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What happens the moment you give up alcohol

<div class="theconversation-article-body"> <p>Alcohol has many negative effects on our health, some of which may surprise you. These include short-term impacts such as waking up with a <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers">pounding head</a> or <a href="https://theconversation.com/why-do-i-get-so-anxious-after-drinking-heres-the-science-behind-hangxiety-240991">anxiety</a>, to <a href="https://www.health.gov.au/topics/alcohol/about-alcohol/what-are-the-effects-of-alcohol#longterm-effects">long-term</a> effects including <a href="https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health">cancer</a>.</p> <p>If you are thinking about taking some time off alcohol, you’ll find many quick wins and long-term gains for your health.</p> <p>How long will you have to wait to feel the benefits?</p> <p>We’ve made a timeline – based on scientific research – that shows what you might feel in the first days, weeks, months and years after taking a break from alcohol.</p> <p>Some benefits start immediately, so every day without alcohol is a win for your health.</p> <p><iframe id="tc-infographic-1187" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1187/3a7f432af336224429f29c110db908db78417797/site/index.html" width="100%" height="400px" frameborder="0"></iframe></p> <h2>After one day</h2> <p>Alcohol takes <a href="https://www.healthline.com/health/how-long-does-alcohol-stay-in-your-system">around 24 hours</a> to completely leave your body, so you may start noticing improvements after just one day.</p> <p>Alcohol makes you <a href="https://pubmed.ncbi.nlm.nih.gov/20497950">need to urinate more often</a>, causing dehydration. But your body can absorb a glass of water <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3351614">almost immediately</a>, so once alcohol is out of your system alcohol dehydration is reduced, improving digestion, brain function and energy levels.</p> <p>Alcohol also reduces the liver’s ability to <a href="https://www.ncbi.nlm.nih.gov/books/NBK573079">regulate blood sugar</a>. Once alcohol leaves the system, blood sugar begins to normalise.</p> <p>If you are a daily drinker you may <a href="https://www.healthline.com/health/alcoholism/withdrawal#symptoms">feel a bit worse</a> to start with while your body adjusts to not having alcohol in its system all the time. You may initially notice disrupted sleep, mood changes, sweating or tremors. Most symptoms usually resolve in about a week without alcohol.</p> <h2>After one week</h2> <p>Even though alcohol can make you feel sleepy at first, it <a href="https://www.sciencedirect.com/science/article/pii/B9780444626196000240">disrupts your sleep cycle</a>. By the end of an alcohol-free week, you may notice you are <a href="https://www.tandfonline.com/doi/full/10.1080/08870446.2020.1743840">more energetic</a> in the mornings as a result of getting better quality sleep.</p> <p>As the body’s filter, the liver does much of the heavy lifting in processing alcohol and can be easily damaged even with <a href="https://www.sciencedirect.com/science/article/pii/S0002916523233262">moderate drinking</a>.</p> <p>The liver is important for cleaning blood, processing nutrients and producing bile that helps with digestion.</p> <p>But it can also regenerate quickly. If you have only mild damage in the liver, <a href="https://britishlivertrust.org.uk/lyl-alcohol-and-the-liver/#:%7E:text=Because%20the%20liver%20is%20able,weeks%20after%20giving%20up%20alcohol">seven days may be enough</a> to reduce liver fat and heal mild scarring and tissue damage.</p> <p>Even small amounts of alcohol can <a href="https://www.bmj.com/content/357/bmj.j2353">impair brain functioning</a>. So quitting can help <a href="https://www.bmj.com/content/357/bmj.j2353">improve brain health</a> within a few days in light to moderate drinkers and <a href="https://movendi.ngo/science-digest/quitting-alcohol-can-improve-cognitive-function-for-people-experiencing-severe-alcohol-use-disorder-in-just-18-days/">within a month</a> even for very heavy dependent drinkers.</p> <h2>After one month</h2> <p>Alcohol can make <a href="https://www.beyondblue.org.au/mental-health/alcohol-and-mental-health">managing mood</a> harder and worsen symptoms of anxiety and depression. After a few weeks, most people start to <a href="https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/alcohol-and-mental-health#:%7E:text=Regular%20heavy%20drinking%20is%20linked,few%20weeks%20of%20stopping%20drinking.">feel better</a>. Even very heavy drinkers report better mood after <a href="https://www.webmd.com/mental-health/addiction/what-to-expect-when-you-quit-drinking">one to two months</a>.</p> <p>As your sleep and mood improve you may also notice <a href="https://pubmed.ncbi.nlm.nih.gov/32216557/">more energy and greater wellbeing</a>.</p> <p>After a month of abstinence regular drinkers also report <a href="https://pubmed.ncbi.nlm.nih.gov/32216557/">feeling more confident</a> about making changes to how they drink.</p> <p>You may <a href="https://bmjopen.bmj.com/content/8/5/e020673">lose weight</a> and body fat. Alcohol contains a lot of <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/Alcohol-and-weight-gain">kilojules</a> and can trigger hunger reward systems, making us overeat or choose less healthy foods when drinking.</p> <p>Even your skin will thank you. Alcohol can make you look <a href="https://pubmed.ncbi.nlm.nih.gov/31531169/">older</a> through <a href="https://www.medicalnewstoday.com/articles/alcoholic-skin#summary">dehydration and inflammation</a>, which can be reversed when you quit.</p> <p>Alcohol <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5513683">irritates the gut</a> and disrupts <a href="https://www.bmj.com/content/341/bmj.c6731">normal stomach functioning</a>, causing bloating, indigestion, heartburn and diarrhoea. These symptoms usually <a href="https://publications.aap.org/pediatricsinreview/article-abstract/18/8/282/36760/Alcoholic-Gastritis">start to resolve</a> within <a href="https://arcr.niaaa.nih.gov/media/671/download">four weeks</a>.</p> <p>One month of abstinence, <a href="https://www.mayoclinic.org/diseases-conditions/obesity/multimedia/vid-20536756">insulin resistance</a> – which can lead to high blood sugar – <a href="https://bmjopen.bmj.com/content/8/5/e020673">significantly</a> reduces by 25%. <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/blood-pressure">Blood pressure</a> also reduces (by 6%) and <a href="https://www.sciencedirect.com/topics/neuroscience/cancer-growth-factor">cancer-related growth factors</a> declines, lowering your risk of cancer.</p> <h2>After six months</h2> <p>The liver <a href="https://pubmed.ncbi.nlm.nih.gov/33868869/">starts to repair</a> within weeks. For moderate drinkers, damage to your liver could be <a href="https://britishlivertrust.org.uk/lyl-alcohol-and-the-liver">fully reversed</a> by six months.</p> <p>At this point, even heavy drinkers may notice they’re better at <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4590616">fighting infections</a> and feel healthier overall.</p> <h2>After one year or more</h2> <p>Alcohol contributes to or causes a large number of <a href="https://www.cdc.gov/alcohol/about-alcohol-use/index.html#:%7E:text=Other%20chronic%20diseases,your%20chances%20of%20getting%20sick">chronic diseases</a>, including heart disease, stroke, type 2 diabetes, and seven different types of cancer, as well as mental health issues. All of these risks can be reduced by quitting or cutting back on alcohol.</p> <p>Alcohol increases <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058254">blood pressure</a>. High blood pressure (hypertension) is the <a href="https://world-heart-federation.org/what-we-do/hypertension/">top risk factor</a> for death in the world. A small <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">2mmHg increase in blood pressure</a> above the normal range (120mmHG) increases death from stroke by 10% and from coronary artery disease by 7%.</p> <p>Cutting back on alcohol to less than two drinks a day can <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058254">reduce blood pressure significantly</a>, reducing risk of stroke and heart disease. Reducing blood pressure also <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868">reduces risk</a> of kidney disease, eye problems and even erectile dysfunction.</p> <p>With sustained abstinence, your risk of getting any type of cancer drops. <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2795595">One study</a> looked at cancer risk for more than 4 million adults over three to seven years and found the risk of alcohol-related cancer dropped by 4%, even for light drinkers who quit. Reducing from heavy to moderate drinking reduced alcohol-related cancer risk by 9%.</p> <h2>Making a change</h2> <p>Any reduction in drinking will have some noticeable and immediate benefits to your brain and general health. The less you drink and the longer you go between drinks, the healthier you will be.</p> <p>Whether you aim to cut back or quit entirely, there are <a href="https://theconversation.com/trying-to-cut-back-on-alcohol-heres-what-works-179664">some simple things</a> you can do to help you stick with it:</p> <ul> <li> <p>set clear goals plus the smaller steps you need to take to get there</p> </li> <li> <p>pay attention to the benefits you notice from quitting</p> </li> <li> <p>monitor your progress with a <a href="https://hellosundaymorning.org/drink-tracker/">Drink Tracker</a></p> </li> <li> <p>get support from others, for example Hello Sunday Morning’s anonymous <a href="https://hellosundaymorning.org/daybreak-app/">Daybreak app</a>, <a href="https://smartrecoveryaustralia.com.au">SMART Recovery</a>, <a href="https://www.counsellingonline.org.au">CounsellingOnline</a> or <a href="https://www.soberinthecountry.org">Sober in the Country</a>.</p> </li> </ul> <p>If you are still wondering about whether to make changes or not you can check your drinking risk <a href="https://hellosundaymorning.org/nib_alcohol_self-assessment/">here</a>.</p> <p>If you have tried to cut back and found it difficult you may need professional help. Call the National Alcohol and other Drug Hotline on 1800 250 015 and they will put you in touch with services in your area that can help. You can also talk to your GP.</p> <p><em>We would like to thank Dr Hannah MacRae for assistance in identifying the research used in this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/249272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/nicole-lee-81635">Nicole Lee</a>, Adjunct Professor at the National Drug Research Institute (Melbourne based), <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/katinka-van-de-ven-159873">Katinka van de Ven</a>, Alcohol and other drug specialist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/even-a-day-off-alcohol-makes-a-difference-our-timeline-maps-the-health-benefits-when-you-stop-drinking-249272">original article</a>.</em></p> <p><em>Pexels / </em><em>Helena Lopes</em></p> </div>

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Julie Goodwin delivers a stern message to the body shamers

<p>Julie Goodwin has always known her way around a kitchen – and now, it turns out, she’s just as adept at roasting unsolicited opinions.</p> <p>The beloved <em>MasterChef Australia</em> winner has issued a spicy statement on Instagram after receiving a barrage of comments about her appearance, particularly her recent weight loss. And while she’s known for dishing out hearty meals, this time she served something else: a well-seasoned helping of boundaries.</p> <p>“Thanks to all who have expressed concern about my health. I am well and I am within the healthy weight range. My doctor concurs,” Goodwin wrote, putting the matter to rest with the kind of authority only a GP – and a fed-up woman with a public profile – can provide.</p> <p>But Julie didn’t stop at a health update. She made it clear that she’s not interested in being your weight-loss coach, thank you very much.</p> <p>“For those who have asked me for advice or tips, I am not qualified to provide this. It’s advice that should be sought from your trusted health professionals, not from me. I’m a TV cook,” she said. A gentle reminder that just because someone can whip up a soufflé doesn’t mean they should be your personal trainer.</p> <p>And as for the chorus of couch critics dissecting her figure?</p> <p>“For those who want to comment on the shape and condition of my body please, do it on your own page because I’m tired of reading it,” she wrote, announcing she’d be turning off comments. “For all of us can we please find something more interesting to talk about. Can we please model kindness to our kids and grandkids and can we please leave this obsession with people’s looks back in the 1980s. Peace and love.”</p> <p>It’s not the first time Goodwin’s appearance has prompted public chatter. In 2016, she told <em>Women’s Weekly</em> she’d “accidentally” lost 20kg amid the chaos of running a business, saying it was hardly a lifestyle to emulate.</p> <p>“It’s not that I’ve gone on some stupid, sad diet and dropped a whole heap of weight in a hurry... I’m running a business and running around like a mad thing, and sometimes I forget to eat, none of which is healthy,” she said at the time.</p> <p>Julie, who first won Australia’s heart in 2009 when she beat Poh Ling Yeow to take the <em>MasterChef</em> crown, has since built a rich career as a cookbook author, columnist and TV regular. But she’s also been candid about the toll fame has taken on her mental health.</p> <p>In a deeply personal episode of the Head Game podcast, she described spiralling into severe depression, at one point believing her family would be better off without her.</p> <p>“I just had nothing left. It’s a sickness, right, severe depression is a serious illness,” she said, adding that she turned to alcohol as a coping mechanism: “The only way I could shut off my brain late at night, was to drink wine... So I was self-medicating, and that’s a terrible, terrible way to sleep.”</p> <p>Thankfully, Goodwin says she’s now in a better place — but acknowledges that wellness is a work in progress.</p> <p>“I’m good, I really am. But it’s a concentrated effort to remain good, you know,” she recently told Nine Honey.</p> <p>So next time you’re tempted to weigh in on someone else’s body, maybe take Julie’s advice: leave it in the 1980s, pop on some Madonna, and focus on something kinder – like her lemon curd recipe. Peace, love, and perhaps a little less commentary.</p> <p><em>Images: Instagram</em></p>

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Why women live longer than men

