Anxiety is a natural response to feeling under threat. It causes people to feel worried, afraid, or stressed. It is natural for a person to feel anxious from time to time.
A person may have an anxiety disorder if they regularly feel severe levels of anxiety that impact their day-to-day life. A person’s feelings of anxiety may last for a long time or be out of proportion to their situation.
Anxiety comes in many different forms. Certain situations or tasks, such as public speaking or driving, can make a person feel anxious.
Additionally, a person may feel anxious about their health, certain body functions, or about relationships.
A person may also feel severe anxiety when faced with certain objects, places, or situations. Mental health professionals call this a phobia.
Anxiety can cause a person to feel restless, worried, tense, and unable to relax.
A person may also experience dizziness, a churning feeling in their stomach, nausea, and sweating.
Ways to overcome anxiety
There are numerous ways a person may overcome anxiety besides those listed here. What works for one person may not work for another.
A person struggling with anxiety can talk to a specialist about the best approach for them.
1. Coping strategies
The Anxiety and Depression Association of America (ADAA) recommends the following coping strategies for anxiety:
- Relaxation: Practicing yoga, or trying meditation, breathing, massage, and relaxation techniques can help a person cope with anxiety.
- Diet: Eating a well-balanced diet with regular meals and healthy snacks will keep the body healthy. Avoiding alcohol and caffeine can also reduce anxiety.
- Sleep: Getting enough sleep each night can help a person feel more able to overcome anxiety.
- Achievable goals: Instead of aiming for perfection, a person can try to do their best instead. This can help a person feel more positive about their achievements, and decrease the pressure they put on themselves.
- Perspective: Stepping back from anxious feelings can help put a situation in perspective and make it seem less scary.
- Support: Talking to friends and family or a health professional to get support with anxiety can help a person overcome anxiety.
2. Exercise and fitness
A recent study suggests that regular exercise has similar effects to antidepressant medications and improves anxiety.
The article explains people with anxiety and depression have decreased levels of brain-derived neurotrophic factor (BDNF), a neurotrophin in the brain,
After exercise, BDNF in the brain increases, which may improve symptoms of anxiety.
The ADAA suggests including 2.5 hours of moderate intensity exercise or 1.25 hours of vigorous intensity exercise each week, or trying a combination of both.
The ADAA suggests jogging, walking, cycling, or dancing three to five times a week for 30 minutes.
Setting smaller exercise goals will make an exercise program feel more achievable, and a person may be more likely to keep up with it for the long term.
A 2016 study concluded that exercise was more effective when done in shorter durations.
The Office on Women’s Health (OASH) lists the following types of medication for anxiety:
- Benzodiazepines: What doctors call antianxiety medication, benzodiazepines are usually prescribed for short periods of time because they can be addictive, according to a 2020 review of the medication. They affect the central nervous system and slow down the body’s functions by increasing the effect of the brain chemical gamma amino butyric acid.
- Beta blockers: According to the National Institute of Mental Health (NIMH), beta blockers reduce the physical symptoms of anxiety, such as trembling, a fast heartbeat, and sweating. People can use them as needed. There are also some natural sources of beta blockers, such as omega-3, that help anxiety.
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs stop the serotonin transporter (SERT) from removing serotonin from the synaptic cleft in the brain. Removing serotonin from the synaptic cleft means the brain does not benefit from its effects. By blocking the action of the SERT, serotonin levels in the brain can increase, which can improve
generalized anxiety disorder (GAD), panic disorders, and social anxiety.
- Tricyclic antidepressants: This type of medication is similar to SSRIs. These medications affect five different neurotransmitter pathways, such as blocking the reuptake of serotonin and norepinephrine. However, they can cause more side effects than SSRIs, according to a 2020 review.
- Monoamine oxidase inhibitors (MAOIs): MAOIs are an older type of antidepressant that work by blocking the monoamine oxidase enzyme, which breaks down serotonin, norepinephrine, dopamine, and tyramine. By stopping the breakdown of these neurotransmitters, their levels can increase in the brain and relieve symptoms of depression, panic disorders, and social phobia. According to OASH, a person should avoid eating certain cheeses and wines if they take MAOIs, and women may not be able to take birth control, some types of pain relief, or cold and allergy medication.
There are many types of therapy a person can try to help overcome anxiety.
Psychotherapy, also called talk therapy, involves a person seeing a mental health professional.
A person can have psychotherapy in a group or on their own.
Types of psychotherapy include:
Acceptance and commitment therapy (ACT)
ACT uses acceptance and mindfulness strategies to help alleviate anxiety.
ACT also encourages a person to commit to behavior changes that will help them overcome anxiety.
Cognitive behavioral therapy (CBT)
CBT focuses on identifying and understanding a person’s thinking and behavioral patterns.
By doing this, a person can change these patterns to reduce their anxiety.
According to the ADAA, people can see benefits in 12 to 16 weeks.
CBT helps a person learn skills they can use throughout their life to overcome anxiety.
Sessions may provide a person with activities or homework to complete to help them progress during their course of therapy.
Exposure therapy is a type of CBT. A person is gradually exposed to the things that make their anxiety worse in a safe environment.
This can help a person feel less anxious about the situations, places, or objects that cause them stress.
According to the ADAA, exposure therapy can be very effective for phobias and obsessive compulsive disorder.
Types of anxiety
There are many different types of anxiety disorder. They include:
Generalized anxiety disorder (GAD)
Generalized anxiety disorder is a type of chronic anxiety.
A person with GAD will feel anxious or worried most days for at least 6 months.
A person may feel anxious about their health, work, social interactions, or their situation in life more generally.
A person with social anxiety will feel anxious about social interactions or social performances.
