, I was so desperate about getting a solution that I gave it a try even though some friends were laughing at me for practicing it. It takes about 3 weeks of every day doing it. If you are doing it, make sure you are doing the postures that you need to do for anxiety, stress, insomnia, etc. I was doing other kind of postures and then it didn't help me, but a yoga teacher taught me the right ones and I have been feeling so much better. It has helped me even more than acupuncture and massages, since they are only temporary fixes. </p>\n\n<p>You can do whatever you want to do to improve your life but this is what worked for me and I was suffering from this for at least 5 years, and now finally I'm seeing an exit from this everlasting problem, I just felt I had to share this because it feels terrible and I don't wish this to anybody. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1259", "https://health.stackexchange.com", "https://health.stackexchange.com/users/650/" ]

[ { "answer_id": 1294, "author": "Mark", "author_id": 333, "author_profile": "https://health.stackexchange.com/users/333", "pm_score": 5, "selected": true, "text": "<p>A <a href=\"https://en.wikipedia.org/wiki/California_Proposition_65_(1986)\">California Proposition 65</a> warning doesn't really tell you anything about the safety of the luggage.</p>\n\n<p>Proposition 65 <em>requires</em> warnings if somebody may be exposed to a substance that has a 1 in 100,000 chance of causing cancer over the course of 70 years, or has the possibility of causing birth defects or reproductive harm, as determined by the <a href=\"https://en.wikipedia.org/wiki/California_Office_of_Environmental_Health_Hazard_Assessment\">California Office of Environmental Health Hazard Assessment</a>.</p>\n\n<p>However, there is nothing preventing warnings even if there is no risk whatsoever. Proposition 65 permits members of the general public to sue over missing warnings, and California has a cottage industry of lawyers filing these suits any time they find something that doesn't have such a warning. As a result, these warnings are often used as an incantation to ward off lawyers rather than an actual indication of hazard. See, for example, <a href=\"http://ag.ca.gov/prop65/pdfs/G035101.pdf\">Consumer Defense Group v. Rental Housing Industry members</a>, where the list of potential carcinogens included \"automobile exhaust from cars in the parking lot\" and \"the possibility that someone on the grounds of the apartment building might be smoking a cigarette\". As part of the initial settlement of that suit, a warning was posted at the entrance to each building referring to a two-page list of things that might reasonably be found in or around an apartment building -- not because the apartment had lead-based paint, or used perchloroethylene cleaners, or had asbestos insulation, but to prevent further lawsuits.</p>\n" }, { "answer_id": 17021, "author": "Uniphonic", "author_id": 14354, "author_profile": "https://health.stackexchange.com/users/14354", "pm_score": 3, "selected": false, "text": "<p>I think the currently accepted answer is incorrect on a number of points. The official <a href=\"https://oehha.ca.gov/proposition-65/proposition-65-faqs\" rel=\"noreferrer\">California Proposition 65 (aka OEHHA) site FAQ</a>, has more accurate information. There is also another <a href=\"https://oag.ca.gov/prop65/faqs-view-all\" rel=\"noreferrer\">FAQ from the Attorney General</a>, which answers the question as well. The OEHHA site says:</p>\n\n<blockquote>\n <p>The purpose of Proposition 65 is to notify consumers that they are being exposed to chemicals that are known to cause cancer and/or reproductive toxicity. Consumers can decide on their own if they want to purchase or use the product. A Proposition 65 warning does not necessarily mean a product is in violation of any product-safety standards or requirements. For additional information about the warning, contact the product manufacturer.</p>\n</blockquote>\n\n<p>The currently accepted answer claims that \"Proposition 65 requires warnings if somebody may be exposed to a substance that has a 1 in 100,000 chance\", which is not true. Simply being exposed to a chemical that has a certain risk does not make the company required to post a warning. The chemical <strong>also</strong> has to be on <a href=\"https://oehha.ca.gov/proposition-65/proposition-65-list\" rel=\"noreferrer\"><strong><em>the list</em></strong></a>. There could be substances which have risk, but are not on the list, and thus they are not required to post a warning. </p>\n\n<p>Here is a quote directly from the <a href=\"https://oehha.ca.gov/proposition-65/proposition-65-faqs\" rel=\"noreferrer\">OEHHA site</a>, which shows the substance not only has to be on the list, but also has to be in a high enough concentration to create an unsafe exposure: </p>\n\n<blockquote>\n <p>Proposition 65 applies only to exposures to listed chemicals. It does not ban or restrict the use of any given chemical. The concentration of a chemical in a product is only one part of the process to determine whether consumers must be warned about an exposure to a listed chemical.</p>\n</blockquote>\n\n<p>The currently accepted answer is also incorrect in that it claims \"However, there is nothing preventing warnings even if there is no risk whatsoever.\" This is blatantly false, because the law allows a business to prove that their use falls below the acceptable use threshold. Here is a quote directly from the <a href=\"https://oag.ca.gov/prop65/faqs-view-all#3GP\" rel=\"noreferrer\">California Attorney General's site</a>: </p>\n\n<blockquote>\n <p><strong>Exposures that pose no significant risk of cancer</strong>: A warning about listed chemicals known to cause cancer (\"carcinogens\") is not required if the business can demonstrate that the exposure occurs at a level that poses \"no significant risk.\" This means the exposure is calculated to result in not more than one excess case of cancer in 100,000 individuals exposed over a 70-year lifetime. The Proposition 65 regulations identify \"no significant risk\" levels for certain carcinogens. The most recent list of no significant risk levels can be found here: <a href=\"http://www.oehha.ca.gov/prop65/getNSRLs.html\" rel=\"noreferrer\">http://www.oehha.ca.gov/prop65/getNSRLs.html</a>.</p>\n</blockquote>\n\n<p>Thus, businesses have the possibility to show their product is safe, and not post a warning even if it contains a chemical from the list. Small companies of <a href=\"https://oehha.ca.gov/proposition-65/proposition-65-faqs\" rel=\"noreferrer\">less than 10 employees</a> are exempted having to post a warning.</p>\n\n<p>If a large company thinks it's cheaper for them to place warnings on all of their products, than it would be for them to do testing to see if their product is safe for consumers, that seems a bit of a red flag to me.</p>\n\n<p>I found a particular product I purchased came with a warning, but when I looked on the company website though they acknowledged the warning, they wouldn't let their consumers know which offending chemicals were. This law is about the <a href=\"https://oag.ca.gov/prop65/faqs-view-all#5GP\" rel=\"noreferrer\">consumers \"right to know\"</a>. If the business posts a warning, but won't let you know what the chemicals are that are the cause for that warning, it seems a bit of a red flag to me as well. If consumer safety is not an important enough issue for a company to do the testing, it seems safer to me to just avoid those products where possible.</p>\n\n<p>One more useful tidbit of information is that, according to the Attorney General, Proposition 65 has been <a href=\"https://oag.ca.gov/prop65/faqs-view-all#8GP\" rel=\"noreferrer\">successful in motivating businesses to eliminate or reduce toxic chemicals in numerous consumer products</a>. This law is not only about helping consumers make informed decisions, it's about motivating companies to be more responsible for the safety of their consumers.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1263", "https://health.stackexchange.com", "https://health.stackexchange.com/users/777/" ]

[ { "answer_id": 1269, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": false, "text": "<p>Unfortunately, height is genetically based.</p>\n\n<p>At 24 years old, it is unlikely that you will grow more, but the only way to know for sure is if you have an x ray done of the growth plates in your bones to see if they have disappeared. If they have, then there really is no natural way to increase height.</p>\n\n<p>There are surgical procedures (<a href=\"http://www.digitaljournal.com/article/320199\">See this article</a>) where you can potentially add a few inches, but they are very costly (The procedure described in the article cost ~ $90,000 US dollars), and they are reported to be very painful, long (3+ months) and require extensive rehabilitation and physical therapy to be successful. According to the article, most places that do the procedure use it primarily for physical afflictions such as dwarfism, and do not recommend it for purely cosmetic reasons.</p>\n" }, { "answer_id": 15517, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>The only known non-surgical method of gaining height at this age is to go into space. Without the pull of earth's ground level gravity astronauts have been shown to gain height.</p>\n\n<blockquote>\n <p>Astronauts in space can grow up to 3 percent taller during the time spent living in microgravity, NASA scientists say. That means that a 6-foot-tall (1.8 meters) person could gain as many as 2 inches (5 centimeters) while in orbit.</p>\n</blockquote>\n\n<p>However, this height is lost once earth's full gravity is restored.</p>\n\n<p><a href=\"https://www.space.com/19116-astronauts-taller-space-spines.html\" rel=\"nofollow noreferrer\">https://www.space.com/19116-astronauts-taller-space-spines.html</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1264", "https://health.stackexchange.com", "https://health.stackexchange.com/users/779/" ]

[ { "answer_id": 1303, "author": "Othya", "author_id": 830, "author_profile": "https://health.stackexchange.com/users/830", "pm_score": 4, "selected": true, "text": "<p>I have eaten McDonalds for lunch every (week) day for the past 2+ years, I can tell you it has nothing to do with weight gain or loss.</p>\n\n<p>For the vast majority of people, losing and gaining weight is <strong>all about calories</strong>; nothing else. Genetics plays a role, but it is insignificant in the grand scheme of things.</p>\n\n<p>There are many problems with the quality of food from McDonalds, but I will focus on answering your question within regards to weight gain/loss only.</p>\n\n<p>The foods at McDonalds are very calorie-dense, and non-satiating. One big mac has ~563 calories... add on the large fires (~480) and large coke (~310) with that and it equals over 1300 calories.</p>\n\n<p><strong>1300</strong>+ calories is an INSANE amount for one meal, which won't even keep you satiated (full) for very long. </p>\n\n<p>Therefore, it's really a poor choice when it comes to weight loss.. because if you are trying to lose weight, your daily caloric intake wouldn't be too much higher than that (unless you're a bodybuilder or athlete). Some short women wouldn't even have 1300 calories total in their daily intake... that's how much calories that is.</p>\n\n<p>That being said, if you're on some kind of diet such as intermittent fasting, and you don't eat much else other than that single meal a day.. you can still successfully lose weight even if you eat this meal each day.</p>\n\n<p><strong>As long as the calories you consume each day is lower than your TDEE (Total Daily Energy Expenditure), you will lose weight.</strong></p>\n" }, { "answer_id": 1306, "author": "Victoria Lam", "author_id": 831, "author_profile": "https://health.stackexchange.com/users/831", "pm_score": 1, "selected": false, "text": "<p>It is <em>theoretically</em> possible. However, if your goal is to lose or even maintain weight, eating fast food every day will make something already difficult even more difficult. Calories are not the whole picture. Achieving lasting weight loss requires changing one's relationship to food.</p>\n" }, { "answer_id": 1323, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": 1, "selected": false, "text": "<p>Yes, it is possible. If you eat 0.0001 grams of McDonald's fast food every day, and nothing else, you will lose weight. Guaranteed.</p>\n\n<p>The point of this rather silly answer is that it's the quantity of calories you eat (and burn), not anything magic about the source of the calories.</p>\n" }, { "answer_id": 1350, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>While it seems logical that you only need to consider the deficit or surplus on the energy balance to see if you'll gain or lose weight, this is not going to work because the body will regulate the metabolic rate to keep a certain amount of energy reserves. How much fat reserves your body decides to keep will depend on your physical fitness and physical activity levels, the intake of minerals that are essential for maintaining physical fitness, how much sleep you get etc. etc. In general, when you live an unhealthy lifestyle, your body's regulation of its metabolic rate will tend to lead to larger fat reserves.</p>\n\n<p>From a theoretical point of view, this is quite easy to understand. Whatever the precise biochemical mechanisms are that are involved in regulating metabolism (not everything is known), it remains the case that all these mechanisms have evolved in order to maximize survival probability of animals in Nature who obviously don't do calorie counting.</p>\n\n<p>One of the problems evolution had to solve was how to make sure you don't starve to death due to a small shortage in the energy balance that you cannot make up for. Suppose you eat one sandwich a day worth 100 Kcal a day less and walk a bit more so that you expend 100 Kcal more per day. While this could lead to some weight loss, it cannot be the case that you'll continue to lose weight without limit. However, naive the calorie counting hypothesis suggests that a 200 Kcal deficit per day would lead to a long term weight loss trend of 1 kg of fat per 40 days. So, in a little over 2 years you would lose 20 kg of weight, which is clearly nonsense.</p>\n\n<p>Animals living in the wild may find themselves having to deal with a bit less food that is also a bit harder to find. If they were to lose weight because the metabolic rate is cannot be actively regulated, it would only increase due to physical exertion, the animal would be doomed. This doesn't make sense for warm blooded animals that we know have mechanisms to regulate the metabolic rate, and who have metabolic rates that are ten times higher than what they need to just barely survive.</p>\n\n<p>Instead, it makes far more sense to make the metabolic rate dependent on the degree to which the fat cells are filled. So, if there is a shortage on the energy balance, the animal will initially lose weight, but then the metabolic rate will be down regulated, correcting the energy balance, a slight surplus will be created, allowing the fat cells to be filled. </p>\n\n<p>While the biochemical mechanisms the body uses for this are not well understood, but recently <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10967095\" rel=\"nofollow\">it has been found</a> that fat cells produce leptin, the more filled a fat cell is the more leptin is produced and besides regulating the appetite, leptin will let the hypothalamus produce more TRH, and TRH will let the pituitary gland produce more TSH and TSH will let the thyroid gland produce more thyroid hormone.</p>\n\n<p>Then the body will likely also make the set point for the fat reserves dependent on factors such as the amount of food intake, stress levels, sleep etc. The whole point of the fat reserves is to maximize survival probability, so the probability of a food emergency, the time it can survive without food etc. will all influence the set point for its fat reserves. It then makes sense that the outcome of evolution would be that the set point would be set higher when the animal has less to eat, has more stress doesn't get the optimal; amount of sleep. In that case, a food emergency is more likely and when it happens it is less likely to survive on some given amount of fat reserves. So, the smart thing to do is to save more energy under these circumstances.</p>\n\n<p>In contrast, when you sleep better, eat more and exercise more, the body will think that the prospects of a food emergency are smaller, and if that were to happen you would be in stronger position to take measures to reverse the situation. So, you'll not keep as much fat reserves, because doing so does come at the cost of having to carry all that fat ballast with you all the time.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1284", "https://health.stackexchange.com", "https://health.stackexchange.com/users/814/" ]

[ { "answer_id": 3941, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 3, "selected": true, "text": "<p>&quot;Normal&quot; eyelid twitching can possibly be caused or be made worse by lack of sleep, or too much caffeine or stress. That information can be found unsourced on <em>a lot</em> of websites, including with such qualifiers as &quot;many experts say&quot;. I couldn't find a single source - which doesn't mean it doesn't exist, or say that these things don't cause eyelid twitches.</p>\n<p>The Kellogg Eye Centre at the University of Michigan just says:</p>\n<blockquote>\n<p>The cause of minor eyelid twitch is unknown.</p>\n</blockquote>\n<p>And for treatment:</p>\n<blockquote>\n<p>Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, correction of any refractive error, and lubrication of the eye with artificial tears may help. Some ophthalmologists recommend reducing caffeine usage</p>\n</blockquote>\n<p>The University of Maryland Medical Center mentions, just like a lot of sources, caffeine, sleep and stress</p>\n<blockquote>\n<p>The most common things that make the muscle in your eyelid twitch are fatigue, stress, and caffeine.</p>\n</blockquote>\n<p>And for treatment:</p>\n<blockquote>\n<p>Eyelid twitching most often goes away without treatment. In the meantime, the following steps may help:</p>\n<ul>\n<li>Get more sleep.</li>\n<li>Drink less caffeine.</li>\n<li>Lubricate your eyes with eye drops</li>\n</ul>\n<p>If twitching is severe or lasts a long time, small injections of botulinum toxin can control the spasms</p>\n</blockquote>\n<p>However, since you specifically mentioned <em>blepharospasm</em>, I am going to include some information on what's called <em>benign essential blepharospasm</em>. That's a condition that worsens with age, and often ends up including more face muscles than just the eyelids. It's probably caused at least in part by genetics, but the exact gene responsible for it remains unclear. Treatment for it includes medication, for example dopamine inhibitors, botox injections, and even surgery to remove the eyelid muscle.</p>\n<p>Interestingly, for benign essential blepharospasm, drinking coffee might actually <em>delay</em> onset of the disease.</p>\n<p><strong>Sources</strong></p>\n<p><a href=\"http://www.kellogg.umich.edu/patientcare/conditions/eyelid.spasms.html\" rel=\"nofollow noreferrer\">Kellogg Eye Center</a></p>\n<p><a href=\"https://umm.edu/health/medical/ency/articles/eyelid-twitch\" rel=\"nofollow noreferrer\">University of Maryland Medical Center</a></p>\n<p><a href=\"http://ghr.nlm.nih.gov/condition/benign-essential-blepharospasm\" rel=\"nofollow noreferrer\">Benign essential blepharospasm</a></p>\n<p><a href=\"https://rarediseases.org/rare-diseases/benign-essential-blepharospasm/\" rel=\"nofollow noreferrer\">Benign essential blepharospasm @ rarediseases.org</a></p>\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676990/#__abstractid883428title\" rel=\"nofollow noreferrer\">Update on blepharospasm</a></p>\n" }, { "answer_id": 8997, "author": "claire20", "author_id": 1247, "author_profile": "https://health.stackexchange.com/users/1247", "pm_score": 1, "selected": false, "text": "<p>There are three core factors that contribute to eye twitching: <strong>caffeine consumption, stress, and fatigue.</strong></p>\n\n<p>If you’ve been noticing that your sleep has been disturbed or if you haven’t been getting enough of zzz time, you may expect daytime tiredness along with eye twitching. So if your eyelids have been bothering you lately, it may be wise to look at your sleep schedule.</p>\n\n<p><strong>Caffeine</strong> is a popular stimulant many of us drink to stay alert. But sometimes that surge of energy not only keeps you awake, but also causes your eyes to twitch. If you consume lots of coffee or even energy drinks on a daily basis, you may want to cut back in order to minimize eye twitching. Keep in mind that smoking and alcohol consumption can contribute to eye twitching, too.</p>\n\n<p><strong>Stress</strong> can play a large role in eye twitches, too. Stress-induced eye twitching can be more nerve-racking, as it may take place during important moments. For example, maybe you’re stressed out about putting a dinner party together. Well, now, not only are you trying to keep things under control, but your annoying eye twitch won’t stop either! All you can do here is handle stress at the best of your ability. And stop thinking about your eye twitch – otherwise, it will only add to the pressure of the moment. Relaxation techniques and other coping mechanisms should be utilized in order to lower stress, which in turn will reduce the eye twitch.</p>\n\n<p>Although these three factors are the most common causes for eyelid twitching, other causes include mineral deficiencies like lack of magnesium, dry eyes, eye strain from looking at a screen, incorrect eye glass prescription, allergies, alcohol consumption, smoking, an underlying eye problem, jaw clenching or teeth grinding. In some cases, eye twitching can be an early symptom of a serious medical condition including hypoglycemia, Parkinson’s disease, Tourette’s syndrome, and neurological dysfunction. If eye twitching worsens or is accompanied by other symptoms, you should see your doctor to determine the exact cause.</p>\n\n<p><strong>Treatment options for eyelid twitching</strong></p>\n\n<p>Treatment options for eyelid twitching depend on the underlying cause. For example, if excessive caffeine is causing your eyelids to twitch, you may need to cut back on your favorite drink. If fatigue or stress is the cause, then more rest or effective stress-reducing remedies are needed.</p>\n\n<p>You may have to work towards getting more sleep, start drinking less caffeine, apply cold compresses to your eyes, make it a point to look away from screens often, reduce stress, use artificial tears and other eye drops, and ensure you are getting adequate nutrition. These are just some ways to address eyelid twitching, but treatment may vary based on the cause.</p>\n\n<p>Proper treatment of eyelid twitches may also aid with prevention. For example, if you are sleeping more and, therefore, are well rested, you may be able to get rid of your existing eye twitching problem and avoid future occurrences.</p>\n\n<p><strong>Tips to manage your eye twitching</strong></p>\n\n<p>Apply hot and cold compresses to the eyelid\nTry acupuncture or massages to ease tension and reduce stress\nReduce stress as best as possible\nReduce your intake of caffeine\nGet more sleep\nTry a face steam</p>\n\n<p>Source: <a href=\"http://www.belmarrahealth.com/eye-twitching-causes-treatment-prevention/\" rel=\"nofollow\">Eyelid twitching causes, treatment, and prevention</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1287", "https://health.stackexchange.com", "https://health.stackexchange.com/users/816/" ]

[ { "answer_id": 1329, "author": "whitebeard", "author_id": 844, "author_profile": "https://health.stackexchange.com/users/844", "pm_score": 5, "selected": true, "text": "<p>I think your skepticism may come from not understanding the process behind the claim. </p>\n\n<p>A single unit of blood is separated into 4 main \"blood products\": red blood cells, plasma, platelets, and white blood cells. Another product called cryoprecipitate can be produced from frozen then thawed plasma and is used in special circumstances. Whole blood is rarely used for transfusions anymore because of problems with transfusion reactions and, quite frankly, except in the case of massive hemorrhage, a single person rarely needs all these components all at once (and even then they probably won't need white blood cells). Red blood cells (or packed red blood cells) are what most people think of when they get a \"blood transfusion.\" Plasma is given to people who do not have enough clotting factors in their blood to stop bleeding that is currently occurring or if it should occur. Platelets are given to people who are not producing enough platelets to keep them from bleeding to death. White blood cells are rarely given anymore, but there may be occasion to use them in specific cases.</p>\n\n<p>Now did that one unit save up to 3 lives? Well, to answer that the question of whether their lives were in danger to begin with has to be answered. The answer is, \"Yes!\" When will they die without the product? For some it's in the next several minutes, for others it may be hours, days or weeks, but in every case these peoples lives are in danger without the products derived from human blood.</p>\n\n<p>But did that unit all by itself achieve this? No, but in concert with the donations of others it <strong>contributed</strong> to saving \"up to 3 lives.\" Because doctors try avoid using precious blood products until it is absolutely necessary by treating patients with other methods if possible, so by the time a person definitely requires blood products, they will get more than one unit, but had they been given products earlier without giving the 'other methods' a chance to work they would have needed just as much, maybe more, over time.</p>\n\n<p>The American Cancer Society has an excellent <a href=\"http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/bloodproductdonationandtransfusion/blood-transfusion-and-donation-types-of-transfusions\" rel=\"noreferrer\">summary of types of blood transfusions and what they are used for here</a>. </p>\n\n<p>I don't think the claim is derived from any particular set of statistics or the hard and fast numbers that you are seeking, but from the process involved.</p>\n\n<p><strong>EDIT:</strong></p>\n\n<p>The best collection of statistical information online may be <a href=\"http://www.nlm.nih.gov/medlineplus/bloodtransfusionanddonation.html\" rel=\"noreferrer\">Blood Transfusion and Donation</a> published by the National Institutes of Health and <a href=\"http://www.hhs.gov/ash/bloodsafety/2011-nbcus.pdf\" rel=\"noreferrer\">The 2011 National Blood Collection and Utilization Survey Report (PDF)</a>, published by the US Department of Health and Human Services (and several other departments and agencies). These 2 documents contain the most current comprehensive data available on blood collection and transfusion.</p>\n" }, { "answer_id": 3909, "author": "dsollen", "author_id": 797, "author_profile": "https://health.stackexchange.com/users/797", "pm_score": 3, "selected": false, "text": "<p>I'm answering my own question, yay! This is my attempt to answer my question despite my lack of familiarity with much of the medicine. I therefore stress that I am not guaranteeing this answer, it's meant to be a very rough estimate and shouldn't be considered exact. Perhaps others will comment on things I missed and allow me to make it better...</p>\n\n<p>First, Here is a quick link that discusses the concept: <a href=\"http://blog.inceptsaves.com/blog/2010/10/27/donor-recruitment-how-can-one-pint-of-blood-save-three-lives/\" rel=\"noreferrer\">http://blog.inceptsaves.com/blog/2010/10/27/donor-recruitment-how-can-one-pint-of-blood-save-three-lives/</a></p>\n\n<p>So there are three types of products that can be produced from whole blood, and each is divided into a nice 'unit', a base number used to define how much of a product is ordered by a hospital. However, one whole blood donation does not make up a full unit in any of these three. So what we get is:</p>\n\n<ol>\n<li>Red Blood Cells(RDC): little less then 2 donations per unit</li>\n<li>Platelets: 5-6 (I've seen both numbers, 6 seems more common) donations per unit</li>\n<li>plasma: less certain, I think about 2 donations per unit?</li>\n</ol>\n\n<p>Thus for 10 donations of red blood cells you will have produced 2 unit if platelets and 5 units of RDC and Plasma. If one unit was required to save a life then you will save 12 lives with those 10 donations, or 1.2 lives per donation.</p>\n\n<p>However, it looks like many units are required per operation/transfusion/emergency. </p>\n\n<p><strong>Red Blood Cells</strong></p>\n\n<p>in 2010 on average <a href=\"http://www.hhs.gov/ash/bloodsafety/2011-nbcus.pdf#page26\" rel=\"noreferrer\">2.75 units were used per patient</a>. This is not anywhere near an accurate estimate of units needed per 'life saved', but I'm trying for a very very rough estimate. So for now lets say that each transfusion saved a life, and thus it took roughly 5.25 whole blood donations per 'life saved' via RBC. In actuality the odds are not every patient was in a life critical situation, so we should look at the number of units used per patient who was in a life critical situation, but I don't have that number. Since it seems likely that those in non-life critical situations would likely require less RBC then those in a life critical situation I would assume the units used per life-critical operation are higher, meaning the overall lives saved per whole blood donation is lower, but I don't have statistics on this.</p>\n\n<p><strong>Platelets</strong></p>\n\n<p>I know it can take up to <a href=\"http://www.universityhealthsystem.com/plateletpheresis/\" rel=\"noreferrer\">30 units</a> for a single organ donation; but that's probably a high estimate, to stress the importance of donations.</p>\n\n<p>Bone marrrow transplants used <a href=\"http://jco.ascopubs.org/content/19/5/1519.full\" rel=\"noreferrer\">54 PC in the 100 days post transfer</a>, where a PC is defined to be the amount of platelets from a single donation of whole blood, but was also defined as requiring 9-6 PC to make a full unit; so a slight discrepancy from other numbers. I would put that at an average of 5 units per bone marrow transfer?</p>\n\n<p>The average <a href=\"http://www.hhs.gov/ash/bloodsafety/2011-nbcus.pdf#page40\" rel=\"noreferrer\">pre-transfusion platelet count was 32,055</a> with a healthy platelet count being <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/003647.htm\" rel=\"noreferrer\">150,000 to 400,000</a>. One unit should raise platelet count by <a href=\"http://pathology.ucla.edu/workfiles/2-3-Platelet-Products.pdf\" rel=\"noreferrer\">30,000-50,000</a>. If we assume they would transfere enough platelets to get someone up to close to the lower end of 'healthy', 150,000, then they would need another 3-4 units per transfusion. This seems in keeping with other math I saw, with all surgeries looking to require 5+ units. Going with a favorable comparison lets say an average of 3 units per life-saving transfusion. I'm not at all confident with this number, but it's the best I've managed so far.</p>\n\n<p>With that number were looking at 15-18 whole blood donations per one life saved with platelets.</p>\n\n<p><strong>Plasma</strong></p>\n\n<p>I give up and throw up my hands here. Plasma is broken down into many different products, and trying to get averages for all those products to expand on the average units used is just too much.</p>\n\n<p>for now, until I get around to doing better research, lets be extra generous and assume every unit saves one life. I highly doubt this, I would say it's likely that it's at least a minimum of 2 units per life saved, but I'm trying to stay on the generous side; and lacking any statistics I can at least say that they define units as a minimal quantity likely suggests they don't expect adults to ever need less then 1 unit per transfer which implies at least one is needed per life saving intervention. </p>\n\n<p>Giving that likely generous presumption were looking at 1 life saved per two whole blood donations via plasma.</p>\n\n<p><strong>Other products</strong></p>\n\n<p>There are other products that can be made out of whole blood. None of them are nearly as useful as the above, and rarely are collected, but at least some of them are utilized and would add to overall lives saved by a very small amount. I don't feel like adding them up since it sounds like they are such a minimal affect, and won't. That's because I think any lives preserved via these methods is counteracted by...</p>\n\n<p><strong>Waste and outdating</strong></p>\n\n<p><a href=\"http://www.hhs.gov/ash/bloodsafety/2011-nbcus.pdf#page27\" rel=\"noreferrer\">Just under 5% of all blood products go unused</a> due to waste or being too old. I figure this waste more then counteracts the above other products, so I'm going to ignore both and just pretend they two affects perfectly countered each other.</p>\n\n<p><strong>Final assessment</strong></p>\n\n<p>This is all very <em>very</em> rough math by a layman, so I am not swearing to any of it. I was trying to error on the side of presuming maximum number of lives saved per donation; though it's entirely possible I missed an important factor which caused me to underestimate these numbers; feedback is welcome.</p>\n\n<p>However, as the math works out we have:</p>\n\n<ul>\n<li>5.25 Whole Blood Donations per life saved (HBD/L) for RBC</li>\n<li>15 HBD/L for platelets</li>\n<li>2 HBD/L as a very generous presumption for plasma.</li>\n</ul>\n\n<p>This works out to .757 lives saved per donation.</p>\n\n<p>so a little less then 1 life saved per donation at my most generous; though I fear my being lazy and not doing a plasma calculation likely raised that number higher then it really should be. Assuming I haven't made some obvious miscalculation; which is quite possible!</p>\n\n<p>So every 2 whole blood donations you make will save a life! I've been donating for about 10 years now at about 1 donation per 2 months, so that still means more then 30 lives saved. Still not bad considering how little it really costs me.</p>\n\n<p>I welcome feedback from anyone who has more knowledge about this then...well a geek googling random statistics who may be able to point out factors I missed. This is definitely not definitive; but it's nice to have at least a rough rule of thumb.</p>\n" }, { "answer_id": 24389, "author": "David Roop", "author_id": 20188, "author_profile": "https://health.stackexchange.com/users/20188", "pm_score": 2, "selected": false, "text": "<p>Here are some statistics:\nEach year, an estimated 6.8 million people in the U.S. donate blood.\n<a href=\"https://www.redcrossblood.org/donate-blood/how-to-donate/how-blood-donations-help/blood-needs-blood-supply.html\" rel=\"nofollow noreferrer\">13.6 million</a> whole blood and red blood cells are collected in the U.S. in a year.\nGiving blood saves <a href=\"https://blog.stridehealth.com/post/save-3-lives-with-1-blood-donation\" rel=\"nofollow noreferrer\">4.5 million</a> lives each year in the U.S.</p>\n<p>The Jehovah's Witness patients' decision to forego transfusions for major surgical procedures appears to add <a href=\"https://www.bmj.com/rapid-response/2011/10/28/risk-blood-transfusion-illegal-breach-confidentiality-addendum-reply-furul\" rel=\"nofollow noreferrer\">0.5% to 1.5% mortality</a> to the overall operative risk</p>\n<p>13.6 million blood donations is used for 4.5 million people. This is .33 people per donation. Using the Jehovah's Witness information then about .5 to 1.5 % of these would actually die without blood. This is .0016 to .0050 people per blood transfusion. So this implies something like 200 to 600 blood transfusions to save a life. At first glance this seems small which is why the number is not readily available. However, you can look at it another way. People who need blood are often of middle age where they have a life expectancy of 30 years or about 8,000 days. So you are saving somewhere between 13 and 40 days of life for every blood donation on the average. One hour or so and 13-40 days of life are added. This seems wonderful.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1289", "https://health.stackexchange.com", "https://health.stackexchange.com/users/797/" ]

