Alpha-gal syndrome is the name for a red meat allergy that develops after a tick bite. Alpha-gal syndrome is rare. But as climate change leads to warmer winters and longer, hotter summers, tick populations are growing and spreading to new areas, increasing the threat of all tick-borne illnesses, including alpha-gal.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a40c109a-5369-4aec-98c2-a84ca69fca6e
Overview Overview What Is Alpha-Gal Syndrome? Alpha-gal syndrome (AGS) is a tick-borne condition in which people become allergic to galactose-α-1,3-galactose, also known as alpha-gal, a sugar found in the tissues of most mammals except for humans and primates. It’s also called mammalian meat allergy, alpha-gal allergy, red meat allergy, and tick bite meat allergy. Symptoms of alpha-gal syndrome can range from mild to severe. There is no cure but the syndrome often goes away or improves on its own within a year or two.e60dc2a1-f33c-4a05-9b50-8e3e8e597629918bbbec-0b53-42ee-a097-f9e6d4f70d05
Signs and Symptoms of Alpha-Gal Syndrome Symptoms Symptoms of alpha-gal typically occur two to six hours after red meat is consumed and include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762974eaf482-d0d1-4bba-b778-17d69621e118 Nausea Diarrhea Heartburn Hives Vomiting Abdominal cramps and pain Bloating Constipation Anaphylactic shock (a potentially deadly reaction) Women are more likely than men to report gastrointestinal symptoms, and nearly half of AGS patients experience at least one gastrointestinal symptom. Many people with alpha-gal don’t have a reaction every time they eat red meat.
Causes and Risk Factors of Alpha-Gal Syndrome Causes Scientists are still working to better understand alpha-gal syndrome, but they have identified a few factors that increase risk. Tick Bites In the United States, alpha-gal syndrome is primarily caused by the lone star tick, which can transfer the alpha-gal sugar molecule into the body. Some people have a strong immune response to these molecules and develop antibodies against them, leading to allergic reactions when eating red meat. Alpha-gal syndrome is more common in areas where lone star ticks are prevalent, such as the southeastern United States and parts of the mid-Atlantic. But because of the increasing prevalence of AGS beyond these areas, experts suspect that the syndrome could be caused by bites from other types of ticks, or by chiggers, a close relative of the tick.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292b110856-d7b5-478c-9fbe-5b21b16f9ff0 The Centers for Disease Control and Prevention (CDC) recently reported two cases of alpha-gal not caused by the lone star tick: one linked to a western black-legged tick, the second linked to a black-legged tick.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ddc9ded2-d788-494c-a0bd-df43c20ff712e60dc2a1-f33c-4a05-9b50-8e3e8e597629df8d54c4-1df9-4781-bfac-c095937c7c3b Outdoor Activities Spending time outdoors, especially near woodland areas, increases the likelihood of developing alpha-gal syndrome. Age People of any age can develop alpha-gal syndrome, but most cases have been in adults.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294ca7f755-2da9-4508-8a87-6161ae027a0b
How Is Alpha-Gal Syndrome Diagnosed? Diagnosis Alpha-gal syndrome is diagnosed by:e60dc2a1-f33c-4a05-9b50-8e3e8e5976292f5d1b47-a7f7-473a-8347-2d0125916a02 A physical exam A detailed patient history, including a thorough history of symptoms An immunoglobulin E test (IgE) to detect the allergic antibody In some cases, allergy skin testing AGS can be difficult to diagnose because some people who have it may not react to red meat every single time they eat it. It is often misdiagnosed as GI conditions like irritable bowel syndrome (IBS) .e60dc2a1-f33c-4a05-9b50-8e3e8e59762995a26252-c3e0-4926-a19d-f050b1a251df
Treatment and Medication Options for Alpha-Gal Syndrome Treatment There isn’t a cure for alpha-gal syndrome but there are ways to minimize symptoms. Allergy Medications Antihistamines can help people with mild reactions to eating red meat. Severe allergic reactions, such as anaphylaxis, may require epinephrine. Oral cromolyn solution may help with gastrointestinal symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ce0aab76-a029-4233-881b-b90fb25187b3 Dietary Changes This is the primary way of minimizing alpha-gal symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ce0aab76-a029-4233-881b-b90fb25187b3 Avoid red meat and mammalian products. This is crucial to prevent allergic reactions. This includes cutting out beef, pork, lamb, venison, goat, and rabbit. Avoid dairy products. Dairy products also contain the alpha-gal sugar, though at lower levels than meat. An estimated 5 to 20 percent of people with alpha-gal have allergic reactions to dairy. In people whose alpha-gal symptoms are not adequately controlled through meat avoidance alone, cutting out dairy may be necessary. Avoid gelatin. A small percentage of people with alpha-gal syndrome may have to limit foods that contain gelatin, an animal product, such as marshmallows, jelly beans, and Jell-O. Medication Avoidance Many medications contain ingredients derived from mammals. People with alpha-gal syndrome should avoid these medications and medical products:e60dc2a1-f33c-4a05-9b50-8e3e8e59762905943a54-46ca-4eb4-8228-0f4e4ecee017 Cetuximab (a chemotherapy drug) Gelatin-based colloid plasma substitute (used to treat hypovolemia, a condition in which there is a decrease in the volume of blood circulating in the body) Thyroid hormone supplements derived from cows or pigs Anti-snake venom therapy derived from horses or sheep A small number of people with AGS may need to additionally avoid the following animal-derived products: Heparin (a blood thinner) Pancreatic enzymes (derived from pigs) Gel capsules Vaccines that contain gelatin (such as the measles, mumps, and rubella [MMR] and yellow fever vaccines) Prosthetic heart valves from cows or pigs
Prevention of Alpha-Gal Syndrome Prevention Tick bite prevention is the best way to avoid getting alpha-gal.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a83fac6-aac5-44cf-9c40-0cbc5bbeb631e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff6d5eea-1b32-4cd3-94ea-3a657ef5750b Avoid ticks when possible. Don’t go off trails in wooded and grassy areas. Use insect repellant with at least 20 percent DEET. Apply permethrin products to clothing, or buy pretreated clothing. Check for ticks after outdoor activities, and if you have one, remove it immediately, using tweezers to grab the tick near its head or mouth. Wear protective clothing like long sleeves. Tuck socks into shoes and pants.