A person may worry that other people will judge them negatively because of what they say or do.
A person may avoid social situations, so social anxiety can affect a person’s work and school life.
Swallowing anxiety is also called phagophobia.
Swallowing anxiety can cause problems with a person’s eating patterns.
According to the National Foundation of Swallowing Disorders (NFOSD), a person with swallowing anxiety may:
- over-chew their food
- avoid certain types of food or textures
- feel as though food is stuck in their throat
- find it difficult to start swallowing
A person may develop swallowing anxiety if they have experienced a traumatic event such as choking, regurgitation, or abuse.
Performance anxiety refers to anxiety a person experiences about performing specific tasks.
Studies into performance anxiety in musicians, summarized in a 2017 review, found that singers had higher amounts of the stress hormone cortisol when someone asked them to perform in front of an audience.
In some cases, even virtual audiences in a VR headset increased a person’s stress levels when performing.
According to the 2017 review, performance anxiety triggers include:
- taking exams
- public speaking
- sexual performance
- the performing arts
This review suggested that performance anxiety may be a type of social anxiety because it overlaps with the fear of negative evaluations and fear of extreme, negative social costs that characterize social anxiety.
However, the specific mechanisms behind performance anxiety in particular are unclear.
Health anxiety is also called hypochondria.
A person with health anxiety will feel excessive anxiety about developing a health condition, and their worry may be out of proportion with the chances of them developing a particular health condition.
According to the Centre for Clinical Interventions (CCI), a person with health anxiety may still believe they are at risk of an illness despite having negative tests from health professionals. They may also check their body obsessively or take medical tests more than necessary.
Health anxiety can occur in people who are healthy and in people who have health conditions, regardless of whether they are experiencing symptoms.
Both men and women can experience sexual anxiety.
Sexual anxiety can have a negative affect on a person’s sex life, as they may worry about their looks or that they will disappoint sexual partners.
A 2015 study found that over one-third of men in the study had a negative self image of their genitalia, which contributed to sex anxiety and erectile dysfunction.
Results from a 2014 study published in the journal Body Image suggest that body self-consciousness and body shame during sexual activity negatively correlated with sexual satisfaction, according to self-reported measures of these criteria in college women who participated in the study.
Relationship anxiety can occur in new relationships or long-term relationships.
According to a 2015 study, a person may seek reassurance excessively from their partner or silence themselves to please their partner if their opinions or feelings differ from their partner.
According to the ADAA, a person’s driving anxiety may include the following fears:
- driving outside their comfort zone on their own
- getting lost
- running out of gas
- being unable to find a parking spot
- going too fast and losing control
- getting into a car accident
Driving anxiety can affect a person’s social and professional life.
A person with a phobia will experience intense fear about specific objects or situations.
The fear they feel will often be out of proportion with the threat the object or situation presents.
A person with a phobia may take steps to avoid the object or situation, and experience excessive anxiety about encountering it.
Specific phobias can include:
- certain animals
Support systems and resources
A person living with anxiety can use their friends and family as a support network to help them cope with and overcome anxiety.
A person can contact a doctor or mental health professional if they have concerns about their anxiety or are seeking treatment.
There are also many online resources that can help a person find information on anxiety, from mental health support provider directories to national mental health organizations such as Mental Health America (MHA) and the National Alliance on Mental Illness (NAMI).
The way a person responds to anxiety treatments is very individualized, and one treatment may work for some people but not others.
Coping strategies, lifestyle changes, therapy, or medication can all be part of a person’s anxiety treatment plan.
There are many different types of anxiety, and treatment may be different for each.
As a result, it is important for a person to get the correct diagnosis before seeking treatment in order to increase their chances of overcoming anxiety.
Morning sickness is often one of the first signs of pregnancy. It is a common complaint, but it often passes by 3 months into the pregnancy. However, for some women, severe morning sickness can be bothersome.
What is morning sickness?
The feelings of nausea do not happen only in the morning. Most women find they ease as the day goes on, but, for some women, they may continue all day.
Nausea during pregnancy is normally associated with an increase in estrogen levels, low blood sugar counts, and a greater susceptibility to some smells.
The exact reason is unknown, but factors may include:
- a rise in hormones, especially estrogen, progesterone, human chorionic gonadotrophin (HCG), and cholecystokinin, leading to changes in digestive activity
- a fall in blood sugar, resulting from the placenta’s need for energy
Another theory on what contributes to nausea in early pregnancy is related to the sense of smell. A woman’s sense of smell is more sensitive in pregnancy, and this could increase the feelings of nausea.
It is most likely to occur during the first 3 months of pregnancy, and it often subsides once into the second trimester.
Research has suggested that nausea and vomiting during pregnancy are a good sign, and they are associated with a lower risk of pregnancy loss.
Over half of all pregnant women experience nausea.
Morning sickness can last all day for some women. It usually starts around week 6 of pregnancy and disappears around week 12, but different women will have different experiences.
Morning sickness does not need medical attention unless it is severe and leads to dehydration and weight loss. Some tips and home remedies can help.
Most women will not experience excessive vomiting, but many will have some discomfort due to nausea.
Here are some tips for minimizing the unpleasant symptoms of nausea during pregnancy.
1) Get plenty of rest
It is important to get a good night´s sleep. Napping during the day may help too, but not straight after a meal, as this can increase nausea.
For those who work night shifts, it may help to wear a sleep mask or use blackout curtains to block out as much light as possible.
As time goes on and the body changes shape, a maternity body pillow may help your back and abdomen.
Go to bed early and wake up early, so you can take time to get out of bed.
Do not use sleeping pills unless a doctor prescribes them.