[ { "answer_id": 4274, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 3, "selected": false, "text": "<p>Results on this are mixed. For instance, Reference 1 states that there is no correlation, whereas, Reference 2 states that their results \"suggest that the overall IQ of the children exposed to high fluoride levels in drinking water and hence suffering from dental fluorosis were significantly lower than those of the low fluoride area.\"</p>\n\n<p>I think the New Zealand study explains these finding quite nicely: \"Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.\"</p>\n\n<p>Reference 3 concludes \"children who live in a fluorosis area have five times higher odds of developing low IQ than those who live in a nonfluorosis area or a slight fluorosis area.\"</p>\n\n<p>Due to the sheer amount of mixed findings on this topic, I cannot answer your question with an iota of certainty. I could most certainly give you my <em>opinion</em>, however, it is hardly relevant ;) .</p>\n\n<p><strong>References</strong></p>\n\n<ol>\n<li>(No correlation) Community Water Fluoridation and Intelligence: Prospective Study in New Zealand. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24832151\" rel=\"noreferrer\">http://www.ncbi.nlm.nih.gov/pubmed/24832151</a></li>\n<li>(Correlation) Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26673535\" rel=\"noreferrer\">http://www.ncbi.nlm.nih.gov/pubmed/26673535</a></li>\n<li>(Correlation) Fluoride and children's intelligence: a meta-analysis, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/18695947/\" rel=\"noreferrer\">http://www.ncbi.nlm.nih.gov/pubmed/18695947/</a></li>\n</ol>\n" }, { "answer_id": 5329, "author": "kenorb", "author_id": 114, "author_profile": "https://health.stackexchange.com/users/114", "pm_score": 3, "selected": true, "text": "<p>There are <a href=\"http://fluoridealert.org/studytracker/?effect=brain-2&amp;sub=&amp;type=&amp;start_year=&amp;end_year=&amp;show=10&amp;fulltext=&amp;fantranslation=\" rel=\"nofollow noreferrer\">over 300 studies</a> have found that fluoride is a neurotoxin (a chemical that can damage the <a href=\"http://fluoridealert.org/issues/health/brain/\" rel=\"nofollow noreferrer\">brain</a>). </p>\n\n<p>According to <a href=\"https://www.epa.gov/chemical-research/toxicity-forecasting\" rel=\"nofollow noreferrer\">EPA</a> scientists (United States Environmental Protection Agency), there is substantial evidence that fluoride is neurotoxin^{<a href=\"http://www.fluoridealert.org/wp-content/uploads/epa_mundy.pdf\" rel=\"nofollow noreferrer\">2009</a>}. They based their conclusion on studies showing that fluoride exposure during pregnancy can damage the brain which was consistent with three other studies from China which found that the brain of the human fetus can be significantly damaged by the mother’s high fluoride intake (safe dose for preventing this effect is not yet known).</p>\n\n<p><a href=\"http://www.fluoridealert.org/wp-content/uploads/epa_mundy.pdf\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/coT9Hl.jpg\" alt=\"EPA.gov - Chemicals with substantial evidence of developmental neurotoxicity\"></a></p>\n\n<p>Further more, the National Research Council (NRC) expressed concern about fluoride’s possible contribution to dementia and \"it is apparent that fluorides have the ability to interfere with the functions of the brain and the body by direct and indirect means\"^{<a href=\"http://fluoridealert.org/studies/brain06/\" rel=\"nofollow noreferrer\">2006</a>}.</p>\n\n<blockquote>\n <p>It is apparent that fluorides have the ability to interfere with the functions of the brain. (National Research Council, 2006)</p>\n</blockquote>\n\n<p>A more recent “meta-analysis” of 27 cross-sectional studies performed by <a href=\"http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/\" rel=\"nofollow noreferrer\">Harvard researchers</a>, did a systematic review of children exposed to fluoride in drinking water (mainly from China), which suggested that children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas (an average IQ decrement of about seven points in children exposed to higher fluoride concentrations)^{<a href=\"http://ehp.niehs.nih.gov/1104912/\" rel=\"nofollow noreferrer\">2012</a>}.</p>\n\n<blockquote>\n <p>Some studies suggested that even slightly increased fluoride exposure could be toxic to the brain. </p>\n</blockquote>\n\n<p>In March of 2014, The Lancet medical journal published a review of <a href=\"http://fluoridealert.org/wp-content/uploads/grandjean-20141.pdf\" rel=\"nofollow noreferrer\">neurobehavioral effects of developmental toxicity</a>, which concluded that fluoride is one of only 11 chemicals that is known to damage the developing brain and it is capable of causing widespread brain disorders such as autism, attention deficit hyperactivity disorder, learning disabilities, and other cognitive impairments. In most cases the damage is often <strong>untreatable</strong> and <strong>permanent</strong>^{<a href=\"http://fluoridealert.org/news/fluoride-newly-identified-as-dangerous-to-brains/\" rel=\"nofollow noreferrer\">2014</a>}. According to this, fluoride is classified as <strong>dangerous</strong> to developing brains.</p>\n\n<p>In a bulletin posted on the <a href=\"http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/\" rel=\"nofollow noreferrer\">Harvard School of Public Health website</a>, Grandjean notes that:</p>\n\n<blockquote>\n <p>Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain. The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.</p>\n</blockquote>\n" }, { "answer_id": 14540, "author": "Fizz", "author_id": 10980, "author_profile": "https://health.stackexchange.com/users/10980", "pm_score": 2, "selected": false, "text": "<p>As the saying goes, anything is a poison, it's the dose that matters. Short summary, the new 2015 US PHS standard (0.7 mg/L) or even the old one (0.7-1.2 mg/L) are below the doses at which negative effects were observed in China (2.5-4.1 mg/L), and the evidence from there is not of high quality, even though there's one meta-analysis of it. (As a cautionary tale on inferring from low quality evidence, <a href=\"https://skeptics.stackexchange.com/a/20353/29579\">the first meta-analysis of homeopathy found positive results</a>, latter ones which filtered out low-quality studies were more skeptical.)</p>\n\n<p>But back to fluoride, what did the United States Public Health Service (PHS), actually <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547570/\" rel=\"nofollow noreferrer\">decide in 2015</a>?</p>\n\n<blockquote>\n <p>For these community water systems that add fluoride, PHS now recommends an optimal fluoride concentration of 0.7 milligrams/liter (mg/L). In this guidance, the optimal concentration of fluoride in drinking water is the concentration that provides the best balance of protection from dental caries while limiting the risk of dental fluorosis. The earlier PHS recommendation for fluoride concentrations was based on outdoor air temperature of geographic areas and ranged from 0.7–1.2 mg/L. </p>\n</blockquote>\n\n<p>As for neurotoxicity, this was PHS's review of the new evidence:</p>\n\n<blockquote>\n <p>IQ and other neurological effects.\n The standard letters and approximately 100 unique responses expressed concern about fluoride's impact on the brain, specifically citing lower IQ in children. Several Chinese studies considered in detail by the NRC review reported lower IQ among children exposed to fluoride in drinking water at mean concentrations of 2.5–4.1 mg/L—several times higher than concentrations recommended for community water fluoridation.[81–83] The NRC found that “the significance of these Chinese studies is uncertain” because important procedural details were omitted, but also stated that findings warranted additional research on the effects of fluoride on intelligence.[6]</p>\n \n <p>Based on animal studies, the NRC committee speculated about potential mechanisms for nervous system changes and called for more research “to clarify the effect of fluoride on brain chemistry and function.” These recommendations should be considered in the context of the NRC review, which limited its conclusions regarding adverse effects to water fluoride concentrations of 2–4 mg/L and did “not address the lower exposures commonly experienced by most U.S. citizens.”[6] A recent meta-analysis of studies conducted in rural China, including those considered by the NRC report, identified an association between high fluoride exposure (i.e., drinking water concentrations ranging up to 11.5 mg/L) and lower IQ scores; study authors noted the low quality of included studies and the inability to rule out other explanations.[84] A subsequent review cited this meta-analysis to support its identification of “raised fluoride concentrations” in drinking water as a developmental neurotoxicant.[85]</p>\n \n <p>A review by SCHER also considered the neurotoxicity of fluoride in water and determined that there was not enough evidence from well-controlled studies to conclude if fluoride in drinking water at concentrations used for community fluoridation might impair the IQ of children. The review also noted that “a biological plausibility for the link between fluoridated water and IQ has not been established.”[79] Findings of a recent prospective study of a birth cohort in New Zealand did not support an association between fluoride exposure, including residence in an area with fluoridated water during early childhood, and IQ measured repeatedly during childhood and at age 38 years.[86]</p>\n</blockquote>\n\n<p>From the actual <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265943/\" rel=\"nofollow noreferrer\">New Zealand study</a> we find out they used a simiar standard as the US, albeit slighly lower at 0.7-1 mg/L, and no effect on IQ was noticeable at this level of exposure.</p>\n\n<p>And the stated reason for lowering the PHS standard in 2015 to just 0.7mg/L was based on risk of fluorosis</p>\n\n<blockquote>\n <p>Although not fully generalizable to the current U.S. context, these findings, along with findings from the 1986–1987 survey of U.S. schoolchildren, suggest that the risk of fluorosis can be reduced and caries prevention maintained toward the lower end (i.e., 0.7 mg/L) of the 1962 PHS recommendations for community water fluoridation.</p>\n</blockquote>\n\n<p>and lack of need for the higher value (1.2 mg/L)</p>\n\n<blockquote>\n <p>Recent data do not show a convincing relationship between water intake and outdoor air temperature. Thus, recommendations for water fluoride concentrations that differ based on outdoor temperature are unnecessary.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/1296", "https://health.stackexchange.com", "https://health.stackexchange.com/users/83/" ]

[ { "answer_id": 1312, "author": "eiridoku", "author_id": 833, "author_profile": "https://health.stackexchange.com/users/833", "pm_score": 3, "selected": true, "text": "<p><a href=\"https://www.google.ca/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=2&amp;ved=0CB8QFjAB&amp;url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F12442909&amp;ei=3R6FVdGmEYKuoQTDuYToCw&amp;usg=AFQjCNH8dDURblsTT3fkyTWv3Q0AsGVhaQ&amp;sig2=T9AqdFHg_Wj5XQv3fCj_OA&amp;bvm=bv.96339352,d.cGU\" rel=\"nofollow\">From the NIH</a>:</p>\n\n<blockquote>\n <p>Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of approximately 1 whereas in Western diets the ratio is 15/1-16.7/1</p>\n</blockquote>\n\n<p>This is not undisputed though.</p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Omega-3_fatty_acid#Interconversion\" rel=\"nofollow\">https://en.wikipedia.org/wiki/Omega-3_fatty_acid#Interconversion</a> explains the importance. It's hard to summarize.</p>\n" }, { "answer_id": 10388, "author": "Mark", "author_id": 7577, "author_profile": "https://health.stackexchange.com/users/7577", "pm_score": 2, "selected": false, "text": "<p>The book Living a Century or More by William Cortvriendt MD, which has a lot of scientific sources that I don't have the expertise to judge but seem reliable, says in the subchapter \"Omega-3 PUFAs and inflammation\" that</p>\n\n<blockquote>\n <p>...COX can in fact stimulate or inhibit inflammation. When omega-3 PUFAs come into contact with COX, they will inhibit inflammation. However when COX comes into contact with omega-6 PUFAs then inflammation will be stimulated.</p>\n</blockquote>\n\n<p>Note that inflammation is often an appropriate response by the body, but too much of it is harmful. This explains why the ratio is important: you don't want too little or too much. There may be other effects.</p>\n\n<p>The ideal ratio is between 5:1 and 1:1 in favour of omega-6. The typical ratio is much higher in favour of omega-6. That's why food and supplements with omega-3 are popular.</p>\n\n<p><strong>EDIT</strong>: you're trying to have low body fat. Of course the ratio can be controlled in two ways: increase omega-3 or decrease omega-6. If you want to keep total fat low, you could consider limiting omega-6. But keep in mind that these are healthy, unsaturated fats. If that's an option, you should definitely cut trans fats instead, and maybe saturated fats.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1297", "https://health.stackexchange.com", "https://health.stackexchange.com/users/780/" ]

[ { "answer_id": 1301, "author": "Freedo", "author_id": 767, "author_profile": "https://health.stackexchange.com/users/767", "pm_score": 3, "selected": false, "text": "<p>Your own Wikipedia page already states that \"There is no scientific evidence of a therapeutic use for untreated urine\" and \"According to the American Cancer Society, \"available scientific evidence does not support claims that urine or urea given in any form is helpful for cancer patients\" \"</p>\n\n<p>But lets me show you more detailed evidence. First urine is nothing more than : </p>\n\n<blockquote>\n <p>Urine is an aqueous solution of greater than 95% water, with the remaining constituents, in order of decreasing concentration, urea 9.3 g/L, chloride 1.87 g/L, sodium 1.17 g/L, potassium 0.750 g/L, creatinine 0.670 g/L and other dissolved ions, inorganic and organic compounds (see this <a href=\"http://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19710023044_1971023044.pdf\">nasa study</a>)</p>\n</blockquote>\n\n<p>We know that urine is <a href=\"https://www.sciencenews.org/blog/gory-details/urine-not-sterile-and-neither-rest-you\">not 100% sterile</a>, but usually won't harm a healthy people if you drink it (and the urine is from a healthy person too that didn't drink any drug or poisons) but the only situation i can see it would be good to drink your own urine is if you are dehydrating to death and even that is not really recommended ( see this wonderful question on <a href=\"https://skeptics.stackexchange.com/questions/1540/is-it-a-good-idea-to-drink-your-own-urine-in-a-survival-situation\">skeptics.se</a> ) </p>\n\n<p>But you could think if we have potassium and other minerals in urine why not drink it? Because you can get much more by eating food and hormones are produced by your own body you don't need to drink pee to replace that, and they become urine for a good reason, see the conclusion of <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032614/\">this study</a> :</p>\n\n<blockquote>\n <p>It is strongly suggested that alternative therapies should be non-hazardous, and therefore, inappropriate administration of remedies, such as urine therapy in pediatric health conditions should be discouraged, considering the fact that no documented scientific / clinical evidence of the beneficial effect of urine therapy in clinical had been reported, while multiple antibiotic resistant bacterial species had also been recovered from such urine.</p>\n</blockquote>\n\n<p>Edit: About your medicines listed.</p>\n\n<ul>\n<li><p><a href=\"http://www.drugs.com/cons/metrodin.html\">Metrodin</a> = Wrong. Metrodin is is a man-made hormone called follicle-stimulating hormone (FSH). FSH is produced in the body by the pituitary gland. <strong>May</strong> appear on urine, however in <strong>very low</strong> concentrations to justify drinking your own pee.</p></li>\n<li><p><a href=\"http://www.drugs.com/cons/pergonal.html\">Pergonal</a> = Wrong. Menotropins are a mixture of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) that are produced in the body by the pituitary gland. <strong>May</strong> appear on urine, however in <strong>very low</strong> concentrations to justify drinking your own pee.</p></li>\n<li><p><a href=\"http://www.druglib.com/druginfo/panafil/description_pharmacology/\">Panafil</a> = Wrong.It is a proteolytic enzyme derived from the fruit of carica papaya. The only <strong>possible</strong> (not 100%) way its going to end up in your urine is if you are eating the fruit.</p></li>\n<li><p><a href=\"http://www.chemocare.com/chemotherapy/drug-info/cladribine.aspx\">2-CdA</a> = 2-CdA is the trade name for cladribine. Leustatin and 2-chlorodeoxyadenosine are other names for cladribine. It <strong>was</strong> extracted from urine and according to Wikipedia it was first synthesized at Brigham Young University (meaning they don't extract it from urine anymore), they do appear in urine but in <strong>too low</strong> concentrations to justify drinking your own pee.</p></li>\n<li><p><a href=\"http://www.drugs.com/mtm/urokinase.html\">Urokinase</a> and <a href=\"https://en.wikipedia.org/?title=Urokinase\">Wikipedia page</a> = Urokinase is a man-made product developed using a protein that occurs naturally in the kidneys. Urokinase is made from human kidney cells and albumin (part of the blood) which may contain viruses and other infectious agents. Urokinase was originally <strong>isolated</strong> from human urine, but is present in several physiological locations, such as blood stream and the extracellular matrix. Again, they do appear in urine but in <strong>too low</strong> concentrations to justify drinking your own pee.</p></li>\n</ul>\n\n<p>Why drinking your own pee to get this substances is completely non-sense?</p>\n\n<blockquote>\n <p>A single <a href=\"http://www.livescience.com/45005-banana-nutrition-facts.html\">Banana</a> have 450mg of potassium or 13% of our recommended intake. 2L of urine have 1500mg potassium or ~31% of recommended daily intake. But at this scale you would get 18,6g of urea, 3,74g of chloride and 2,34g of sodium too.</p>\n</blockquote>\n\n<p>Now <a href=\"http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Frequently-Asked-Questions-FAQs-About-Sodium_UCM_306840_Article.jsp\">American Heart Association in 2010 chose to recommend that Americans eat less than 1,500 mg/day sodium as part of the definition of ideal cardiovascular health.</a>. So you going 840mg above your ideal sodium consumption only with urine, <strong>long term drinking urine and a diet high in sodium will really hurt your health.</strong> (I don't think i have to cite the consequences of too much sodium right? Just google for it)</p>\n\n<p>Now see the dangers of excess of <a href=\"http://chemocare.com/chemotherapy/side-effects/hyperchloremia-high-chloride.aspx\">Chloride</a> note that <strong>The normal adult value for chloride is 97-107 mEq/L.</strong> and you will be consuming 3,74g to get only ~31% of your potassium intake. I didn't find a good converter online so i will let this to someone who can do this math. But just 1g/l is a lot more than 107meq/l. You only going to make your poor kidney to work much harder to handle all this chloride.</p>\n\n<p>Now about urea, this <a href=\"http://www.epa.gov/iris/toxreviews/1022tr.pdf\">study</a> says:</p>\n\n<blockquote>\n <p>There is limited information to suggest that the liver, kidney, and pituitary could be targets of urea toxicity. Under the Guidelines for Carcinogen Risk Assessment (U.S. EPA, 2005a), there is “inadequate information to assess the carcinogenic potential” of urea. Epidemiologic studies of humans chronically exposed to urea alone or urea-containing mixtures are limited.</p>\n</blockquote>\n\n<p>But drinking 18,6g of urea daily surely can't be good to you. There is no scientific evidence for health benefits of drinking this. Lack of studies is not equal to no toxicity! </p>\n\n<p>For hormones i think you can see why is totally no-sense, the amount of urine you would have to drink to get any considerable amount would be insane and toxic.</p>\n" }, { "answer_id": 1373, "author": "MoonMind", "author_id": 815, "author_profile": "https://health.stackexchange.com/users/815", "pm_score": -1, "selected": false, "text": "<p>Have finished with the book 'The Water of Life' by John W. Armstrong and at the end of this translation there are references to different books wrote on Urine therapy from different authors from various part of the world. These books are examples for the researches conducted on this treatment technique.</p>\n\n<ul>\n<li><p>The Golden Fountain - Coen Van Der Kroon(Netherlands)</p></li>\n<li><p>Your Own Perfect Medicine - Martha Christy(USA)</p></li>\n<li><p>Urine Therapy - Dr.Beatrice Barnett(USA)</p></li>\n<li><p>Wonders of Urine Therapy - Dr. G.K. Thakkar(India)</p></li>\n<li><p>Shivambu Gita - Dr.G.K Thakkar</p></li>\n<li><p>Amroli - Swami Sathyanand Saraswathi(India)</p></li>\n<li><p>The Urine Cure - John Rabitoch(Australia)</p></li>\n<li><p>Suppressed Medical Discovery - Dr.Robert Beck(USA)</p></li>\n<li><p>Urine The Holy Water - Herald W.Tietze(Germany)</p></li>\n</ul>\n\n<p>I found these references towards the last pages of the book 'The Water of Life', so this is not a case of single author J.W Armstrong (he is considered as author of first book of this kind in modern medicine). There are old texts on the subject which is a 3000 years old book named 'Damar tantra shivambu kalpa vidhi' in India. </p>\n\n<p>As I understood from the book, there were researches on this therapy and scientists have experimented with it and following are a few examples to the studies conducted on Urine, Urine's components and medicinal importance. </p>\n\n<ol>\n<li><p>Hegyeli.A; M Laughlin. J.A; and Szent-Gyorgyi.A: 'Preparation of Retine from Human Urine', 'Science Magazine', December 20, 1963, pp.1571-1572 quoted in Your Own Perfect Magazine.</p></li>\n<li><p>Davies.O; 'Youthful Uric Acid' Omni Magazine, October 1982, continuum Section.</p></li>\n<li><p>Souvenir of FNCUT, 2008, Kolhapur, page 37.</p></li>\n<li><p>Tierze W. Herald, Urine The Holy Water, p.78. Souvenir of FNCUT, 2008</p></li>\n</ol>\n\n<p>Note: The answer is incomplete and needs to deal with some part of the question, will update with more details later.</p>\n" }, { "answer_id": 8748, "author": "Nae Yi Shin", "author_id": 6447, "author_profile": "https://health.stackexchange.com/users/6447", "pm_score": -1, "selected": false, "text": "<p>Urine is being use as estrogen. One of the example is the animal urine (not sure in particular) but It is an ingredient that can be use for hormonal medicines like Premarin (conjugated estrogens). Conjugated estrogens treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. But I don't think that it is good to drink urine directly, as everything should be processed and examined. It is a waste from our body but small amount will not harm you. On the other side, there might be some substance that can be use for hormonal treatments. For added info, you can also check the link: <a href=\"http://health.cvs.com/GetContent.aspx?token=f75979d3-9c7c-4b16-af56-3e122a3f19e3&amp;chunkiid=161688\" rel=\"nofollow\">True or False: It's safe to drink urine</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1300", "https://health.stackexchange.com", "https://health.stackexchange.com/users/815/" ]

[ { "answer_id": 1327, "author": "whitebeard", "author_id": 844, "author_profile": "https://health.stackexchange.com/users/844", "pm_score": 3, "selected": false, "text": "<p>These interaction checkers are great tools and many physicians use them in making prescription decisions. A very experienced physician will already know this information about medications they prescribe regularly, but there is so much information and so many medications now, it is good for healthcare consumers to educate themselves about what they are putting into their bodies.</p>\n\n<p>The next part of that education is to bring these results and your concerns to your healthcare provider and ask them to explain the risk/benefit balance they believe is being achieved with this particular mix of medications. At the same time, make sure they are aware of the over-the-counter medications you are using as well, and get their advice on which of those to use or avoid with the mix of medications you are on. </p>\n\n<p>Your question was, \"How offput should one be by this?\"</p>\n\n<p>The ultimate answer for you question is be offput enough to <em>really</em> understand the decisions being made for you in the physician's office, so you can help in making those decisions. That is how you become a participant, rather than just a consumer, in your healthcare.</p>\n\n<p><a href=\"http://www.fda.gov/Drugs/ResourcesForYou/ucm163354.htm\">Drug Interactions: What You Should Know</a> is an article published by the U.S. Food and Drug Administration about this very topic.</p>\n" }, { "answer_id": 1333, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 2, "selected": false, "text": "<p>These programs tend to flag <em>all</em> interactions, making it difficult for the patient to interpret the reaction's significance.</p>\n<p>A decreased effect is usually not as dangerous (or as noticeable) as an increased effect (depending on the medication, of course), for example decreasing the metabolism of coumadin - a blood thinner - or it's active metabolites by adding an agent which inhibits it's clearance (e.g. an antifungal agent, ketaconazole). This can result in a life-threatening increased effect of coumadin.</p>\n<p>Note also that not all drug checkers are alike in their ability to calculate risks/side effects.</p>\n<p>For example, at Web.MD, the combination of ketoconazole oral + warfarin oral will give you a &quot;serious&quot; risk:</p>\n<blockquote>\n<p>ketoconazole oral will increase the level or effect of warfarin oral by altering drug metabolism</p>\n</blockquote>\n<p>But <a href=\"http://www.drugs.com/interactions-check.php?drug_list=1412-0,2311-0&amp;types%5B%5D=major&amp;types%5B%5D=minor&amp;types%5B%5D=moderate&amp;types%5B%5D=food&amp;professional=1\" rel=\"nofollow noreferrer\">Drugs.com</a> gives only a &quot;moderate&quot; risk, with the &quot;professional&quot; option going into more detail:</p>\n<blockquote>\n<p>MONITOR: Azole antifungal agents that are potent inhibitors of CYP450 3A4 such as itraconazole, ketoconazole, and posaconazole may increase the plasma concentrations and hypoprothrombinemic effect of warfarin... (etc.)</p>\n<p>MANAGEMENT: Patients receiving warfarin should be closely monitored during concomitant therapy with azole antifungal agents that are potent inhibitors of CYP450 3A4. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation, change of dosage, or discontinuation of azole antifungal therapy. The same precaution may be applicable during therapy with other coumarin anticoagulants, although clinical data are lacking. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.</p>\n</blockquote>\n<p>And gives you references!</p>\n<p>This is not a recommendation of one over another, but an example of how online checkers differ. A third option is to Google only the drugs you're mixing, which will give you not only several calculators but specific papers.</p>\n<p>In my opinion, the best advice you can get is from a clinical pharmacologist, or from programs written for professionals by clinical pharmacologists. These programs cost money.</p>\n<p>You might be wise to approach drug interactions by asking both your doctor (when the drug is prescribed) <em>and</em> your pharmacist; if they have different advice, they should resolve it by discussing with a clinical pharmacologist.</p>\n<p>_{Even though I check for and advise patients about possible drug interactions, I <em>always</em> tell them to check with their pharmacist as well (in fact, it's a written part of my discharge instructions when I've prescribed a drug, mostly because many patients don't report all the drugs they are taking, don't consider OTC medications as drugs, etc.) This is a case where two heads are better than one.}</p>\n" } ]

[ "https://health.stackexchange.com/questions/1307", "https://health.stackexchange.com", "https://health.stackexchange.com/users/832/" ]

[ { "answer_id": 1314, "author": "Kenshin", "author_id": 83, "author_profile": "https://health.stackexchange.com/users/83", "pm_score": 2, "selected": false, "text": "<p>I have seen many lists of macro-nutrients that exclude alcohol but this is often due to the fact that alcohol is not essential to our survival. Alcohol is the only other substance that provides the body energy in addition to the three main macro-nutrients.</p>\n\n<p>In short, alcohol definitely can be absorbed by the body (as evidenced by the behaviors exhibited by many after consuming large quantities of it) and the body is able to utilize the energy from alcohol. Therefore you should definitely include it in your Calorie counting.</p>\n\n<p>This site has a list of various alcoholic beverages and their energy contents for you to peruse at your leisure:</p>\n\n<p><a href=\"http://www.weightlossresources.co.uk/calories-in-food/alcoholic-drinks.htm\" rel=\"nofollow\">http://www.weightlossresources.co.uk/calories-in-food/alcoholic-drinks.htm</a> </p>\n" }, { "answer_id": 10546, "author": "Volker", "author_id": 7707, "author_profile": "https://health.stackexchange.com/users/7707", "pm_score": 0, "selected": false, "text": "<p>Alcohol metabolism has evolved in most living beings as a vital part of digesting fermenting food. This is a process that happens naturally in the gut even if you don't drink alcohol. The digestive system has evolved to not waste such a valuable source of energy many millions of years ago. There is a complete enzyme chain in place to break down and use alcohol as a source of energy. \nPlease note that naturally occurring fermentation yields only small amounts of alcohol and that our digestive system is not geared to deal long term with the large amounts of alcohol that some people ingest. Liver damage occurs when the enzymes available to break down alcohol safely get overwhelmed and leave toxic metabolites behind which then in turn damage liver cells. \nSo the answer is : yes - alcohol will definitely make you gain weight, roughly to the tune of 7 calories per gram. </p>\n" }, { "answer_id": 10548, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 3, "selected": true, "text": "<p>There is some agreement that the calories and other nutrition data, except the percent of alcohol, do not need to be shown on the labels of alcoholic beverages.</p>\n\n<p>But these nutrition facts are listed in the <a href=\"https://ndb.nal.usda.gov/ndb/search/list\" rel=\"nofollow noreferrer\">USDA.gov nutrients database</a> (search for beer, wine, vodka, gin...)</p>\n\n<p>For example, <a href=\"https://ndb.nal.usda.gov/ndb/foods/show/4158?fgcd=&amp;manu=&amp;lfacet=&amp;format=&amp;count=&amp;max=50&amp;offset=&amp;sort=default&amp;order=asc&amp;qlookup=vodka&amp;ds=\" rel=\"nofollow noreferrer\">1 jigger or 1.5 oz of 80 proof vodka has 97 Calories.</a> These calories represent \"metabolic energy,\" which is energy that can be actually used by your body.</p>\n\n<p>A source that claims that alcohol provides metabolic energy:</p>\n\n<ul>\n<li><a href=\"http://www.nature.com/ejcn/journal/v61/n1s/fig_tab/1602938t3.html\" rel=\"nofollow noreferrer\">European Journal of Clinical Nutrition</a>: Alcohol has 29.6 kJ (7 Cal) of combustible energy and 29 kJ (6.9 Cal) of metabolic energy per gram.</li>\n</ul>\n" } ]

