The best treatment for high bilirubin depends on the underlying cause.
Treating High Bilirubin in Adults
Moderately high bilirubin levels, such as those below 4 mg/dL, don’t typically require treatment. Doctors will typically begin intervening when your levels are at or above 4 mg/dL. At this point, addressing underlying conditions, such as liver disease, can typically treat the root cause of high bilirubin.
If medications like rifampin (Rifadin) or probenecid are the cause, speak with your doctor about the possibility of switching to another drug. If high bilirubin is caused by an obstruction, such as gallstones, you may require an endoscopic procedure or surgery to prevent repeat bouts of elevated bilirubin or to lower already elevated levels.
Gilbert syndrome does not require treatment and isn’t considered dangerous. However, people with this condition can expect to have periodic bouts of high bilirubin, especially in times of physiologic stress, such as when fasting or exercising.
Treating High Bilirubin in Infants
High bilirubin is typically treated in infants using phototherapy. During the treatment, a healthcare provider will place the infant under a blue light to help flush bilirubin from their system. This treatment isn’t harmful to the infant and takes place over one to two days.
Keeping the infant hydrated, particularly if elevated bilirubin is caused by dehydration, can help treat high bilirubin. This can involve supplementing breast milk with bottle feeding or administering intravenous fluids. “Depending on where you are in the country, that can even be done at home, but in some places, that needs to happen in the hospital,” Guttman says. “Those are our first line interventions and for the vast majority of infants, that is enough.”
For infants with a high risk of hemolytic anemia, in which red blood cells are destroyed, doctors may use a therapy called intravenous immunoglobulin (IVIG). This involves giving the infant human antibodies from blood donations through an IV.
“IVIG can be helpful because it helps address the immunologic issue that is causing them to break down the red blood cells; that’s a limited number of patients, but it can be helpful for some babies,” Guttman says.
In extreme cases, in which levels are getting very high or the first lines of treatment are not working, a baby may need an exchange transfusion. This involves removing the baby’s blood and replacing it with a donor’s blood. “Most of the time we are able to manage with more conservative measures,” Guttman says.
High bilirubin levels do not cause long-term issues in the vast majority of infants. However, untreated severely high bilirubin levels can cause brain damage, hearing loss, and cerebral palsy. “It is exceedingly rare these days that it hits these levels because this is a very well-understood phenomenon,” Guttman says. “We are, at all costs, avoiding the levels getting to the point where it would cause that.”
A fever is a temporary rise in body temperature . It’s not considered an illness on its own, but rather a symptom that can be caused by many different conditions. Elevated body temperature can be a sign that the immune system is working — it’s most likely battling a type of infection or illness. Fevers usually aren’t a cause for serious concern, and they usually go away when the infection does. But extremely high fevers that won’t go down may need treatment. Here’s what you need to know about what temperature is considered a fever, common causes, at-home remedies, medications, and when to see the doctor.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb0aa1a9-973c-4426-bf5e-43d532662626
What Is Considered a Fever? What Is Fever? Since the mid-1800s, normal body temperature has been considered 98.6 degrees, though newer studies suggest that the average person now is a little cooler than that — somewhere between 97.5 and 97.9.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e23c73a2-ba7d-4c61-ad16-3fbc5987685f There are several ways to measure body temperature, so it’s important to read the instructions that come with the thermometer. First, wash your hands with soap and warm water, and clean the thermometer with rubbing alcohol or soap and lukewarm water. Wait to take your temperature until at least 30 minutes after you eat or drink anything hot or cold. Oral temperature: Turn on the digital thermometer and place the thermometer tip under your tongue. Close your mouth around the thermometer and keep it in place until the thermometer beeps. Ear temperature: Turn on the digital thermometer and gently place it into the ear canal as indicated by the instructions. Hold the thermometer tightly in place until you hear the thermometer beep. Temporal artery temperature: Turn on the digital thermometer and gently sweep it across your forehead or point it at the forehead. Armpit temperature: A digital (oral) thermometer can be used in your armpit, if necessary, but it won’t be as accurate as taking it orally under your tongue. Turn on the digital thermometer and put it under your armpit, making sure it touches skin, not clothing. Hold the thermometer tightly in place until you hear the thermometer beep.