The comfort, affordability, and flat-out enjoyable of e-bikes and e-scooters are plain. However as th…

The recognition of e-bikes and e-scooters is hovering, however are they protected? – Harvard Well being

<div x-data="{ posts: [{"id":19237,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Might imaging scans change biopsies throughout prostate most cancers screening?","short_title":"","subheading":"A big European examine gives encouraging proof in favor of omitting biopsies for some males with elevated PSA values.","abstract":"n

Irregular outcomes on a prostate-specific antigen (PSA) screening check for most cancers are sometimes adopted by a scientific biopsy. However systematic biopsies might be problematic, and researchers are looking for alternate options. A big European examine gives encouraging proof favoring a distinct strategy that makes use of MRI as an alternative of biopsy.n ","content material":"

n n n

Irregular outcomes on a prostate-specific antigen (PSA) screening check for most cancers are sometimes adopted by a scientific biopsy. Throughout that process, docs use an extended needle to extract roughly a dozen samples from the prostate whereas wanting on the gland on an ultrasound machine. These samples can then be checked for most cancers underneath a microscope.n

Limitations and concernsn

However systematic biopsies might be problematic. A serious concern is that they overdiagnose low-grade, slow-growing tumors that may by no means turn into life-threatening, thereby resulting in pointless therapies.n

Researchers are looking for alternate options to the systematic biopsy in males flagged by PSA screening. One choice is to start out with a magnetic resonance imaging (MRI) scan of the prostate, after which focus the biopsy solely on areas that look suspicious for most cancers. That is referred to as an MRI-targeted biopsy, and it is changing into more and more frequent.n

Might an MRI miss early-stage most cancers that later seems to be incurable? That is an impressive fear, particularly since systematic biopsies generally discover newly-forming most cancers that MRIs aren’t but in a position to detect. Certainly, systematic and focused biopsies are sometimes given collectively to spice up the percentages of discovering clinically important illness which will want instant remedy.n

Methodologyn

Now, a big Swedish study provides encouraging evidence favoring the MRI-only approach.n

The team invited 38,316 men ranging from 50 to 60 years in age to undergo PSA screening. If a man’s PSA level was 3.0 nanograms per milliliter (ng/mL) or higher, then he was enrolled into the study. The investigators wound up with 13,153 men who were randomly distributed between two groups:n

n

Systematic biopsy group: All the men in this group got a systematic biopsy plus an MRI. If a man’s MRI was positive for suspicious lesions, then he also got a targeted biopsy.n
MRI-targeted biopsy group: All of the men in this group got an MRI, but none got a systematic biopsy. Men with suspicious lesions on MRI got a targeted biopsy.n n
This initial screening round was followed by repeat screening rounds — all following the same protocols — at two-, four-, and eight-year-intervals.n
What the study showedn

After a median follow-up of 3.9 years (starting from and including the first screening round), prostate cancer had been detected in 185 men from the MRI-targeted group and 298 men from the systematic biopsy group. Systematic biopsies generated more clinically insignificant cancer diagnoses — 159 compared to 68 in the MRI-targeted group. During the first screening round, "The risk of such a diagnosis was 51% lower in the MRI-targeted biopsy group than the systematic biopsy group," the authors wrote.n

The authors emphasized that omitting biopsies in patients with MRI-negative results cut diagnoses of clinically insignificant cancer, meaning cancer that is slow-growing and may never need treatment, by more than half. "And importantly, the associated risk of detecting clinically significant cancer during follow-up and at later screening visits was very low in both groups," said Dr. Jonas Hugosson, chief urologist at the University of Gothenberg and the study’s first author. "A total of 14 such cases (0.2 % of men who participated) were diagnosed in the systematic biopsy group and eight (0.1 %) in the MRI-targeted biopsy group."n

Commentary from expertsn

"This study provides encouraging — though very early — data that supports the increasing use of MRI as the first diagnostic modality, following evaluation of an abnormal PSA value," said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor-in-chief of the Harvard Medical School Guide to Prostate Diseases. "The practice of not automatically going to prostate needle biopsy when an abnormal PSA is detected has gained in popularity in Europe, and this study may help increase its usefulness in the United States."n

"While these results are encouraging, the decision to omit biopsy in men with a negative MRI must be individualized based on the risk of detecting prostate cancer," added Dr. Boris Gershman, a urologist at Beth Israel Deaconess Medical Center and an assistant professor at Harvard Medical School focusing on prostate and bladder cancer. "For example, biopsy may still be considered in men with markedly elevated PSA, even if the prostate MRI does not identify any lesions."","excerpt":"n

Abnormal results on a prostate-specific antigen (PSA) screening test for cancer are typically followed by a systematic biopsy. But systematic biopsies can be problematic, and researchers are seeking alternatives. A large European study provides encouraging evidence favoring a different approach that uses MRI instead of biopsy.n ","alternate_summary":"n

Abnormal results on a prostate-specific antigen (PSA) screening test for cancer are typically followed by a systematic biopsy. But systematic biopsies can be problematic, and researchers are seeking alternatives. A large European study provides encouraging evidence favoring a different approach that uses MRI instead of biopsy.n ","description":null,"supplemental_content":null,"author":null,"slug":"could-imaging-scans-replace-biopsies-during-prostate-cancer-screening-202411083080","sort_date":"2024-11-08T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3080,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL110824","publication_date":"2024-11-08T11:30:00.000000Z","last_review_date":null,"imported_at":"2024-11-08T10:00:02.000000Z","last_import_type":"update","last_modified_date":"2024-11-07T05:00:00.000000Z","active":1,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-08T10:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":35,"ecommerce_type":"CATALOG","authors":[{"id":44,"cr_id":113,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Charlie Schmidt","title":null,"first_name":"Charlie","middle_name":null,"last_name":"Schmidt","suffix":null,"slug":"charlie-schmidt","byline":"Editor, Harvard Medical School Annual Report on Prostate Diseases","description":"

Charlie Schmidt is an award-winning freelance science writer based in Portland, Maine. In addition to writing for Harvard Health Publishing, Charlie has written for Science magazine, the Journal of the National Cancer Institute, Environmental Health Perspectives, Nature Biotechnology, and The Washington Post.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/B8ArUdl31ldNmyg4tWPVPBYhHyJEUiOrbAccVwEB.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:22:23.000000Z","updated_at":"2022-08-03T16:58:48.000000Z","deleted_at":null,"pivot":{"content_id":19237,"author_id":44,"sort_order":1}}],"contentable":{"id":3080,"comments_open":1,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-07T18:52:33.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15843,"model_type":"AppModelsMarketingContent","model_id":19237,"uuid":"b495369a-acc3-4b81-a74e-c39d8de923ff","collection_name":"contents","name":"gettyimages-170089177","file_name":"gettyimages-170089177.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":47306,"manipulations":[],"custom_properties":{"alt":"A radiologist in blue scrubs speaks to a patient who is about to be sent into an M R I machine for a scan."},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15760,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-07T18:52:35.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15843/gettyimages-170089177.jpg"}],"primary_content_topic":{"id":35,"name":"Men’s Health","slug":"mens-health","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mens-health"}},{"id":19235,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Celiac disease: Exploring four myths","short_title":"","subheading":"An expert shines light on common misconceptions about this genetic autoimmune disease triggered by gluten.","summary":"n

While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","content":"

n n n
Celiac disease is a digestive and immune disorder that can keep the body from absorbing necessary nutrients. "Our conception and awareness of celiac disease has evolved over the past few decades, but there are still aspects that remain poorly understood," says Dr. Ciaran Kelly, medical director of the Celiac Center at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School.n

Perhaps not surprisingly, misconceptions are widespread among the general public. One example? Many people assume that everyone who has celiac disease is plagued by abdominal pain, bloating, or diarrhea. But actually, many adults newly diagnosed with this inherited gluten intolerance don’t have these symptoms.n

What’s more, gluten — the sticky protein found in grains such as wheat, barley, and rye — can cause gastrointestinal distress and other symptoms in people who don’t have celiac disease. Read on for a deeper dive into four myths and facts about celiac disease and related digestive conditions.n
Myth # 1: Celiac disease is usually diagnosed at a young agen

Not typically. While celiac disease can develop any time after a baby’s first exposure to gluten, it’s usually diagnosed much later in life. According to the National Celiac Association, the average age of diagnosis is between 46 and 56. Around 25% of people are diagnosed after age 60.n

Celiac disease is slightly more common in women and among people with other autoimmune conditions, including type 1 diabetes, Hashimoto’s thyroiditis (a common cause of low thyroid levels), and dermatitis herpetiformis (a rare condition marked by an itchy, blistering rash).n

"We don’t know why some people go from being susceptible to actually having celiac disease," says Dr. Kelly. The prevailing theory is that some sort of physical or emotional stress — such as a viral infection, surgery, or anxiety from a stressful life event — may "flip the switch" and cause the disease to appear, he says. "Increasing numbers of people are being diagnosed at midlife and older, often after they’re found to have conditions such as anemia or osteoporosis caused by nutrient deficiencies," says Dr. Kelly.n

Myth #2: Celiac disease only affects the gutn

When people have celiac disease, eating gluten triggers an immune system attack that can ravage the lining of the small intestine. A healthy small intestine is lined with fingerlike projections, called villi, that absorb nutrients. In celiac disease, the immune system attacks the villi, causing them to flatten and become inflamed — and thus unable to adequately absorb nutrients.n

While gastrointestinal problems can occur, they aren’t always present. In fact, celiac disease can present with many different symptoms that affect the nervous, endocrine, and skeletal systems. A few examples are brain fog, changes in menstrual periods, or muscle and joint pain.n

Myth # 3: Celiac disease versus gluten intolerancen

If you feel sick after eating gluten, you probably have celiac disease, right? Actually, that may not be true. Some people have non-celiac gluten sensitivity (also called gluten intolerance), which can cause uncomfortable digestive symptoms after eating gluten. But gluten intolerance differs from celiac disease.n

n

Celiac disease is diagnosed with blood tests that look for specific antibodies. If antibodies are present, a definitive diagnosis requires an intestinal biopsy to look for signs of damage that characterize the condition.n
Non-celiac gluten sensitivity does not trigger antibodies or cause intestinal damage. Yet some people with this problem say they also experience brain fog, trouble concentrating, muscle aches and pain, and fatigue after eating gluten-containing foods.n n
"Non-celiac gluten sensitivity appears to be a real phenomenon, but it’s not well defined," says Dr. Kelly. It’s unclear whether people experiencing it are intolerant to gluten or to something else in gluten-containing foods.n

n

One possibility is sugarlike molecules known as FODMAPs, which are found in many foods — including wheat. Short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, gas and bloating can occur when gut bacteria feed on FODMAPs.n
Another possibility is an allergy to wheat, which can cause symptoms such as swelling, itching, or irritation of the mouth and throat after eating wheat. Other symptoms include a skin rash, stuffy nose, and headache, as well as cramps, nausea, and vomiting. Some people may develop a life-threating allergic reaction known as anaphylaxis.n n

Myth #4: A gluten-free diet always relieves the symptoms and signs of celiac diseasen

The sole treatment for celiac disease — adopting a diet that avoids all gluten-containing foods — doesn’t always help. This problem is known as nonresponsive celiac disease.n

"About 20% of people with celiac disease have ongoing symptoms, despite their best efforts to stick to a gluten-free diet," says Dr. Kelly. Others have intermittent signs and symptoms, particularly when they are accidentally exposed to gluten. Accidental exposures often happen when people eat prepared or restaurant foods that claim to be gluten-free but are not. Cross contamination with gluten-containing foods is another potential route.n

Potential solutions to nonresponsive celiac disease are being studied. Three promising approaches are:n

n

Enzymes that break down gluten, which people could take alongside gluten-containing foods. "It’s a similar concept to the lactase pills taken by people who are lactose intolerant to help them digest dairy products," says Dr. Kelly.n
Dampening the immune response to gluten by inhibiting an enzyme called tissue transglutaminase that makes gluten more potent as an antigen.n
Reprogramming the immune response to prevent the body from reacting to gluten.n ","excerpt":"n
While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","alternate_summary":"n

While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","description":null,"supplemental_content":null,"author":null,"slug":"celiac-disease-exploring-four-myths-202411063079","sort_date":"2024-11-06T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3079,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL110624","publication_date":"2024-11-06T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-11-08T10:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-11-07T05:00:00.000000Z","active":1,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-08T10:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":28,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":19235,"author_id":14,"sort_order":1}}],"contentable":{"id":3079,"comments_open":1,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-06T10:00:03.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15838,"model_type":"AppModelsMarketingContent","model_id":19235,"uuid":"dbab7088-65c5-4daa-9eda-dcd17c1a39f5","collection_name":"contents","name":"gettyimages-1135309751","file_name":"gettyimages-1135309751.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":127505,"manipulations":[],"custom_properties":{"alt":"Gluten-free bread & bagels with 12 appetitizing toppings like avocado & olives, hummus & chickpeas, sliced hardboiled eggs & greens; concept is celiac disease"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15755,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-06T10:00:06.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15838/gettyimages-1135309751.jpg"}],"primary_content_topic":{"id":28,"name":"Diseases & Conditions","slug":"diseases-and-conditions","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/diseases-and-conditions"}},{"id":18676,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Does drinking water before meals really help you lose weight?","short_title":"","subheading":"Why people think it does and what the evidence says.","summary":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","content":"

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If you’ve ever tried to lose excess weight, you’ve probably gotten this advice: drink more water. Or perhaps it was more specific: drink a full glass of water before each meal.n

The second suggestion seems like a reasonable idea, right? If you fill your stomach with water before eating, you’ll feel fuller and stop eating sooner. But did that work for you? Would drinking more water throughout the day work? Why do people say drinking water can help with weight loss — and what does the evidence show?n
Stretching nerves, burning calories, and thirst versus hungern

Three top theories are:n

Feel full, eat less. As noted, filling up on water before meals has intuitive appeal. Your stomach has nerves that sense stretch and send signals to the brain that it’s time to stop eating. Presumably, drinking before a meal could send similar signals.n
n

The evidence: Some small, short-term studies support this idea. For example, older study subjects who drank a full glass of water before meals tended to eat less than those who didn’t. Another study found that people following a low-calorie diet who drank extra water before meals had less appetite and more weight loss over 12 weeks than those on a similar diet without the extra water. But neither study assessed the impact of drinking extra water on long-term weight loss.n n
Burning off calories. The water we drink must be heated up to body temperature, a process requiring the body to expend energy. The energy spent on this — called thermogenesis — could offset calories from meals.n
n

The evidence: Though older studies provided some support for this explanation, more recent studies found no evidence that drinking water burned off many calories. That calls the thermogenesis explanation for water-induced weight loss into question.n n
You’re not hungry, you’re thirsty. This explanation suggests that sometimes we head to the kitchen for something to eat when we’re actually thirsty rather than hungry. If that’s the case, drinking calorie-free water can save us from consuming unnecessary calories — and that could promote weight loss.n
n

The evidence: The regulation of thirst and hunger is complex and varies over a person’s lifespan. For example, thirst may be dulled in older adults. But I could find no convincing studies in humans supporting the notion that people who are thirsty misinterpret the sensation for hunger, or that this is why drinking water might help with weight loss.n n

Exercise booster, no-cal substitution, and burning fat demands watern

Being well-hydrated improves exercise capacity and thus weight loss. Muscle fatigue, cramping, and heat exhaustion can all be brought on by dehydration. That’s why extra hydration before exercise may be recommended, especially for elite athletes exercising in warm environments.n

n

The evidence: For most people, hydrating before exercises seems unnecessary, and I could find no studies specifically examining the role of hydration to exercise-related weight loss.n n
Swapping out high calorie drinks with water. Yes, if you usually drink high-calorie beverages (such as sweetened sodas, fruit juice, or alcohol), consistently replacing them with water can aid weight loss over time.n
n

The evidence: A dramatic reduction in calorie intake by substituting water for higher-calorie beverages could certainly lead to long-term weight loss. While it’s hard to design a study to prove this, indirect evidence suggests a link between substituting water for high-cal beverages and weight loss. Even so, just as calorie-restricting diets are hard to stick with over the long term, following a water-only plan may be easier said than done.n n
Burning fat requires water. Dehydration impairs the body’s ability to break down fat for fuel. So, perhaps drinking more water will encourage fat breakdown and, eventually, weight loss.n
n

The evidence: Though some animal studies support the idea, I could find no compelling evidence from human studies that drinking extra water helps burn fat as a means to lose excess weight.n n

The bottom linen

So, should you bump up hydration by drinking water before or during meals, or even at other times during the day?n

Some evidence does suggest this might aid weight loss, at least for some people. But those studies are mostly small or short-term, or based on animal data. Even positive studies only found modest benefits.n