[ "https://health.stackexchange.com/questions/1313", "https://health.stackexchange.com", "https://health.stackexchange.com/users/193/" ]

[ { "answer_id": 1721, "author": "Alex L", "author_id": 1175, "author_profile": "https://health.stackexchange.com/users/1175", "pm_score": 4, "selected": true, "text": "<p><strong><a href=\"http://www.aafp.org/afp/2006/0801/p449.html\">Antidepressant Discontinuation Syndrome</a></strong></p>\n\n<p>Affects approximately 20% of patients who experience abrupt discontinuation of an antidepressant that has been taken for at least 6 weeks. There are a myriad of symptoms including flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal.</p>\n\n<p>The definitive cause of antidepressant discontinuation syndrome is currently unknown. However, there is speculation of temporary deficiencies in synaptic serotonin which is compounded by hypoactive receptors remaining in that state for days to weeks. This is thought to be the direct cause or indirect cause (due to downstream effects on other neurotransmitter systems) for antidepressant discontinuation syndrome.</p>\n\n<p>So far not enough quality <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627130/#__sec5title\">studies</a> have been done to fully understand the causes for antidepressant discontinuation syndrome.</p>\n" }, { "answer_id": 11537, "author": "R. A.", "author_id": 8528, "author_profile": "https://health.stackexchange.com/users/8528", "pm_score": 2, "selected": false, "text": "<p>Short answer: No. There is no technical term for \"brain zaps.\"</p>\n\n<p>\"Antidepressant discontinuation syndrome\" accurately names the <em>cause</em> of brain zaps, but brain zaps are only one of many symptoms of antidepressant discontinuation syndrome.</p>\n\n<p>WebMD calls them \"electric shock sensations,\" psychopharmacologyinstitute.com calls them \"electric shock-like sensations\" and (possibly, assuming they're referring to the same thing) \"rushing sensations in the head.\"</p>\n\n<p><a href=\"https://www.psychologytoday.com/blog/creativity-way-life/201107/fireworks-or-brain-zaps\" rel=\"nofollow noreferrer\">Psychology Today</a> refers to them as \"Brain zaps, brain shivers, brain shocks, head shocks or electrical shocks\" and describes them as \"brief but repeated electric shock-like sensations in the brain and head, or originating in the brain but extending to other parts of the body.\"</p>\n\n<p>Medhealthdaily.com says some folks refer to them as \"cranial shivers.\"</p>\n\n<p>A variety of sources are proposing \"myalotinasis\" from the Greek for \"brain\" and \"jolt,\" but although it certainly sounds much more medical, it doesn't seem to be catching on.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1321", "https://health.stackexchange.com", "https://health.stackexchange.com/users/838/" ]

[ { "answer_id": 1392, "author": "jonpd", "author_id": 736, "author_profile": "https://health.stackexchange.com/users/736", "pm_score": 3, "selected": true, "text": "<p>I'm not a dentist, and I would look forward to reading other answers (I believe this topic is misunderstood and there is a lack of guidance generally), but these are my top tips:</p>\n\n<p><strong>Don't brush straight after eating</strong></p>\n\n<p>Your mouth becomes acidic after eating, and this can last for 60 minutes or so. So brushing immediately after eating is a bad idea, no matter what you've eaten, because the acidity will temporarily weaken the enamel. </p>\n\n<p><strong>Brush lightly</strong></p>\n\n<p>I believe you can brush too hard, and I've heard that brushing should be more like a gentle tickle, without forcing the brush against your teeth, but I think this is hard to get across, as it is rather subjective. The very term 'brushing' also refers to activities that require physical effort and involve forcing things to move, eg brushing the floor or brushing your hair straight, so I'm not surprised if people over do it. Television has also been flooded with toothbrush adverts over the years, which normally contain an animation illustrating particles being 'brushed off' the tooth, and this gives the impression that some force is required.\nAlso, use a toothbrush with soft bristles. </p>\n\n<p><strong>Don't rinse</strong></p>\n\n<p>If you rinse your mouth immediately after brushing, most of the residual toothpaste will be washed out completely, but if you don't rinse then the active ingredients are given a bit longer to help clean your teeth. </p>\n\n<p><strong>Use a circular action</strong> </p>\n\n<p>If you use a small circular action when you brush, then you'll increase the contact of the bristles with the gaps between your teeth, and the circular motion can help to ease out little bits. If you simply move the toothbrush over and along the teeth, there will be less contact with the gaps. </p>\n" }, { "answer_id": 16351, "author": "rocky", "author_id": 13799, "author_profile": "https://health.stackexchange.com/users/13799", "pm_score": -1, "selected": false, "text": "<p>This is an excellent question and, sadly, it is one that doesn't seem to get much attention, even by dental professionals. But it should.</p>\n\n<p><strong>Disclaimer</strong>: The material given below is based on my own observations and study. It is not established dogma.</p>\n\n<p>I'll give my personal answer to this question, but I think this focuses on the wrong aspect: toothbrush brushing. Perhaps the question you are driving at is: what's an effective dental practice that can be used to reduce cavities and periodontal disease? </p>\n\n<p>A toothbrush serves two purposes: </p>\n\n<ol>\n<li>\"cleaning\" teeth in the same way that you would use a broom to dislodge and sweep aside dirt </li>\n<li>applying toothpaste as a polish or wax</li>\n</ol>\n\n<p>I recommendation that you not try to do both things at the same time. </p>\n\n<p>Think of these two things like painting a wall, or waxing a surface like your floor or car: you scrape the surface to remove the old debris, <em>then</em> you apply the paint or wax to a clean(er) surface so it lasts longer. </p>\n\n<p>The same is true here: break up the microfilm and sweep away plaque (and tartar) as a separate step. This is done <em>without</em> toothpaste. After that, apply toothpaste to a clean surface as you would paint a surface. </p>\n\n<p>Notice this is also the process that professional uses to clean your teeth. The step with toothpaste comes at the very end, and perhaps does not need to be done so frequently (as evidenced by the fact that it's not done every dental visit if there are several in succession.)</p>\n\n<p>There are many ways to clean the surface. A wet or dry toothbrush is just one mechanism, but I think it clumsy since most toothbrushes cover more than one tooth, can't get easily at the back or in between of the teeth as other things do. As one alternative, there is Christmas tree-like brush called a proxabrush. There are also toothpicks, dental floss, and you can buy a scraper like the dentist uses (but not as fancy) has sometimes right next to stores that sell toothbrushes and other oral supplies. But if you do use a metal scraper, I'd go very gently; (Dental enamel <a href=\"http://www.sciencefocus.com/article/human-body/how-hard-tooth-enamel-compared-to-other-materials\" rel=\"nofollow noreferrer\">is harder than steel but it is more brittle</a>); also stay away from the gums. There is something commonly found, and that is less hard than enamel, and kind of obvious that can be used. I suspect many people may find it gross: your fingernail.</p>\n\n<p>But here's a case for the fingernail. Consider this example of a mouth with advanced tartar: \n<a href=\"https://i.stack.imgur.com/VYtnR.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/VYtnR.png\" alt=\"enter image description here\"></a></p>\n\n<p>Between a toothbrush and your fingernail, which do you think would be able to do better at removing the tartar in affected areas? I'd submit that even compared to a toothpick, a fingernail can be better for certain areas. You can feel the flaring of the tooth and make sure to get in that area, for example. Concerned about germs? Disinfect your finger and fingernail.</p>\n\n<p>Ok. So now that we've separated the cleaning and toothpaste part. Let's get to the toothpaste since that's what everyone seems to focus on. Again think of it like painting. Brush in one direction, at an angle with little force engaging just the tip. A toothbrush is after all just a brush like a broom or a paint brush. All of the ways you can damage a paintbrush quickly by using too much paint on it, smashing it perpendicularly into the surface and moving in random haphazard directions apply to a toothbrush as well. It is the same physical forces. In the painting community, a lot has been written about how to prolong the life of brushes and the proper way to use a brush. For example, <a href=\"https://www.youtube.com/watch?v=mhOzqI0mWmA\" rel=\"nofollow noreferrer\">this link</a> shows what happens when you push with a brush rather pull with it. <a href=\"http://journals.sagepub.com/doi/pdf/10.1177/00220345800590120401\" rel=\"nofollow noreferrer\">This article</a> has pictures of worn out tooth brushes.</p>\n\n<p>But rather than tell you how not to damage a toothbrush, the usual dental recommendation is to just throw the toothbrush out and buy another one (which you can also then damage quickly). </p>\n\n<p>But here's another alternative that I don't think has gotten much attention: why not also use your finger? Here this is for spreading it around, not for abrasive use. After that you can swish the toothpaste around in your mouth to cover in between the teeth, then then spit the stuff out. You'll find that you do this faster and more efficiently, use less toothpaste while covering more surface area this way. </p>\n\n<hr>\n\n<p>Okay having written all of the above, I'll just say that the toothbrush and toothpaste (especially in areas with fluoridated water) is as not important as cleaning the surface which is done more effectively by means other than via a toothbrush. This I largely haven't described. That's not to say that a toothbrush is useless, just not every effective given that there are other very simple alternatives. </p>\n\n<p>But that's a topic for a different question, and one which I also think has not been covered very much. </p>\n\n<p>If this verbiage isn't enough I've written about this also in <a href=\"https://rockyramblings.quora.com/Demystifying-Dental-Care\" rel=\"nofollow noreferrer\">https://rockyramblings.quora.com/Demystifying-Dental-Care</a> . </p>\n" }, { "answer_id": 25749, "author": "Ojasvi", "author_id": 19734, "author_profile": "https://health.stackexchange.com/users/19734", "pm_score": 1, "selected": false, "text": "<p>There are a number of techniques available to brush one's teeth and gums.\nNow each technique has its own indications and contraindications.\nTo name a few these include, modified bass technique, charter's technique, horizontal scrub technique, vertical, Stillman, etc etc.<a href=\"https://periobasics.com/tooth-brushing-techniques/\" rel=\"nofollow noreferrer\">Reference</a></p>\n<p>Now as you have mentioned that the best technique for someone who has healthy teeth and healthy gums, and considering that individual is dextrous.</p>\n<p>A number of researches and studies have been done to find out the best technique for plaque removal.\nAnd all of them have presented similar results.</p>\n<blockquote>\n<p>This review has found that, compared to all the prevalent\ntoothbrushing techniques, modified Bass/Bass technique is the most effective in reducing plaque and gingivitis.\n<a href=\"https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;url=https://www.jcdr.net/articles/PDF/12204/32186_CE%5BRa1%5D_F(SL)_PF1(AB_SHU)_PFA(SHU)_PB(AB_SL)_PN(SHU).pdf&amp;ved=2ahUKEwj1gJ_02fXuAhVKAXIKHVCED-gQFjAVegQIDBAC&amp;usg=AOvVaw0wlr_qTMS8hTt4_ym6flW_&amp;cshid=1613729391294\" rel=\"nofollow noreferrer\">Reference</a></p>\n</blockquote>\n<p>Another <a href=\"https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;url=https://www.researchgate.net/publication/283495464_Tooth_Brush_and_Brushing_Technique&amp;ved=2ahUKEwj1gJ_02fXuAhVKAXIKHVCED-gQFjAUegQIIRAC&amp;usg=AOvVaw0_7SwaIJlJFBVzJN_VlvsY&amp;cshid=1613729391294\" rel=\"nofollow noreferrer\">article</a> to claim that modified bass technique is the most effective method-</p>\n<blockquote>\n<p>Most widely accepted and most effective method.</p>\n</blockquote>\n<p>Now how to do the modified bass technique?</p>\n<p><img src=\"https://i.stack.imgur.com/3N2DF.jpg\" alt=\"enter image description here\" /></p>\n<p><img src=\"https://i.stack.imgur.com/kH0ob.jpg\" alt=\"enter image description here\" /></p>\n<p><img src=\"https://i.stack.imgur.com/rIv4S.jpg\" alt=\"enter image description here\" /></p>\n<p><a href=\"https://www.sensodyne.in/blogs/tooth-brushing-techniques.html\" rel=\"nofollow noreferrer\">Reference</a></p>\n<p><a href=\"https://www.ada.org/en/member-center/oral-health-topics/toothbrushes\" rel=\"nofollow noreferrer\">American Dental Association</a> also suggests this same technique.\nAlso according to ADA,</p>\n<blockquote>\n<p>Regardless of the technique used, brushing should touch upon all surfaces—inner, outer and chewing. Also, when brushing, the ADA recommends that people use a soft-bristled toothbrush and apply gentle pressure, both of which may help reduce the risk of gingival injury</p>\n</blockquote>\n<p><a href=\"https://www.ada.org/en/member-center/oral-health-topics/toothbrushes\" rel=\"nofollow noreferrer\">Reference</a></p>\n<p>You may also find other helpful instructions in the same website regarding toothpastes, toothbrushes, etc.</p>\n<p>Hope I have satisfactorily answered your question :)</p>\n" } ]

[ "https://health.stackexchange.com/questions/1376", "https://health.stackexchange.com", "https://health.stackexchange.com/users/87/" ]

[ { "answer_id": 1431, "author": "Agent_L", "author_id": 929, "author_profile": "https://health.stackexchange.com/users/929", "pm_score": 4, "selected": false, "text": "<p>There are two mechanisms of action how light affect humans discussed here:</p>\n\n<ol>\n<li>Amount of energy: shorter (blue) wavelengths are more energetic than lower (red), so it can be assumed that they damage photoreceptors more.</li>\n<li>Psychological: bluish light is associated with day by our biochemistry. Higher amounts of bluish light makes our brains more awake (e.g. suppressing production of melatonin)</li>\n</ol>\n\n<p>Point 1 leaves conclusion that reducing amount of blue light from the monitor is always a good thing, while point 2 means that it's helpful as you plan to go to sleep. From my experience I can say that #2 is very true, as dim and warm light in the workplace made me sleepy and inefficient. Changing light sources to bright and cool fluorescent lights helped a lot. Also I've installed RGB led lighting in my living room and discovered that using only red light at the end of the day makes falling asleep easier. Just looking at BenQ's idea it certainly appeals to me.</p>\n\n<p>However, the purpose of a monitor is to reproduce colors accurately. The question remains if the amount of blue can be reduced without affecting either color balance or just lowering brightness altogether. Modern \"white\" LEDs commonly used as source of light in LCD monitors are primarily blue light sources with some yellow phosphorus thrown in to balance out main emission. If BenQ used different kind of LEDs of CCFLs (less bluish) then this technology could not be turned on and off, much less adjusted. To truly limit the amount of certain component on the fly, RGB-LEDs would have to be used as backlight (they are not used here, and I'm not aware of any affordable monitor with RGB LEDs). What is presented on the video seems like simply changing color temperature to a warmer one - which is available in almost every color monitor. Even if it's not plain old color temperature, but something more sophisticated, e.g. clamp on blue channel in gamma ramp then same effect can still be achieved in software, in graphic card's gamma settings.</p>\n\n<p>I disagree much with the video on the site you've linked. Even layman like me can easily point out errors:</p>\n\n<ol>\n<li>Saying that blue light is almost as bad as UV light just because it sits next to it on a spectrum is plain scaremongering. The biggest danger of UV comes from the fact that human eye can't see UV, so it won't close the iris to block it. The eye may \"think\" it's dark in very bright UV light and let it all in. Blue light, as part of visible spectrum, does not present this danger.</li>\n<li>The picture of blue-violet going \"deep into your eye\" is laughable. It shows other parts of spectrum stop at the lens while only blue reaches retina. It's plain lie, of course. Red and green do reach the retina just as well, otherwise we wouldn't be able to perceive them.</li>\n</ol>\n\n<p>Bottom line: <strong>I think that the idea of reducing amount of blue light is good, but BenQ's execution is just a marketing gimmick or not much more</strong> in the best case.</p>\n\n<p>If you really want to considerably reduce amount of blue light coming from your monitor, I recommend changing white backgrounds to yellow ones (if you work with lots of white backgrounds). This will drastically cut blue light reaching your eyes in a way not possible when still retaining impression of whiteness. Of course, eliminating large, bright areas by using dark themes (white-on-black text) will greatly cut ALL light.</p>\n\n<p>If you seek to reduce strain on your eyes from monitor then I agree with statement that the biggest issue is not just the amount of light coming from the monitor. The biggest factor IMHO is the <strong>difference</strong> between monitor and it's background, that is the rest of the room. Therefore never use a computer/phone/tablet in total darkness - leave some nightlight + lower brightness to match. Also don't be afraid to crank up monitor up to 11 in a sunny day. Most monitors are set up to allow easy access to brightness and contrast adjustment - exactly for this very reason. They are meant to be used every time light in the room changes.</p>\n" }, { "answer_id": 9735, "author": "poshest", "author_id": 7134, "author_profile": "https://health.stackexchange.com/users/7134", "pm_score": 1, "selected": false, "text": "<p>I don't have any information about whether the Benq monitor in particular will effectively reduce blue light.</p>\n<p>But to your question... &quot;Is it helpful?&quot;</p>\n<p><a href=\"http://articles.mercola.com/sites/articles/archive/2016/10/23/near-infrared-led-lighting.aspx\" rel=\"nofollow noreferrer\">This article</a> is fairly well referenced, and includes an interview with Dr Wunsch, a German light therapist. In summary, it seems long exposure to blue light from artificial sources is indeed a bad for you in both the ways mentioned by Agent_L.</p>\n<p>The article mentions blue-blocking glasses as an alternative solution. Maybe give that a try - it'll be cheaper than a new monitor, and even the layman that Agent_L's mentions, would probably accept that blue light is reduced by wearing a filter over your eyes.</p>\n<p>UPDATE: a partially functional archive copy of this article is now <a href=\"https://archive.ph/wShBy\" rel=\"nofollow noreferrer\">here</a>.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1377", "https://health.stackexchange.com", "https://health.stackexchange.com/users/877/" ]

[ { "answer_id": 1424, "author": "Iron Pillow", "author_id": 332, "author_profile": "https://health.stackexchange.com/users/332", "pm_score": -1, "selected": false, "text": "<p>If you weigh 400 pounds, the answer is: No.</p>\n\n<p>If you are an Olympic distance swimmer, the answer is: Go ahead.</p>\n\n<p>If you are in between, the answer is: See your doctor.</p>\n\n<p>In other words, no one can give you a safe answer without knowing a lot more about you. It is unwise to ask questions like this on the internet, and even unwiser to heed the answers.</p>\n" }, { "answer_id": 1430, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": true, "text": "<p>Provided that you are healthy, not suffering from a cold, disease state or other suppression of the immune system, moderate exercise during fasting periods should not impact your health. For submaximal efforts, you may notice earlier fatigue, and there will be definite performance impacts the closer you get to maximal efforts.</p>\n\n<p>Caveat: You are still introducing an artificial state (fasted), which may have health complications. I would schedule a consult with a physician and explain your plans, and have them give you a checkup with that in mind before starting this.</p>\n\n<p>However, there will be some impact on the effective level of the exercise, and how well you are able to perform the exercise during the later parts of the fasting period. These changes include depression in max VO2 (Although this value is more of a performance predictor, not really a measurement metric), higher levels of free fatty acids (FFA's) in the blood, as well as a somewhat suppressed gluconeogenesis as well as a concurrent rise in fat based oxidation for energy.</p>\n\n<p>What this means, is that your body will (mostly) use up all muscle and hepatic (liver) glycogen storage, and will turn to fax oxidation (ketone bodies) for fuel. There is not that much difference in the lactate/pyruvate levels during this time, suggesting that the switch is adequate to fuel performing muscles. There are other short term changes in several hormone and substrate (glycogen, pyruvate, lactate, etc) levels, but these are returned to normal after resuming normal dietary intake.</p>\n\n<p>While not an ideal state to pursue, intermittent periods of short fasting ( &lt; 12 hours) or even up to a few days shouldn't have any health impacts, although you may notice some performance impairment.</p>\n\n<p><a href=\"http://ajpendo.physiology.org/content/238/4/E322\" rel=\"noreferrer\">This study</a> I was able to obtain, only the first page is freely available. This took 5 obese subjects, and in a clinical setting (hospital), underwent a 3-5 week fast, with only water and vitamin supplements for health. They showed the changes described above in hormone and substrates, with a drop in VO2 max levels at the 2 and 4 week exercise marks. There was also substantial weight loss, but that is to be expected. They showed no other adverse health effects during the prolonged fast, but to emphasize, they had adequate water intake and daily vitamin and potassium supplementation.</p>\n\n<p>Another paper <a href=\"http://www.dartmouthsports.com/pdf9/2318985.pdf?DB_OEM_ID=11600\" rel=\"noreferrer\">available through Dartmouth Sports</a> looked at 12 hour fasting for Ramadan and the effect on athletic performance, and found that even in the limited fasting state, there is some performance impact. One passage stands out in the paper:</p>\n\n<blockquote>\n <p>An extensive review of the older literature on the effects of \n fasting on endurance performance was published by Aragón-\n Vargas.(21)\n The conclusion of this review was that a short period \n (24 h to 4 days) of fasting in humans resulted in a decreased \n capacity to perform endurance exercise. In spite of a rather \n consistent effect of fasting, however, there was no clear evi-\n dence as to the mechanism responsible for the earlier onset of \n fatigue.</p>\n</blockquote>\n\n<p>That is corroborated by other sections in the paper, one detailing performance impacts on cycling at 100% VO2 max level after 24 hours fast, and impacts on high intensity events such as the 100m and 800m runs. Interestingly, one section shows no difference in muscle glycogen stores in the absence of exercise during fasting.</p>\n\n<blockquote>\n <p>There may be some effect of a reduction in the muscle \n glycogen store on the maximal rates of muscle glycogenol-\n ysis with a consequent loss of exercise performance dur-\n ing high-intensity exercise, but a few days of fasting in \n the absence of exercise has little effect on muscle glycogen \n content.(18)</p>\n</blockquote>\n\n<p>They do postulate that because of the metabolic acidosis that starts rising with prolonged fast is part of the reason for early fatigue in exercise, which is interesting.</p>\n\n<p>The second paper also has 57 cited studies relating to exercise in a fasted state.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1393", "https://health.stackexchange.com", "https://health.stackexchange.com/users/891/" ]

[ { "answer_id": 2016, "author": "FarO", "author_id": 1472, "author_profile": "https://health.stackexchange.com/users/1472", "pm_score": 0, "selected": false, "text": "<p>Rising removes the material the toothbrush detached. I see no reason NOT to rinse. The main use of tooth paste is actually to provide a suspension where the food and other particles can be incorporated during brushing. If you don't rinse, they will deposit again.</p>\n\n<p>Source: <a href=\"https://www.choice.com.au/health-and-body/dentists-and-dental-care/dental-products/articles/toothpaste-whats-the-difference\" rel=\"nofollow\">https://www.choice.com.au/health-and-body/dentists-and-dental-care/dental-products/articles/toothpaste-whats-the-difference</a> \"Tartar is the build-up of hardened plaque that can lead to gum disease. Although regular brushing can minimise its build-up, tartar can only be properly removed by a dentist. Of the toothpastes we looked at, almost all contain a tartar suspension agent – the most common being pyrophosphates and xanthan gum – designed to suspend tartar particles in saliva and prevent them from clinging to teeth.\"</p>\n\n<p>Other source: <a href=\"http://www.stab-iitb.org/newton-mirror/askasci/chem03/chem03188.htm\" rel=\"nofollow\">http://www.stab-iitb.org/newton-mirror/askasci/chem03/chem03188.htm</a></p>\n" }, { "answer_id": 18234, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 4, "selected": true, "text": "<p>The previous answer does not refer to clinical studies so I thought I would have a look.</p>\n\n<p>TLDR; the clinical studies I've seen suggest not to rinse with water after brushing.\n<hr>\nAccording to <a href=\"https://doi.org/10.1007/s41894-018-0025-5\" rel=\"noreferrer\">Doméjean, et al. (2018)</a>, you should not rinse after brushing.</p>\n\n<blockquote>\n <p>For maximizing the topical effect of the fluoride toothpaste, patients should be encouraged to spit out excess toothpaste and not rinse with water after brushing (<a href=\"https://doi.org/10.1007/s41894-018-0025-5\" rel=\"noreferrer\">Doméjean, et al. 2018</a>).</p>\n</blockquote>\n\n<p><a href=\"https://doi.org/10.1159/000016540\" rel=\"noreferrer\">Ashley, et al. (1999)</a> looked at the DMFT (Decayed, Missing or Filled Teeth) levels for rinsing with water and no rinsing, and the DMFT levels were lower amongst those who rinsed by other methods or did not rinse after brushing. However, those who claimed not to rinse had a lower mean DMFT than the other subjects, which was <em>\"on the borderline of significance\"</em>.</p>\n\n<blockquote>\n <p>The mean DMFT of the 1,137 subjects who rinsed with a cup or beaker of water after brushing was significantly higher (mean 3.97, SD 3.74) than those who rinsed by other methods or did not rinse (mean 3.61, SD 3.79, p= 0.012, table 1). This represents a 9% difference in DMFT when compared with those who did not use a beaker. The 69 (2%) who claimed not to rinse had a lower mean DMFT (2.91, SD 3.24) than the other subjects, which was on the borderline of significance (p= 0.063) (<a href=\"https://doi.org/10.1159/000016540\" rel=\"noreferrer\">Ashley, et al. 1999</a>)</p>\n</blockquote>\n\n<p>So to answer your question</p>\n\n<blockquote>\n <p>Should we rinse with water after brushing our teeth?</p>\n</blockquote>\n\n<p>Looking at the DMFT levels after rinsing with water compared to not, and looking at <a href=\"https://doi.org/10.1007/s41894-018-0025-5\" rel=\"noreferrer\">Doméjean, et al. (2018)</a>, <strong>the clinical studies suggest not to rinse with water after brushing</strong></p>\n\n<h2>References</h2>\n\n<p>Ashley, P. F., Attrill, D. C., Ellwood, R. P., Worthington, H. V., &amp; Davies, R. M. (1999). Toothbrushing habits and caries experience. <em>Caries research, 33</em>(5), 401-402. doi: <a href=\"https://doi.org/10.1159/000016540\" rel=\"noreferrer\">10.1159/000016540</a></p>\n\n<p>Doméjean, S., Muller-Bolla, M., &amp; Featherstone, J. D. (2018). Caries preventive therapy. <em>Clinical Dentistry Reviewed, 2</em>(1), 14. doi: <a href=\"https://doi.org/10.1007/s41894-018-0025-5\" rel=\"noreferrer\">10.1007/s41894-018-0025-5</a></p>\n" }, { "answer_id": 21184, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 2, "selected": false, "text": "<h2>Summary:</h2>\n\n<ul>\n<li>Not rinsing after tooth brushing may somewhat increase the effectiveness of fluoridated toothpaste, but the evidence is inconsistent and the effect can vary greatly among individuals.</li>\n<li><a href=\"http://www.oralanswers.com/rinse-after-brushing/\" rel=\"nofollow noreferrer\">One possible explanation</a> for inconsistent effect: not rinsing after brushing appears to be only beneficial if you are at a high risk of getting cavities.</li>\n<li>Researchers and dental experts usually do not mention any time to wait before rinsing.</li>\n<li><a href=\"https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1741-2358.2001.00015.x\" rel=\"nofollow noreferrer\">Some authors</a> recommend a single brief slurry rinse. This can remove the toothpaste from the tongue and cheeks and greatly reduce the unpleasant aftertaste of the toothpaste, while still keeping the fluoride on the teeth.</li>\n</ul>\n\n<h2>Evidence:</h2>\n\n<p><strong>1)</strong> <a href=\"https://www.researchgate.net/publication/224005110_Post-brushing_rinsing_for_the_control_of_dental_caries_Exploration_of_the_available_evidence_to_establish_what_advice_we_should_give_our_patients\" rel=\"nofollow noreferrer\">Post-brushing rinsing for the control of dental caries: exploration of the available \nevidence to establish what advice we should give our patients, British Dental Journal, 2012</a></p>\n\n<p>The opinion of participants of the 2012 meeting between the authors and other \nexperts in the UK:</p>\n\n<blockquote>\n <p>Rinsing with water after brushing with fluoride toothpaste can reduce\n the benefit of fluoride toothpaste.</p>\n \n <p>Post-tooth brushing rinsing behaviours have the potential to <strong>either\n reduce or enhance the effectiveness of fluoride toothpaste</strong> and show\n <strong>wide variation in the general population.</strong> There is a lack of\n high-quality evidence to support definitive guidance in this area.</p>\n</blockquote>\n\n<p><strong>2)</strong> <a href=\"https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1741-2358.2001.00015.x\" rel=\"nofollow noreferrer\">The influence of rinsing routines on fluoride retention after toothbrushing (Gerodontology, 2001)</a>:</p>\n\n<blockquote>\n <p>It is suggested that for maximal effect, brushing with fluoride\n toothpaste should be followed by <strong>one brief slurry rinse,</strong> at the\n convenience and comfort of the patient/user.</p>\n</blockquote>\n\n<p><strong>3)</strong> <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12399689\" rel=\"nofollow noreferrer\">Prospective study of the effect of post-brushing rinsing behaviour on dental caries (Caries Research, 2002)</a></p>\n\n<blockquote>\n <p>A 3-year clinical trial of daily supervised brushing with fluoride\n toothpaste at school was used to test the effect of post-brushing\n rinsing with water on caries increment. A total of 407 children, mean\n age 11.8 years, attending three schools in Kaunas, Lithuania were\n enrolled following informed consent of the children and their parents.\n Caries was recorded at baseline and annually for 3 years. During the\n study, children in two schools (A and B) performed daily supervised\n brushing with a 1,500-ppm fluoride toothpaste. <strong>Children in school A\n rinsed their mouths thoroughly with a beaker of water after\n toothbrushing whereas children in school B were only permitted to spit\n out once after brushing.</strong> Furthermore, the children in these schools\n were supplied with toothpaste and toothbrushes for use at home and in\n school. A third school (C), without daily brushing and without supply\n of toothpaste, served as control. Compliance with the protocol was\n consistently better in school B. After 3 years 276 children were\n available for examination. Three-year DMFS increments, including\n non-cavitated lesions (mean, 95% CI), were: school A, 6.8 (5.3; 8.3);\n school B, 6.2 (4.6; 7.8), and school C, 12.4 (10.6; 14.1). Mean\n increments for schools A and B did not differ significantly but were\n both significantly lower than those of school C (p&lt; 0.001). It is\n concluded that post-brushing <strong>rinsing with water, under the\n conditions of this study, does not significantly affect the caries\n reducing effect of a fluoride toothpaste.</strong></p>\n</blockquote>\n\n<p><strong>4)</strong> <a href=\"https://www.karger.com/Article/Abstract/16540\" rel=\"nofollow noreferrer\">Toothbrushing habits and caries experience (Caries Research, 1999)</a></p>\n\n<blockquote>\n <p>The mean DMFT of the 1,137 subjects who rinsed with a cup or beaker of\n water after brushing was significantly higher (mean <strong>3.97</strong>, SD 3.74)\n than those who rinsed by other methods or did not rinse (mean <strong>3.61</strong>, SD\n 3.79, p= 0.012, table 1). This represents a 9% difference in DMFT when compared with those who did not use a beaker. The 69 (2%) who claimed\n not to rinse had a lower mean DMFT (2.91, SD 3.24) than the other\n subjects, which was on the borderline of significance (p= 0.063).</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/1401", "https://health.stackexchange.com", "https://health.stackexchange.com/users/87/" ]