<p>It turns out the real survival champions of history weren’t the sword-wielding warriors or the swashbuckling adventurers – they were women. Yes, even during famines, plagues and periods of mass human awfulness (see: enslavement and measles), women have been quietly outliving men like it’s just another Tuesday.</p> <p>That’s the conclusion of researchers who dove deep into history’s most miserable moments, including the Irish Potato Famine, enslavement in Trinidad and Icelandic measles outbreaks, only to find that female bodies just won’t quit.</p> <p>According to a study led by demographer Virginia Zarulli, even newborn girls during these crises had better survival rates than their male counterparts. That’s right; baby girls basically stared down famine and disease and said, “Not today”.</p> <p>So, what gives? According to science – and a new CNN-backed book titled <em>The Stronger Sex</em> – the female body is a marvel of survival engineering. Despite monthly bleeding, pregnancy (aka growing a human from scratch) and the general rollercoaster of hormones, women consistently outlive men. It’s like Mother Nature looked at the assignment and went “build to last”.</p> <p>Part of the secret lies in the chromosomes. Women are rocking two X chromosomes (which are loaded with immune-boosting genes) while men are stuck with a lonely Y that brings little to the survival party. According to evolutionary biologist Dr Sharon Moalem, this gives women a sort of immunological superpower. As he put it, “Women have immunologically evolved to out-mutate men.” Translation: their immune systems are like Swiss Army knives. Men's? More like... rusty butter knives.</p> <p>And hormones help too – specifically oestrogen, which acts like a biological bodyguard, boosting immune responses, upping antibody production and improving long-term disease resistance. Meanwhile, testosterone (the male hormone known for encouraging risky behaviour and unnecessary purchases of motorcycles) appears to weaken the immune system. In fact, early animal experiments showed that removing testosterone improved immunity. (No word on whether the animals also started asking for directions.)</p> <p>It gets better. Recent research has found that women’s small intestines are longer – which may not sound sexy, but is biologically brilliant. More intestine means more nutrients absorbed, which means better odds of surviving when calories are scarce. Essentially, women can squeeze more nutritional value out of a potato than a man can out of a steak.</p> <p>Add all that to the fact that women typically engage in fewer risky behaviours (looking at you, lawnmower-beer-balancing stunts), and you’ve got a recipe for a longer life. Even when women adopt some of the same bad habits as men (like smoking) they still tend to outlive them. Because of course they do.</p> <p>To be fair, there is a catch: women’s superhero immune systems can sometimes turn on them, leading to more autoimmune diseases and chronic conditions. But even then, women often live with those conditions longer than men would.</p> <p>So, what’s the takeaway here? For one, the next time someone calls women the “weaker sex”, feel free to laugh out loud. And second, it’s about time medicine caught up. Researchers argue that understanding these biological differences can help create more personalised healthcare – for all genders.</p> <p>In short: female bodies aren’t just built different. They’re built better, tougher and, according to science, longer-lasting; kind of like the biological version of a Toyota Hilux.</p> <p>Move over, Superman. It’s Superwoman who’s still standing.</p> <p><em>Image: Pexels / Chelsi Peter</em></p>

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Unusual use of nicotine patches or gum to fight brain fog

<div class="theconversation-article-body"> <p>Some people with long COVID are turning to an unlikely remedy: nicotine gum and patches. Though typically used to quit smoking, nicotine is now being explored as a possible way to ease symptoms such as brain fog and fatigue.</p> <p>One such case, detailed in a recent <a href="https://slate.com/technology/2025/06/nicotine-gum-patch-cigarettes-cognitive-benefits-research.html">article in Slate</a>, describes a woman who found significant relief from debilitating brain fog after trying low-dose nicotine gum. Her experience, while anecdotal, aligns with findings from a small but interesting study from Germany.</p> <p>The <a href="https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7">study</a> involved four participants suffering from symptoms related to long COVID. The researcher administered low-dose nicotine patches once daily and noticed marked improvements in the participants’ symptoms. Tiredness, weakness, shortness of breath and trouble with exercise rapidly improved – by day six at the latest.</p> <p>For those who had lost their sense of taste or smell, it took longer, but these senses came back fully within 16 days. Although it’s not possible to draw definitive conclusions on cause and effect from such a small study, the results could pave the way for larger studies.</p> <p>While some people slowly recover from COVID, others remain unwell for years, especially those who became sick before vaccines were available. Between <a href="https://www.ox.ac.uk/news/2024-08-01-new-study-highlights-scale-and-impact-long-covid">3% and 5%</a> of people continue to experience symptoms months, and sometimes even years, after the initial infection. In the UK, long COVID affects around <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/4august2022">2.8% of the population</a>.</p> <p>Brain fog and other neurological symptoms of long COVID are thought to result from a combination of factors – including inflammation, reduced oxygen to the brain, vascular damage and disruption to the <a href="https://www.cidrap.umn.edu/covid-19/researchers-identify-mechanism-behind-brain-fog-long-covid">blood-brain barrier</a>. Research continues as there is still a lot we don’t know about this condition.</p> <p>The researcher in the German study thinks that long COVID symptoms, such as fatigue, brain fog and mood changes, might partly be due to problems with a brain chemical called acetylcholine, a neurotransmitter. This chemical is important for many functions in the body, including memory, attention and regulating mood.</p> <p>Normally, acetylcholine works by attaching to special “docking sites” on cells called nicotinic acetylcholine receptors, which help send signals in the brain and nervous system. But the COVID virus may interfere with these receptors, either by blocking them or disrupting how they work. When this happens, the brain may not be able to send signals properly, which could contribute to the mental and physical symptoms seen in long COVID.</p> <p>So why would nicotine potentially be useful? Nicotine binds to the same receptors and might help restore normal signalling, but the idea that it displaces the virus directly is still speculative.</p> <p>Nicotine is available in different forms, such as patches, gum, lozenges and sprays. Using nicotine through the skin, for example, with a patch, keeps the amount in the blood steady without big spikes. Because of this, people in the study didn’t seem to develop a dependence on it.</p> <p>Chewing nicotine gum or using a lozenge can cause spikes in nicotine levels, since the nicotine is absorbed gradually through the lining of the mouth. But unlike a patch, which delivers a steady dose, the user has more control over how much nicotine they take in when using gum or lozenges.</p> <p>There are mixed <a href="https://pubmed.ncbi.nlm.nih.gov/33899218/">results</a> on the effectiveness of nicotine on cognitive functions such as memory and concentration. But most <a href="https://pubmed.ncbi.nlm.nih.gov/36736944/">studies</a> agree that it can enhance attention. Larger studies are needed to gauge the effectiveness of nicotine specifically for long COVID symptoms.</p> <h2>Not without risks</h2> <p>Despite its benefits, nicotine is <a href="https://www.verywellmind.com/nicotine-addiction-101-2825018">not without risks</a>. Even in gum or patch form, it can cause side-effects like nausea, dizziness, increased heart rate and higher blood pressure.</p> <p>Some of these stimulant effects on heart rate may be useful for people with long COVID symptoms such as exercise intolerance. But this needs to be closely monitored. Long-term use may also affect heart health. For non-smokers, the risk of developing a nicotine dependency is a serious concern.</p> <p>So are there any options to treat long COVID symptoms?</p> <p>There are some <a href="https://www.sciencedirect.com/science/article/pii/S2667257X22001000">studies</a> looking at guanfacine in combination with N-acetylcysteine, which have shown improvement in brain fog in small groups of people. There has been at least <a href="https://clinicaltrials.gov/study/NCT02720445">one clinical trial</a> exploring nicotine for mild cognitive impairment in older adults, though not in the context of long COVID. Given that anecdotal reports and small studies continue to draw attention, it is likely that targeted trials are in development.</p> <p>The main <a href="https://www.nhsinform.scot/long-term-effects-of-covid-19-long-covid/signs-and-symptoms/long-covid-brain-fog/">recommendations</a> by experts are to implement lifestyle measures. Slowly increasing exercise, having a healthy diet, avoiding alcohol, drugs and smoking, sleeping enough, practising mindfulness and doing things that stimulate the brain are all thought to help brain fog.</p> <p>For those grappling with long COVID or persistent brain fog, the idea of using nicotine patches or gum might be tempting. But experts caution against self-medicating with nicotine. The lack of standardised dosing and the potential for addiction and unknown long-term effects make it a risky experiment.</p> <p>While nicotine isn’t a cure and may carry real risks, its potential to ease long COVID symptoms warrants careful study. For now, those battling brain fog should approach it with caution – and always under medical supervision. What’s clear, though, is the urgent need for more research into safe, effective treatments for the lingering effects of COVID.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/259093/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/dipa-kamdar-1485027">Dipa Kamdar</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/kingston-university-949">Kingston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/some-people-are-turning-to-nicotine-gum-and-patches-to-treat-long-covid-brain-fog-259093">original article</a>.</em></p> <p><em>Image: Wikimedia Commons </em></p> </div>

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“So many flaws”: Post-menopausal bone-strengthening exercise under scrutiny

<p>A study claiming that the OsteoStrong exercise program helps strengthen bones in post-menopausal women has come under heavy criticism from international experts, with some calling for the research to be retracted.</p> <p>Published earlier this year in the Journal of Clinical Endocrinology & Metabolism (JCEM), <a href="https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaf077/8004985?login=false" target="_blank" rel="noopener">the study</a> was initially celebrated by OsteoStrong, a commercial franchise offering brief, high-intensity weekly sessions designed to improve bone density. The company described its publication as a “monumental step” in validating the program as a science-backed option for managing osteoporosis.</p> <p>However, scientists say the research suffers from major flaws in design, data analysis and ethical oversight – with some arguing it should never have passed peer review.</p> <p>“We really questioned the editor on how this paper got through the peer-review process,” said Professor Robin Daly, an expert in exercise and ageing at Deakin University. “It had so many flaws and so many holes in it… There’s no way that you can make a claim that it’s an effective program.”</p> <p>The study followed 147 post-menopausal women over 12 months, dividing them into groups that either participated in OsteoStrong or did not. The researchers claimed participants who did the program saw bone density gains, particularly those who also took bone-strengthening medication. But critics say these conclusions are unsupported.</p> <p>“The claims are totally misleading,” said Professor Daly. “The whole paper is extremely difficult to interpret.”</p> <p>Among the concerns are the lack of a pre-defined statistical plan, failure to minimise bias, no ethical approval, and no registration of the trial – a standard practice designed to ensure transparency and guard against selective reporting.</p> <p>Lora Giangregorio, a bone researcher at the University of Waterloo, co-authored a letter calling for the study’s retraction. She said the study’s statistical analysis “doesn’t make any sense” and that its claims were “not appropriate.”</p> <p>Other experts, including Professor Chris Maher from the University of Sydney, agreed the study was too flawed to offer credible evidence. “It does not conform to the Declaration of Helsinki, so it has no standing in medical science and should never have been published,” Maher said.</p> <p>The Endocrine Society, which publishes JCEM, <a href="https://www.abc.net.au/news/health/2025-06-20/osteostrong-bone-density-health-study-retraction-health-research/105225286" target="_blank" rel="noopener">acknowledged to the ABC</a> that “shortcomings in the research’s design and analyses” and said the authors are submitting a revised version.</p> <p>Despite these criticisms, the concept behind OsteoStrong – that placing load on bones can help strengthen them – is considered physiologically plausible. Yet experts stress that rigorous evidence is needed.</p> <p>“The idea of osteogenic loading makes sense,” said Dr Shoshana Sztal-Mazer, an endocrinologist at Alfred Health. “But a 10-minute-a-week quick fix needs to be proven by rigorous studies.”</p> <p>OsteoStrong did not address the criticisms directly but pointed to unpublished, company-sponsored research it says supports its program’s benefits.</p> <p>Health authorities, including Osteoporosis Canada and Healthy Bones Australia, continue to recommend exercise as part of a comprehensive approach to bone health – but caution that no short-cut solution has yet been proven to replace established treatments.</p> <p>“Exercise is important as part of holistic care for osteoporosis,” Dr Sztal-Mazer said. “But claims of dramatic benefits from minimal effort need solid evidence before they can be endorsed.”</p> <p><em>Image: OsteoStrong</em></p>

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Five common habits that might be harming your liver

