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How to Prevent Chafing

Prep your body before exercise by applying anti-chafing sticks, balms, or creams to the areas of your body that are most prone to friction, such as your inner thighs, underarms, nipples, or bra line. These products help create a protective barrier that reduces skin-on-skin or fabric-on-skin rubbing, says Lal.

“These anti-chafing sticks and creams repel sweat and water. They keep skin dry and allow the skin to slide over itself, again decreasing friction,” he says. You can also use these tools if you plan on exercising in wet weather, so that the rain will “bounce off” the skin instead of seeping into it, he adds.

Look for fragrance-free, sweat-resistant formulas designed for athletes, and reapply the product as needed during long workouts, especially in hot or humid conditions, says Lal. You could also try layering a bit of petroleum jelly on top of sensitive areas, dusting anti-chafing powder into your shoes, or using antiperspirant to prevent sweat and armpit chafing, he adds.

Other anti-chafing tools that may be worth purchasing include athletic tape to wear over chafe-prone areas, such as the nipples.

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What Is Gastritis?

Gastritis is when your stomach lining becomes inflamed. Many people with gastritis don’t have symptoms. Among those who do, symptoms can include nausea , vomiting, bloating , indigestion, or heartburn . This common condition can be acute (meaning it has a sudden onset) or chronic (meaning it develops gradually). In either case, there are many treatment options for gastritis, such as medication and lifestyle changes, that may alleviate symptoms.
Types of Gastritis Types Gastritis is classified according to how long you’ve had symptoms and what the underlying cause is. Acute vs. Chronic Gastritis Gastritis can be a temporary illness resulting from an acute cause, like an infection. Other times, gastritis is a chronic condition that develops slowly, with symptoms that may be unnoticeable or inconsistent but lead to more serious problems over time.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c4edbe4f-c109-4f43-9f8d-72b3720ffeb2 Acute gastritis is a sudden and temporary condition characterized by inflammation and irritation, which may include shallow breaks in the stomach lining.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b359baa4-bcac-4982-9b1f-2dc62c81df77 It often leads to a noticeable upset stomach or bowel problems, but these symptoms often get better on their own in a few days.e60dc2a1-f33c-4a05-9b50-8e3e8e59762980e8cad2-794f-4b48-9b17-54d543e6a145 Chronic gastritis is a persistent, long-term inflammatory condition that deteriorates the stomach lining over time. Left untreated, certain types of inflammation may result in gastric adenocarcinoma, a type of stomach cancer .e60dc2a1-f33c-4a05-9b50-8e3e8e59762954cf1f77-0a86-4940-a356-84699e41243b It can be caused by a number of factors, including frequent and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) , Helicobacter pylori (H. pylori) infection, extreme stress, smoking, and autoimmune diseases .e60dc2a1-f33c-4a05-9b50-8e3e8e597629ef69f9d7-aeb6-47c8-94c9-e70741961fd7 Erosive vs. Nonerosive Gastritis Gastritis can also be erosive or nonerosive:e60dc2a1-f33c-4a05-9b50-8e3e8e597629eff578f0-b52c-4f87-a04d-ffa61e2e4ecae60dc2a1-f33c-4a05-9b50-8e3e8e5976296f310afd-5143-4fb4-a1ef-a88f31189bfc Erosive gastritis: When the illness wears away at your stomach lining, leaving ulcers Nonerosive gastritis: When the illness doesn’t eat away at your stomach lining, but instead causes irritation, such as reddening. It may also lead to atrophy (thinning) of the stomach lining, which can cause digestive problems. Other Ways to Classify Gastritis Sometimes you may hear gastritis categorized based on cause. Infectious gastritis: A type of gastritis induced by bacteria, viruses, parasites, or fungie60dc2a1-f33c-4a05-9b50-8e3e8e5976299f31b9ad-a352-4de3-aa0e-ae1f83260c19 Reactive or chemical gastritis: A form of gastritis triggered by drugs (typically NSAIDs), alcohol, or bile reflux (when bile from the small intestine flows backward into the stomach or esophagus rather than flowing as usual into the small intestine)e60dc2a1-f33c-4a05-9b50-8e3e8e597629be0ce870-1d61-4ef1-ad44-4205333331b1 Autoimmune gastritis: A type of gastritis caused by an autoimmune disorder and the resulting dysfunction of gastric acid secretione60dc2a1-f33c-4a05-9b50-8e3e8e59762944f285f1-ba37-4d92-b625-c127c92c2ff1 Eosinophilic gastritis: A rare, chronic disease caused by an overproduction of white blood cells called eosinophils, which can lead to inflammation and damage in the stomach. Eosinophilic gastritis is often associated with allergies.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290e918100-725d-465f-bd96-5f159c26529b