[ { "answer_id": 1419, "author": "TFD", "author_id": 842, "author_profile": "https://health.stackexchange.com/users/842", "pm_score": -1, "selected": true, "text": "<p>Most viruses can be in your body with no indications or current antibodies to detect</p>\n\n<p>Viruses live inside your cells, if they stay there they are very hard to detect, but may also do no damage, so they are generally not a problem</p>\n\n<p>While some medical organisations may claim they can detect a virus from blood test, there is no 100% guarantee, especially if it not currently causing as antibody reaction</p>\n\n<p>For HSV specifically, the antibody tests are known not to be 100% accurate. The main failure is for lack of detection, not for false positive. See <a href=\"http://cid.oxfordjournals.org/content/35/Supplement_2/S173.full\" rel=\"nofollow\">oxford journals</a></p>\n\n<p>Many people get HSV (1 or 2), have one minor reaction, which they may not even notice, and that's it for the rest of their live, no further issues. Only a small percentage of the population have continual issues. This applies to many other viruses</p>\n\n<p>You can probably also say that close to 100% of people will carry the HSV virus by their time of death. So don't worry about it</p>\n\n<p>If you have active sores from HSV, treat them, and avoid behaviour that would spread them</p>\n\n<p>...\"Unlike love, Herpes is forever\"</p>\n" }, { "answer_id": 1444, "author": "Fomite", "author_id": 206, "author_profile": "https://health.stackexchange.com/users/206", "pm_score": 2, "selected": false, "text": "<p>There are several types of HSV tests, with varying benefits and drawbacks. To address your questions regarding the antibody test:</p>\n\n<ul>\n<li>Can it detect an inactive infection: Yes. The antibody test isn't actually looking for the virus, it's looking for signs that your body has responded to an infection and produced antibodies for it. As such, infections in the past that are now inactive <em>may</em> produce a positive antibody test, though this depends on a lot of factors, like how long ago the infection took place, etc.</li>\n<li>If that test finds antibodies, does it mean I carry this virus for sure? No. All diagnostic tests have a false positive rate. That being said, based on the literature I can find for people without symptoms, <a href=\"http://cid.oxfordjournals.org/content/35/Supplement_2/S173.full\" rel=\"nofollow\">this rate appears to be fairly low</a>.</li>\n</ul>\n\n<p>It should be noted that <a href=\"http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm\" rel=\"nofollow\">\"CDC does not recommend screening for HSV-1 or HSV-2 in the general population.\"</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1408", "https://health.stackexchange.com", "https://health.stackexchange.com/users/911/" ]

[ { "answer_id": 1479, "author": "Upsilon", "author_id": 980, "author_profile": "https://health.stackexchange.com/users/980", "pm_score": 3, "selected": false, "text": "<p>Well regular sleeping during the day might damage health. Try avoiding it if possible as research has been conducted which suggests that there is a linkage between irregular sleep and hormone production.</p>\n\n<p>Evidence also suggests that lack of sleep won't do you as much damage as irregular or day sleep. I suggest try changing your profession. If that isn't possible due to personal or social reasons then I'd say try adjusting your shift so you can sleep at night.</p>\n\n<p>Erratic sleep is bad no matter what. While you might be able to reduce the effects bit napping at night, it won't make much difference.</p>\n\n<p>You have Vitamin D deficiency because of lack of exposure to sunlight and pills and taking walk in the sunlight can fix that easily.</p>\n\n<p>Growth Hormone deficiency does as a matter of fact effect your sleeping pattern and vice versa. I don't know your age neither am I a doctor but assuming you are young enough, this can be fixed by medical help and change in habits.</p>\n\n<blockquote>\n <p>...shifted sleep appears to disrupt gene activity even more than not getting enough sleep, according to the research.</p>\n</blockquote>\n\n<p>In a study published in PNAS, 22 young, healthy subjects were tested in a sleep lab. Interrupting their sleep so that their longest period of sleep was from noon until about 6:30 p.m., they found</p>\n\n<blockquote>\n <p>On the days of shifted sleep... the number of genes tied to the body's clock dropped dramatically, to 228 genes, or only 1 percent of genes analyzed. ...The researchers estimated that the sleep disruptions would ultimately impact about a third of a person's genes.</p>\n</blockquote>\n\n<p>This is significantly more than found in studies done on sleep deprivation.</p>\n\n<blockquote>\n <p>\"We think that may be related to the negative health outcomes associated with long-term shift work,\" Dijk said. Shift workers are at higher risk for many health problems, including obesity, diabetes, high blood pressure, heart disease, disrupted menstrual cycles and cancer, he said.</p>\n</blockquote>\n\n<p>SOURCE: <a href=\"http://www.webmd.com/sleep-disorders/news/20140121/sleep-during-the-day-may-throw-genes-into-disarray\">WebMD</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21464567\">Growth hormone deficient children</a> have a significant decrease in total sleep time, efficiency, movement and in non-rapid eye movement sleep stage 2.</p>\n" }, { "answer_id": 1509, "author": "Eli Riekeberg", "author_id": 991, "author_profile": "https://health.stackexchange.com/users/991", "pm_score": 2, "selected": false, "text": "<p>Alright let's address some of those deficiencies!</p>\n\n<p>Vitamin-D: You produce this when you stand in the sun. Seriously.\nUnfortunately there isn't really good research about how long to go outside to get enough. Some sources suggest that 30 minutes twice a week is good enough. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17634462?dopt=Abstract\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/17634462?dopt=Abstract</a></p>\n\n<p>AST and the IGF growth factor tests mean that the doc is checking for liver and/or pituitary gland issues that could be affecting your growth or overall health. It's entirely possible that these are out of range and not indicative of a problem. Assuming that you are healthy aside from the Vit-D, we will only consider sleep.</p>\n\n<p>There is quite a bit of evidence for shift workers having increased rates of certain illnesses. Unfortunately, it is hard to say whether this is because of the actual timing of the work or because of the interruptions in sleep that tend to be more prevalent among people who sleep in this way.</p>\n\n<p><a href=\"http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.324.9801&amp;rep=rep1&amp;type=pdf\" rel=\"nofollow\">http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.324.9801&amp;rep=rep1&amp;type=pdf</a> </p>\n\n<p>Long story short, yes. Sleep can cause some illnesses. I can't find any references for growth hormone supression, but sleep disturbances can affect the endocrine system in other ways (like diabetes) that are fairly well documented. Now get off stack-exchange and go to bed. Oh, and go outside tomorrow and get your Vitamin D!</p>\n" } ]

[ "https://health.stackexchange.com/questions/1415", "https://health.stackexchange.com", "https://health.stackexchange.com/users/767/" ]

[ { "answer_id": 1428, "author": "TFD", "author_id": 842, "author_profile": "https://health.stackexchange.com/users/842", "pm_score": -1, "selected": false, "text": "<p>With most off-the-shelf oral laxatives, prune juice, or a couple of Kiwi fruits, they only have a mild laxative effect. They should be used when constipation first becomes painful, and will rarely cause more than one or two irregular bowel motions</p>\n\n<p>Most of these laxatives will require some hours to work, often overnight is the recommended time frame. And they produce a reasonably normal bowel motion when they do work</p>\n\n<p>e..g <a href=\"https://www.dulcolax.com/laxatives.html#faqs\" rel=\"nofollow\">dulcolax</a>, <a href=\"http://www.miralax.com/miralax/faq/index.jspa\" rel=\"nofollow\">miralax</a>, <a href=\"http://www.phillipsrelief.com/phillips-frequently-asked-questions/#quest4\" rel=\"nofollow\">phillips</a> etc</p>\n\n<p>They should not require you to sit on the toilet for six hours. If they did, you do need to see a doctor</p>\n\n<p>Constipation is a good sign you need to change your diet to suite your body better, and if frequent, a sign you need to see a doctor</p>\n" }, { "answer_id": 1448, "author": "Rana Prathap", "author_id": 37, "author_profile": "https://health.stackexchange.com/users/37", "pm_score": 2, "selected": false, "text": "<p><a href=\"https://en.wikipedia.org/wiki/Laxative\" rel=\"nofollow\">Laxatives</a> can be of multiple types - from simple dietary roughage to some OTC mineral oils to prescription intestinal stimulants, there are simply a wide range of substances that can loosen stools and increase bowel movements. </p>\n\n<p>When should one take a laxative? I would say everyday. Dietary fibres are very good laxatives in normal individuals. Any diet should include plenty of dietary fibres. They also reduce the <a href=\"http://www.wjgnet.com/1007-9327/14/6453.pdf\" rel=\"nofollow\">risk of colorectal carcinomas</a> and <a href=\"http://nutritionreviews.oxfordjournals.org/content/67/4/188\" rel=\"nofollow\">reduce cholesterol</a> and are all the more reasons to include in the diet - especially in the western population. For someone who follows a regular food habit and is generally healthy there won't be any reason to take anything else to increase bowel movements. So in short, dietary fibres(roughage) should be your everyday laxative. </p>\n\n<p>If you are acutely constipated for some reason, and is making you miserable, and do not have any other symptoms(such as vomiting, abdominal pain, blood in stool, etc) then you can take an over the counter laxative for one day and see if it resolves the issue. That can be simple mineral oil, castor oil, Isapghula, etc. If a single dose of any of those does not improve your costipation, then you should consult a doctor. The doctor can look at the cause of constipation and prescribe a medicine for you appropriately for a short duration of time. Some people who take certain pills (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26126675\" rel=\"nofollow\">opiod narcotics for example</a>) are likely to be chronically constipated. In that case one may have to use laxatives for a long duration of time, but that decision is taken by a doctor. </p>\n\n<p>The reason why it is not recommended to take a laxative for a long duration of time without a good reason is that some laxatives reduce cause colonic tissues to wear out over time and make the patient permanently consipated(<a href=\"https://en.wikipedia.org/wiki/Laxative#Laxative_gut\" rel=\"nofollow\">laxative gut</a>) There is also the risk of <a href=\"https://en.wikipedia.org/wiki/Laxative#Laxative_abuse\" rel=\"nofollow\">reduced nutrient absorption, fluid and electrolyte imbalance, intestinal paralysis, irritable bowel syndrome, factitious diarrhea, etc</a>. So chronic use of stimulant laxatives should be avoided whenever possible. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1425", "https://health.stackexchange.com", "https://health.stackexchange.com/users/925/" ]

[ { "answer_id": 1436, "author": "Freedo", "author_id": 767, "author_profile": "https://health.stackexchange.com/users/767", "pm_score": 3, "selected": false, "text": "<p>I think there's a link, but no one can say that this is the cause of myopia</p>\n\n<p>According to <a href=\"http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia?sso=y\" rel=\"noreferrer\">American Optometric Association</a> : </p>\n\n<ul>\n<li>The exact cause of nearsightedness is unknown, but two factors may be primarily responsible for its development: Heredity and Visual Stress</li>\n</ul>\n\n<blockquote>\n <p>Even though the tendency to develop nearsightedness may be inherited, its actual development may be affected by how a person uses his or her eyes. Individuals who spend considerable time reading, working at a computer, or doing other intense close visual work may be more likely to develop nearsightedness.</p>\n</blockquote>\n\n<p>Also :</p>\n\n<ul>\n<li><p>Some people may experience blurred distance vision only at night. This “night myopia” may be due to the low level of light making it difficult for the eyes to focus properly or the increased pupil size during dark conditions, allowing more peripheral, unfocused light rays to enter the eye.</p></li>\n<li><p>People who do an excessive amount of near vision work may experience a false or “pseudo” myopia. Their blurred distance vision is caused by over use of the eyes’ focusing mechanism. After long periods of near work, their eyes are unable to refocus to see clearly in the distance. The symptoms are usually temporary and clear distance vision may return after resting the eyes. However, over time constant visual stress may lead to a permanent reduction in distance vision.</p></li>\n<li><p>Symptoms of nearsightedness may also be a sign of variations in blood sugar levels in persons with diabetes or an early indication of a developing cataract.</p></li>\n</ul>\n\n<p><a href=\"http://www.nhs.uk/Conditions/Short-sightedness/Pages/Causes.aspx\" rel=\"noreferrer\">NSH</a> give us more input about your specifics questions :</p>\n\n<blockquote>\n <p>One study found that children who read for 30 minutes or more each day were one-and-a-half times more likely to develop myopia than children who didn't read for this period of time.\n Research has also shown that children who spend time doing outdoor activities, such as playing sports, are less likely to become short-sighted and existing short-sightedness may progress less quickly.\n It is thought that this protective effect could be associated with the higher light levels outside than inside, and the fact that you are not constantly focusing on near objects.\n An \"everything in moderation\" approach is recommended. Although children should be encouraged to read, they should also spend some time away from reading and computer games each day doing outdoor activities.</p>\n</blockquote>\n\n<p>That being said, since most of studies link this cause of effect on developing eye's, i don't think this could make your myopia worse after you is past 21 years old and your eye's is completely grown.</p>\n" }, { "answer_id": 14542, "author": "Fizz", "author_id": 10980, "author_profile": "https://health.stackexchange.com/users/10980", "pm_score": 2, "selected": false, "text": "<p>I think the best known environmental risk factor (to date) for myopia is lack of intense/outdoor light exposure. The pathway for this is reasonably well understood, namely: lack of intense light exposure leads to lowered dopamine, which is necessary to prevent eye growth, which in turn leads to myopia.</p>\n\n<p>This based on relatively recent evidence, but it is of reasonable quality:</p>\n\n<ul>\n<li><p>three successful interventional studies (clinical trials) have been conducted <a href=\"https://doi.org/10.1016/j.ophtha.2012.11.009\" rel=\"nofollow noreferrer\">first in Taiwan</a>, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495846/\" rel=\"nofollow noreferrer\">then in China</a> and <a href=\"https://doi.org/10.1001/jama.2015.10803\" rel=\"nofollow noreferrer\">again in China</a> (<a href=\"https://en.wikipedia.org/wiki/Randomized_controlled_trial\" rel=\"nofollow noreferrer\">RCT</a> this time); there's <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599950/\" rel=\"nofollow noreferrer\">a meta-analysis</a> of these which gives the <a href=\"https://en.wikipedia.org/wiki/Forest_plot\" rel=\"nofollow noreferrer\">forrest plot</a> below:\n<a href=\"https://i.stack.imgur.com/k78Hp.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/k78Hp.png\" alt=\"enter image description here\"></a></p></li>\n<li><p>three older <a href=\"https://en.wikipedia.org/wiki/Cohort_study\" rel=\"nofollow noreferrer\">cohort studies</a> included in the aforementioned meta-analysis also found an association between light exposure and myopia, and so did a bunch of <a href=\"https://en.wikipedia.org/wiki/Cross-sectional_study\" rel=\"nofollow noreferrer\">cross-sectional studies</a>, albeit weakly. The meta-analysis conclusion was \"Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. But paradoxically, outdoor time was not effective in slowing progression in eyes that were already myopic.\" </p></li>\n<li><p>a prospective <a href=\"https://en.wikipedia.org/wiki/Longitudinal_study\" rel=\"nofollow noreferrer\">longitudinal study</a> (i.e. repeated measures) <a href=\"https://doi.org/10.1167/iovs.14-15978\" rel=\"nofollow noreferrer\">in Australia</a> using for the first time a wrist-worn light sensor to measure actual light exposure found \"modest but statistically significant relationship between objectively measured daily light exposure and axial eye growth (adjusting for potential confounders) indicating that greater average daily light exposure results in less axial growth of the eye in childhood.\" And concluded that \"These findings support the role of light exposure in the documented association between time spent outdoors and childhood myopia.\" Its findings are consistent with other older studies e.g. <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/23380471\" rel=\"nofollow noreferrer\">one in Denmark</a> that used day length as an approximation for light exposure. </p></li>\n<li><p>some animal models <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/23434455\" rel=\"nofollow noreferrer\">support</a> the pathway: in particular a dopamine blocker <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/20445123\" rel=\"nofollow noreferrer\">given to chicken</a> abolished the preventative effect of sunlight on myopia development. Some questions remain in this area though, in particular knock-out mice models insofar did not reproduce the effect.</p></li>\n<li><p>High-quality science news sources highlighted the new discoveries: in particular, <em>Nature</em> had <a href=\"https://www.nature.com/news/the-myopia-boom-1.17120\" rel=\"nofollow noreferrer\">featured news story</a>. And if you wonder why all intervention studies in this regard have been conducted in East Asia, <em>Nature</em> has this eye opener on prevalence increase in the region:</p></li>\n</ul>\n\n<p><a href=\"https://i.stack.imgur.com/Pjw9r.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/Pjw9r.png\" alt=\"enter image description here\"></a></p>\n\n<ul>\n<li>Education, at least in some countries, is correlated with a lack of said outdoors light exposure, but it is a much easier proxy to measure than light exposure. Several article have looked at the <a href=\"https://en.wikipedia.org/wiki/Gene%E2%80%93environment_interaction\" rel=\"nofollow noreferrer\">interaction</a> between recently discovered genetic risk factors for myopia and education; the latest one seems to be <a href=\"https://www.nature.com/articles/ncomms11008\" rel=\"nofollow noreferrer\">a meta-analysis</a>, whose main finding is reproduced below in graphical form:</li>\n</ul>\n\n<p><a href=\"https://i.stack.imgur.com/3K6EH.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/3K6EH.png\" alt=\"enter image description here\"></a></p>\n\n<p>The effect appears more significant in Asians than in Europeans.</p>\n\n<p>I should probably mention that education also correlates with near-work exposure, an old favorite hypothesis (advanced centuries ago by Kepler!), but for which <a href=\"https://doi.org/10.1097/OPX.0b013e31819974ae\" rel=\"nofollow noreferrer\">direct evidence is weaker</a>.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1432", "https://health.stackexchange.com", "https://health.stackexchange.com/users/193/" ]

[ { "answer_id": 1470, "author": "Eric", "author_id": 44, "author_profile": "https://health.stackexchange.com/users/44", "pm_score": -1, "selected": false, "text": "<p>I don't know if there is an official definition of junk food. I think similar to pornography, it's best put by \"I know it when I see it.\" Most everything on your list is quite bad for normal consumption, especially the pizza, pastries, burgers, and fruit juice.</p>\n\n<p>I would really recommend you see a movie called <a href=\"http://fedupmovie.com/#/page/home\" rel=\"nofollow\">Fed Up</a>. It came out last year and addresses:</p>\n\n<ul>\n<li>What makes food \"good\" vs \"bad\".</li>\n<li>How food manufacturers use their lobbying power and marketing skills to trick the general public.</li>\n<li>The real damage that comes from high sugar diets (which the one you listed is loaded with).</li>\n</ul>\n\n<p>You can buy it on amazon for <a href=\"http://amzn.to/1S38Xkj\" rel=\"nofollow\">$5</a>. I would watch it and then get as many others as you can do the same.</p>\n" }, { "answer_id": 1472, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 3, "selected": false, "text": "<p>Junk food is a somewhat generic term that basically includes calories from food that has no real nutritional value, or is so loaded with artificial flavors, added sugars/fats that it overwhelms the nutritional value that was there.</p>\n\n<p>Many of the items on your list <em>could</em> be considered junk food, depending on how they are eaten, how much and how often.</p>\n\n<p>For example, a Domino's thick crust pizza with pepperoni, sausage, extra cheese is loaded with saturated fats, lots of calories for not a lot of substance. However, you could get a thin crust pizza with a light amount of cheese, green peppers, mushrooms and black olives, and while still not the best of foods would be a much better option.</p>\n\n<p>Same for fruit juice - If you get a pure juice such as a squeezed orange juice with no additives, it will be much better than a cranberry juice from extract with added sugar.</p>\n\n<p>Also, as noted in this <a href=\"http://www.webmd.com/diet/junk-food-facts\">WebMD article on junk food</a>, these foods tend to be less satiating, that is they satisfy hunger much less than \"real\" foods, so that you typically end up eating more of them to satisfy hunger, which in turn leads to higher caloric intake.</p>\n\n<p>Other items, such as the chocolate, spring roll may not be the best (Depending on what is in the spring roll), but in little bits are ok. It's very hard to eat a clean diet, especially if you are busy, but with some planning and cooking ahead, you can make a diet very healthy, and still leave room for some items like chocolates, candies. </p>\n\n<p>As long as the junk food is limited in intake, and doesn't make up the majority of the diet (As a personal rule, I try to limit \"junk\" calories to no more than 10% of my weekly intake), a little bit should be fine.</p>\n\n<p>However, in light of this being a doctor's recommendation, and given the lab values in your other question, it might be a good idea to have a consultation with a dietitian/nutritionist to help create an achievable, healthy eating plan.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1469", "https://health.stackexchange.com", "https://health.stackexchange.com/users/940/" ]

[ { "answer_id": 1486, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": -1, "selected": false, "text": "<p>My professor at university, class of nutrition, said he would prefer full fat milk because is much richer in liposoluble vitamins. The difference of calories is not that big if the rest of the diet is balanced.</p>\n" }, { "answer_id": 8996, "author": "Grzegorz Adam Kowalski", "author_id": 6557, "author_profile": "https://health.stackexchange.com/users/6557", "pm_score": 1, "selected": false, "text": "<p>From \"<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911011/\" rel=\"nofollow\">Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies</a>\" (2016):</p>\n\n<blockquote>\n <p>The current state of knowledge regarding the association of dairy products and weight gain, overweight, and obesity is based on studies reporting <strong>contradicting and inconclusive results</strong>.</p>\n</blockquote>\n\n<p>I recommend reading above review and reading through its bibliography.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1482", "https://health.stackexchange.com", "https://health.stackexchange.com/users/861/" ]

[ { "answer_id": 1489, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 3, "selected": true, "text": "<p>Your blood sugar, as well as other blood markers, are in equilibrium most of the time. </p>\n\n<p>A meal will create a rise in glucose, but this will only last about 2 hours, so that you will have raised glucose only 6 hours out of 24. So this is one reason why the fasting glucose is the glucose to which your body is exposed most of the time. </p>\n\n<p>But more important, the doctors don't care for your peak glucose levels, they care for the equilibrium level of your glucose homeostasis, and that's 5 mmol or somewhere very close to it. If it is not there, then the mechanism for achieving it is broken, no matter what your postprandial glucose levels are. So both of your assumptions are incorrect. </p>\n\n<p>And if you are on a diet which has your blood glucose levels constantly elevated, that's a very calorie dense diet and you are probably indeed in trouble. But even then, measuring your fasting glucose is important, because the doctor cannot make any conclusions from the raised levels. </p>\n\n<p>By the way, there is also another test for blood sugar which gives you an estimation of not the current blood sugar, but of the average blood sugar over the last few weeks. Both an elevated fasting glucose and an elevated hgb 1ac levels are diagnostic criteria for diabetes, so if you somehow managed to keep your fasting glucose low but your average glucose unreasonably high, this could be discovered and you will be diagnosed with diabetes or warned that you are in a prediabetic condition, depending on the current diagnose guidelines used in your country. But if you suspect this, you should probably inform your physician, as I don't think hgb a1c is measured in routine blood tests. </p>\n\n<p>Source: a Coursera course on diabetes I can't link because it's no longer open, sorry. Maybe somebody else has a linkable source and can edit it in. </p>\n" }, { "answer_id": 1508, "author": "Eli Riekeberg", "author_id": 991, "author_profile": "https://health.stackexchange.com/users/991", "pm_score": 0, "selected": false, "text": "<p>The main reason is because your body conditions change rapidly after a meal. These changes are also meal dependent (I work in a lab and we recently found a way to estimate a person's citrus fruit consumption fairly reliably based on changes in urine). </p>\n\n<p>By instructing you to fast, healthcare providers are attempting to check you when your wildly fluctuating lab results are as stable as possible by minimizing factors like the timing and composition of your meal. That way any results they draw are more likely to reflect something actually wrong with your heath rather than what you last ate.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1487", "https://health.stackexchange.com", "https://health.stackexchange.com/users/985/" ]

[ { "answer_id": 1500, "author": "scottb", "author_id": 994, "author_profile": "https://health.stackexchange.com/users/994", "pm_score": 4, "selected": true, "text": "<p>The \"common cold\" is a syndrome that is characterized by signs and symptoms of upper respiratory infection: sneezing, itchy or watery eyes, rhinorrhea, cough, and sinus congestion. Malaise (the feeling of \"feeling sick\") is reported, but is generally more mild than with the flu. Fever is uncommon with colds. Myalgias and arthralgias (muscle and joint aches) are also reported but are typically more mild than with flu).</p>\n\n<p>The common cold is invariably caused by viruses and more than one family of viruses is capable of producing this syndrome with varying degrees of severity and duration depending on the virus. The best known virus family is the <em>rhinoviridae</em>.</p>\n\n<p>Rhinovirus has at least 99 serotypes. This presents a challenge to the body's immune system as an immune response to one serotype may not provide any protection against other serotypes. It is possible for a person to be consecutively infected with rhinoviridae of different serotypes. The durability of immunity to a rhinovirus strain, once established, is not known. It remains possible that over time, a person can become susceptible to reinfection.</p>\n\n<p>Because human adaptive immunity requires antigen exposure, there is little that someone can do on their own to \"boost\" their specific immunity against cold viruses. There is no vaccine (so many viruses and serotypes to consider). Boosting non-specific immunity (the acute inflammatory mechanisms) is a strategy that has not been well explored, but this approach is hard to recommend. Non-specific immunity is a two-edged sword with the potential to damage the host's own body in addition to its role as the \"first responders\" to a pathogen.</p>\n\n<p><strong>Airborne like products.</strong> Over the counter products that purport to \"boost immunity to colds\" are largely clinically untested. Vitamin C has been examined. In a July 2007 study, researchers wanted to discover whether taking 200 milligrams or more of vitamin C daily could reduce the frequency, duration, or severity of a cold. After reviewing 60 years of clinical research, they found that when taken after a cold starts, vitamin C supplements do not make a cold shorter or less severe. When taken daily, vitamin C very slightly shorted cold duration.</p>\n\n<p>Most over the counter immune boosters for colds are vitamin B and C based, which makes them safe and reasonably non-toxic so their use can't be discouraged. Therapeutic doses of water-soluble vitamins usually result in very expensive urine.</p>\n\n<p><strong>Zinc.</strong> Recently an analysis of several studies showed that zinc lozenges or syrup reduced the length of a cold by one day, especially when taken within 24 hours of the first signs and symptoms of a cold. Studies also showed that taking zinc regularly might reduce the number of colds each year, the number of missed school days, and the amount of antibiotics required in otherwise healthy children. Zinc can potentially have some side-effects, so you should talk to your doctor before beginning zinc supplementation.</p>\n\n<p><strong>TLDR:</strong> Rhinoviridae is very infectious, lives outside the body for hours to days, and is readily transmitted by auto-inoculation from encounters with contaminated surfaces. The best \"immune booster\" for colds really, truly is frequent hand-washing.</p>\n" }, { "answer_id": 4910, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 0, "selected": false, "text": "<p><a href=\"http://www.nlm.nih.gov/medlineplus/ency/article/007165.htm\" rel=\"nofollow\">As explained here</a>, exercise is theorized to have a positive effect on the immune system via a few different mechanisms, although the rigorous proof that it does anything at all is still lacking (that's most likely a result of a lack of research in this area). As this source says, you should not overdo it, but then the amount of exercise that will be too much for you depends on your fitness level to begin with. So, the fitter you are the harder you can actually exercise before you pass the break even point where the negative effects start to grow larger than the positive effects. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1488", "https://health.stackexchange.com", "https://health.stackexchange.com/users/981/" ]

