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Does eating cheese before bed really give you nightmares?

<div class="theconversation-article-body"> Have you heard people say eating cheese before bed will cause you to have vivid dreams or nightmares? It’s a relatively common idea. And this week, a <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2025.1544475/full">new study</a> has landed this suggestion <a href="https://www.canberratimes.com.au/story/9005656/are-cheese-dreams-real-new-study-reveals-how-diet-affects-sleep/">back in the spotlight</a>. But is it true? Let’s unpack the evidence. <h2>A gouda night’s sleep?</h2> Canadian researchers recently <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2025.1544475/full#h3">investigated this idea</a> in a sample of 1,082 undergraduate psychology students. The students completed a survey, which included questions about how they perceived their diet influenced their sleep and dreams. Some 40% of participants reported certain foods impacted their sleep, with 25% of the whole sample claiming certain foods worsened their sleep, and 20% reporting certain foods improved their sleep. Only 5.5% of respondents believed what they ate affected the nature of their dreams. But many of these people thought sweets or dairy products (such as cheese) made their dreams more strange or disturbing and worsened their sleep. In contrast, participants reported fruits, vegetables and herbal teas led to better sleep. <blockquote class="twitter-tweet"> Snacking on cheese late at night may haunt your dreams, Canadian study finds<a href="https://t.co/ne5poEo7N7">https://t.co/ne5poEo7N7</a> <a href="https://t.co/rMpSbzoGzk">pic.twitter.com/rMpSbzoGzk</a> — Edmonton Journal (@edmontonjournal) <a href="https://twitter.com/edmontonjournal/status/1940531062615990327?ref_src=twsrc%5Etfw">July 2, 2025</a></blockquote> This study used self-reporting, meaning the results rely on the participants recalling and reporting information about their sleep and dreams accurately. This could have affected the results. It’s also possible participants were already familiar with the notion that cheese causes nightmares, especially given they were psychology students, many of whom may have studied sleep and dreaming. This awareness could have made them more likely to notice or perceive their sleep was disrupted after eating dairy. In other words, the idea cheese leads to nightmares may have acted like a self-fulfilling prophecy and results may overestimate the actual likelihood of strange dreams. Nonetheless, these findings show some people perceive a connection between what they eat and how they dream. While there’s no evidence to prove cheese causes nightmares, there is evidence that does explain a link. <h2>The science behind cheese and nightmares</h2> Humans are diurnal creatures, meaning our body is primed to be asleep at night and awake during the day. Eating cheese before bed means we’re challenging the body with food at a time when it really doesn’t want to be eating. At night, our physiological systems <a href="https://doi.org/10.1016/j.smrv.2024.101953">are not primed to digest food</a>. For example, it takes longer for food to move through our <a href="https://doi.org/10.1111/j.1440-1681.2009.05254.x">digestive tract</a> at night compared with during the day. If we eat close to going to sleep, our body has to process and digest the food while we’re sleeping. This is a bit like running through mud – we can do it, but it’s slow and inefficient. Cheese can be particularly challenging to digest at night because of <a href="https://doi.org/10.1016/j.idairyj.2006.11.006">high concentrations of fat and protein</a>, which <a href="https://doi.org/10.1113/jphysiol.1997.sp021881">slows down our digestion</a>. If your body is processing and digesting food instead of focusing all its resources on sleep, this can affect your shut-eye. Research has shown eating close to bedtime <a href="https://doi.org/10.3945/an.116.012336">reduces our sleep quality</a>, particularly our time spent in rapid eye movement (REM) sleep, which is the stage of sleep associated with <a href="https://doi.org/10.1016/j.tics.2009.12.001">vivid dreams</a>. People will have an even harder time digesting cheese at night if they’re lactose intolerant, which might mean they experience even greater impacts on their sleep. This follows what the Canadian researchers found in their study, with lactose intolerant participants reporting poorer sleep quality and more nightmares. It’s important to note we might actually have vivid dreams or nightmares every night – what could change is whether we’re aware of the dreams and can remember them when we wake up. Poor sleep quality often means we wake up more during the night. If we wake up during REM sleep, <a href="https://doi.org/10.1126/science.1063530">research shows</a> we’re more likely to report vivid dreams or nightmares that we mightn’t even remember if we hadn’t woken up during them. This is very relevant for the cheese and nightmares question. Put simply, eating before bed impacts our sleep quality, so we’re more likely to wake up during our nightmares and remember them. <h2>Can I still have brie before bedtime?</h2> Don’t panic – I’m not here to tell you to give up your cheesy evenings. But what we eat before bed can make a real difference to how well we sleep, so timing matters. General <a href="https://www.sleephealthfoundation.org.au/sleep-topics/sleep-hygiene-good-sleep-habits">sleep hygiene guidelines</a> suggest avoiding meals at least two hours before bed. So even if you’re eating a very cheese-heavy meal, you have a window of time before bed to digest the meal and drift off to a nice peaceful sleep. <h2>How about other dairy products?</h2> Cheese isn’t the only dairy product which may influence our sleep. Most of us have heard about the benefits of having a warm glass of milk before bed. Milk can be easier to digest than cheese. In fact, milk is a good choice in the evening, as <a href="https://doi.org/10.3390/nu12040936">it contains tryptophan</a>, an amino acid that helps promote sleep. Nonetheless, we still don’t want to be challenging our body with too much dairy before bed. Participants in the Canadian study did report nightmares after dairy, and milk close to bed might have contributed to this. While it’s wise to steer clear of food (especially cheese) in the two hours before lights out, there’s no need to avoid cheese altogether. Enjoy that cheesy pasta or cheese board, just give your body time to digest before heading off to sleep. If you’re having a late night cheese craving, opt for something small. Your sleep (and your dreams) will thank you.<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/260205/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, Senior Postdoctoral Research Fellow, Appleton Institute, HealthWise Research Group, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> 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/does-eating-cheese-before-bed-really-give-you-nightmares-heres-what-the-science-says-260205">original article</a>. Image: Pexels / Ivan Oboleninov </div>