How Long Does Alpha-Gal Syndrome Last? Prognosis Alpha-gal syndrome can persist for years, but symptoms may improve or even go away entirely over time. Some people with alpha-gal syndrome can eat mammal food products again after one or two years, especially if they don’t get any more tick bites. The condition can return if a person is bitten again by a tick.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d368aa4-c759-4944-a152-4c7218e5b6e3 The overall outlook for alpha-gal syndrome is good if you follow your treatment plan and your health provider’s recommendations.e60dc2a1-f33c-4a05-9b50-8e3e8e59762998d5e76b-20f0-48ca-b709-5255b8ebfcd1
How Many People Have Alpha-Gal Syndrome? Prevalence Awareness of alpha-gal syndrome has grown in the past decade, but it can still be hard to diagnose, and so many cases might be missed. It’s estimated that between 96,000 and 450,000 people in the United States have been affected by AGS since 2010.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ca97a7ab-1566-4d25-bcb4-89c3f493d78e
The Takeaway Alpha-gal syndrome is a rare but serious allergy triggered by tick bites that can cause severe reactions to red meat and other mammalian foods. There is no cure for AGS, but people can minimize symptoms by avoiding mammalian meat and other foods and medicines derived from animal products. Prevent tick bites and alpha-gal infection by using bug repellents, avoiding outside activities in areas where ticks thrive, and checking for and removing ticks as soon as possible. If you suspect you have alpha-gal syndrome, it’s essential to get tested by an allergist and eliminate red meat from your diet to manage symptoms.
Resources We Trust Cleveland Clinic: Alpha-Gal SyndromeCenters for Disease Control and Prevention: Products That May Contain Alpha-GalYale Medicine: Alpha-Gal SyndromeUnited States Environmental Protection Agency: Tips to Prevent Tick BitesAmerican Gastroenterological Association: Diagnosis and Management of Alpha-Gal Syndrome
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5 Common Antipsychotic Side Effects and How to Cope With Them
Antipsychotics can be life-changing for anyone experiencing psychosis, including people with schizophrenia . But they can also come with challenging side effects.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294da2de8a-627d-4195-a820-dfce5c5b1ce9 Older, first-generation antipsychotics, like chlorpromazine (Thorazine) and haloperidol (Haldol), usually cause movement-related side effects, such as tremors, says Randall Turner, DO , a psychiatrist based in Southern California. Newer, second-generation antipsychotics like aripiprazole (Abilify) and olanzapine (Zyprexa) have a lower risk of movement-related side effects. But they can lead to weight gain and high blood sugar more often than first-generation antipsychotics, says Dr. Turner. A new class of antipsychotics called muscarinic agonists emerged in 2024 for the treatment of schizophrenia. Unlike other antipsychotics, muscarinic agonists don’t cause weight gain as a side effect, but they can cause side effects like nausea, constipation, high blood pressure, rapid heart rate, and acid reflux.e60dc2a1-f33c-4a05-9b50-8e3e8e59762993d006db-cee1-455d-97a3-2d9ec65f39f2e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ca80924-b89e-459c-ae81-7d9635fc8045 Antipsychotic side effects can be so bothersome that they may prompt some people to skip doses or give up on the medications altogether. “When patients experience significant side effects, they may stop taking their medication abruptly, increasing the risk of relapse, hospitalization, or worsening symptoms,” says Zishan Khan, MD , a psychiatrist based in Frisco, Texas. If you’re experiencing side effects, it’s important to let your provider know so you can find ways to manage them. Here are five of the most common side effects of antipsychotics and tips on how to cope with them.
1. Fatigue Fatigue Sleep problems like daytime fatigue are common among people with schizophrenia, and one reason is antipsychotic medication.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a046f02e-fa59-4475-b6ba-7429055690ff One of the most common side effects of antipsychotics is fatigue or sedation. Certain drugs, like olanzapine (Zyprexa) and chlorpromazine (Thorazine), are more likely to cause fatigue than others.e60dc2a1-f33c-4a05-9b50-8e3e8e59762945991598-0799-41f0-9cec-ba2c4a2ecdaa Fatigue and drowsiness can make it hard to function effectively at work, school, or other aspects of daily life, says Dr. Khan. To help you feel more alert while on antipsychotics, Turner recommends taking the medication at night instead of the morning if your provider approves. And if possible, work with your provider to avoid other medications that could cause drowsiness during waking hours and worsen fatigue.e60dc2a1-f33c-4a05-9b50-8e3e8e59762963305a7f-102b-407e-8b48-11cb61a7c35a In addition, following healthy sleep habits each night — such as going to bed and waking up at the same times each day and avoiding long naps during the day, which can impede your ability to fall asleep at night — can also help you manage daytime fatigue.e60dc2a1-f33c-4a05-9b50-8e3e8e597629210929fd-305a-43af-a898-fac427c5d28f Know that fatigue may improve as your body gets used to the medication.e60dc2a1-f33c-4a05-9b50-8e3e8e59762963305a7f-102b-407e-8b48-11cb61a7c35a If it doesn’t, your healthcare provider may be able to lower the dose or switch to a less sedating antipsychotic, says Turner.