[ { "answer_id": 1491, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": -1, "selected": false, "text": "<p>It's best to stick to drinking less than 3 liters if you are not sweating a lot. That will give you more room to increase fluid intake when it is necessary. Also, while water poisoning won't happen at 4 liters a day, you may get <a href=\"http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/causes/con-20026841\" rel=\"nofollow\">other problems</a>:</p>\n\n<blockquote>\n <p>Prolonged excessive water intake by itself can damage the kidneys and suppress ADH, making your body unable to concentrate urine. Primary polydipsia can be the result of abnormal thirst caused by damage to the thirst-regulating mechanism, situated in the hypothalamus. Primary polydipsia can also be caused by mental illness.</p>\n</blockquote>\n" }, { "answer_id": 1492, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 4, "selected": false, "text": "<p>This answer is based on normal situations (examples of an abnormal situations include patrolling in high temperatures in full protective gear, and strenuous exercise, especially in heat/cold) and normal health.</p>\n\n<p>I'm going to go on record here as a renegade who does <em>not</em> believe in an \"8 glasses of water a day\" (1.9 L) regimen for normal healthy people in normal circumstances. My belief is, <em>if you're thirsty, drink something</em>; make sure at least some of the time, it's water. If you're drinking caffeinated beverages or alcohol, drink a little more water.</p>\n\n<p>Most people will disbelieve this because of the popular press's obsession with 8 8-ounce glasses (1.9 L) per day myth. So some science is in order.</p>\n\n<p>Total water intake includes water in beverages, water in food, and water intake. Daily water <em>needs</em> vary depending on humidity, temperature (sweating), physical exercise etc. But normal, healthy people regulate their daily water balance incredibly well despite changes in size/development (some factors, such as dementia, etc. can interfere with hydration.) <em>In general</em>, as long as food and fluids are readily available, people only need to drink when they are thirsty. (Obviously strenuous exercise, illness, and other special circumstances require a different approach.)</p>\n\n<p>People born around the same time I was spent a large part of their lives never having seen people drink purchased water or toting bottles of water everywhere, and were probably as amused as I was to see the explosive growth of the bottled water industry.</p>\n\n<p>The Institutes of Medicine's Food and Nutrition Board issued a new report in 2004 establishing nutrient recommendations on \"water, salt and potassium to maintain health and reduce chronic disease risk\". They stated that the vast majority of healthy people adequately meet their daily hydration needs <strong>by letting thirst be their guide</strong>. In a press release:</p>\n\n<blockquote>\n <p>\"We don't offer any rule of thumb based on how many glasses of water people should drink each day because our hydration needs can be met through a variety of sources in addition to drinking water,\" said Lawrence Appel, chair of the panel that wrote the report and professor of medicine, epidemiology, and international health, Johns Hopkins University, Baltimore. \"While drinking water is a frequent choice for hydration, people also get water from juice, milk, coffee, tea, soda, fruits, vegetables, and other foods and beverages as well. Moreover, we concluded that <em>on a daily basis, people get adequate amounts of water from normal drinking behavior -- consumption of beverages at meals and in other social situations -- and by letting their thirst guide them</em>.\" </p>\n</blockquote>\n\n<p>The report did not specify exact requirements for water, but </p>\n\n<blockquote>\n <p>set general recommendations for women at approximately 2.7 liters (91 ounces) of total water - <em>from all beverages and foods</em> - each day, and men an average of approximately 3.7 liters (125 ounces daily) of total water. </p>\n</blockquote>\n\n<p>The panel did not set an upper level for water.</p>\n\n<p>They also stated that caffeinated beverages counted towards fluid requirements:</p>\n\n<blockquote>\n <p>About 80 percent of people's total water intake comes from drinking water and beverages -- including caffeinated beverages -- and the other 20 percent is derived from food.</p>\n</blockquote>\n\n<p>How will drinking even more water than necessary benefit people? Many ways. Here are a few that I can think of:</p>\n\n<ul>\n<li><p><strong>Decreased food intake</strong>: drinking a glass of water half an hour before a meal has been shown to slightly decrease the amount of food a person will eat <em>without any distractions</em>.</p></li>\n<li><p><strong>Decreased spending</strong> on high-calorie drinks: drinking water decreases thirst. <em>Maybe</em> the decrease is enough to discourage reaching for unnecessarily high-calorie beverages. Unfortunately water doesn't taste as good as sugary beverages. :(</p></li>\n<li><p><strong>Increased cardiovascular health</strong>: drinking excess water, then using <em>a bathroom several flights up or down from the floor people work on</em> (walking, not using the elevator) will promote a bit of decent exercise several times/day.</p></li>\n<li><p><strong>Increased spiritual well being</strong>: Before drinking, meditating for a few minutes (think about life without clean water to drink, to bathe in, to launder clothes, etc.; imagining a drought seriously impacting people, then thinking about water available for drinking) and experiencing gratitude for the gift of it is beneficial. Gratitude has been shown in many studies to increase happiness.</p></li>\n</ul>\n\n<p>There are medical conditions wherein drinking more than as guided by thirst is recommended, but that is a different question.</p>\n\n<p>_{<a href=\"http://ajpregu.physiology.org/content/283/5/R993\">“Drink at least eight glasses of water a day.” Really? Is there scientific evidence for “8 × 8”?</a>}<br>\n_{<a href=\"http://iom.nationalacademies.org/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx\">Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate</a>}<br>\n_{<a href=\"http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=10925\">Report Sets Dietary Intake Levels for Water, Salt, and Potassium\nTo Maintain Health and Reduce Chronic Disease Risk</a>}<br>\n_{<a href=\"http://psycnet.apa.org/journals/psp/84/2/377/\">Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life.</a>}</p>\n" }, { "answer_id": 8902, "author": "Grzegorz Adam Kowalski", "author_id": 6557, "author_profile": "https://health.stackexchange.com/users/6557", "pm_score": 1, "selected": false, "text": "<p>Probably you may safely ignore all those recommendations. Quote from \"<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151163/\" rel=\"nofollow\">Medical myths</a>\" article published in British Medical Journal):</p>\n\n<blockquote>\n <p>(...) existing studies suggest that adequate fluid intake is usually met through typical daily consumption of juice, milk, and even caffeinated drinks. In contrast, drinking excess amounts of water can be dangerous, resulting in water intoxication, hyponatraemia, and even death.</p>\n</blockquote>\n\n<p>About the lack of evidence to the popular 8 glasses / 2 litres recommendation:</p>\n\n<blockquote>\n <p>The complete lack of evidence supporting the recommendation to drink six to eight glasses of water a day is exhaustively catalogued in an <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12376390\" rel=\"nofollow\">invited review by Heinz Valtin in the American Journal of Physiology</a>.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/1490", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 1495, "author": "Ihkavs", "author_id": 989, "author_profile": "https://health.stackexchange.com/users/989", "pm_score": 2, "selected": false, "text": "<p>Cancer starts when the growth of a cell is no longer controlled by the body, but the cell replicates itself without control (due to changes in the DNA) (refer to <a href=\"http://www.cancer.org/cancer/cancerbasics/what-is-cancer\">http://www.cancer.org/cancer/cancerbasics/what-is-cancer</a>). Diet is known to <strong>alter the risk of developing cancer</strong> but <strong>cancer cannot be cured by a healthy diet</strong>. </p>\n\n<p>In fact, the cancer needs a lot of nutrients for its growth. It is organized in a way that it actually gets more nutrients than the rest of the body (which is part of the illness). This quite often causes a weight loss in people suffering from cancer. Often enough the rest of the body does not get provided with enough nutrients, so other organs are impaired. It is strongly advised to provide the body with enough energy during illness.</p>\n\n<p>Secondly, <strong>processed food in general is not considered bad for the body.</strong></p>\n\n<p>Now, your mother's case cannot be adressed individually here. You couldn't be able to provide sufficient information for that. But in general, I would strongly advise your mother to stop this diet. She is obviously suffering from malnutrition at the moment. This can actually worsen the prognosis. Please go and see a doctor and talk about other options.</p>\n" }, { "answer_id": 1496, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": false, "text": "<p>The problem with these diets is not only do they not <em>treat</em> the cancer, but the false hope they offer prevents people (in this case, a woman with breast cancer) from receiving treatment that <em>does</em> reduce or potentially even eliminate the cancer.</p>\n\n<p>Breast cancer is a common cancer in women, and it was politicized a couple of decades ago, meaning the discrepancies in funding for research (which was strongly geared towards studies of male diseases) was brought to light. </p>\n\n<p>In 1993, a private philanthropist gave a generous grant to study the role of diet in preventing cancer progression because he/she believed that female cancer survivors should be able to make decisions without having “to rely on folklore, rumor and hearsay.</p>\n\n<p>One of these studies was <em>The Women's Healthy Eating and Living</em> study.</p>\n\n<p>Studies available then indicated that plant-derived foods contained anti-carcinogens. It was believed that a diet high in vegetables and fruit probably decreased breast cancer risk and that a diet high in total fat possibly increased risk. That belief was put to the test in the WHEL study.</p>\n\n<p>The study subjects were previously treated <strong>early stage</strong> breast cancer. These women had been <em>treated</em> for breast cancer, that is, they were not only diagnosed, but had followed all the recommendations for breast cancer treatment at the time. This was a group for which there was high hope.</p>\n\n<p>The diet was very intensive, very high in vegetables, fruit, and fiber and low in fat. Blood tests confirmed that the women were indeed on the diet. Unfortunately, no difference in breast cancer recurrence or death from breast cancer was found.</p>\n\n<blockquote>\n <p>In conclusion, during a mean 7.3-year follow-up, we found no evidence that adoption of a dietary pattern very high in vegetables, fruit, and fiber and low in fat vs a 5-a-day fruit and vegetable diet prevents breast cancer recurrence or death among women with previously treated early stage breast cancer.</p>\n</blockquote>\n\n<p>If hair loss is a major concern to your mother, please let her know that some patients have responded very favorably to \"scalp cooling\" during chemotherapy. The theory is that cooling the scalp causes vasoconstriction and thus less drug to the scalp. An early study is referenced below.</p>\n\n<p>_{<a href=\"http://jama.jamanetwork.com/article.aspx?articleid=208026\">Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial</a>}<br>\n_{<a href=\"http://annonc.oxfordjournals.org/content/16/3/352.short\">Prevention of chemotherapy-induced hair loss by scalp cooling</a>}</p>\n" } ]

[ "https://health.stackexchange.com/questions/1493", "https://health.stackexchange.com", "https://health.stackexchange.com/users/988/" ]

[ { "answer_id": 1495, "author": "Ihkavs", "author_id": 989, "author_profile": "https://health.stackexchange.com/users/989", "pm_score": 2, "selected": false, "text": "<p>Cancer starts when the growth of a cell is no longer controlled by the body, but the cell replicates itself without control (due to changes in the DNA) (refer to <a href=\"http://www.cancer.org/cancer/cancerbasics/what-is-cancer\">http://www.cancer.org/cancer/cancerbasics/what-is-cancer</a>). Diet is known to <strong>alter the risk of developing cancer</strong> but <strong>cancer cannot be cured by a healthy diet</strong>. </p>\n\n<p>In fact, the cancer needs a lot of nutrients for its growth. It is organized in a way that it actually gets more nutrients than the rest of the body (which is part of the illness). This quite often causes a weight loss in people suffering from cancer. Often enough the rest of the body does not get provided with enough nutrients, so other organs are impaired. It is strongly advised to provide the body with enough energy during illness.</p>\n\n<p>Secondly, <strong>processed food in general is not considered bad for the body.</strong></p>\n\n<p>Now, your mother's case cannot be adressed individually here. You couldn't be able to provide sufficient information for that. But in general, I would strongly advise your mother to stop this diet. She is obviously suffering from malnutrition at the moment. This can actually worsen the prognosis. Please go and see a doctor and talk about other options.</p>\n" }, { "answer_id": 1496, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": false, "text": "<p>The problem with these diets is not only do they not <em>treat</em> the cancer, but the false hope they offer prevents people (in this case, a woman with breast cancer) from receiving treatment that <em>does</em> reduce or potentially even eliminate the cancer.</p>\n\n<p>Breast cancer is a common cancer in women, and it was politicized a couple of decades ago, meaning the discrepancies in funding for research (which was strongly geared towards studies of male diseases) was brought to light. </p>\n\n<p>In 1993, a private philanthropist gave a generous grant to study the role of diet in preventing cancer progression because he/she believed that female cancer survivors should be able to make decisions without having “to rely on folklore, rumor and hearsay.</p>\n\n<p>One of these studies was <em>The Women's Healthy Eating and Living</em> study.</p>\n\n<p>Studies available then indicated that plant-derived foods contained anti-carcinogens. It was believed that a diet high in vegetables and fruit probably decreased breast cancer risk and that a diet high in total fat possibly increased risk. That belief was put to the test in the WHEL study.</p>\n\n<p>The study subjects were previously treated <strong>early stage</strong> breast cancer. These women had been <em>treated</em> for breast cancer, that is, they were not only diagnosed, but had followed all the recommendations for breast cancer treatment at the time. This was a group for which there was high hope.</p>\n\n<p>The diet was very intensive, very high in vegetables, fruit, and fiber and low in fat. Blood tests confirmed that the women were indeed on the diet. Unfortunately, no difference in breast cancer recurrence or death from breast cancer was found.</p>\n\n<blockquote>\n <p>In conclusion, during a mean 7.3-year follow-up, we found no evidence that adoption of a dietary pattern very high in vegetables, fruit, and fiber and low in fat vs a 5-a-day fruit and vegetable diet prevents breast cancer recurrence or death among women with previously treated early stage breast cancer.</p>\n</blockquote>\n\n<p>If hair loss is a major concern to your mother, please let her know that some patients have responded very favorably to \"scalp cooling\" during chemotherapy. The theory is that cooling the scalp causes vasoconstriction and thus less drug to the scalp. An early study is referenced below.</p>\n\n<p>_{<a href=\"http://jama.jamanetwork.com/article.aspx?articleid=208026\">Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial</a>}<br>\n_{<a href=\"http://annonc.oxfordjournals.org/content/16/3/352.short\">Prevention of chemotherapy-induced hair loss by scalp cooling</a>}</p>\n" } ]

[ "https://health.stackexchange.com/questions/1507", "https://health.stackexchange.com", "https://health.stackexchange.com/users/169/" ]

[ { "answer_id": 1517, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 2, "selected": false, "text": "<p>You start with your doctor. You can also learn about how memory is made from reading new material.</p>\n<p>No one can answer you over the internet regarding your particular problem; a neurologist would be able to test you for serious health problems regarding your memory, ability to concentrate, etc. But a few general guidelines can be given that might help those young, healthy people who feel they have mentally &quot;slowed down&quot;.</p>\n<p>People of all ages can have problems with their thyroid gland. Virtually every cell in your body is dependent on this <em>master gland's</em> product. Both hypothryoidism and hyperthyroidism can affect thinking, from subtly to profoundly.^[1] If your diet is deficient in any way, tests for that can be done as well.</p>\n<p>You are very young for early onset Alzheimer's &amp; Dementia, but you can be tested for that as well. (The likelihood of having such a cognitive impairment with no other symptoms whatsoever - and without anyone else noticing it - are small.)</p>\n<p>Many, many people worry about their ability to concentrate. I remember feeling mentally sluggish enough decades ago to take the then much-touted herbal supplement <em>ginko biloba</em> (it hasn't been shown to do anything; don't waste your money.) The point is, that was three decades ago, I was young, concerned, and in a demanding profession, and I'm fine.</p>\n<p>Cognitive science has given us some good information about learning; maybe this will help people identify when memory problems are &quot;normal&quot;. Here, I'll deal mainly with reading, concentration, and learning together. And since it might all be new to you, you will very likely need to read it more than once.</p>\n<p>Cognitive load theory and schema (learning) theory^[2][3] go hand in hand in <em>learning</em>. <em>Schemas</em> are frameworks of information (imagine an empty skyscraper in your mind; you want to fill those rooms with what each needs to work and communicate with other rooms, so that in the end, you'll have a pretty-well functioning skyscraper with communication between all the departments.)</p>\n<p>Schemas start as very basic (&quot;This is a cell&quot;) and become more complex and facile (&quot;NADH-Q oxidoreductase, Q-cytochrome c oxidoreductase, and cytochrome c oxidase are mitochondrial transmembranous enzyme complexes responsible for oxidative phosphorylation, etc.&quot;) Schemas allow (and are the basic unit of) <em>Long Term Memory</em> (LTM). To learn something, we need a framework (&quot;cell&quot;) into which we can stick a fact before we can remember it for more than a very few minutes. (Do you think you can remember what you just read about &quot;mitochondrial transmembranous enzyme complexes&quot;? I highly doubt it.)</p>\n<p>The more we know about something (the better our schemas are), the more easily we learn. <em>Working memory</em> (WM) allows us to process what we are exposed to and place it <em>into a schema</em> so that we can remember it. Like a computer, we have limited working memory (processing ability) available to us at any given time. Efficient processing results in placing material into a schema which then facilitates Long Term Memory (LTM). Efficient processing -&gt; Long Term Memory (LTM).</p>\n<blockquote>\n<ul>\n<li><p>Inefficient Processing (IP) -&gt; <em>&quot;What Did I Just Read?&quot;</em> (I know I read it, I know it was in a language I understand, I understood it, but I can't remember what it said.) IP blocks schema identification which then blocks LTM. Failed schema identification means leads to inability to use information.</p>\n</li>\n<li><p>Efficient processing (EP) -&gt; <em>&quot;OK, That Makes Sense; What's Next?&quot;</em> (This relates to things I know; how does it relate to things I'm about to be exposed to?) EP allows schema identification which then allows LTM.</p>\n</li>\n</ul>\n</blockquote>\n<p>Where does cognitive load come in? Cognitive Load takes up processing speed (reducing working memory). If cognitive load is great enough, all working memory is used up, and we will be unable to identify/form a schema.</p>\n<p>There are several types of Cognitive load:</p>\n<ul>\n<li><em>intrinsic</em> (how complex is the information?)</li>\n<li><em>extrinsic</em>/ineffective (a bunch of things including distractions, emotionally demanding states [stress, anxiety, even the anxiety you feel when you see something new], and especially <em>the way in which material is presented</em>, i.e. does it induce splitting of attention? etc.)</li>\n<li><em>germane</em> (what's left over to actually form schemas). They are (kind of) additive. Good schemas <em>reduce</em> cognitive load (increasing working memory).</li>\n</ul>\n<p>They are (kind of) additive. Good schemas reduce cognitive load thereby increasing working memory.</p>\n<p>If you are reading at your limit of working memory, one final additional 'load' (resulting in cognitive overload) will make you unable to remember what you have just/will immediately read.</p>\n<p>Because cognitive overload <em>does not disappear immediately upon reduction of load</em>, you need a few moments to experience reduced load before you regain working memory.</p>\n<p>An example: you read something while at the very edge of working memory. You realize that you have not remembered what you read, so you decrease attention splits (you commit to reread with intent.) Because you need a few moments of reduced load before your second reading, it might not sink in (now you become concerned, further increasing cognitive load), whereas if you got up, sipped water, and sat down again, you might have enough recovery time to regain working memory.</p>\n<p>In an interview with Felipe De Brigard, PhD of the Center for Cognitive Neuroscience at Duke University, He emphasizes the importance of good sleep and giving learning tasks one's full attention:</p>\n<blockquote>\n<ul>\n<li>I also like to highlight the importance of attending to the information we want to encode. In today's world, people love to multitask. But, unfortunately, multitasking is very detrimental to memory consolidation. Attention and working memory are of the essence for information to be encoded. If you divide your attention between two events, you fail to fully encode either of them; at best, you end up half-encoding both of them.</li>\n</ul>\n</blockquote>\n<p>A very minor example of cognitive overload: if 100 people write <em>which</em> or <em>else</em> or other word you're familiar with 30 times in one minute, ~70% will begin to doubt that it is a real word. This is because of the increase of extrinsic load resulting in cognitive overload.</p>\n<p>You might pay attention when your mind starts to not absorb material to see if anything like this is going on (How well is the material presented? Am I experiencing distractions (&quot;not having so many surrounding words helps&quot;)? Am I feeling stressed? Does a short break/turning off the music/etc. help? Try reading something undemanding (a line in a recipe book if you like cooking, or a few lines from a favorite book you've read a few times. Is your memory better with this more familiar and less working-memory-requiring information?)</p>\n<p>The linked site presents different models of presenting information that promotes schema formation, identification and processing in different situations, and links to further work.</p>\n<p>_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17543038\" rel=\"nofollow noreferrer\">1 Thyroid hormones, learning and memory.</a>}<br />\n_{<a href=\"http://coral.ufsm.br/tielletcab/Apostilas/cognitive_load_theory_sweller.pdf\" rel=\"nofollow noreferrer\">2 COGNITIVE LOAD THEORY, LEARNING DIFFICULTY, AND INSTRUCTIONAL DESIGN</a>}<br />\n_{<a href=\"http://prezi.com/1apjupioiqts/schema-theory-and-cognitive-load-theory/\" rel=\"nofollow noreferrer\">3 Schema Theory and Cognitive Load Theory</a></p>\n<p>_{General references}<br />\n_{<a href=\"http://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/basics/definition/con-20026392\" rel=\"nofollow noreferrer\">Mild cognitive impairment</a>}<br />\n_{<a href=\"http://archneur.jamanetwork.com/article.aspx?articleid=774828\" rel=\"nofollow noreferrer\">Mild Cognitive Impairment: Clinical Characterization and Outcome</a>}<br />\n_{<a href=\"http://www.alz.org/alzheimers_disease_early_onset.asp\" rel=\"nofollow noreferrer\">Younger/Early Onset Alzheimer's and Dementia</a>}</p>\n<p>}</p>\n" }, { "answer_id": 1668, "author": "Mousey", "author_id": 1127, "author_profile": "https://health.stackexchange.com/users/1127", "pm_score": -1, "selected": false, "text": "<p>This sounds very familiar! The symptoms you said are:</p>\n<ul>\n<li>Concentration problems</li>\n<li>Feeling overwhelmed (by what never bothered you before - like number of words on a page</li>\n<li>Comprehension (can't take in what you read)</li>\n<li>forgetfulness/memory problems (short term memory only)</li>\n</ul>\n<p>You mentioned being under pressure to read a lot and having both studying and a regular job. You also found a way to cope better - reducing the number of words to a page. Having the information read out electronically might also be helpful (normally you can set the speed too).</p>\n<p>These symptoms sound like the <strong>cognitive effects of stress</strong>, which may also incude:</p>\n<ul>\n<li>mental slowness</li>\n<li>confusion</li>\n<li>general negative attitudes or thoughts</li>\n<li>constant worry</li>\n<li>your mind races at times</li>\n<li>difficulty thinking in a logical sequence</li>\n<li>the sense that life is overwhelming; you can’t problem-solve</li>\n</ul>\n<p><a href=\"http://psychcentral.com/lib/the-impact-of-stress/\" rel=\"nofollow noreferrer\">source: Dr Steve Bressert, psychcentral</a></p>\n<p>Stress is very misunderstood and has many physical symptoms as well cognitive, emotional and behavioral changes. It affects 43% of adults according to the American Psychological Association.</p>\n<p>Physical symptoms include:</p>\n<ul>\n<li>Disturbed sleep or insomnia</li>\n<li>digestive problems</li>\n<li>stumbling over words</li>\n<li>nervousness</li>\n<li>restlessness</li>\n<li>lack of energy</li>\n<li>high blood pressure\n(source as above)</li>\n</ul>\n<p>The treatments for stress are generally straightfoward (especially if caught early), including learning relaxation techniques.</p>\n<ul>\n<li>deep breathing exercises</li>\n<li>setting aside time every day for relaxation</li>\n<li>guided imagery</li>\n<li>meditation</li>\n<li>make a list of important things to do each day</li>\n<li>learn to identify and monitor your stressors</li>\n<li>avoid caffeine, alcohol, junk food, binge eating</li>\n<li>psychotherapy (talking therapy)</li>\n<li>humor</li>\n</ul>\n<p>(source: 20 Tips to Tame your Stress, Dr Lynn Ponton, psychcentral)</p>\n<p>With humor comedian <strong>Ruby Wax</strong> has made some funny and interesting videos about depression.</p>\n<p>Because reading is linked with learning you might find researching <strong>different learning styles</strong> helps and reduces the stress. <a href=\"https://i.stack.imgur.com/AFnzD.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/AFnzD.png\" alt=\"Learning styles\" /></a></p>\n<p>Nobody can diagnose over the internet or without asking for much more information that you have given, so talking to a professional is best.</p>\n<p>I think it is really important to talk to a health professional about it, both to <strong>rule out other things</strong> and because if it is stress then <strong>reassurance from a professional</strong> can reduce the worrying which is often a major part of stress.</p>\n<h2>Professionals</h2>\n<p>Counseling is a good place to start for diagnosis. Search for a counseling directory or try the American Association of Counseling (counseling.org).</p>\n<p>Online support groups and mental health sites often give good information on how to find a professional to help. Psychcentral and HealthyPlace and two of the well known sites that include forums. Other forums and websites only allow answers to be viewed by those signed in so they are more private.\nPsychcentral is professionally written. Healthyplace is more about lived experience with many tips and videos from people with different diagnoses and a few general ones.</p>\n<p>Many professionals also have websites and blogs. Some do counseling or assessment in person and some do it online especially by Skype (face to face contact allows them to observe subtle things like body language and facial expressions).</p>\n" } ]

[ "https://health.stackexchange.com/questions/1514", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 1531, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": false, "text": "<p>I don't wear glasses much (only to read) and I feel that same groove. I also feel other grooves on my head, for example I can feel a groove over either temple going somewhat vertically for quite a distance - all the way to the top of my head, actually.</p>\n<p>I think what you (and I) are feeling is a <em>suture</em>.</p>\n<p><img src=\"https://i.stack.imgur.com/zPqfu.jpg\" alt=\"enter image description here\" /></p>\n<p>Between the plates or bones in our heads (separate in utero and infancy) are sutures which form slight depressions in our skulls which we can feel with our fingertips. Although they are similarly located on everyone, there is a degree of variation (on some skulls, for example, the squamous suture (between the pink parietal bone and the mauve temporal bone, the one I think we are feeling) is <a href=\"https://www.google.com/search?hl=en&amp;authuser=0&amp;site=imghp&amp;tbm=isch&amp;source=hp&amp;biw=1274&amp;bih=761&amp;q=skull+anatomy+with+sutures&amp;oq=skull+anatomy+with+sutures&amp;gs_l=img.3...2045.26194.0.26670.28.14.0.14.4.0.127.1552.0j14.14.0....0...1ac.1.64.img..11.17.1455.rExtjoTtRXM#hl=en&amp;authuser=0&amp;tbm=isch&amp;q=human+skull+anatomy+sutures\" rel=\"noreferrer\">less curved</a> posterior to the eye. I can clearly feel my lambdoid, coronal, and sagittal sutures (not shown) as well. So, I think this is what you're feeling and seeing.*</p>\n<p>This is, I would guess, why the people you explain this to don't say much. That dent is pretty much there on everyone (note, I'm not saying a lifetime of tight glasses don't make their mark. I just don't think that dent is unique to people who wear glasses.</p>\n<p>The question about headaches from tight glasses is therefore separate.</p>\n<p>The problem with that question is that both headaches and refractive errors requiring glasses are very common conditions in the general population. People often associate glasses and headaches.</p>\n<p>However, there isn't a very strong correlation between refractive errors and headaches.</p>\n<blockquote>\n<p>Is this perhaps a psychological effect or my tight glasses be causing headaches?</p>\n</blockquote>\n<p>I think it's safe to say that you might be projecting <em>the cause of your headaches</em> onto your glasses. The only way to tell for sure is to switch to contacts and see if this relieves your activity-associated headaches.</p>\n<p>Headaches are very common and very often benign. However, if you're concerned, or perceive a change in the frequency or severity of your headaches, or they are associated with other symptoms, you should seek medical attention.</p>\n<p>_{<a href=\"http://onlinelibrary.wiley.com/doi/10.1046/j.1526-4610.2002.02077.x/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+on+12th+July+2015+at+10%3A00-16%3A00+BST+%2F+05%3A00-11%3A00+EDT+%2F+17%3A00-23%3A00+SGT+for+essential+maintenance.++Apologies+for+the+inconvenience.&amp;userIsAuthenticated=false&amp;deniedAccessCustomisedMessage=\" rel=\"noreferrer\">Headaches Associated With Refractive Errors: Myth or Reality?</a>}<br />\n_{<a href=\"http://onlinelibrary.wiley.com/doi/10.1046/j.1475-1313.2001.00571.x/abstract\" rel=\"noreferrer\">Why do we still not know whether refractive error causes headaches? Towards a framework for evidence based practice</a>}</p>\n<p>*_{Now I just woke up my dog by poking around on her skull. I can feel her sagittal suture really well, the others not so much, probably because of the muscles she uses to orient her ears. I should know better, but she's very gracious and went right back to sleep.}</p>\n" }, { "answer_id": 7013, "author": "Matthew", "author_id": 4858, "author_profile": "https://health.stackexchange.com/users/4858", "pm_score": 1, "selected": false, "text": "<p>I had fun reading all the above reponses regarding this inquiry of having tight frames possibly leading to headaches... I also have tight frames and I tend to rest them on top of my ears to relieve the pressure it has on the temporals...i do believe like anywhere in the body, prolonged pressure leads to decrease in circulation and if left for a while it can lead to ulcerations and necrosis. This is why health care providers advise patients to move every 15 mins in chair and every 2 hours in bed. I highly disagree with the palpable suture hypothesis one person mentioned above and fluid shifting made by whom I think is a practicing nurse... Fluid shifting is seen when there's a shift or change in osmotic pressure of intravascular osmolality that causes a shift in fluid from one compartment to another. So on conclusion, to alleviate the headache I would either take them off intermittently or buy frames that fit your facial structure. Oh and if this headache is relate to something that you think isn't from the pressure of the glasses, I would have ur health care provider examine it. </p>\n" }, { "answer_id": 7592, "author": "goldengrain", "author_id": 5218, "author_profile": "https://health.stackexchange.com/users/5218", "pm_score": 1, "selected": false, "text": "<p>You are probably aware of this already, but there are frames with earpieces that not only fold in, but are on hinges with a spring and can be moved out. This might alleviate the pressure a bit. </p>\n\n<p>Also, I had wire frames which left the indentation on the skin at the temples, which I think is what you are describing. When I chose frames on hinges as mentioned above, made out of plastic, the indentations were no more. I think it also helps that the plastic earpieces are thicker which distributes the pressure a bit more than concentrating it on a smaller area. </p>\n" }, { "answer_id": 9337, "author": "xji", "author_id": 1612, "author_profile": "https://health.stackexchange.com/users/1612", "pm_score": 0, "selected": false, "text": "<p>Just my personal experience, but I feel my head to be extremely sensitive to glasses. I've been wearing glasses since childhood, but I finally changed to contact lenses about two years ago. Since then the discomfort on my head largely stopped and I feel much more natural now in various activities. I guess people feeling the same can definitely try it out and see if that makes them feel better.</p>\n" }, { "answer_id": 11142, "author": "Jon", "author_id": 8216, "author_profile": "https://health.stackexchange.com/users/8216", "pm_score": 1, "selected": false, "text": "<p>I've been wearing glasses since 1980. I too get those depressions in the side of my head just above my ears. These don't give me headaches, but the frames do cause great tension in my scalp and eyes.</p>\n\n<p>If I lightly pull the frames that go over my ears outward and away from my scalp, all the tension melts away instantly. </p>\n\n<p>Contacts would probably relieve this. I haven't tried them since 1980 - - they didn't work well for astigmatism at the time. I never tried them again.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1530", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1019/" ]