Mind

"Devastated": Football star dies at 28, just days after wedding

Liverpool and Portugal football star Diogo Jota has died in a tragic car crash in Spain, just days after celebrating his wedding to long-time partner Rute Cardoso. The 28-year-old forward was killed alongside his younger brother, 26-year-old Andre Silva, in the early hours of Thursday morning near Zamora in north-western Spain. Authorities confirmed the pair died at the scene after their Lamborghini suffered a tyre blowout while overtaking, veered off the road, and burst into flames. The heartbreaking accident comes less than two weeks after Jota married Rute in Portugal on June 22. The couple, who shared three children, had posted a joyful photo from their wedding day with the caption: “Yes to forever.” Now, that forever has been cruelly cut short. Jota had only recently capped off one of the most successful periods of his career. In May, he helped Liverpool clinch the English Premier League title, contributing six goals across the season. He also featured for Portugal in their dramatic UEFA Nations League final win over Spain last month, coming off the bench in extra time before his team triumphed in a penalty shootout. In a statement, Liverpool FC expressed their devastation: “Liverpool Football Club are devastated by the tragic passing of Diogo Jota,” it read. “We will be making no further comment at this time and request privacy for the family, friends, teammates, and club staff as they try to come to terms with an unimaginable loss.” Portuguese football is also in mourning. Pedro Proenca, President of the Portuguese Football Federation, paid tribute to both brothers, describing Jota as “much more than a fantastic player... an extraordinary person, respected by all.” “We have lost two champions,” he added. “The passing of Diogo and Andre Jota represents an irreparable loss for Portuguese football and we will do everything we can to honour their legacy.” <blockquote class="twitter-tweet"> Everyone at the Premier League is shocked and devastated to learn of the tragic passing of Diogo Jota and his brother Andre. Our sincerest condolences go to Diogo’s family, friends, Liverpool FC, and all their supporters at this heartbreaking time. Football has lost a champion… <a href="https://t.co/KG4coUHY1P">pic.twitter.com/KG4coUHY1P</a> — Premier League (@premierleague) <a href="https://twitter.com/premierleague/status/1940707922608054436?ref_src=twsrc%5Etfw">July 3, 2025</a></blockquote> Jota made almost 50 appearances for the national team and was known as much for his spirited play as for his humility and positivity off the pitch. A minute’s silence was held ahead of Portugal’s Women’s Euros match against Spain on Thursday, following a request from the federation. Jota’s career began at Paços de Ferreira in Portugal, before moving to Atletico Madrid in 2016. He was loaned to Porto and then moved to England, joining Wolverhampton Wanderers in 2017. His performances at Wolves were electric, helping the club earn promotion and firmly establish themselves in the Premier League. Wolves, where Jota is still adored by fans, released a heartfelt statement: “We are heartbroken. Diogo was adored by our fans, loved by his teammates and cherished by everyone who worked with him. The memories he created will never be forgotten.” He joined Liverpool in 2018, quickly becoming a vital part of Jurgen Klopp’s side. In the 2021-22 season, he played key roles in Liverpool’s FA Cup and League Cup victories, scoring in both final shootouts against Chelsea. Off the field, Jota was a dedicated family man, sharing a quiet life away from the spotlight with Rute and their three young children. The world of football – and the families of both men – are reeling from the loss. Jota was 28. Andre Silva was 26. Images: X (Formerly Twitter)

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Iconic Hollywood star found dead at 67

Michael Madsen, the gravel-voiced Hollywood tough guy who made his mark in Quentin Tarantino's blood-soaked cinematic universe, has died. He was 67. The veteran actor was found unresponsive at his Malibu home on Thursday morning and later pronounced dead, authorities confirmed. His manager, Ron Smith, said the cause of death was cardiac arrest. Known for portraying menacing antiheroes and morally ambiguous outlaws, Madsen built a career playing unforgettable characters on the fringes of society – from the ear-slicing Mr. Blonde in Reservoir Dogs to the washed-up hitman Budd in Kill Bill: Vol. 2. “In the last two years Michael Madsen has been doing some incredible work with independent film... and was really looking forward to this next chapter in his life,” his team – managers Ron Smith and Susan Ferris, along with publicist Liz Rodriguez – said in a joint statement. “He was one of Hollywood’s most iconic actors, who will be missed by many.” Over a career spanning four decades, Madsen became a cult figure, equally at home in gritty crime thrillers, indie dramas, and blockbuster fare. His smouldering screen presence, weary stare, and distinctive voice earned him dozens of roles — many of them dangerous, unpredictable, and unforgettable. Born in Chicago on September 25, 1957, Madsen was the son of a firefighter and a filmmaker. His sister, Virginia Madsen, is an Oscar-nominated actor. He got his start on stage at Chicago’s renowned Steppenwolf Theatre, where he apprenticed under John Malkovich – an experience that shaped his early work in films like WarGames and The Natural. But it was 1992’s Reservoir Dogs that turned Madsen into a cinematic icon. As Mr. Blonde, the sadistic criminal who danced gleefully to “Stuck in the Middle With You” while torturing a cop, he etched one of the most disturbing, charismatic villains in film history. His performance earned praise from critic Roger Ebert, who wrote, “Madsen… emerges with the kind of really menacing screen presence only a few actors achieve.” He was originally cast to play Vincent Vega in Pulp Fiction, a role that eventually went to John Travolta after Madsen opted instead for Wyatt Earp – a decision he later said he regretted. Still, his collaborations with Tarantino remained a defining element of his career. Beyond Reservoir Dogs and Kill Bill, Madsen appeared in The Hateful Eight and Once Upon a Time in Hollywood, helping bring the director’s stylised worlds to life with quiet intensity and simmering menace. Outside of Tarantino’s orbit, Madsen racked up credits in films like The Doors, Donnie Brasco, Thelma & Louise, Sin City, and even the James Bond adventure Die Another Day. He also lent his voice to video games including Grand Theft Auto III and Dishonored, and published poetry and photography that revealed a softer, more introspective side. Though his name became synonymous with grit and danger, Madsen's passion for art in all forms endured. His independent film work remained prolific until the end, with several projects – Resurrection Road, Concessions, and Cookbook for Southern Housewives – still on the horizon. Madsen was married three times, most recently to DeAnna Morgan. He is survived by four children, including actor Christian Madsen. His son Hudson tragically died in 2022, a loss that friends say weighed heavily on him. Michael Madsen may have spent much of his screen life on the edge, but behind the gruff exterior was a fiercely devoted artist who never stopped working, creating or chasing the next role. He leaves behind a legacy of fearless performances, an indelible mark on American cinema – as well as a generation of fans who will never hear “Stuck in the Middle With You” the same way again. Images: X (Formerly Twitter)

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Australia's worst drivers caught on camera