That said, if you think it’s working for you, there’s little downside to drinking a bit more water, other than the challenge of trying to drink if you aren’t particularly thirsty. My take? Though plenty of people recommend this approach, it seems based on a theory that doesn’t hold water.","excerpt":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","alternate_summary":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","description":null,"supplemental_content":null,"author":null,"slug":"does-drinking-water-before-meals-really-help-you-lose-weight-202402203018","sort_date":"2024-02-20T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3018,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL022024","publication_date":"2024-02-20T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-02-19T10:00:03.000000Z","last_import_type":"insert","last_modified_date":"2024-02-18T05:00:00.000000Z","active":1,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":18676,"author_id":23,"sort_order":1}}],"contentable":{"id":3018,"comments_open":1,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:03.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":14938,"model_type":"AppModelsMarketingContent","model_id":18676,"uuid":"e88312cf-ca6d-425a-9113-34160d35cc3d","collection_name":"contents","name":"2000a249-a535-402b-bd6b-32311bd847c7","file_name":"2000a249-a535-402b-bd6b-32311bd847c7.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":71889,"manipulations":[],"custom_properties":{"alt":"A stream of water pouring into and splashing around a tall glass with ice against blue background; concept is water and weight"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":14874,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:05.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/14938/2000a249-a535-402b-bd6b-32311bd847c7.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","slug":"staying-healthy","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/staying-healthy"}},{"id":18627,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Which migraine medications are most helpful?","short_title":"","subheading":"Drugs known as triptans came out on top, based on real-world data from some 278,000 migraine sufferers.","summary":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","content":"

n n n

If you suffer from the throbbing, intense pain set off by migraine headaches, you may well wonder which medicines are most likely to offer relief. A recent study suggests a class of drugs called triptans are the most helpful option, with one particular drug rising to the top.n

The study drew on real-world data gleaned from more than three million entries on My Migraine Buddy, a free smartphone app. The app lets users track their migraine attacks and rate the helpfulness of any medications they take.n

Dr. Elizabeth Loder, professor of neurology at Harvard Medical School and chief of the Division of Headache at Brigham and Women’s Hospital, helped break down what the researchers looked at and learned that could benefit anyone with migraines.n

What did the migraine study look at?n

Published in the journal Neurology, the study included self-reported data from about 278,000 people (mostly women) over a six-year period that ended in July 2020. Using the app, participants rated migraine treatments they used as "helpful," "somewhat helpful," or "unhelpful."n

The researchers looked at 25 medications from seven drug classes to see which were most helpful for easing migraines. After triptans, the next most helpful drug classes were ergots such as dihydroergotamine (Migranal, Trudhesa) and anti-emetics such as promethazine (Phenergan). The latter help ease nausea, another common migraine symptom.n

"I’m always happy to see studies conducted in a real-world setting, and this one is very clever," says Dr. Loder. The results validate current guideline recommendations for treating migraines, which rank triptans as a first-line choice. "If you had asked me to sit down and make a list of the most helpful migraine medications, it would be very similar to what this study found," she says.n

What else did the study show about migraine pain relievers?n

Ibuprofen, an over-the-counter pain reliever sold as Advil and Motrin, was the most frequently used medication in the study. But participants rated it "helpful" only 42% of the time. Only acetaminophen (Tylenol) was less helpful, helping just 37% of the time. A common combination medication containing aspirin, acetaminophen, and caffeine (sold under the brand name Excedrin) worked only slightly better than ibuprofen, or about half the time.n

When researchers compared helpfulness of other drugs to ibuprofen, they found:n

n

Triptans scored five to six times more helpful than ibuprofen. The highest ranked drug, eletriptan, helped 78% of the time. Other triptans, including zolmitriptan (Zomig) and sumatriptan (Imitrex), were helpful 74% and 72% of the time, respectively. In practice, notes Dr. Loder, eletriptan seems to be just a tad better than the other triptans.n
Ergots were rated as three times more helpful than ibuprofen.n
Anti-emetics were 2.5 times as helpful as ibuprofen.n n

Do people take more than one medicine to ease migraine symptoms?n

In this study, two-thirds of migraine attacks were treated with just one drug. About a quarter of the study participants used two drugs, and a smaller number used three or more drugs.n

However, researchers weren’t able to tease out the sequence of when people took the drugs. And with anti-nausea drugs, it’s not clear if people were rating their helpfulness on nausea rather than headache, Dr. Loder points out. But it’s a good reminder that for many people who have migraines, nausea and vomiting are a big problem. When that’s the case, different drug formulations can help.n

Are pills the only option for migraine relief?n

No. For the headache, people can use a nasal spray or injectable version of a triptan rather than pills. Pre-filled syringes, which are injected into the thigh, stomach, or upper arm, are underused among people who have very rapid-onset migraines, says Dr. Loder. "For these people, injectable triptans are a game changer because pills don’t work as fast and might not stay down," she says.n

For nausea, the anti-emetic ondansetron (Zofran) is very effective, but one of the side effects is headache. You’re better off using promethazine or prochlorperazine (Compazine), both of which treat nausea but also help ease headache pain, says Dr. Loder.n

Additionally, many anti-nausea drugs are available as rectal suppositories. This is especially helpful for people who have "crash" migraines, which often cause people to wake up vomiting with a migraine, she adds.n

What are the limitations of this migraine study?n

The data didn’t include information about the timing, sequence, formulation, or dosage of the medications. It also omitted two classes of newer migraine medications — known as gepants and ditans — because there was only limited data on them at the time of the study. These options includen

n

atogepant (Qulipta) and rimegepant (Nurtec)n
lasmiditan (Reyvow).n n
"But based on my clinical experience, I don’t think that any of these drugs would do a lot better than the triptans," says Dr. Loder.n

Another shortcoming is the study population: a selected group of people who are able and motivated to use a migraine smartphone app. That suggests their headaches are probably worse than the average person, but that’s exactly the population for whom this information is needed, says Dr. Loder.n

"Migraines are most common in young, healthy people who are trying to work and raise children," she says. It’s good to know that people using this app rate triptans highly, because from a medical point of view, these drugs are well tolerated and have few side effects, she adds.n

Are there other helpful takeaways?n

Yes. In the study, nearly half the participants said their pain wasn’t adequately treated. A third reported using more than one medicine to manage their migraines.n

If you experience these problems, consult a health care provider who can help you find a more effective therapy. "If you’re using over-the-counter drugs, consider trying a prescription triptan," Dr. Loder says. If nausea and vomiting are a problem for you, be sure to have an anti-nausea drug on hand.n

She also recommends using the Migraine Buddy app or the Canadian Migraine Tracker app (both are free), which many of her patients find helpful for tracking their headaches and triggers.","excerpt":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","alternate_summary":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","description":null,"supplemental_content":null,"author":null,"slug":"which-migraine-medications-are-most-helpful-202402053014","sort_date":"2024-02-05T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3014,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL020524","publication_date":"2024-02-05T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-02-09T10:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-02-05T05:00:00.000000Z","active":1,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-09T10:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":39,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":18627,"author_id":14,"sort_order":1}}],"contentable":{"id":3014,"comments_open":1,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-05T16:02:48.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":14819,"model_type":"AppModelsMarketingContent","model_id":18627,"uuid":"92a43219-7a59-4061-bcc2-50f48be5211c","collection_name":"contents","name":"86a58fef-cf16-4980-a584-708c1162bf0a","file_name":"86a58fef-cf16-4980-a584-708c1162bf0a.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":54680,"manipulations":[],"custom_properties":{"alt":"A head and shoulders view of a woman with eyes closed and storm clouds with lightening suggesting pain circling her head; concept is migraine "},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":14755,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-05T16:02:50.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/14819/86a58fef-cf16-4980-a584-708c1162bf0a.jpg"}],"primary_content_topic":{"id":39,"name":"Pain","slug":"pain","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/pain"}},{"id":19230,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Want a calmer brain? Try this","short_title":null,"subheading":"Meditation alters areas of the brain that help cope with fear and anxiety.","summary":"

Meditation helps us calm the body and shift perspective, and certain types of it offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","content":"

rn rn rn
For neuroscientist Sara Lazar, a form of meditation called open awareness is as fundamental to her day as breathing.rn

"I just become aware that I am aware, with no particular thing that I focus on," explains Lazar, an associate researcher in the psychiatry department at Massachusetts General Hospital and assistant professor of psychology at Harvard Medical School. "This sort of practice helps me become more aware of the subtle thoughts and emotions that briefly flit by, that we usually ignore but are quite useful to tune into."rn

But meditation doesn’t just change your perspective in the moment. Some studies show certain types of meditation offer an array of benefits, from easing chronic pain and stress and lowering high blood pressure to helping to relieve anxiety and depression. And, as Lazar’s research has shown, meditation can actually change the structure and connectivity of brain areas that help us cope with fear and anxiety.rn

"It’s become really clear that all of our experiences shape our brain in one way or another," Lazar says. "A lot of people talk about meditation being a mental exercise. Just as you build your physical muscles, you can build your calm muscles. Meditation is a very effective way of training those muscles."rn

What counts as meditation?rn

More than you might have believed. An intriguing if somewhat perplexing aspect of meditation is that it encompasses a broad range of practices. "It’s clear what is not meditation, but there’s less consensus on what it is," Lazar says.rn

Open awareness, Lazar’s go-to meditation, joins other forms, including focused awareness, slow deep breathing, guided meditation, and mantra meditation, along with many variations. At their core, Lazar says, is an awareness of the moment, noticing what you’re experiencing and nonjudgmentally disengaging from intrusive thoughts that might interfere with your ability to attend to this task.rn

Meditation can also involve sitting with eyes closed and paying attention to your body and any sensations that are present. A regular meditation practice typically involves slowing down, breathing, and observing inner experience.rn

"Meditation can involve flickering candles, breath awareness, or mantras — all of these things," Lazar says. "But there’s definitely an element of focusing and regulating your attention."rn

A close look at how meditation alters the brainrn

Small MRI imaging studies have zeroed in meditation’s effects on the amygdala, an almond-shaped structure deep within the brain that processes fear and anxiety as well as other emotions.rn

Lazar and her colleagues have spent many years laying the groundwork to show how practicing mindfulness-based stress reduction (MBSR) alters the amygdala after only about two months. The MBSR practice in this research consisted of weekly group meetings and daily home mindfulness practices, including sitting meditation and yoga.rn

What has their research found?rn

One key study involved 26 people with high levels of perceived stress. After an eight-week regimen of MBSR, brain scans showed the density of their amygdalae decreased, and these brain changes correlated to lower reported stress levels.rn

Building on this, Lazar and colleagues designed a study that focused on 26 people diagnosed with generalized anxiety, a disorder marked by excessive, ongoing, and often illogical anxiety levels. The researchers randomized participants to either practice MBSR or receive stress management education. These participants were compared to 26 healthy participants.rn

In this first-of-its-kind research, participants were shown a series of images with angry or neutral facial expressions while their brain activity was gauged using functional MRI imaging. At the beginning of the study, anxiety patients showed higher levels of amygdala activation in response to neutral faces than healthy participants. This suggests a stronger fear response to a nonthreatening situation.rn

But after eight weeks of MBSR, MRI imaging showed increased connections between the amygdala and the prefrontal cortex, a brain area crucial to emotional regulation. The amygdalae in participants with generalized anxiety no longer displayed a fear response to neutral faces. These participants also reported their symptoms had improved.rn

"It seems meditation helps to down-regulate the amygdala in response to things it perceives to be threatening," Lazar says.rn

How can meditation benefits help us in daily life?rn

Lazar believes training your brain to stop and notice your thoughts in a slightly detached way can calm you amidst the muddle of work deadlines, family friction, or distressing news.rn

"That’s one of the biggest translations" of meditation to everyday benefits, she says. "The person or situation that is stressing you out won’t go away, but you can watch your reactivity to the situation in a mindful, detached way, which shifts your relationship to it."rn

"It’s not indifference," she adds. "It’s sort of like a bubble bursting — you realize you don’t need to keep going on this loop. Once you see that, it totally shifts your relationship to that reaction bubbling through your brain."rn

Want to try meditation — or expand your practice?rn

Haven’t tried meditating? To get started, Lazar recommends the Three-Minute Breathing Space Meditation. This offers a quick taste of meditation, walking you through three pared-down but distinct steps. "It’s simple, fast, and anyone can do it," she says.rn

Simple ways to expand this basic approach are:rn

rn

adding minutes, just as you might for exercisern
meditating outdoorsrn
pausing to notice how you feel after you meditate.rn rn
"Or try either doing a longer session or short hits throughout the day, such as a three-minute breathing break four to five times a day," Lazar suggests.rn

Another way to enhance your practice is to use ordinary, repetitive moments throughout the day — such as reaching for a doorknob — as a cue to pause for five seconds and notice the sensation of your hand on the knob.rn

"As you walk from your office to your car, for instance, instead of thinking of all the things you have to do, you can be mindful while you’re walking," Lazar says. "Feel the sunshine and the pavement under your feet. There are simple ways to work meditation into each day."","excerpt":"

Meditation helps us calm the body and shift perspective, and certain types of it offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","alternate_summary":"

Meditation helps us calm the mind and body and can offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","description":null,"supplemental_content":null,"author":null,"slug":"want-a-calmer-brain-try-this-202410293078","sort_date":"2024-10-29T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3078,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL103024","publication_date":"2024-10-29T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-10-29T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-10-28T04:00:00.000000Z","active":1,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-11-04T12:43:00.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":420,"cr_id":779,"featured":0,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Maureen Salamon","title":null,"first_name":"Maureen","middle_name":null,"last_name":"Salamon","suffix":null,"slug":"maureen-salamon","byline":"Executive Editor, Harvard Women's Health Watch","description":"

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has appeared in The New York Times, The Atlantic, CNN.com, WebMD, Medscape and HealthDay, among other major outlets. Maureen earned a BA in print journalism from Penn State University.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/MWQyHwiFAPooqhDKsjTfFjCCCoIooqQNLj1M7LRO.jpg","twitter_username":null,"sort_order":0,"created_at":"2022-02-24T21:39:38.000000Z","updated_at":"2022-07-17T15:04:53.000000Z","deleted_at":null,"pivot":{"content_id":19230,"author_id":420,"sort_order":1}}],"contentable":{"id":3078,"comments_open":1,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-11-04T12:43:51.000000Z","deleted_at":null,"media":[{"id":15834,"model_type":"AppModelsMarketingBlogPost","model_id":3078,"uuid":"3b6ce61c-4df5-410f-9bc2-4488a7a79d16","collection_name":"featured","name":"gettyimages-1304744681","file_name":"gettyimages-1304744681.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":463371,"manipulations":[],"custom_properties":[],"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15751,"created_at":"2024-11-04T12:43:51.000000Z","updated_at":"2024-11-04T12:43:54.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15834/gettyimages-1304744681.jpg"}]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15829,"model_type":"AppModelsMarketingContent","model_id":19230,"uuid":"945034ec-14b5-41ad-a905-a4fd5630052a","collection_name":"contents","name":"gettyimages-1494861266","file_name":"gettyimages-1494861266.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":102006,"manipulations":[],"custom_properties":{"alt":"An older man calmly meditatating while seated in a sunny spot with eyes closed and a slight smile; hanging flowers in the background"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15747,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-10-28T17:26:21.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15829/gettyimages-1494861266.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}},{"id":18968,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Do tattoos cause lymphoma?","short_title":null,"subheading":"Recent headlines about a link between tattoos and cancer seem a lot more worrisome than warranted.","summary":"
rn

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The number of adults in the US with at least one tattoo has risen dramatically in recent decades, so headlines about a study that found an association between having a tattoo and higher risk of lymphoma may have caused worry. But there's much more to the story than just the headlines.rnrnrnrnrn","content":"

rnrn

Not so long ago, a friend texted me from a coffee shop. He said, "I can't believe it. I'm the only one here without a tattoo!" That might not seem surprising: a quick glance around practically anywhere people gather shows that tattoos are widely popular.rnrn

Nearly one-third of adults in the US have a tattoo, according to a Pew Research Center survey, including more than half of women ages 18 to 49. These numbers have increased dramatically over the last 20 years: around 21% of US adults in 2012 and 16% of adults in 2003 reported having at least one tattoo.rnrn

If you're among them, some recent headlines may have you worried:rnrn

              Study Finds That Tattoos Can Increase Your Risk of Lymphoma (OnlyMyHealth)rnrn

              Getting a Tattoo Puts You At Higher Risk of Cancer, Claims Study (NDTV)rnrn

              Inky waters: Tattoos increase risk of lymphoma by over 20%, study says (Local12.com)rnrn

              Shocking study reveals tattoos may increase risk of lymphoma by 20% (Fox News)rnrn

What study are they talking about? And how concerned should you be? Let's go through it together. One thing is clear: there's much more to this story than the headlines.rnrn

Why are researchers studying a possible link between tattoos and lymphoma?rnrn

Lymphoma is a type of cancer that starts in the lymphatic system, a network of vessels and lymph nodes that twines throughout the body. With about 90,000 newly diagnosed cases a year, lymphoma is one of the most common types of cancer.rnrn