Signs and Symptoms of Gastritis Symptoms Many people don’t experience symptoms of gastritis, or they notice a gradual onset of symptoms. Other people notice more sudden changes to their stomach, as is the case with acute gastritis. The most common symptoms of gastritis are:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cca3e7f4-5188-4c3b-a24c-0612f24d320ae60dc2a1-f33c-4a05-9b50-8e3e8e597629caa94624-8535-4e36-81b6-1370fcd2b3b9e60dc2a1-f33c-4a05-9b50-8e3e8e5976290dc4dae3-7880-4b49-81b6-5b889438b035e60dc2a1-f33c-4a05-9b50-8e3e8e597629785d2f07-0958-4919-8866-1d5d788ee68f A loss of appetite or feeling full quickly when eating Nausea and vomiting Indigestion, which can feel like a burning sensation in the belly that heightens after eating Bloating and abdominal pain Hiccups and belching Dark blood in your vomit or black, tarry stools, which can indicate the stomach lining is bleeding Unexplained weight loss Anemia
Causes and Risk Factors of Gastritis Causes Gastritis can be caused by several factors, including: Bacterial and Viral Infections Infection caused by the bacteria H. pylori is overwhelmingly the most common cause of chronic gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629421f60a1-139e-4d9b-afd5-ea800716c051 Other bacteria, viruses, parasites and fungus can cause gastritis, too.e60dc2a1-f33c-4a05-9b50-8e3e8e597629519fbc34-b0e4-4e1a-9c25-28dbebb2dd6a Long-Term Use of NSAIDs NSAID pain relievers like ibuprofen and naproxen sodium can damage the stomach lining and lead to gastritis if taken often for an extended period of time.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a0b1c3e-0a2f-42eb-98b6-7dec8570169f Extreme Stress Stress due to bodily trauma, severe illness, major surgery, or untreated chronic depression can lead to gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e59762991624a11-c910-4ac3-a1e1-90e35a38fae3 Alcohol and Cigarettes Drinking too much alcohol and smoking both can irritate the stomach lining.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295e6e4ab3-de0d-4796-870e-98c7cf3da1ee Drug Use Recreational drugs, such as cocaine, can also cause gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7091505-4d71-48b6-a478-1db1d807fdd3 Chemotherapy and Radiation Gastritis is a potential side effect of cancer treatments like chemotherapy or radiation therapy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b52d8bdb-8942-4b24-b624-9388cbb2fc19 Acidic Beverages Drinking too much coffee or other acidic beverages can irritate the stomach lining.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d27323f8-8342-49c0-b18e-7fe42135ad2f Autoimmune Disease Certain autoimmune conditions, such as celiac disease and Crohn’s disease , cause inflammation in the digestive tract.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292f1be44c-279a-4278-993f-1707b23a238b Food Allergies An abnormal immune response to certain foods can cause a rare type of gastritis known as eosinophilic gastritis. As mentioned, people with this condition experience a buildup of eosinophils, which can lead to inflammation and damage in the stomach.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d3a260e9-a1d4-41d2-9a34-9ea83c659cdb Older Age Older adults are at an increased risk of gastritis because the stomach lining often gets thinner with age. In addition, common causes of gastritis, such as H. pylori infection and autoimmune disorders, are usually more severe in older adults than in younger adults.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b39ddda7-0657-4c91-85be-83b3f9801108 Bile Reflux This occurs when bile, a bodily fluid that helps break down food in the small intestine, comes back up into the esophagus and stomach, damaging the stomach lining.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cf8c76ea-e128-4f40-971b-ce2fa50e8135 Bile reflux is a common side effect in people who have just had weight loss surgery or other types of surgery that remove part of the stomach.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d62409d7-e459-4587-b192-033b461465cc
How Is Gastritis Diagnosed? Diagnosis A healthcare provider may suspect you have gastritis after talking to you about your symptoms, diet, lifestyle, and health history. But because a diagnosis of gastritis is only confirmed with testing, your doctor will likely recommend one or more of the following procedures to confirm the diagnosis and determine the root cause.e60dc2a1-f33c-4a05-9b50-8e3e8e597629171d4826-1bbd-40f4-909c-8e6e35118c62 Upper endoscopy exam: An endoscopy is a procedure in which a long, thin tube with a tiny camera is passed down the GI tract from the throat and into the esophagus to examine the stomach and small intestine. Using the endoscope, your doctor will look for signs of inflammation and conduct a biopsy (removing a small tissue sample from your stomach) to test it for specific bacteria and viruses.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c6ab60a-4854-440a-a962-f51a56fd9c92 Breath or stool tests: Breath or stool tests can detect H. pylori . During a breath test, individuals drink a glass of clear, tasteless liquid that contains radioactive carbon, which is broken down by H. pylori bacteria. They then blow into a bag, which is sealed afterward. Those with an H. pylori infection will have radioactive carbon present in the bag.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d9da2c0a-4938-45ac-a0c6-658b5782c45e Your medical team may also collect a stool sample to test for bacteria that can cause gastritis. These tests can also check for blood in your stool, another potential indicator of gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629abb4a2f0-0ece-4671-bd9b-50d23c3c4845 Blood tests: Although blood tests can’t actually diagnose gastritis, they can identify potential indicators of gastritis, such as a vitamin B12 deficiency.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f7e38ac5-b933-4d55-af44-ed0a30abce67