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291867be92-4c12-4d5b-a9c0-35841a6bf611 Rectal temperature : To take an infant or a child’s temperature rectally, use a thermometer specially made for that purpose, if possible. Follow the instructions to gently place the thermometer in the baby’s anus, and remove after it beeps. Most experts agree that a fever is 100.4 degrees and over, and that’s the same for adults and children. But kids get more frequent and higher fevers than adults. That’s because their immune systems are still developing, and so more germs trigger a reaction. Adults may already be immune to those infections.e60dc2a1-f33c-4a05-9b50-8e3e8e597629038c70d4-d5de-4c65-8139-c3da6aabff66
Signs and Symptoms of a Fever Symptoms Common symptoms accompanying a fever include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f2cfa9cc-d6af-4996-ac36-8c685505d7cd Elevated body temperature Sweating and chills Headache and muscle aches Fatigue and weakness Loss of appetite Dehydration
Common Causes of Fever Causes of Fever A fever can be a symptom of almost any illness. The most common infections that often come with a fever include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762919b73da7-9d84-42e8-8307-c1be7a9d464f Viral infections like the flu or COVID-19 Bacterial infections such as strep throat and some types of pneumonia Urinary tract infections (UTIs) Gastrointestinal (GI) infections, such as the stomach flu Skin infections, including cellulitis , which is caused when bacteria enter through a break in the skin. Non-infectious causes of a fever include: Heat exhaustion Certain inflammatory conditions such as rheumatoid arthritis A reaction to a medication or vaccination Cancer
When Is a Fever Considered Serious? When Is It Serious? Although fevers usually go away within a few days, there are signs that a fever could be more serious. Adults Adults with a fever should call 911 or be taken to the nearest emergency room if they also have one or more of the following signs or symptoms:e60dc2a1-f33c-4a05-9b50-8e3e8e59762916a842f3-d018-4393-8ef2-6e513d40a30e Seizure Loss of consciousness Confusion Trouble breathing Severe headache Stiff neck Severe pain in your belly, back, or sides Difficulty waking or extreme sleepiness Any other unusual or concerning symptom Infants and Children Call 911 or go to the closest ER if a child’s fever is accompanied by any of the following:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e4efe700-7676-448e-82bb-899ed6a35139 Crying inconsolably Difficult to wake up Stiff neck Red or purple spots on the skin Breathing is difficult and doesn’t improve after the nose is cleared Unable to swallow anything or drooling excessively Extreme sluggishness or drowsiness Pain or tenderness in the abdomen Dehydration or decreased urination Unusual behavior Convulsions or seizures In case of a seizure, put the child on their side. Do not put anything in their mouth. Infants younger than 3 months with fever need immediate medical evaluation even if they don’t display any other symptoms.
Home Remedies and Initial Treatments Home Remedies Fevers can often be managed at home with over-the-counter medications and comfort care. Effective at-home care tips for managing a fever include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e6591fa-d7ef-445f-921f-a23cbf973e1f Stay hydrated. You can get dehydrated more quickly if you’re not drinking fluids while you have a fever. Drink what sounds good to you, but avoid overconsuming caffeine. Rest and recover. Get plenty of rest and sleep to help your immune system fight off your illness. Cool your fever. Adults and older children can use a cold pack to reduce a fever, though it’s best not to use them on small children and babies, because they may be too cold for their sensitive skin. A cool, wet washcloth or a cool or room-temperature bath or shower can help, too. If cooling-down methods cause chills, don’t continue; it may make you or your child feel worse. Warm up if you have the shivers. It may seem counterintuitive, but it’s okay to use a blanket to help with your chills. But experts don’t recommend piling on blankets in an effort to “sweat it out.” That raises the risk of dehydration. Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen can lower a fever and help with symptoms like headaches or muscle aches. Aspirin can also help with fever, but it should not be given to children under 18, because it can cause Reye’s syndrome, a serious and potentially life-threatening condition. In children, don’t give any medication, even over-the-counter fever reducers, without getting your healthcare provider’s okay first. For adults and children, follow the dosing instructions on the label. Do not take more than recommended.