<div class="theconversation-article-body"> <p>The liver is one of the hardest working organs in the human body. It detoxifies harmful substances, helps with digestion, stores nutrients, and regulates metabolism.</p> <p>Despite its remarkable resilience – and even its ability to regenerate – the liver is not indestructible. In fact, many everyday habits, often overlooked, can slowly cause damage that may eventually lead to serious conditions <a href="https://www.nhs.uk/conditions/cirrhosis/">such as cirrhosis</a> (permanent scarring of the liver) or liver failure.</p> <p>One of the challenges with liver disease is that it can be a silent threat. In its early stages, it may cause only vague symptoms like constant fatigue or nausea.</p> <p>As damage progresses, more obvious signs may emerge. <a href="https://britishlivertrust.org.uk/information-and-support/liver-health-2/symptoms-of-liver-disease/">One of the most recognisable</a> is jaundice, where the skin and the whites of the eyes turn yellow. While most people associate liver disease with heavy drinking, alcohol isn’t the only culprit. Here are five common habits that could be quietly harming your liver.</p> <h2>1. Drinking too much alcohol</h2> <p>Alcohol is perhaps the most well-known cause of liver damage. When you drink, your liver works to break down the alcohol and clear it from your system. But too much alcohol overwhelms this process, causing toxic by products to build up and damage liver cells.</p> <p>Alcohol-related liver disease <a href="https://britishlivertrust.org.uk/lyl-alcohol-and-the-liver/">progresses in stages</a>. At first, fat begins to accumulate in the liver (fatty liver), often without any noticeable symptoms and reversible if drinking stops. Continued drinking can lead to <a href="https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/">alcoholic hepatitis</a>, where inflammation and scar tissue begin to form as the liver attempts to heal itself.</p> <p>Over time, this scarring can develop into cirrhosis, where extensive hardening of the liver seriously affects its ability to function. While cirrhosis is difficult to reverse, stopping drinking can help prevent further damage.</p> <p>Even moderate drinking, if sustained over many years, can take its toll, particularly when combined with other risk factors like obesity or medication use. Experts recommend sticking to <a href="https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/">no more than 14 units of alcohol</a> per week, and including alcohol-free days to give your liver time to recover.</p> <h2>2. Poor diet and unhealthy eating habits</h2> <p>You don’t need to drink alcohol to develop liver problems. Fat can build up in the liver due to an unhealthy diet, leading to a condition now called <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease">metabolic dysfunction-associated steatotic liver disease</a> (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD).</p> <p>Excess fat in the liver can impair its function and, over time, cause inflammation, scarring, and eventually cirrhosis. People who are overweight – particularly those who carry excess weight around their abdomen – are more likely to develop MASLD. <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease">Other risk factors include</a> high blood pressure, diabetes and high cholesterol.</p> <figure><iframe src="https://www.youtube.com/embed/gZQ3VFHq17E?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Diet plays a huge role. Foods high in saturated fat, such as red meat, fried foods and processed snacks, can raise cholesterol levels and contribute to liver fat accumulation. Sugary foods and drinks are also a major risk factor. <strong>In 2018</strong>, <a href="https://link.springer.com/article/10.1007/s00394-018-1711-4">a review found</a> that people who consumed more sugar sweetened drinks had a 40% higher risk of developing fatty liver disease.</p> <p>Ultra-processed foods such as fast food, ready meals and snacks packed with added sugar and unhealthy fats also contribute to liver strain. <a href="https://www.sciencedirect.com/science/article/pii/S000291652366188X#sec6">A large study found</a> that people who ate more processed foods were significantly more likely to develop liver problems.</p> <p>On the flip side, eating a balanced, wholefood diet can help prevent – and even reverse – fatty liver disease. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370227/">Research suggests</a> that diets rich in vegetables, fruit, whole grains, legumes, and fish may reduce liver fat and improve related risk factors such as high blood sugar and cholesterol.</p> <p>Staying hydrated is also important. Aim for around eight glasses of water a day to support your liver’s natural detoxification processes.</p> <h2>3. Overusing painkillers</h2> <p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10645398/">Many people turn to</a> over-the-counter painkillers such as paracetamol for headaches, muscle pain, or fever. While generally safe when used as directed, taking too much – even slightly exceeding the recommended dose – can be <a href="https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.13656#:%7E:text=As%20the%20toxic%20metabolite%20of,predispose%20patients%20to%20liver%20injury.">extremely dangerous</a> for your liver.</p> <p>The liver breaks down paracetamol, but in the process, produces a toxic by-product called NAPQI. Normally, the body neutralises NAPQI using a <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Glutathione">protective substance called glutathione</a>. However, in an overdose, glutathione stores become depleted, allowing NAPQI to accumulate and attack liver cells. This can <a href="https://britishlivertrust.org.uk/researchers-shed-new-light-paracetamol-causes-liver-damage/#:%7E:text=Paracetamol%20is%20an%20effective%20treatment,came%20out%20worse%20than%20Britain.">result in acute liver failure</a>, which can be fatal.</p> <p>Even small overdoses, or <a href="https://cks.nice.org.uk/topics/analgesia-mild-to-moderate-pain/management/paracetamol/">combining paracetamol with alcohol</a>, can increase the risk of serious harm. Always stick to the recommended dose and speak to a doctor if you find yourself needing pain relief regularly.</p> <h2>4. Lack of exercise</h2> <p>A sedentary lifestyle is another major risk factor for liver disease. Physical inactivity contributes to weight gain, insulin resistance, and metabolic dysfunction – all of which can promote fat accumulation in the liver.</p> <p>The good news is that exercise can benefit your liver even if you don’t lose much weight. <a href="https://gut.bmj.com/content/gutjnl/60/9/1278.full.pdf">One study found</a> that just eight weeks of resistance training reduced liver fat by 13% and improved blood sugar control. Aerobic exercise is <a href="https://liver.org.au/news/exercise-for-fatty-liver-disease-has-benefits-beyond-weight-loss/#:%7E:text=%E2%80%9CExercise%20can%20benefit%20liver%20health%20by%20reducing,physical%20strength%20and%20body%20composition%2C%E2%80%9D%20she%20says.&amp;text=To%20reduce%20liver%20fat%2C%20it's%20recommended%20that,of%20at%20least%20moderate%20intensity%20aerobic%20exercise.">also highly effective</a>: regular brisk walking for 30 minutes, five times a week, has been shown to reduce liver fat and improve insulin sensitivity.</p> <h2>5. Smoking</h2> <p>Most people associate smoking with lung cancer or heart disease, but many don’t realise the <a href="https://www.journal-of-hepatology.eu/article/S0168-8278(22)00029-0/fulltext">serious damage</a> it can do to the liver.</p> <p>Cigarette smoke contains thousands of toxic chemicals that <a href="https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/stopping-smoking/">increase the liver’s workload</a> as it tries to filter and break them down. Over time, this can lead to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4088100/">oxidative stress</a>, where unstable molecules (free radicals) damage liver cells, restrict blood flow, and contribute to scarring (cirrhosis).</p> <p>Smoking also significantly raises the risk of liver cancer. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8683172/">Harmful chemicals</a> in tobacco smoke, including nitrosamines, vinyl chloride, tar, and 4-aminobiphenyl, are <a href="https://www.healthline.com/health/cancer/what-is-a-carcinogen#bottom-line">all known carcinogens</a>. <a href="https://www.cancerresearchuk.org/about-cancer/liver-cancer/risks-causes">According to Cancer Research UK</a>, smoking accounts for around 20% of liver cancer cases in the UK.</p> <h2>Love your liver</h2> <p>The liver is a remarkably robust organ – but it isn’t invincible. You can protect it by drinking alcohol in moderation, quitting smoking, taking medications responsibly, eating a balanced diet, staying active and keeping hydrated.</p> <p>If you notice any symptoms that may suggest liver trouble, such as ongoing fatigue, nausea, or jaundice, don’t delay speaking to your doctor. The earlier liver problems are detected, the <a href="https://britishlivertrust.org.uk/information-and-support/love-your-liver/free-liver-scan/#:%7E:text=Finding%20liver%20disease%20early%20means,t%20give%20anyone%20a%20diagnosis.&amp;text=Liver%20scans%20are%20also%20available,to%20check%20your%20liver%20health.">better the chance of successful treatment</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/256921/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/dipa-kamdar-1485027">Dipa Kamdar</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/kingston-university-949">Kingston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/five-common-habits-that-might-be-harming-your-liver-256921">original article</a>.</em></p> <p><em>Pexels / </em><em>Andrea Piacquadio</em></p> </div>

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Weight loss drug approved to treat sleep apnoea

<div class="theconversation-article-body"> <p>Last week, Australia’s <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2023-PI-02114-1&amp;d=20250603172310101">Therapeutic Goods Administration</a> (TGA) approved <a href="https://www.afr.com/companies/healthcare-and-fitness/tga-approves-weight-loss-drug-to-treat-sleep-disorder-20250604-p5m4vq">the weight-loss drug Mounjaro</a> to treat sleep apnoea, a condition in which breathing stops and starts repeatedly during sleep.</p> <p>The TGA has indicated Mounjaro can be used to treat moderate to severe obstructive sleep apnoea in adults with obesity (a body-mass index of 30 or above).</p> <p>The <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea">United States Food and Drug Administration</a> approved the same drug for sleep apnoea last year.</p> <p>So how could this drug, most commonly used for weight management and conditions such as type 2 diabetes, help people with sleep apnoea?</p> <h2>What is sleep apnoea?</h2> <p>Obstructive sleep apnoea is a common sleep disorder affecting almost <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)30198-5/abstract#:%7E:text=To%20our%20knowledge%2C%20this%20is,and%20to%20maximise%20cost%2Deffectiveness.">1 billion people</a> worldwide. It’s characterised by repeated closures of the airway during sleep (called “<a href="https://www.healthdirect.gov.au/obstructive-sleep-apnoea">apnoeas</a>”). These can be partial or complete closures, meaning breathing can become shallow or stop completely.</p> <p>As well as causing fragmented sleep, repeated collapse of the airway disrupts oxygen flow to the body. This strains the heart and contributes to an increased risk of <a href="https://www.sciencedirect.com/science/article/pii/S1875213620300413">cardiovascular and metabolic complications</a> <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11172971/">such as</a> diabetes, high blood pressure and stroke.</p> <p>One of the key risk factors for obstructive sleep apnoea is obesity. About <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9130173/">80% of people</a> with the condition live with obesity. In fact, obesity and sleep apnoea share a <a href="https://www.sciencedirect.com/science/article/pii/S0939475325001681">bidirectional relationship</a>, with obesity increasing the risk of developing sleep apnoea, and vice versa.</p> <p>Obesity increases the risk of sleep apnoea by adding fat around the neck, which narrows the airway and impacts breathing during sleep.</p> <p>In turn, sleep apnoea can contribute to weight gain by disrupting hormones that regulate hunger (ghrelin) and fullness signals (leptin). Fatigue also contributes, making it harder to maintain a healthy weight and easier to gain weight over time, creating <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5836788/">a vicious cycle</a> where each condition worsens the other.</p> <p>Weight loss is a key part of <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9059581/">treating sleep apnoea</a>. It helps reduce the severity of symptoms and also lowers the risk of heart disease and other health problems which may arise as a result of <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7874414/">sleep apnoea</a>. However, achieving and sustaining weight loss through lifestyle changes is often challenging.</p> <p>A continuous positive airway pressure (CPAP) machine is generally the <a href="https://www1.racgp.org.au/ajgp/2024/june/management-of-obstructive-sleep-apnoea-in-primary">first-line therapy</a> for managing moderate to severe sleep apnoea. It delivers a steady stream of pressurised air through a mask to keep the airway open during sleep, which stabilises breathing and improves sleep quality.</p> <p>Despite being an effective treatment, many people find the CPAP machine uncomfortable, unattractive or hard to use regularly. This can mean people don’t always <a href="https://pubmed.ncbi.nlm.nih.gov/30684472/">stick to it</a>.</p> <p>Given the significant human and <a href="https://pubmed.ncbi.nlm.nih.gov/34015136/">economic costs of sleep apnoea</a> it’s pertinent to keep exploring new prevention and management strategies.</p> <h2>What is Mounjaro, and how could it help people with sleep apnoea?</h2> <p>Mounjaro is the brand name of a drug called tirzepatide. Elsewhere, it goes by other brand names, such as Zepbound.</p> <p>Tirzepatide works by <a href="https://www.pnas.org/doi/full/10.1073/pnas.2116506119">mimicking two hormone receptors</a> in the gut, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).</p> <p>These <a href="https://www.sciencedirect.com/science/article/pii/S2212877818309001">two hormones</a> play a key role in regulating our appetite, food intake and blood sugar levels. GLP-1 and GIP are released naturally in the body when we eat, but by mimicking their effects, tirzepatide allows people to feel fuller with smaller meals.</p> <p>If a person is eating less overall, this can lead to weight loss.</p> <p>In <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2404881">a study of 469 people</a> with obesity and moderate to severe obstructive sleep apnoea, one year of tirzepatide treatment was associated with up to a 60% reduction in sleep apnoea severity. This is compared to a 3% reduction in people receiving a placebo.</p> <p>In addition, evidence shows tirzepatide is associated with improvements in <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11598664/pdf/nihms-2005020.pdf">several key health indicators</a>, including reduced systemic inflammation, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11972082/">enhanced insulin sensitivity</a> and lower blood pressure. Changes <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10157777/">such as these</a> may improve respiratory function and help protect against cardiovascular and metabolic complications, which are common outcomes of untreated sleep apnoea.</p> <h2>Are there any side effects?</h2> <p>While Mounjaro could be helpful for people with sleep apnoea, gastrointestinal <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10088547/pdf/jomes-32-1-25.pdf">side effects</a> are relatively common with this medication. These can include nausea, vomiting, diarrhoea, constipation and loss of appetite. These side effects typically go away as the person gets used to the medication.</p> <p>Some patients have also reported <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790392">gallbladder problems</a>.</p> <p>Despite these concerns, there is an <a href="https://assets.cureus.com/uploads/review_article/pdf/343603/20250405-83416-dhs9d8.pdf">interest in Mounjaro as sleep apnoea treatment</a> as it provides the first pharmaceutical option for a condition that has traditionally relied on mechanical treatments such as CPAP machines.</p> <p>That said, it’s important to note Mounjaro is indicated for use in patients with obesity, and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9130173/">not all patients</a> with sleep apnoea are overweight or obese.</p> <p>In some <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00153-1/fulltext?rss=yes">people of a healthy weight</a>, narrow skeletal structure or upper airway anatomy, such as larger soft palates (which can reduce airway space and make it more prone to collapse during sleep), could contribute to obstructive sleep apnoea.</p> <p>For those patients, non-pharmacological treatment options such as mandibular advancement devices (oral appliances that move the lower jaw forward and keep the airway open) and upper airway surgery may be needed to effectively manage the condition.</p> <p>Mounjaro is given as a weekly injection. In Australia, Mounjaro is not currently subsidised under the Pharmaceutical Benefits Scheme and is available only by private prescription, with prices beginning at around <a href="https://cosmeticclinic.net.au/mounjaro-australia-cost/#:%7E:text=On%20average%2C%20the%20cost%20of%20Mounjaro%20in%20Australia,the%20frequency%20of%20use%20and%20the%20required%20dosage.">A$395 per month</a>. The significant out-of-pocket cost will limit access to Mounjaro for many patients.</p> <p>Mounjaro’s approval for the treatment of sleep apnoea may offer new hope for many people. But considering the diversity in patient presentations and limited data from large population studies, it’s too early to say whether this will transform sleep apnoea care in Australia.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/258195/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/yaqoot-fatima-2407464">Yaqoot Fatima</a>, Professor of Sleep Health, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a> and <a href="https://theconversation.com/profiles/nisreen-aouira-2407465">Nisreen Aouira</a>, Research Program Manager, Thompson Institute, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-weight-loss-drug-mounjaro-has-been-approved-to-treat-sleep-apnoea-how-does-it-work-258195">original article</a>.</em></p> </div>

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Is it better to shower in the morning or at night?