2. Weight Gain Weight Gain As mentioned, second-generation antipsychotics are more likely than others to cause weight gain. They do this by making you hungrier and changing the way your body processes sugar. This side effect comes along with high blood sugar levels, increased risk of diabetes , and higher cholesterol, which can cause problems for your physical health, says Yalda Safai, MD , a psychiatrist based in New York City.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c4650f4b-9e7f-49b0-a87f-b15a90beddd9 “For weight gain and metabolic concerns, I recommend making small, sustainable lifestyle changes like eating more protein and fiber, cutting back on sugary drinks, and getting regular movement — even if it’s just a daily walk,” says Turner. Lifestyle changes like these can fight weight gain in the long run. If you’re having trouble making dietary changes for weight management, it could also help to meet with a registered dietitian-nutritionist (RDN), who could help you create a nutrition plan that meets your needs. You could also ask your provider about switching to another antipsychotic that causes less weight gain, says Khan. For some, adding metformin — a medication often used to treat diabetes — can slow weight gain, research suggests.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293f0fb2b4-e0e1-4bb6-8020-1cdca5456a1c
3. Extrapyramidal Symptoms Extrapyramidal Symptoms Extrapyramidal symptoms (EPS) refer to a range of movement-related issues. These can include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629c867af95-7984-4050-9d1f-9d8495159120e60dc2a1-f33c-4a05-9b50-8e3e8e597629b398c96a-dfde-4b2d-9e1d-9ae1f005ceec Involuntary muscle contractions (dystonia) Restlessness Tremors, stiffness, or slowed movements (Parkinsonism) Tardive dyskinesia , a condition involving repetitive, uncontrolled movements that can stick around even after you stop taking the medication.e60dc2a1-f33c-4a05-9b50-8e3e8e597629efd5c606-1c60-44a8-adc3-e3a42f762d0b These side effects are most common with long-term use of antipsychotics, often at high doses, says Khan. You can lessen your risk of EPS by avoiding substance use, quitting smoking , and ensuring you’re managing diabetes well if you have it. Smoking, substance use, and unmanaged diabetes are all factors that can raise your risk for EPS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ff382a2-f569-4afb-b058-eb64f875de28 If you already have EPS, you may need additional medication to manage it. Deutetrabenazine (Austedo) and valbenazine (Ingrezza) are standard-of-care medications that can help manage tardive dyskinesia and other EPS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d6427c7-21d7-408f-a28b-0b66b66e6b00 These medications work by altering levels of dopamine in the brain, which are thought to play a key role in involuntary movements.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292f6999ff-2a65-441b-ac2f-3203a61c6360 “Lowering the dose [of antipsychotics] or switching to a different medication may also be necessary,” Khan adds. Your provider needs to monitor you carefully for movement-related side effects, which makes consistent follow-up very important, Khan adds. But not all healthcare providers are familiar with EPS or how to manage it. If you feel these side effects aren’t being properly addressed, it could help to get a second opinion from another provider or ask for a referral to a movement disorder specialist.e60dc2a1-f33c-4a05-9b50-8e3e8e59762912a8e03a-d029-40e3-9f3f-0628030dcfe3
4. High Prolactin Levels High Prolactin Levels Prolactin , a hormone that develops breast tissue and triggers milk production, can increase with antipsychotics.e60dc2a1-f33c-4a05-9b50-8e3e8e59762993b04ec7-62b3-4954-a255-7267679c2a10 This rise is most common with risperidone (Risperdal), says Khan. High prolactin levels can cause enlarged breast tissue in men or women, irregular periods , and sexual dysfunction, says Khan.e60dc2a1-f33c-4a05-9b50-8e3e8e59762993b04ec7-62b3-4954-a255-7267679c2a10 For these symptoms, Khan recommends switching to a medication that doesn’t cause as much prolactin release, such as newer, second-generation antipsychotics. These side effects can feel isolating and discouraging, and it’s important to discuss them with your provider if you’re experiencing them, says Turner. “In some cases, lowering the dose or switching medications can help. It is a sensitive topic that’s absolutely worth bringing up,” he adds.
5. Anticholinergic Effects Anticholinergic Effects Antipsychotic medications cause anticholinergic effects, meaning they block cholinergic receptors that help control a wide range of body functions.e60dc2a1-f33c-4a05-9b50-8e3e8e59762908f350a4-762d-4baf-8862-40b5077a6c88 These effects can include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6459ff1-017f-4e1f-b41c-4a458e15c005 Dry mouth Constipation Urinary retention Blurred vision e60dc2a1-f33c-4a05-9b50-8e3e8e597629394ed1b7-a9f0-4515-9a94-bdfcdeddac8b Some people also get very dizzy when their blood pressure plummets after standing up. This is known as orthostatic hypotension. These effects are most often seen with clozapine (Clozaril) and chlorpromazine (Thorazine), says Khan. “For dry mouth and dizziness, simple changes like staying hydrated , chewing gum, and standing up slowly from a seated position can help manage symptoms,” says Turner. If these effects don’t fade or become difficult, let your provider know, and they can adjust your medication to help lessen these effects, Turner adds.
When to Call Your Doctor When to Call Your Doctor Antipsychotics help many with schizophrenia live well, and it’s important to take them as prescribed. Because side effects can feel uncomfortable, you may feel tempted to stop taking them or skip doses.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a029aae1-8bfa-4ba7-bde6-d096c0aba41a But doing this can make your schizophrenia symptoms much worse, says Dr. Safai. Not everyone stops their medications because of side effects, but, regardless, it’s important to let your provider know if they’re happening. Khan agrees, adding, “Many side effects can be managed or minimized with the right approach and so reaching out to the provider is essential.” The key is finding a balance between symptom control and side effects, says Turner. “If something does not feel right, do not just stop taking your medication — talk to your doctor first,” he adds. “There are almost always adjustments that can be made to help you feel better while staying on track with your mental health treatment. Your comfort and well-being matter, and you deserve a treatment plan that works for you.”
The Takeaway Antipsychotics can vastly improve symptoms of health conditions involving psychosis, like schizophrenia, but they can come with side effects that may make it difficult to stick to them. Common side effects of antipsychotics include weight gain, fatigue, uncontrollable movements, sexual dysfunction, and dizziness. If you experience side effects like these, let your doctor know right away. Together you can make a plan for maximum symptom management with the fewest possible side effects.
Resources We Trust Mayo Clinic: Schizophrenia: Diagnosis and TreatmentCleveland Clinic: Antipsychotic MedicationsNational Alliance on Mental Illness: How I Manage the Side Effects of AntipsychoticsMental Health America: What Are the Side-Effects of Antipsychotic Meds?Centre for Addiction and Mental Health (CAMH): Antipsychotic Medications
The Best Supplements to Help Manage Ulcerative Colitis
1. Iron
Iron supplements may be necessary for some people with UC. That’s because iron deficiency anemia is very common in this population, and it can make symptoms worse if it goes untreated. Iron deficiency anemia, which commonly causes fatigue and lethargy, can happen at any stage of UC — it can even be the first sign of UC for some people.
“There is frequent loss of blood from the inflammation and ulcers in the colon even if they aren’t seeing blood in the stool,” says Alyssa Parian, MD, a gastroenterologist who specializes in inflammatory bowel diseases (IBD) at Hackensack Meridian Medical Group in New Jersey.
“We recommend checking iron levels every 6 to 12 months,” says Brogan Taylor, RD, who specializes in gastrointestinal health at Banner Health in Phoenix.
Dr. Parian and Taylor both note that iron can be difficult to tolerate when taken orally. Some patients find that iron bisglycinate, an iron supplement that’s more easily absorbed, is easier on the stomach, says Taylor.