2) Eat with care
Fatty and spicy foods and caffeine increase the chance of triggering the release of stomach acid, especially as the pregnancy progresses and the fetus pushes against the digestive tract. Bland foods may be less aggravating.
Small portion sizes can help reduce the chance of vomiting but keep something in the stomach. Having an empty stomach can worsen the feelings of nausea. The stomach produces acids, but they have nothing to work on, except for the stomach lining. This adds to the feelings of nausea.
Having some salty crackers or a protein snack before getting out of bed in the morning may help.
At breakfast, cold apple sauce, pears, bananas or any citrus fruit will help you feel satisfied early. The fruit’s potassium may help prevent morning sickness.
Carbohydrates can help. Baked potatoes, rice, and dry toast are often suitable options.
At night, eating a high-protein snack before going to bed will help regulate your blood-glucose levels during the night.
Eat food cold to reduce the smells experienced when eating.
3) Keep physically and mentally active
Being physically active has been found to improve symptoms in women who experience nausea during pregnancy.
Keeping busy can help take your mind off the feelings of nausea. Reading a book, doing puzzles, watching television, playing cards, or going for short walks around the block will help to keep you preoccupied.
4) Ensure good fluid intake
It is important to stay hydrated for good health, especially during pregnancy.
It may be hard to consume eight glasses of water a day while experiencing nausea, but dehydration can aggravate feelings of nausea.
Adding apple cider vinegar and honey to water may make it more palatable.
Sucking ice cubes made from water or fruit juice is also an effective method.
5) Ginger and peppermint teas
Ginger has long been used to aid digestion and reduce abdominal discomfort. Studies show that it may also help relieve the symptoms of nausea.
Other options are to sip cold ginger ale or to add a slice of raw ginger to water or tea.
Snacks such as gingerbread, or ginger cookies may also help.
Peppermint tea may also help settle the stomach.
6) Wear loose and comfortable clothing
Restrictive or tight clothing may worsen the symptoms of nausea. Women who experience nausea during pregnancy have fewer symptoms of nausea when they wear loose-fitting clothes.
7) Vitamins and supplements
Supplements should only be used under a doctor’s supervision. If you are taking vitamins, it may be best to take them before bed and with a snack.
Vitamin B6 may help reduce nausea.
Iron supplements that are prescribed during pregnancy can sometimes lead to nausea. A doctor may recommend a slower-release form or a lower dosage. Take iron supplements with orange juice or another drink with Vitamin C to increase absorption.
8) Avoid computer monitor flicker
A computer monitor flickers rapidly and almost unnoticeably. This may contribute to morning sickness.
If it is not possible to avoid using a computer monitor, it may help to adjust the screen by making the fonts bold and larger and changing the background to a soft tan or pink color. This will help reduce eye strain.
9) Avoid triggers
Morning sickness is linked to an increased sensitivity to smell.
Some strong smells can worsen the symptoms, but scents such as lemon extract and rosemary may help.
An individual will learn to recognize which triggers bring on an episode of nausea, and they can avoid these as far as possible.
10) Help for acid reflux
Sometimes, the nausea and vomiting may be due to acid reflux.
A doctor may be able to recommend antacid medication to take before going to bed to reduce stomach acid levels, and the subsequent morning vomiting.
Always check with a doctor before taking any medication during pregnancy.
Alternative therapies such as acupressure may help. Applying pressure on specific points on the body may help control symptoms. It may involve wearing a motion-sickness band on the forearm.
Fast facts about morning sickness
- Morning sickness occurs in over 50 percent of women who become pregnant.
- It can be managed in a number of ways, including through dietary measures, acupressure, and rest.
- Active medical treatment is only required in cases of excessive vomiting.
- The use of medications is not recommended during pregnancy until prescribed.
We may take it for granted that our diet can influence the way our immune systems work. But how and why does what we eat impact the immune response? In this Honest Nutrition feature, we investigate.
that constantly works to protect the body from antigens, which have associations with pathogens, including bacteria, toxins, parasites, and viruses.
The immune system offers two lines of defense: innate immunity and adaptive immunity.
Innate immunity is the first line of defense and consists of physical barriers, such as the skin and mucous membranes and chemical and cellular defenses. The innate immune system is nonspecific
because it reacts the same way to all foreign invaders.
If the innate immune system is ineffective against a potential threat, the adaptive immune system takes over.
The adaptive immune system consists of specialized blood cells and proteins that target the specific cause of infection. The adaptive immune system has a “memory” which is why a person’s body becomes immune to specific illnesses after initial exposure.
A person’s immune system needs to function well for them to remain healthy. Certain illnesses, medications, and lifestyle choices, such as smoking and excessive drinking, can adversely affect immune function.
Research shows that a person’s diet can impact immune health as well.
Can diet influence the immune system?
suggest that a person’s diet influences their immune system, like all other aspects of health.
For example, nutrition can affect the microbiome, gut barrier function, inflammatory processes, and white blood cell function, all of which impact immune function.
Dietary patterns and individual foods have associations with increased disease risk, greater risk of allergy, and impaired immune response.
Western-type diets tend to contain high levels of saturated fat, ultra-processed foods, added sugar and salt, and overall calories. This diet is often low in foods associated with better health, such as vegetables, fruits, and fatty fish, and has strong links to an increased risk of chronic disease.
Research suggests that Western-type diets induce inflammation and alter immune system function, promoting disease development.
In contrast, diets rich in whole foods, such as vegetables, fruits, nuts, legumes, and seafood, and low in ultra-processed foods can reduce disease risk and promote healthy immune function.
Additionally, a deficiency or insufficiency of nutrients essential to immune function, including vitamin D, zinc, and vitamin C, can also affect immune response.