<div class="theconversation-article-body"> <p>It’s a question that’s long been the cause of debate: is it better to shower in the morning or at night?</p> <p>Morning shower enthusiasts will say this is the obvious winner, as it helps you wake up and start the day fresh. Night shower loyalists, on the other hand, will argue it’s better to “wash the day away” and relax before bed.</p> <p>But what does the research actually say? As a microbiologist, I can tell you there actually is a clear answer to this question.</p> <p>First off, it’s important to stress that showering is an integral part of any good hygiene routine — regardless of when you prefer to have one.</p> <p>Showering helps us remove dirt and oil from <a href="https://royalsocietypublishing.org/doi/10.1098/rspb.2015.2586">our skin</a>, which can help prevent skin rashes and infections.</p> <p>Showering also removes sweat, which can quell body odour.</p> <p>Although many of us think that body odour is caused by sweat, it’s actually produced by bacteria that live on the surface of our skin. Fresh sweat is, in fact, odourless. But skin-dwelling bacteria – specifically <a href="https://www.cdc.gov/staphylococcus-aureus/about/index.html">staphylococci</a> – use sweat as a direct nutrient source. When they break down the sweat, it releases a sulphur-containing compound called <a href="https://www.nature.com/articles/s41598-020-68860-z">thioalcohols</a> which is behind that pungent BO stench many of us are familiar with.</p> <h2>Day or night?</h2> <p>During the day, your body and hair inevitably collect pollutants and allergens (such as dust and pollen) alongside their usual accumulation of sweat and sebaceous oil. While some of these particles will be <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16378">retained by your clothes</a>, others will inevitably be transferred to your <a href="https://pubmed.ncbi.nlm.nih.gov/16364170/">sheets and pillow cases</a>.</p> <p>The sweat and oil from you skin will also support the growth of the bacteria that comprise your <a href="https://academic.oup.com/femsle/article-abstract/362/16/fnv111/558026?redirectedFrom=fulltext">skin microbiome</a>. These bacteria may then also be transferred from your body <a href="https://www.scirp.org/journal/paperinformation?paperid=40029">onto your sheets</a>.</p> <p>Showering at night may remove some of the allergens, sweat and oil picked up during the day so less ends up on your bedsheets.</p> <p>However, even if you’ve freshly showered before bed, you will still <a href="https://washingtoncitypaper.com/article/221338/straight-dope-do-you-really-sweat-one-liter-each-night/">sweat during the night</a> – whatever the temperature is. Your skin microbes will then eat the nutrients in that sweat. This means that by the morning, you’ll have both deposited microbes onto your bed sheets and you’ll probably also wake up with some BO.</p> <p>What particularly negates the cleaning benefits of a night shower is if your bedding is not regularly laundered. The odour causing microbes present in your bed sheets may be transferred while you sleep onto your clean body.</p> <p>Showering at night also does not stop your <a href="https://doi.org/10.1136/jcp.18.1.16">skin cells</a> being shed. This means they can potentially become the food source of house dust mites, whose waste can be allergenic. If you don’t regularly wash your sheets, this could lead to a build-up of dead skin cell deposits which will feed more dust mites. The droppings from these dust mites can <a href="https://aafa.org/allergies/types-of-allergies/insect-allergy/dust-mite-allergy/">trigger allergies</a> and <a href="https://www.asthmaandlung.org.uk/living-with/indoor-air-pollution/home#dust-mites">exacerbate asthma</a>.</p> <p>Morning showers, on the other hand, can help remove dead skin cells as well as any sweat or bacteria you’ve picked up from your bed sheets during the night. This is especially important to do if your sheets weren’t freshly washed when you went to bed.</p> <p>A morning shower suggests your body will be cleaner of night-acquired <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7690701/">skin microbes</a> when putting on fresh clothes. You’ll also start the day with less sweat for odour-producing bacteria to feed on – which will probably help you smell fresher for longer during the day compared to someone who showered at night. As a microbiologist, I am a day shower advocate.</p> <p>Of course, everyone has their own shower preference. Whatever time you choose, remember that the effectiveness of your shower is influenced by many aspects of your personal hygiene regime – such as how frequently you <a href="https://www.scirp.org/journal/paperinformation?paperid=40029">wash your bed sheets</a>.</p> <p>So regardless of whether your prefer a morning or evening shower, it’s important to clean your bed linen regularly. You should launder your sheets and pillow cases at least weekly to remove all the sweat, bacteria, <a href="https://doi.org/10.1136/jcp.18.1.16">dead skin cells</a> and sebaceous oils that have built up on your sheets.</p> <p>Washing will also remove any <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.16378">fungal spores</a> that might be growing on the bed linen – alongside the nutrient sources these odour producing microbes use to grow.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/256242/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/primrose-freestone-315921">Primrose Freestone</a>, Senior Lecturer in Clinical Microbiology, <a href="https://theconversation.com/institutions/university-of-leicester-1053">University of Leicester</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-better-to-shower-in-the-morning-or-at-night-heres-what-a-microbiologist-says-256242">original article</a>.</em></p> <p><em>Image: Pexels / </em><em>Caique the Creator</em></p> <p> </p> </div>

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Unexpected side-effects of Ozempic and Wegovy

<div class="theconversation-article-body">Ozempic and Wegovy have been hailed as wonder drugs when it comes to weight loss. But as the drug has become more widely used, a number of unintended side-effects have become apparent – with the weight loss drug affecting the appearance of everything from <a href="https://www.today.com/health/diet-fitness/ozempic-butt-rcna164286">your butt</a> to <a href="https://www.dailymail.co.uk/femail/article-14621617/hollywood-feet-ozempic.html">your feet</a>.</p> <p><a href="https://www.thieme-connect.com/products/ejournals/html/10.1055/a-2148-6321">“Ozempic face”</a> is another commonly reported consequences of using these popular weight loss drugs. This is a sunken or hollowed out appearance the face can take on in people taking weight loss drugs. It can also increase signs of ageing – including lines, wrinkles and sagging skin.</p> <p>This happens because semaglutide (the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10092593/">active ingredient</a> in both Ozempic and Wegovy) isn’t localised to act just on the fat we want to lose. Instead, it targets all of our body’s fat – including in the face.</p> <p>But it isn’t just the appearance of your face that semaglutide affects. These drugs may also affect the mouth and teeth, too. And these side-effects could potentially lead to lasting damage.</p> <h2>Dry mouth</h2> <p>Semaglutide effects the salivary glands in the mouth. It does this by reducing saliva production (<a href="https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03192-8">hyposalivation</a>), which can in turn <a href="https://www.drugs.com/medical-answers/why-ozempic-cause-dry-mouth-taste-changes-3575056/">lead to dry mouth</a> (<a href="https://www.nidcr.nih.gov/health-info/dry-mouth">xerostomia</a>). This means there isn’t enough saliva to keep the mouth wet.</p> <p>It isn’t exactly clear why semaglutide has this effect on the salivary glands. But in animal studies of the drug, it appears the drug <a href="https://www.jbtr.or.kr/archive/view_article?pid=jbtr-24-4-139">makes saliva stickier</a>. This means there’s less fluid to moisten the mouth, causing it to dry out.</p> <p>GLP-1 receptor agonist drugs (such as semaglutide) can also <a href="https://pubmed.ncbi.nlm.nih.gov/16809911/">reduce water intake</a> by affecting <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3233845/">areas in the brain</a> responsible for thirst. Low fluid intake further <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3233845/">reduces saliva production</a>, and may even cause the saliva to become <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10754586">thick and frothy</a> and the tongue to <a href="https://pubmed.ncbi.nlm.nih.gov/38206684/">become sticky</a>.</p> <h2>Bad breath</h2> <p>One other commonly reported unwanted effect by semaglutide users is <a href="https://www.perioimplantadvisory.com/clinical-tips/article/14298799/how-ozempic-has-the-potential-to-cause-halitosis">bad breath</a> (halitosis).</p> <p>When there’s less saliva flowing through the mouth, this <a href="https://pubmed.ncbi.nlm.nih.gov/10439028/">encourages bacteria</a> that contribute to bad breath and the <a href="https://pubmed.ncbi.nlm.nih.gov/10439028/">formation of cavities</a> to thrive. These bacterial species include <em><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6615571/">Streptococcus mutans</a></em> and some strains of <em><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4547204/">Lactobacillus</a></em>.</p> <p>Another species that has been shown to thrive in conditions where saliva is reduced is <em><a href="https://academic.oup.com/femsle/article-abstract/333/1/1/586464?redirectedFrom=fulltext">Porphyromonas gingivalis</a></em>. This bacteria is a significant contributor to the production of volatile sulphur compounds, which <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2871590/">cause the foul odours</a> characteristic of halitosis.</p> <p>Another factor that might explain why semaglutide causes bad breath is because less saliva being produced means the tongue isn’t cleaned. This is the same reason why your “morning breath” is so bad, because we naturally produce less saliva at night. This allows bacteria to grow and produce odours. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10754586/">Case report images</a> show some people taking semaglutide have a “furry”-like or coated appearance to their tongue. This indicates a build up of bacteria that contribute to bad breath.</p> <h2>Tooth damage</h2> <p>One of the <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf">major side-effects</a> of Ozempic is <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">vomiting</a>. Semaglutide slows how quickly the stomach empties, delaying digestion which can lead to bloating, nausea and vomiting.</p> <p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10573129/">Repeated vomiting</a> can <a href="https://pubmed.ncbi.nlm.nih.gov/12139263/">damage the teeth</a>. This is because stomach acid, composed primarily of <a href="https://www.ncbi.nlm.nih.gov/books/NBK279304/">hydrochloric acid</a>, erodes the enamel of the teeth. Where vomiting occurs over a prolonged period of months and years the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4125596">more damage will occur</a>. The <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4125596/">back surface of the teeth</a> (palatal surface) closest to the tongue are more likely to see damage – and this damage may not be obvious to the sufferer.</p> <p>Vomiting also <a href="https://www.ncbi.nlm.nih.gov/books/NBK555956/">reduces the amount of fluid</a> in the body. When combined with reduced saliva production, this puts the teeth at even greater risk of damage. This is because saliva helps <a href="https://www.gastrojournal.org/article/S0016-5085(82)80286-2/pdf">neutralise the acid</a> that causes dental damage.</p> <p>Saliva also contributes to the dental pellicle – a thin, protective layer that the saliva forms on the surface of the teeth. It’s thickest on the <a href="https://journals.sagepub.com/doi/abs/10.1177/00220345990780120901">tongue-facing surface</a> of the bottom row of teeth. In people who produce less saliva, the dental pellicle <a href="https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2023.1260442/full">contains fewer mucins</a> – a type of mucus which helps saliva <a href="https://journals.sagepub.com/doi/pdf/10.1177/10454411900010040201">stick to the teeth</a>.</p> <h2>Reducing the risk of damage</h2> <p>If you’re taking semaglutide, there are many things you can do to keep your mouth healthy.</p> <p>Drinking water regularly during the day can help to keep the oral surfaces from drying out. This helps maintain your natural <a href="https://pubmed.ncbi.nlm.nih.gov/34642755/">oral microbiome</a>, which can reduce the risk of an overgrowth of the bacteria that cause bad breath and tooth damage.</p> <p>Drinking plenty of water also enables the body to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5052503/">produce the saliva needed</a> to prevent dry mouth, ideally the recommended daily amount of six to eight glasses. Chewing sugar-free gum is also a sensible option as it helps to encourage saliva production. Swallowing this saliva keeps the <a href="https://www.ncbi.nlm.nih.gov/books/NBK542251/">valuable fluid within the body</a>. Gums <a href="https://pubmed.ncbi.nlm.nih.gov/20594055/">containing eucalyptus</a> may help to prevent halitosis, too.</p> <p>There’s some evidence that probiotics may help to <a href="https://pubmed.ncbi.nlm.nih.gov/36600415/">alleviate bad breath</a>, at least in the short term. Using a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8173312/">probiotic supplements</a> or consuming probiotic-rich foods (such as yoghurt or kefir) may be a good idea.</p> <p>Practising good <a href="https://www.nidcr.nih.gov/health-info/oral-hygiene">basic oral hygiene</a>, tooth brushing, reducing acidic foods and <a href="https://pubmed.ncbi.nlm.nih.gov/25227396/">sugary drinks</a> and using <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10690548/">a mouthwash</a> all help to protect your teeth as well.</p> <p>Women are <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7567832/">twice as likely</a> to have side-effects when taking GLP-1 receptor agonists – including <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8950819/">gastrointestinal symptoms</a> such as vomiting. This may be due to the sex hormones oestrogen and progesterone, which can <a href="https://time.com/7020911/women-gut-health-ibs-ibd">alter the gut’s sensitivity</a>. To avoid vomiting, try eating smaller meals since the stomach stays fuller for longer while taking semaglutide.</p> <p>If you are sick, don’t immediately brush your teeth as this will spread the stomach’s acid over the surface of the teeth and increase the risk of damage. Instead, rinse your mouth out with water or mouthwash to reduce the strength of the acid and wait at least 30 minutes before brushing.</p> <p>It isn’t clear how long these side effects last, they’ll likely disappear when the medication is stopped, but any damage to the teeth is permanent. Gastrointestinal side-effects can last a few weeks but <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9821052/">usually resolve on their own</a> unless a higher dose is taken.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/257859/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor of Anatomy, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dry-mouth-bad-breath-and-tooth-damage-the-effects-ozempic-and-wegovy-can-have-on-your-mouth-257859">original article</a>.</em></p> <p><em>Image: Pexels / Mart Production</em></p> </div>

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The surprising ways that coffee can interfere with medication