Risk factors for it include:rnrn

rnt

advancing agernt
certain infections (such as Epstein-Barr virus, HIV, and hepatitis C)rnt
exposure to certain chemicals (such as benzene, or possibly pesticides)rnt
family history of lymphomarnt
exposure to radiation (such as nuclear reactor accidents or after radiation therapy)rnt
having an impaired immune systemrnt
certain immune diseases (such as rheumatoid arthritis, Sjogren's disease, or celiac disease).rnrnrn
Tattoos are not known to be a cause or risk factor for lymphoma. But there are several reasons to wonder if there might be a connection:rnrn

rnt

Ink injected under the skin to create a tattoo contains several chemicals classified as carcinogenic (cancer causing).rnt
Pigment from tattoo ink can be found in enlarged lymph nodes within weeks of getting a tattoo.rnt
Immune cells in the skin can react to the chemicals in tattoo ink and travel to nearby lymph nodes, triggering a bodywide immune reaction.rnt
Other triggers of lymphoma, such as pesticides, have a similar effect on immune cells in lymph nodes.rnrnrn

Is there a connection between tattoos and lymphoma?rnrn

Any potential connection between tattoos and lymphoma has not been well studied. I could find only two published studies exploring the possibility, and neither found evidence of a compelling link.rnrn

The first study compared 737 people with the most common type of lymphoma (called non-Hodgkin's lymphoma) with otherwise similar people who did not have lymphoma. The researchers found no significant difference in the frequency of tattoos between the two groups.rnrn

A study published in May 2024 — the one that triggered the scary headlines above — was larger. It compared 1,398 people ages 20 to 60 who had lymphoma with 4,193 people who did not have lymphoma but who were otherwise similar. The study found thatrnrn

rnt

lymphoma was 21% more common among those with tattoosrnt
lymphoma risk varied depending on how much time had passed since getting the tattoo:rnt
rntt

within two years, lymphoma risk was 81% higherrntt
between three and 10 years, no definite increased lymphoma risk was detectedrntt
11 or more years after getting a tattoo, lymphoma risk was 19%rntrntrnrnrn
There was no correlation between the size or number of tattoos and lymphoma risk.rnrn

What else should you know about the study?rnrn

Importantly, nearly all of the differences in rates of lymphoma between people with and without tattoos were not statistically significant. That means the reported link between lymphoma and tattoos is questionable — and quite possibly observed by chance. In fact, some of the other findings argue against a connection, such as the lack of a link between size or number of tattoos and lymphoma risk.rnrn

In addition, if tattoos significantly increase a person's risk of developing lymphoma, we might expect lymphoma rates in the US to be rising along with the popularity of tattoos. Yet that's not the case.rnrn

Finally, a study like this one (called an association study) cannot prove that a potential trigger of disease (in this case, tattoos) actually caused the disease (lymphoma). There may be other factors (called confounders) that are more common among people who have tattoos, and those factors might account for the higher lymphoma risk.rnrn

Do tattoos come with other health risks?rnrn

While complication rates from reputable and appropriately certified tattooists are low, there are health risks associated with tattoos:rnrn

rnt

infection, including bacterial skin infections or viral hepatitisrnt
allergic reactions to the inkrnt
scarringrnt
rarely, skin cancer (melanoma and other types of skin cancer).rnrnrn

The bottom linernrn

Despite headlines suggesting a link between tattoos and the risk of lymphoma, there's no convincing evidence it's true. We'll need significantly more research to say much more than that. In the meantime, there are more important health concerns to worry about and much better ways for all of us to reduce cancer risk.","excerpt":"

rn

rn

rn

rn

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The number of adults in the US with at least one tattoo has risen dramatically in recent decades, so headlines about a study that found an association between having a tattoo and higher risk of lymphoma may have caused worry. But there’s much more to the story than just the headlines.rn rn rn rn rn ","alternate_summary":"

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A recent study found an association between having a tattoo and a higher risk of lymphoma. Learn more about the evidence and potential health risks from tattoos.rnrnrnrnrn","description":null,"supplemental_content":null,"author":null,"slug":"do-tattoos-cause-lymphoma-202407193059","sort_date":"2024-07-19T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3059,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL071924","publication_date":"2024-07-19T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-07-19T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-07-17T04:00:00.000000Z","active":1,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-29T12:06:38.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":6,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":18968,"author_id":23,"sort_order":1}}],"contentable":{"id":3059,"comments_open":1,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-29T12:06:38.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15415,"model_type":"AppModelsMarketingContent","model_id":18968,"uuid":"8f10159d-b234-4a23-9f37-6ff59e718593","collection_name":"contents","name":"2acee670-1e43-413e-a07b-437512d22803","file_name":"2acee670-1e43-413e-a07b-437512d22803.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":66764,"manipulations":[],"custom_properties":{"alt":"A light shining on a black and dark blue sign that says "Tatooo" in white letters and has an arrow pointing to a doorway"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15345,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-18T09:00:06.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15415/2acee670-1e43-413e-a07b-437512d22803.jpg"}],"primary_content_topic":{"id":6,"name":"Cancer","slug":"cancer","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/cancer"}},{"id":18836,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"PTSD: How is treatment changing?","short_title":null,"subheading":"New PTSD guidelines highlight targeted psychotherapy and caution about common anti-anxiety drugs and cannabis.","summary":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","content":"rn

rn rn rn

Over the course of a lifetime, as many as seven in 10 adults in the United States will directly experience or witness harrowing events. These include gun violence, car accidents, and other personal trauma; natural or human-made disasters, such as Hurricane Katrina and the 9/11 terrorist attacks; and military combat. And some — though not all — will experience post-traumatic stress disorder, or PTSD.rn

New guidelines released in 2024 can help guide effective treatment.rn

What is PTSD?rn

PTSD is a potentially debilitating mental health condition. It’s marked by recurrent, frightening episodes during which a person relives a traumatic event.rn

After a disturbing event, it’s normal to have upsetting memories, feel on edge, and have trouble sleeping. For most people, these symptoms fade over time. But when certain symptoms persist for more than a month, a person may be experiencing PTSD.rn

These symptoms includern

rn

recurring nightmares or intrusive thoughts about the eventrn
feeling emotionally numb and disconnectedrn
withdrawing from people and certain situationsrn
being jumpy and on guard.rn rn
The National Center for PTSD offers a brief self-screening test online, which can help you decide whether to seek more information and help.rn

Who is more likely to experience PTSD?rn

Not everyone who experiences violence, disasters, and other upsetting events goes on to develop PTSD. However, military personnel exposed to combat in a war zone are especially vulnerable. About 11% to 20% of veterans who served in Iraq or Afghanistan have PTSD, according to the National Center for PTSD.rn

What about people who were not in the military? Within the general population, estimates suggest PTSD occurs in 4% of men and 8% of women — a difference at least partly related to the fact that women are more likely to experience sexual assault.rn

What are the new guidelines for PTSD treatment?rn

Experts from the U.S. Department of Veterans Affairs and Department of Defense collaborated on new guidelines for treating PTSD. They detailed the evidence both for and against specific therapies for PTSD.rn

Their findings apply to civilian and military personnel alike, says Dr. Sofia Matta, a psychiatrist at Harvard-affiliated Massachusetts General Hospital and senior director of medical services at Home Base, a nonprofit organization that provides care for veterans, service members, and their families.rn

The circle of care is widely drawn for good reason. "It’s important to recognize that PTSD doesn’t just affect the person who is suffering but also their families and sometimes, their entire community," Dr. Matta says. The rise in mass shootings in public places and the aftermath of these events are a grim reminder of this reality, she adds.rn

Which treatment approaches are most effective for PTSD?rn

The new guidelines looked at psychotherapy, medications, nondrug therapies. Psychotherapy, sometimes paired with certain medicines, emerged as the most effective approach.rn

The experts also recommended not taking certain drugs due to lack of evidence or possible harm.rn

Which psychotherapies are recommended for PTSD?rn

The recommended treatment for PTSD, psychotherapy, is more effective than medication. It also has fewer adverse side effects and people prefer it, according to the guidelines.rn

Which type of psychotherapy can help? Importantly, the most effective therapies for people with PTSD differ from those for people with other mental health issues, says Dr. Matta.rn

Both cognitive processing therapy and prolonged exposure therapy were effective. These two therapies teach people how to evaluate and reframe the upsetting thoughts stemming from the traumatic experience. The guidelines also recommend mindfulness-based stress reduction, an eight-week program that includes meditation, body scanning, and simple yoga stretches.rn

Which medications are recommended for PTSD?rn

Some people with severe symptoms need medication to feel well enough to participate in therapy. "People with PTSD often don’t sleep well due to insomnia and nightmares, and the resulting fatigue makes it hard to pay attention and concentrate," says Dr. Matta.rn

Three medicines commonly prescribed for depression and anxiety — paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor) — are recommended. Prazosin (Minipress) may help people with nightmares, but the evidence is weak.rn

Which medications are not recommended for PTSD?rn

The guidelines strongly recommended not taking benzodiazepines (anti-anxiety drugs often taken for sleep). Benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin) offer no proven benefits for people with PTSD. They have several potential harms, including negative cognitive changes and decreased effectiveness of PTSD psychotherapies.rn

What about cannabis, psychedelics, and brain stimulation therapies?rn

Right now, evidence doesn’t support the idea that cannabis helps ease PTSD symptoms. And there are possible serious side effects from the drug, such as cannabis hyperemesis syndrome (severe vomiting related to long-term cannabis use).rn

There isn’t enough evidence to recommend for or against psychedelic-assisted therapies such as psilocybin (magic mushrooms) and MDMA (ecstasy). "Because these potential therapies are illegal under federal law, the barriers for conducting research on them are very high," says Dr. Matta. However, recent legislative reforms may make such studies more feasible.rn

Likewise, the evidence is mixed for a wide range of other nondrug therapies, such as brain stimulation therapies like repetitive transcranial magnetic stimulation or transcranial direct current stimulation.rn ","excerpt":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","alternate_summary":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","description":null,"supplemental_content":null,"author":null,"slug":"ptsd-how-is-treatment-changing-202405153041","sort_date":"2024-05-15T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3041,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL051524","publication_date":"2024-05-15T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-05-17T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-05-16T04:00:00.000000Z","active":1,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-08-12T14:13:21.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":18836,"author_id":14,"sort_order":1}}],"contentable":{"id":3041,"comments_open":1,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-08-12T14:13:21.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15204,"model_type":"AppModelsMarketingContent","model_id":18836,"uuid":"a383b83f-562c-47f3-9347-49ef98964710","collection_name":"contents","name":"ba14ccdc-4bea-4260-9fb1-2465775b9662","file_name":"ba14ccdc-4bea-4260-9fb1-2465775b9662.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":99638,"manipulations":[],"custom_properties":{"alt":"A while spiral notebook with words related to PTSD written on it, such as depression, fear, anxiety, negative thoughts); desk also has pen and coffee cup"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15136,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-05-14T09:00:05.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15204/ba14ccdc-4bea-4260-9fb1-2465775b9662.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}},{"id":18769,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Concussion in children: What to know and do","short_title":"","subheading":"Expert advice on how to help children and teens recover from concussion has changed in recent years.","summary":"n

Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","content":"

n n n
Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. It is a particular kind of injury that happens when a blow to the head or somewhere else on the body makes the brain move back and forth within the skull.n

It’s possible to get a concussion after what might seem like a minor injury, like a forceful push from behind, or a collision between two players in a football or soccer game.n

What are the signs and symptoms of concussion?n

Because the injury may not seem that significant from the outside, it’s important to know the symptoms of a concussion. There are many different possible symptoms, includingn

n

passing out (this could be a sign of a more serious brain injury)n
headachen
dizzinessn
changes in visionn
feeling bothered by light or noisen
confusion or feeling disorientedn
memory problems (such as difficulty remembering details of the injury) or difficulty concentratingn
balance or coordination problemsn
mood changes.n n
Some of these are visible to others and some are felt by the person with the concussion. That’s why it’s important to know the signs and to ask all the right questions of a child who has had an injury.n

Sometimes the symptoms might not be apparent right away, but show up in the days following the injury. The CDC’s Heads Up website has lots of great information about how to recognize a concussion.n

How can further harm to the brain be avoided?n

The main reason it’s important to recognize a possible concussion early is that the worst thing you can do after getting a concussion is get another one. The brain is vulnerable after a concussion; if it is injured again, the symptoms can be longer lasting — or even permanent, as in cases of chronic traumatic encephalopathy (CTE), a condition that has been seen in football players and others who have repeated head injuries.n

If there is a chance that a child has had a concussion during a sports competition, they must stop playing — and get medical attention. It’s important to get medical attention any time there is concern about a possible concussion, both to be sure there isn’t a more serious brain injury, and to do a good assessment of the symptoms, so that they can be monitored over time. There are some screening questionnaires that are used by doctors that can be used again in the days and weeks after the concussion to see how the child is improving.n

What helps children recover after a concussion?n

Experts have struggled with figuring out how to protect the brain after a concussion. For a long time, the recommendation was to rest and do very little at all. This meant not doing any exercise, not going to school, not even reading or watching television. As symptoms improved, the restrictions were lifted gradually.n

Over time, though, research showed that not only was this much rest not necessary, it was counterproductive. It turns out that getting kids back into their daily lives, and back into being active, is safe and leads to quicker recovery. Experts still recommend rest and then moving gradually back into activities, but the guidelines are no longer as strict as they once were.n

One important note: A medical professional should guide decisions to move from rest to light activity, and then gradually from there to moderate and then regular activities based on how the child is doing. This step-by-step process may extend for days, weeks, or longer, depending on what the child needs. Parents, coaches, and schools can help support a child or teen as they return to school and return to activities and sports.n

Some children will be able to get back into regular activities quickly. But for others it can take weeks or even months. Schools and sports trainers should work with children to support them in their recovery. Some children develop post-concussive syndromes with headache, fatigue, and other symptoms. This is rare but can be very disabling.n

How can parents help prevent concussions?n

It's not always possible to prevent concussions, but there are things that parents can do:n

n

Be sure that children use seat belts and other appropriate restraints in the car.n
Have clear safety rules and supervise children when they are playing, especially if they are riding bikes or climbing in trees or on play structures.n
Since at least half of concussions happen during sports, it’s important that teams and coaches follow safety rules. Coaches should teach techniques and skills to avoid dangerous collisions and other injuries. Talk to your child’s coaches about what they are doing to keep players safe. While helmets can prevent many head injuries, they don’t prevent concussions.n ","excerpt":"n
Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","alternate_summary":"n

Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","description":null,"supplemental_content":null,"author":null,"slug":"concussion-in-children-what-to-know-and-do-202404123032","sort_date":"2024-04-12T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3032,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041224","publication_date":"2024-04-12T10:30:00.000000Z","last_review_date":null,"imported_at":"2024-04-12T09:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-04-11T04:00:00.000000Z","active":1,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-12T09:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":24,"ecommerce_type":"CATALOG","authors":[{"id":46,"cr_id":4,"featured":0,"hhp_staff":1,"editorial_board":0,"hidden":0,"name":"Claire McCarthy, MD","title":null,"first_name":"Claire","middle_name":null,"last_name":"McCarthy","suffix":"MD","slug":"claire-mccarthy-md","byline":"Senior Faculty Editor, Harvard Health Publishing","description":"Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy writes about health and parenting for Boston Children’s Hospital, Boston.com, and the Huffington Post.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/mvCBqecmOmDXOhy74hH3DviJmMAprZqhFgGbhTJL.jpg","twitter_username":null,"sort_order":5,"created_at":"2021-05-11T10:23:17.000000Z","updated_at":"2024-04-10T21:36:29.000000Z","deleted_at":null,"pivot":{"content_id":18769,"author_id":46,"sort_order":1}}],"contentable":{"id":3032,"comments_open":1,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-11T17:58:34.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15118,"model_type":"AppModelsMarketingContent","model_id":18769,"uuid":"3a5c62e4-3dce-475d-95bf-43095fab2ae4","collection_name":"contents","name":"7046141e-2210-416a-a9a8-8790bf65693e","file_name":"7046141e-2210-416a-a9a8-8790bf65693e.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":50504,"manipulations":[],"custom_properties":{"alt":"Illustration of a tiny person with black hair putting two crossed bandages on a large, pink injured brain; concept is concussion"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15050,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-11T17:57:33.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15118/7046141e-2210-416a-a9a8-8790bf65693e.jpg"}],"primary_content_topic":{"id":24,"name":"Child & Teen Health","slug":"child-and-teen-health","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/child-and-teen-health"}},{"id":19225,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Ever hear of tonsil stones?","short_title":"","subheading":"They’re a common cause of bad breath and sore throats &mdash; and apparently a well-kept secret.","summary":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","content":"

n n n

Recently, a friend asked me about tonsil stones. He has sore throats several times a year, which are instantly relieved by gargling to remove them. When I told him I thought tonsil stones were pretty rare, he asked: "Are you sure about that? My ear, nose, and throat doctor says they’re common as rocks." (Get it? stones? rocks?)n

It turns out, my friend and his doctor are on to something. Tonsil stones are surprisingly common and often quite annoying. Here’s what to know and do.n

What are tonsil stones?n

Tonsil stones (medical term: tonsilloliths) are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations called crypts.n

They vary considerably between people, including:n

n

Size. They may be so small that you can’t see them with the naked eye. Or they may grow to the size of gravel or, rarely, much larger.n
Consistency. They’re often soft but may calcify, becoming hard as a rock. Hence, the name.n
How long they last. Tonsil stones can last days to weeks, or may persist far longer before they break up and fall out.n
How often they occur. New tonsilloliths may appear several times each month or just once or twice a year.n n
While they’re more likely to form if you have poor oral hygiene, good oral hygiene doesn’t provide complete protection. Even those who brush, floss, and see their dentists regularly can develop tonsil stones.n
How common are tonsil stones?n