When to See a Doctor When to See a Doctor Rest and fluids are often enough until the fever breaks, but there are situations when you should contact your healthcare provider. Adults Adults with a fever should see a healthcare provider in the following situations: The fever lasts several days or keeps coming back.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ab0669e-02b8-4065-848f-a82631a63100 The fever doesn’t respond to fever-reducing medications. You’re unable to eat or drink without vomiting. You recently traveled to an area where a serious infectious disease such as malaria is common.e60dc2a1-f33c-4a05-9b50-8e3e8e59762987397d66-ad03-4383-a0e9-677ad1f5bd49 You take immunosuppressant medications. You had a recent tick bite . You had a recent hospital stay or a recent surgery or another medical procedure. You get infections often. You have a serious health condition, such as diabetes, heart disease, cancer, lupus , or sickle cell anemia . You’re on chemotherapy and your temperature goes above 100.4 for longer than one hour, or above 101 degrees — even just one time.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d26109d6-7316-4245-88c5-5574d6ebc963 Infants and Children Nonurgent signs and symptoms in infants and children that should be checked by a healthcare provider include the following:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ee629346-1575-4745-ab9f-fbc7115d3aca Infants up to 3 months with a temperature of 100.4 or higher. Fever in infants younger than 3 months could indicate a serious infection.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cf2dabcd-0724-4b27-b284-8bcd779bfc16 Children older than 3 months who have a fever of 100.4 or higher for more than three days or who are ill and acting sick by being fussy, clingy, or refusing to drink fluids Temperature of 104 or greater or if the fever doesn’t come down with a fever-reducing medicine Fever that lasts more than 5 days Recurrent fever without any other symptoms for more than 7 days, even if the fevers last only a few hours Fever and a chronic medical problem such as heart disease, cancer, lupus, or sickle cell anemia
Prevention Tips and Healthy Practices How to Prevent Fever Fevers are a part of life, but there are ways to reduce your chances of getting an infection or illness that have fever as a symptom. Prevention tips include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a730e4c4-055e-4832-be0c-d161a91424bb Adults and children should stay up-to-date on vaccinations as recommended for infectious diseases, such as influenza and COVID-19. Wash your hands frequently, especially before eating, after using the toilet, after spending time in a crowd or around someone who’s sick, after petting animals, and during or after travel on public transportation. Show children how to wash their hands thoroughly, lathering both the front and back of each hand with soap, and rinsing completely under running water. Use hand sanitizer when you don’t have access to soap and water. Try to avoid touching your nose, mouth, or eyes, especially during cold and flu season. Cover your mouth when you cough and your nose when you sneeze. Whenever possible, turn away from others, and cough or sneeze into your elbow. Avoid sharing cups, water bottles, and utensils.
The Takeaway A fever is typically a symptom of an underlying infection or illness and is usually not serious. Home remedies, such as good hydration, rest, and over-the-counter medications like ibuprofen or acetaminophen, can help manage a fever. In some cases, attention from a healthcare provider or even emergency medical care is necessary. Preventive measures like staying up-to-date on vaccinations, washing hands frequently, and avoiding close contact with sick people can reduce the likelihood of fevers caused by infections.
These 15 foods and beverages provide nutrients that can help your body heal. Some have the added benefit of being gentle on your gastrointestinal (GI) system, which may be helpful if your symptoms include nausea or stomachache.
1. Chicken Soup
Though there’s little concrete research on chicken soup’s healing potential, older studies have found that it may have an anti-inflammatory effect, helping the respiratory system fight off illness.
Amy Brownstein, RDN, a registered dietitian-nutritionist based in the San Francisco Bay Area, says chicken soup helps meet your nutritional needs when sick, since it contains electrolytes (minerals that regulate fluid levels and support other important functions), fluids, protein, vitamins (like vitamin A from carrots and B vitamins from wheat noodles), and minerals (like iron from the chicken).
2. Herbal Tea
Warm drinks are known for their soothing effects on sore throats, as they can help thin the post-nasal drip that causes irritation.
One good choice for a sore throat: herbal tea.
“Chamomile tea contains compounds that reduce inflammation and support sleep, while other teas like peppermint may provide relief from GI upset,” says Simran Malhotra, MD, a lifestyle medicine physician in Bethesda, Maryland. Meanwhile, ginger tea contains compounds that may fight bacteria and viral infections and reduce nausea.
3. Honey
Honey has antimicrobial and anti-inflammatory properties, making it helpful for decreasing throat irritation and mucus from coughing.
“Some research indicates that honey may be more effective than a cough medication in relieving symptoms in children with an acute cough,” says Brownstein. Still, higher-quality studies are needed to confirm, per the authors of a systematic review.
Note that honey should not be given to children younger than 1 year old.
4. Tuna
Canned tuna provides a quick, easy meal that’s rich in nutrients. “Packed with immune-supporting omega-3 fatty acids, protein, and vitamin D, tuna can help give your body what it needs to fight an infection and maintain good protein status,” says VenHuizen. (This means getting sufficient protein to meet your daily needs.)
A single can (142 grams) of tuna has 27 grams (g) of protein and 1.7 micrograms (mcg), or 8.5 percent of your daily value (DV), of vitamin D.