<div class="theconversation-article-body"> <p>For many of us, the day doesn’t start until we’ve had our first cup of coffee. It’s comforting, energising, and one of the most widely consumed beverages in the world. But while your morning brew might feel harmless, it can interact with certain medicines in ways that reduce their effectiveness – or increase the risk of side-effects.</p> <p>From common cold tablets to antidepressants, caffeine’s impact on the body goes far beyond a quick energy boost. Tea also contains caffeine but not in the same concentrations as coffee, and doesn’t seem to affect people in the same way. Here’s what you should know about how coffee can interfere with your medications – and how to stay safe.</p> <h2>1. Cold and flu medicines</h2> <p>Caffeine is a stimulant, which means it speeds up the central nervous system. Pseudoephedrine, a decongestant found in cold and flu remedies such as Sudafed, is <a href="https://medlineplus.gov/druginfo/meds/a682619.html">also a stimulant</a>. When taken together, the effects can be amplified – potentially leading to jitters or restlessness, headaches, fast heart rate and insomnia.</p> <p>Many cold medications already contain added caffeine, increasing these risks further. <a href="https://www.mdpi.com/1422-0067/22/10/5146">Some studies</a> also suggest that combining caffeine with pseudoephedrine can raise blood sugar and body temperature – particularly important for people with diabetes.</p> <p>Stimulant effects are also a concern when combining caffeine with ADHD medications such as amphetamines, or with <a href="https://allergyasthmanetwork.org/news/coffee-and-asthma/">asthma drugs</a> such as theophylline, which shares a similar chemical structure to caffeine. Using them together may increase the risk of side-effects such as a rapid heartbeat and sleep disruption.</p> <figure><iframe src="https://www.youtube.com/embed/9eL16Exry48?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>2. Thyroid medication</h2> <p>Levothyroxine, the standard treatment for an underactive thyroid, is highly sensitive to timing – and your morning coffee can get in the way. <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">Studies show</a> that drinking coffee too soon after taking levothyroxine can reduce its absorption by up to 50%.</p> <p>Caffeine speeds up gut motility (the movement of food and waste through the digestive tract), giving the drug <a href="https://www.jandonline.org/article/S2212-2672(16)00200-8/abstract">less time to be absorbed</a> – and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8002057/#:%7E:text=Several%20studies%20on%20patients%20with,Benvenga%20et%20al.">may also bind</a> to it in the stomach, making it harder for the body to take in. These effects reduce the drug’s bioavailability, meaning less of it reaches your bloodstream where it’s needed. This interaction <a href="https://www.endocrine.org/news-and-advocacy/news-room/2022/drinking-coffee-does-not-hinder-the-absorption-of-liquid-thyroid-medication">is more common</a> with tablet forms of levothyroxine, and less likely with liquid formulations.</p> <p>If absorption is impaired, <a href="https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/">symptoms of hypothyroidism</a> – including fatigue, weight gain and constipation – can return, even if you’re taking your medicine correctly.</p> <p>The same timing rule applies to a class of osteoporosis medications called <a href="https://medlineplus.gov/druginfo/meds/a601011.html#precautions">bisphosphonates</a>, including alendronate and risedronate, which also require an empty stomach and around 30-60 minutes before food or drink is taken.</p> <h2>3. Antidepressants and antipsychotics</h2> <p>The interaction between caffeine and mental health medications can be more complex.</p> <p><a href="https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/overview/">Selective serotonin reuptake inhibitors</a> (SSRIs), such as sertraline and citalopram, are a type of antidepressant medication <a href="https://purehost.bath.ac.uk/ws/portalfiles/portal/225886346/Lalji_McGrogan_and_Bailey_JADR_2021.pdf">widely used</a> to treat depression, anxiety and other psychiatric conditions. <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">Lab studies</a> suggest caffeine can bind to these drugs in the stomach, reducing absorption and potentially making them less effective.</p> <p>Tricyclic antidepressants (TCAs), such as amitriptyline and imipramine, are a class of older antidepressants that work by affecting the levels of neurotransmitters in the brain. They were among the first antidepressants developed and are <a href="https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/#:%7E:text=Tricyclic%20antidepressants%20(TCAs),to%20treat%20chronic%20nerve%20pain.">less commonly used</a> today, compared with newer antidepressants such as SSRIs, due to their potential for more side-effects and higher risk of overdose.</p> <p>TCAs are broken down by the liver enzyme <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">CYP1A2</a>, which also metabolises caffeine. The competition between the two can slow drug breakdown, <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">increasing side-effects</a>, or delay caffeine clearance, making you feel jittery or wired longer than usual.</p> <p>Clozapine, an antipsychotic, is also processed by CYP1A2. <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">One study showed</a> that drinking two-to-three cups of coffee could increase blood levels of clozapine by up to 97%, <a href="https://medlineplus.gov/druginfo/meds/a691001.html#side-effects">potentially increasing risks</a> such as drowsiness, confusion, or more serious complications.</p> <h2>4. Painkillers</h2> <p>Some over-the-counter painkillers, such as those containing aspirin or paracetamol, include added caffeine. <a href="https://link.springer.com/article/10.2165/00003088-200039020-00004">Coffee can speed up</a> how quickly these drugs are absorbed by accelerating how fast the stomach empties and making the <a href="https://onlinelibrary.wiley.com/doi/10.1155/2020/7909703">stomach more acidic</a>, which improves absorption for some medications such as aspirin.</p> <p>While this may help painkillers work faster, it could also raise the risk of side-effects like stomach irritation or bleeding, especially when combined with other sources of caffeine. Though no serious cases have been reported, caution is still advised.</p> <h2>5. Heart medications</h2> <p>Caffeine can temporarily raise blood pressure and heart rate, typically lasting three-to-four hours after consumption. For people taking blood pressure medication or drugs that control irregular heart rhythms (arrhythmias), this <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8101832/#:%7E:text=Table%20I.&amp;text=The%20next%20stage%20of%20hypertension,response%20to%20calcium%20channel%20blockers.&amp;text=The%20potential%20for%20caffeine%20to,Table%20II%20summarizes%20these%20recommendations.">may counteract</a> the intended effects of the medication.</p> <p>This doesn’t mean people with heart conditions must avoid coffee altogether – but they should monitor how it affects their symptoms, and consider limiting intake or switching to decaf if needed.</p> <figure><iframe src="https://www.youtube.com/embed/r-YwCCNDOy0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>What can you do?</h2> <p>Coffee may be part of your daily routine, but it’s also a potent chemical compound that can influence how your body processes medicine. Here’s how to make sure it doesn’t interfere.</p> <p>Take levothyroxine or bisphosphonates on an empty stomach with water, and wait 30-60 minutes before drinking coffee or eating breakfast.</p> <p>Be cautious with cold and flu remedies, asthma treatments and ADHD medications, as caffeine can amplify side-effects.</p> <p>If you’re on antidepressants, antipsychotics, or blood pressure drugs, discuss your caffeine habits with your doctor.</p> <p>Consider reducing intake or choosing a decaffeinated option if you experience side-effects like restlessness, insomnia or heart palpitations.</p> <p>Everyone metabolises caffeine differently – some people feel fine after three cups, while others get side-effects after just one. Pay attention to how your body responds and talk to your pharmacist or GP if anything feels off.</p> <p>If you’re ever unsure whether your medicine and your coffee are a good match, ask your pharmacist or doctor. A short conversation might save you weeks of side-effects or reduced treatment effectiveness – and help you enjoy your brew with peace of mind.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/256919/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/dipa-kamdar-1485027">Dipa Kamdar</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/kingston-university-949">Kingston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/coffee-can-interfere-with-your-medication-heres-what-you-need-to-know-256919">original article</a>.</em></p> <p><em>Image: Pexels / Jonathan Borba</em></p> </div>

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Why do some people need less sleep than others?

<div class="theconversation-article-body"> <p>Have you ever noticed how some people bounce out of bed after just a few hours of sleep, while others can barely function without a solid eight hours?</p> <p>Take Margaret Thatcher, for example. The former British prime minister was known for sleeping <a href="https://www.bbc.com/news/magazine-22084671">just four hours a night</a>. She worked late, rose early, and seemed to thrive on little sleep.</p> <p>But for most of us, that kind of sleep schedule would be disastrous. We’d be groggy, unfocused, and reaching for sugary snacks and caffeinated drinks by mid-morning.</p> <p>So why do some people seem to need less sleep than others? It’s a question that’s fascinated scientists for years. Here’s what we know so far.</p> <h2>Natural short sleepers</h2> <p>There is a small group of people who don’t need much sleep. We call them <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6879540/">natural short sleepers</a>. They can function perfectly well on just four to six hours of sleep each night, often for their entire lives.</p> <p>Generally they <a href="https://academic.oup.com/sleep/article/44/Supplement_2/A154/6260529">don’t feel tired</a>, they don’t nap, and they don’t suffer the usual negative consequences of sleep deprivation. Scientists call this the natural short sleep phenotype – a biological trait that allows people to get all the benefits of sleep in less time.</p> <p>In 2010 researchers discovered genetic mutations that help explain this phenomenon. Natural short sleepers carry rare variants <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2884988/">in certain genes</a>, which seem to make their sleep more efficient.</p> <p>More recently, a <a href="https://www.pnas.org/doi/epub/10.1073/pnas.2500356122">2025 study</a> assessed a woman in her 70s with one of these rare mutations. Despite sleeping just six hours a night for most of her life, she remained physically healthy, mentally sharp, and led a full, active life. Her body, it seems, was simply wired to need less sleep.</p> <p>We’re still learning about how common these genetic mutations are and why they occur.</p> <h2>Not everyone who sleeps less is a natural short sleeper</h2> <p>But here’s the catch: most people who think they’re natural short sleepers aren’t. They’re just chronically sleep-deprived. Often, their short sleep is due to long work hours, social commitments, or a belief sleeping less is a sign of strength or productivity.</p> <p>In today’s hustle culture, it’s common to hear people boast about getting by on only a few hours of sleep. But for the average person, that’s not sustainable.</p> <p>The effects of short sleep build up over time, creating what’s known as a “sleep debt”. This <a href="https://www.sciencedirect.com/science/article/pii/S0149763417301641">can lead to</a> poor concentration, mood swings, micro-sleeps (brief lapses into sleep), reduced performance and even <a href="https://www.sciencedirect.com/science/article/pii/S1389945716301381">long-term health risks</a>. For example, short sleep has been linked to an increased risk of obesity, diabetes, high blood pressure and cardiovascular disease (heart disease and stroke).</p> <h2>The weekend catch-up dilemma</h2> <p>To make up for lost sleep during the week, many people try to “catch up” on weekends.</p> <p>This can help repay some of the sleep debt that has accumulated in the short term. Research <a href="https://www.sciencedirect.com/science/article/pii/S2352721823001663?via%3Dihub">suggests</a> getting one to two extra hours of sleep on the weekend or taking naps when possible may help reduce the negative effects of short sleep.</p> <p>However, it’s not a perfect fix. Weekend catch-up sleep and naps may not fully resolve sleep debt. The topic remains one of ongoing scientific debate.</p> <p>A recent <a href="https://academic.oup.com/sleep/article/47/11/zsae135/7696120">large study</a> suggested weekend catch-up sleep may not offset the cardiovascular risks associated with chronic short sleep.</p> <p>What’s more, large swings in sleep timing can disrupt your body’s <a href="https://www.nature.com/articles/s41598-017-03171-4">internal clock</a>, and sleeping in too much on weekends may make it harder to fall asleep on Sunday night, which can mean starting the working week less rested.</p> <p>Increasing evidence indicates <a href="https://academic.oup.com/sleep/article/47/1/zsad253/7280269">repeated cycles of irregular sleep</a> may have an important influence on general health and the risk of early death, potentially even more so than how long we sleep for.</p> <p>Ultimately, while moderate catch-up sleep might offer some benefits, it’s no substitute for consistent, high-quality sleep throughout the week. That said, maintaining such regularity can be particularly challenging for people with non-traditional schedules, such as shift workers.</p> <h2>So, was Thatcher a true natural short sleeper?</h2> <p>It’s hard to say. Some reports suggest <a href="https://www.theguardian.com/lifeandstyle/2021/aug/27/from-aristotle-to-einstein-a-brief-history-of-power-nappers">she napped during the day</a> in the back of a car between meetings. That could mean she was simply sleep-deprived and compensating for an accumulated sleep debt when she could.</p> <p>Separate to whether someone is a natural short sleeper, there are a range of other reasons people may need more or less sleep than others. Factors <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need">such as age</a> and underlying health conditions can significantly influence sleep requirements.</p> <p>For example, older adults often experience changes in their circadian rhythms and are more likely to suffer from fragmented sleep due to conditions <a href="https://link.springer.com/article/10.1007/s00702-019-02067-z">such as arthritis</a> or <a href="https://link.springer.com/article/10.1007/s11886-023-01939-x">cardiovascular disease</a>.</p> <p>Sleep needs vary from person to person, and while a lucky few can thrive on less, most of us need <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need">seven to nine hours</a> a night to feel and function our best. If you’re regularly skimping on sleep and relying on weekends to catch up, it might be time to rethink your routine. After all, sleep isn’t a luxury – it’s a biological necessity.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/256342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/kelly-sansom-2390567">Kelly Sansom</a>, Research Associate, College of Medicine and Public Health, Flinders University; Research Associate, Centre for Healthy Ageing, <a href="https://theconversation.com/institutions/murdoch-university-746">Murdoch University</a> and <a href="https://theconversation.com/profiles/peter-eastwood-2316718">Peter Eastwood</a>, Deputy Vice Chancellor, Research and Innovation, <a href="https://theconversation.com/institutions/murdoch-university-746">Murdoch University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-people-need-less-sleep-than-others-a-gene-variation-could-have-something-to-do-with-it-256342">original article</a>.</em></p> <p><em>Image: </em></p> </div>

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What’s the difference between ageing and frailty?