You’ve heard of kidney stones and gallstones, right? Clearly, those conditions are better known than tonsil stones. Yet tonsil stones are far more common: studies suggest that up to 40% of the population have them. Fortunately, unlike kidney stones and gallstones, tonsil stones are usually harmless.n

What are the symptoms of tonsil stones?n

Often people have no symptoms. In fact, if tonsil stones are small enough, you may not even know you have them. When tonsil stones do cause symptoms, the most common ones are:n

n

sore throat, or an irritation that feels as though something is stuck in the throatn
bad breathn
coughn
discomfort with swallowingn
throat infections.n n

Who gets tonsil stones?n

Anyone who has tonsils can get them. However, some people are more likely than others to form tonsil stones, including those whon

n

have tonsils with lots of indentations and irregular surfaces rather than a smooth surfacen
smoken
drink lots of sugary beveragesn
have poor oral hygienen
have a family history of tonsil stones.n n

How are tonsil stones treated?n

That depends on whether you have symptoms and how severe the symptoms are.n

n

If you have no symptoms, tonsil stones may require no treatment.n
If you do have symptoms, gargling with salt water or removing tonsil stones with a cotton swab or a water flosser usually helps. Avoid trying to remove them with sharp, firm objects like a toothpick or a pen, as that can damage your throat or tonsils.n
If your tonsils are inflamed, swollen, or infected, your doctor may prescribe antibiotics or anti-inflammatory medications.n n

Is surgery ever necessary?n

Occasionally, surgery may be warranted. It’s generally reserved for people with severe symptoms or frequent infections who don’t improve with the measures mentioned above.n

Surgical options are:n

n

tonsillectomy, which is removing the tonsilsn
cryptolysis, which uses laser, electrical current, or radio waves to smooth the deep indentations in tonsils that allow stones to form.n n

Can tonsil stones be prevented?n

Yes, there are ways to reduce the risk that tonsil stones will recur. Experts recommend the following:n

n

Brush your teeth and tongue regularly (at least twice a day: in the morning and before sleep).n
Floss regularly.n
Gargle with salt water after eating.n
Eliminate foods and drinks that contain a lot of sugar, which feeds bacteria that can help stones form.n
Don’t smoke, because smoking irritates and inflames tonsils, which can encourage stone formation. The same may apply to vaping, though there is limited research to rely upon.n n

The bottom linen

Considering how common tonsil stones are and how bothersome they can be, it seems strange that they aren’t more well known. Maybe that’s because they often get better on their own, or people figure out how to deal with them without needing medical attention.n

I hope you aren’t one of the many millions of people bothered by tonsil stones. But if you are, it’s good to know that they’re generally harmless and can be readily treated and prevented.n

Now that you know more about them, feel free to spread the word: tonsil stones should be a secret no more.","excerpt":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","alternate_summary":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","description":null,"supplemental_content":null,"author":null,"slug":"ever-hear-of-tonsil-stones-202410213077","sort_date":"2024-10-21T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3077,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL102124","publication_date":"2024-10-21T14:30:00.000000Z","last_review_date":null,"imported_at":"2024-10-22T09:00:03.000000Z","last_import_type":"update","last_modified_date":"2024-10-21T04:00:00.000000Z","active":1,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-22T09:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":28,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":19225,"author_id":23,"sort_order":1}}],"contentable":{"id":3077,"comments_open":1,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-21T13:25:14.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15823,"model_type":"AppModelsMarketingContent","model_id":19225,"uuid":"8aa0af7d-a96c-4c90-8c7d-550c1d9ee8f3","collection_name":"contents","name":"gettyimages-1317910199","file_name":"gettyimages-1317910199.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":24096,"manipulations":[],"custom_properties":{"alt":"Illustration of a woman with black hair pulled into a bun, head tipped back, gargling with salt water to relieve sore throat from tonsil stones"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15741,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-21T13:25:15.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15823/gettyimages-1317910199.jpg"}],"primary_content_topic":{"id":28,"name":"Diseases & Conditions","slug":"diseases-and-conditions","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/diseases-and-conditions"}},{"id":16209,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Midlife ADHD? Coping strategies that can help","short_title":null,"subheading":"Tools, timers, and steps to take for staying organized.","summary":"

When ADHD persists through early adulthood into middle age, it presents many of the same challenges it does in childhood, but with added pressures from the busier pace of life and expectations from work and family. Fortunately there are strategies that can help you navigate this condition.","content":"

rn rn rn

Trouble staying focused and paying attention are two familiar symptoms of attention deficit hyperactivity disorder (ADHD), a common health issue among children and teens.rn

When ADHD persists through early adulthood and on into middle age, it presents many of the same challenges it does in childhood: it’s hard to stay organized, start projects, stay on task, and meet deadlines. But now life is busier, and often expectations from work and family are even higher. Fortunately, there are lots of strategies that can help you navigate this time in your life.rn

Staying organizedrn

Organizational tools are a must for people with adult ADHD. They’ll help you prioritize and track activities for each day or the coming weeks.rn

rn

Pick the right tools. Tools can include a pen and paper to make lists, or computer or smartphone apps to set appointment reminders, highlight important days on the calendar, mark deadlines, and keep lists and other information handy.rn
Schedule updates. Set aside time each day to update your lists and schedules. Don’t let the task become a chore in itself; think of it like a routine task such as brushing your teeth, and do it daily so it becomes an established habit.rn
Set a timer. And a word of caution: smartphones and computers can also turn into a distraction. If you have adult ADHD, you may find yourself spending hours looking at less useful apps or sites. If that’s a frequent trap for you, set a timer for each use or keep the phone off or in another room when you are trying to work.rn rn

Staying focusedrn

Just being organized doesn’t mean your work will get done. But a few simple approaches can at least make it easier to do the work.rn

rn

Declutter your home and office. Give yourself an appealing work environment and keep important items easily accessible.rn
Reduce distractions. This could mean changing your workstation so it doesn’t face a window, moving to a quieter space, or just silencing your smartphone and email alerts.rn
Jot down ideas as they come to you. You may have an "aha" moment for one task while you’re in the middle of another. That’s okay; just write down that thought and get back to it later, after your more pressing work is finished.rn rn

Meeting deadlinesrn

Deadlines pose two big challenges when you have adult ADHD. First, it’s hard to start a project, often because you want it to be perfect, or you’re intimidated by it so you put it off. Second, when you do start a project, it’s very easy to become distracted and leave the task unfinished.rn

How can you avoid these traps?rn

rn

Put off procrastinating. Put procrastination on your to-do list — like a chore — and fool yourself into actually starting your work.rn
Deal with emails, phone calls, or other matters as soon as you can. That way there will be fewer things hanging over your head and overwhelming you later on.rn
Be a clock watcher. Get a watch and get in the habit of using it. The more aware you are of time, the more likely you’ll be able to avoid spending too long on a task.rn
Take one thing at a time. Multitasking is overrated for everyone — and it’s a nightmare for people with adult ADHD. Focus on completing one task, then move on to the next.rn
Be realistic about your time. This can mean having to say no to new projects or other commitments.rn rn

Get more helprn

The ideas listed here can help you start coping with adult ADHD, but they may not be enough to help you overcome adult ADHD’s challenges.rn

Consider hiring an ADHD coach who can provide more strategies and give you additional tools to cope with your condition. Look for an ADHD coach who is a licensed mental health professional who specializes in treating ADHD, and may also have a certification in ADHD coaching from the ADHD Coaches Organization.","excerpt":"

When ADHD persists through early adulthood into middle age, it presents many of the same challenges it does in childhood, but with added pressures from the busier pace of life and expectations from work and family. Fortunately there are strategies that can help you navigate this condition.","alternate_summary":"

Trouble staying organized, starting projects, or meeting deadlines are just some of the challenges adults with ADHD face. Fortunately, there are strategies that can help.","description":null,"supplemental_content":null,"author":null,"slug":"midlife-adhd-coping-strategies-that-can-help-202102052381","sort_date":"2021-02-05T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":2381,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL020521","publication_date":"2021-02-05T05:00:00.000000Z","last_review_date":"2024-10-18T04:00:00.000000Z","imported_at":"2024-10-17T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-10-16T04:00:00.000000Z","active":1,"created_at":"2021-02-05T11:30:08.000000Z","updated_at":"2024-10-28T12:26:06.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":21862,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":31,"cr_id":117,"featured":0,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Heidi Godman","title":null,"first_name":"Heidi","middle_name":null,"last_name":"Godman","suffix":null,"slug":"heidi-godman","byline":"Executive Editor, Harvard Health Letter","description":"

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow of the American Academy of Neurology, and has been honored by the Associated Press, the American Heart Association, the Wellness Community, and other organizations for outstanding medical reporting. Heidi holds a bachelor of science degree in journalism from West Virginia University.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/jmHxTqYhe8m1bTrPQJnvY8odf8gsq1y1Q0i6Wp6Y.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:08:08.000000Z","updated_at":"2022-08-03T17:04:41.000000Z","deleted_at":null,"pivot":{"content_id":16209,"author_id":31,"sort_order":1}}],"contentable":{"id":2381,"comments_open":1,"created_at":"2021-05-11T11:08:33.000000Z","updated_at":"2024-10-28T12:26:06.000000Z","deleted_at":null,"media":[{"id":10411,"model_type":"AppModelsMarketingBlogPost","model_id":2381,"uuid":"62fcddd5-827f-4009-8894-fb55eae14f1e","collection_name":"featured","name":"GettyImages-1128675197","file_name":"GettyImages-1128675197.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":70265,"manipulations":[],"custom_properties":[],"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":10411,"created_at":"2021-05-11T11:08:34.000000Z","updated_at":"2021-06-23T14:36:24.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/10411/GettyImages-1128675197.jpg"}]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15774,"model_type":"AppModelsMarketingContent","model_id":16209,"uuid":"cf8315a0-c31d-44d2-9268-cece85e8458d","collection_name":"contents","name":"gettyimages-1128675197","file_name":"gettyimages-1128675197.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":44546,"manipulations":[],"custom_properties":{"alt":"A laptop sits on a desk alongside glasses, note pads, and a mug; multiple sticky notes in assorted colors are stuck to the wall adjacent to the desk."},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15692,"created_at":"2024-10-16T17:30:06.000000Z","updated_at":"2024-10-16T17:30:08.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15774/gettyimages-1128675197.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}}], currentIndex: 0 }” x-on:slide-change.window=”currentIndex = $event.detail.currentIndex”>

Recent Blog Articles

Staying Healthy

10 steps you may take that can assist you keep away from accidents.

September 9, 2024

By Robert H. Shmerling, MD, Senior School Editor, Harvard Well being Publishing; Editorial Advisory Board Member, Harvard Well being Publishing

Ever ridden an e-scooter or e-bike? The comfort, affordability, and flat-out enjoyable of those “micromobility” modes of transportation are plain. However did it additionally appear a bit harmful?

Actually, the speed of accidents involving e-bikes and e-scooters is climbing. Perhaps that should not be shocking given their dramatic soar in recognition. After which there’s the best way riders typically use them: at excessive velocity, close to vehicles and pedestrians, and on roads and sidewalks that weren’t designed for them.

Disruptive improvements, corresponding to e-bikes and e-scooters, inevitably include downsides. So, how can we reduce dangers for accidents?

E-bikes, e-scooters, and accidents

Between 2018 and 2022, gross sales of e-bikes rose from round 250,00zero per 12 months to greater than one million. E-bike and e-scooter leases have additionally elevated dramatically. As their recognition grows, emergency rooms are seeing many extra individuals injured whereas using e-bikes and e-scooters.

A 2024 examine in JAMA Community Open highlights this. Researchers drew information from the Nationwide Digital Harm Surveillance System, which is run by the US Client Product Security Fee. They analyzed ER care between 2017 and 2022 for individuals injured whereas using an e-bike or e-scooter, in contrast with individuals injured whereas using typical bikes and scooters.

What did the examine discover?

In the course of the six-year examine interval, roughly three million individuals using e-bikes, e-scooters, or their typical counterparts sought care within the ER, together with about 45,500 e-bike riders and 190,00zero e-scooter riders, and about 2.5 million typical bike riders and 305,00zero typical scooter riders.

Sure themes emerged round e-micromobility:

ER care spiked upward

E-bike accidents greater than doubled yearly, going from 751 in 2017 to 23,493 in 2022.

E-scooter accidents elevated by greater than 45% yearly, going from 8,566 in 2017 to 56,847 in 2022.

Extra dangerous habits

43% of e-bike and e-scooter riders wore helmets versus 52% for typical micromobility riders

7% of e-bike riders and 9% of e-scooter riders have been consuming earlier than their accidents versus 4% of typical bike riders and three% of typical scooter riders.

Extra accidents occurred in city areas in contrast with rural settings:

83% of e-bike and e-scooter accidents

71% of typical bike and scooter accidents.

All riders skilled related forms of accidents: scrapes, bruises, damaged bones, and head and neck accidents have been most typical.

What are the restrictions of this examine?

This examine solely included individuals evaluated in an ER, so it excluded individuals with much less extreme accidents — and even these with important accidents who did not go to an ER. Some could have sought no care in any respect, or gone to a main care follow or walk-in clinic to keep away from expensive ER care or for different causes.

Nor did the examine rely accidents suffered by pedestrians injured by e-bike or e-scooter riders. Property harm, corresponding to harm to a automobile, wasn’t calculated.

And in the end the examine can not examine the protection of e-bikes and e-scooters with typical choices. That is as a result of no information have been collected on the variety of miles traveled utilizing a selected mode of transportation, or over how a lot time.

How are you going to keep away from e-bike or e-scooter accidents?

Ten common sense precautions may also help you keep away from accidents and ER visits:

Put on a helmet. For those who’re renting an e-bike or e-scooter, it’s possible you’ll must carry your individual since many rental techniques don’t present helmets.

Apply. E-bikes are a lot heavier than typical bicycles and will deal with otherwise. And lots of adults haven’t ridden a scooter since elementary faculty! So for those who aren’t aware of using an e-bike or e-scooter, follow in a protected location the place there is not any site visitors or pedestrians.

Observe highway guidelines. Trip on out there bike lanes and keep away from sidewalks. On an e-bike, use arm alerts to alert these close by of your intentions to show or change lanes. (On an e-scooter, it is best to maintain each palms on the deal with bars always.).

Decelerate. Some e-bikes strategy speeds of 30 miles per hour. The sooner you go, the much less time you must react to surprising potholes or veering automobiles, and the extra critical an harm is more likely to be in case you have an accident.

Decrease dangers. Do not journey whereas inebriated or medicine, or use your cellphone whereas shifting.

Go it alone. Do not add riders. Most e-bikes and e-scooters are constructed for one rider at a time.

Trip defensively. Be careful for potholes or opening automobile doorways.

Replicate. Put on reflective clothes or connect a light-weight if using at evening.

Name out. Announce your presence to others. For instance, shout “in your left!” as you strategy pedestrians or slower riders that you simply intend to move.

Foyer. Attain out to native politicians to create bike lanes and different infrastructure to make micromobility safer.

The underside line

Whether or not it is a part of your day by day commute, an occasional fast zip from level A to level B, or only a journey for the enjoyable of it, e-bikes and e-scooters are a good way to get round. Although they do include some threat, you are able to do loads to attenuate the percentages of wrapping up your travels with a visit to an ER.

Concerning the Creator

Robert H. Shmerling, MD, Senior School Editor, Harvard Well being Publishing; Editorial Advisory Board Member, Harvard Well being Publishing

Dr. Robert H. Shmerling is the previous scientific chief of the division of rheumatology at Beth Israel Deaconess Medical Heart (BIDMC), and is a present member of the corresponding college in drugs at Harvard Medical College. … See Full Bio

View all posts by Robert H. Shmerling, MD

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As a service to our readers, Harvard Well being Publishing gives entry to our library of archived content material. Please observe the date of final overview or replace on all articles.

No content material on this web site, no matter date, ought to ever be used as an alternative to direct medical recommendation out of your physician or different certified clinician.