“When the iron is significantly low, we frequently will supplement with IV iron, which brings iron levels up faster and without the GI side effects,” says Parian.
2. Calcium
People with UC may also be low in calcium, a mineral that’s important for tooth and bone health. Low calcium levels can lead to reduced bone density and osteoporosis, which raises the risk of bone fractures.
Prolonged use of corticosteroids, a common treatment for UC, can make calcium harder to absorb.
“Many patients with UC also have lactose intolerance or sensitivity, especially during flares, and may have some calcium deficiency,” says Parian. But calcium supplements may not be the best remedy for low calcium.
The data isn’t clear that calcium supplements help prevent osteoporosis, and they could contribute to the risk of health issues like heart disease or prostate cancer.
According to Parian, if tolerated, yogurt or other dairy sources are still the best option, provided they don’t have too much added sugar.
You should talk to your doctor before taking calcium supplements.
3. Vitamin D
Vitamin D is another nutrient that is frequently low in people with IBD, says Parian, and it’s one that can be hard to get enough of from dietary sources.
“We frequently check these levels in the blood and recommend oral supplements. Studies have shown an association between higher vitamin D levels and improved outcomes, such as fewer hospitalizations and fewer flares,” she says.
A double-blind randomized clinical trial found that people with UC who took 2,000 international units (IU) of vitamin D daily for 12 weeks experienced improvements in quality of life and in their levels of serum 25-hydroxyvitamin D (25-OHD), the primary form of vitamin D that circulates in the bloodstream. The supplement also reduced disease activity in people who had vitamin D deficiency when the trial began.
4. Zinc
Zinc deficiency can develop in people with UC, especially if they have severe diarrhea, says Parian. In those people, there is some evidence that zinc supplements can improve outcomes and reduce the risk of hospitalization and surgery.
“Unfortunately, there isn’t great data to support the benefits of zinc supplementation if the levels are not low. In addition, excessive zinc can cause toxicity, so it’s important to discuss zinc with your doctor before taking it,” she says.
5. Fiber
Fiber can be tricky when it comes to IBD, says Taylor. “It’s important to adjust dietary intake of fiber when you are in a flare, but you can increase intake at baseline. We usually do not recommend a fiber supplement immediately and would recommend dietary adjustments first,” she says.
During flares, many patients feel better on low fiber diets, says Parian. “However, this doesn’t mean that people with ulcerative colitis shouldn’t consume fruits and vegetables,” she says.
The painful bloating and gas can be minimized by cooking vegetables until they are very soft, and fruits can be pureed into smoothies, Parian suggests.
Both Taylor and Parian cite the difficulties of finding the right level of fiber intake as one of the reasons it’s a good idea to work with an RD who is well-versed in UC.
“An RD, especially one with experience with IBD patients, is invaluable to review your specific and individualized dietary plan,” says Parian.
6. Prebiotics
Prebiotics are good for the microbes that live in your gut. “Psyllium husk is one example [of a fiber supplement with some prebiotic benefit], which can come in capsules or powder (Metamucil is a popular brand) has been shown to improve the good bacteria in your colon and potentially mediate inflammation in people with ulcerative colitis,” says Parian.
A review of existing evidence suggested that prebiotics might be an effective add-on therapy in people with mild to moderately active UC; however, it is important to note there is no strong evidence of its benefits and it is currently not part of guideline recommendations.
“We recommend this to patients when they are in remission. Because it can cause gas and bloating, it’s best to start with a small dose and monitor and adjust accordingly over time,” Parian says.
7. Probiotics
Probiotics are live bacteria and yeasts that are believed to have beneficial effects on the body, particularly the digestive tract. Some foods, such as yogurt and raw sauerkraut, contain probiotics, and you can also buy probiotic supplements, usually in capsule form.
“Probiotics have very mixed data and are not regulated by the FDA. Some studies do show some beneficial effects for ulcerative colitis patients, and they may help certain patients,” says Parian.
In an analysis of existing evidence on probiotics, the authors concluded that because probiotics are generally safe, they could be used as an add-on therapy in the treatment of UC, but more research in humans is needed and its benefits are unclear.
As far as what strain of bacteria or yeast might be best, so far there have been no head-to-head studies of probiotics to know, says Parian.
Probiotics is another area of research that is still evolving when it comes to diet and UC, says Taylor. “We do not usually recommend patients start with a probiotic, and we especially would not introduce these during a flare. If symptoms such as gas, bloating, or irregular stool continue when inflammation has subsided, you could speak with your gastroenterologist to see if a probiotic could help,” she says.
8. Folate (B9) and B12
Folate (vitamin B9) and vitamin B12 are also commonly low in people with UC, says Taylor. “This can be due to poor absorption in the gut due to inflammation and because some UC medications can further limit absorption.”
People on a plant-based diet or people who have had an ileal resection — the surgical removal of a part of the small intestine — are at high-risk for vitamin B12 deficiency, says Jacquelin Danielle Fryer, RD, who focuses on athletic performance at Banner Sports Medicine in Scottsdale, Arizona.
“It is important to monitor labs frequently in people with these risk factors,” says Taylor.
If there are deficiencies, timely supplementation of folate and B12 can help prevent megaloblastic anemia, a form of anemia that causes very large and immature red blood cells that can’t carry oxygen efficiently.
9. Omega-3s
Omega-3 fatty acids are essential fatty acids that your body can’t produce on its own, so they must be consumed in foods, such as plant oils and fish, or in supplements.
“Omega-3s can be beneficial for UC due to the role they can play with decreasing inflammation. But I would recommend patients get their omega-3s from dietary sources such as fatty fish a few times per week,” says Taylor.
Parian agrees, saying that omega-3s have been shown to have the most benefit when they’re consumed as part of a healthy diet. “For example, eating foods from the Mediterranean diet, which has been shown to be anti-inflammatory,” she says.
“However, if you struggle with increasing your dietary sources of omega-3 fats, then you could also include a supplement,” says Taylor.
Although some studies have been inconclusive, there is evidence that omega-3 supplements may help with relapses in people with UC.
Coffee and Diabetes
A cup of coffee is a must-have start to the day for many, but people with diabetes may have concerns about how the brew could impact their blood sugar. Caffeine can raise it slightly, even if you don’t add milk or sugar to your mug. But not everyone with diabetes has noticeable changes in their blood glucose, and coffee can be a part of a healthy diet for those who have diabetes.