Nutrient deficiencies may be more common in those consuming ultra-processed diets low in whole, nutrient-dense foods.
Although it is clear that dietary choices impact overall health, including immune function, the interaction between diet and immune health is highly complex. Scientists are still learning how the foods a person consumes may help or harm immune function.
Adverse effects of unhealthy diets
Western-type diets tend to be high in refined carbohydrates, added sugars, saturated fat, and calories. This pattern of eating affects immune function in several ways.
Most of the foods in Western diets are ultra-processed and contain high levels of added sugar, which can promote inflammatory responses of the immune system.
For example, foods and beverages that significantly impact blood sugar levels, such as soda, candy, sugary cereals, and sugary baked goods, increase levels of inflammatory proteins, including tumor necrosis-alpha (TNF-alpha), C-reactive protein (CRP), and interleukin-6 (IL-6). They also interfere with the function of protective immune cells, including neutrophils and phagocytes.
A 2012 study that included 562 adults aged 85 years and older without diabetes found that the participants who had higher blood sugar levels had lower innate immune responses. They also had higher levels of CRP, which is a marker of inflammation.
Higher blood sugar levels have links to an impaired immune response in people with diabetes as well.
Also, diets high in added sugar and refined carbs may adversely alter gut bacteria, leading to dysbiosis, which involves digestive disturbances, such as bloating.
A healthy microbiome is essential to immune function because gut bacteria play a critical role in the development and function of the immune system.
Experts have also linked Western-type diets to an altered immune response due to high levels of saturated fat and added salt.
Studies indicate that diets high in saturated fat may promote inflammation, modify gut bacteria, and inhibit the functioning of white blood cells.
Diets high in added salt have links to excessive immune response, impaired inflammation regulation in the body, and an increased risk of certain autoimmune diseases, such as rheumatoid arthritis.
Western-type diets have links to an increased risk of developing several chronic diseases, including certain cancers, heart disease, and type 2 diabetes.
Researchers attribute this to the chronic low-grade inflammation and altered immune response that Western-type diets, sedentary lifestyles, and toxin exposure cause.
However, research investigating the relationship between diet and immune function is ongoing, and scientists do not entirely understand this complex relationship.
Diets for healthy immune function
While a diet high in ultra-processed foods, added sugar, and excessive calories may lead to immune dysfunction, dietary patterns rich in whole, nutrient-dense foods are beneficial for immune function.
The Mediterranean diet is rich in vegetables, legumes, nuts, fruits, whole grains, olive oil, and other healthy foods. Research has shown that it can reduce disease risk, lower markers of inflammation, and beneficially modulate gut bacteria.
Diets high in fiber, such as the Mediterranean diet, promote the production of short-chain fatty acids (SCFAs), including acetate, propionate, and butyrate. SCFAs are end products of bacterial fermentation in the gut and have health benefits.
SCFAs act locally and systemically to modulate the immune response. They maintain the health of and improve the immune defensive function of the intestinal epithelium. This is an important part of the immune system that serves as a barrier against microorganisms. It also reduces the production of inflammatory proteins from immune cells.
Diets high in fruits, vegetables, olive oil, nuts, seeds, and fatty fish contain high levels of nutrients, such as vitamin A, vitamin C, zinc, vitamin D, B6, B12, copper, folate, iron, and selenium. The immune system needs these nutrients to function optimally.
Experts know that vegetarian-based diets reduce markers of chronic inflammation, such as CRP, fibrinogen, and IL-6. This might be partly due to the array of nutrients and nonnutritive components found in fruits and vegetables strengthening the immune system response.
Foods rich in healthy fats, fiber, vitamins, protein, minerals, and beneficial plant compounds help reduce systemic inflammation, promote healthy gut bacteria balance, reduce oxidative stress and cellular damage, and improve blood sugar and insulin sensitivity. All of these activities are essential for healthy immune function.
Additionally, studies show that supplementing the diet with nutrients including vitamin D, zinc, and vitamin C may help optimize immune function and reduce infection risk.
To support immune function, a person should concentrate on following a balanced dietary pattern rich in whole, nutrient-dense foods, especially plant foods, such as vegetables, fruits, legumes, nuts, and seeds. People should avoid or limit ultra-processed foods high in refined grains and added sugar.
The bottom line
It is essential to follow a healthy diet to ensure good immune function.
Studies show that while certain dietary patterns may lead to impaired immune function, other dietary patterns promote optimal immune function.
A dietary pattern low in ultra-processed foods and rich in whole, nutrient-dense foods, such as vegetables, fruits, fish, and legumes, protects against chronic disease risk and supports a healthy immune response.
Following a healthy dietary pattern and leading a lifestyle that includes stress reduction techniques, restful sleep, daily physical activity, and other healthy habits is the best way to support the immune system and reduce disease risk.
Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin.
Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases.
This article looks at the early signs and symptoms of type 2 diabetes, the risk factors, and potential complications.
What is type 2 diabetes?
People with type 2 diabetes do not make or use insulin correctly.
Insulin is a hormone that regulates the movement of blood glucose, or sugar, into cells, which use it as energy.
When sugar cannot enter cells, this means:
- too much glucose collects in the blood
- the body’s cells cannot use it for energy
A doctor may diagnose diabetes if a person’s blood sugar levels are 126 milligrams per deciliter (mg/dl) or above after fasting for 8 hours.
The symptoms of high blood sugar in type 2 diabetes tend to appear gradually. Not everyone with type 2 diabetes will notice symptoms in the early stages.
If a person does experience symptoms, they may notice the following:
- Frequent urination and increased thirst: When excess glucose builds up in the bloodstream, the body will extract fluid from tissues. This can lead to excessive thirst and the need to drink and urinate more.