<div x-data="{ posts: [{"id":19237,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Might imaging scans change biopsies throughout prostate most cancers screening?","short_title":"","subheading":"A big European examine gives encouraging proof in favor of omitting biopsies for some males with elevated PSA values.","abstract":"n

Irregular outcomes on a prostate-specific antigen (PSA) screening check for most cancers are sometimes adopted by a scientific biopsy. However systematic biopsies might be problematic, and researchers are looking for alternate options. A big European examine gives encouraging proof favoring a distinct strategy that makes use of MRI as an alternative of biopsy.n ","content material":"

n n n

Irregular outcomes on a prostate-specific antigen (PSA) screening check for most cancers are sometimes adopted by a scientific biopsy. Throughout that process, docs use an extended needle to extract roughly a dozen samples from the prostate whereas wanting on the gland on an ultrasound machine. These samples can then be checked for most cancers underneath a microscope.n

Limitations and concernsn

However systematic biopsies might be problematic. A serious concern is that they overdiagnose low-grade, slow-growing tumors that may by no means turn into life-threatening, thereby resulting in pointless therapies.n

Researchers are looking for alternate options to the systematic biopsy in males flagged by PSA screening. One choice is to start out with a magnetic resonance imaging (MRI) scan of the prostate, after which focus the biopsy solely on areas that look suspicious for most cancers. That is referred to as an MRI-targeted biopsy, and it is changing into more and more frequent.n

Might an MRI miss early-stage most cancers that later seems to be incurable? That is an impressive fear, particularly since systematic biopsies generally discover newly-forming most cancers that MRIs aren’t but in a position to detect. Certainly, systematic and focused biopsies are sometimes given collectively to spice up the percentages of discovering clinically important illness which will want instant remedy.n
Methodologyn

Now, a big Swedish study provides encouraging evidence favoring the MRI-only approach.n

The team invited 38,316 men ranging from 50 to 60 years in age to undergo PSA screening. If a man’s PSA level was 3.0 nanograms per milliliter (ng/mL) or higher, then he was enrolled into the study. The investigators wound up with 13,153 men who were randomly distributed between two groups:n

n

Systematic biopsy group: All the men in this group got a systematic biopsy plus an MRI. If a man’s MRI was positive for suspicious lesions, then he also got a targeted biopsy.n
MRI-targeted biopsy group: All of the men in this group got an MRI, but none got a systematic biopsy. Men with suspicious lesions on MRI got a targeted biopsy.n n
This initial screening round was followed by repeat screening rounds — all following the same protocols — at two-, four-, and eight-year-intervals.n
What the study showedn

After a median follow-up of 3.9 years (starting from and including the first screening round), prostate cancer had been detected in 185 men from the MRI-targeted group and 298 men from the systematic biopsy group. Systematic biopsies generated more clinically insignificant cancer diagnoses — 159 compared to 68 in the MRI-targeted group. During the first screening round, "The risk of such a diagnosis was 51% lower in the MRI-targeted biopsy group than the systematic biopsy group," the authors wrote.n

The authors emphasized that omitting biopsies in patients with MRI-negative results cut diagnoses of clinically insignificant cancer, meaning cancer that is slow-growing and may never need treatment, by more than half. "And importantly, the associated risk of detecting clinically significant cancer during follow-up and at later screening visits was very low in both groups," said Dr. Jonas Hugosson, chief urologist at the University of Gothenberg and the study’s first author. "A total of 14 such cases (0.2 % of men who participated) were diagnosed in the systematic biopsy group and eight (0.1 %) in the MRI-targeted biopsy group."n

Commentary from expertsn

"This study provides encouraging — though very early — data that supports the increasing use of MRI as the first diagnostic modality, following evaluation of an abnormal PSA value," said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor-in-chief of the Harvard Medical School Guide to Prostate Diseases. "The practice of not automatically going to prostate needle biopsy when an abnormal PSA is detected has gained in popularity in Europe, and this study may help increase its usefulness in the United States."n

"While these results are encouraging, the decision to omit biopsy in men with a negative MRI must be individualized based on the risk of detecting prostate cancer," added Dr. Boris Gershman, a urologist at Beth Israel Deaconess Medical Center and an assistant professor at Harvard Medical School focusing on prostate and bladder cancer. "For example, biopsy may still be considered in men with markedly elevated PSA, even if the prostate MRI does not identify any lesions."","excerpt":"n

Abnormal results on a prostate-specific antigen (PSA) screening test for cancer are typically followed by a systematic biopsy. But systematic biopsies can be problematic, and researchers are seeking alternatives. A large European study provides encouraging evidence favoring a different approach that uses MRI instead of biopsy.n ","alternate_summary":"n

Abnormal results on a prostate-specific antigen (PSA) screening test for cancer are typically followed by a systematic biopsy. But systematic biopsies can be problematic, and researchers are seeking alternatives. A large European study provides encouraging evidence favoring a different approach that uses MRI instead of biopsy.n ","description":null,"supplemental_content":null,"author":null,"slug":"could-imaging-scans-replace-biopsies-during-prostate-cancer-screening-202411083080","sort_date":"2024-11-08T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3080,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL110824","publication_date":"2024-11-08T11:30:00.000000Z","last_review_date":null,"imported_at":"2024-11-08T10:00:02.000000Z","last_import_type":"update","last_modified_date":"2024-11-07T05:00:00.000000Z","active":1,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-08T10:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":35,"ecommerce_type":"CATALOG","authors":[{"id":44,"cr_id":113,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Charlie Schmidt","title":null,"first_name":"Charlie","middle_name":null,"last_name":"Schmidt","suffix":null,"slug":"charlie-schmidt","byline":"Editor, Harvard Medical School Annual Report on Prostate Diseases","description":"

Charlie Schmidt is an award-winning freelance science writer based in Portland, Maine. In addition to writing for Harvard Health Publishing, Charlie has written for Science magazine, the Journal of the National Cancer Institute, Environmental Health Perspectives, Nature Biotechnology, and The Washington Post.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/B8ArUdl31ldNmyg4tWPVPBYhHyJEUiOrbAccVwEB.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:22:23.000000Z","updated_at":"2022-08-03T16:58:48.000000Z","deleted_at":null,"pivot":{"content_id":19237,"author_id":44,"sort_order":1}}],"contentable":{"id":3080,"comments_open":1,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-07T18:52:33.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15843,"model_type":"AppModelsMarketingContent","model_id":19237,"uuid":"b495369a-acc3-4b81-a74e-c39d8de923ff","collection_name":"contents","name":"gettyimages-170089177","file_name":"gettyimages-170089177.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":47306,"manipulations":[],"custom_properties":{"alt":"A radiologist in blue scrubs speaks to a patient who is about to be sent into an M R I machine for a scan."},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15760,"created_at":"2024-11-07T18:52:33.000000Z","updated_at":"2024-11-07T18:52:35.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15843/gettyimages-170089177.jpg"}],"primary_content_topic":{"id":35,"name":"Men’s Health","slug":"mens-health","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mens-health"}},{"id":19235,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Celiac disease: Exploring four myths","short_title":"","subheading":"An expert shines light on common misconceptions about this genetic autoimmune disease triggered by gluten.","summary":"n

While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","content":"

n n n
Celiac disease is a digestive and immune disorder that can keep the body from absorbing necessary nutrients. "Our conception and awareness of celiac disease has evolved over the past few decades, but there are still aspects that remain poorly understood," says Dr. Ciaran Kelly, medical director of the Celiac Center at Beth Israel Deaconess Medical Center and professor of medicine at Harvard Medical School.n

Perhaps not surprisingly, misconceptions are widespread among the general public. One example? Many people assume that everyone who has celiac disease is plagued by abdominal pain, bloating, or diarrhea. But actually, many adults newly diagnosed with this inherited gluten intolerance don’t have these symptoms.n

What’s more, gluten — the sticky protein found in grains such as wheat, barley, and rye — can cause gastrointestinal distress and other symptoms in people who don’t have celiac disease. Read on for a deeper dive into four myths and facts about celiac disease and related digestive conditions.n
Myth # 1: Celiac disease is usually diagnosed at a young agen

Not typically. While celiac disease can develop any time after a baby’s first exposure to gluten, it’s usually diagnosed much later in life. According to the National Celiac Association, the average age of diagnosis is between 46 and 56. Around 25% of people are diagnosed after age 60.n

Celiac disease is slightly more common in women and among people with other autoimmune conditions, including type 1 diabetes, Hashimoto’s thyroiditis (a common cause of low thyroid levels), and dermatitis herpetiformis (a rare condition marked by an itchy, blistering rash).n

"We don’t know why some people go from being susceptible to actually having celiac disease," says Dr. Kelly. The prevailing theory is that some sort of physical or emotional stress — such as a viral infection, surgery, or anxiety from a stressful life event — may "flip the switch" and cause the disease to appear, he says. "Increasing numbers of people are being diagnosed at midlife and older, often after they’re found to have conditions such as anemia or osteoporosis caused by nutrient deficiencies," says Dr. Kelly.n

Myth #2: Celiac disease only affects the gutn

When people have celiac disease, eating gluten triggers an immune system attack that can ravage the lining of the small intestine. A healthy small intestine is lined with fingerlike projections, called villi, that absorb nutrients. In celiac disease, the immune system attacks the villi, causing them to flatten and become inflamed — and thus unable to adequately absorb nutrients.n

While gastrointestinal problems can occur, they aren’t always present. In fact, celiac disease can present with many different symptoms that affect the nervous, endocrine, and skeletal systems. A few examples are brain fog, changes in menstrual periods, or muscle and joint pain.n

Myth # 3: Celiac disease versus gluten intolerancen

If you feel sick after eating gluten, you probably have celiac disease, right? Actually, that may not be true. Some people have non-celiac gluten sensitivity (also called gluten intolerance), which can cause uncomfortable digestive symptoms after eating gluten. But gluten intolerance differs from celiac disease.n

n

Celiac disease is diagnosed with blood tests that look for specific antibodies. If antibodies are present, a definitive diagnosis requires an intestinal biopsy to look for signs of damage that characterize the condition.n
Non-celiac gluten sensitivity does not trigger antibodies or cause intestinal damage. Yet some people with this problem say they also experience brain fog, trouble concentrating, muscle aches and pain, and fatigue after eating gluten-containing foods.n n
"Non-celiac gluten sensitivity appears to be a real phenomenon, but it’s not well defined," says Dr. Kelly. It’s unclear whether people experiencing it are intolerant to gluten or to something else in gluten-containing foods.n

n

One possibility is sugarlike molecules known as FODMAPs, which are found in many foods — including wheat. Short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, gas and bloating can occur when gut bacteria feed on FODMAPs.n
Another possibility is an allergy to wheat, which can cause symptoms such as swelling, itching, or irritation of the mouth and throat after eating wheat. Other symptoms include a skin rash, stuffy nose, and headache, as well as cramps, nausea, and vomiting. Some people may develop a life-threating allergic reaction known as anaphylaxis.n n

Myth #4: A gluten-free diet always relieves the symptoms and signs of celiac diseasen

The sole treatment for celiac disease — adopting a diet that avoids all gluten-containing foods — doesn’t always help. This problem is known as nonresponsive celiac disease.n

"About 20% of people with celiac disease have ongoing symptoms, despite their best efforts to stick to a gluten-free diet," says Dr. Kelly. Others have intermittent signs and symptoms, particularly when they are accidentally exposed to gluten. Accidental exposures often happen when people eat prepared or restaurant foods that claim to be gluten-free but are not. Cross contamination with gluten-containing foods is another potential route.n

Potential solutions to nonresponsive celiac disease are being studied. Three promising approaches are:n

n

Enzymes that break down gluten, which people could take alongside gluten-containing foods. "It’s a similar concept to the lactase pills taken by people who are lactose intolerant to help them digest dairy products," says Dr. Kelly.n
Dampening the immune response to gluten by inhibiting an enzyme called tissue transglutaminase that makes gluten more potent as an antigen.n
Reprogramming the immune response to prevent the body from reacting to gluten.n ","excerpt":"n
While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","alternate_summary":"n

While medical knowledge on celiac disease has evolved over the past few decades, there are still aspects that remain poorly understood. Perhaps not surprisingly, misconceptions are widespread among the general public.n ","description":null,"supplemental_content":null,"author":null,"slug":"celiac-disease-exploring-four-myths-202411063079","sort_date":"2024-11-06T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3079,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL110624","publication_date":"2024-11-06T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-11-08T10:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-11-07T05:00:00.000000Z","active":1,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-08T10:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":28,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":19235,"author_id":14,"sort_order":1}}],"contentable":{"id":3079,"comments_open":1,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-06T10:00:03.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15838,"model_type":"AppModelsMarketingContent","model_id":19235,"uuid":"dbab7088-65c5-4daa-9eda-dcd17c1a39f5","collection_name":"contents","name":"gettyimages-1135309751","file_name":"gettyimages-1135309751.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":127505,"manipulations":[],"custom_properties":{"alt":"Gluten-free bread & bagels with 12 appetitizing toppings like avocado & olives, hummus & chickpeas, sliced hardboiled eggs & greens; concept is celiac disease"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15755,"created_at":"2024-11-06T10:00:03.000000Z","updated_at":"2024-11-06T10:00:06.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15838/gettyimages-1135309751.jpg"}],"primary_content_topic":{"id":28,"name":"Diseases & Conditions","slug":"diseases-and-conditions","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/diseases-and-conditions"}},{"id":18676,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Does drinking water before meals really help you lose weight?","short_title":"","subheading":"Why people think it does and what the evidence says.","summary":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","content":"

n n n

If you’ve ever tried to lose excess weight, you’ve probably gotten this advice: drink more water. Or perhaps it was more specific: drink a full glass of water before each meal.n

The second suggestion seems like a reasonable idea, right? If you fill your stomach with water before eating, you’ll feel fuller and stop eating sooner. But did that work for you? Would drinking more water throughout the day work? Why do people say drinking water can help with weight loss — and what does the evidence show?n
Stretching nerves, burning calories, and thirst versus hungern

Three top theories are:n

Feel full, eat less. As noted, filling up on water before meals has intuitive appeal. Your stomach has nerves that sense stretch and send signals to the brain that it’s time to stop eating. Presumably, drinking before a meal could send similar signals.n
n

The evidence: Some small, short-term studies support this idea. For example, older study subjects who drank a full glass of water before meals tended to eat less than those who didn’t. Another study found that people following a low-calorie diet who drank extra water before meals had less appetite and more weight loss over 12 weeks than those on a similar diet without the extra water. But neither study assessed the impact of drinking extra water on long-term weight loss.n n
Burning off calories. The water we drink must be heated up to body temperature, a process requiring the body to expend energy. The energy spent on this — called thermogenesis — could offset calories from meals.n
n

The evidence: Though older studies provided some support for this explanation, more recent studies found no evidence that drinking water burned off many calories. That calls the thermogenesis explanation for water-induced weight loss into question.n n
You’re not hungry, you’re thirsty. This explanation suggests that sometimes we head to the kitchen for something to eat when we’re actually thirsty rather than hungry. If that’s the case, drinking calorie-free water can save us from consuming unnecessary calories — and that could promote weight loss.n
n

The evidence: The regulation of thirst and hunger is complex and varies over a person’s lifespan. For example, thirst may be dulled in older adults. But I could find no convincing studies in humans supporting the notion that people who are thirsty misinterpret the sensation for hunger, or that this is why drinking water might help with weight loss.n n

Exercise booster, no-cal substitution, and burning fat demands watern

Being well-hydrated improves exercise capacity and thus weight loss. Muscle fatigue, cramping, and heat exhaustion can all be brought on by dehydration. That’s why extra hydration before exercise may be recommended, especially for elite athletes exercising in warm environments.n

n

The evidence: For most people, hydrating before exercises seems unnecessary, and I could find no studies specifically examining the role of hydration to exercise-related weight loss.n n
Swapping out high calorie drinks with water. Yes, if you usually drink high-calorie beverages (such as sweetened sodas, fruit juice, or alcohol), consistently replacing them with water can aid weight loss over time.n
n

The evidence: A dramatic reduction in calorie intake by substituting water for higher-calorie beverages could certainly lead to long-term weight loss. While it’s hard to design a study to prove this, indirect evidence suggests a link between substituting water for high-cal beverages and weight loss. Even so, just as calorie-restricting diets are hard to stick with over the long term, following a water-only plan may be easier said than done.n n
Burning fat requires water. Dehydration impairs the body’s ability to break down fat for fuel. So, perhaps drinking more water will encourage fat breakdown and, eventually, weight loss.n
n

The evidence: Though some animal studies support the idea, I could find no compelling evidence from human studies that drinking extra water helps burn fat as a means to lose excess weight.n n

The bottom linen

So, should you bump up hydration by drinking water before or during meals, or even at other times during the day?n

Some evidence does suggest this might aid weight loss, at least for some people. But those studies are mostly small or short-term, or based on animal data. Even positive studies only found modest benefits.n

That said, if you think it’s working for you, there’s little downside to drinking a bit more water, other than the challenge of trying to drink if you aren’t particularly thirsty. My take? Though plenty of people recommend this approach, it seems based on a theory that doesn’t hold water.","excerpt":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","alternate_summary":"n

If you’ve ever tried to lose weight, you’ve probably heard the advice to drink water before a meal because it makes you feel fuller and you’ll stop eating sooner. It seems like a reasonable idea — but does it work? And if it doesn’t, why do people think it does?n ","description":null,"supplemental_content":null,"author":null,"slug":"does-drinking-water-before-meals-really-help-you-lose-weight-202402203018","sort_date":"2024-02-20T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3018,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL022024","publication_date":"2024-02-20T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-02-19T10:00:03.000000Z","last_import_type":"insert","last_modified_date":"2024-02-18T05:00:00.000000Z","active":1,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":18676,"author_id":23,"sort_order":1}}],"contentable":{"id":3018,"comments_open":1,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:03.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":14938,"model_type":"AppModelsMarketingContent","model_id":18676,"uuid":"e88312cf-ca6d-425a-9113-34160d35cc3d","collection_name":"contents","name":"2000a249-a535-402b-bd6b-32311bd847c7","file_name":"2000a249-a535-402b-bd6b-32311bd847c7.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":71889,"manipulations":[],"custom_properties":{"alt":"A stream of water pouring into and splashing around a tall glass with ice against blue background; concept is water and weight"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":14874,"created_at":"2024-02-19T10:00:03.000000Z","updated_at":"2024-02-19T10:00:05.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/14938/2000a249-a535-402b-bd6b-32311bd847c7.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","slug":"staying-healthy","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/staying-healthy"}},{"id":18627,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Which migraine medications are most helpful?","short_title":"","subheading":"Drugs known as triptans came out on top, based on real-world data from some 278,000 migraine sufferers.","summary":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","content":"

n n n

If you suffer from the throbbing, intense pain set off by migraine headaches, you may well wonder which medicines are most likely to offer relief. A recent study suggests a class of drugs called triptans are the most helpful option, with one particular drug rising to the top.n