Western Australia's drivers have made headlines – and not the good kind – with police left shaking their heads and muttering “mind-boggling” after a high-tech camera trial captured more than 130,000 road offences in just six months. The cameras, rolled out across hotspots since January 26, have been snapping everything from missing seatbelts to mobile phone acrobatics, with one driver managing the feat of being caught 81 times. Police Minister Reece Whitby laid out the astonishing numbers in WA Parliament on Tuesday, describing the evidence as “quite astonishing” and the rate of offending as “astounding”. “I cannot believe that one driver has been caught offending 81 times,” he said, no doubt wondering if that driver even knows what a road rule is. In total, the AI-powered cameras – apparently more observant than some humans – spotted 50,000 people misusing seatbelts, and 75,000 using phones illegally. That’s 800 offences every single day. Makes you nostalgic for the days when traffic violations were rare enough to make dinner conversation. Among the greatest hits caught on camera: <ul> <li>A driver simultaneously drinking beer and using a mobile phone, while forgoing the inconvenience of a seatbelt.</li> <li>A motorist smoking a glass pipe (yes, that kind).</li> <li>Someone literally holding a child while driving.</li> <li>A P-plater outsourcing steering duties to their passenger.</li> <li>And a personal favourite: a driver cruising with their leg casually resting on the dashboard. Perhaps auditioning for Australia’s Got Lazy Limbs?</li> </ul> “These cameras are the most advanced in the country,” Whitby said, showing off images of offenders mid-disaster. “They capture multiple offending within the cabin of the vehicle.” Unfortunately, they can’t yet capture common sense. The Road Safety Commission backed the rollout, noting other states had seen massive behavioural shifts after similar tech went live. “Queensland saw nearly a 75 per cent drop-off in the first months after it introduced similar cameras,” said Commissioner Adrian Warner. “We are hopeful… there will be a significant shift in behaviour.” One could argue that shift should probably start before you're caught 50 times. For now, the cameras are still in “trial mode”, meaning over 44,000 caution letters have been issued instead of fines. But come October, the real fun begins – and by fun, we mean fines. A lot of them. “If this continues at the rate we’ve seen, we are going to see revenue roll in like we’ve never seen it before,” Whitby warned, “and I’ll be gladly spending it on more safety measures.” Translation: keep it up, and we’ll have gold-plated speed bumps and diamond-studded seatbelt reminders in no time. So buckle up (correctly), put the phone down, and maybe – just maybe – don’t smoke anything while driving. WA’s new cameras are watching, and frankly, they’ve seen enough. Images: WA Govt / Road Safety Commission

Legal

‘It feels like I am being forced to harm a child’: Why Aussie teachers are burning out

<div class="theconversation-article-body">Australia is in the grip of a <a href="https://www.education.gov.au/national-teacher-workforce-action-plan">teacher shortage</a>. Teachers are <a href="https://theconversation.com/i-am-exhausted-australian-teachers-speak-about-how-compassion-fatigue-is-harming-them-and-their-work-244519#:%7E:text=I%20found%2073.9%25%20of%20respondents,Victorian%20teachers%20reported%20similar%20rates.">burning out</a>, warning the job is no longer sustainable and leaving the profession. We know this is due to <a href="https://theconversation.com/this-is-like-banging-our-heads-against-the-wall-why-a-move-to-outsource-lesson-planning-has-nsw-teachers-hopping-mad-188081">excessive workloads</a>, <a href="https://journals.sagepub.com/doi/abs/10.1177/00049441221086654">stress</a> and <a href="https://theconversation.com/make-me-a-sandwich-our-surveys-disturbing-picture-of-how-some-boys-treat-their-teachers-228891">abuse</a>. But research suggests there is another element at play: some teachers are also experiencing moral injury. Moral injury occurs when teachers are forced to act against their values – leaving them feeling disillusioned and complicit in harm. In <a href="https://www.tandfonline.com/doi/full/10.1080/00131911.2025.2504523">my study</a> of 57 Australian teachers, many shared emotionally-charged accounts of being put in impossible situations at work. <h2>What is moral injury?</h2> Moral injury is when professionals cannot act in line with their values due to external demands. It differs from burnout or compassion fatigue: <a href="https://www.researchgate.net/publication/303817089_Understanding_the_burnout_experience_Recent_research_and_its_implications_for_psychiatry">burnout</a> stems from chronic stress and <a href="https://www.psychologytoday.com/au/basics/compassion-fatigue">compassion fatigue</a> comes from emotional overload. Moral injury was initially developed in <a href="https://moralinjuryproject.syr.edu/about-moral-injury/">military psychology</a> but has since been applied to <a href="https://journals.sagepub.com/doi/full/10.1177/0969733020966776">healthcare</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/03057240.2023.2237202#abstract">education</a> – professions where high-stakes ethical decision-making and institutional failures often collide. Previous studies on <a href="https://journals.sagepub.com/doi/10.3102/0002831219848690">moral injury in schools</a> have shown how rigid disciplinary policies, high-stakes testing regimes and chronic underfunding often force teachers to act in ways that contradict their professional judgement. This can lead to frustration, guilt and professional disillusionment. Recent studies have <a href="https://www.tandfonline.com/doi/full/10.1080/03057240.2023.2237202">reframed moral injury as a systemic issue</a> rather than an individual psychological condition. This is because institutional constraints – such as inflexible accountability measures and bureaucratic inefficiencies – prevent teachers from fulfilling their ethical responsibilities. <h2>My new study</h2> This research stems from an <a href="https://link.springer.com/article/10.1007/s13384-024-00755-8">initial study</a>, which looked at burnout in Australian teachers. The initial study included a national sample of 2,000 educators. This <a href="https://www.tandfonline.com/doi/full/10.1080/00131911.2025.2504523">new study</a> is a subset of 57 teachers who participated in follow-up surveys and focus groups. The teachers were a mix of primary and secondary teachers and some also held leadership positions within their schools. While the original study focused on compassion fatigue and burnout, a striking pattern emerged: teachers repeatedly described moral conflicts in their work. <h2>‘It feels like I’m being forced to harm a child’</h2> A key theme of the new research was teachers having to enforce school or departmental policies they believed were harmful. This was particularly the case when it came to discipline. As one teacher described: <blockquote> The policy says I should suspend a student for attendance issues, but their home life is falling apart. How does that help? It feels like I’m being forced to harm a child instead of helping them. </blockquote> Others talked about having to focus on standardised tests (for example, NAPLAN), rather than using their professional judgement to meet children’s individual needs. This is a <a href="https://www.theeducatoronline.com/k12/news/opinion-the-fundamental-flaws-of-standardised-testing/273711">contentious issue for teachers</a>. As one high school teacher told us: <blockquote> We’re asked to push students through the curriculum even when we know they haven’t grasped the basics […] but we’re the ones who carry the guilt. </blockquote> A primary teacher similarly noted: <blockquote> Teaching to the test means leaving so many kids behind. It’s not what education should be. </blockquote> <h2>‘It’s heartbreaking’</h2> Teachers also spoke about teaching in environments that were not adequately resourced. In some schools, teacher shortages were so severe that unqualified staff were delivering classes: <blockquote> We’ve got classes being taught by teacher aides […] but that’s because we don’t have enough staff. </blockquote> Or in other classes, students were not getting the help they needed. <blockquote> Larger class sizes and fewer staff mean that the kids who need the most attention are getting the least. It’s heartbreaking. </blockquote> The emotional impact was profound, as one high school teacher told us: <blockquote> At some point, you stop fighting. You realise that no matter how many times you raise concerns, nothing changes. It’s like the system is designed to wear you down until you just comply. </blockquote> <h2>What can schools do to prevent moral injury?</h2> While these findings are confronting, teachers also gave positive examples of what can buffer against moral injury in the workplace. This involved listening to teachers and including them in policies and decisions. One primary teacher told us how their school had changed their disciplinary approach: <blockquote> Our school’s push for restorative justice instead of punitive measures has been a game changer. It lets us address the root causes of issues instead of just punishing kids. </blockquote> Others talked about being asked to collaborate with school leadership to address discipline issues. As one primary teacher said: <blockquote> We helped create a new behaviour management framework. Having a say in the process made all the difference. </blockquote> <h2>What now?</h2> My research indicates when teachers are consistently asked to compromise their ethics, they don’t just burn out, they question the integrity of the entire system. This suggests if we want to keep teachers in classrooms, we need to do more than lighten their workloads. We need to make sure they are no longer placed in positions where doing their job means going against their professional values. This means teachers need to feel heard, respected and empowered in classrooms and schools.<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/258821/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> By <a href="https://theconversation.com/profiles/glenys-oberg-1334483">Glenys Oberg</a>, PhD candidate in education and trauma, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> 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/it-feels-like-i-am-being-forced-to-harm-a-child-research-shows-how-teachers-are-suffering-moral-injury-258821">original article</a>. Image: Pexels / Andrea Piacquadio </div>