<div class="theconversation-article-body"> <p>Ageing is a normal part of the life course. It doesn’t matter how many green smoothies you drink, or how many “anti-ageing” skin care products you use, you can’t stop the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2685272/">ageing process</a>.</p> <p>But while we’re all getting older, not everyone who ages will necessarily become frail. Ageing and frailty are closely related, but they’re not the same thing.</p> <p>Let’s break down the difference between the two.</p> <h2>What is ageing?</h2> <p>On a biological level, ageing is the result of the build-up of <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">cellular and molecular damage</a> in the body over time.</p> <p>The ageing process causes a gradual decline in physical and mental function, a higher risk of disease, and eventual (and unavoidable) death.</p> <p>Still, some people think they can cheat the system, <a href="https://fortune.com/well/article/bryan-johnson-live-longer-unrecognizable-anti-aging-procedure/">spending millions</a> trying to stay young forever. While we may be able to reduce the <a href="https://theconversation.com/do-these-three-popular-anti-ageing-skincare-ingredients-work-heres-what-the-evidence-says-182200">appearance of ageing</a>, ultimately there’s <a href="https://www.nature.com/articles/s44324-024-00040-3">no magic pill</a> to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2685272/">increase our longevity</a>.</p> <p>Around one in six Australians are over the age of 65 (<a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">16% of the total population</a>). Yet <a href="https://www.tandfonline.com/doi/full/10.1080/03601277.2024.2402056">as individuals</a> and <a href="https://theconversation.com/fear-of-ageing-is-really-a-fear-of-the-unknown-and-modern-society-is-making-things-worse-220925">a society</a> many of us still have a <a href="https://www.smh.com.au/lifestyle/health-and-wellness/we-ve-been-constructed-to-think-a-certain-way-the-psychology-of-ageing-20231213-p5er6a.html">fear of ageing</a>.</p> <p>But what is it about ageing we are so afraid of? When it comes down to it, many people are probably less afraid of ageing, and more afraid of becoming frail.</p> <h2>What is frailty?</h2> <p><a href="https://www.afn.org.au/what-is-frailty/">Frailty</a> is defined as a state of vulnerability characterised by a loss of reserve across multiple parts of the body.</p> <p>Frailty is generally characterised by <a href="https://www1.racgp.org.au/newsgp/clinical/frailty-declared-a-medical-condition">several physical symptoms</a>, such as weakness, slow walking speed, exhaustion, unintentional weight loss, and low activity level.</p> <p>Lower bone density and osteoporosis (a condition where the bones become weak and brittle) are also <a href="https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04875-w">associated with frailty</a>, increasing the risk of <a href="https://www.sciencedirect.com/science/article/pii/S1279770723020250">falls and fractures</a>.</p> <p>Notably, someone who is frail is less able to “bounce back” (or recover) after a stressor event compared to someone who is not frail. A stressor event could be, for example, having a fall, getting a urinary infection, or even being admitted to hospital.</p> <p>Frailty is more common in older people. But in some cases, frailty can affect younger people too. For example, people with advanced chronic diseases, such as <a href="https://academic.oup.com/eurjcn/article/22/4/345/6775229">heart failure</a>, can <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja15.00801">develop frailty</a> much younger.</p> <p>Frailty is dynamic. While it can get worse over time, in some cases <a href="https://www.sciencedirect.com/science/article/pii/S037851221830478X">frailty can also be reversed</a> or even prevented through health and lifestyle changes.</p> <p>For example, we know physical inactivity and a sedentary lifestyle can <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31786-6/abstract">significantly increase a person’s risk</a> of becoming frail. On the flip side, evidence shows doing more exercise can <a href="https://pubmed.ncbi.nlm.nih.gov/36746389/">reduce frailty in older adults</a>.</p> <p>There are other lifestyle modifications we can make too. And the earlier we make these changes, the better.</p> <h2>Preventing frailty</h2> <p>Here are some <a href="https://youtu.be/41cMkvsaOOM">key things</a> you can do to <a href="https://www.self.com/story/how-to-avoid-frailty-old-age">help prevent frailty</a>:</p> <p><strong>1. Get moving</strong></p> <p>Exercise more, including resistance training (such as squats and lunges, or grab some stretchy resistance bands). Many of these sorts of exercises can be done at home. YouTube has some <a href="https://youtu.be/XDQo4wslr7I?si=FAoyHLDZgSG5AN1r">great resources</a>.</p> <p>You might also consider joining a gym, or asking your GP about seeing an accredited exercise physiologist or physiotherapist. Medicare <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&amp;q=10953&amp;qt=item">subsidies may be available</a> for these specialists.</p> <p>The <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-older-australians-65-years-and-over">physical activity guidelines</a> for older Australians recommend at least 30 minutes of moderate intensity physical activity on most days or preferably every day.</p> <p>The guidelines also highlight the importance of incorporating different types of activities (such as resistance, balance or flexibility exercises) and reducing the time you spend sitting down.</p> <p><strong>2. Stay socially active</strong></p> <p>Social isolation and loneliness can <a href="https://academic.oup.com/gerontologist/article-abstract/64/10/gnae114/7734069">contribute to the progression of frailty</a>. Reach out to friends and family for support or contact local community groups that you may be able to join. This might include your local Zumba class or bridge club.</p> <p><strong>3. Ask your doctor or pharmacist to regularly check your medications</strong></p> <p>“Polypharmacy” (when someone is prescribed <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over">five or more medications</a>) is associated with an increased <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6005607/">risk of frailty</a>. The presence of frailty can also interfere with how the <a href="https://www.sciencedirect.com/science/article/pii/S0047637419300387">body absorbs medicines</a>.</p> <p><a href="https://www.healthdirect.gov.au/home-medicines-review">Home medicine reviews</a> are available for older adults with a <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&amp;q=900">chronic medical condition or a complex medication regimen</a>. These reviews aims to help people get the most benefit from their medicines and reduce their risk of <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.2_medications_management_reviews_75_years_and_over_0.pdf">experiencing adverse effects</a>.</p> <p>Always consult your doctor before making any changes to your current medications.</p> <p><strong>4. Eat a protein-rich diet with plenty of fruit and vegetables</strong></p> <p><a href="https://academic.oup.com/biomedgerontology/article/61/6/589/589472?login=true#9578331">Low nutrient intake</a> can negatively impact physical function and may increase your risk of becoming frail. There’s some evidence to suggest eating more protein may <a href="https://academic.oup.com/ageing/article/49/1/32/5618813">delay the onset of frailty</a>.</p> <p>A food-first approach is best when looking to increase the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7598653/#:%7E:text=Many%20studies%20have%20described%20an,are%20necessary%20to%20prevent%20frailty.">protein in your diet</a>. Protein is found in <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein#protein-foods">foods such as</a> lean meats, poultry, seafood, eggs, dairy products, legumes and nuts.</p> <p>Adults over 50 should aim to eat <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/protein">64 grams of protein</a> per day for men and 46g per day for women. Adults over 70 should aim for 81g per day for men and 57g per day for women.</p> <p>Ask your GP for a referral to a dietitian who can provide advice on a dietary regime that is best for you.</p> <p>Supplements may be recommended if you are struggling to meet your protein needs from diet alone.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/247450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/julee-mcdonagh-1525476">Julee McDonagh</a>, Senior Research Fellow of Frailty Research, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, Professor of Nursing and Director of Health Innovations, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-ageing-and-frailty-one-is-inevitable-the-other-is-not-247450">original article</a>.</em></p> <p><em>Image: Mikhail Nikov / Pexels</em></p> </div>

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Could cold sores increase the risk of Alzheimer’s disease?

<div class="theconversation-article-body"> <p>A <a href="https://bmjopen.bmj.com/content/15/5/e093946">new study</a> has found the herpes simplex virus type 1 (HSV-1), which causes cold sores, may be linked to the development of Alzheimer’s disease.</p> <p>This idea is not entirely new. Previous research has suggested there <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.1890330403">may be an association</a> between HSV-1 and Alzheimer’s disease, the <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">most common form of dementia</a>.</p> <p>So what can we make of these new findings? And how strong is this link? Let’s take a look at the evidence.</p> <h2>First, what is HSV-1?</h2> <p>HSV-1 is a neurotropic virus, meaning it can infect nerve cells, which send and receive messages to and from the brain. It’s an extremely common virus. The <a href="https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus">World Health Organization estimates</a> nearly two-thirds of the global population aged under 50 carries this virus, often unknowingly.</p> <p>An initial infection can cause mild to severe symptoms including fever, headache and muscle aches, and may manifest as blisters and ulcers around the mouth or lips.</p> <p>After this, HSV-1 typically <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8923070/">lies dormant</a> in the body’s nervous system, sometimes reactivating due to stress or illness. During reactivation, it can cause symptoms such as cold sores, although in many people it doesn’t cause any symptoms.</p> <h2>What did the new research look at?</h2> <p>In a study published this week <a href="https://bmjopen.bmj.com/content/15/5/e093946">in BMJ Open</a>, researchers analysed data from hundreds of thousands of people drawn from a large United States health insurance dataset.</p> <p>They conducted a matched “case-control” analysis involving more than 340,000 adults aged 50 and older diagnosed with Alzheimer’s disease between 2006 and 2021. Each Alzheimer’s disease patient (a “case”) was matched to a control without a diagnosis of Alzheimer’s disease based on factors such as age, sex and geographic region, a method designed to reduce statistical bias.</p> <p>The team then examined how many of these people had a prior diagnosis of HSV-1 and whether they had been prescribed antiviral treatment for the infection.</p> <p>Among people with Alzheimer’s disease, 0.44% had a previous HSV-1 diagnosis, compared to 0.24% of controls. This translates to an 80% increased relative risk of Alzheimer’s disease in those diagnosed with HSV-1, however the absolute numbers are small.</p> <p>The researchers also found people who received antiviral treatment for HSV-1 had roughly a 17% lower risk of developing Alzheimer’s disease compared to those who were untreated.</p> <h2>Not a new hypothesis</h2> <p>This isn’t the first time researchers have speculated about a viral role in Alzheimer’s disease. <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.1890330403">Earlier studies</a> have detected <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10149-5/abstract">HSV-1 DNA in postmortem brain tissues</a> from people who had Alzheimer’s disease.</p> <p>Laboratory research has also shown <a href="https://doi.org/10.1016/j.neuron.2018.06.030">HSV-1 can trigger amyloid-beta plaque accumulation</a> in nerve cells and mouse brains. Amyloid-beta plaques are one of the defining features of Alzheimer’s disease pathology, so this has led to speculation that reactivation of the virus may contribute to brain inflammation or damage.</p> <p>But importantly, previous research and the current study show associations, not proof HSV-1 causes Alzheimer’s disease. These links do not confirm the virus initiates or drives disease progression.</p> <blockquote class="bluesky-embed" data-bluesky-uri="at://did:plc:f3ph3ymzcnhpchwqiu4u37g2/app.bsky.feed.post/3lpn5axtbvj2i" data-bluesky-cid="bafyreifwdab7rnvdpu6t3vnupdymct77ojzrhjkwxcndc2lo5b4ipjkvee" data-bluesky-embed-color-mode="system"> <p lang="">Got Cold Sores? You Might Be at Higher Risk for Alzheimer’s https://gizmodo.com/got-cold-sores-you-might-be-at-higher-risk-for-alzheimers-2000603873</p> <p><a href="https://bsky.app/profile/did:plc:f3ph3ymzcnhpchwqiu4u37g2/post/3lpn5axtbvj2i?ref_src=embed">[image or embed]</a></p> <p>— Gizmodo (<a href="https://bsky.app/profile/did:plc:f3ph3ymzcnhpchwqiu4u37g2?ref_src=embed">@gizmodo.com</a>) <a href="https://bsky.app/profile/did:plc:f3ph3ymzcnhpchwqiu4u37g2/post/3lpn5axtbvj2i?ref_src=embed">May 21, 2025 at 8:31 AM</a></p></blockquote> <h2>Some other important caveats</h2> <p>The study relied on insurance claim data, which may not always reflect accurate or timely clinical diagnoses. HSV-1 is also frequently underdiagnosed, especially when symptoms are mild or absent. These points could explain why both the Alzheimer’s group and the control group saw such low rates of HSV-1, when population rates of this virus <a href="https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus">are estimated to be far higher</a>.</p> <p>This means many carriers of HSV-1 in the study may have gone unrecorded and therefore makes the link harder to interpret clearly. The dataset also doesn’t capture how often people had recurring symptoms, or the severity or duration of infections – conditions which might influence risk more directly.</p> <p>Another complicating factor is people with HSV-1 might differ in other ways from those without it. Differences in health-care access, the health of a person’s <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00144-4/fulltext">immune system</a>, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract">lifestyle</a>, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60630-3/abstract">genetics</a>, or even <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract">education</a> – could all influence Alzheimer’s disease risk.</p> <h2>So should you be concerned if you have cold sores?</h2> <p>The short answer is no – at least not based on current evidence. Most people with HSV-1 will never develop Alzheimer’s disease. The vast majority live with the virus without any serious neurological issues.</p> <p>The “herpes hypothesis” of Alzheimer’s disease is an interesting area for further research, but far from settled science. This study adds weight to the conversation but doesn’t offer a definitive answer.</p> <p>Alzheimer’s disease is a complex condition with <a href="https://www.thelancet.com/commissions-do/dementia-prevention-intervention-and-care">multiple risk factors</a>, including age, genetics, heart health, education, lifestyle and environmental exposures.</p> <p>Infections such as HSV-1 may be one part of a larger, interconnected puzzle, but they are highly unlikely to be the sole cause.</p> <p>With this in mind, the best thing to do is to focus on what we already know can help keep your brain healthy as you age. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00184-9/abstract#:%7E:text=Emerging%20evidence%20suggests%20that%20sedentary,impairment%20and%20reduce%20dementia%20risk.">Regular physical activity</a>, <a href="https://www.health.harvard.edu/blog/sleep-well-and-reduce-your-risk-of-dementia-and-death-2021050322508">good quality sleep</a>, <a href="https://www.alzheimers.org.uk/about-dementia/managing-the-risk-of-dementia/reduce-your-risk-of-dementia/social-isolation">social engagement</a>, <a href="https://www.alzheimersresearchuk.org/dementia-information/dementia-risk/diet-and-dementia-risk/">a balanced diet</a> and <a href="https://www.health.harvard.edu/mind-and-mood/protect-your-brain-from-stress">managing stress</a> can all support long-term brain health.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/257140/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, Associate Professor | Deputy Director, The MARCS Institute for Brain, Behaviour, and Development, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-cold-sores-increase-the-risk-of-alzheimers-disease-a-new-study-is-no-cause-for-panic-257140">original article</a>.</em></p> <p><em>Image: Gizmodo</em></p> </div>

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Why do some people get a curved back as they age and what can we do to avoid it?