[ { "answer_id": 1537, "author": "Black Swan", "author_id": 584, "author_profile": "https://health.stackexchange.com/users/584", "pm_score": -1, "selected": false, "text": "<p>Consuming anything in excessive amounts for a long period of time is not good for your health. There are two main problems. One is that the stomach will get upset and other is that you can have allergies. The other problems depend on the elements that the food or drink contain most. Generally high amounts of milk are taken for protein and calcium. Such amounts are generally taken by body builders and athletes, but not for a long time. They start to take it several months before their competition, usually three or four months. Sometimes, for people with some medical conditions, consumption of high amounts of milk is suggested but not as high as 1.5 or 2 liters. </p>\n\n<p>Before I answer your question some important things need to know are why you are drinking such a high amount of milk, how long will you be doing this, have you done this before, and what kind of the milk will it be (ie: cow, goat, soybean etc.). I am assuming that you want to drink cow's milk. The best way to get answer this question is google just type \"side effect of take excessive amount of milk\". you will get many result. Here I have given some link generally i use these links...</p>\n\n<hr>\n\n<p>^{<a href=\"http://www.livestrong.com/article/414574-are-there-any-side-effects-from-drinking-too-much-milk/\" rel=\"nofollow\">Are There Any Side-Effects From Drinking Too Much Milk</a>}\n^{<a href=\"http://www.whfoods.com/genpage.php/genpage.php?tname=nutrient&amp;dbid=92#toxicitysymptoms\" rel=\"nofollow\">Risk of Dietary Toxicity</a>}</p>\n\n<p>^{<a href=\"http://www.whfoods.com/genpage.php?tname=faq&amp;dbid=30\" rel=\"nofollow\">Food Sensitivities</a>}</p>\n\n<p>^{<a href=\"http://www.whfoods.com/genpage.php?tname=george&amp;dbid=148\" rel=\"nofollow\">Milk and Food Allergy/Intolerance</a>}</p>\n\n<p>^{<a href=\"http://www.whfoods.com/genpage.php?tname=foodspice&amp;dbid=130\" rel=\"nofollow\">Cow's milk, grass-fed</a>}</p>\n\n<p>^{<a href=\"http://www.whfoods.com/genpage.php/genpage.php?tname=nutrient&amp;dbid=45\" rel=\"nofollow\">calcium</a>}</p>\n\n<p>^{<a href=\"http://ndb.nal.usda.gov/ndb/foods\" rel=\"nofollow\">Foods List</a>}</p>\n\n<p>^{<a href=\"http://en.wikipedia.org/wiki/Milk\" rel=\"nofollow\">Wikipedia - Milk</a>}</p>\n" }, { "answer_id": 1538, "author": "Attilio", "author_id": 120, "author_profile": "https://health.stackexchange.com/users/120", "pm_score": 3, "selected": false, "text": "<p>There are <strong>several risks</strong> related to excessive consumption of milk. A 12 years prospective study run on around 78000 women showed that high consumption of milk (2-3 glasses per day) increased the <strong>risk of fracture</strong> when compared to people who used to drink one glass or less per week. (<a href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.87.6.992\">1</a>) Similar results were found in other studies like, for example: <a href=\"http://aje.oxfordjournals.org/content/139/5/493.short\">2</a>.</p>\n\n<p>The amount that you say, 1.5 L, contains about 1800 mg of calcium, that must be sum to other daily dietary sources (as dairy, green leaves, sesam seeds, water). A study showed that dietary intakes of calcium greater than 1400 were associated with <strong>higher death rates</strong> from all causes, cardiovascular disease and ischaemic heart disease (<a href=\"http://www.bmj.com/content/346/bmj.f228\">3</a>).</p>\n\n<p>Finally, high intakes of calcium can interfere with iron absorption and lead to <strong>iron deficiency</strong> (<a href=\"http://ajcn.nutrition.org/content/68/1/3.full.pdf\">4</a>, <a href=\"https://en.wikipedia.org/wiki/Human_iron_metabolism\">5</a>).</p>\n" } ]

[ "https://health.stackexchange.com/questions/1536", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1027/" ]

[ { "answer_id": 5269, "author": "Pobrecita", "author_id": 167, "author_profile": "https://health.stackexchange.com/users/167", "pm_score": 3, "selected": true, "text": "<p><a href=\"http://www.webmd.com/diet/guide/vitamin-d-deficiency\" rel=\"nofollow\">WebMD</a></p>\n\n<p>Signs and Symptoms of Vitamin D deficiency can be subtle, but can manifest as bone pain and muscle weakness. Also, <a href=\"http://www.prevention.com/health/symptoms-vitamin-d-deficiency\" rel=\"nofollow\">excessive sweating</a>(when not indicated due to exercise level and heat).</p>\n\n<p>Because of the sometimes subtle symptoms, getting appropiate screening based on risk factors and regular physician exams is important to discovering and managing deficiency.</p>\n\n<p><a href=\"http://www.webmd.com/diet/guide/vitamin-d-deficiency?page=2\" rel=\"nofollow\">Tests for Vitamin D Deficiency</a></p>\n\n<blockquote>\n <p>The most accurate way to measure how much vitamin D is in your body is\n the 25-hydroxy vitamin D blood test. A level of 20\n nanograms/milliliter to 50 ng/mL is considered adequate for healthy\n people. A level less than 12 ng/mL indicates vitamin D deficiency.</p>\n</blockquote>\n\n<p><a href=\"http://articles.mercola.com/sites/articles/archive/2014/05/28/vitamin-d-deficiency-signs-symptoms.aspx\" rel=\"nofollow\">7 Signs You May Have a Vitamin D Deficiency</a> can help in the you understand risk factors, because knowing risk factors can mean better understanding to what symptoms may mean. </p>\n\n<p>Treatment is diet with adequate Vitamin D and supplements. While treatment may be simple, prolonged deficiency can manifest as very serious manifestations so if worried about deficiency a Vitamin D test and Physician Workup is indicated. </p>\n\n<hr>\n\n<p>Risk Factors:</p>\n\n<p><a href=\"http://www.webmd.com/diet/guide/vitamin-d-deficiency\" rel=\"nofollow\">Include:</a> Allegy to milk, vegan diets, darker skin and amount of sun you recieve. </p>\n" }, { "answer_id": 5360, "author": "Margaret S.", "author_id": 3369, "author_profile": "https://health.stackexchange.com/users/3369", "pm_score": 1, "selected": false, "text": "<p>Vitamin D deficiency can actually cause or exacerbate depression, and it can manifest itself in feelings of tiredness, persistent sadness, weakness, etc... It also prevents your bones from mineralizing so your bone density may decline and cause bone pain (as stated by WebMD). I've experienced this, and it feels like an ache deep inside your limbs. I also had pretty strong dairy cravings, which I think may have been However, sometimes these symptoms are slight and you may not even know you have a deficiency. I came to the doctor once with complaints of depression and tiredness. She ordered a blood test for a bunch of things, including blood iron levels and vitamin D levels. My iron levels were good but my vit D was low, and I never would have guessed; I thought I was depressed and just needed antidepressants. </p>\n\n<p>Definitely get a blood test for it if you're concerned because the symptoms of vitamin D deficiency can be attributed to so many different causes, and you may feel pretty \"ok\" when you could be feeling much better.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1540", "https://health.stackexchange.com", "https://health.stackexchange.com/users/861/" ]

[ { "answer_id": 1586, "author": "Eli Riekeberg", "author_id": 991, "author_profile": "https://health.stackexchange.com/users/991", "pm_score": 0, "selected": false, "text": "<p>While most people don't want to believe it, the effect of winter on your mood is mostly all in how you choose to deal with it.</p>\n\n<p>In Tromso Norway, winter-time depression is among the lowest rates of any population in the entire world. They also have some of the longest winters, owing to the fact that they are among the northern-most cities in the world.</p>\n\n<p>The main reason they don't experience depression is because they view the coming of winter as a positive thing. You should do anything you can to make you look forward to the season, such as taking up skiing or another winter sport. You could also ask some of your friends what they are doing during the season and see if you could join them. You can even stay inside and get the same effects, but you have to look forward to the time. Hot chocolate and a good book or favorite movie for example. </p>\n\n<p>You can read more in this article in the atlantic: <a href=\"http://www.theatlantic.com/health/archive/2015/07/the-norwegian-town-where-the-sun-doesnt-rise/396746/\" rel=\"nofollow\">http://www.theatlantic.com/health/archive/2015/07/the-norwegian-town-where-the-sun-doesnt-rise/396746/</a></p>\n" }, { "answer_id": 1590, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": -1, "selected": false, "text": "<p>Toronto is cold in Winter, but it is located at 43.7 degrees Northern Lattitude, which is similar to the lattitude of Marseille in Southern France. So, you can hardly say that this is a dark place in Winter. I think the main problem is that in Winter the days are a bit shorter so it may still be dark when you go to work and when you're back it is already starting to get dark. You can then get some sunlight by going outside during the lunch break.</p>\n\n<p>You also mention the cold, but Toronto isn't so extremely cold that going outside would be a challenge even when properly dressed. This this means that you are not wearing good winter clothing and then suffer as a result of that. This makes you avoid going outside, which leads to the winter blues, which causes you to become reticent to going outside even more. And, of course, if you feel like going to sleep, you may start to feel a bit chilly even while sitting in a properly heated room; the thought of going outside when it is -20 C alone may then make you stay indoors.</p>\n\n<p>You have to stop associating the feeling of cold with the outside conditions. What you feel is your own body heat, this is regulated by your own body thermostat. Simply dressing properly will allow you to use your own body heat to stay warm outside.</p>\n\n<p>The basics of how to dress well is quite simple:</p>\n\n<p><img src=\"https://i.stack.imgur.com/OfEeO.jpg\" alt=\"Winter clothing\"></p>\n\n<p>The key thing is to wear multiple layers, a lot of air will be trapped in between the layers which will give a good insulation against the cold. In the picture the girl is wearing rather light clothing appropriate for physical exertion in cold conditions. If you're going to be doing only light exertions, then the thermal underwear must be thicker different, e.g. you can use <a href=\"http://www.aclima.no/products/dame/doublewool/doublewool-unisex-longs\" rel=\"nofollow noreferrer\">this</a>. If it is colder than about -25 C then ski trousers won't do, you must wear <a href=\"http://www.westernmountaineering.com/index.cfm?section=products&amp;page=Down-Garments&amp;cat=Pants\" rel=\"nofollow noreferrer\">down filled trousers</a>. You may also need a wind stopper on top of that. The hat you wear cannot be just any ordinary hat, if it is cold you need to wear an Arctic hat like this:</p>\n\n<p><img src=\"https://i.stack.imgur.com/bNqGS.jpg\" alt=\"Arctic hat\"></p>\n\n<p>In extremely cold conditions, <a href=\"http://coldavenger.com\" rel=\"nofollow noreferrer\">face masks like this</a> can keep your entire face warm and moisten the air you breath in using the moist in the exhaled air.</p>\n\n<p>Finally, the boots should be of good quality, the best boots have multiple layers with removable inner boots, these are capable of keeping your feet warm at temperatures as low as -40 C.</p>\n" }, { "answer_id": 3603, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 3, "selected": false, "text": "<p>This answer is based on the fact that you have been in a region with less sunlight for several years and continue to suffer. It therefore focuses on Seasonal Affective Disorder, which you may or may not have. </p>\n\n<p>Seasonal affective disorder is an actual illness, and a form of depression. Unfortunately, it is underdiagnosed and undertreated. It is recognized in DSM—5 as Depressive Disorder with Seasonal Pattern. </p>\n\n<p>Diagnosis and treatment are best left to a professional, and may include therapy and medication. However, there are some ways to at least try to make it less severe or that can ease \"winter blues\" that isn't severe enough to be diagnosed as SAD. </p>\n\n<ul>\n<li>Go outside when it's light as often as possible. This even helps when it's grey and cloudy outside </li>\n<li>while it's light outside, if you need to be indoors, be close to a window where your body can register that it is still light outside </li>\n<li>Exercise regularly </li>\n</ul>\n\n<p>Light therapy is effective, but is hard to get right alone - just sitting in front of a bright light occasionally is not enough. </p>\n\n<p><strong>Sources and further reading</strong></p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047\" rel=\"noreferrer\">Mayo Clinic: Seasonal Affective Disorder</a></p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298\" rel=\"noreferrer\">Mayo Clinic: Light Box Therapy</a></p>\n\n<p><a href=\"http://www.aafp.org/afp/2012/1201/p1037.html\" rel=\"noreferrer\">Seasonal Affective Disorder</a> in <em>Am Fam Physician</em> (good overview with details on light therapy) </p>\n" } ]

[ "https://health.stackexchange.com/questions/1544", "https://health.stackexchange.com", "https://health.stackexchange.com/users/981/" ]

[ { "answer_id": 1574, "author": "Chris Jenks", "author_id": 1003, "author_profile": "https://health.stackexchange.com/users/1003", "pm_score": -1, "selected": false, "text": "<p>The volume of blood that the psychoactive substance dissolves in will be roughly proportional to the lean body mass, making its concentration in the brain inversely proportional to lean body mass. If the substance were highly lipophilic then it might additionally partition into fat, further reducing its blood concentration. An exception to this </p>\n\n<p><a href=\"https://pubpeer.com/publications/2E2AFC4B2BFD48105D8BBF43E1993B\" rel=\"nofollow\">This study</a> of the best way to calculate a dose of propofol adjusts the dose to depend on body weight, after excluding the weight of the fat. Propofol is a slightly polar phenol like the psilocin in Psilocybe mushrooms.</p>\n" }, { "answer_id": 1580, "author": "Lucky", "author_id": 613, "author_profile": "https://health.stackexchange.com/users/613", "pm_score": 5, "selected": true, "text": "<p>I think the centre of confusion for you is this question:</p>\n\n<blockquote>\n <p>If the active substance finally goes to the brain, where is the weight's role in this process?</p>\n</blockquote>\n\n<p>The thing is, when a substance has a systemic effect (as opposed to local) it somehow has to get from the point where it is applied to the site of action. So, if one ingests something that affects the brain, it has to travel from the stomach to the head somehow - and substances do this via blood. So <strong>the substance is liberated from the form in which one took it, then dissolved and absorbed into the bloodstream.</strong> Since blood reaches all parts of the body, so does the substance. We usually see most of its effects on one body part/organ, but it gets distributed (more or less) everywhere.</p>\n\n<ul>\n<li><strong>What does this have to do with body mass?</strong></li>\n</ul>\n\n<p>To answer this, we must look into the process in which a substance passes from the blood stream to a tissue. This can be done by several mechanisms such as: diffusion, active transport, pinocitosis etc. For many <a href=\"https://en.wikipedia.org/wiki/Xenobiotic\" rel=\"noreferrer\">xenobiotics</a> (substances foreign to our body) the route of transport is diffusion through cellular membranes. <strong>The rate and the extent of diffusion are proportional to concentration gradient.</strong><br>\nThis means two things:</p>\n\n<ul>\n<li>The higher the difference in the <strong>concentrations</strong> between the blood and the other tissue, the higher the rate and extent of diffusion will be.</li>\n<li>This process doesn't depend solely on the total amount of the substance taken; it depends on concentration.</li>\n</ul>\n\n<p>And since: <strong>c = amount/V</strong></p>\n\n<p>we can see that, if we dissolve the same amount of a substance if different volumes (of blood e.g.) we will get different concentrations. Which brings us to the fact that <strong>blood volume is important</strong>. Among other factors, <strong>blood volume depends on body mass</strong>. The mass of the blood amounts for roughly 7% of our body mass, and the volume is proportional to that.*</p>\n\n<ol>\n<li><em>Bigger body mass => higher blood volume => lesser substance concentration => lesser the rate and the extent of diffusion into the target organ (such as the brain)</em></li>\n</ol>\n\n<p>When the substance gets into a tissue, depending on its chemical structure it can: find a target protein and have an effect (note that this doesn't have to be the \"desired\" effect); it can dissolve in fat tissue; it can bind to proteins or other structures such as bones. Again the strength of these bonds depends on the chemical structure of the substance (among other factors) - it can bind reversibly and soon be on its way again or it can get deposed in a tissue it has chemical affinity for. We say that the substance is distributed to various compartments**. If the size of these compartments is bigger, than there is more \"room\" for the substance to be distributed, and potentially \"stored\", so to speak.</p>\n\n<ol start=\"2\">\n<li><em>Bigger body mass => (usually proportionally) bigger mas of many tissues => bigger volume to distribute the substance and potentially bigger deposing capacity.</em> \n<img src=\"https://i.stack.imgur.com/VsCm9.png\" alt=\"enter image description here\"></li>\n</ol>\n\n<p>Source: ref. 4</p>\n\n<ul>\n<li><strong>The catch</strong></li>\n</ul>\n\n<p>Things get complicated because many substances in our blood bind to plasma proteins (usually albumin) and the bound fraction is in equilibrium with the unbound (free fraction). It is only the free fraction of the substance that can diffuse through cell membranes (protein-substance complex is too large). Various substances have different binding potential, and they compete with each other for the same binding sites, and affect each other's kinetics. What's more, Liberation, Absorption and Distribution are followed by Metabolism and Excretion (the so called LADMER system). All these processes happen simultaneously after a (usually short) lag time. </p>\n\n<p>This means that <strong>the concentration of a substance in blood depends on many factors</strong>. We calculate most of these factors in, based on information we get from testing on animals and from clinical trials, and use mathematical models and computer simulations to determine the dose and dosage which would achieve and maintain the concentration of a substance in blood in a certain range, and assume that this will have a predicted effect. <strong>All these calculations are approximations. Although body mass is an important factor in them, calculating a dose of a substance based only on total body mass is a very rough approximation.</strong></p>\n\n<p>Another catch for controlled substances: there is significantly less data on the kinetics of these substances than on medicines (which are intended to cure or manage a disease). So the \"calculations\" are limited. On the other hand when these substances reach other parts of the body, and are metabolised, aside from their psychoactive effects they can affect other organs as well, causing liver or kidney failure, for instance.</p>\n\n<hr>\n\n<p>*Gender, body structure (especially lean body mass), age and other factors determine the exact mass and volume of the blood; still total body mass is strongly correlated with the amount of blood in the body.</p>\n\n<p>** The division into compartments is theoretical, designed to make the calculations easier. It is based on the fact that the concentrations of a substance change differently in different compartments. In reality, all \"compartments\" are connected, and interact with each other at all times. </p>\n\n<p>*** This explanation is simplified for general public. The equation above is for concentration in general. Blood concentration of a substance is never equal to simple quotient of the quantity and volume (remember to take point 2 and the catch into account). The theoretical term <em>volume of distribution</em> or <em>apparent volume of distribution</em> is not equal to blood volume - it is calculated by considering various factors. </p>\n\n<hr>\n\n<p>References:</p>\n\n<ol>\n<li><a href=\"https://books.google.rs/books?id=YKPjtT-8GV8C&amp;printsec=frontcover&amp;dq=pharmacokinetics&amp;hl=en&amp;sa=X&amp;redir_esc=y#v=onepage&amp;q=disposition&amp;f=false\" rel=\"noreferrer\">Biopharmaceutics and Clinical Pharmacokinetics: An Introduction, Fourth Edition</a>, Notari, CRC Press, 1986; chapter 2, pages 48-49</li>\n<li><a href=\"https://books.google.rs/books?id=9fwUQvF4r-cC&amp;printsec=frontcover&amp;dq=pharmacokinetics&amp;hl=en&amp;sa=X&amp;redir_esc=y#v=onepage&amp;q=chapter%201&amp;f=false\" rel=\"noreferrer\">Pharmacokinetics and Pharmacodynamics of Abused Drugs</a>\nedited by Steven B. Karch, MD, FFFLM, CRC Press, 2007 - chapter 1 (especially: 1.2.1, 1.2.2 and 1.6)</li>\n<li><a href=\"http://www.columbia.edu/itc/gsas/g9600/2004/GrazianoReadings/Drugabs.pdf\" rel=\"noreferrer\">DRUG ABSORPTION, DISTRIBUTION AND ELIMINATION; \nPHARMACOKINETICS</a> - pages 25-26</li>\n<li><a href=\"https://www.us.elsevierhealth.com/media/us/samplechapters/9781416066279/Chapter%2002.pdf\" rel=\"noreferrer\">Pharmacology 3rd Edition</a>, By George M. Brenner, PhD, Professor Emeritus of Pharmacology, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK; and Craig Stevens, PhD, Professor of Pharmacology, Oklahoma State University, Tulsa, OK</li>\n<li><a href=\"http://reference.medscape.com/calculator/estimated-blood-volume\" rel=\"noreferrer\">Estimated blood volume</a></li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/1557", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1042/" ]

[ { "answer_id": 1566, "author": "Freedo", "author_id": 767, "author_profile": "https://health.stackexchange.com/users/767", "pm_score": -1, "selected": true, "text": "<p>As long the condom don't break you are 99% safe of diseases and babies. Beware that even if the male doesn't ejaculate you can still get pregnant or get diseases if you do not use condoms.</p>\n\n<p>Also you can get pregnant or a disease even if the first time, the second or whatever. Always do safe sex.</p>\n\n<p>All pregnancy tests look for the presence of hCG. hCG is short for \"human chorionic gonadotropin\" a hormone produced during pregnancy.<a href=\"http://pregnancy.lovetoknow.com/wiki/How_Soon_Can_I_Take_a_Pregnancy_Test\" rel=\"nofollow\">[1]</a></p>\n\n<p>To get accurate results, take a pregnancy test 12-14 days after ovulation and retest after you miss your period if you get a negative result. Approximately 90 percent of pregnant women will get a positive result the first day after a missed period, but 10 percent of women will test negative even though they are pregnant.<a href=\"http://pregnancy.lovetoknow.com/wiki/How_Soon_Can_I_Take_a_Pregnancy_Test\" rel=\"nofollow\">[1]</a></p>\n\n<p>Your doctor may be able to perform a blood test that can pick up hCG in smaller amounts than a urine test. However, even blood tests cannot tell you whether or not you're pregnant until at least six to eight days after you ovulate, because hCG is not produced until implantation. The soonest you can take a pregnancy test, even if you go to your doctor, is seven days after you ovulate.<a href=\"http://pregnancy.lovetoknow.com/wiki/How_Soon_Can_I_Take_a_Pregnancy_Test\" rel=\"nofollow\">[1]</a></p>\n" }, { "answer_id": 1575, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": false, "text": "<p>There are many facts to consider in answering the question, but in effect, yes, one can calculate the chances. Things to consider:</p>\n\n<ul>\n<li>type of condom</li>\n<li>correct usage of condom</li>\n<li>point in the menstrual cycle</li>\n</ul>\n\n<p><strong>Condom type</strong></p>\n\n<p>Latex condoms are somewhat more effective than polyurethane condoms, mostly due to breakage and slippage. However, since in your scenario the condom doesn't break (and we assume it didn't slip), breakage or slippage would not be a problem in the calculations. For this scenario, we'll use the effectiveness of a latex condom.</p>\n\n<p><strong>Correct usage</strong></p>\n\n<p>Male condoms remain a highly effective contraceptive method when used correctly. Latex condoms are 98% effective, meaning that two out of 100 women correctly using male condoms as a means of contraception will become pregnant <strong>in one year</strong>. Use of out-of-date condoms, spermicidal jelly or the wrong kind of lubricant with latex condoms, etc. decreases the efficacy of condoms. In this scenario, we'll assume a not-expired condom, applied properly (not applied and taken off and reapplied, or used more than once, etc.) (Please note, however, it only takes one \"successful\" mating to become pregnant.)</p>\n\n<p><strong>The menstrual cycle</strong></p>\n\n<p>A menstrual cycle begins on the first day of your period and ends the day before the next period begins. Most women will experience some variation in the length of cycles throughout their lives; normally, though, a cycle is between 21 and 35 days. </p>\n\n<p>Ovulation usually occurs about 14 days before the next cycle begins, but it can vary. If you have a short cycle (say, 24 days) and your bleeding lasts 5 days, this means you likely ovulate around day 10; add one day for every day that your cycle is longer (so in a 35 day cycle, you will likely ovulate on day 21.) Pregnancies occur within a 6 day fertile window. This “fertile window” is comprised of the five days before ovulation and the day of ovulation itself. Sex must occur on one of these days (and, yes, it can be only once. It makes no difference if it's the first time or the 50th.) This is because sperm can live for up to five days, traveling to meet the ovulated egg. </p>\n\n<blockquote>\n <p>Overall, an estimated 2% of women were in their fertile window by the fourth day of their cycle and 17% by the seventh day (based on 213 women). This percentage peaked on days 12 and 13, when 54% of women were in their fertile window. If ovulation was delayed, women reached their fertile days much later. Among women who reached the fifth week of their cycle, 4-6% were in their fertile window.</p>\n</blockquote>\n\n<p>This graph shows the probability of women being in their fertile window on a specific day in their cycle.</p>\n\n<p><img src=\"https://i.stack.imgur.com/BwiRy.gif\" alt=\"enter image description here\"></p>\n\n<p>If a woman has a 28 day cycle (the most common), and stops bleeding on day five, on day 6, there is a less than 20% chance that of her being in her fertile window.</p>\n\n<p><strong>What it boils down to</strong></p>\n\n<p>Even with ejaculation, a latex condom used correctly is between 98% and 99% effective (odds of pregnancy: .02); if the woman has a 28 day cycle, the odds of being in her window of fertility on day 6 is ~15% (.15). Doing the math, .15 x .02 = .0003, which means she has <strong>at most</strong> a 3 in 10,000 chance of becoming pregnant from this interaction. Because of the lack of ejaculation, the chance is reduced by a factor of 10 (to account for sperm in the pre-ejaculate), so the chance is approximately 3 in 100,000. </p>\n\n<p>That is a very small chance of being pregnant. As a way to put that into perspective, that is only (roughly) 15 times more likely than a person's chance of being killed by an asteroid. </p>\n\n<p>Though the chance is very small, it is not zero. For this reason, one can take a urine test to reassure oneself as soon as the 28th day.</p>\n\n<p>_{Read the information in the references below to learn how to keep yourself safe while having sex.}</p>\n\n<p>_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=Nonlatex+vs.+latex+male+condoms+for+contraception%3A+a+systematic+review+of+randomized+controlled+trials.\" rel=\"noreferrer\">Nonlatex vs. latex male condoms for contraception: a systematic review of randomized controlled trials.</a>}<br>\n_{<a href=\"http://www.nhs.uk/conditions/contraception-guide/pages/male-condoms.aspx\" rel=\"noreferrer\">Condoms</a>}<br>\n_{<a href=\"http://www.bmj.com/content/321/7271/1259.short\" rel=\"noreferrer\">The timing of the “fertile window” in the menstrual cycle: day specific estimates from a prospective study</a>} </p>\n" } ]

[ "https://health.stackexchange.com/questions/1565", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1049/" ]