The study drew on real-world data gleaned from more than three million entries on My Migraine Buddy, a free smartphone app. The app lets users track their migraine attacks and rate the helpfulness of any medications they take.n

Dr. Elizabeth Loder, professor of neurology at Harvard Medical School and chief of the Division of Headache at Brigham and Women’s Hospital, helped break down what the researchers looked at and learned that could benefit anyone with migraines.n

What did the migraine study look at?n

Published in the journal Neurology, the study included self-reported data from about 278,000 people (mostly women) over a six-year period that ended in July 2020. Using the app, participants rated migraine treatments they used as "helpful," "somewhat helpful," or "unhelpful."n

The researchers looked at 25 medications from seven drug classes to see which were most helpful for easing migraines. After triptans, the next most helpful drug classes were ergots such as dihydroergotamine (Migranal, Trudhesa) and anti-emetics such as promethazine (Phenergan). The latter help ease nausea, another common migraine symptom.n

"I’m always happy to see studies conducted in a real-world setting, and this one is very clever," says Dr. Loder. The results validate current guideline recommendations for treating migraines, which rank triptans as a first-line choice. "If you had asked me to sit down and make a list of the most helpful migraine medications, it would be very similar to what this study found," she says.n

What else did the study show about migraine pain relievers?n

Ibuprofen, an over-the-counter pain reliever sold as Advil and Motrin, was the most frequently used medication in the study. But participants rated it "helpful" only 42% of the time. Only acetaminophen (Tylenol) was less helpful, helping just 37% of the time. A common combination medication containing aspirin, acetaminophen, and caffeine (sold under the brand name Excedrin) worked only slightly better than ibuprofen, or about half the time.n

When researchers compared helpfulness of other drugs to ibuprofen, they found:n

n

Triptans scored five to six times more helpful than ibuprofen. The highest ranked drug, eletriptan, helped 78% of the time. Other triptans, including zolmitriptan (Zomig) and sumatriptan (Imitrex), were helpful 74% and 72% of the time, respectively. In practice, notes Dr. Loder, eletriptan seems to be just a tad better than the other triptans.n
Ergots were rated as three times more helpful than ibuprofen.n
Anti-emetics were 2.5 times as helpful as ibuprofen.n n

Do people take more than one medicine to ease migraine symptoms?n

In this study, two-thirds of migraine attacks were treated with just one drug. About a quarter of the study participants used two drugs, and a smaller number used three or more drugs.n

However, researchers weren’t able to tease out the sequence of when people took the drugs. And with anti-nausea drugs, it’s not clear if people were rating their helpfulness on nausea rather than headache, Dr. Loder points out. But it’s a good reminder that for many people who have migraines, nausea and vomiting are a big problem. When that’s the case, different drug formulations can help.n

Are pills the only option for migraine relief?n

No. For the headache, people can use a nasal spray or injectable version of a triptan rather than pills. Pre-filled syringes, which are injected into the thigh, stomach, or upper arm, are underused among people who have very rapid-onset migraines, says Dr. Loder. "For these people, injectable triptans are a game changer because pills don’t work as fast and might not stay down," she says.n

For nausea, the anti-emetic ondansetron (Zofran) is very effective, but one of the side effects is headache. You’re better off using promethazine or prochlorperazine (Compazine), both of which treat nausea but also help ease headache pain, says Dr. Loder.n

Additionally, many anti-nausea drugs are available as rectal suppositories. This is especially helpful for people who have "crash" migraines, which often cause people to wake up vomiting with a migraine, she adds.n

What are the limitations of this migraine study?n

The data didn’t include information about the timing, sequence, formulation, or dosage of the medications. It also omitted two classes of newer migraine medications — known as gepants and ditans — because there was only limited data on them at the time of the study. These options includen

n

atogepant (Qulipta) and rimegepant (Nurtec)n
lasmiditan (Reyvow).n n
"But based on my clinical experience, I don’t think that any of these drugs would do a lot better than the triptans," says Dr. Loder.n

Another shortcoming is the study population: a selected group of people who are able and motivated to use a migraine smartphone app. That suggests their headaches are probably worse than the average person, but that’s exactly the population for whom this information is needed, says Dr. Loder.n

"Migraines are most common in young, healthy people who are trying to work and raise children," she says. It’s good to know that people using this app rate triptans highly, because from a medical point of view, these drugs are well tolerated and have few side effects, she adds.n

Are there other helpful takeaways?n

Yes. In the study, nearly half the participants said their pain wasn’t adequately treated. A third reported using more than one medicine to manage their migraines.n

If you experience these problems, consult a health care provider who can help you find a more effective therapy. "If you’re using over-the-counter drugs, consider trying a prescription triptan," Dr. Loder says. If nausea and vomiting are a problem for you, be sure to have an anti-nausea drug on hand.n

She also recommends using the Migraine Buddy app or the Canadian Migraine Tracker app (both are free), which many of her patients find helpful for tracking their headaches and triggers.","excerpt":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","alternate_summary":"n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.n ","description":null,"supplemental_content":null,"author":null,"slug":"which-migraine-medications-are-most-helpful-202402053014","sort_date":"2024-02-05T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3014,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL020524","publication_date":"2024-02-05T15:30:00.000000Z","last_review_date":null,"imported_at":"2024-02-09T10:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-02-05T05:00:00.000000Z","active":1,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-09T10:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":39,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":18627,"author_id":14,"sort_order":1}}],"contentable":{"id":3014,"comments_open":1,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-05T16:02:48.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":14819,"model_type":"AppModelsMarketingContent","model_id":18627,"uuid":"92a43219-7a59-4061-bcc2-50f48be5211c","collection_name":"contents","name":"86a58fef-cf16-4980-a584-708c1162bf0a","file_name":"86a58fef-cf16-4980-a584-708c1162bf0a.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":54680,"manipulations":[],"custom_properties":{"alt":"A head and shoulders view of a woman with eyes closed and storm clouds with lightening suggesting pain circling her head; concept is migraine "},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":14755,"created_at":"2024-02-05T16:02:48.000000Z","updated_at":"2024-02-05T16:02:50.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/14819/86a58fef-cf16-4980-a584-708c1162bf0a.jpg"}],"primary_content_topic":{"id":39,"name":"Pain","slug":"pain","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/pain"}},{"id":19230,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Want a calmer brain? Try this","short_title":null,"subheading":"Meditation alters areas of the brain that help cope with fear and anxiety.","summary":"

Meditation helps us calm the body and shift perspective, and certain types of it offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","content":"

rn rn rn
For neuroscientist Sara Lazar, a form of meditation called open awareness is as fundamental to her day as breathing.rn

"I just become aware that I am aware, with no particular thing that I focus on," explains Lazar, an associate researcher in the psychiatry department at Massachusetts General Hospital and assistant professor of psychology at Harvard Medical School. "This sort of practice helps me become more aware of the subtle thoughts and emotions that briefly flit by, that we usually ignore but are quite useful to tune into."rn

But meditation doesn’t just change your perspective in the moment. Some studies show certain types of meditation offer an array of benefits, from easing chronic pain and stress and lowering high blood pressure to helping to relieve anxiety and depression. And, as Lazar’s research has shown, meditation can actually change the structure and connectivity of brain areas that help us cope with fear and anxiety.rn

"It’s become really clear that all of our experiences shape our brain in one way or another," Lazar says. "A lot of people talk about meditation being a mental exercise. Just as you build your physical muscles, you can build your calm muscles. Meditation is a very effective way of training those muscles."rn

What counts as meditation?rn

More than you might have believed. An intriguing if somewhat perplexing aspect of meditation is that it encompasses a broad range of practices. "It’s clear what is not meditation, but there’s less consensus on what it is," Lazar says.rn

Open awareness, Lazar’s go-to meditation, joins other forms, including focused awareness, slow deep breathing, guided meditation, and mantra meditation, along with many variations. At their core, Lazar says, is an awareness of the moment, noticing what you’re experiencing and nonjudgmentally disengaging from intrusive thoughts that might interfere with your ability to attend to this task.rn

Meditation can also involve sitting with eyes closed and paying attention to your body and any sensations that are present. A regular meditation practice typically involves slowing down, breathing, and observing inner experience.rn

"Meditation can involve flickering candles, breath awareness, or mantras — all of these things," Lazar says. "But there’s definitely an element of focusing and regulating your attention."rn

A close look at how meditation alters the brainrn

Small MRI imaging studies have zeroed in meditation’s effects on the amygdala, an almond-shaped structure deep within the brain that processes fear and anxiety as well as other emotions.rn

Lazar and her colleagues have spent many years laying the groundwork to show how practicing mindfulness-based stress reduction (MBSR) alters the amygdala after only about two months. The MBSR practice in this research consisted of weekly group meetings and daily home mindfulness practices, including sitting meditation and yoga.rn

What has their research found?rn

One key study involved 26 people with high levels of perceived stress. After an eight-week regimen of MBSR, brain scans showed the density of their amygdalae decreased, and these brain changes correlated to lower reported stress levels.rn

Building on this, Lazar and colleagues designed a study that focused on 26 people diagnosed with generalized anxiety, a disorder marked by excessive, ongoing, and often illogical anxiety levels. The researchers randomized participants to either practice MBSR or receive stress management education. These participants were compared to 26 healthy participants.rn

In this first-of-its-kind research, participants were shown a series of images with angry or neutral facial expressions while their brain activity was gauged using functional MRI imaging. At the beginning of the study, anxiety patients showed higher levels of amygdala activation in response to neutral faces than healthy participants. This suggests a stronger fear response to a nonthreatening situation.rn

But after eight weeks of MBSR, MRI imaging showed increased connections between the amygdala and the prefrontal cortex, a brain area crucial to emotional regulation. The amygdalae in participants with generalized anxiety no longer displayed a fear response to neutral faces. These participants also reported their symptoms had improved.rn

"It seems meditation helps to down-regulate the amygdala in response to things it perceives to be threatening," Lazar says.rn

How can meditation benefits help us in daily life?rn

Lazar believes training your brain to stop and notice your thoughts in a slightly detached way can calm you amidst the muddle of work deadlines, family friction, or distressing news.rn

"That’s one of the biggest translations" of meditation to everyday benefits, she says. "The person or situation that is stressing you out won’t go away, but you can watch your reactivity to the situation in a mindful, detached way, which shifts your relationship to it."rn

"It’s not indifference," she adds. "It’s sort of like a bubble bursting — you realize you don’t need to keep going on this loop. Once you see that, it totally shifts your relationship to that reaction bubbling through your brain."rn

Want to try meditation — or expand your practice?rn

Haven’t tried meditating? To get started, Lazar recommends the Three-Minute Breathing Space Meditation. This offers a quick taste of meditation, walking you through three pared-down but distinct steps. "It’s simple, fast, and anyone can do it," she says.rn

Simple ways to expand this basic approach are:rn

rn

adding minutes, just as you might for exercisern
meditating outdoorsrn
pausing to notice how you feel after you meditate.rn rn
"Or try either doing a longer session or short hits throughout the day, such as a three-minute breathing break four to five times a day," Lazar suggests.rn

Another way to enhance your practice is to use ordinary, repetitive moments throughout the day — such as reaching for a doorknob — as a cue to pause for five seconds and notice the sensation of your hand on the knob.rn

"As you walk from your office to your car, for instance, instead of thinking of all the things you have to do, you can be mindful while you’re walking," Lazar says. "Feel the sunshine and the pavement under your feet. There are simple ways to work meditation into each day."","excerpt":"

Meditation helps us calm the body and shift perspective, and certain types of it offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","alternate_summary":"

Meditation helps us calm the mind and body and can offer an array of health benefits. What’s more, imaging research shows that meditation can change the structure and connectivity of brain areas to help us cope with fear and anxiety.","description":null,"supplemental_content":null,"author":null,"slug":"want-a-calmer-brain-try-this-202410293078","sort_date":"2024-10-29T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3078,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL103024","publication_date":"2024-10-29T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-10-29T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-10-28T04:00:00.000000Z","active":1,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-11-04T12:43:00.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":420,"cr_id":779,"featured":0,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Maureen Salamon","title":null,"first_name":"Maureen","middle_name":null,"last_name":"Salamon","suffix":null,"slug":"maureen-salamon","byline":"Executive Editor, Harvard Women's Health Watch","description":"

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has appeared in The New York Times, The Atlantic, CNN.com, WebMD, Medscape and HealthDay, among other major outlets. Maureen earned a BA in print journalism from Penn State University.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/MWQyHwiFAPooqhDKsjTfFjCCCoIooqQNLj1M7LRO.jpg","twitter_username":null,"sort_order":0,"created_at":"2022-02-24T21:39:38.000000Z","updated_at":"2022-07-17T15:04:53.000000Z","deleted_at":null,"pivot":{"content_id":19230,"author_id":420,"sort_order":1}}],"contentable":{"id":3078,"comments_open":1,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-11-04T12:43:51.000000Z","deleted_at":null,"media":[{"id":15834,"model_type":"AppModelsMarketingBlogPost","model_id":3078,"uuid":"3b6ce61c-4df5-410f-9bc2-4488a7a79d16","collection_name":"featured","name":"gettyimages-1304744681","file_name":"gettyimages-1304744681.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":463371,"manipulations":[],"custom_properties":[],"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15751,"created_at":"2024-11-04T12:43:51.000000Z","updated_at":"2024-11-04T12:43:54.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15834/gettyimages-1304744681.jpg"}]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15829,"model_type":"AppModelsMarketingContent","model_id":19230,"uuid":"945034ec-14b5-41ad-a905-a4fd5630052a","collection_name":"contents","name":"gettyimages-1494861266","file_name":"gettyimages-1494861266.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":102006,"manipulations":[],"custom_properties":{"alt":"An older man calmly meditatating while seated in a sunny spot with eyes closed and a slight smile; hanging flowers in the background"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15747,"created_at":"2024-10-28T17:26:19.000000Z","updated_at":"2024-10-28T17:26:21.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15829/gettyimages-1494861266.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}},{"id":18968,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Do tattoos cause lymphoma?","short_title":null,"subheading":"Recent headlines about a link between tattoos and cancer seem a lot more worrisome than warranted.","summary":"
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The number of adults in the US with at least one tattoo has risen dramatically in recent decades, so headlines about a study that found an association between having a tattoo and higher risk of lymphoma may have caused worry. But there's much more to the story than just the headlines.rnrnrnrnrn","content":"

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Not so long ago, a friend texted me from a coffee shop. He said, "I can't believe it. I'm the only one here without a tattoo!" That might not seem surprising: a quick glance around practically anywhere people gather shows that tattoos are widely popular.rnrn

Nearly one-third of adults in the US have a tattoo, according to a Pew Research Center survey, including more than half of women ages 18 to 49. These numbers have increased dramatically over the last 20 years: around 21% of US adults in 2012 and 16% of adults in 2003 reported having at least one tattoo.rnrn

If you're among them, some recent headlines may have you worried:rnrn

              Study Finds That Tattoos Can Increase Your Risk of Lymphoma (OnlyMyHealth)rnrn

              Getting a Tattoo Puts You At Higher Risk of Cancer, Claims Study (NDTV)rnrn

              Inky waters: Tattoos increase risk of lymphoma by over 20%, study says (Local12.com)rnrn

              Shocking study reveals tattoos may increase risk of lymphoma by 20% (Fox News)rnrn

What study are they talking about? And how concerned should you be? Let's go through it together. One thing is clear: there's much more to this story than the headlines.rnrn

Why are researchers studying a possible link between tattoos and lymphoma?rnrn

Lymphoma is a type of cancer that starts in the lymphatic system, a network of vessels and lymph nodes that twines throughout the body. With about 90,000 newly diagnosed cases a year, lymphoma is one of the most common types of cancer.rnrn

Risk factors for it include:rnrn

rnt

advancing agernt
certain infections (such as Epstein-Barr virus, HIV, and hepatitis C)rnt
exposure to certain chemicals (such as benzene, or possibly pesticides)rnt
family history of lymphomarnt
exposure to radiation (such as nuclear reactor accidents or after radiation therapy)rnt
having an impaired immune systemrnt
certain immune diseases (such as rheumatoid arthritis, Sjogren's disease, or celiac disease).rnrnrn
Tattoos are not known to be a cause or risk factor for lymphoma. But there are several reasons to wonder if there might be a connection:rnrn