- Increased hunger: In type 2 diabetes, the cells are not able to access glucose for energy. The muscles and organs will be low on energy, and the person may feel more hungry than usual.
- Weight loss: When there is too little insulin, the body may start burning fat and muscle for energy. This causes weight loss.
- Fatigue: When cells lack glucose, the body becomes tired. Fatigue can interfere with daily life when a person has type 2 diabetes.
- Blurred vision: High blood glucose can cause fluid to be pulled from the lenses of the eyes, resulting in swelling, leading to temporarily blurred vision.
- Infections and sores: It takes longer to recover from infections and sores because blood circulation is poor and there may be other nutritional deficits.
If people notice these symptoms, they should see a doctor. Diabetes can lead to a number of serious complications. The sooner a person starts to manage their glucose levels, the better chance they have of preventing complications.
Symptoms in children and teens
Type 2 diabetes is more likely to appear after the age of 45 years, but it can affect children and teens who:
- have excess weight
- do not do much physical activity
- have high blood pressure
- have a family history of type 2 diabetes
- have an African American, Asian American, Hispanic American, or American Indian background
The following symptoms may occur:
- weight loss, despite increased appetite and hunger
- extreme thirst and dry mouth
- frequent urination and urinary tract infections
- blurred vision
- slow healing of cuts or wounds
- numbness or tingling in hands and feet
- itchy skin
If caregivers notice these symptoms, they should take the child to see a doctor. These are also symptoms of type 1 diabetes. Type 1 is less common but more likely to affect children and teenagers than adults. However, type 2 diabetes is becoming more common in young people than it was in the past.
Symptoms in older adults
At least 25.2 percent of people aged 65 and above have type 2 diabetes in the United States. They may have some or all the classic symptoms of type 2 diabetes.
They may also experience one or more of the following:
- flu-like fatigue, which includes feeling lethargic and chronically weak
- urinary tract infections
- numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage
- dental problems, including infections of the mouth and red, inflamed gums
Most people do not experience symptoms in the early stages, and they may not have symptoms for many years.
A possible early sign of type 2 diabetes is darkened skin on certain areas of the body, including:
- the neck
- the elbows
- the knees
- the knuckles
This is known as acanthosis nigricans.
Other early symptoms include:
- frequent bladder, kidney, or skin infections
- cuts that take longer to heal
- extreme hunger
- increased thirst
- urinary frequency
- blurred vision
A person may have mild or subtle symptoms for many years, but these can become in time. Further health problems can develop.
Prediabetes and diabetes prevention
A person with blood sugar levels of 100–125 mg/dl will receive a diagnosis of prediabetes. This means that their blood sugar levels are high, but they do not have diabetes. Taking action at this stage can prevent diabetes from developing.
According to a 2016 report published in The Journal of the American Board of Family Medicine, 33.6 percent of people aged 45 years and older had prediabetes in 2012.
The CDC estimate that around 84 million
Diabetes may cause a number of health complications if people do not manage it properly. Many of these are chronic, or long-term, but they can become life-threatening. Others need immediate medical attention as soon as they appear.
Complications can arise quickly if blood sugar rises or falls too far.
If blood glucose dips below 70 mg/dl, this is hypoglycemia, or low blood sugar.
This can happen if a person who uses insulin takes more than they need for a particular time.
A home blood glucose test can check for hypoglycemia.
It is vital to know the early signs of hypoglycemia, as it can progress quickly, resulting in seizures and a coma. In the early stages, however, it is easy to treat.
Symptoms of hypoglycemia include:
- feeling faint
- heart palpitations
- rapid heartbeat
- mood changes
- loss of consciousness
If symptoms are mild, a person can often resolve low blood sugar levels by consuming:
- a few pieces of hard candy
- a cup of orange juice
- a teaspoon of honey
- a glucose tablet
The person should then wait 15 minutes, test their blood sugar, and if it is still low, they should take another glucose tablet or sweet.
When levels return to above 70 mg/dl, the person should eat a meal, to stabilize their glucose levels.
If they remain low for 1 hour or longer, or if symptoms worsen, someone should take the person to the emergency room.
Anyone who has frequent or severe hypoglycemic episodes should speak to their doctor, as they may need to adjust their treatment plan.
Hyperglycemia and diabetic ketoacidosis (DKA)
If blood sugar levels rise too far, hyperglycemia can result. If a person notices increased thirst and urination, they should check their blood sugar levels.
It the level is above the target level that their doctor recomends, they take appropriate action.
Without treatment, high a person with hyperglycemia can develop diabetic ketoacidosis (DKA), which happens when high levels of ketones collect in the blood, making it too acidic. For this reason, the person should also test their ketone levels.
Ketoacidosis can lead to:
- difficulty breathing
- a fruity smell on the breath
- a dry mouth
- nausea and vomiting
It can be life-threatening. A person with these signs and symptoms should seek immediate medical attention.
People who regularly experience high blood sugar should speak to their doctor about adjusting their treatment plan.
Blood glucose testing kits and ketone testing kits are available for purchase online. People should check with their doctor how often they need to test.
Keeping blood glucose within target levels can prevent complications that can become life-threatening and disabling over time.
Some possible complications of diabetes are:
- heart and blood vessel diseases
- high blood pressure
- nerve damage (neuropathy)
- foot damage
- eye damage and blindness
- kidney disease
- hearing problems
- skin problems
Effective management of blood glucose levels can reduce the risk of complications.
Diagnosis and treatment
A doctor can diagnose type 2 diabetes with blood tests that measure blood glucose levels. Many people discover they have high blood sugar during a routine screening test, but anyone who experiences symptoms should see a doctor.