[ { "answer_id": 1816, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 2, "selected": false, "text": "<p>There are three types of heart attacks: unstable angina pectoris, non-ST-elevation myocardial infarct (NSTEMI) and ST-elevation myocardial infarct (STEMI). Choosing between thrombolysis and angioplasty matters only in the STEMI.</p>\n\n<blockquote>\n <p>Which is better: thrombolysis (treatment with clot busting medication) or primary angioplasty (an invasive procedure for mechanical opening of the blocked artery)?</p>\n</blockquote>\n\n<p>If the patient arrives within 2-3 hours to the hospital from the onset of the pain, \"drug of choise\" is angioplasty. The evidence is overwhelming. <a href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa025142\" rel=\"nofollow\">The largest study</a> on this topic involves 1572 randomized to either thrombolysis or primary angioplasty. The latter was superior. Footnote includes other smaller studies on this topic.</p>\n\n<p>The primary angioplasty is best to be performed in less than 120 minutes from the pain. After that, superiority over thrombolysis is not clear, as stated in <a href=\"http://eurheartj.oxfordjournals.org/content/ehj/27/7/779.full.pdf\" rel=\"nofollow\">this high quality meta-analysis</a>.</p>\n\n<blockquote>\n <p>Does it matter if the patient reaches very early to hospital (within 2-3 hours) or reaches late after onset of chest pain?</p>\n</blockquote>\n\n<p>If paramedics reaches the patient rapidly after the onset of pain and the patient cannot be moved to a hospital capable performing angioplasty in less than 2-3 hours, it is preferable to perform thrombolysis <strong>on-site.</strong> This has been showed in many studies <a href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308053290602\" rel=\"nofollow\">(1)</a><a href=\"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140673696025147.pdf\" rel=\"nofollow\">(2)</a>. What is the optimal time cut-off remains to be shown.</p>\n\n<hr>\n\n<p><strong>References:</strong></p>\n\n<p>Busk M, Maeng M, Rasmussen K ym. The Danish multicentre randomized study of fibrinolytic therapy vs. primary angioplasty in acute myocardial infarction (the DANAMI-2 trial): outcome after 3 years follow-up. Eur Heart J 2008;29(10):1259-66. </p>\n\n<p>Widimsky P, Bilkova D, Penicka M ym. Long-term outcomes of patients with acute myocardial infarction presenting to hospitals without catheterization laboratory and randomized to immediate thrombolysis or interhospital transport for primary percutaneous coronary intervention. Five years' follow-up of the PRAGUE-2 Trial. Eur Heart J 2007;28(6):679-84. </p>\n\n<p>Nunn CM, O'Neill WW, Rothbaum D ym. Long-term outcome after primary angioplasty: report from the primary angioplasty in myocardial infarction (PAMI-I) trial. J Am Coll Cardiol 1999;33(3):640-6. </p>\n\n<p>Zijlstra F, Hoorntje JC, de Boer MJ ym. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction. N Engl J Med 1999;341(19):1413-9. </p>\n\n<p>Bonnefoy E, Lapostolle F, Leizorovicz A ym. Primary angioplasty versus prehospital fibrinolysis in acute myocardial infarction: a randomised study. Lancet 2002;360(9336):825-9. </p>\n\n<p>Bonnefoy E, Steg PG, Boutitie F ym. Comparison of primary angioplasty and pre-hospital fibrinolysis in acute myocardial infarction (CAPTIM) trial: a 5-year follow-up. Eur Heart J 2009;30(13):1598-606. </p>\n\n<p>Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003;361(9351):13-20. </p>\n\n<p>Svensson L, Aasa M, Dellborg M ym. Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial. Am Heart J 2006;151(4):798.e1-7. </p>\n" }, { "answer_id": 1817, "author": "SalkinD", "author_id": 1193, "author_profile": "https://health.stackexchange.com/users/1193", "pm_score": 0, "selected": false, "text": "<p>Many studie claim that primary angioplasty is better than thrombolyis, as short-time mortality and morbidity of angioplasty is significantly lower than with thrombolysis treatment. (1,3) Reaching late after onset of pain generally reduces effectiveness of any treatment. (2)</p>\n\n<p>You may see this table : <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377579/table/A01tab02/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377579/table/A01tab02/</a></p>\n\n<p>[1] Primary angioplasty versus intravenous thrombolysis for acute myocardial infarction. - <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12917910\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/12917910</a></p>\n\n<p>[2] Assessing the effectiveness of primary angioplasty compared with thrombolysis and its relationship to time delay: a Bayesian evidence synthesis. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17277350\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/17277350</a></p>\n\n<p>[3] Primary Angioplasty and Thrombolysis for the Treatment of Acute ST-Segment Elevated Myocardial Infarction <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377579/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377579/</a></p>\n" }, { "answer_id": 3363, "author": "rncardio", "author_id": 1477, "author_profile": "https://health.stackexchange.com/users/1477", "pm_score": 3, "selected": true, "text": "<p>A number of studies have shown that in early period (within 2-3 hours of onset of chest pain), thrombolysis is as good or even better than primary angioplasty: </p>\n\n<ul>\n<li><a href=\"http://www.tctmd.com/show.aspx?id=123817\" rel=\"nofollow\">FAST-MI study</a></li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768566/\" rel=\"nofollow\">USIC 2000 registry</a></li>\n<li><a href=\"http://circ.ahajournals.org/content/108/23/2851.full\" rel=\"nofollow\">CAPTIM trial</a> and <a href=\"http://eurheartj.oxfordjournals.org/content/ehj/30/13/1598.full.pdf\" rel=\"nofollow\">its 5 year results</a></li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26162464\" rel=\"nofollow\">Vienna registry</a></li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12559941\" rel=\"nofollow\">PRAGUE-2 study</a></li>\n<li><a href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1301092?viewType=Print&amp;viewClass=Print\" rel=\"nofollow\">STREAM trial</a></li>\n<li><a href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa025142\" rel=\"nofollow\">DANAMI-2 study</a> Subgroup analysis of this study quoted by arkiaamu also showed clear benefit only in patients who had duration of chest pain > 4 hours. </li>\n</ul>\n\n<p>Thrombolytic therapy (clot busting medicines e.g. tPA, also called fibrinolytics since they lyse fibrin strands of thrombi or clots) has major advantage in ease of administration. They are administered via intravenous route and hence can be give by nurses or paramedical personnel. The drug travels in the blood stream to reach arteries of the heart and lyses the thrombus (clot) there. Thrombolysis treatement can be given in ambulance while patients are being transported to hospitals or even at patient's home to save time. Tenecteplase, a type of thrombolytic therapy, can be given just as a bolus injection and does not even need infusion. Early after onset of heart attack, the thrombus is soft and possibly smaller in size and hence is more easily lysed by thrombolytic agents.</p>\n\n<p>On the other hand, primary angioplasty needs a fully functioning cardiac catheterization laboratory which costs a lot and are available only in tertiary centers. Trained cardiologists and cath lab technician/nursing staff are needed to perform primary angioplasty. The access has to be through high pressure artery rather than simple vein for thrombolysis. The procedure itself is very complex since the coronary arteries of the heart have to be hooked, wires, balloon catheters, thrombo-suction devices and stents have to be passed into them to open the block caused by thrombus. The logistics of availablity are difficult, especially at nights and on weekends. Hence, the costs are also much more with primary angioplasty. </p>\n\n<p>Because of all these reasons, we should not ignore the role of thrombolytic therapy in patients presenting early after onset of chest pain in acute heart attack. For patients presenting late, primary angioplasty has been shown to be more beneficial than thrombolytic treatment, presumably because the thrombus become more extensive and firm with time and is not easily lysed wih thrombolytic agents (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12517460\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/12517460</a>).</p>\n" } ]

[ "https://health.stackexchange.com/questions/1582", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1043/" ]

[ { "answer_id": 20026, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 2, "selected": false, "text": "<p><strong>Is saturated fat beneficial after all?</strong></p>\n<p>There seems to be no convincing evidence to say that high intake of saturated fat prevents any disease and the evidence about harmful effects is very inconsistent.</p>\n<p><strong>Saturated fat and stroke</strong></p>\n<p>There is some inconsistent evidence about the association between high saturated fat intake and a decreased or no risk of stroke.</p>\n<blockquote>\n<p>This meta-analysis reveals that higher SFA intake is inversely\nassociated with risk of stroke morbidity and mortality...<em>(<a href=\"https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack\" rel=\"nofollow noreferrer\">Neurological Sciences, 2016</a>)</em></p>\n<p>Saturated fats are not associated with all cause mortality, CVD, CHD,\nischemic stroke, or type 2 diabetes, but the evidence is heterogeneous\nwith methodological limitations. <em>(<a href=\"https://www.bmj.com/content/351/bmj.h3978\" rel=\"nofollow noreferrer\">systematic review and meta-analysis of observational studies, BMJ, 2015</a>)</em></p>\n<p>Studies on SAFA <em>[saturated fatty acids]</em> intakes and risk of ischemic\nstroke are inconsistent. Compared with the abundant data on SAFA\nconsumption and risk of CHD, there is insufficient evidence to support\ndietary SAFA recommendations to reduce stroke risk. <em>(<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475232/\" rel=\"nofollow noreferrer\">Annals of Nutrition and Metabolism, 2017</a>)</em></p>\n</blockquote>\n<p><strong>Why has saturated fat been considered harmful?</strong></p>\n<p>High saturated fat intake has been <em>associated</em> with increased levels of LDL cholesterol, which in turn has been <em>associated</em> with an increased risk of cardiovascular disease, but this does not automatically mean that saturated fat <em>causes</em> cardiovascular disease (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943062/\" rel=\"nofollow noreferrer\">Current Atherosclerosis reports, 2010</a>).</p>\n<p>Large studies and study reviews according to which saturated fat intake has been associated with:</p>\n<ul>\n<li>Increased risk of cardiovascular disease: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121105/\" rel=\"nofollow noreferrer\">BMJ, 2016</a></li>\n<li>No increase of risk of cardiovascular disease or diabetes type 2: <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/20071648\" rel=\"nofollow noreferrer\">AJCN, 2010</a>, <a href=\"https://annals.org/aim/article-abstract/1846638/association-dietary-circulating-supplement-fatty-acids-coronary-risk-systematic-review\" rel=\"nofollow noreferrer\">Annals of Internal Medicine, 2014</a>, <a href=\"https://www.bmj.com/content/351/bmj.h3978\" rel=\"nofollow noreferrer\">BMJ, 2015</a>)</li>\n</ul>\n<p>The conflicting results can be due to neglecting the effect of other nutrients in the diet and individual differences (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814348/\" rel=\"nofollow noreferrer\">Circulation, 2018</a>).</p>\n<p><strong>1) The effect of other nutrients on the effect of saturated fat</strong></p>\n<p>According to some systematic reviews, replacing some saturated fat with <strong>unsaturated fat</strong> decreases the risk of heart disease (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26068959\" rel=\"nofollow noreferrer\">Cochrane, 2015</a>, <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29174025\" rel=\"nofollow noreferrer\">NMCD, 2017</a>).</p>\n<p>A <a href=\"https://www.cochrane.org/CD012345/VASC_polyunsaturated-fatty-acids-prevention-and-treatment-diseases-heart-and-circulation\" rel=\"nofollow noreferrer\">2018 Cochrane systematic review</a> have found a weak association between increased intake of <strong>polyunsaturated</strong> fats and lower risk of cardiovascular disease, but another review in <a href=\"https://annals.org/aim/article-abstract/1846638/association-dietary-circulating-supplement-fatty-acids-coronary-risk-systematic-review\" rel=\"nofollow noreferrer\">Annals of Internal Medicine, 2014</a> has not.</p>\n<p>It is possible that not every polyunsaturated fat is beneficial. In two meta-analyses, replacing saturated fat with <strong>omega-6</strong> polyunsaturated fatty acids was associated with a higher risk of heart disease, and replacing with <strong>omega-3</strong> fatty acids with a reduced risk (<a href=\"https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/n6-fatty-acidspecific-and-mixed-polyunsaturate-dietary-interventions-have-different-effects-on-chd-risk-a-metaanalysis-of-randomised-controlled-trials/938F3F74E18033ED061F7D8CEAB0A24A/core-reader#\" rel=\"nofollow noreferrer\">Cambridge Core, 2010</a>, <a href=\"https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0254-5\" rel=\"nofollow noreferrer\">Nutrition Journal, 2017</a>).</p>\n<p><strong>Dairy,</strong> despite being high in saturated fat, has not been associated with increased risk of cardiovascular disease (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26786887\" rel=\"nofollow noreferrer\">British Journal of Nutrition, 2016</a>, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244750/\" rel=\"nofollow noreferrer\">Current Nutrition Reports, 2018</a>). It was suggested that high levels of calcium and vitamin D in milk may counteract the effect of saturated fat (<a href=\"https://onlinelibrary.wiley.com/doi/full/10.1111/nbu.12283\" rel=\"nofollow noreferrer\">Nutrition Bulletin, 2017</a>).</p>\n<p><strong>Red meat</strong> and <strong>processed meat</strong> are both high in saturated fat, but processed meat intake has been associated with much higher risk of heart disease and diabetes 2 than unprocessed red meat (<a href=\"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.109.924977?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%3Dpubmed\" rel=\"nofollow noreferrer\">Circulation, 2010</a>, <a href=\"https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-63\" rel=\"nofollow noreferrer\">BMC Medicine, 2013</a>). This suggests that it may not be saturated fat but preservatives (sodium, nitrates) in processed meat that can be harmful.</p>\n<p>High intake of <strong>refined carbohydrates</strong> (sugar, plain starch) in combination with saturated fat intake has been associated with increased risk of cardiovascular disease (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21978979\" rel=\"nofollow noreferrer\">The Netherlands Journal of Medicine, 2011</a>).</p>\n<p><strong>2) Individual differences in response to saturated fat</strong></p>\n<p>Individuals who produce <strong>small dense LDL particles</strong> can be more negatively affected by saturated fat than those who produce large particles.</p>\n<blockquote>\n<p>Because medium and small LDL particles are more highly associated with\ncardiovascular disease than are larger LDL, the present results\nsuggest that very high saturated fat intake may increase\ncardiovascular disease risk in phenotype B individuals <em>[who produce a\nlarge percent of small LDL particles]</em>. <em>(<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293238/\" rel=\"nofollow noreferrer\">Plos One, 2017</a>)</em></p>\n</blockquote>\n<p>Individuals with <strong>increased risk of heart disease</strong> seem to be more prone for harmful effects of saturated fat. In a prospective PREDIMED study following 7038 participants at high risk of cardiovascular disease for 6 years, high intake of saturated fat was strongly positively associated (+81%) and unsaturated fat strongly inversely associated (-32-50%) with cardiovascular events and deaths.</p>\n<p><strong>In conclusion,</strong> the effect of saturated fat on health cannot be evaluated in isolation but only in context of overall diet and individual differences. High saturated fat intake can be harmful in individuals with risk factors for heart disease, but less likely in healthy individuals without risk factors who consume enough whole grains and unsaturated fat. There is no evidence to recommend increasing saturated fat intake.</p>\n" }, { "answer_id": 21141, "author": "paulj", "author_id": 16600, "author_profile": "https://health.stackexchange.com/users/16600", "pm_score": 1, "selected": false, "text": "<p>Yes, having too little saturated fat will cause health issues. There is no need for most in a Western diet to increase it though. There are several papers that can be found similar to the one below. Insufficient animal products as being the a culprit as to why Japanese suffer strokes dis-proportionally higher than those in other populations with markedly different dietary intake.</p>\n\n<p><a href=\"https://www.ahajournals.org/doi/full/10.1161/01.str.0000130426.52064.09\" rel=\"nofollow noreferrer\">Japan Stroke</a> </p>\n" } ]

[ "https://health.stackexchange.com/questions/1583", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1056/" ]

[ { "answer_id": 1592, "author": "Daniel Griscom", "author_id": 1070, "author_profile": "https://health.stackexchange.com/users/1070", "pm_score": 2, "selected": false, "text": "<p>You have three separate issues here; I'll focus on how they affect bacteria in the gut. First, are different yet similar bacteria better or worse for people? Clearly yes; with various types of <a href=\"http://www.mayoclinic.org/diseases-conditions/e-coli/basics/definition/con-20032105\" rel=\"nofollow\"><em>Escherichia coli</em></a> being common and usually benign inhabitants, but <em>E. coli O157:H7</em> causing severe problems.</p>\n\n<p>Second, can directed evolution coax a bad type of bacteria into being a less harmful type? Also clearly yes: this is being done all the time in the biofuels industry to create bacteria with specific abilities to break down and reform materials into fuel.</p>\n\n<p>Third, can such improved bacteria be used to crowd out the bad bacteria? Again, yes: <em>Clostridium difficile</em> is (see the name) a difficult-to-control gut inhabitant. Classic treatment with antibiotics has not been very effective, but transplanting good gut flora with <a href=\"http://www.mayoclinic.org/medical-professionals/clinical-updates/digestive-diseases/quick-inexpensive-90-percent-cure-rate\" rel=\"nofollow\">fecal microbiota transplantation</a> (FMT) seems to be very effective in the limited studies so far.</p>\n\n<p>The trouble is when you want to combine them all. FMT is still controversial, because it's difficult to control exactly what gets transplanted, and we don't completely (or even mostly) understand the functionality of the gut biota. What if a transplant recipient goes downhill in an unexpected way: was it the fault of the transplant? It may be tough to tell, but lawyers could make enormous amounts of money on the question. Now, if you're working with a <strong>designed</strong> bacteria, the consequences could be even harder to predict, and the legal fault could be even clearer. (Plus there's the \"ick\" factor of poop transplantation.)</p>\n\n<p>To summarize, the basic idea is good, but the proof is in the implementation. </p>\n" }, { "answer_id": 1596, "author": "Fomite", "author_id": 206, "author_profile": "https://health.stackexchange.com/users/206", "pm_score": 0, "selected": false, "text": "<p>Yes.</p>\n\n<p>In principle, this is what happens with any vaccine using an <a href=\"http://vaccine-safety-training.org/live-attenuated-vaccines.html\" rel=\"nofollow\">\"attenuated\"</a> virus or bacteria - they have been directed through essentially forced evolution to lose some of their properties that effect virulence - how sick they make you when you get infected.</p>\n\n<p>Some examples of this include the <a href=\"http://www.cdc.gov/flu/about/qa/nasalspray.htm\" rel=\"nofollow\">influenza nasal spray vaccine</a> or the type of <a href=\"http://www.polioeradication.org/Polioandprevention/Thevaccines/Oralpoliovaccine(OPV).aspx\" rel=\"nofollow\">polio vaccine</a> used in developing countries. These are both viral examples, but bacterial examples exist, including tuberculosis.</p>\n\n<p>In a grander sense outside vaccination research, this is theoretically possible, but has some complications. The first is whether or not you can actually get attenuation. There are some microbes (norovirus and <em>C. difficile</em> come to mind) that are very hard to culture, so this kind of directed evolution is difficult. And, if successful, you'd have to reintroduce them in a setting where the \"full strength\" microbes exist, and if those full strength microbes have a selective advantage in the environment, the engineered strains are unlikely to be successful in the long term.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1587", "https://health.stackexchange.com", "https://health.stackexchange.com/users/997/" ]

[ { "answer_id": 3371, "author": "Sean Duggan", "author_id": 31, "author_profile": "https://health.stackexchange.com/users/31", "pm_score": 0, "selected": false, "text": "<p>Short answer, there is no definitive link between oral contraception and breast cancer.</p>\n<p>You can find a short rundown on the relative risks in this article on <a href=\"https://www.sciencebasedmedicine.org/birth-control/\" rel=\"nofollow noreferrer\">Birth Control</a> on <em>Science-Based Medicine</em>.</p>\n<blockquote>\n<p>Information on cancer and oral contraceptives can be found <a href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives\" rel=\"nofollow noreferrer\">here</a>. There is an increased risk of cervical cancer, but most cases are related to HPV infection, so hopefully the new vaccines will eliminate much of that risk. There is an increased risk of liver cancer in low risk populations but not in high-risk populations. The risk of breast cancer may or may not be slightly increased: studies do not agree.</p>\n<p>On the other hand, the pill clearly reduces the risk of uterine and ovarian cancers. And a meta-analysis found that the <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19414526\" rel=\"nofollow noreferrer\">risk of colorectal cancer is also decreased</a>.</p>\n<p>The magnitude of these risks is small. I couldn’t find any information about overall cancer risk: whether the increase in some types of cancer outweighs the decrease in others.</p>\n</blockquote>\n<p>....</p>\n<blockquote>\n<p>[The International Agency for Research on Cancer] does classify estrogen/progesterone in the same group 1 category as cigarettes and asbestos, but all that category means is that there is sufficient evidence to prove carcinogenicity in humans.</p>\n</blockquote>\n" }, { "answer_id": 4114, "author": "HDE 226868", "author_id": 2192, "author_profile": "https://health.stackexchange.com/users/2192", "pm_score": 2, "selected": false, "text": "<p>The <a href=\"http://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet#q3\" rel=\"nofollow noreferrer\">National Cancer Institute</a> has a nice summary of the relationship between oral contraceptives and cancer, based on several reports. While there were some conflicting results, there seemed to be a consensus that there is a mild increase in the risk of breast cancer among women using oral contraceptives.</p>\n\n<p>Here are the three reports:</p>\n\n<ul>\n<li><strong><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/15105794\" rel=\"nofollow noreferrer\">Burkman et al. (2004)</a>:</strong> This is a general overview of studies done since the first oral contraceptives became widely used, in the 1960s. Data indicates that there is a slightly higher risk of breast cancer among women taking oral contraceptives.</li>\n<li><strong><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20802021\" rel=\"nofollow noreferrer\">Hunter et al. (2010)</a>:</strong> Data was complied from biannual screenings of over 116,00 women over a twelve-year period. It was found that the use of oral contraceptives in the past did not contribute to breast cancer, while the current use of these contraceptives led to a slight increase in risk. However, this focused on a specific type of oral contraceptive.</li>\n<li><strong><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8656904\" rel=\"nofollow noreferrer\">Lancet (1996)</a>:</strong> Over 150,000 women from 54 studies were analyzed. There were three main findings:\n\n<ul>\n<li>There is a slight increase in breast cancer risk in those who stop taking oral contraceptives after using them regularly for a long time.</li>\n<li>Breast cancers in women using these contraceptives was detected or diagnosed at any earlier stage.</li>\n<li>Women who used contraceptives before the age of twenty had a slightly higher risk of breast cancer.</li>\n</ul></li>\n</ul>\n\n<p>There are, of course, other studies not mentioned in the NCI article, including these two:</p>\n\n<ul>\n<li><strong><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26667320\" rel=\"nofollow noreferrer\">Heikkinen et al. (2015)</a>:</strong> The use of general exogenous hormones in oral contraceptives and in hormone-releasing intrauterine devices. In these cases, a slightly higher risk of breast cancer was observed.</li>\n<li><strong><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26437729\" rel=\"nofollow noreferrer\">Jordan et al. (2015)</a>:</strong> This used statistics to estimate cases of breast cancer caused by the use of oral contraceptives. The result was that about 100 cases in Australia in 2010 can be attributed to the use of these contraceptives.</li>\n<li><strong><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26333690\" rel=\"nofollow noreferrer\">Zhong et al. (2015)</a>:</strong> This search of PubMed combined with data analysis methods suggested that there is no link between oral contraceptives and breast cancer.</li>\n</ul>\n\n<p>These three studies have all been published (or even only submitted to PubMed) extremely recently, so their results are not necessarily confirmed by other studies. However, they are certainly more recent than some of the other studies.</p>\n\n<p>There appears to be a slight increase in the risk of breast cancer in women who use oral contraceptives - including the types used today. However, this risk is very, very tiny, and the benefits of contraceptives far outweigh any possible risks in this regard. The results of Jordan et al. (2015), if definitive, should show that any real-world effects are negligible when looked at in the big picture.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1609", "https://health.stackexchange.com", "https://health.stackexchange.com/users/381/" ]

[ { "answer_id": 1625, "author": "Jaeger Jay", "author_id": 1017, "author_profile": "https://health.stackexchange.com/users/1017", "pm_score": -1, "selected": false, "text": "<p>I would advise you to consult a doctor. Tonsilloliths is not a cough or fever that can be remedied only by nutritious intake and rest. It is considered a mucosal infection, thats why, any reckless action may result to further infection and more complication. </p>\n" }, { "answer_id": 1943, "author": "Chloe", "author_id": 1089, "author_profile": "https://health.stackexchange.com/users/1089", "pm_score": 2, "selected": true, "text": "<p>I found these water injectors on Amazon which squirt a thin stream of water for several dozen seconds and have a curved tip that can reach back into the crevices of tonsils. I was able to remove several of the tonsilliths. The tips are slightly rough but I suppose they can be cut or filed. Shining a flashlight with the other hand lets you see what you are doing. I had hoped for a vacuum solution but this seems to work for less money. Just take a deep breath and hold your breath while doing it.</p>\n\n<p><a href=\"http://rads.stackoverflow.com/amzn/click/B007Y8230G\" rel=\"nofollow\">http://www.amazon.com/gp/product/B007Y8230G</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1614", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1089/" ]

[ { "answer_id": 1625, "author": "Jaeger Jay", "author_id": 1017, "author_profile": "https://health.stackexchange.com/users/1017", "pm_score": -1, "selected": false, "text": "<p>I would advise you to consult a doctor. Tonsilloliths is not a cough or fever that can be remedied only by nutritious intake and rest. It is considered a mucosal infection, thats why, any reckless action may result to further infection and more complication. </p>\n" }, { "answer_id": 1943, "author": "Chloe", "author_id": 1089, "author_profile": "https://health.stackexchange.com/users/1089", "pm_score": 2, "selected": true, "text": "<p>I found these water injectors on Amazon which squirt a thin stream of water for several dozen seconds and have a curved tip that can reach back into the crevices of tonsils. I was able to remove several of the tonsilliths. The tips are slightly rough but I suppose they can be cut or filed. Shining a flashlight with the other hand lets you see what you are doing. I had hoped for a vacuum solution but this seems to work for less money. Just take a deep breath and hold your breath while doing it.</p>\n\n<p><a href=\"http://rads.stackoverflow.com/amzn/click/B007Y8230G\" rel=\"nofollow\">http://www.amazon.com/gp/product/B007Y8230G</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1639", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1106/" ]

[ { "answer_id": 3600, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 2, "selected": false, "text": "<p>Blood pressure that is lower in the morning than at noon or evening is perfectly normal. Variations on the level that you describe, which is 5 mm Hg systolic (the first number), are also completely normal. Blood pressure doesn't stay the same, it varies with activity, emotional state, etc. </p>\n\n<p>The first figure in the following paper illustrates normal blood pressure variations throughout a day: <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261916/#!po=10.4938\" rel=\"nofollow\">Prognostic Significance of the Morning Blood Pressure Surge in Clinical Practice: A Systematic Review</a>. The paper's topic is abnormal surges in blood pressure, which are surges before waking. </p>\n\n<p>A fluctuation of more than 14 mm Hg systolic as taken at the same time a day (without doing sports beforehand etc) should be checked out <a href=\"http://www.m.webmd.com/a-to-z-guides/news/20150727/big-swings-in-blood-pressure--could-spell-trouble\" rel=\"nofollow\">by a doctor</a></p>\n" }, { "answer_id": 3756, "author": "Sympa", "author_id": 1309, "author_profile": "https://health.stackexchange.com/users/1309", "pm_score": -1, "selected": false, "text": "<p>YviDe has already given you an excellent answer. And, I know this website is really against people writing answers without any valid reference. But, I would like to contribute valid information based on extensive first hand empirical data I have conducted on myself over more than a decade.</p>\n\n<p>I take my blood pressure several times a year, always 3 or more times at one sitting. I notice something amazing, and that is how much your blood pressure can move around within just a 5 minute interval. Divergences of more than 20 points are common for systolic pressure and 10 to 15 points for diastolic pressure. </p>\n\n<p>The first time you take the pressure, you may have a high reading. You wait a few minutes, and you make a conscious effort to calm yourself (thinking about relaxing on a sunny beach, etc...). And, you get a lot lower reading. I have learned to take my blood pressure several times as mentioned, and take the average as the representative measure for that date. By doing so, I have noticed that my blood pressure has remained perfectly stable over the years. Had I just relied on doctor's office readings, they probably could have randomly derived very different trends and potentially put me or any other patient on hypertension lowering prescription drugs, when none is necessary. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1640", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1107/" ]

[ { "answer_id": 3600, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 2, "selected": false, "text": "<p>Blood pressure that is lower in the morning than at noon or evening is perfectly normal. Variations on the level that you describe, which is 5 mm Hg systolic (the first number), are also completely normal. Blood pressure doesn't stay the same, it varies with activity, emotional state, etc. </p>\n\n<p>The first figure in the following paper illustrates normal blood pressure variations throughout a day: <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261916/#!po=10.4938\" rel=\"nofollow\">Prognostic Significance of the Morning Blood Pressure Surge in Clinical Practice: A Systematic Review</a>. The paper's topic is abnormal surges in blood pressure, which are surges before waking. </p>\n\n<p>A fluctuation of more than 14 mm Hg systolic as taken at the same time a day (without doing sports beforehand etc) should be checked out <a href=\"http://www.m.webmd.com/a-to-z-guides/news/20150727/big-swings-in-blood-pressure--could-spell-trouble\" rel=\"nofollow\">by a doctor</a></p>\n" }, { "answer_id": 3756, "author": "Sympa", "author_id": 1309, "author_profile": "https://health.stackexchange.com/users/1309", "pm_score": -1, "selected": false, "text": "<p>YviDe has already given you an excellent answer. And, I know this website is really against people writing answers without any valid reference. But, I would like to contribute valid information based on extensive first hand empirical data I have conducted on myself over more than a decade.</p>\n\n<p>I take my blood pressure several times a year, always 3 or more times at one sitting. I notice something amazing, and that is how much your blood pressure can move around within just a 5 minute interval. Divergences of more than 20 points are common for systolic pressure and 10 to 15 points for diastolic pressure. </p>\n\n<p>The first time you take the pressure, you may have a high reading. You wait a few minutes, and you make a conscious effort to calm yourself (thinking about relaxing on a sunny beach, etc...). And, you get a lot lower reading. I have learned to take my blood pressure several times as mentioned, and take the average as the representative measure for that date. By doing so, I have noticed that my blood pressure has remained perfectly stable over the years. Had I just relied on doctor's office readings, they probably could have randomly derived very different trends and potentially put me or any other patient on hypertension lowering prescription drugs, when none is necessary. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1646", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1110/" ]