5. Wild Salmon
Besides boasting anti-inflammatory omega-3s, wild-caught salmon is an especially good source of vitamin D (nearly 8 mcg or 39 percent of DV per 3-ounce serving). “Vitamin D contributes to the body’s immune response and may reduce the risk of certain respiratory infections like colds,” Brownstein says.
6. Citrus Fruits
“Citrus fruits are rich in vitamin C, which boosts the immune system by reducing oxidative stress and may shorten the duration of colds,” Dr. Malhotra says. Oxidative stress occurs when there’s an imbalance of free radicals (unstable molecules) and antioxidants in your body. Since this can lead to cell damage, it can make you more susceptible to illness.
7. Turmeric and Ginger
Malhotra recommends using ginger and turmeric to help lower cold- and flu-related inflammation. “Ginger and the curcumin in turmeric have powerful anti-inflammatory and antioxidant effects that can help in recovery from respiratory illness,” she says. Foods like golden milk (a drink made of milk, turmeric powder, and other spices), spiced lentils, and curries can add more of these spices in your diet.
That said, turmeric supplements provide significantly more active compounds than the amount you’d get from foods. For the most impact, you may prefer to take this spice in supplement form. Fresh ginger and ginger supplements, on the other hand, offer comparable amounts of beneficial compounds, so you can stick with food sources, if preferred.
Consult your healthcare provider before taking any supplement to ensure it won’t interact with medications or health conditions.
8. Sauerkraut
If you can handle a potent flavor while you’re sick, try adding some sauerkraut to a sandwich or meat dish. “Fermented plant foods, such as sauerkraut, offer a good dose of probiotics and antioxidants, both of which may benefit the immune system,” VeHhuizen says. (Probiotics are microorganisms like bacteria and fungi that may offer health benefits when consumed.)
9. Yogurt
For probiotics in a milder flavor package, turn to yogurt. “Probiotics in yogurt support gut health, and much of your immune system is located in your gut,” Brownstein says. “Plus, yogurt is loaded with other nutrients like protein and vitamin D that assist your body in fighting illnesses,” she adds.
10. Berries
Berries may dial down the systemic inflammation at the root of an illness. “Berries like strawberries, blueberries, and blackberries are rich in antioxidants, which can support the immune system and help in recovery from a variety of infections or illnesses,” Malhotra says.
11. Tomatoes
Tomatoes, another anti-inflammatory power player, can be enjoyed raw, added to soups and sandwiches, or chopped into salsa. “They’re a great source of vitamin C and antioxidants, making them a good pick when you are sick,” VenHuizen says. One cup of chopped or sliced tomatoes provides nearly 25 mg or 27 percent of your DV of vitamin C.
12. Spinach
A spinach salad or pasta is an ideal food to eat when you have the flu. “As a significant source of vitamin E and magnesium, spinach may help soothe muscle aches,” Brownstein says. One cup of raw spinach provides 0.6 mg of vitamin E (4 percent DV) and nearly 24 mg of magnesium (6 percent DV).
Spinach also contains vitamin C (8.4 mg or more than 9 percent DV per cup), which works with vitamin E to help protect immune cells from damage and reduce inflammation, Brownstein notes.
13. Broccoli
“Broccoli is a great source of vitamin C, an essential nutrient for immune function,” Brownstein says. (One cup of chopped broccoli provides a whopping 81 mg, which is 90 percent of your DV). She notes that this veggie also contains the compound sulforaphane, which may help reduce the duration of cold symptoms.
14. Broth
VenHuizen says broth is one of the most hydrating foods for sickness. “Broth is a standout when it comes to immune support and recovering from illness,” she says. It provides fluids, vitamins, minerals, and antioxidants your body needs to feel better. “But most people love it simply because it’s warm and comforting,” VenHuizen notes.
15. BRAT Diet
This simple diet of bananas, rice, applesauce, and toast is a great option if you have diarrhea or nausea. As VenHuizen explains, these foods are easy to digest and less likely to provoke symptoms that make you feel worse.
However, note that the BRAT diet lacks vital nutrients and is only meant to be followed until diarrhea or nausea subsides — or for a day or two (at most).
In January 2018, Kelly Thomas was diagnosed with stage 3C triple-negative breast cancer, a rare and aggressive breast cancer type. At Thomas’s first oncology appointment, her doctor told her to prepare for the worst. “[It] was absolutely soul crushing,” says Thomas.