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Ink injected under the skin to create a tattoo contains several chemicals classified as carcinogenic (cancer causing).rnt
Pigment from tattoo ink can be found in enlarged lymph nodes within weeks of getting a tattoo.rnt
Immune cells in the skin can react to the chemicals in tattoo ink and travel to nearby lymph nodes, triggering a bodywide immune reaction.rnt
Other triggers of lymphoma, such as pesticides, have a similar effect on immune cells in lymph nodes.rnrnrn

Is there a connection between tattoos and lymphoma?rnrn

Any potential connection between tattoos and lymphoma has not been well studied. I could find only two published studies exploring the possibility, and neither found evidence of a compelling link.rnrn

The first study compared 737 people with the most common type of lymphoma (called non-Hodgkin's lymphoma) with otherwise similar people who did not have lymphoma. The researchers found no significant difference in the frequency of tattoos between the two groups.rnrn

A study published in May 2024 — the one that triggered the scary headlines above — was larger. It compared 1,398 people ages 20 to 60 who had lymphoma with 4,193 people who did not have lymphoma but who were otherwise similar. The study found thatrnrn

rnt

lymphoma was 21% more common among those with tattoosrnt
lymphoma risk varied depending on how much time had passed since getting the tattoo:rnt
rntt

within two years, lymphoma risk was 81% higherrntt
between three and 10 years, no definite increased lymphoma risk was detectedrntt
11 or more years after getting a tattoo, lymphoma risk was 19%rntrntrnrnrn
There was no correlation between the size or number of tattoos and lymphoma risk.rnrn

What else should you know about the study?rnrn

Importantly, nearly all of the differences in rates of lymphoma between people with and without tattoos were not statistically significant. That means the reported link between lymphoma and tattoos is questionable — and quite possibly observed by chance. In fact, some of the other findings argue against a connection, such as the lack of a link between size or number of tattoos and lymphoma risk.rnrn

In addition, if tattoos significantly increase a person's risk of developing lymphoma, we might expect lymphoma rates in the US to be rising along with the popularity of tattoos. Yet that's not the case.rnrn

Finally, a study like this one (called an association study) cannot prove that a potential trigger of disease (in this case, tattoos) actually caused the disease (lymphoma). There may be other factors (called confounders) that are more common among people who have tattoos, and those factors might account for the higher lymphoma risk.rnrn

Do tattoos come with other health risks?rnrn

While complication rates from reputable and appropriately certified tattooists are low, there are health risks associated with tattoos:rnrn

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infection, including bacterial skin infections or viral hepatitisrnt
allergic reactions to the inkrnt
scarringrnt
rarely, skin cancer (melanoma and other types of skin cancer).rnrnrn

The bottom linernrn

Despite headlines suggesting a link between tattoos and the risk of lymphoma, there's no convincing evidence it's true. We'll need significantly more research to say much more than that. In the meantime, there are more important health concerns to worry about and much better ways for all of us to reduce cancer risk.","excerpt":"

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The number of adults in the US with at least one tattoo has risen dramatically in recent decades, so headlines about a study that found an association between having a tattoo and higher risk of lymphoma may have caused worry. But there’s much more to the story than just the headlines.rn rn rn rn rn ","alternate_summary":"

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A recent study found an association between having a tattoo and a higher risk of lymphoma. Learn more about the evidence and potential health risks from tattoos.rnrnrnrnrn","description":null,"supplemental_content":null,"author":null,"slug":"do-tattoos-cause-lymphoma-202407193059","sort_date":"2024-07-19T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3059,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL071924","publication_date":"2024-07-19T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-07-19T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-07-17T04:00:00.000000Z","active":1,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-29T12:06:38.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":6,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":18968,"author_id":23,"sort_order":1}}],"contentable":{"id":3059,"comments_open":1,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-29T12:06:38.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15415,"model_type":"AppModelsMarketingContent","model_id":18968,"uuid":"8f10159d-b234-4a23-9f37-6ff59e718593","collection_name":"contents","name":"2acee670-1e43-413e-a07b-437512d22803","file_name":"2acee670-1e43-413e-a07b-437512d22803.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":66764,"manipulations":[],"custom_properties":{"alt":"A light shining on a black and dark blue sign that says "Tatooo" in white letters and has an arrow pointing to a doorway"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15345,"created_at":"2024-07-18T09:00:03.000000Z","updated_at":"2024-07-18T09:00:06.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15415/2acee670-1e43-413e-a07b-437512d22803.jpg"}],"primary_content_topic":{"id":6,"name":"Cancer","slug":"cancer","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/cancer"}},{"id":18836,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"PTSD: How is treatment changing?","short_title":null,"subheading":"New PTSD guidelines highlight targeted psychotherapy and caution about common anti-anxiety drugs and cannabis.","summary":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","content":"rn

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Over the course of a lifetime, as many as seven in 10 adults in the United States will directly experience or witness harrowing events. These include gun violence, car accidents, and other personal trauma; natural or human-made disasters, such as Hurricane Katrina and the 9/11 terrorist attacks; and military combat. And some — though not all — will experience post-traumatic stress disorder, or PTSD.rn

New guidelines released in 2024 can help guide effective treatment.rn

What is PTSD?rn

PTSD is a potentially debilitating mental health condition. It’s marked by recurrent, frightening episodes during which a person relives a traumatic event.rn

After a disturbing event, it’s normal to have upsetting memories, feel on edge, and have trouble sleeping. For most people, these symptoms fade over time. But when certain symptoms persist for more than a month, a person may be experiencing PTSD.rn

These symptoms includern

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recurring nightmares or intrusive thoughts about the eventrn
feeling emotionally numb and disconnectedrn
withdrawing from people and certain situationsrn
being jumpy and on guard.rn rn
The National Center for PTSD offers a brief self-screening test online, which can help you decide whether to seek more information and help.rn

Who is more likely to experience PTSD?rn

Not everyone who experiences violence, disasters, and other upsetting events goes on to develop PTSD. However, military personnel exposed to combat in a war zone are especially vulnerable. About 11% to 20% of veterans who served in Iraq or Afghanistan have PTSD, according to the National Center for PTSD.rn

What about people who were not in the military? Within the general population, estimates suggest PTSD occurs in 4% of men and 8% of women — a difference at least partly related to the fact that women are more likely to experience sexual assault.rn

What are the new guidelines for PTSD treatment?rn

Experts from the U.S. Department of Veterans Affairs and Department of Defense collaborated on new guidelines for treating PTSD. They detailed the evidence both for and against specific therapies for PTSD.rn

Their findings apply to civilian and military personnel alike, says Dr. Sofia Matta, a psychiatrist at Harvard-affiliated Massachusetts General Hospital and senior director of medical services at Home Base, a nonprofit organization that provides care for veterans, service members, and their families.rn

The circle of care is widely drawn for good reason. "It’s important to recognize that PTSD doesn’t just affect the person who is suffering but also their families and sometimes, their entire community," Dr. Matta says. The rise in mass shootings in public places and the aftermath of these events are a grim reminder of this reality, she adds.rn

Which treatment approaches are most effective for PTSD?rn

The new guidelines looked at psychotherapy, medications, nondrug therapies. Psychotherapy, sometimes paired with certain medicines, emerged as the most effective approach.rn

The experts also recommended not taking certain drugs due to lack of evidence or possible harm.rn

Which psychotherapies are recommended for PTSD?rn

The recommended treatment for PTSD, psychotherapy, is more effective than medication. It also has fewer adverse side effects and people prefer it, according to the guidelines.rn

Which type of psychotherapy can help? Importantly, the most effective therapies for people with PTSD differ from those for people with other mental health issues, says Dr. Matta.rn

Both cognitive processing therapy and prolonged exposure therapy were effective. These two therapies teach people how to evaluate and reframe the upsetting thoughts stemming from the traumatic experience. The guidelines also recommend mindfulness-based stress reduction, an eight-week program that includes meditation, body scanning, and simple yoga stretches.rn

Which medications are recommended for PTSD?rn

Some people with severe symptoms need medication to feel well enough to participate in therapy. "People with PTSD often don’t sleep well due to insomnia and nightmares, and the resulting fatigue makes it hard to pay attention and concentrate," says Dr. Matta.rn

Three medicines commonly prescribed for depression and anxiety — paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor) — are recommended. Prazosin (Minipress) may help people with nightmares, but the evidence is weak.rn

Which medications are not recommended for PTSD?rn

The guidelines strongly recommended not taking benzodiazepines (anti-anxiety drugs often taken for sleep). Benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin) offer no proven benefits for people with PTSD. They have several potential harms, including negative cognitive changes and decreased effectiveness of PTSD psychotherapies.rn

What about cannabis, psychedelics, and brain stimulation therapies?rn

Right now, evidence doesn’t support the idea that cannabis helps ease PTSD symptoms. And there are possible serious side effects from the drug, such as cannabis hyperemesis syndrome (severe vomiting related to long-term cannabis use).rn

There isn’t enough evidence to recommend for or against psychedelic-assisted therapies such as psilocybin (magic mushrooms) and MDMA (ecstasy). "Because these potential therapies are illegal under federal law, the barriers for conducting research on them are very high," says Dr. Matta. However, recent legislative reforms may make such studies more feasible.rn

Likewise, the evidence is mixed for a wide range of other nondrug therapies, such as brain stimulation therapies like repetitive transcranial magnetic stimulation or transcranial direct current stimulation.rn ","excerpt":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","alternate_summary":"

PTSD (post-traumatic stress disorder) is a potentially debilitating mental health condition marked by recurrent, frightening episodes during which a person relives a traumatic event. Newly released guidelines can help guide treatment; they recommend which therapies are most effective, and which are not recommended.","description":null,"supplemental_content":null,"author":null,"slug":"ptsd-how-is-treatment-changing-202405153041","sort_date":"2024-05-15T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3041,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL051524","publication_date":"2024-05-15T04:00:00.000000Z","last_review_date":null,"imported_at":"2024-05-17T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-05-16T04:00:00.000000Z","active":1,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-08-12T14:13:21.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, Harvard Heart Letter","description":"

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2023-05-12T20:42:51.000000Z","deleted_at":null,"pivot":{"content_id":18836,"author_id":14,"sort_order":1}}],"contentable":{"id":3041,"comments_open":1,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-08-12T14:13:21.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15204,"model_type":"AppModelsMarketingContent","model_id":18836,"uuid":"a383b83f-562c-47f3-9347-49ef98964710","collection_name":"contents","name":"ba14ccdc-4bea-4260-9fb1-2465775b9662","file_name":"ba14ccdc-4bea-4260-9fb1-2465775b9662.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":99638,"manipulations":[],"custom_properties":{"alt":"A while spiral notebook with words related to PTSD written on it, such as depression, fear, anxiety, negative thoughts); desk also has pen and coffee cup"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15136,"created_at":"2024-05-14T09:00:02.000000Z","updated_at":"2024-05-14T09:00:05.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15204/ba14ccdc-4bea-4260-9fb1-2465775b9662.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}},{"id":18769,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Concussion in children: What to know and do","short_title":"","subheading":"Expert advice on how to help children and teens recover from concussion has changed in recent years.","summary":"n

Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","content":"

n n n
Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. It is a particular kind of injury that happens when a blow to the head or somewhere else on the body makes the brain move back and forth within the skull.n

It’s possible to get a concussion after what might seem like a minor injury, like a forceful push from behind, or a collision between two players in a football or soccer game.n

What are the signs and symptoms of concussion?n

Because the injury may not seem that significant from the outside, it’s important to know the symptoms of a concussion. There are many different possible symptoms, includingn

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passing out (this could be a sign of a more serious brain injury)n
headachen
dizzinessn
changes in visionn
feeling bothered by light or noisen
confusion or feeling disorientedn
memory problems (such as difficulty remembering details of the injury) or difficulty concentratingn
balance or coordination problemsn
mood changes.n n
Some of these are visible to others and some are felt by the person with the concussion. That’s why it’s important to know the signs and to ask all the right questions of a child who has had an injury.n

Sometimes the symptoms might not be apparent right away, but show up in the days following the injury. The CDC’s Heads Up website has lots of great information about how to recognize a concussion.n

How can further harm to the brain be avoided?n

The main reason it’s important to recognize a possible concussion early is that the worst thing you can do after getting a concussion is get another one. The brain is vulnerable after a concussion; if it is injured again, the symptoms can be longer lasting — or even permanent, as in cases of chronic traumatic encephalopathy (CTE), a condition that has been seen in football players and others who have repeated head injuries.n

If there is a chance that a child has had a concussion during a sports competition, they must stop playing — and get medical attention. It’s important to get medical attention any time there is concern about a possible concussion, both to be sure there isn’t a more serious brain injury, and to do a good assessment of the symptoms, so that they can be monitored over time. There are some screening questionnaires that are used by doctors that can be used again in the days and weeks after the concussion to see how the child is improving.n

What helps children recover after a concussion?n

Experts have struggled with figuring out how to protect the brain after a concussion. For a long time, the recommendation was to rest and do very little at all. This meant not doing any exercise, not going to school, not even reading or watching television. As symptoms improved, the restrictions were lifted gradually.n

Over time, though, research showed that not only was this much rest not necessary, it was counterproductive. It turns out that getting kids back into their daily lives, and back into being active, is safe and leads to quicker recovery. Experts still recommend rest and then moving gradually back into activities, but the guidelines are no longer as strict as they once were.n

One important note: A medical professional should guide decisions to move from rest to light activity, and then gradually from there to moderate and then regular activities based on how the child is doing. This step-by-step process may extend for days, weeks, or longer, depending on what the child needs. Parents, coaches, and schools can help support a child or teen as they return to school and return to activities and sports.n

Some children will be able to get back into regular activities quickly. But for others it can take weeks or even months. Schools and sports trainers should work with children to support them in their recovery. Some children develop post-concussive syndromes with headache, fatigue, and other symptoms. This is rare but can be very disabling.n

How can parents help prevent concussions?n

It's not always possible to prevent concussions, but there are things that parents can do:n

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Be sure that children use seat belts and other appropriate restraints in the car.n
Have clear safety rules and supervise children when they are playing, especially if they are riding bikes or climbing in trees or on play structures.n
Since at least half of concussions happen during sports, it’s important that teams and coaches follow safety rules. Coaches should teach techniques and skills to avoid dangerous collisions and other injuries. Talk to your child’s coaches about what they are doing to keep players safe. While helmets can prevent many head injuries, they don’t prevent concussions.n ","excerpt":"n
Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","alternate_summary":"n

Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. Understanding signs, symptoms, questions to ask, and how concussion care has changed in recent years can make a difference in identifying concussion and recovery.n ","description":null,"supplemental_content":null,"author":null,"slug":"concussion-in-children-what-to-know-and-do-202404123032","sort_date":"2024-04-12T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3032,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041224","publication_date":"2024-04-12T10:30:00.000000Z","last_review_date":null,"imported_at":"2024-04-12T09:00:04.000000Z","last_import_type":"update","last_modified_date":"2024-04-11T04:00:00.000000Z","active":1,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-12T09:00:04.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":24,"ecommerce_type":"CATALOG","authors":[{"id":46,"cr_id":4,"featured":0,"hhp_staff":1,"editorial_board":0,"hidden":0,"name":"Claire McCarthy, MD","title":null,"first_name":"Claire","middle_name":null,"last_name":"McCarthy","suffix":"MD","slug":"claire-mccarthy-md","byline":"Senior Faculty Editor, Harvard Health Publishing","description":"Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy writes about health and parenting for Boston Children’s Hospital, Boston.com, and the Huffington Post.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/mvCBqecmOmDXOhy74hH3DviJmMAprZqhFgGbhTJL.jpg","twitter_username":null,"sort_order":5,"created_at":"2021-05-11T10:23:17.000000Z","updated_at":"2024-04-10T21:36:29.000000Z","deleted_at":null,"pivot":{"content_id":18769,"author_id":46,"sort_order":1}}],"contentable":{"id":3032,"comments_open":1,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-11T17:58:34.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15118,"model_type":"AppModelsMarketingContent","model_id":18769,"uuid":"3a5c62e4-3dce-475d-95bf-43095fab2ae4","collection_name":"contents","name":"7046141e-2210-416a-a9a8-8790bf65693e","file_name":"7046141e-2210-416a-a9a8-8790bf65693e.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":50504,"manipulations":[],"custom_properties":{"alt":"Illustration of a tiny person with black hair putting two crossed bandages on a large, pink injured brain; concept is concussion"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15050,"created_at":"2024-04-11T17:57:32.000000Z","updated_at":"2024-04-11T17:57:33.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15118/7046141e-2210-416a-a9a8-8790bf65693e.jpg"}],"primary_content_topic":{"id":24,"name":"Child & Teen Health","slug":"child-and-teen-health","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/child-and-teen-health"}},{"id":19225,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Ever hear of tonsil stones?","short_title":"","subheading":"They’re a common cause of bad breath and sore throats &mdash; and apparently a well-kept secret.","summary":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","content":"

n n n

Recently, a friend asked me about tonsil stones. He has sore throats several times a year, which are instantly relieved by gargling to remove them. When I told him I thought tonsil stones were pretty rare, he asked: "Are you sure about that? My ear, nose, and throat doctor says they’re common as rocks." (Get it? stones? rocks?)n