Treatment aims to keep blood glucose levels stable at a healthy level and prevent complications. The main ways to do this are through lifestyle measures.
- following a healthful diet
- reaching and maintaining a healthy weight and body mass index (BMI)
- doing physical activity
- getting enough sleep
- avoiding or quitting smoking
- taking medications or insulin as the doctor recommends
There is currently no cure for diabetes, but most people with the condition can lead a healthful life by managing their condition properly.
People who maintain a healthy weight, follow a healthful diet, and do regular exercise may not need medication. Taking these steps can help manage blood sugar levels.
Routine screening can alert a person to high blood sugar levels in the early stages, when there is still time to slow, stop, or reverse the progress of diabetes.
Current guidelines recommend regular screening from the age of 45 years, or younger if an individual has other risk factors, such as obesity. A doctor can advise on individual needs.
Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of melanoma, among others.
Receiving an early diagnosis and getting prompt treatment can improve the outlook for people with melanoma.
For this reason, people should keep track of any changing or growing moles. Using adequate protection against sun exposure can help a person prevent melanoma altogether.
What is melanoma?
Melanoma is a type of skin cancer that occurs when pigment producing cells called melanocytes mutate and begin to divide uncontrollably.
Most pigment cells develop in the skin. Melanomas can develop anywhere on the skin, but certain areas are more at risk than others. In men, it is most likely to affect the chest and back. In women, the legs are the most common site. Other common sites of melanoma include the face.
However, melanoma can also occur in the eyes and other parts of the body, including — on very rare occasions — the intestines.
Melanoma is relatively rare in people with darker skin.
The stage of a cancer at diagnosis will indicate how far it has already spread and what kind of treatment will be suitable.
One method of assigning a stage to melanoma describes the cancer in five stages, from 0 to 4:
- Stage 0: The cancer is only present in the outermost layer of skin. Doctors refer to this stage as “melanoma in situ.”
- Stage 1: The cancer is up to 2 millimeters (mm) thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated.
- Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.
- Stage 3: The cancer has spread to one or more lymph nodes or nearby lymphatic channels but not distant sites. The original cancer may no longer be visible. If it is visible, it may be thicker than 4 mm and also ulcerated.
- Stage 4: The cancer has spread to distant lymph nodes or organs, such as the brain, lungs, or liver.
The more advanced a cancer is, the harder it is to treat and the worse the outlook becomes.
There are four types of melanoma. Learn more about each type in the sections below.
Superficial spreading melanoma
This is the most common type of melanoma, and it often appears on the trunk or limbs. The cells tend to grow slowly at first before spreading across the surface of the skin.
This is the second most common type of melanoma, appearing on the trunk, head, or neck. It tends to grow quicker than other types, and it may appear as a reddish or blue-black color.
Lentigo maligna melanoma
This is less common and tends to develop in older adults, especially in parts of the body that have had excessive sun exposure over several years, such as the face.
It starts as a Hutchinson’s freckle, or lentigo maligna, which looks like a stain on the skin. It usually grows slowly and is less dangerous than other types of melanoma.
Acral lentiginous melanoma
This is the rarest kind of melanoma. It appears on the palms of the hands, soles of the feet, or under the nails.
Since people with darker skin do not typically get other types of melanoma, these tend to be the most common type of melanoma in those with darker skin types.
Research into the exact causes of melanoma is ongoing.
However, scientists do know that people with certain skin types are more prone to developing melanoma.
The following factors may also contribute to an increased risk of skin cancer:
- a high density of freckles or a tendency to develop freckles following exposure to the sun
- a high number of moles
- five or more atypical moles
- the presence of actinic lentigines, also known as liver spots or age spots
- giant congenital melanocytic nevi, a type of brown birthmark
- pale skin that does not tan easily and tends to burn
- light eyes
- red or light hair
- high sun exposure, particularly if it produces blistering sunburn, and if sun exposure is intermittent rather than regular
- older age
- a family or personal history of melanoma
- a previous organ transplant
Of these risk factors, only sun exposure and sunburn are avoidable. Avoiding overexposure to the sun and preventing sunburn can significantly lower the risk of skin cancer. Tanning beds are also a source of damaging ultraviolet (UV) rays.
Being able to tell the difference between normal moles or freckles and those that indicate skin cancer can support an early diagnosis.
- Superficial spreading melanoma
- Nodular melanoma
- Lentigo maligna melanoma
- Acral lentiginous melanoma
- Skin changes due to cancer
- Normal mole
In its early stages, melanoma can be difficult to detect. It is important to check the skin for any signs of change.
Alterations in the appearance of the skin are vital indicators of melanoma. Doctors use them in the diagnostic process.
The Melanoma Research Foundation offer pictures of melanomas and normal moles to help a person learn how to tell the difference.
They also list some symptoms that should prompt a person to visit the doctor, including:
- any skin changes, such as a new spot or mole or a change in the color, shape, or size of an existing spot or mole
- a skin sore that fails to heal
- a spot or sore that becomes painful, itchy, or tender
- a spot or sore that starts to bleed
- a spot or lump that looks shiny, waxy, smooth, or pale
- a firm, red lump that bleeds or looks ulcerated or crusty
- a flat, red spot that is rough, dry, or scaly
The ABCDE examination of moles is an important method for revealing potentially cancerous lesions. It describes five simple characteristics to check for in a mole that can help a person either confirm or rule out melanoma:
- Asymmetric: Noncancerous moles tend to be round and symmetrical, whereas one side of a cancerous mole is likely to look different to the other side.