She immediately searched for other women with triple-negative breast cancer (TNBC) on social media, trying to find someone who could offer hope. “It was very hard to find someone with breast cancer, let alone triple-negative breast cancer — triple-negative is its own shade of pink. There was nothing for me. I couldn’t find my people,” Thomas says. But she didn’t give up.
As she went through IV chemotherapy, a double mastectomy, and radiation, Thomas continued to search for a group who would understand what she was going through. She found some helpful communities, but none that could speak to the specifics of triple-negative breast cancer.
We’re on a mission to make triple-negative breast cancer feel a little less lonely.
— Kelly Thomas
Thomas once dreamed of becoming a journalist, so she felt eager and comfortable sharing her diagnosis and treatment journey on social media. “It just felt natural to start counting chemos and share [my experience].”
“In 2019, I finally put together what I so desperately needed — I created TNBC Thrivers,” says Thomas. “My goal was that all the future Kelly Thomases would find the one story they could hold on to.” She wanted others with TNBC to say, ”If Kelly Thomas can beat this thing, I can beat this thing.”
Throughout 2019, Kelly attended breast cancer conferences to discover new ways to reach out to her TNBC community and provide more support. But then the COVID-19 pandemic hit, and lockdowns stopped her from growing the community in person. That’s when Thomas discovered Zoom. She bought an account, announced it on Instagram, and started a regular video chat named Thriver Thursday.
Her Zoom chats and Instagram community quickly grew popular, and soon, Thomas was recruited by another cancer organization to help with their community support. She worked with them for four years. After their partnership ended, Thomas’s husband encouraged her to throw all her efforts into TNBC Thrivers.
In June 2024, Thomas relaunched not only Thriver Thursday chats, but a website offering chats, webinars, events, and community support.
As we grow older, the chances we’ll develop stroke, dementia, and late-life depression increase. An extensive new scientific review has identified 17 modifiable risk factors that can affect the likelihood of these age-related brain diseases.
“By modifying any one of the factors, you may reduce your risk of all three conditions, and there are many behavioral and lifestyle changes people can make to achieve this,” says the principal investigator Sanjula Singh, MD, PhD, a physician-scientist and epidemiologist with the Brain Care Labs at Massachusetts General Hospital in Boston.
These are the 17 risk factors, in no particular order:
Blood pressure
Kidney disease
Body mass index (BMI)
Blood sugar
Alcohol use
Total cholesterol
Diet
Pain
Hearing loss or impairment
Physical activity
Purpose in life
Sleep
Smoking
Social engagement
Stress
Cognitive activity
Depressive symptoms
New Scientific Review Builds on Reams of Earlier Data
To arrive at this list, Dr. Singh and her team analyzed data from 59 previous studies. Each of those studies was itself a meta-analysis, based on an examination of data from a number of other prior independent studies.
Singh and her collaborators estimated that improvements to modifiable risk factors could prevent or slow at least 60 percent of strokes, 40 percent of dementia cases, and 35 percent of late-life depression cases.
The ultimate goal of identifying these risk factors, according to Singh, is “to help people take better care of their brains.” She says the results raise the question, “What are things that everybody can do on a daily basis that lower risk for not only dementia and stroke, but also late-life depression?”
High Blood Pressure Has the Biggest Impact on Brain Health as We Age
When assessing the 17 modifiable risk factors, high blood pressure (hypertension) emerged as the one with the biggest impact.
“The finding emphasizes that taking care of your blood pressure is one of the best things you can do for your brain,” says Singh.
That result was no surprise, according to Mitchell Elkind, MD, the chief clinical science officer at the American Heart Association. “Hypertension is the biggest risk factor for stroke,” says Dr. Elkind, who was not involved in the study. High blood pressure is responsible for about 50 percent of ischemic strokes (caused by a blocked blood vessel) and up to 80 percent of hemorrhagic strokes (caused by the rupture of a blood vessel in the brain), he explains.
“Growing evidence suggests that injury to the brain from stroke can lead to secondary neurodegeneration, inflammation, and blood brain barrier leakage that contribute to cognitive loss and dementia,” Elkind says.
High blood pressure can also damage small blood vessels in the brain, which likely contributes to depression as well.
Kidney Disease, Smoking, and Hearing Loss Are Also Cause for Concern
After blood pressure, kidney disease had the strongest association with these three age-related brain conditions. Kidney disease can cause changes in blood vessels, making them more prone to damage and blockages, disrupting blood flow to the brain.
Amanda Opaskar, MD, a clinical assistant professor in the division of vascular neurology at the Case Western Reserve University School of Medicine in Cleveland, flags tobacco use as another major risk factor among her patients.