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Play School icon passes away at 86

Australia is mourning the loss of one of its most cherished performers, with the passing of actor and playwright Donald Macdonald, aged 86. The former Play School presenter and prolific stage and screen actor died following a battle with cancer. News of his death was shared on Monday by entertainment reporter Craig Bennett, who described him as “one of our showbiz greats”. Macdonald’s contributions to Australian entertainment stretched across more than four decades. He began his television career in the 1960s, notably appearing on Play School between 1966 and 1969, captivating a generation of young viewers with his warmth and charisma. Beyond the children’s show, Macdonald carved out a distinguished career on the stage and screen. He wrote the hit play Caravan, dazzled on London’s West End, and brought joy to audiences through roles in iconic Australian series including Certain Women, The Box, Cop Shop, Skyways, and A Country Practice. His film appearances included Superman Returns, while his stage credits also included Is Australia Really Necessary, A Cup of Tea, a Bex and a Good Lie Down, and more. Bennett, who had spent time with Macdonald in his final days, paid tribute with a touching post on social media. “Donald Macdonald was a stalwart of stage and screen,” he wrote. “Donald was a dapper delight and always great company.” In a poignant detail, Bennett recalled turning Macdonald’s hospital room into a celebration just days before his passing, joined by his cousins Paula Duncan and Amelia Barrett. “On Saturday we turned his hospital room into a party, laughs and smiles a-plenty, as Donald enjoyed some bubbly and lemon meringue pie,” Bennett wrote. “Blue was always his colour, even in a hospital gown! He gave his permission to post his last photo, saying ‘what the heck!’ Vale to a true gentleman.” Fans and colleagues have taken to social media to share their grief and memories. One wrote, “We were VERY LUCKY to meet Donald… What a lovely gentleman.” Another added, “A very good man… was honoured to be part of the first national tour of Caravan. Some wonderful memories.” In a heartfelt message, one fan wrote: “A sad day for those left behind who loved this dear gentleman… May he rest in peace.” Donald Macdonald is remembered not just for the roles he played, but for the kindness, humour and generosity he brought to every stage he graced and every person he met. Images: Supplied

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Unusual use of nicotine patches or gum to fight brain fog

<div class="theconversation-article-body"> 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. 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. 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. 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. 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>. 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. 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. 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. 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. 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. 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. 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. <h2>Not without risks</h2> 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. 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. So are there any options to treat long COVID symptoms? 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. 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. 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. 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.<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" /> 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> 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>. Image: Wikimedia Commons </div>