- Border: This is likely to be irregular rather than smooth and may appear ragged, notched, or blurred.
- Color: Melanomas tend to contain uneven shades and colors, including black, brown, and tan. They may even contain white or blue pigmentation.
- Diameter: Melanoma can cause a change in the size of a mole. For example, if a mole becomes larger than one-quarter of an inch in diameter, it might be cancerous.
- Evolving: A change in a mole’s appearance over weeks or months can be a sign of skin cancer.
The treatment of skin cancer is similar to that of other cancers. However, unlike many cancers inside the body, it is easier to access the cancerous tissue and remove it completely. For this reason, surgery is the standard treatment option for melanoma.
Surgery involves removing the lesion and some of the noncancerous tissue around it. When the surgeon removes the lesion, they send it to pathology to determine the extent of the involvement of the cancer, and to make sure that they have removed all of it.
If melanoma covers a large area of skin, a skin graft may be necessary.
If there is a risk that the cancer has spread to the lymph nodes, a doctor may request a lymph node biopsy.
They may also recommend radiation therapy for treating melanoma, especially in the later stages.
Melanoma may metastasize to other organs. If this happens, a doctor will request treatments depending on where the melanoma has spread, including:
- chemotherapy, in which a doctor uses medications that target the cancer cells
- immunotherapy, in which a doctor administers drugs that work with the immune system to help fight the cancer
- targeted therapy, which uses medications that identify and target particular genes or proteins specific to melanoma
Avoiding excessive exposure to UV radiation can reduce the risk of skin cancer. People can achieve this by:
- avoiding sunburn
- wearing clothes that protect the body from the sun
- using broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30, preferably a physical blocker such as zinc oxide or titanium dioxide
- liberally applying sunscreen about half an hour before going outside in the sun
- reapplying sunscreen every 2 hours and after swimming or sweating to maintain adequate protection
- avoiding the highest sun intensity by finding shade between the hours of 10 a.m. and 4 p.m.
- keeping children in the shade as much as possible, having them wear protective clothing, and applying SPF 50+ sunscreen
- ]keeping infants out of direct sunlight
Wearing sunscreen is not a reason to spend longer in the sun. People should still take steps to limit sun exposure where possible.
Those who work outdoors should also take precautions to minimize exposure.
Doctors recommend avoiding tanning booths, lamps, and sunbeds.
What about vitamin D?
The American Academy of Dermatology (AAD) do not currently recommend sun exposure (or tanning) for the purpose of obtaining vitamin D.
Instead, they suggest “getting vitamin D from a [healthful] diet that includes foods naturally rich in vitamin D, foods and beverages fortified with vitamin D, and/or vitamin D supplements”
Most cases of melanoma affect the skin. They usually produce changes in existing moles.
A person can detect the early signs of melanoma themselves by regularly examining existing moles and other colored blemishes and freckles. People should have their backs checked regularly, as it may be harder to see moles in this area.
A partner, family member, friend, or doctor can help check the back and other areas that are hard to see without assistance.
Any changes in the skin’s appearance require further examination by a doctor.
Some apps claim to help a person identify and track changing moles. However, many are not reliable.
Doctors may use microscopic or photographic tools to examine a lesion in more detail.
If they suspect skin cancer, they will have a dermatologist biopsy the lesion to determine whether or not it is cancerous. A biopsy is a procedure wherein a medical professional takes a sample of a lesion and sends it for examination in the laboratory.
Melanoma is an aggressive type of cancer that can be dangerous when it spreads. However, people who identify a lesion early can have a very good outlook.
The ACS have calculated the 5 year relative survival rates for melanoma. These compare the likelihood that a person with melanoma will survive for 5 years with that of a person without cancer.
If a doctor diagnoses and treats melanoma before it spreads, the 5 year relative survival rate is 98%. If it spreads to deeper tissues or nearby lymph nodes, however, the rate drops to 64%.
If it reaches distant organs or tissues, the likelihood of surviving for 5 years reduces to 23%.
For this reason, it is important to monitor any changing moles and seek medical attention for any that are changing, irregular, or growing. Taking preventive steps is also vital when spending long periods of time in the sun.
This week’s edition of Medical Myths will focus its beams on the many half-truths and misconceptions that surround heart disease. Among other topics, we cover smoking, coughing, exercising, supplements, and statins.
Globally, heart disease is the number one cause of death. It is responsible for 17.9 million deaths each year.
According to the Centers for Disease Control and Prevention (CDC), in the United States, one person dies every 36 seconds from cardiovascular disease. Heart disease accounts for 1 in 4 deaths in the U.S.
1. Young people do not need to worry about heart disease
It is true that heart disease is more likely to affect people over the age of 65, but 4–10% of heart attacks occur in people under the age of 45 years, mainly in men. In addition, it is how we live our lives as children, adolescents, and adults that lays the groundwork for heart health as we age.
For instance, eating a diet that is high in trans and saturated fats or smoking tobacco slowly increases the risk of heart disease as we age. Changes to lifestyle today build the foundation for a healthier heart in later life.
In the U.S. as a whole, heart disease mortality has slowly dropped since the 1970s , although the trend seems to be slowing. However, in some regions, rates have increased.
One study that investigated heart disease mortality in different age groups in the U.S. found that “over 50% of counties experienced increases in heart disease mortality from 2010 through 2015 among adults aged 35–64 years.”
2. People should avoid exercise if they have heart disease
This is a myth. Exercise helps strengthen the heart muscle and improve blood flow around the body.
In August 2020, the European Society of Cardiology published guidelines on exercise in patients with cardiovascular disease. Prof. Sanjay Sharma, who was involved in creating the guidelines, explains:
“The chance of exercise triggering a cardiac arrest or heart attack is extremely low.” However, he also adds a note of caution: “People who are completely inactive and those with advanced heart disease should consult their doctor before taking up sports.”