<div class="theconversation-article-body"> <p>As we age, it’s common to notice posture changes: shoulders rounding, head leaning forward, back starting to curve. You might associate this with older adults and wonder: will this happen to me? Can I prevent it?</p> <p>It’s sometimes called “hunchback” or “roundback”, but the medical term for a curved back is kyphosis.</p> <p>When the curve is beyond what’s considered normal (greater than 40 degrees), we refer to this as hyperkyphosis. In more <a href="https://www.jospt.org/doi/10.2519/jospt.2010.3099#_i12:%7E:text=gold%2Dstandard%20radiograph.-,Clinical%20Consequences%20of%20Hyperkyphosis,-Functional%20Limitations">severe cases</a>, it may lead to pain, reduced mobility and physical function, or lower quality of life.</p> <p>Here’s how it happens, and how to reduce your risk.</p> <h2>What causes a curved back?</h2> <p>A healthy spine has an elongated s-shape, so a curve in the upper spine is completely normal.</p> <p>But when that curve becomes exaggerated and fixed (meaning you can’t stand up straight even if you try), it can signal a problem.</p> <p>One common cause of a curved back is poor posture. This type, called postural kyphosis, usually develops over time due to muscle imbalances, particularly in younger people who spend hours:</p> <ul> <li>hunched over a desk</li> <li>slouched in a chair, or</li> <li>looking down at a phone.</li> </ul> <p>Fortunately, this kind of curved back is often reversible with the right exercises, stretches and posture awareness.</p> <p>Older adults often develop a curved back, known as age-related kyphosis or hyperkyphosis.</p> <p>This is usually due to wear and tear in the spine, including vertebral compression fractures, which are tiny cracks in the bones of the spine (vertebrae).</p> <p>These cracks are most often caused by osteoporosis, a condition that makes bones more fragile with age.</p> <p>In these cases, it’s not just bad posture – it’s a structural change in the spine.</p> <h2>How can you tell the difference?</h2> <p>Signs of age-related hyperkyphosis include:</p> <ul> <li>your back curves even when you try to stand up straight</li> <li>back pain or stiffness</li> <li>a loss of height (anything greater than 3-4 centimetres compared to your peak adult height may be considered outside of “normal” ageing).</li> </ul> <p>Other causes of a curved back include:</p> <ul> <li><a href="https://pubmed.ncbi.nlm.nih.gov/30407981/">Scheuermann’s kyphosis</a> (which often develops during adolescence when the bones in the spine grow unevenly, leading to a forward curve in the upper back)</li> <li><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4347150/">congenital kyphosis</a> (a rare condition present from birth, caused by improper formation of the spinal bones. It can result in a more severe, fixed curve that worsens as a child grows)</li> <li>scoliosis (where the spine curves sideways into a c- or s-shape when viewed from behind), and</li> <li>lordosis (an excessive inward curve in the lower back, when viewed from the side).</li> </ul> <p>In addition to these structural conditions, arthritis, and in rare cases, spinal injuries or infections, can also play a role.</p> <h2>Should I see a doctor about my curved back?</h2> <p>Yes, especially if you’ve noticed a curve developing, have ongoing back pain, or have lost height over time.</p> <p>These can be signs of vertebral fractures, which can occur in the absence of an obvious injury, and are often painless.</p> <p>While one in five older adults have a vertebral fracture, as many as two-thirds of these fractures are <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002934315010128?casa_token=DzXngmS6GIoAAAAA:3ub0V4PuHbKjrqO9xYDo8vx2m9k6tbOtmz4yIVzkQvH-VylhgO_KnKaTYDLXpiHc9_4Jz0iNdQ">not diagnosed and treated</a>.</p> <p>In Australia, the Royal Australian College of General Practitioners and Healthy Bones Australia <a href="https://healthybonesaustralia.org.au/wp-content/uploads/2022/12/oa-racgp-osteoporosis-clinical-guidelines-2nd-ed.pdf">recommend</a> a spine x-ray for:</p> <ul> <li>people with kyphosis</li> <li>height loss equal to or more than 3 centimetres, or</li> <li>unexplained back pain.</li> </ul> <h2>What can I do to reduce my risk?</h2> <p>If you’re young or middle-aged, the habits you build today matter.</p> <p>The best way to prevent a curved back is to keep your bones strong, muscles active, and posture in check. That means:</p> <ul> <li>doing regular resistance training, especially targeting upper back muscles</li> <li>staying physically active, aiming for at least <a href="https://www.who.int/initiatives/behealthy/physical-activity">150 minutes per week</a></li> <li>getting enough protein, calcium, and vitamin D to support bone and muscle health</li> <li>avoiding smoking and limiting alcohol to reduce risk factors that worsen bone density and overall wellbeing</li> </ul> <p>Pay attention to your posture while sitting and standing. Position your head over your shoulders and shoulders over your hips. This reduces strain on your spine.</p> <h2>What exercises help prevent and manage a curved back?</h2> <p>Focus on <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5112023/">exercises that strengthen the muscles</a> that support an upright posture, particularly the upper back and core, while improving mobility in the chest and shoulders.</p> <p>In general, you want to prioritise extension-based movements. These involve straightening or lifting the spine and pulling the shoulders back.</p> <p>Repeated forward-bending (or flexion) movements may make things worse, especially in people with osteoporosis or spinal fractures.</p> <p>Good exercises include:</p> <ul> <li>back extensions (gently lift your chest off the floor while lying face down)</li> <li>resistance exercises targeting the muscles between your shoulder blades</li> <li>weight-bearing activities (such as brisk walking, jogging, stair climbing, or dancing) to keep bones strong and support overall fitness</li> <li>stretching your chest and hip flexors to open your posture and relieve tightness.</li> </ul> <p>Flexibility and balance training (such as yoga and pilates) can be <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3700806/">beneficial</a>, particularly for posture awareness, balance, and mobility. But <a href="https://pubmed.ncbi.nlm.nih.gov/31034509/">research</a> increasingly supports muscle strengthening as the cornerstone of prevention and management.</p> <p>Muscle strengthening exercises, such as weight lifting or resistance training, reduces spinal curvature while enhancing muscle and bone mass.</p> <p>If you suspect you have kyphosis or already have osteoporosis or a vertebral fracture, consult a health professional before starting an exercise program. There may be some activities to avoid.</p> <h2>Can a curved back be reversed?</h2> <p>If it’s caused by poor posture and muscle weakness, then yes, it’s possible.</p> <p>But if it’s caused by bone changes, especially vertebral fractures, then full reversal is unlikely. However, treatment can reduce pain, improve function, and slow further progression.</p> <p>Protecting your posture isn’t just about appearance. It’s about staying strong, mobile and independent as you age.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/252811/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/jakub-mesinovic-2351870">Jakub Mesinovic</a>, Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/david-scott-1258511">David Scott</a>, Associate Professor (Research) and NHMRC Emerging Leadership Fellow, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-people-get-a-curved-back-as-they-age-and-what-can-i-do-to-avoid-it-252811">original article</a>.</em></p> <p><em>Image: Life Care Home Health</em></p> </div>

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What’s the difference between osteoarthritis and rheumatoid arthritis?

<div class="theconversation-article-body"> <p><a href="https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis">Arthritis</a> – an umbrella term for around <a href="https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/sources-of-arthritis-pain">100 conditions</a> that damage the joints – affects <a href="https://pubmed.ncbi.nlm.nih.gov/39647490/">4.1 million</a> Australians. This is expected <a href="https://pubmed.ncbi.nlm.nih.gov/39647490/">to rise</a> by 31% to 5.4 million by 2040 and cost the Australian health-care system an estimated $12 billion each year.</p> <p>The two most common types, osteoarthritis and rheumatoid arthritis, can both cause joint pain, swelling and stiffness. Both are more common in <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis">women</a>. Neither can be cured.</p> <p>But their causes, risk factors and treatments are different – here’s what you need to know.</p> <h2>What is osteoarthritis?</h2> <p>Osteoarthritis is the most common form of arthritis. It affects <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/osteoarthritis">2.1 million Australians</a>, mostly older people. About a third of <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/osteoarthritis">Australians</a> aged 75 and older have the condition.</p> <p>It can affect any joint but is most common in the knees, hips, fingers, thumbs and big toes.</p> <p>The main symptom is pain, especially during movement. Other symptoms may include swelling, stiffness and changes to the shape of joints.</p> <p>The <a href="https://www.who.int/news-room/fact-sheets/detail/osteoarthritis">main risk factors</a> are ageing and obesity, as well as previous injuries or surgery. For osteoarthritis in the hands, <a href="https://pubmed.ncbi.nlm.nih.gov/35843480/">genetics</a> also play a big role.</p> <p>Signs of osteoarthritis can appear on knee scans from around <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">age 45</a> and become more common with age.</p> <p>However, this type of arthritis not simply the “wear and tear” of ageing. Osteoarthritis is a complex disease that affects the <a href="https://www.nature.com/articles/nrdp201672">whole joint</a>. This includes the <a href="https://my.clevelandclinic.org/health/body/23173-cartilage">cartilage</a> (“shock-absorbing” connective tissue protecting your bones), bones, <a href="https://my.clevelandclinic.org/health/body/21604-ligament">ligaments</a> (connective tissue holding bones and body parts in place) and joint lining.</p> <h2>How is it diagnosed?</h2> <p>Diagnosis is <a href="https://www.nice.org.uk/guidance/ng226/chapter/Recommendations#diagnosis">based on</a> symptoms (such as pain and restricted movement) and a physical exam.</p> <p>The disease generally worsens over time and cannot be reversed. But the severity of damage does not always <a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">correlate with pain</a> levels.</p> <p>For this reason, x-rays and <a href="https://pubmed.ncbi.nlm.nih.gov/29886437/">MRI scans</a> are usually unhelpful. Some people with early osteoarthritis experience severe pain, but the damage won’t show up on a scan. Others with advanced and visible osteoarthritis may have few symptoms or none at all.</p> <h2>What about rheumatoid arthritis?</h2> <p>Unlike osteoarthritis, rheumatoid arthritis is an autoimmune disease. This means the immune system attacks the joint lining, causing inflammation and damage.</p> <p>Common symptoms include pain, joint swelling and stiffness, <a href="https://arthritis-research.biomedcentral.com/articles/10.1186/ar4146">especially in the morning</a>.</p> <p>Rheumatoid arthritis is less common than osteoarthritis, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/rheumatoid-arthritis">around 514,000 Australians</a>. It mostly impacts the wrists and small joints in the hands and feet, though larger joints such as the elbows, shoulders, knees and ankles can also be involved.</p> <p>It can also affect other organs, including the skin, lungs, eyes, heart and blood vessels. Fortunately, disease outside the joint has become <a href="https://pubmed.ncbi.nlm.nih.gov/38240831/">less common</a> in recent years, likely due to better and earlier treatment.</p> <p><a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/rheumatoid-arthritis?request=smoothstate">Rheumatoid arthritis</a> often develops earlier than osteoarthritis but can occur at any age. Onset is most frequent in those aged <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/rheumatoid-arthritis">35–64</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/21149499/">Smoking</a> increases your risk.</p> <h2>How is it diagnosed?</h2> <p>As with osteoarthritis, your doctor will diagnose rheumatoid arthritis based on your symptoms and a physical exam.</p> <p>Some other tests can be useful. Blood tests may pick up specific <a href="https://www.nature.com/articles/nrdp20181">antibodies</a> that indicate rheumatoid arthritis, although you can still have the condition <a href="https://arthritisaustralia.com.au/managing-arthritis/medical-management/blood-test-for-arthritis/">with negative results</a>.</p> <p>X-rays may also reveal joint damage if the disease is advanced. If there is uncertainty, an <a href="https://pubmed.ncbi.nlm.nih.gov/35022703/">ultrasound or MRI</a> can help detect inflammation.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/664530/original/file-20250429-56-okmp6o.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <h2>How is osteoarthritis treated?</h2> <p>No treatment can stop osteoarthritis progressing. However many people manage their symptoms well with advice from their doctor and self-care. Exercise, weight management and pain medicines <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/osteoarthritis-knee-clinical-care-standard-2024">can help</a>.</p> <p>Exercise has been shown to be safe for osteoarthritis of the <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004376.pub4/full">knee</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/24756895/">hip</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/29032354/">hand</a>. Many types of exercise are <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">effective</a> at reducing pain, so you can choose what suits you best.</p> <p>For knee osteoarthritis, managing weight through diet and/or exercise is <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/osteoarthritis-knee-clinical-care-standard-2024">strongly recommended</a>. This may be because it reduces pressure on the joint or because losing weight <a href="https://pubmed.ncbi.nlm.nih.gov/30390883/">can reduce inflammation</a>. <a href="https://theconversation.com/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">Anti-obesity medicines</a> may also reduce pain.</p> <p>Topical and oral <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/osteoarthritis-knee-clinical-care-standard-2024">anti-inflammatories</a> are usually recommended to manage pain. However, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> (such as tramadol or oxycodone) are not, due to their risks and limited evidence they help.</p> <p>In some cases <a href="https://pubmed.ncbi.nlm.nih.gov/33472813/">antidepressants</a> such as duloxetine may also be considered as a treatment for pain though, again, evidence they help is limited.</p> <h2>What about rheumatoid arthritis?</h2> <p>Treatments for rheumatoid arthritis focus on preventing joint damage and reducing inflammation.</p> <p>It’s essential to get an <a href="https://rheumatology.org.au/Portals/2/Documents/Public/Professionals/Clinical%20Care%20Standards/RAQS-UPDATE-Clinicians-ACCESS-03-7May24.pdf?ver=2024-05-07-135934-023">early referral to a rheumatologist</a>, so that treatment with medication – called “disease-modifying anti-rheumatic drugs” – can begin quickly.</p> <p>These <a href="https://app.magicapp.org/#/guideline/LqRV3n">medicines</a> suppress the immune system to stop inflammation and prevent damage to the joint.</p> <p>With no cure, the <a href="https://creakyjoints.org/about-arthritis/rheumatoid-arthritis/ra-treatment/remission-low-disease-activity-rheumatoid-arthritis/">overall goal</a> is to achieve remission (where the disease is inactive) or get symptoms under control.</p> <h2>Advances in treatment</h2> <p>There is an increasing interest in prevention for both types of arthritis.</p> <p>A large international <a href="https://pubmed.ncbi.nlm.nih.gov/38144515/">clinical</a> trial is currently investigating whether a diet and exercise program can prevent knee osteoarthritis in those with higher risk – in this case, women who are overweight and obese.</p> <p>For those already affected, <a href="https://acrabstracts.org/abstract/levi-04-a-novel-neurotrophin-3-inhibitor-substantially-improves-pain-and-function-without-deleterious-effects-on-joint-structure-in-people-with-knee-osteoarthritis-a-randomized-controlled-phase-ii/">new medicines</a> in early-stage clinical trials show promise in reducing pain and improving function.</p> <p>There is also hope for rheumatoid arthritis with Australian researchers <a href="https://www.uq.edu.au/news/article/2024/07/drug-free-life-rheumatoid-arthritis-patients-possible-within-decade">developing</a> a new immunotherapy. This treatment aims to reprogram the immune system, similar to a vaccine, to help people achieve long-term remission without lifelong treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/249154/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/rachelle-buchbinder-449750">Rachelle Buchbinder</a>, Professor of Clinical Epidemiology and Rheumatologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-osteoarthritis-and-rheumatoid-arthritis-249154">original article</a>.</em></p> <p><em>Image: Shutterstock</em></p> </div>

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Andre Agassi victorious in pro pickleball debut!

<p>Andre Agassi, former tennis demigod and proud wearer of 1990s denim shorts, just served up a win in his professional pickleball debut, the sport that sounds like a snack and plays like a caffeine-fuelled family reunion in Florida.</p> <p>Fresh off turning 55 (and presumably fuelled by birthday cake and a lifetime supply of Voltarin), Agassi teamed up with 18-year-old phenom Anna Leigh Waters. Together, they defeated a duo of teens young enough to still ask permission before downloading apps. The final score: 11-8, 9-11, 11-7 – a tight match that was equal parts strategy, reflex and Agassi’s uncanny ability to intimidate opponents with his résumé.</p> <p>Let’s take a moment to appreciate this image: one of tennis’s all-time greats, who once faced Pete Sampras at Wimbledon, now facing… someone who probably wasn't alive when Agassi last hoisted a Grand Slam trophy. And yet, here he is, paddle in hand, knees holding together like true American heroes, navigating a sport that’s basically what would happen if tennis and ping pong had a baby in a Florida retirement community.</p> <p>Agassi, who retired from tennis in 2006 and was inducted into the Hall of Fame when flip phones still roamed the earth, has since dabbled in pickleball exhibition matches, mostly as an excuse to promote paddle gear online and to remind the world that he still has better footwork than most 25-year-olds.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">✅ make pro Pickleball debut<br />✅ WIN pro Pickleball debut</p> <p>Andre Agassi and Anna Leigh Waters take home the W! <a href="https://t.co/ONUqDLaxWc">pic.twitter.com/ONUqDLaxWc</a></p> <p>— CBS Sports Network (@CBSSportsNet) <a href="https://twitter.com/CBSSportsNet/status/1917629532716073248?ref_src=twsrc%5Etfw">April 30, 2025</a></p></blockquote> <p>Pickleball, in case you’ve been trapped under a yoga mat, is the fastest-growing sport in America, and is making huge strides here in Australia too. It’s played with paddles, a plastic wiffleball, and the unwavering confidence of people who own ergonomic lawn chairs. It now boasts over 13 million U.S. players and rising – about 12.9 million of whom are currently trying to explain the rules to their confused spouses.</p> <p>Naturally, Agassi wasn’t quite sure how to feel about entering the pro scene.</p> <p>"I have this conflict, like I can't tell. Is this fun? Is this anxiety?" he admitted, possibly while trying to remember if his insurance covers pickleball-related injuries. He also joked that many of his tennis peers were tuning in “to watch a slow-motion train wreck”. (Spoiler: it never crashed.)</p> <p>His personal goal for the tournament wasn’t medals or glory – it was approval from his teenaged partner. “A win for me will be when this is over and Anna Leigh looks at me and says, ‘Do you want to play again?’” he said. </p> <p>While it’s too early to say whether this marks the start of a new career or just an elaborate midlife crisis with a paddle, one thing’s for sure: pickleball will never be the same.</p> <p>And who knows? At this rate, Roger Federer could be lacing up orthopaedic sneakers any minute now...</p> <p><em>Images: Instagram</em></p>