Body

Lung cancer screening is about to start. Here's what you need to know

<div class="theconversation-article-body"> From July, eligible Australians will be screened for <a href="https://www.health.gov.au/our-work/nlcsp">lung cancer</a> as part of the nation’s first new <a href="https://www.health.gov.au/topics/cancer/screening-for-cancer">cancer screening</a> program for almost 20 years. The program aims to detect lung cancer early, before symptoms emerge and cancer spreads. This early detection and treatment is predicted to <a href="https://www.nejm.org/doi/10.1056/NEJMoa1911793?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">save lives</a>. <h2>Why lung cancer?</h2> <a href="https://www.canceraustralia.gov.au/sites/default/files/migrated-files/publications/report-lung-cancer-screening-enquiry/pdf/report_on_the_lung_cancer_screening_enquiry_0.pdf">Lung cancer</a> is Australia’s fifth most diagnosed cancer but causes the greatest number of cancer deaths. It’s <a href="https://www.canceraustralia.gov.au/sites/default/files/migrated-files/publications/report-lung-cancer-screening-enquiry/pdf/report_on_the_lung_cancer_screening_enquiry_0.pdf">more common</a> in Aboriginal and Torres Strait Islander people, rural and remote Australians, and lower income groups than in the general population. <a href="https://www.canceraustralia.gov.au/sites/default/files/migrated-files/publications/report-lung-cancer-screening-enquiry/pdf/report_on_the_lung_cancer_screening_enquiry_0.pdf">Overall</a>, less than one in five patients with lung cancer will survive five years. But for those diagnosed when the cancer is small and has not spread, two-thirds of people survive five years. <h2>Who is eligible?</h2> The lung cancer screening program only targets people at higher risk of lung cancer, based on their smoking history and their age. This is different to a population-wide screening program, such as screening for bowel cancer, which is based on age alone. The lung cancer program <a href="https://www.health.gov.au/our-work/nlcsp">screens people</a> 50-70 years old with no signs or symptoms of lung cancer such as breathlessness, a persisting cough, coughing up blood, chest pain, becoming very tired or losing weight. To be eligible, current smokers must also have a history of at least 30 “<a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year">pack years</a>”. To calculate this you multiply the number of packets (of 20 cigarettes) you smoke a day by the number of years you’ve been smoking them. For instance, if you smoke one packet (20 cigarettes) a day for a year that is one pack year. Smoking two packets a day for six months (half a year) is also a pack year. People who have quit smoking in the past ten years but have accumulated 30 or more pack years before quitting are also eligible. <h2>What does screening involve?</h2> Ask your GP or health worker if you are eligible. If you are, you will be referred for a low-dose computed tomography (CT) scan. This uses much lower doses of x-rays than a regular CT but is enough to find nodules in the lung. These are small lumps which could be clumps of cancer cells, inflammatory cells or scarring from old infections. Imaging involves lying on a table for 10-15 minutes while the scanner takes images of your chest. So people must also be able to lie flat in a scanner to be part of the program. After the scan, the results are sent to you, your GP and the <a href="https://www.ncsr.gov.au/">National Cancer Screening Register</a>. You’ll be contacted if the scan is normal and will then be reminded in two years’ time to screen again. If your scan has findings that need to be followed, you will be sent back to your GP who may arrange a further scan in <a href="https://www.health.gov.au/our-work/nlcsp/about#the-screening-pathway">three to 12 months</a>. If lung cancer is suspected, you will be referred to a lung specialist for further tests. <h2>What are the benefits and risks?</h2> <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1911793">International</a> <a href="https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(25)00082-8/fulltext">trials</a> show screening people at high risk of lung cancer reduces their chance of dying prematurely from it, and the benefits outweigh any harm. The aim is to <a href="https://www.nejm.org/doi/10.1056/NEJMoa1911793?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">save lives</a> by <a href="https://www.health.gov.au/our-work/nlcsp/about#why-screening-is-important">increasing the detection</a> of <a href="https://www.cancercouncil.com.au/lung-cancer/diagnosis/staging-prognosis/">stage 1 disease</a> (a small cancer, 4 centimetres or less, confined to the lung), which has a greater chance of being treated successfully. The risks of radiation exposure are minimised by using low-dose CT screening. The other greatest risk is a false positive. This is where the imaging suggests cancer, but further tests rule it out. This varies across studies from almost <a href="https://jamanetwork.com/journals/jama/fullarticle/2777242">one in ten to one in two</a> of those having their first scan. If imaging suggests cancer, this usually requires a repeat scan. But about <a href="https://jamanetwork.com/journals/jama/fullarticle/2777242">one in 100</a> of those whose imaging suggests cancer but were later found not to have it have invasive biopsies. This involves taking a sample of the nodule to see if it contains cancerous cells. Some people will be diagnosed with a cancer that will never cause a problem in their lifetime, for instance because it is slow growing or they are likely to die of other illnesses first. This so-called overdiagnosis varies from <a href="https://jamanetwork.com/journals/jama/fullarticle/2777242">none to two-thirds of lung cancers diagnosed</a>, depending on the study. <h2>How much will it cost?</h2> The Australian government <a href="https://lungfoundation.com.au/advocacy/national-lung-cancer-screening-program/">has earmarked</a> A$264 million over four years to screen for lung cancer, and $101 million a year after that. The initial GP consultation will be free if your GP bulk bills, or if not you may be charged an out-of-pocket fee for the consultation. This may be a barrier to the uptake of screening. Subsequent investigations and consultations will be billed as usual. There will be no cost for the low-dose CT scans. <h2>What should I do?</h2> If you are 50-70 and a heavy smoker see your GP about screening for lung cancer. But the <a href="https://www.ilcn.org/smoking-cessation-in-lung-cancer-screening-the-latest-randomized-controlled-trial-evidence/">greater gain</a> in terms of reducing your risk of lung cancer is to also give up smoking. If you’ve already given up smoking, you’ve already reduced your risk of lung cancer. However, since lung cancer can take several years to develop or show on a CT scan, see your GP if you were once a heavy smoker but have quit in the past ten years to see if you are eligible for screening. By <a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> 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/lung-cancer-screening-is-about-to-start-what-you-need-to-know-if-you-smoke-or-have-quit-253227">original article</a>. Image: Pexels / Towfiqu barbhuiya </div>

Caring

"I’ve had nine melanomas - now I help others detect skin cancer before it’s too late"

You never know when a moment could change your life. Just ask Melissa Bates. At 43, Melissa was rundown and exhausted, focused solely on caring for her sick daughter. But during a routine GP visit, the doctor noticed something unusual – not in her child, but in Melissa. "You don’t sound too great either – mind if I listen to your chest?" the GP asked. What followed was a chance discovery of a suspicious spot on her back and a suggestion she never expected: get it checked. Melissa admits she didn’t rush. "It took me six months to get a biopsy and it turned out to be melanoma." That was just the beginning. Over the next seven years, Melissa had nine melanomas removed – from her back, left leg and left arm. But here's the surprising part: Melissa had always played it safe in the sun. "I don’t tan. I don’t lie in the sun. I’ve never touched a solarium in my life. I’ve always worn sunscreen and hats." Growing up with a GP stepdad who drilled in sun safety, Melissa followed all the rules. "Don’t go out between 11 and 2,” he’d say. Even so, her fair skin, blonde hair and blue eyes made her high-risk. "I played sports outdoors constantly as a kid – tennis, surfing, little athletics, horse riding. Even with all the caution, my skin’s always been high-risk." The good news? Melissa’s melanomas were all caught early. "I feel very fortunate they were melanoma in situ, and I only had to have 9 biopsies and 10 operations without chemotherapy or radiation because they were detected early." Today, at 49, Melissa lives on 130 acres with 20 head of cattle, raising two teenage daughters – and she’s passionate about encouraging others to stay vigilant. "I have a mission to help others catch skin cancers early." Leading dermatologist <a href="https://www.getmoshy.com.au/?utm_source=paid-search&utm_medium=adwords&utm_campaign=Moshy_Cross_Search_Brand&utm_content=150994372969&utm_term=get%20moshy&hsa_acc=9605530456&hsa_cam=19998630651&hsa_grp=150994372969&hsa_ad=690117752345&hsa_src=g&hsa_tgt=kwd-2273660214860&hsa_kw=get%20moshy&hsa_mt=b&hsa_net=adwords&hsa_ver=3&gad_source=1&gad_campaignid=19998630651&gbraid=0AAAAApT1_CN5CSXJEVhBexqHMmCQF3We2&gclid=CjwKCAjwvO7CBhAqEiwA9q2YJUsDL3T-6Mwc8iq0OJi6CBWpC2YlJaV_dUCWiU5AW4kz2zhkc542NhoCqS4QAvD_BwE" target="_blank" rel="noopener">Moshy</a>'s Dr Ludi Ge agrees that year-round protection is key. She warns that even in winter, UV levels can reach 3 or higher – high enough to damage skin. And while most people remember sunscreen in summer, winter is just as important. Making a skin check part of your yearly routine might just save your life – just like it did for Melissa. Images: Supplied