[ { "answer_id": 5917, "author": "Ramyar ", "author_id": 3748, "author_profile": "https://health.stackexchange.com/users/3748", "pm_score": 0, "selected": false, "text": "<p>Sleep quality is multi-factorial. It depends on several physical and mental factors which differ person to person. For instance patients with spinal problems are better to sleep in a supine position (sleep on the back) on a hard surface while allergic patients and children are better to sleep in a prone position (sleep on the stomach) because in this position mucosal secretions can run out easily and cause no breathing difficulty. So generally speaking, sleeping on the floor does not improve your sleep quality unless you have spinal or neck or muscular difficulties. For experiencing a good deep sleep it is suggested to have an early dinner, exercise daily, meditate before sleep and avoid caffeine and smocking.</p>\n" }, { "answer_id": 9556, "author": "Prince", "author_id": 6972, "author_profile": "https://health.stackexchange.com/users/6972", "pm_score": 1, "selected": false, "text": "<p>Sleeping on the floor could be comfortable for some people who does such, but when you sleep on bed usually and eventually decide to sleep on the floor, it'll seem impossible due to body adaptation. </p>\n\n<p>It might take some weeks for such a person's body to adapt to sleeping on the floor. Let me use myself as a case study, I usually sleep on the bed, but a day arose when visitors came and I had to sleep on the floor, sincerely I found it hard to breathe because my ribs felt pressed against the floor.</p>\n\n<p>So yes sleeping on the floor can improve sleep quality but on the other hand, it can't improve sleep quality.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1672", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1134/" ]

[ { "answer_id": 1724, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 3, "selected": true, "text": "<p>I viewed your question in the Biology Stack and I think the answers you received are quite good. I´ll try sum up those long answers in the Biology Stack and present them more clearly.</p>\n\n<p>Major factor influencing to the presumed effects of any drug is the first pass effect <a href=\"https://en.wikipedia.org/wiki/First_pass_effect\" rel=\"nofollow\">(Wikipedia)</a>. That means that every substance taken orally must absorb from intestine to the surrounding blood stream. All this blood with all absorbed substance (incl. sugar, fat, protein from food) are transported to liver. Liver then processes all the substances in the blood.</p>\n\n<p>There are dozen of enzymes in the liver which processes the substances in the blood. One enzyme family particularly processes all the foreign substances (inc. drugs) <a href=\"https://en.wikipedia.org/wiki/Cytochrome_P450\" rel=\"nofollow\">(Wikipedia)</a>. Liver aims to remove all foreign substances from the blood, but some of the absorbed substance always escapes the liver to the systemic circulation. Only those molecules which escape liver without processing are transported to the tissues and afterwards can bind to their receptors in the tissue thus eliciting the proposed actions (ie. reducing pain).</p>\n\n<p>Enzymes in the liver processes the foreign molecules in a way that they are secreted to bile and eventually to feces. For example enzyme CYP2E1 processes paracetamol <a href=\"https://en.wikipedia.org/wiki/CYP2E1\" rel=\"nofollow\">(Wikipedia)</a>. There are three different CYP-enzymes which processes diclofenac molecules <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12871048\" rel=\"nofollow\">(PubMed)</a>. And for naproxen two CYP-enzymes exist <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8866821\" rel=\"nofollow\">(PubMed)</a>. </p>\n\n<p>One major reason why diclofenac does not help you but naproxen does, is the different action of these enzymes. DNA in our cell nucleus defines how each protein is expressed in our body. These enzymes are these proteins. In your case it seems that enzymes responsible for processing diclofenac are expressed in large number in your liver, resulting to very low concentration of diclofenac molecules in your bloodstream. In other word the level of diclofenac in your blood stream is out of therapeutic window to elicit any responses in the body <a href=\"https://en.wikipedia.org/wiki/Therapeutic_window\" rel=\"nofollow\">(Wikipedia)</a>. In contrary, your liver may express enzymes responsible for the processing of naproxen very little and thus many naproxen molecules may escape liver to the systematic circulation resulting the therapeutic level to elicit tissue responses.</p>\n\n<p>This only one player in this topic, although very important and influential. There are also factor influencing after the first pass effect (receptor, expression of genes responsible for receptors, binding affinity ec.) </p>\n" }, { "answer_id": 1738, "author": "SalkinD", "author_id": 1193, "author_profile": "https://health.stackexchange.com/users/1193", "pm_score": 1, "selected": false, "text": "<p>At first I want to note arkiaamu's answer is very good. If you also need a shorter answer take this:</p>\n\n<p>Naproxene and Aspirine do not only 'directly' relieve pain, they also work antiinflammatory. In many cases the inflammation itself causes pain, so these drugs have different targets to work. <a href=\"https://en.wikipedia.org/wiki/Mechanism_of_action_of_aspirin\" rel=\"nofollow\">See this</a></p>\n\n<p>Tramadol is not antiinflammatory, neither is paracetamol. </p>\n\n<p>You are not the only on feeling a difference between naproxene and diclofenac. Read the answer from arkiaamu for some ideas why. Reasons are multi-factorial including some personal things like genetics and gene-expression. </p>\n\n<p>Please note that naproxene and aspirine have dangerous adverse effects (gastrointestinal bleeding). Aspirine should not be given to children, as it has some rare but very severe adverse effects that others do not have. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17523700\" rel=\"nofollow\">(1)</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/1696", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1157/" ]

[ { "answer_id": 1747, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": -1, "selected": false, "text": "<p><a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0096695\" rel=\"nofollow noreferrer\">Vitamin D plays an important role in the immune system</a>, and there is some evidence that higher vitamin D levels help people to prevent upper respiratory tract infections, <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/\" rel=\"nofollow noreferrer\">see here</a>:</p>\n\n<blockquote>\n <p>There have been multiple cross-sectional studies associating lower levels of vitamin D with increased infection. One report studied almost 19,000 subjects between 1988 and 1994. Individuals with lower vitamin D levels (&lt;30 ng/ml) were more likely to self-report a recent upper respiratory tract infection than those with sufficient levels, even after adjusting for variables including season, age, gender, body mass and race[8]. Vitamin D levels fluctuate over the year. Although rates of seasonal infections varied, and were lowest in the summer and highest in the winter, the association of lower serum vitamin D levels and infection held during each season. Another cross-sectional study of 800 military recruits in Finland stratified men by serum vitamin D levels[9]. Those recruits with lower vitamin D levels lost significantly more days from active duty secondary to upper respiratory infections than recruits with higher vitamin D levels (above 40 nmol). There have been a number of other cross-sectional studies looking at vitamin D levels and rates of influenza [10] as well as other infections including bacterial vaginosis[11] and HIV[12-13]. All have reported an association of lower vitamin D levels and increased rates of infection.</p>\n</blockquote>\n\n<p><a href=\"http://www.nature.com/bonekey/knowledgeenvironment/2011/1104/bonekey20110505/fig_tab/bonekey20110505_F1.html\" rel=\"nofollow noreferrer\">The basic mechanisms that are known can be summarized as follows:</a></p>\n\n<p><a href=\"https://i.stack.imgur.com/92l9O.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/92l9O.jpg\" alt=\"Basic picture\"></a></p>\n\n<blockquote>\n <p>The immunomodulatory effects of 1,25(OH)2D3. 1,25(OH)2D3 targets different players of the innate and adaptive immune compartment. 1,25(OH)2D3 stimulates innate immune responses by enhancing the chemotactic and phagocytotic responses of macrophages as well as the production of antimicrobial proteins such as cathelicidin. On the other hand, 1,25(OH)2D3 also modulates adaptive immunity. At the level of the APC (like the DC), 1,25(OH)2D3 inhibits the surface expression of MHC-II-complexed antigen and of co-stimulatory molecules, in addition to production of the cytokines IL-12 and IL-23, thereby indirectly shifting the polarization of T cells from a Th1 and Th17 phenotype towards a Th2 phenotype. In addition, 1,25(OH)2D3 directly affects T cell responses, by inhibiting the production of Th1 cytokines (IL-2 and IFN-γ) and Th17 cytokines (IL-17 and IL-21), and by stimulating Th2 cytokine production (IL-4). Moreover, 1,25(OH)2D3 favors Treg cell development via modulation of DCs and by directly targeting T cells. Finally, 1,25(OH)2D3 blocks plasma cell differentiation, IgG and IgM production and B cell proliferation.</p>\n</blockquote>\n\n<p>In addition to this, <a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101659\" rel=\"nofollow noreferrer\">vitamin D is needed to build muscle</a>, heavy exercise will deplete vitamin D levels, potentially compromising your immune system:</p>\n\n<blockquote>\n <p>Our findings support our hypothesis. Analysis of our results showed that vitamin D levels are associated with neuromuscular performance and aerobic capacity in professional soccer players. Notably, to the best of our knowledge, for the first time our study provides evidence of a linear relationship between vitamin D serum levels, not only with jumping performance, but also with VO2max and speed in non-supplemented soccer players. In addition, we have found that even the short off-season period of reduced training stress had a boosting effect on vitamin D levels. Interestingly, this increase in vitamin D levels was evident in parallel to a reduction in aerobic and neuromuscular performance parameters. The latter finding strengthens the well-documented concept that training plays the principal role for exercise adaptations and improvements in exercise performance, whereas all other parameters including vitamin D play a supportive role.</p>\n</blockquote>\n\n<p>I make sure I get about 7000 IU of vitamin D per day, and I keep my calcidiol level at about 200 nmol/l. In the summer I adjust the intake of vitamin D supplements to take into account the amount I get from the Sun, in the winter I get the entire dose of 7000 IU/day from supplements (I then take 10,000 IU/day, 5 times per week). Note that such doses and calcidiol levels <a href=\"http://ajcn.nutrition.org/content/88/2/582S.full\" rel=\"nofollow noreferrer\">are safe</a>.</p>\n\n<p>I don't exercise in a gym, I only exercise outside. This helps to build immunity against cold viruses early on when they are still evolving to become next winter's scourge. When you run, your lungs filter the air less, allowing viruses to enter your body more easily. Also, you are inhaling an enormous amount of air up to ten times more per unit time compared to being in rest. Chances are then that your immune system will already have encounter the cold viruses that will later mutate a bit and then make many people ill.</p>\n" }, { "answer_id": 1753, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 2, "selected": false, "text": "<p>First, let me say that I highly doubt your assertion that workouts make you more likely to get ill than someone who \"just goes to the office &amp; back each day.\" I don't know what you base that assertion on and I think you're 100% wrong until you can provide evidence to support it. Working out and staying fit have the exact opposite effect, if anything. Why are you even doing it if you think being fit makes you sick?</p>\n\n<p>That said, it is true that you touch a lot of surfaces at a gym that many other people touch, and that does indeed open a pathway to infection. I don't know that you touch more surfaces than an office worker does, but for the sake of argument let's suppose you do. </p>\n\n<p><a href=\"http://health.universityofcalifornia.edu/2012/12/13/cold-supplements-from-airborne-to-zinc/\" rel=\"nofollow\">There are many well known prevention strategies</a>, and quite frankly few of them that are actually known to work involve supplements, vitamins or anything else you have to pay for. Most mainly involve soap.</p>\n\n<p>In my personal experience, which comes with significant scientific backing, two simple things will prevent more upper respiratory infections than anything else you can do:</p>\n\n<p>1) <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16553905\" rel=\"nofollow\">Wash your hands -- well and often</a>. And since you can't do that as often as you should, <a href=\"http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html\" rel=\"nofollow\">carry a bottle of alcohol hand sanitizer</a> in your car, your purse, or wherever you'll actually have it when you need it. Use it whenever you leave a public place. And in the gym, use the sanitizer they (should) have all over the place.</p>\n\n<p>2) <a href=\"http://www.cdc.gov/features/rhinoviruses/\" rel=\"nofollow\">Do not ever touch your eyes, nose or mouth with your fingers</a>. No, not ever, not even once. When your eye itches, rub it with a tissue or even your sleeve if that's all you've got. Use napkins or tissues or sleeves or as the absolute last choice, <em>the back</em> of your hand if you must touch your face. Just never touch mucous membranes with bare fingers.</p>\n\n<p>Do those two things, then put your wallet back in your pocket at the vitamins and supplements store, and enjoy your freedom from upper respiratory tract infections.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1745", "https://health.stackexchange.com", "https://health.stackexchange.com/users/462/" ]

[ { "answer_id": 1778, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 3, "selected": true, "text": "<p>This is a very pragmatic question and I would like give you an explicit answer. Unfortunately I think that there is only so little objective information which hearing aid is the best.</p>\n\n<p>As said when the best aid is considered it is a very subjective matter. There is no clear comparative studies about different hearing aids, especially if those without ear canal implant are used. If your father suffers from fungal infection is is natural that aids figured below are not pleasant due to ear canal irritation:</p>\n\n<p><a href=\"https://i.stack.imgur.com/ckQBB.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/ckQBB.jpg\" alt=\"enter image description here\"></a> </p>\n\n<blockquote>\n <p>Many choices of hearing aid styles are available, including the following: completely in the canal (A), in the canal (B), in the ear (C), behind the ear (D), receiver in canal or receiver in the ear (E), and open fit (F).</p>\n</blockquote>\n\n<p>Sources: <a href=\"http://www.mayoclinic.org/diseases-conditions/hearing-loss/multimedia/hearing-aid-styles/img-20008215\" rel=\"nofollow noreferrer\">MayoClinic</a></p>\n\n<p>As so, <strong>Personal Sound Amplification Products</strong> (PSAP) may seem appropriate as a temporary aid <a href=\"http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/HearingAids/ucm181482.htm#1\" rel=\"nofollow noreferrer\">(FDA)</a>. It is however, important to notice that these aids are not as powerful as actual hearing aids.</p>\n\n<p><em>I would recommend to consult an audiologist to get some insight to PSAPs. Also I would seek a brick-and-mortar shop which sells these aids, since most likely the sellers have valuable consumer info on these aids and can help deciding the right aid.</em></p>\n\n<p>I would like to also remind that it is <strong>extremely important</strong> to get the fungal infection treated and return to use the ordinary aid, since <strong>hearing loss can severely reduce the quality of life</strong>.</p>\n" }, { "answer_id": 1781, "author": "SPRBRN", "author_id": 1218, "author_profile": "https://health.stackexchange.com/users/1218", "pm_score": 0, "selected": false, "text": "<p>You can look for <a href=\"http://www.hearingaidmuseum.com/gallery/Non-Electric/index-nonelect.htm\" rel=\"nofollow\">Ear Trumpets or Conversation Tubes</a>, or instruments used in the old age. I've googled for <a href=\"https://www.google.com/?q=old%20fashioned%20hearing%20aid\" rel=\"nofollow\">old fashioned hearing aids</a>.</p>\n" }, { "answer_id": 7570, "author": "StrongBad", "author_id": 55, "author_profile": "https://health.stackexchange.com/users/55", "pm_score": 1, "selected": false, "text": "<p><a href=\"https://en.wikipedia.org/wiki/Bone-anchored_hearing_aid\" rel=\"nofollow\">Bone Anchored Hearing Aids (BAHA)</a> do not require having anything in the ear. Rather, they are placed behind the ear and work based on bone conduction. Commercially available BAHAs are both expensive and typically require surgery (outpatient procedure with local anesthesia), but they can be used without surgery. For example, at <a href=\"http://www.hopkinsmedicine.org/hearing/hearing_aids/baha.html\" rel=\"nofollow\">John Hopkins</a> they let you test one out with a headband during your appointment. <a href=\"http://www.oticonmedical.com/Medical/YourTreatment/The%20treatment%20process/Softband%20solution.aspx\" rel=\"nofollow\">Oticon</a> sells a headband to be used with a BAHA.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1771", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1221/" ]

[ { "answer_id": 1788, "author": "SalkinD", "author_id": 1193, "author_profile": "https://health.stackexchange.com/users/1193", "pm_score": 1, "selected": false, "text": "<p>Not knowing about HETA air filters some general information: Small particles in air may cause cancer or other lung diseases, but preferably when inhaled in large amounts for a long time(>10 years). In regions of low small-particle-pollution you won't need any air filter, in regions with high pollution this may cause health damage. (<a href=\"http://www.who.int/mediacentre/factsheets/fs313/en/\" rel=\"nofollow\">http://www.who.int/mediacentre/factsheets/fs313/en/</a>) In a highly polluted area (like the air is \"grey\") a filter wouldn't be a bad idea, I would use one. In a low polluted area it won't be too effective. Also, as I assume the place you use it is not air-thight it wont have full effect. Assuming you are 12h/day at home I would be impressed if it has more that 20%-30% effect on your day-intake of PM.</p>\n\n<p>So to answer you question (I did not find numbers, but look at the WHO link above): It may have an significant positive impact to your health in high polluted regions. Many (non published) studies tried to prove that things like this work in low polluted regions but never got significant.</p>\n" }, { "answer_id": 1793, "author": "arkiaamu", "author_id": 153, "author_profile": "https://health.stackexchange.com/users/153", "pm_score": 2, "selected": false, "text": "<p>I found three well conducted (randomized trial) studies on this topic. Synthesis seems to be that HEPA results to significant reduction in the particulate matter in the air but the objective effects on health remains to be shown.</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25896330\" rel=\"nofollow\">Study 1</a>:</p>\n\n<p>HEPA filtration resulted to better air quality. In subjects exposed to traffic-related matter, use of HEPA resulted to lower level of C-reactive protein indicating less intensive systemic inflammation. No effect was when examining subjects exposed to woodsmoke matter.</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515693/\" rel=\"nofollow\">Study 2:</a></p>\n\n<p>Subjects were exposed to traffic-realted particles and use of HEPA filtration had no effect on blood pressure, level of C-reactive protein, fibrinogen or tumor necrosis factor alpha-receptor.</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893545/\" rel=\"nofollow\">Study 3:</a></p>\n\n<p>Investigators examined subjects exposed to \"regular\" indoor air. HEPA filtration had no effect on microvascular and lung function or the biomarkers of systemic inflammation.</p>\n\n<hr>\n\n<p>My personal opinion is that I strongly believe that use of HEPA filtration has beneficial health effects IF one is subjected to particulate-matter (like traffic induced). The theory is quite solid: we reduce the bad, potentially carcinogenic particulate matter in the air which we breath daily. </p>\n\n<p>As so, it is very reasonable to assume that intervention has it´s advantages. What they are, remains to be shown. It should be noted that these studies mentioned investigate only the short term effects. It reasonable to assume that long-term effects are evident (lung cancer, chronic bronchitis, COPD etc.)</p>\n" } ]

[ "https://health.stackexchange.com/questions/1783", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 1786, "author": "SalkinD", "author_id": 1193, "author_profile": "https://health.stackexchange.com/users/1193", "pm_score": 2, "selected": false, "text": "<p>Basically this depends of the product you use. Your question does not give enough information to provide a \"curve\", as this has many variants including the produc you use, skin temperature(!), humidity and other influences. Read product instructions. These patches are generally made to provide a more or less constant uptake of the used drug, so in a perfect world with given temperature, humidity and skin type it should be more or less constant for some hours. The amount of hours depend on the specific product. </p>\n\n<p>As you seem to assume right the effect decreases after some time, so if you change every 12 hours you may get more effect than every 24 hours, but most producs seem to be made to work for 24 hours. </p>\n\n<p>In conclusion, if you use a 24-hour patch it won't make much difference to apply it every 12h, because the drug intake/hour should be more or less constant. If you leave your 24h patch for a longer time, like 72h, it is to be expected that the effect decreases. </p>\n\n<p><a href=\"http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021234s005lbl.pdf\" rel=\"nofollow\">http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021234s005lbl.pdf</a> gives you some information, but better you search for the product you use.</p>\n" }, { "answer_id": 4091, "author": "YviDe", "author_id": 1830, "author_profile": "https://health.stackexchange.com/users/1830", "pm_score": 3, "selected": true, "text": "<p>As previously said, this is dependent on the product. However, there is at least one study available comparing the bioavailability (which is what you are asking about - in this case, how much diclofenac permeates into the skin) of several of these patches and the differences don't look too big to me. </p>\n\n<p>Patel, Kunal N., Hetal K. Patel, and Vishnu A. Patel. \"<a href=\"http://www.ijppsjournal.com/Vol4Issue1/2992.pdf\" rel=\"nofollow noreferrer\">Formulation and characterization of drug in adhesive transdermal patches of diclofenac acid.</a>\" Int. J. Pharm. Pharm. Sci 4.1 (2012): 296-299.</p>\n\n<p>What you are interested in is table 2:</p>\n\n<p><a href=\"https://i.stack.imgur.com/OZaWY.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/OZaWY.jpg\" alt=\"Bioavailability of diclofenac for four patches\"></a></p>\n\n<p>As you can see, they do look rather similar, and an obvious feature is that the bioavailability for the first hours isn't as \"good\" as later. So in my nonexpert opinion, keeping a 24 hour patch on for 24 hours would be preferable to switching after 12. </p>\n" } ]

[ "https://health.stackexchange.com/questions/1785", "https://health.stackexchange.com", "https://health.stackexchange.com/users/43/" ]

[ { "answer_id": 1797, "author": "rumtscho", "author_id": 193, "author_profile": "https://health.stackexchange.com/users/193", "pm_score": 2, "selected": false, "text": "<h3>Is tinnitus curable?</h3>\n<p>No, there is no cure for tinnitus. It is connected to a malfunction in the neurons which turn the signals from the ear into the perception of hearing. The usual cause is that the inner ear is damaged, and nobody knows how to repair this organ. You have to accept the idea that it will almost certainly stay with you for the rest of your life.</p>\n<h3>What can you do about tinnitus?</h3>\n<p>The German association for ENT, Head and Neck surgery <a href=\"http://www.awmf.org/leitlinien/detail/ll/017-064.html\" rel=\"nofollow noreferrer\">classifies tinnitus</a> as:</p>\n<blockquote>\n<p>grade I: Does not cause suffering</p>\n<p>grade II: Noticed primary during silence, only interferes during stressful moments and psychic load</p>\n<p>grade III: Causes persistent impairment in the private or professional life, with interference in the emotional, cognitive and body areas</p>\n<p>grade IV: Causes full decompensation in the private area and inability to work</p>\n</blockquote>\n<p>The goal of the existing therapies is not to remove the tinnitus, but to lower it to grade II or I. They usually consist of a combination of relaxation techniques, mental relaxation (meditation, cognitive therapy) which allows you to concentrate on other things without being bothered by tinnitus, and music therapy, which trains your auditory perception to discriminate more between sounds and focus less on the tinnitus sound. After a successful therapy, sufferers of permanent tinnitus can tolerate the tinnitus well, sometimes forgetting it for hours at a time, while sufferers of episodic tinnitus can have less frequent episodes. The subjective loudness of the tinnitus can also go down.</p>\n<p>Tinnitus itself is not treatable, but most of its consequences are, for example sleep problems, depression, speech understanding difficulties, hyperacusis or tensions in the neck area. If they occur, don't hesitate to seek help for them.</p>\n<h3>Where to go for help</h3>\n<p>Tinnitus requires specialized cross-disciplinary knowledge in ENT, neurology and psychiatry. &quot;Standard&quot; ENT doctors are rarely well versed in tinnitus. Your first place to go with acute tinnitus is still the ENT, who can confirm the diagnosis and exclude other, more pressing problems. In the long term, you are much better off going to a clinic specializing in inner ear disorders, or even a pure tinnitus clinic. This type of clinic can also diagnose other, not yet detected types of inner ear damage. Find out if there is a local patient group for tinnitus or hearing loss, and ask them which clinic to go to. They can give you the best regional advice. Also consider becoming a member of your national association for tinnitus, such as <a href=\"http://www.tinnitus-liga.de/index.php\" rel=\"nofollow noreferrer\">Deutsche Tinnitus Liga</a> or <a href=\"https://www.ata.org/about-us\" rel=\"nofollow noreferrer\">American tinnitus association</a>. They are an excellent source for news about promising research.</p>\n<h3>Resources</h3>\n<p>As far as I'm aware, <a href=\"http://www.amazon.de/Tinnitus-Leiden-Chance-Helmut-Schaaf\" rel=\"nofollow noreferrer\">my preferred book</a> about tinnitus is not yet translated into English, but I can recommend it for anybody who reads German. It is written by the director of a clinic specializing in inner ear disorders and his senior physician who is a tinnitus patient himself. If you are researching literature on tinnitus, don't fall for the popular books which promise a miracle healing. I have never met a patient for whom they delivered.</p>\n" }, { "answer_id": 7324, "author": "Weezy", "author_id": 5142, "author_profile": "https://health.stackexchange.com/users/5142", "pm_score": 2, "selected": false, "text": "<p>While there is no single treatment to tinnitus as a variety of reasons can cause it some kinds of therapy might help ease symptoms. Tinnitus is a symptom and not a disease so it is helpful to pinpoint the underlying issue itself and then address it. My tinnitus started after I was on a anti-depressants course(Escitalopram Oxalate) and as soon as I found out one night my ears won't stop ringing I discontinued the drug. The following weeks I experienced natural side-effects of the medication and since then the tinnitus has been there. Now I believe my issue is not with the ear but the auditory cortex itself: the part of the brain associated with processing audio signals. Overexcitation of neurons caused by hearing loss over certain frequencies so the neurons associated with those frequencies start generating their own signals and you get tinnitus or even chronic anxiety/depression. Acoustic neuromodulation is a nice effective therapy to combat this type of tinnitus. Watch this to understand what it is: <a href=\"https://www.youtube.com/watch?v=X_XjYnPooPk\" rel=\"nofollow\">https://www.youtube.com/watch?v=X_XjYnPooPk</a></p>\n\n<blockquote>\n <p>Also this website lets you use your earphones to do ACRN yourself:\n <a href=\"http://generalfuzz.net/acrn/\" rel=\"nofollow\">http://generalfuzz.net/acrn/</a></p>\n</blockquote>\n\n<p>The other kind of tinnitus is caused by mechanical issues to the ear and those might require a deep investigation and surgical intervention of the inner ear which I don't believe is safe. Pulsatile tinnitus is one of the variants where there is some blood vessel pressing to the inner ear causing a pulsing sound signal as blood is pumped by the heart. </p>\n\n<p>My best advice would be to find out what caused your tinnitus in the first place and then treat it. Of course while it may not be completely treatable you can still train yourself to ignore it and proceed on with life. If you constantly worry about it (<strong>stress aggravates tinnitus</strong>) then you're not helping.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1789", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 1823, "author": "Ooker", "author_id": 99, "author_profile": "https://health.stackexchange.com/users/99", "pm_score": -1, "selected": false, "text": "<p>In my question I link above, I have listed 7 reasons why you should take a bath:</p>\n\n<blockquote>\n <p>If you are about to think that not shower/bath because it's make your skin dry, there are other reasons to reconsider. According to Medical Daily¹, there is 7 reasons to take a <strong>cool</strong> shower:</p>\n \n <ol>\n <li>Increases Alertness</li>\n <li>“Seal” the pores in the skin and scalp</li>\n <li>Improves Immunity and Circulation</li>\n <li>Stimulates Weight Loss</li>\n <li>Speeds Up Muscle Soreness and Recovery</li>\n <li>Eases Stress</li>\n </ol>\n</blockquote>\n\n<p>However, in one of his book, Intimate Behavior², Desmond Morris has explained the <strong>deep down reason</strong> why we feel relax when bathing as well as swimming.</p>\n\n<p>It is because we try to mimic the feeling when we are <strong>inside our mother's uterus</strong>. When our senses start to develop, the first tactile feeling we have is the amniotic fluid. And since inside the womb, we are fed and protected, so we attach the safe feeling to the soaking feeling. Therefore, when we bathing or swimming, it will instinctively trigger the relaxation. Other benefits are the consequences of this.</p>\n\n<hr>\n\n<ol>\n<li>Medical Daily, <a href=\"http://www.medicaldaily.com/benefits-cold-showers-7-reasons-why-taking-cool-showers-good-your-health-289524\" rel=\"nofollow\">7 Surprising Cold Shower Benefits For Your Body And Skin</a> </li>\n<li>If you interest in this topic, I suggest you to read the whole book. Another thing that attached to the safe feeling is the mother's heartbeat. Music has beat.</li>\n</ol>\n" }, { "answer_id": 1824, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 4, "selected": true, "text": "<p>One big problem here is that it's difficult to do double blind studies. One is then forced to use more theoretical arguments, but because medical science is not a hard science like physics, such arguments are not very reliable. The best we can then do is argue from biological plausibility, in this case we should take serious the fact that Homo Sapiens evolved more than 200,000 years ago while people only started to take baths relatively recently. The adaptation via natural selection over hundreds of millions years since the first land animals evolved is thus still relevant for us. The human microbiome consisting of all the microbes that live on our skins, in our intestines is known to play non-trivial roles, but we don't know a lot about how this impacts our health (from rigorous randomly controlled trials) </p>\n\n<p>This means that the null hypothesis should assume that never washing, bathing or taking showers is beneficial for health over even occasionally doing so. You should need strong evidence to overturn this null hypothesis. Such strong evidence is lacking, what evidence there is there is consistent with this null hypothesis. E.g. we can <a href=\"http://www.bbc.com/news/health-28934415\">read here</a>:</p>\n\n<blockquote>\n <p>One hunter-gatherer community was found to not only have a higher diversity of bacteria, but only one in 1,500 suffered from an allergy - compared with one in three in the UK.</p>\n</blockquote>\n\n<p>Theoretical arguments can e.g. be <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518434/\">found here</a>.</p>\n" } ]

[ "https://health.stackexchange.com/questions/1819", "https://health.stackexchange.com", "https://health.stackexchange.com/users/838/" ]