“Some patients can appear really healthy with a normal BMI and good blood pressure, but then they exhibit stroke-like symptoms,” says Dr. Opaskar, who was not involved in the research. “Almost inevitably, their tobacco use is their main risk factor. Quitting smoking dramatically reduces the risk.”
Hearing loss is an underappreciated but very serious health concern, and linked more to dementia and depression than stroke, suggests Elkind.
“Hearing loss can lead to dementia and depression by limiting social connection or the input of information for the brain to process, leading to diminished neuronal activity,” he says. “People who can’t hear may become socially isolated and depressed, and without social interaction, their cognitive faculties decline.”
The Good News: You Have the Power to Lower These Risks
Singh urges people to use the list of 17 modifiable risk factors as a “menu,” from which they can choose factors to work on that best fit their lives.
“Exercise may not be feasible for you right now, for example, but maybe you can start to work on your dietary intake and eat more vegetables,” she says.
“Also, because a lot of these risk factors are interconnected, by working on one risk factor, you might actually improve a few others indirectly,” she notes.
The results do highlight exercise as a very significant factor to focus on. Plenty of previous research shows it provides a strong protective effect on health.
While this analysis is interpreted from a large body of prior research, it’s also limited because the findings are not directly determined from clinical trials following human participants. Opaskar underscores that the results indicate a link between the 17 risk factors and stroke, dementia, and depression — but they do not prove these factors cause age-related brain diseases.
3 Critical Ways to Keep the Brain Healthy
Are you motivated to make a change to improve your brain health? Consider these three important actions.
Get regular exercise. The American Heart Association recommends that adults get at least two and a half hours per week of moderate-intensity aerobic activity or an hour and 15 minutes per week of vigorous aerobic activity, or some combination of both, preferably spread throughout the week.
Opaskar advises people to choose exercise that they can tolerate: “If you have osteoarthritis or musculoskeletal pain, you can do low-impact activities like riding a recumbent bike or swimming.”
Follow a heart-healthy diet. To support heart health, the National Institutes of Health recommend a diet that emphasizes vegetables, fruits, whole grains, fish, poultry, beans, nuts, vegetable oils, and fat-free or low-fat dairy products. The diet should limit foods that are high in saturated fat and sodium.
Keep the brain stimulated. “I was surprised by the relative impact of leisure-time cognitive activity on overall brain health [in this study],” says Elkind. Pursuits that may strengthen the brain include reading, playing music, pursuing hobbies, and doing puzzles. “These activities are like exercise for the brain, the way physical activity is exercise for the body and muscles,” he says.
Dr. Geldsetzer and his collaborators were able to compare two groups of older adults who had nearly identical characteristics other than vaccination status because of an immunization program in Wales that began on September 1, 2013.
Under the program, which was designed to ration vaccine supply, anyone who was age 79 on that date was eligible for the vaccine for one year. People who were 80 or older on that date were out of luck — they would never become eligible. (As more people reached age 79 in the years to come, they would become eligible until they turned 80.)
The investigative team reviewed health records of over 280,000 individuals between ages 71 and 88 who did not have dementia at the start of the vaccination program. They focused their analysis, however, on those closest to either side of the eligibility threshold — comparing people who turned 80 in the week before September 1, 2013, with those who turned 80 in the week after.
The study took into account confounding factors that might have influenced dementia risk, such as use of preventive health services, past common disease diagnoses, and educational attainment. The scientists found the two groups to be indistinguishable in all characteristics.
“So, this is just like a randomized trial,” says Geldsetzer. “We have a vaccine-eligible and a vaccine-ineligible group for which we know that they should be on average similar to each other, and therefore good comparison groups, because all that’s different about these two groups is if they were born a few days earlier or a few days later.”
Results published this month in the journal Nature showed that the shingles vaccine reduced the probability of a new dementia diagnosis by 20 percent over a follow-up period of seven years.
Furthermore, the researchers noted that the effect of vaccination on dementia risk was much more pronounced in women than men.
“This could potentially be due to sex differences in the immune response or in the way in which dementia develops,” says Geldsetzer. “Women on average have higher antibody responses to vaccination, for example. We also know that both shingles and dementia are more common in women than in men.”
What Causes Shingles?
Shingles is caused by varicella-zoster, the same virus that causes chicken pox. After people contract chicken pox, usually in childhood, the virus stays dormant in the nerve cells for life. But in people who are older or have weakened immune systems, the virus can reactivate, attacking the nervous system and causing inflammation and potential nerve damage among other possible shingles complications.