Treatment and Medication Options for Gastritis Treatment The best treatment options will depend on the root cause of your gastritis and may include one or a combination of the options below: Medication for Gastritis Medication options for gastritis include: Antibiotics If you have H. pylori infection in your digestive tract, your doctor will likely prescribe antibiotics, usually taken for 7 to 14 days.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290d7cac4a-34e0-4e8c-8101-04ebd52fabf1 Proton Pump Inhibitors These medications reduce stomach acid production. They can be bought over-the-counter or with a prescription.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6806f98-f197-4ec8-ac51-deedea8699c1 They include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex).e60dc2a1-f33c-4a05-9b50-8e3e8e597629a9384c41-632d-4b51-a6b1-16c838b2ff7d H2 Blockers H2 blockers decrease how much stomach acid is secreted by glands in your stomach lining. They include famotidine (Pepcid AC, Zantac 360), cimetidine (Tagamet), or nizatidine (Acid AR).e60dc2a1-f33c-4a05-9b50-8e3e8e597629675f3a1a-7d9e-43c6-9d83-74b6ce75bcae Antacids These over-the-counter medications neutralize stomach acid, decreasing symptoms like heartburn and indigestion quickly, but they don’t treat ulcers. They include aluminum hydroxide (Amphojel), magnesium hydroxide (Phillips’ Milk of Magnesia), calcium carbonate (Rolaids, Titralac, Tums), sodium bicarbonate (Alka-Seltzer), and aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta). Antacids can lead to more side effects like constipation or diarrhea compared to PPIs and acid blockers.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dfe702b0-b3a2-404e-8a53-cd5c185a5b6ee60dc2a1-f33c-4a05-9b50-8e3e8e5976299907fc1e-92eb-4030-a054-c346e1a92635
Prevention of Gastritis Prevention You may be able to reduce your risk of gastritis in the following ways.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d10fe3d6-3edb-4993-96e5-4c20683e754ee60dc2a1-f33c-4a05-9b50-8e3e8e59762963cfb14b-0be2-4f0e-ac5a-4648aece055f Practice good hygiene. As mentioned, H. pylori infection is the most common cause of chronic gastritis. It can be prevented with good hygiene habits, including handwashing. Limit or avoid foods and beverages that irritate the stomach lining. Too much alcohol, caffeine, or spicy and acidic foods can cause stomach discomfort, and wear down your stomach lining when consumed in excess. Decrease use of NSAIDs. Be mindful of how often you use pain medications including aspirin, ibuprofen, and naproxen. Try not to use them long-term.
Lifestyle Changes for Gastritis Lifestyle Changes Certain lifestyle changes can make a big difference if you have gastritis. They include: Make dietary changes. If you don’t have symptoms, you may not have to change your diet. But if you do, pay attention to what you eat and how you feel afterward, as certain foods can be a trigger for gastritis symptoms. In general, try to avoid alcohol, coffee, carbonated drinks, acidic or spicy foods, ultra-processed or deep-fried foods and foods that are high in fat. If the root cause of your gastritis is celiac disease or food allergies, your doctor may refer you to a dietitian to create a nutrition plan for you.e60dc2a1-f33c-4a05-9b50-8e3e8e59762984b09062-a55e-4f96-85a7-39bad72b6772e60dc2a1-f33c-4a05-9b50-8e3e8e5976290cc087ff-72b0-48c9-9395-93c7f9748940 Reduce NSAID use. If long-term use of NSAIDs triggered your gastritis, your doctor may suggest you stop taking NSAIDs, take a lower dose, find a replacement medication for pain, or try taking it alongside a PPI.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294add26c2-31bc-453b-b80a-b920fe0309e7 Quit smoking. Smoking cigarettes can irritate the stomach lining. Quitting can relieve symptoms of gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bf8b59c3-7453-4235-9221-a366a7ad8529 Consider vitamin supplementation. If you have gastritis caused by an autoimmune condition, your doctor may recommend certain vitamin supplements to prevent anemia. Talk to your doctor about what kinds and how much you should take.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb0405e5-effa-4fb2-bbc7-3b0d57a4394e Consider acupuncture. Some research suggests that acupuncture may lessen inflammation, protect the stomach lining, and improve quality of life among people with chronic gastritis. Research in this area has been limited, though, and more studies are needed to confirm these findings.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cbcbd93b-a544-4a6c-8a03-2496f476ec19