Body

Shock after true extent of Princess Kate's cancer battle revealed

Shocking new revelations have shed light on the true severity of Catherine, Princess of Wales’ private health battle, with reports now claiming the royal is “fortunate to even be speaking of recovery” following an intense and harrowing cancer fight throughout 2024. In June last year, the princess appeared poised and radiant at Trooping the Colour – waving to crowds and smiling with trademark composure. But hidden beneath her Jenny Packham dress was a semi-permanent port embedded in her chest, a small but vital medical device delivering life-saving chemotherapy. At the time, the extent of her illness remained entirely unknown to the public. Kensington Palace has never confirmed what type of cancer Kate was battling, nor offered a timeline beyond a brief video statement in March. But now, a deeply personal report by the Daily Mail’s royal editor Rebecca English has detailed just how critical her condition was – and the lengths the future queen went to maintain a sense of normalcy. English writes that the princess had already been “seriously unwell” before undergoing major abdominal surgery in January. Post-operative testing revealed cancer, prompting immediate chemotherapy and the insertion of the port – a direct line for potent treatment into a vein near the heart. “It was a literal lifeline,” English reported, “which offers no cast-iron guarantee of success, even if you are a royal.” Kate’s courage to appear publicly – even as she endured punishing side effects – was reportedly accompanied by deeply private suffering. Aides have since revealed she endured “months of hell” with multiple hospital visits conducted in secrecy, entering through side doors at London’s Royal Marsden Hospital. The new information arrives in the wake of a last-minute cancellation at Royal Ascot earlier this month, where palace insiders reportedly reacted with alarm after the princess withdrew just 30 minutes before her expected arrival. Rumours briefly swirled that she required urgent medical attention, a sign that her recovery remains fragile. Sources say the ordeal has prompted Kate to “recalibrate her entire life”, with royal duties to be dramatically scaled back for the rest of the year. She is still expected to attend Wimbledon and join the French state visit in July, but a broader return to public life appears uncertain. An overseas tour remains unlikely, and Prince William is expected to travel alone to Brazil in November for the Earthshot Prize. As one palace insider put it, the recent upheaval is “a good reminder that she was really seriously ill last year and underwent a significant period of chemo… It can take years [to recover].” While Kate is now said to be through treatment, the question of when – or if – she will return to a full royal workload remains unanswered. As English wrote earlier this year: “The Princess of Wales has been to hell and back.” Now, it’s clear just how far she had to travel – and how much strength it took to return. Images: Instagram

Caring

Why women turn to illegal cannabis despite rising medical demand

<div class="theconversation-article-body"> The number of women using medicinal cannabis is growing in New Zealand and overseas. They use cannabis treatment for general conditions such as <a href="https://www.liebertpub.com/doi/pdf/10.1089/jwh.2020.8437">pain, anxiety, inflammation and nausea</a>, as well as gynaecological conditions, including <a href="https://pubmed.ncbi.nlm.nih.gov/40445778/">endometriosis</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/39766334/">pelvic floor conditions</a>, and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10314536/">menopause</a>. However, their experiences with medicinal cannabis remain under-explored in research and overlooked in policy and regulation. As our work shows, they face several gender-specific barriers to accessing medicinal cannabis. Some of these hurdles lead women to seeking cannabis from illegal markets. New Zealand introduced the <a href="https://www.health.govt.nz/regulation-legislation/medicinal-cannabis/about-the-medicinal-cannabis-scheme">medicinal cannabis scheme</a> five years ago to enable access to legal, safe and quality-controlled cannabis products for any condition a doctor would deem suitable for a prescription. A <a href="https://pubmed.ncbi.nlm.nih.gov/39418607/">recent analysis</a> found the number of medicinal cannabis products dispensed has increased more than 14-fold since 2020, with more than 160,000 prescriptions administered during 2023/2024. In the first two years of the scheme, women were the primary recipients of medicinal cannabis prescriptions. Between 2022 and 2023, the number of prescriptions issued to female patients <a href="https://www.nzherald.co.nz/nz/the-regions-age-groups-and-ethnicities-using-the-most-medicinal-cannabis/LNG7NHEDI5GYJMG6SCER7B3HKQ/">doubled to 47,633</a>. Our findings from a <a href="https://nzdrugtrends.co.nz/">large-scale national survey</a> show that although women perceive physicians as supportive of prescribing medicinal cannabis, they were less likely to have prescriptions than men. This is similar to <a href="https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-00992-1">findings from Australia</a>. Potential reasons include the <a href="https://www.health.govt.nz/publication/annual-update-key-results-2022-23-new-zealand-health-survey">cost of visiting health professionals</a>, unpaid care-giving duties, lower workforce participation and a <a href="https://www.women.govt.nz/women-and-work/gender-pay-gap">pay disparity</a> – all creating barriers to accessing health services. Women were also more likely not to disclose their medicinal cannabis use to others, citing it would be less accepted by society because of their gender. <h2>Gendered risks in illegal cannabis markets</h2> Our <a href="https://www.tandfonline.com/doi/full/10.1080/09687637.2025.2481297?src=#d1e531">latest study</a> aligned with <a href="https://www.mdpi.com/1660-4601/19/3/1536">Australia</a> in finding that women often seek cannabis from illegal sources because of perceived lower prices. Many could not financially sustain accessing legal prescriptions because medicinal cannabis is not funded by New Zealand’s drug-buying agency Pharmac. Study participants discussed the health risks of accessing illegal cannabis such as consuming products without knowing how strong they are or whether they have been <a href="https://www.tga.gov.au/news/news/tga-warns-consumers-about-potential-harm-unlawfully-supplied-medicinal-cannabis">contaminated</a> with harmful substances. They also characterised illegal cannabis markets as unsafe and intimidating for women, with little legal protection and the presence of predatory male sellers. Some even described gender-specific experiences of physical assault, intimidation and sexual harassment, particularly when cannabis buying occurred in drug houses or locations controlled by the seller. Women accessing medicinal cannabis in illegal markets increasingly relied on female suppliers, viewing them as safer and more reliable. Some also helped connect others to these suppliers and used social media to warn other women of unsafe male suppliers. This created informal women-led support networks for access. <h2>Accessing legal prescriptions</h2> <figure class="align-right "><figcaption></figcaption></figure> One of our <a href="https://doi.org/10.1080/09687637.2025.2476989">recent studies</a> found many women begin their journeys with medicinal cannabis online via social media, often leading them to <a href="https://doi.org/10.1186/s12913-022-09021-y">cannabis clinics</a> with a strong digital presence. Women are now a growing demographic for specialised medicinal cannabis clinics in <a href="https://pubmed.ncbi.nlm.nih.gov/32019776/">New Zealand</a> and in <a href="https://www.sciencedirect.com/science/article/pii/S0965229921000819">other countries</a>. Cannabis clinics have a reputation among medicinal cannabis consumers for being more knowledgeable and positive about treatments than general practitioners and other health providers. Women have been encouraged by positive online testimonies from other women using cannabis treatments for gynaecological and other conditions. Female medicinal cannabis patients also described the financial burden of accessing a prescription, including consultation fees and the costs of products as barriers to access. Their relationships with their GPs strongly influenced their decision to seek a prescription. Those with prior experiences of having their pain underestimated or misdiagnosed in mainstream care were more likely to source legal medicinal cannabis from cannabis clinics. <h2>Policy and practice</h2> The current scientific evidence for using medicinal cannabis for gynaecological conditions is still emerging. Clinical trials are under way in Australia to evaluate cannabis treatment for <a href="https://www.westernsydney.edu.au/nicmhri/research/research_projects/medicinal_cannabis_and_endometriosis">endometriosis and period pain</a>. Women’s reliance on online sources and personal recommendations to learn about medicinal cannabis highlights a gap in public awareness and government education about the legal prescription scheme. <a href="https://www.publish.csiro.au/hc/HC22122">Hesitance to discuss and recommend cannabis</a> treatment among GPs also persists as a barrier to access. Online peer networks on social media platforms are promoting women’s agency and informing their decision making around medicinal cannabis, but also raise the risks of misinformation. Although marketing of medicinal cannabis to women may improve their engagement with the prescription scheme, it may also put them in a vulnerable position where they are encouraged to pursue expensive treatment options which may not be effective. The collective findings from our studies indicate complex financial, social and systemic factors affecting safe and equitable access to medicinal cannabis for women. To improve women’s engagement with New Zealand’s medicinal cannabis scheme, we suggest GPs should have informed and non-stigmatising discussions with female patients to explore when medicinal cannabis might be an appropriate treatment option. Better access to good official consumer information about medicinal cannabis and greater investment in clinical trials for gynaecological conditions would also improve and support women’s decision making about their health.<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/258797/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> By <a href="https://theconversation.com/profiles/vinuli-withanarachchie-1278697">Vinuli Withanarachchie</a>, PhD candidate, College of Health, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/chris-wilkins-1110463">Chris Wilkins</a>, Professor of Policy and Health, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/marta-rychert-1108013">Marta Rychert</a>, Associate Professor in Drug Policy and Health Law, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a> 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/more-women-are-using-medical-cannabis-but-new-research-shows-barriers-push-some-into-illegal-markets-258797">original article</a>. Image: Pexels / Binoid CBD and Alesia Kozik </div>