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Brain disorder more common than MS – but often goes undiagnosed

<div class="theconversation-article-body"> <p>Imagine suddenly losing the ability to move a limb, walk or speak. You would probably recognise this as a medical emergency and get to hospital.</p> <p>Now imagine the doctors at the hospital run some tests and then say, “Good news! All your tests were normal, clear scans, and nothing is wrong. You can go home!” Yet, you are still experiencing very real and disabling symptoms.</p> <p>Unfortunately, <a href="https://doi.org/10.1080/09638288.2024.2333491">this is the experience of many people</a> with functional neurological disorder. Even worse, some are blamed and reprimanded for <a href="https://academic.oup.com/brain/article/148/1/27/7750481?login=false">exaggerating</a> or faking their symptoms.</p> <p>So, what is this disorder, and why is it so challenging to recognise and treat?</p> <h2>What is functional neurological disorder?</h2> <p><a href="https://my.clevelandclinic.org/health/diseases/neurological-disorders">Neurological disorders</a> are conditions that affect how the nervous system works. The nervous system sends and receives messages between the brain and other parts of your body to regulate a wide range of functions, such as movement, speaking, vision, thinking and digestion.</p> <p>To the untrained eye, functional neurological disorder can resemble other conditions such as stroke, multiple sclerosis or epilepsy.</p> <p>But, unlike these conditions, functional neurological symptoms <a href="https://neurosymptoms.org/en/causes/how-was-it-happened/">aren’t due</a> to damage or a disease process affecting the nervous system. This means the disorder doesn’t appear on routine brain imaging and other tests.</p> <p>Functional symptoms are, instead, due to dysfunction in the processing of information between several brain networks. Simply put, <a href="https://neurosymptoms.org/en/causes/how-was-it-happened/">it’s a problem</a> of the brain’s software, not the hardware.</p> <h2>What are the symptoms?</h2> <p>Functional neurological disorder can produce a kaleidoscope of diverse and changing symptoms. This often adds to confusion for patients and make diagnosis more challenging.</p> <p><a href="https://neurosymptoms.org/en/symptoms/">Symptoms</a> may include paralysis or abnormal movements such as tremors, jerks and tics. This often leads to difficulty walking or coordinating movements.</p> <p>Sensory symptoms may involve numbness, tingling or loss of vision.</p> <p>Dissociative symptoms, such as functional seizures and blackouts, are also common.</p> <p>Some people experience cognitive symptoms including brain fog or problems finding the right words. Fatigue and chronic pain frequently coexist with these symptoms.</p> <p>These symptoms can be severe and distressing and, without treatment, <a href="https://pubmed.ncbi.nlm.nih.gov/31167232/">can persist for years</a>. For example, some people with functional neurological disorder cannot walk and must use a wheelchair for decades.</p> <p>Diagnosis involves <a href="https://www.bmj.com/content/371/bmj.m3745">identifying established diagnostic signs</a> and ensuring no other diagnoses are missed. This process is best carried out by an experienced neurologist or neuropsychiatrist.</p> <h2>How common is it?</h2> <p>Functional neurological disorder is one of the most common medical conditions seen in <a href="https://doi.org/10.1001/jamaneurol.2020.3753">emergency care</a> and in <a href="https://doi.org/10.1093/brain/awp220">outpatient neurology clinics</a>.</p> <p>It affects around <a href="https://doi.org/10.1136/jnnp-2024-334767">10–22 people per 100,000 per year</a>. This makes it more common than multiple sclerosis.</p> <p>Despite this, it is often under-recognised and misunderstood by health-care professionals. This leads to <a href="https://academic.oup.com/brain/article/148/1/27/7750481?login=false">delays in diagnosis and treatment</a>.</p> <p>This lack of awareness also contributes to the perception that it’s rare, when it’s actually common among neurological disorders.</p> <h2>Who does functional neurological disorder affect?</h2> <p>This condition can affect anyone, although it is more common in women and younger people. Around two thirds of patients are female, but this <a href="https://jnnp.bmj.com/content/93/6/609">gender disparity reduces with age</a>.</p> <p>Understanding of the disorder has <a href="https://pubmed.ncbi.nlm.nih.gov/33722822/">developed significantly over the past few decades</a>, but there’s still more to learn. Several biological, psychological, and social factors can <a href="https://pubmed.ncbi.nlm.nih.gov/35430029/">predispose people</a>.</p> <p>Genetics, traumatic life experiences, anxiety and depression can increase the risk. Stressful life events, illness, or physical injuries can trigger or worsen existing symptoms.</p> <p>But not everyone with the disorder has experienced significant trauma or stress.</p> <h2>How is it treated?</h2> <p>If left untreated, about <a href="https://doi.org/10.1093/brain/awz138">half the people</a> with this condition will remain the same or their symptoms will worsen. However, with the help of experienced clinicians, many people can make rapid recoveries when treatment starts early.</p> <p>There are no specific medications for functional neurological disorder but personalised rehabilitation guided by experienced clinicians is <a href="https://fndhope.org/living-fnd/">recommended</a>.</p> <p>Some people may need a team of multidisciplinary clinicians that may include physiotherapists, occupational therapists, speech therapists, psychologists and doctors.</p> <p>People also need accurate information about their condition, because <a href="https://doi.org/10.1093/brain/aws129">understanding and beliefs</a> about the disorder play an important role in recovery. Accurate information helps patients to develop more realistic expectations, reduces anxiety and can empower people to be more active in their recovery.</p> <p>Treating common co-existing conditions, such as anxiety or depression, can also <a href="https://www.bmj.com/content/376/bmj.o64.abstract">be helpful</a>.</p> <h2>A dark history</h2> <p>The origins of the disorder are deeply rooted in the sexist <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8564048/">history of its pre-scientific ancestor – hysteria</a>. The legacy of hysteria has cast a long shadow, contributing to a misogynistic bias in perception and treatment. This historical context has led to ongoing stigma, where symptoms were often labelled as psychological and not warranting treatment.</p> <p>Women with functional symptoms often face scepticism and dismissal. In some cases, <a href="https://jnnp.bmj.com/content/94/10/855">significant harm</a> occurs through stigmatisation, inadequate care and poor management. Modern medicine has attempted to address these biases by recognising functional neurological disorder as a legitimate condition.</p> <p>A <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11414792/">lack of education</a> for medical professionals likely contributes to stigma. Many <a href="https://doi.org/10.1016/j.jocn.2019.06.008">clinicians report low confidence and knowledge</a> about their ability to manage the disorder.</p> <h2>A bright future?</h2> <p>Fortunately, awareness, research and interest has grown over the past decade. Many treatment approaches are being trialled, including <a href="https://www.physio4fmd.org/">specialist physiotherapy</a>, <a href="https://jnnp.bmj.com/content/92/1/36.abstract">psychological therapies</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35115389/">non-invasive brain stimulation</a>.</p> <p>Patient-led organisations and <a href="https://fndhope.org/">support networks</a> are making headway advocating for improvements in health systems, research and education. The goal is to unite patients, their families, clinicians, and researchers to advance a new standard of care across the world.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/250501/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>By</em> <a href="https://theconversation.com/profiles/benjamin-scrivener-2329913"><em>Benjamin Scrivener</em></a><em>, PhD Candidate, Faculty of Medical and Health Sciences, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/tremors-seizures-and-paralysis-this-brain-disorder-is-more-common-than-multiple-sclerosis-but-often-goes-undiagnosed-250501">original article</a>.</em></p> <p><em>Image: Shutterstock</em></p> </div>

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Huge update in search for Samantha Murphy's body

<p>The man accused of murdering Ballarat mother Samantha Murphy has reportedly been removed from prison and taken under heavy police guard to bushland near Ballarat, as Victoria Police intensify their search for her remains.</p> <p>Patrick Orren Stephenson, 23, who has pleaded not guilty to the murder of the 51-year-old, was previously escorted to the search site from jail last year. According to <em>Sunrise</em>, he remains under tight security as police continue their investigation.</p> <p>Murphy was last seen on February 4 last year, setting out for a routine 14-kilometre run through the Canadian State Forest. Despite extensive searches by police and community volunteers across the Canadian State Forest, Enfield State Park, and the Buninyong Bushland Reserve, her body has not been found.</p> <p>While police have not confirmed that Stephenson is cooperating with the search, nor suggested that he knows the location of Murphy's body, his presence at the scene signals ongoing investigative efforts.</p> <p>In June last year, a significant breakthrough emerged when Murphy’s personal belongings – including her credit cards, driver’s licence and an iPhone encased in a teal cover – were discovered submerged in mud at the bottom of a dam in Buninyong, close to her home. Investigators found the phone in near-perfect condition, raising hopes that its data might reveal clues about Murphy's final movements.</p> <p>Police subsequently focused their search on bushland south of Buninyong, roughly two kilometres from the dam.</p> <p>Victoria Police have declined to comment on the latest developments, citing the ongoing court proceedings. Stephenson’s trial is expected to take place later this year.</p> <p>During a February court hearing, Prosecutor Raymond Gibson KC indicated that police officers and a DNA expert are among eight proposed witnesses for the trial. The list also includes a road crash reconstruction specialist, a digital data expert and a phone data analyst.</p> <p>Stephenson, the son of former AFL player Orren Stephenson, had never personally met Murphy. However, the pair shared a local connection: Murphy volunteered at the uniform shop at St Francis Xavier Primary School, where Stephenson had been a student.</p> <p>It is understood that police had been monitoring Stephenson for two weeks prior to his arrest in March last year, at a Ballarat home where he and his girlfriend were house-sitting.</p> <p>The investigation continues.</p> <p><em>Images: File photos</em></p>

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"Absolutely stunning!": Jelena Dokic wows fans with new look

<p>Former tennis star Jelena Dokic has debuted a striking new look, showcasing her dramatic weight loss and inspiring thousands with her message of self-love.</p> <p>The 41-year-old, once ranked world No. 4, made a radiant return to the spotlight as part of Channel 9’s coverage of the Billie Jean King Cup. A photo from the broadcast set quickly sparked an outpouring of support from fans, celebrating not just her transformation, but her ongoing role as a symbol of strength and positivity.</p> <p>“Back in the studio and back doing the tennis and TV with my @channel9 @wwos family,” Dokic shared with her 285,000 Instagram followers on Thursday. “Nice little lead into the next 3 grand slams of the year with a @billiejeankingcup week.”</p> <p>Supportive messages flooded the post, with fans praising her radiant presence. “You’re a dead set LEGEND Jelena,” one admirer wrote, while another added, “Absolutely stunning!”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/DIQMMW5pIcp/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DIQMMW5pIcp/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by JELENA DOKIC 🇦🇺🇦🇺🇦🇺 (@dokic_jelena)</a></p> </div> </blockquote> <p>Dokic has been open about her personal struggles, candidly discussing her battles with mental health, weight challenges and online bullying. In a heartfelt Instagram post from March 11, she reflected on her journey, using side-by-side images to convey a powerful message about body image.</p> <p>“What is the difference between the two images?” she asked. “Nothing except what you see on the outside, my BODY SIZE. I am the same hardworking person, respectful, generous, empathetic, compassionate, humble, kind, driven, strong, resilient, capable and loving person, woman and friend.”</p> <p>She continued, urging her followers to look beyond appearances: “Beauty has nothing to do with looks. It’s how you are as a person. It’s how you make others feel especially about themselves. No beauty shines brighter than that of a kind heart.”</p> <p>Now thriving as an author, expert tennis commentator and vocal advocate for mental health and body positivity, Dokic continues to inspire others with her authenticity and courage. Her documentary <em>Unbreakable</em>, which aired on Channel 9 earlier this year after its successful cinematic release in December 2024, has been met with rave reviews for its raw and honest portrayal of her life and career.</p> <p><em>Image: Instagram</em></p>

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Incredible new pacemaker tinier than a grain of rice

<p>Engineers from Northwestern University in the US have developed a groundbreaking pacemaker so tiny that it can fit inside the tip of a syringe – is smaller than a grain of rice – and be non-invasively injected into the body. This innovation could revolutionise cardiac care by offering a minimally invasive alternative to traditional pacemakers.</p> <p>"We have developed what is, to our knowledge, the world's smallest pacemaker," said bioelectronics pioneer John A Rogers, who led the development. The small, wireless device is biocompatible and designed to be gradually broken down and absorbed by the body, reducing the need for surgical extraction.</p> <p>Rogers and his colleagues tested the effectiveness of their tiny, temporary pacemaker in human heart tissue and animal models. Measuring just 1.8mm by 3.5mm by 1mm, the device is smaller than any previously reported pacemaker. It is paired with a soft, flexible, wireless wearable device mounted on a patient’s chest, which controls the pacing. When an irregular heartbeat is detected, the wearable device emits a light pulse that penetrates through the skin, breastbone and muscles to activate the pacemaker and regulate heart rhythm.</p> <p>While designed to work for hearts of all sizes, the pacemaker is particularly well-suited for newborns with congenital heart defects. Northwestern experimental cardiologist Igor Efimov, who co-led the study, said this device could play a<span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> critical role in the effective treatment</span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> of infants.</span></p> <p>"Our major motivation was children," Efimov explained. "About 1 percent of children are born with congenital heart defects, regardless of whether they live in a low-resource or high-resource country. The good news is that these children only need temporary pacing after surgery. In about seven days or so, most patients’ hearts will self-repair. But those seven days are absolutely critical."</p> <p>Researchers believe this pacemaker could provide a safer alternative to traditional pacemakers for temporary pacing in patients with bradycardia, a condition characterised by a resting heart rate below 60 beats per minute. Additionally, they suggest that the technology’s versatility could extend to broader medical applications in bioelectronic medicine, such as aiding nerve and bone healing and blocking pain.</p> <p>This revolutionary development represents a significant step forward in cardiac treatment, potentially improving outcomes for both infants and adults requiring temporary heart pacing.</p> <p><em>Images: Northwestern University</em></p>

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