Does Coffee Raise Blood Sugar? Does Caffeine Raise Blood Sugar? In the short term, it can. Coffee can temporarily lead to a small uptick in blood sugar after drinking it, even when it doesn’t contain the carb-heavy extras like sugar, syrups, or creamers.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290e0590dd-b87d-4f45-b98b-a9124ab44bbf And it’s not something your body will eventually adjust to: Even habitual coffee drinkers aren’t immune to the brew’s hyperglycemic effects.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c90c705e-bbba-4a4b-864c-0f96fc8c2716 “Many of my clients are surprised that even black coffee may raise their blood sugar slightly,” says Vandana Sheth, RDN, CDCES , a Los Angeles–based diabetes consultant and plant-based nutrition expert. “Caffeine can trigger the release of hormones like adrenaline, which can cause the liver to release glucose into the bloodstream.” But not everyone with diabetes will notice a difference in their blood sugar from drinking black coffee. What’s more, the increase likely isn’t enough to make a big difference for your overall blood sugar control, notes Ethan Chandler, MD , a family medicine practitioner with Texas Health Family Care in Saginaw. Sheth says if you’d rather not give up that morning cup of joe, you probably don’t need to. “The key is to be aware of how your body responds and take action accordingly,” she says.
Carbohydrates in Coffee Carbohydrates in Coffee The real issue for coffee lovers with diabetes is the carbs found in the add-ins that make a bitter cup of black coffee more sweet and creamy, says Sheth: Sugar Flavored syrups Natural sweeteners like honey, agave syrup, or maple syrup Milk Nondairy milk Cream or half-and-half Dairy or nondairy creamer Whipped cream Keep in mind that the carbs found in beverages have the same effect on blood sugar as the carbs found in food.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3b98ca9-c8fa-4642-8d55-4b9275314dce If rapid sugar spikes happen regularly because of these add-ins, that increases your risk for diabetes-related complications , says Dr. Chandler. One study found that adults who frequently drank coffee with sugar and creamer were 1.5 times more likely to have trouble managing their A1C compared with those who typically drank black coffee or didn’t drink coffee at all.e60dc2a1-f33c-4a05-9b50-8e3e8e597629024e909d-b12f-41a9-bc9f-2fd6d0821920 Beyond the carbs, creamy, sugary coffee drinks also tend to be high in saturated fat, which can increase your risk for heart disease.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298063d70f-f34b-44a1-93b9-4a4b4e58e34f “My general rule is, if you have diabetes, I advise you not to drink sugary drinks, including coffee drinks,” Chandler says.
Long-Term Coffee Consumption Long-Term Coffee Consumption Coffee may elevate blood sugar in the short term, but it has a different effect on the body over time. Research finds that drinking coffee may lower the risk for type 2 diabetes in the long run. People who consume 200 to 300 milligrams of caffeine from coffee daily (roughly equal to two to three 8-ounce cups of coffee) have a nearly 50 percent lower risk of cardiometabolic diseases including type 2 diabetes, heart disease , or stroke, found a 12-year study of nearly 188,000 adults.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c7c8946a-39a1-46d5-9d10-1b16a30a3ff4 Other studies have found similar associations, enough to convince experts that there’s really something to this connection. One theory is that coffee’s phytochemical compounds support healthy liver function, which in turn might support better blood sugar control.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ea59f4e4-e707-4983-bfd6-dbe5432b33ba However, these potential long-term preventive benefits are different from coffee’s short-term blood sugar effects in people who already have diabetes. So while it’s fine to drink black (or lightly sweetened) coffee as long as your body is okay with it, you shouldn’t assume that having coffee will improve your blood sugar or reverse your diabetes, says Chandler.
Navigating Morning Sugar Spikes Morning Sugar Spikes If you suspect coffee contributes to morning blood sugar spikes, these adjustments to how you consume it can help you keep them better controlled. Be mindful about your insulin use. If you typically take insulin in the morning, you may need to use it before having coffee. Chandler suggests working with your doctor to determine the best morning regimen for you. Avoid overly sweetened coffee drinks at the coffee shop or grocery store. It’s not uncommon for a coffee drink to look and taste like a milkshake — and have as many carbs. Drink water first. Drinking a glass of H2O before having your coffee supports healthy glucose metabolism, and being dehydrated can make your blood sugar go up, says Sheth. Watch your sweeteners. Stick with 1 teaspoon or less of caloric sweeteners like sugar or honey. Or swap the sugar out for a no-carb sweetener like stevia, sucralose, or monk fruit, Sheth recommends. Choose a nondairy milk or cream. Unsweetened plant milks like almond or soy milk are lower in carbs than dairy milk. Avoid oat milk, which is higher in carbs, says Sheth. Combine your coffee with exercise. Taking a short, brisk walk after your coffee can help keep blood sugar spikes in check.e60dc2a1-f33c-4a05-9b50-8e3e8e59762911079436-8f33-4341-b33f-ac8e812a4670 Rule out the dawn phenomenon . Some people with diabetes experience daily morning blood sugar spikes (sometimes called the dawn phenomenon ) that have nothing to do with coffee or breakfast. If your blood sugar regularly seems higher than it should be in the morning, talk with your doctor. Together you can talk about adjustments that can help better manage the spikes.
The Takeaway Regular coffee consumption can cause minor spikes in blood glucose levels due to its caffeine content, but not everyone with diabetes will experience noticeable changes. Sugar and carb-rich additives like syrups and creamers can significantly increase blood glucose. Opt for low-carb alternatives such as unsweetened plant milks and low- to no-calorie sweeteners instead. Long-term studies link moderate coffee consumption to a lower risk of type 2 diabetes, but these benefits don’t mitigate the need for careful blood sugar monitoring if you already have diabetes. To help avoid morning blood sugar spikes caused by coffee, try pairing it with fiber-rich foods, drinking water first, and skipping heavily sweetened options.
Resources We Trust Cleveland Clinic: How to Follow a Diabetes-Friendly Diet Mayo Clinic: 10 Surprising Things That Can Spike Your Blood Sugar Harvard T.H. Chan School of Public Health: Is Coffee Good or Bad For Your Health? Centers for Disease Control and Prevention: Rethink Your Drink U.S. Food and Drug Administration: Spilling the Beans: How Much Caffeine Is Too Much?
Sugar Substitutes May Not Help You Lose Weight
Diet drinks and foods that contain sucralose, a widely used sugar substitute popularly known as Splenda, may actually increase your appetite and cravings, a new study found.