Caring

Cricket icon dies just days after receiving King's Birthday award

The cricket world is in mourning following the death of David “Syd” Lawrence, the pioneering fast bowler who became the first British-born Black cricketer to play for the national side. Lawrence, 61, passed away after a brave battle with motor neurone disease, a diagnosis he received just last year. The former Gloucestershire star, remembered as much for his generosity and spirit as for his fearsome pace, was recently awarded an MBE in the King’s Birthday Honours. It was recognition that filled him with pride in his final months. “It is not something I ever thought would sit after my name,” he said just last week. “I am absolutely delighted that it will do so for however long I am here and will be a part of my legacy when I am gone.” Lawrence’s family confirmed his passing in a statement filled with love and sorrow. “’Syd’ was an inspirational figure on and off the cricket field and no more so than to his family who were with him when he passed,” they said. Tributes have poured in from across the cricketing world. The England and Wales Cricket Board (ECB) described Lawrence as a “trailblazer” and a man who made an “indelible mark” on the sport. ECB chair Richard Thompson reflected on his extraordinary legacy: “David ‘Syd’ Lawrence was a true trailblazer of English cricket and a man of immense courage, character, and compassion. His impact on the game extended far beyond the boundary ropes... Even in the face of his illness, David showed extraordinary strength and dignity, continuing to uplift others with his resilience and spirit. He leaves behind a legacy that will endure in the hearts of all who love cricket. Our thoughts are with his family, friends, and the entire cricketing community at this time.” Lawrence’s international career, which promised so much, was cruelly cut short by a devastating knee injury during England’s 1992 tour of New Zealand. He played five Tests but left an unforgettable impression, not least for his fiery pace and unrelenting passion. His beloved Gloucestershire Cricket Club, where he played 280 matches over 16 years and later served as president, expressed their devastation. “Gloucestershire Cricket is devastated to learn of the passing of former player and Club President, David ‘Syd’ Lawrence MBE, aged 61. Everyone at Gloucestershire Cricket would like to send their best wishes to David’s family during this terribly sad time.” Before England’s clash with India at Headingley, the cricketing world paused to remember Lawrence, with stars including Ben Stokes joining in a minute’s applause – a small gesture to honour a giant of the game whose courage, charisma and kindness touched so many. Lawrence’s loss leaves a hole in the heart of English cricket – a reminder of a player who not only broke barriers but inspired generations. Images: England and Wales Cricket Board / X (formerly Twitter)

Caring

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

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. 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. 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. “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.” 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. “The claims are totally misleading,” said Professor Daly. “The whole paper is extremely difficult to interpret.” 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. 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.” 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. 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. 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. “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.” OsteoStrong did not address the criticisms directly but pointed to unpublished, company-sponsored research it says supports its program’s benefits. 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. “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.” Image: OsteoStrong

Body

Five common habits that might be harming your liver

<div class="theconversation-article-body"> 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. 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. 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. 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. <h2>1. Drinking too much alcohol</h2> 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. 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. 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. 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. <h2>2. Poor diet and unhealthy eating habits</h2> 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). 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. <figure><iframe src="https://www.youtube.com/embed/gZQ3VFHq17E?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> 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. In 2018, <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. 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. 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. Staying hydrated is also important. Aim for around eight glasses of water a day to support your liver’s natural detoxification processes. <h2>3. Overusing painkillers</h2> <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. 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. 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. <h2>4. Lack of exercise</h2> 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. 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.&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. <h2>5. Smoking</h2> 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. 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). 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. <h2>Love your liver</h2> 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. 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.&text=Liver%20scans%20are%20also%20available,to%20check%20your%20liver%20health.">better the chance of successful treatment</a>.<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" /> 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> 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>. Pexels / Andrea Piacquadio </div>