It turns out, my friend and his doctor are on to something. Tonsil stones are surprisingly common and often quite annoying. Here’s what to know and do.n

What are tonsil stones?n

Tonsil stones (medical term: tonsilloliths) are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations called crypts.n

They vary considerably between people, including:n

n

Size. They may be so small that you can’t see them with the naked eye. Or they may grow to the size of gravel or, rarely, much larger.n
Consistency. They’re often soft but may calcify, becoming hard as a rock. Hence, the name.n
How long they last. Tonsil stones can last days to weeks, or may persist far longer before they break up and fall out.n
How often they occur. New tonsilloliths may appear several times each month or just once or twice a year.n n
While they’re more likely to form if you have poor oral hygiene, good oral hygiene doesn’t provide complete protection. Even those who brush, floss, and see their dentists regularly can develop tonsil stones.n
How common are tonsil stones?n

You’ve heard of kidney stones and gallstones, right? Clearly, those conditions are better known than tonsil stones. Yet tonsil stones are far more common: studies suggest that up to 40% of the population have them. Fortunately, unlike kidney stones and gallstones, tonsil stones are usually harmless.n

What are the symptoms of tonsil stones?n

Often people have no symptoms. In fact, if tonsil stones are small enough, you may not even know you have them. When tonsil stones do cause symptoms, the most common ones are:n

n

sore throat, or an irritation that feels as though something is stuck in the throatn
bad breathn
coughn
discomfort with swallowingn
throat infections.n n

Who gets tonsil stones?n

Anyone who has tonsils can get them. However, some people are more likely than others to form tonsil stones, including those whon

n

have tonsils with lots of indentations and irregular surfaces rather than a smooth surfacen
smoken
drink lots of sugary beveragesn
have poor oral hygienen
have a family history of tonsil stones.n n

How are tonsil stones treated?n

That depends on whether you have symptoms and how severe the symptoms are.n

n

If you have no symptoms, tonsil stones may require no treatment.n
If you do have symptoms, gargling with salt water or removing tonsil stones with a cotton swab or a water flosser usually helps. Avoid trying to remove them with sharp, firm objects like a toothpick or a pen, as that can damage your throat or tonsils.n
If your tonsils are inflamed, swollen, or infected, your doctor may prescribe antibiotics or anti-inflammatory medications.n n

Is surgery ever necessary?n

Occasionally, surgery may be warranted. It’s generally reserved for people with severe symptoms or frequent infections who don’t improve with the measures mentioned above.n

Surgical options are:n

n

tonsillectomy, which is removing the tonsilsn
cryptolysis, which uses laser, electrical current, or radio waves to smooth the deep indentations in tonsils that allow stones to form.n n

Can tonsil stones be prevented?n

Yes, there are ways to reduce the risk that tonsil stones will recur. Experts recommend the following:n

n

Brush your teeth and tongue regularly (at least twice a day: in the morning and before sleep).n
Floss regularly.n
Gargle with salt water after eating.n
Eliminate foods and drinks that contain a lot of sugar, which feeds bacteria that can help stones form.n
Don’t smoke, because smoking irritates and inflames tonsils, which can encourage stone formation. The same may apply to vaping, though there is limited research to rely upon.n n

The bottom linen

Considering how common tonsil stones are and how bothersome they can be, it seems strange that they aren’t more well known. Maybe that’s because they often get better on their own, or people figure out how to deal with them without needing medical attention.n

I hope you aren’t one of the many millions of people bothered by tonsil stones. But if you are, it’s good to know that they’re generally harmless and can be readily treated and prevented.n

Now that you know more about them, feel free to spread the word: tonsil stones should be a secret no more.","excerpt":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","alternate_summary":"n

Tonsil stones are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations on the tonsils. While usually harmless, they can cause bad breath and sore throats.n ","description":null,"supplemental_content":null,"author":null,"slug":"ever-hear-of-tonsil-stones-202410213077","sort_date":"2024-10-21T04:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":3077,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL102124","publication_date":"2024-10-21T14:30:00.000000Z","last_review_date":null,"imported_at":"2024-10-22T09:00:03.000000Z","last_import_type":"update","last_modified_date":"2024-10-21T04:00:00.000000Z","active":1,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-22T09:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":28,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"editorial_board":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":4,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2024-10-16T13:48:13.000000Z","deleted_at":null,"pivot":{"content_id":19225,"author_id":23,"sort_order":1}}],"contentable":{"id":3077,"comments_open":1,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-21T13:25:14.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15823,"model_type":"AppModelsMarketingContent","model_id":19225,"uuid":"8aa0af7d-a96c-4c90-8c7d-550c1d9ee8f3","collection_name":"contents","name":"gettyimages-1317910199","file_name":"gettyimages-1317910199.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":24096,"manipulations":[],"custom_properties":{"alt":"Illustration of a woman with black hair pulled into a bun, head tipped back, gargling with salt water to relieve sore throat from tonsil stones"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15741,"created_at":"2024-10-21T13:25:14.000000Z","updated_at":"2024-10-21T13:25:15.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15823/gettyimages-1317910199.jpg"}],"primary_content_topic":{"id":28,"name":"Diseases & Conditions","slug":"diseases-and-conditions","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/diseases-and-conditions"}},{"id":16209,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Midlife ADHD? Coping strategies that can help","short_title":null,"subheading":"Tools, timers, and steps to take for staying organized.","summary":"

When ADHD persists through early adulthood into middle age, it presents many of the same challenges it does in childhood, but with added pressures from the busier pace of life and expectations from work and family. Fortunately there are strategies that can help you navigate this condition.","content":"

rn rn rn

Trouble staying focused and paying attention are two familiar symptoms of attention deficit hyperactivity disorder (ADHD), a common health issue among children and teens.rn

When ADHD persists through early adulthood and on into middle age, it presents many of the same challenges it does in childhood: it’s hard to stay organized, start projects, stay on task, and meet deadlines. But now life is busier, and often expectations from work and family are even higher. Fortunately, there are lots of strategies that can help you navigate this time in your life.rn

Staying organizedrn

Organizational tools are a must for people with adult ADHD. They’ll help you prioritize and track activities for each day or the coming weeks.rn

rn

Pick the right tools. Tools can include a pen and paper to make lists, or computer or smartphone apps to set appointment reminders, highlight important days on the calendar, mark deadlines, and keep lists and other information handy.rn
Schedule updates. Set aside time each day to update your lists and schedules. Don’t let the task become a chore in itself; think of it like a routine task such as brushing your teeth, and do it daily so it becomes an established habit.rn
Set a timer. And a word of caution: smartphones and computers can also turn into a distraction. If you have adult ADHD, you may find yourself spending hours looking at less useful apps or sites. If that’s a frequent trap for you, set a timer for each use or keep the phone off or in another room when you are trying to work.rn rn

Staying focusedrn

Just being organized doesn’t mean your work will get done. But a few simple approaches can at least make it easier to do the work.rn

rn

Declutter your home and office. Give yourself an appealing work environment and keep important items easily accessible.rn
Reduce distractions. This could mean changing your workstation so it doesn’t face a window, moving to a quieter space, or just silencing your smartphone and email alerts.rn
Jot down ideas as they come to you. You may have an "aha" moment for one task while you’re in the middle of another. That’s okay; just write down that thought and get back to it later, after your more pressing work is finished.rn rn

Meeting deadlinesrn

Deadlines pose two big challenges when you have adult ADHD. First, it’s hard to start a project, often because you want it to be perfect, or you’re intimidated by it so you put it off. Second, when you do start a project, it’s very easy to become distracted and leave the task unfinished.rn

How can you avoid these traps?rn

rn

Put off procrastinating. Put procrastination on your to-do list — like a chore — and fool yourself into actually starting your work.rn
Deal with emails, phone calls, or other matters as soon as you can. That way there will be fewer things hanging over your head and overwhelming you later on.rn
Be a clock watcher. Get a watch and get in the habit of using it. The more aware you are of time, the more likely you’ll be able to avoid spending too long on a task.rn
Take one thing at a time. Multitasking is overrated for everyone — and it’s a nightmare for people with adult ADHD. Focus on completing one task, then move on to the next.rn
Be realistic about your time. This can mean having to say no to new projects or other commitments.rn rn

Get more helprn

The ideas listed here can help you start coping with adult ADHD, but they may not be enough to help you overcome adult ADHD’s challenges.rn

Consider hiring an ADHD coach who can provide more strategies and give you additional tools to cope with your condition. Look for an ADHD coach who is a licensed mental health professional who specializes in treating ADHD, and may also have a certification in ADHD coaching from the ADHD Coaches Organization.","excerpt":"

When ADHD persists through early adulthood into middle age, it presents many of the same challenges it does in childhood, but with added pressures from the busier pace of life and expectations from work and family. Fortunately there are strategies that can help you navigate this condition.","alternate_summary":"

Trouble staying organized, starting projects, or meeting deadlines are just some of the challenges adults with ADHD face. Fortunately, there are strategies that can help.","description":null,"supplemental_content":null,"author":null,"slug":"midlife-adhd-coping-strategies-that-can-help-202102052381","sort_date":"2021-02-05T05:00:00.000000Z","contentable_type":"AppModelsMarketingBlogPost","contentable_id":2381,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL020521","publication_date":"2021-02-05T05:00:00.000000Z","last_review_date":"2024-10-18T04:00:00.000000Z","imported_at":"2024-10-17T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2024-10-16T04:00:00.000000Z","active":1,"created_at":"2021-02-05T11:30:08.000000Z","updated_at":"2024-10-28T12:26:06.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":21862,"hide_ads":0,"primary_content_topic_id":37,"ecommerce_type":"CATALOG","authors":[{"id":31,"cr_id":117,"featured":0,"hhp_staff":0,"editorial_board":0,"hidden":0,"name":"Heidi Godman","title":null,"first_name":"Heidi","middle_name":null,"last_name":"Godman","suffix":null,"slug":"heidi-godman","byline":"Executive Editor, Harvard Health Letter","description":"

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow of the American Academy of Neurology, and has been honored by the Associated Press, the American Heart Association, the Wellness Community, and other organizations for outstanding medical reporting. Heidi holds a bachelor of science degree in journalism from West Virginia University.","image_url":"https://d2icykjy7h7x7e.cloudfront.net/authors/jmHxTqYhe8m1bTrPQJnvY8odf8gsq1y1Q0i6Wp6Y.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:08:08.000000Z","updated_at":"2022-08-03T17:04:41.000000Z","deleted_at":null,"pivot":{"content_id":16209,"author_id":31,"sort_order":1}}],"contentable":{"id":2381,"comments_open":1,"created_at":"2021-05-11T11:08:33.000000Z","updated_at":"2024-10-28T12:26:06.000000Z","deleted_at":null,"media":[{"id":10411,"model_type":"AppModelsMarketingBlogPost","model_id":2381,"uuid":"62fcddd5-827f-4009-8894-fb55eae14f1e","collection_name":"featured","name":"GettyImages-1128675197","file_name":"GettyImages-1128675197.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":70265,"manipulations":[],"custom_properties":[],"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":10411,"created_at":"2021-05-11T11:08:34.000000Z","updated_at":"2021-06-23T14:36:24.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/10411/GettyImages-1128675197.jpg"}]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":15774,"model_type":"AppModelsMarketingContent","model_id":16209,"uuid":"cf8315a0-c31d-44d2-9268-cece85e8458d","collection_name":"contents","name":"gettyimages-1128675197","file_name":"gettyimages-1128675197.jpg","mime_type":"image/jpeg","disk":"s3","conversions_disk":"s3","size":44546,"manipulations":[],"custom_properties":{"alt":"A laptop sits on a desk alongside glasses, note pads, and a mug; multiple sticky notes in assorted colors are stuck to the wall adjacent to the desk."},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":15692,"created_at":"2024-10-16T17:30:06.000000Z","updated_at":"2024-10-16T17:30:08.000000Z","full_url":"https://domf5oio6qrcr.cloudfront.net/medialibrary/15774/gettyimages-1128675197.jpg"}],"primary_content_topic":{"id":37,"name":"Mind & Mood","slug":"mind-and-mood","is_primary":1,"canonical":"https://www.health.harvard.edu/topics/mind-and-mood"}}], currentIndex: 0 }” x-on:slide-change.window=”currentIndex = $event.detail.currentIndex”>

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10 steps you may take that can assist you keep away from accidents.

E-bikes, e-scooters, and accidents

What did the examine discover?

What are the restrictions of this examine?

How are you going to keep away from e-bike or e-scooter accidents?

The underside line

Concerning the Creator

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Myth # 1: Celiac disease is usually diagnosed at a young agen

Myth #4: A gluten-free diet always relieves the symptoms and signs of celiac diseasen

Exercise booster, no-cal substitution, and burning fat demands watern

The bottom linen So, should you bump up hydration by drinking water before or during meals, or even at other times during the day?n

What did the migraine study look at?n

What counts as meditation?rn More than you might have believed. An intriguing if somewhat perplexing aspect of meditation is that it encompasses a broad range of practices. "It’s clear what is not meditation, but there’s less consensus on what it is," Lazar says.rn

What has their research found?rn

Want to try meditation &mdash; or expand your practice?rn

Why are researchers studying a possible link between tattoos and lymphoma?rnrn

Is there a connection between tattoos and lymphoma?rnrn Any potential connection between tattoos and lymphoma has not been well studied. I could find only two published studies exploring the possibility, and neither found evidence of a compelling link.rnrn

Do tattoos come with other health risks?rnrn

The bottom linernrn

Who is more likely to experience PTSD?rn

What are the new guidelines for PTSD treatment?rn

What about cannabis, psychedelics, and brain stimulation therapies?rn

What are the signs and symptoms of concussion?n Because the injury may not seem that significant from the outside, it’s important to know the symptoms of a concussion. There are many different possible symptoms, includingn

How can further harm to the brain be avoided?n

How can parents help prevent concussions?n It's not always possible to prevent concussions, but there are things that parents can do:n

What are tonsil stones?n

How common are tonsil stones?n

What are the symptoms of tonsil stones?n Often people have no symptoms. In fact, if tonsil stones are small enough, you may not even know you have them. When tonsil stones do cause symptoms, the most common ones are:n

Who gets tonsil stones?n Anyone who has tonsils can get them. However, some people are more likely than others to form tonsil stones, including those whon

How are tonsil stones treated?n

Is surgery ever necessary?n

Can tonsil stones be prevented?n Yes, there are ways to reduce the risk that tonsil stones will recur. Experts recommend the following:n

Staying organizedrn Organizational tools are a must for people with adult ADHD. They’ll help you prioritize and track activities for each day or the coming weeks.rn

Staying focusedrn Just being organized doesn’t mean your work will get done. But a few simple approaches can at least make it easier to do the work.rn

Recent Blog Articles

E-bikes, e-scooters, and accidents

What did the examine discover?

What are the restrictions of this examine?

How are you going to keep away from e-bike or e-scooter accidents?

The underside line

Concerning the Creator

Disclaimer:

Methodologyn

Myth # 1: Celiac disease is usually diagnosed at a young agen

Myth #4: A gluten-free diet always relieves the symptoms and signs of celiac diseasen

Exercise booster, no-cal substitution, and burning fat demands watern

The bottom linen So, should you bump up hydration by drinking water before or during meals, or even at other times during the day?n

What did the migraine study look at?n

What counts as meditation?rn More than you might have believed. An intriguing if somewhat perplexing aspect of meditation is that it encompasses a broad range of practices. "It’s clear what is not meditation, but there’s less consensus on what it is," Lazar says.rn

What has their research found?rn

Want to try meditation &mdash; or expand your practice?rn

Why are researchers studying a possible link between tattoos and lymphoma?rnrn

Is there a connection between tattoos and lymphoma?rnrn Any potential connection between tattoos and lymphoma has not been well studied. I could find only two published studies exploring the possibility, and neither found evidence of a compelling link.rnrn

Do tattoos come with other health risks?rnrn

The bottom linernrn

Who is more likely to experience PTSD?rn

What are the new guidelines for PTSD treatment?rn

What about cannabis, psychedelics, and brain stimulation therapies?rn

What are the signs and symptoms of concussion?n Because the injury may not seem that significant from the outside, it’s important to know the symptoms of a concussion. There are many different possible symptoms, includingn

How can further harm to the brain be avoided?n

How can parents help prevent concussions?n It's not always possible to prevent concussions, but there are things that parents can do:n

What are tonsil stones?n

How common are tonsil stones?n

What are the symptoms of tonsil stones?n Often people have no symptoms. In fact, if tonsil stones are small enough, you may not even know you have them. When tonsil stones do cause symptoms, the most common ones are:n

Who gets tonsil stones?n Anyone who has tonsils can get them. However, some people are more likely than others to form tonsil stones, including those whon

How are tonsil stones treated?n

Is surgery ever necessary?n

Can tonsil stones be prevented?n Yes, there are ways to reduce the risk that tonsil stones will recur. Experts recommend the following:n

Staying organizedrn Organizational tools are a must for people with adult ADHD. They’ll help you prioritize and track activities for each day or the coming weeks.rn

Staying focusedrn Just being organized doesn’t mean your work will get done. But a few simple approaches can at least make it easier to do the work.rn

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