Researchers discovered that compared with sugar, this artificial sweetener increases activity in the hypothalamus, a brain region that regulates appetite and body weight.
“Our findings suggest that sucralose may create a mismatch in the brain: It provides a sweet taste but lacks the expected caloric energy,” says corresponding author, Kathleen Alanna Page, MD, director of the USC Diabetes and Obesity Research Institute and co-chief of the division of endocrinology and diabetes at the Keck School of Medicine of USC in Los Angeles.
In other words, if your body is expecting a calorie because of the sweetness, but doesn’t get the calorie it’s expecting, that could trigger cravings and increase appetite, says Dr. Page.
Do Sugar Substitutes Help With Weight Loss?
Sugar substitutes like sucralose, used in drinks including sugar-free Red Bull, are a popular choice for people trying to cut calories or reduce their sugar intake. It’s estimated that about 40 percent of Americans eat and drink them.
But there’s a growing body of evidence that suggests replacing foods and drinks containing real sugar with ones containing sugar substitutes doesn’t help with weight loss and may even cause people to gain weight.
In 2023, the World Health Organization released a guideline recommending against the use of sugar substitutes to control weight.
The American Heart Association still suggests sugar alternatives as “one way to limit calories and achieve or maintain a healthy weight,” though the group acknowledges it isn’t certain that using them “makes people actually eat or drink few calories every day.”
How Sugar Substitutes Affect the Brain
Researchers set out to try to find out what happens in the body and brain to explain how zero calories may end up adding to weight gain rather than subtracting, and if the effects are the same on men versus women and people of different sizes.
Earlier research that’s been mostly done with animal models and large population studies has hinted at a link between calorie-free sweeteners and obesity, but has not directly shown how they might impact hunger in humans.
The study included 75 participants between 18 and 35 years old. They were roughly evenly split between male and female and weight status (healthy weight, overweight, or obese).
On three separate visits, each participant drank 10 ounces of one of the following:
- A sugar-sweetened drink
- A matched-sweetness drink made with sucralose
- Water
This allowed the researchers to look for differences both within and between each person. At each visit, researchers collected brain scans and blood samples, and participants rated how hungry they were both before and after consuming the drink.
Sucralose increased brain activity in the hypothalamus and increased feelings of hunger compared with drinking sugar. Sucralose also increased brain activity compared with water, but people felt the same amount of hunger.
The researchers also used MRI scans to study functional connectivity, which shows how regions of the brain communicate with one another.
Sucralose led to increased connectivity between the hypothalamus and several brain areas involved with motivation and sensory processing — including the anterior cingulate cortex, which plays a role in decision-making.
This mismatch may alter how the brain processes sweet taste and metabolic signals, which could impact cravings and eating behavior, says Page.
The MRIs showed sex-related differences in response to sucralose: Female participants showed greater changes in brain activity than male participants did.
“And the impact of sucralose on the hypothalamus was strongest in individuals with obesity,” says Page.
How Your Hormones Respond to Artificial Sweeteners
Scientists also looked at how sugar and sucralose affected hormones tied to hunger.
As expected, the sugar drink led to increases in blood sugar and the hormones that regulate it, including insulin and glucagon-like peptide 1 (GLP-1). “The body uses these hormones to tell the brain you’ve consumed calories, in order to decrease hunger,” Pageshe says.
Drinking sucralose, on the other hand, had no effect on those hormones, leading hunger and cravings to continue.
Artificial Sweeteners May Not Support Weight Loss in the Long Run
The findings support earlier research showing that, paradoxically, low-calorie, artificially-sweetened products don’t help you reduce calorie intake or lose weight in the long run, says Susan Spratt, MD, a professor of medicine and endocrinologist at the Duke Health in Durham, North Carolina, who was not involved in the study.
“I like the explanation that the authors propose, that sucralose increases blood flow from the hypothalamus to areas of the brain involved in stimulation and hunger,” says Dr. Spratt.
Should You Kick Your Diet Soda Habit?
Artificial sweeteners can be a useful alternative to sugar for people with diabetes, Spratt says. But otherwise, she recommends avoiding sugar substitutes.
If you’re hooked on diet soda, she says, “Natural alternatives like water and unsweetened tea or coffee are the best options,” says Spratt.
Sparkling water is also an option, though it’s unclear what impact, if any, artificially flavored water would have on the hypothalamus, she says.
“But you could flavor your tea or water with a slice of actual lemon or lime or with mint leaves. One of the things I love to do is infuse my water with fruits and vegetables. My favorite combination is pineapple and rosemary,” says Spratt.
10 Myths — and the Facts — About Fibromyalgia
Fibromyalgia is a chronic condition that causes pain throughout the body, as well as fatigue. Research suggests that fibromyalgia happens when the body’s central and peripheral nervous systems don’t process pain properly.
While it’s often grouped with rheumatic diseases, it’s not considered to be a disease of inflammation, or a joint or muscle disorder. And it’s also not an autoimmune disorder, in which the body’s immune system mistakenly attacks healthy tissues.
Everyone who has fibromyalgia experiences it differently, which is one reason why misunderstandings and myths often surround this condition. Even healthcare professionals may be misinformed about it.
Knowing the facts about fibromyalgia — and being able to separate them from myths — is essential to making the best choices to control the condition.
“The more informed and active the patient is, the better off they are in conditions like this,” says Don L. Goldenberg, MD, a rheumatologist and professor emeritus of medicine at Tufts University School of Medicine in Boston. “They really need to get solid medical information.”
In that spirit, here are 10 widely held misconceptions about fibromyalgia, as well as what we know to be true.
Myth 1: It Isn’t a Real Disorder
Fact: Fibromyalgia was officially recognized as a disease by the World Health Organization in 1994.
And for people who experience the pain and other symptoms associated with fibromyalgia, the disorder is all too real, says Dr. Goldenberg.
The condition causes “chronic, widespread muscle pain,” he notes. “By the time people see doctors, it’s usually many months or years” since symptoms began.
But many doctors, Goldenberg laments, still don’t understand the condition.
“Most doctors think that if your elbow hurts, or your knee hurts, or your shoulder hurts, the pathology is directly in those areas,” he says. “In fibromyalgia, that doesn’t work. The pain is actually coming from the brain.”
This misunderstanding of the origins of the pain, says Goldenberg, is “one of the reasons it’s very controversial, and was for a long time kind of pooh-poohed as, ‘it’s all in your head.'”