In the United States, shingles vaccination is recommended for all healthy adults age 50 years and older, and for adults age 19 years and older who have weakened immune systems because of disease or treatment.
Shingrix vs. Zostavax
The only brand of shingles vaccine currently available in the United States is Shingrix. The vaccine used during this study was an older shot, Zostavax, that is no longer in use in the United States, points out Robert H. Hopkins Jr., MD, medical director of the National Foundation for Infectious Diseases (NFID).
Zostavax contained a weakened form of the live varicella-zoster virus. Shingrix works with an inactivated version of the virus, and it is considered to be more effective and longer-lasting than Zostavax.
Recent research indicates that Shingrix offers similar benefits to Zostavax regarding reduction in dementia risk, according to Dr. Hopkins, who was not involved in the study.
As to why the shot may have this positive effect on brain health, Hopkins speculates that immune system stimulation may be a factor, adding that more research is needed to explore this potential benefit.
“Shingles can have a devastating impact on a person’s health and quality of life,” he says. “ If the shingles vaccine also reduces the risk of dementia, that is one more important benefit that may improve the quality of life of many older persons.”
The recalled hot sauces were shipped to distributors and stores in California, Colorado, Connecticut, Illinois, Massachusetts, North Carolina, New Jersey, Ohio, Virginia, and Vermont.
The affected hot sauces should be thrown away or returned to where they were purchased for a refund.
Anyone with questions can contact Katerine Cardoso, the director of quality assurance at 336-231-6417 or by email at ContactUs@garnerfoods.com.
Tostitos Yellow Corn Tortilla Chips Recalled for Undeclared Milk Allergen
Frito-Lay today has recalled about 1,300 13-ounce (oz) bags of Tostitos Cantina Traditional Yellow Corn Tortilla Chips because they may contain nacho cheese tortilla chips, which would mean undeclared dairy. The recalled tortilla chips can pose a serious or life-threatening risk to people with an allergy or severe sensitivity to milk.
The specific manufacturing codes of affected chips can be found on the FDA’s website.
The recalled chips were shipped to grocery, convenience, and drugstores, as well as e-commerce distributors, in the following 13 states: Alabama, Florida, Georgia, Illinois, Indiana, Kentucky, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Virginia and West Virginia.
The chips would have been available for sale as early as March 7, 2025.
There have been no allergic reactions reported so far related to this recall. No other Tostitos products, flavors, sizes, or variety packs have been recalled.
Unless you are allergic or have a sensitivity to milk, the chips are safe to eat.
Anyone with questions can contact Frito-Lay at 800-352-4477.
Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.
A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.
Harper graduated magna cum laude from Furman University with a bachelor’s degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.
Harper volunteered for a five-year term on her medical school’s admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board’s medical disciplinary commission, on which she has served since 2015.
She and her husband are avid travelers and have been to over 55 countries and territories.
Despite modern advances in treatment and a greater openness for talking about mental health, people often misunderstand schizophrenia. Here’s what to know about the condition.
Truth: Schizophrenia Is Not the Same as Having a Split Personality
The number of episodes a person with schizophrenia experiences can vary, but there will be times when it’s better or worse. This is not the same as having a split personality. “Schizophrenia shows up when a person is having an episode. It can be episodic and relapsing-remitting,” explains Diane Solomon, PhD, a psychotherapist based in Portland, Oregon.
Kody Green
Living with schizophrenia
‘I’ve gotten a lot of misconceptions over the years about schizophrenia. … [Humor] helps me be able to still talk about these things but do it in a way that isn’t so traumatic.’
Transcript Available
Truth: Schizophrenia Is Not the Result of a ‘Bad’ Childhood
Like other mental health conditions, schizophrenia is caused by a complex combination of brain chemistry, environment, and genetic factors that are not yet fully understood by researchers. It is not due solely to poor parenting or a traumatic life event. But it does tend to run in families and is estimated to be 60 to 80 percent hereditary.
Truth: People With Schizophrenia Are Not Violent or Dangerous
While some people with schizophrenia may feel agitated during an episode, research shows the majority do not become violent. But taking steps to identify and avoid risk factors for violent behaviors, such as avoiding substance use, can also help prevent aggression.
Truth: You Can Work When You Have Schizophrenia
Although some may think that people who have schizophrenia are unpredictable and unreliable, “With excellent treatment, people with schizophrenia can have a job, a life, all the things,” says Dr. Solomon. And you can even ask for certain accommodations to help you be successful on the job.