Body

Bruce Willis' daughter reveals sad new health update

Hollywood icon Bruce Willis’s family has shared a poignant and devastating update about the beloved actor’s health on social media. Willis, 70, known to millions as the wisecracking hero of Die Hard and Pulp Fiction, has been waging a quiet, painful battle with frontotemporal dementia (FTD) for several years. Now, his family reveals, the star has heartbreakingly lost the ability to speak. His eldest daughter, Rumer Willis, 36, expressed her sorrow and longing in a deeply emotional tribute posted on Instagram. “Today is hard,” she wrote on Father's Day. “I feel a deep ache in my chest to talk to you and tell you everything I’m doing and what’s going on in my life. To hug you and ask you about life and your stories and struggles and successes. I wish I asked you more questions while you could still tell me about it all.” Despite her heartbreak, Rumer shared that she is trying to focus on gratitude. “I can still hold you and hug you and kiss your cheek and rub your head. I can tell you stories. I will be grateful for every moment I have with you. I love you so much dad. Happy Father’s Day.” Rumer also extended support to others facing similar grief: “Sending love to all those who are in the boat with me or have lost their fathers, to the single mums who are the dads too.” <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/DK7qQadSgi5/?utm_source=ig_embed&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/DK7qQadSgi5/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Rumer Glenn Willis (@rumerwillis)</a> </div> </blockquote> Willis’s battle with FTD has been well documented by his family, including ex-wife Demi Moore, 62, and his wife of 16 years, Emma Heming Willis, 46. Together with his children – Rumer, Scout, 33, Tallulah, 31, Mabel, 12, and Evelyn, 10 – they have united to share his journey, raising awareness about a little-understood disease. Frontotemporal dementia affects parts of the brain responsible for personality, behaviour and language. Unlike Alzheimer’s, which primarily impacts memory, FTD robs its victims of speech and social functioning – devastating symptoms for someone once celebrated for his charisma and quick wit. Emma Heming Willis previously reflected on how Bruce’s stutter as a child masked the early signs of his condition. “When he began to experience difficulties with language, it seemed like it was just a part of his stutter,” she told Town and Country magazine. “Never in a million years would I think it would be a form of dementia for someone so young.” The family has called for greater awareness and research into FTD, describing it as a “cruel disease” and urging the public to focus attention on finding treatments. “Bruce always believed in using his voice in the world to help others,” the family said. “If he could today, he would want to bring global attention to this disease and help connect those who are also dealing with its devastating effects.” Image: Rumer Willis / Instagram

Caring

Weight loss drug approved to treat sleep apnoea

<div class="theconversation-article-body"> Last week, Australia’s <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2023-PI-02114-1&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. 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). 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. So how could this drug, most commonly used for weight management and conditions such as type 2 diabetes, help people with sleep apnoea? <h2>What is sleep apnoea?</h2> 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. 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. 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. Obesity increases the risk of sleep apnoea by adding fat around the neck, which narrows the airway and impacts breathing during sleep. 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. 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. 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. 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>. 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. <h2>What is Mounjaro, and how could it help people with sleep apnoea?</h2> Mounjaro is the brand name of a drug called tirzepatide. Elsewhere, it goes by other brand names, such as Zepbound. 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). 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. If a person is eating less overall, this can lead to weight loss. 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. 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. <h2>Are there any side effects?</h2> 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. Some patients have also reported <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790392">gallbladder problems</a>. 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. 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. 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. 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. 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. 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.<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" /> 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> 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>. </div>

Body

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

<div class="theconversation-article-body"> It’s a question that’s long been the cause of debate: is it better to shower in the morning or at night? 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. But what does the research actually say? As a microbiologist, I can tell you there actually is a clear answer to this question. 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. 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. Showering also removes sweat, which can quell body odour. 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. <h2>Day or night?</h2> 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>. 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>. Showering at night may remove some of the allergens, sweat and oil picked up during the day so less ends up on your bedsheets. 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. 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. 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>. 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. 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. 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>. 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. 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.<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" /> 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> 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>. Image: Pexels / Caique the Creator </div>

Body

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>. <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. 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. 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. <h2>Dry mouth</h2> 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. 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. 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>. <h2>Bad breath</h2> 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). 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 <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6615571/">Streptococcus mutans</a> and some strains of <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4547204/">Lactobacillus</a>. Another species that has been shown to thrive in conditions where saliva is reduced is <a href="https://academic.oup.com/femsle/article-abstract/333/1/1/586464?redirectedFrom=fulltext">Porphyromonas gingivalis</a>. 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. 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. <h2>Tooth damage</h2> 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. <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. 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. 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>. <h2>Reducing the risk of damage</h2> If you’re taking semaglutide, there are many things you can do to keep your mouth healthy. 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. 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. 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. 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. 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. 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. 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.<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" /> 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> 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>. Image: Pexels / Mart Production </div>

Body

Iconic singer reveals sad diagnosis

Morten Harket, the iconic voice behind A-ha’s global smash "Take on Me", has revealed he has been diagnosed with Parkinson’s disease – a progressive condition that may bring an end to his singing career. The 65-year-old Norwegian singer shared the news in a moving interview published on the band’s official website, explaining that although treatment has eased some of the condition’s physical toll, it has also affected his voice – the very heart of his artistry. “I don’t feel like singing, and for me that’s a sign,” Harket said candidly. “As things stand now, that’s out of the question.” For the past year, Harket has undergone deep brain stimulation, a complex treatment involving two surgeries to implant electrodes on both sides of his brain. The procedure delivers electrical impulses that help control tremors and muscle stiffness, but in Harket’s case, has also dulled his soaring vocal range. Despite the gravity of the diagnosis, Harket said he feels at peace with it. He credits his 94-year-old father for encouraging him to “use whatever works” in coping with the challenges of the degenerative disorder. “There’s so much to weigh up,” he said. “It’s a difficult balancing act between taking the medication and managing its side effects.” A-ha last toured in 2020 and played what may be their final show together in 2022 at the Hollywood Bowl. Harket said he has continued to work on new music but is unsure whether the songs will ever be finished. Still, in classic form, he offered fans words of hope rather than despair. “Don’t worry about me,” he said. “Spend your energy addressing real problems… and know that I am being taken care of.” Images: Instagram

Caring

The surprising ways that coffee can interfere with medication

<div class="theconversation-article-body"> 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. 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. <h2>1. Cold and flu medicines</h2> 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. 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. 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. <figure><iframe src="https://www.youtube.com/embed/9eL16Exry48?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>2. Thyroid medication</h2> 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%. 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. 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. 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. <h2>3. Antidepressants and antipsychotics</h2> The interaction between caffeine and mental health medications can be more complex. <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. 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. 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. 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. <h2>4. Painkillers</h2> 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. 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. <h2>5. Heart medications</h2> 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.&text=The%20next%20stage%20of%20hypertension,response%20to%20calcium%20channel%20blockers.&text=The%20potential%20for%20caffeine%20to,Table%20II%20summarizes%20these%20recommendations.">may counteract</a> the intended effects of the medication. 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. <figure><iframe src="https://www.youtube.com/embed/r-YwCCNDOy0?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>What can you do?</h2> 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. Take levothyroxine or bisphosphonates on an empty stomach with water, and wait 30-60 minutes before drinking coffee or eating breakfast. Be cautious with cold and flu remedies, asthma treatments and ADHD medications, as caffeine can amplify side-effects. If you’re on antidepressants, antipsychotics, or blood pressure drugs, discuss your caffeine habits with your doctor. Consider reducing intake or choosing a decaffeinated option if you experience side-effects like restlessness, insomnia or heart palpitations. 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. 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.<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" /> 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> 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>. Image: Pexels / Jonathan Borba </div>

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