Myth 2: Fibromyalgia Is a ‘Catchall’ Diagnosis
Fact: Fibromyalgia has specific diagnostic criteria, developed and updated by the American College of Rheumatology (ACR).
Many people are under the impression that fibromyalgia is a “catchall” or “fallback” diagnosis because there isn’t any single test or obvious symptom used to diagnose it.
“There’s very little to see on a physical exam,” Goldenberg says. “Laboratory tests to look for causes of pain are unremarkable.”
According to the ACR, fibromyalgia is diagnosed based on the following factors:
- Multiple painful areas of the body (on both sides, above and below the waist)
- Additional symptoms, like fatigue, poor sleep, and difficulty thinking or concentrating
- Symptoms that last for at least three months
- No other apparent cause of these symptoms
Myth 3: Fibromyalgia Only Affects Women
Fact: Between 75 and 90 percent of people diagnosed with the disorder are women, according to the National Fibromyalgia Association (NFA).
Fibromyalgia affects an estimated 10 million adults in the United States, the NFA says, which means that between 1 million and 2.5 million men in the United States have been diagnosed with fibromyalgia.
But Goldenberg says that the actual incidence among men may be even higher, since gender-based bias may play a role in how doctors diagnose fibromyalgia.
Fibromyalgia can also occur in children and teens.
Myth 4: Fibromyalgia and Arthritis Are the Same Condition
Fact: Fibromyalgia and arthritis have little in common, other than sensations of pain and fatigue.
Unlike arthritis, fibromyalgia “doesn’t primarily affect joints. It affects muscles and soft tissue,” says Goldenberg.
And unlike arthritis and other rheumatic (arthritis-like) disorders, fibromyalgia isn’t a disease characterized by inflammation. In fact, markers of inflammation tend to be normal.
Instead of the pain coming from an inflamed area of the body, in fibromyalgia, “The pain is actually coming from the brain, from the central nervous system,” says Goldenberg.
Myth 5: A Special Fibromyalgia Diet Is Needed
Fact: There’s no specific diet recommended for people with fibromyalgia, but certain foods can worsen symptoms while others may improve them.
Researchers have found that dietary fiber from fruits, whole grains, vegetables, and other plant products may ease fibromyalgia symptoms by altering the gut microbiota and that supplementing with probiotics may improve cognitive function. Evidence also suggests that an anti-inflammatory and gluten-free diet may have beneficial effects.
Focus on following a healthy, balanced diet that includes whole grains, lean protein sources, low-fat dairy products, fruits and vegetables, and plenty of water.
It’s also a good idea to limit your consumption of caffeine, refined sugars, fried foods, red meat, processed foods, and alcohol.
Myth 6: Complementary Treatments Are Pointless
Fact: Meditative movement therapies — such as tai chi, yoga, and qigong — appear to improve fibromyalgia symptoms, according to research.
Acupuncture has also been found to reduce pain and improve quality of life.
And connective tissue massage was found to help with pain, fatigue, and sleep disruption in women with fibromyalgia.
Myth 7: You Should Avoid Exercise
Aerobic exercise, in particular, has been shown to be helpful in reducing fibromyalgia symptoms.
This includes activities like walking, biking, swimming, and water aerobics.
Goldenberg believes that stretching and strength training are also helpful for many people. Strength training can mean using weights, exercise machines, exercise bands, or your own body weight for resistance.
While exercise may be painful or difficult at first if you have fibromyalgia, regular physical activity can help improve your symptoms and make exercising easier.
Myth 8: You’re Just Tired
Fact: Fatigue in fibromyalgia goes far beyond just being tired. As Goldenberg notes, the condition causes “a tremendous amount of fatigue. People are very exhausted.”
While fatigue is a common symptom of fibromyalgia, research has found that it doesn’t occur in isolation.
Instead, fatigue in fibromyalgia is interwoven with other symptoms — including pain, sleep disruption, and mood disturbances — and all of these symptoms can influence one another.
Myth 9: You Can Take a Pill to Make Fibromyalgia Symptoms Disappear
Fact: Drug treatments don’t work very well for many people with fibromyalgia.
“The truth is, we don’t have very good medications,” says Goldenberg. “They work well in maybe one out of three or four patients.”
While you may see some benefit from taking a drug approved to treat fibromyalgia, your symptoms will probably just diminish, not disappear.
You’ll probably also still need to incorporate lifestyle measures, like exercise, stress reduction, good sleep habits, and possibly cognitive behavioral therapy (CBT), into your treatment plan.
Myth 10: There’s Nothing You Can Do
Fact: While there’s no cure for fibromyalgia — and medication doesn’t work for everyone — there’s still a wide range of options available for treatment.
“Nonpharmacological approaches actually work as well, or maybe even better,” than drugs for many people with fibromyalgia, Goldenberg notes.
If your current treatment isn’t giving you the relief you need, work with your doctor to try something new, whether it’s exercise, prescription drugs, over-the-counter (OTC) pain relievers, or alternative treatments, like massage or meditative movement.
The Takeaway
- Misconceptions about fibromyalgia persist, despite specific diagnostic criteria and the fact that it affects approximately 10 million adults in the United States.
- Talk with your healthcare providers to explore both medical and lifestyle interventions, as medication alone might not fully relieve symptoms.
- While there is no cure for fibromyalgia, treatments such as aerobic exercise, stretching, strength training, and complementary therapies like tai chi and acupuncture can help manage symptoms.
- Diet plays a supportive role in managing fibromyalgia. A balanced diet rich in whole grains, lean proteins, fruits, and vegetables, and with few refined sugars or processed foods, may alleviate symptoms for some.
Low A1C and Diabetes
Your A1C is largely a reflection of your lifestyle habits and the accuracy of your insulin doses if you take them, says Jones.
Chris Szoke, NP, CDCES, a nurse practitioner and diabetes specialist based in Tucson, Arizona, says that if you have diabetes and experience regular low blood sugar, you need to check in with your healthcare providers. “This is a clear sign that your insulin doses aren’t meeting your body’s needs. You need to work with your team to adjust them.”
Szoke recommends starting by testing your blood sugar more often. “If you have diabetes or you’re concerned about your A1C, your doctor can help you get a glucose meter or a continuous glucose monitor (CGM) to look more closely at your blood sugar levels.”