Truth: There’s No Cure for Schizophrenia, But It Can Be Treated
A prompt diagnosis and treatment are crucial to managing schizophrenia. “Just like diabetes or high blood pressure, if you identify schizophrenia early and you do everything you can, it’s going to be a lot less severe,” Solomon notes. “The sooner we get a diagnosis and start treatment, the better.”
In fact, according to the World Health Organization, at least one-third of people with schizophrenia are able to experience a complete remission from symptoms. Research shows that sticking with your treatment plan can help improve the likelihood of remission and improve your overall quality of life.
While there’s currently no cure for PCOS, the symptoms can be managed with medications, lifestyle modifications, and, in rare cases, surgery. The right PCOS treatment method for you will depend on your symptoms and whether you’re planning to become pregnant.
Medication Options
Medications to help treat PCOS symptoms include:
Combined hormonal birth control pills: Birth control pills containing both estrogen and progestin help regulate your period and are the primary treatment for women with PCOS who are not trying to become pregnant. They can be used long term and may help reduce excess hair and acne, as well as decrease the risk of endometrial cancer.
Diabetes medications: Certain diabetes drugs, such as metformin, can be prescribed off-label to help your body respond to insulin, lose weight, decrease the risk of type 2 diabetes, and improve ovulation.
Anti-androgens: These medications can block the effects of excess androgens on your body, helping to decrease unwanted hair growth, reduce scalp hair loss, and improve acne.
Acne treatments: Retinoids, antibacterial agents, and antibiotics are all common medications used to treat acne.
It’s important to tell your doctor if you’re trying to become pregnant, as they can help advise you on the best medications for your situation. Women who are trying to conceive need to take a special approach to treating PCOS, because they will not be able to use hormonal birth control.
Treatments for Infertility
For many women, infertility is one of the most distressing complications of PCOS. Many women with PCOS do not naturally ovulate, or only ovulate irregularly, and will struggle to conceive without treatment.
A doctor may recommend the following treatments to start ovulation and improve your chances of becoming pregnant:
clomiphene (Serophene)
letrozole (Femara)
metformin (Glucophage)
gonadotropins
If you are overweight or have obesity, losing weight may also help improve your fertility.
If medications are unsuccessful, a doctor may recommend in vitro fertilization, or IVF. In this procedure, eggs are removed from the ovaries, fertilized outside of the body, and then placed into the uterus.
Complementary and Integrative Therapies
If you’re experiencing excess, bothersome hair growth as a PCOS symptom, there are many ways to remove it. You can shave, pluck, or wax hair as a temporary fix. For a longer-lasting option, you can also use laser hair removal. And to permanently remove hair, there’s electrolysis, which involves a trained professional using a small needle to destroy hair follicles.
Researchers are beginning to look into other complementary treatments, including vitamins and supplements, for managing PCOS symptoms. While available research is limited and more studies are needed to determine their benefits, the following therapies may be useful:
Vitamin D: Taking a vitamin D supplement may help improve insulin metabolism and regulate ovulation issues. Vitamin D also has anti-inflammatory properties, so it could help if you have low-grade inflammation.
Vitamin E: Some evidence suggests that vitamin E can improve blood sugar and cholesterol. It may also affect androgen hormones.
Acupuncture: This complementary therapy may benefit PCOS treatment by improving symptoms related to ovulation and period irregularities.
Probiotics and prebiotics: Your gut microbiome has a hand in many aspects of your health and is associated with PCOS. Prebiotics and probiotics can support a healthy gut, improve your hormones, and reduce inflammation.
Folic acid: Folic acid supplements have been shown to reduce body mass index in people with PCOS. Weight gain is a common symptom of PCOS.
Selenium: This supplement is an antioxidant and has anti-inflammatory properties. While selenium doesn’t seem to help with hormone imbalances, it may reduce cholesterol and insulin levels.
Be sure to contact a doctor before starting any new supplement, as it may interfere with the medications you’re already taking. Plus, your doctor can do a simple blood test to check your vitamin and mineral levels, showing where you may have a deficiency.
Surgery
Surgery to treat PCOS is rarely used.
However, your doctor might recommend an outpatient surgical procedure, known as ovarian drilling, if you want to become pregnant and medications are not helping you ovulate.
In this procedure, a surgeon will make a small incision in your belly and use tools to destroy some ovarian follicles and androgen-producing ovarian tissue. This can sometimes help improve ovulation and follicle maturation.