3. I take cholesterol-lowering drugs, so I can eat whatever I like
Some drugs, such as statins, reduce the level of cholesterol in the blood. However, this does not mean that a person who is taking statins can consume foods containing saturated fats with abandon.
Cholesterol is either consumed in the food that you eat or produced in the liver. Statins block an enzyme in the liver that is necessary for producing cholesterol, reducing overall blood cholesterol levels. However, this means that ingested cholesterol can still make it into the blood.
In short, statins may just be able to override the adverse effects of a poor diet, but a poor diet will increase risk of other independent risk factors for heart disease, such as obesity, hypertension, and diabetes.
4. Heart disease runs in my family, so there is nothing I can do to stop it
If close family members have experienced heart disease, it could mean that you have an increased risk. However, it is not set in stone, and there are a number of ways to reduce the risk, even for people with a genetic susceptibility.
These include eating a healthful diet, stopping smoking, managing blood pressure, and exercising regularly.
It is also worth noting that if heart disease runs in the family, it may not be a sign of genetic susceptibility. Families tend to share lifestyle factors, such as diet and exercise habits, both of which can impact the risk of heart disease.
5. Vitamins can prevent heart disease
Although most vitamins, taken at the recommended doses, are unlikely to be bad for heart health, there is no evidence that taking any vitamin supplements can reduce the risk of heart disease. And they certainly cannot replace a healthful diet and regular exercise.
For instance, a systematic review and meta-analysis looked for associations between multivitamin and mineral supplements and a number of cardiovascular outcomes, including coronary heart disease and stroke.
The analysis, published in 2018, took data from 18 existing studies, including 2,019,862 participants.
The authors concluded that multivitamin and mineral “supplementation does not improve cardiovascular outcomes in the general population.”
According to Victoria Taylor, the nutrition lead at the British Heart Foundation: “There are no shortcuts when it comes to nutrition — supplements are not a replacement for healthy food. You might be prescribed a vitamin or mineral supplement by a health professional for other reasons, but we do not recommend people take multivitamins to help prevent heart and circulatory diseases.”
6. I have smoked for years, there is no point stopping now
This is a myth. Smoking tobacco is a major cause of heart disease. As soon as a person stops smoking, the health benefits begin. The National Institute on Aging write:
“It doesn’t matter how old you are or how long you’ve been smoking, quitting smoking at any time improves your health. When you quit, you are likely to add years to your life, breathe more easily, have more energy, and save money.”
They also explain that you will lower the risk of heart attack and stroke and have better circulation.
7. Heart disease only really affects men
This is a myth, as heart disease is the leading cause of death in both men and women. In 2017 in the U.S., 24.2% of men and 21.8% of women died from heart disease.
However, when strokes, which have similar risk factors, are added in, the figures are even more similar between men and women: 28.7% of men and 28% of women died from heart disease or stroke.
It is a common misconception that only men are affected by heart disease. It is true that men tend to develop cardiovascular disease at an earlier age than women and have a greater risk of coronary heart disease. However, women have a higher risk of stroke.
One paper explains, “Although the incidence of [cardiovascular disease] in women is usually lower than in men, women have a higher mortality and worse prognosis after acute cardiovascular events.”
8. Cardiac arrest and heart attack are the same
Heart attacks and cardiac arrests are not the same thing. A heart attack is a circulation problem. It occurs when the coronary artery, which carries oxygenated blood to the muscles of the heart, becomes blocked.
A cardiac arrest is an “electrical problem,” where the heart stops pumping blood around the body effectively. Cardiac arrests are often caused by a heart attack.
During a heart attack, an individual is likely to be conscious. During a cardiac arrest, they are almost always unconscious. Both are a medical emergency.
9. Coughing during a heart attack can save your life
According to some sources, coughing vigorously during a heart attack — so-called cough CPR — can save your life.
This is an internet distortion of a paper published over 40 years ago, which showed that patients who had a cardiac arrest during arteriography in hospital and who coughed every 1–3 seconds stayed conscious for an additional 39 seconds.
There is no evidence that this technique works in the community for heart attacks that are not induced by medical procedures.
According to Christopher Allen, a senior cardiac nurse:
“The absolute priority when you think you or someone else is having a heart attack is to call [the emergency services]. This way, paramedics can assess and aid you, and you’ll get to hospital as fast as possible. There is no medical evidence to support ‘cough CPR.’”
10. People with heart disease should avoid eating all fat
A person with cardiovascular disease certainly should reduce their intake of saturated fats — which are found in foods such as butter, biscuits, bacon, and sausages — and partially hydrogenated and trans fats, which are found in foods such as baked goods, frozen pizzas, and microwave popcorn.
However, unsaturated fats can provide benefits. For instance, there is some evidence that omega-3, which is a polyunsaturated fat, might protect heart health.
The American Heart Association recommend “that all adults eat fish (particularly fatty fish) at least 2 times a week. Fish is a good source of protein and is low in saturated fat. Fish, especially oily species like mackerel, lake trout, herring, sardines, albacore tuna, and salmon, provide significant amounts of the two kinds of omega-3 fatty acids shown to be cardioprotective, eicosapentaenoic acid and docosahexaenoic acid.”
They also recommend eating plant-derived omega-3 fatty acids. These can be found in tofu and other forms of soybeans; walnuts, flaxseeds, and their oils; and canola oil.
Heart disease is common, but it is not inevitable. There are lifestyle changes that we can all implement to reduce the risk of developing cardiovascular problems, whatever our age.