A CGM allows you to better anticipate and measure your risk of hypoglycemia. And today, newer insulin pumps can work in tandem with a CGM to automatically adjust your insulin rates, making it easier to stay in a healthy blood sugar range. These devices, known as automated insulin delivery (AID) systems or hybrid closed-loop insulin pumps, may be able to lower your A1C even while reducing the risk of hypoglycemia.
Diabetes authorities also recommend higher A1C targets for certain populations. Children and teens, for example, tend to have an especially difficult time managing their blood sugar levels, and may not be able to target a lower A1C.
And Szoke says that older people with diabetes may experience some hypoglycemia unawareness after decades with the disease.
“That means it simply isn’t safe for them to aim for tight blood sugar levels and a target range between 70 and 140 mg/dL,” he says. “Instead, they may need to aim a bit higher for their daily safety, and this will correlate with a higher A1C level, too, closer to 8 percent instead of below 7.”
People with heart disease and chronic kidney disease are also at particularly high risk if they develop hypoglycemia, and they may need to set higher glycemic targets, too.
It’s important to consult with your endocrinologist or doctor to decide what your own blood sugar targets should be, and how careful you need to be about the risk of hypoglycemia.
Egg Beaters Recalled for Possible Contamination With Bleach Ingredient
Monroe Hammond joined Everyday Health in 2021 and now runs the news desk as an editor. They received a master’s degree from the Newmark Graduate School of Journalism at CUNY, as well as a bachelor’s degree in film and media studies from Emory University in Atlanta.
Hammond has written and edited explainers on a number of health and wellness topics, including racial disparities in HIV treatment, the metabolic benefits of cold exposure, how the flu shot works, and solutions for seasonal dermatology woes. They have also edited pieces on the latest developments from NASA, the health repercussions of climate change, and the cutting edge of quantum physics. Their work has appeared in Popular Science, Insider, Psychology Today, and Health Digest, among other outlets.
Before turning to journalism, Hammond taught English while living in Thailand and Malaysia. They were born and raised in the American South, and currently live in Brooklyn with their spouse, three cats, and too many houseplants to count.
Prostate Cancer With Bone Metastases: Answers to Your Questions
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains and staying physically active can help your overall health. These lifestyle changes can also have a positive effect on bone metastases, Tagawa says. “Both diet and exercise,” he says, “are things that are under [your] direct control.”
A healthy lifestyle can also help you better manage side effects from treatment. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting exercise.
While no single food benefits prostate cancer specifically, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If you’re not sure which foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancer’s growth and keeping you as healthy as possible.
As an oncologist, Tagawa concentrates on treating the cancer itself, but he’s aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
“I focus on the cancer,” Tagawa says, “but I don’t want to see [these men] go through all of that and then die from a heart attack or stroke. Attention to both diet and exercise can lead to improvements in quality and quantity of life.”
The recommendation for adults with any type of cancer is to get at least 40 minutes of exercise that elevates the heart rate, four times a week.
For men who aren’t able to achieve that, Tagawa says, “Walking is always good.”
When it comes to exercise, what matters is that you do it. Just keep moving your body. Swimming, bicycling, walking, and gardening all count. Aim for a certain number of steps each day, and consider using a pedometer to help stay on track. Mix things up, set goals for yourself, and try being active with a friend or group to stay motivated.
And if you’re on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength, too.
Atrial Fibrillation Raises Dementia Risk, Especially Early-Onset Dementia
“While afib is a modest predictor of dementia in the general population, its impact is particularly significant in younger individuals and in early-onset dementia,” says lead study author Julián Rodriguez García, MD, PhD, a cardiologist with the electrophysiology and arrhythmia department of the Bellvitge University Hospital in Barcelona, Spain.
“These findings highlight the importance of early detection and management of afib,” says Dr. Rodriguez García, “and suggest the need for further research into whether afib treatment could mitigate dementia risk.”
Afib Raises Early-Onset Dementia Risk by 36 Percent
Presented at the annual meeting of the European Heart Rhythm Association, the research drew on a database of more than 2.5 million adults who were 45 or older and had no prior diagnosis of dementia.
At the start of the study, nearly 80,000 participants (3.25 percent) had a recorded afib diagnosis.
Based on an average follow-up of 13 years, the researchers determined that in people under age 70 with afib, the risk of developing future dementia was 21 percent higher than for those without afib.
The risk of developing early-onset dementia (meaning dementia that begins between the ages 45 and 65) was 36 percent higher than for those without afib.
Rodriguez García and his team highlighted that people in the youngest afib group, ages 45 to 50, had a 229 percent higher risk of developing future dementia.
Atrial fibrillation significantly increases the risk of stroke, but even after researchers removed stroke patients from the analysis, the association between afib and dementia remained unchanged.
This suggests that mechanisms other than typical stroke may be involved, such as so-called silent strokes (those that show no clinical symptoms), microinfarcts (microscopic strokes), and microbleeds, according to the study authors.
The scientists noted that the association between afib and dementia risk lost all statistical significance from age 70 onward.
“In younger individuals, afib may play a more prominent role in dementia pathophysiology [changes that occur in the disease process],” says Rodriguez García. “In older adults, other age-related factors likely overshadow the effect of afib.”
Heart Health Is Linked to Brain Health
Scientists have long known that a healthy heart promotes a healthy brain. Research has linked common cardiovascular diseases in adults — such as coronary heart disease and heart failure — to cognitive impairment and increased risk of dementia.
But prior studies have shown mixed results regarding the associations between atrial fibrillation and dementia, according to Paul Wang, MD, a cardiologist and director of the Stanford Cardiac Arrhythmia Service in Palo Alto, California.
“This study is important because it examines the occurrence of dementia in a large study population of over two million individuals with a substantial average follow-up of 13 years,” says Dr. Wang, who was not involved in the research. “The main limitation is that the study can only show that some patients with afib may have a higher rate of dementia. It cannot show that afib causes dementia, only that they are associated.”
He suggests that inflammation affecting the heart and blood vessels may affect brain cells as well.
“Afib, by disturbing blood flow to the brain, may contribute to the development of dementia,” says Wang. “Blood clots due to afib might also contribute to dementia.”
Taking Steps to Lower Afib Risks
More study is needed to see if measures to treat atrial fibrillation might help ward off dementia. Still, Rodriguez García recommends following these preventive strategies for afib:
For those already diagnosed with afib, he recommends using appropriate anticoagulation medications and heart-rhythm control strategies to help reduce the risk of long-term cognitive effects.