How Long Does Gastritis Last? Prognosis and Outlook Some acute cases of gastritis can be cured within weeks with the help of treatment, such as a course of antibiotics for H. pylori infection.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295330eb10-d1b1-44b4-9fa6-0fb0c0d3274b For some people, such as those diagnosed with autoimmune diseases, recovery may include a longer-term plan to address nutritional deficiencies and prevent cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ea7f3b51-7dae-4d00-a504-43c8735ba100
Complications of Gastritis Complications Untreated gastritis can worsen digestive health and may lead to issues such as: Peptic ulcer disease: Painful sores (ulcers) can form along the stomach lining and small intestine, exacerbating gastritis symptoms. These ulcers can be caused by H. pylori infection or overuse of NSAID medications.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e0a3b6ee-235d-44ed-b669-a84c54b4c099 Gastric polyps: These small masses of cells can form along the stomach lining. Most times they’re harmless, but in rare cases they can develop into cancer. In rare instances, polyps can block the opening between the stomach and small intestine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c731adf6-ee5a-405d-b170-6aea5bcd4cd3 Stomach bleeding: Ulcers can bleed, causing low red blood cell counts or anemia. When ulcers break through the stomach lining, stomach contents leak into the abdominal cavity, causing an infection called peritonitis, which is a surgical emergency.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297f7a6957-65ab-43c4-bf81-feb57a813ca1 Anemia: Autoimmune gastritis can also cause malabsorption of vitamin B12, which can lead to pernicious anemia.e60dc2a1-f33c-4a05-9b50-8e3e8e59762923aae86b-cbf9-471f-abda-643a84ee9c0e Stomach cancer: Certain types of gastritis can increase the risk of developing tumors — benign or cancerous — in the stomach lining. Gastritis caused by H. pylori infection, for example, increases the risk of gastric mucosa-associated lymphoid tissue (MALT) lymphoma , a type of cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294eeccdee-7ff4-48c5-8561-023ac0616cdd Researchers suggest that the bacteria converts substances in some foods into chemicals that cause DNA mutations in the stomach lining.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c7c0859-19e3-4d45-9fc6-2ec18fe52c3a
Research and Statistics: How Many People Have Gastritis? Research and Statistics Researchers estimate that about 25 percent of people worldwide have chronic atrophic gastritis. While infectious gastritis caused by bacteria such as H. pylori is on the decline in the Western world, instances of autoimmune gastritis are on the rise.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bd38f41d-14be-47db-8fa5-4c5e5d7a31de In the United States, as much as 15 percent of the population is affected by chronic gastritis, with higher rates in nonwhite racial and ethnic groups and communities of first-generation immigrants from countries with increased prevalence of H. pylori infection.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bf073a8b-69c7-47ae-b078-3f9e1361630b H. pylori infection is more prevalent among African Americans, Hispanic and Latinx people, American Indians, and Alaska Natives than non-Hispanic white people. Older people are more commonly infected than younger people.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bd500e21-9920-4cb3-bc5b-1c6ebdb17861 Autoimmune gastritis is more prevalent in women and older adults, with rates ranging from 2 to 5 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e59762957f23596-5d63-4947-956d-dddceb4c455b In the United States people with other autoimmune disorders, such as type 1 diabetes , Addison’s disease , and thyroid diseases like Hashimoto’s are more likely to develop autoimmune gastritis.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293e1b2548-7262-4d82-bc80-c40e16be1a05
The Takeaway Gastritis is an inflammation of the stomach lining that can be temporary (acute) or chronic. H. pylori infection and frequent, long-term NSAID use are the most common causes of gastritis. There are many treatment options for gastritis, including medication and lifestyle changes.
Resources We Trust Mayo Clinic: Gastritis OverviewCleveland Clinic: GastritisJohns Hopkins Medicine: GastritisBMJ Best Practice: GastritisMount Sinai: Gastritis

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How to Buy the Healthiest Yogurt

Traditional Yogurt

Traditional yogurt is made by introducing “live cultures,” aka bacteria, to milk so they can convert the lactose, or sugars, into lactic acid, explains Janette Marsac, RDN, LCSW, a New York City-based registered dietitian nutritionist. It’s unstrained, and can be made from skim, low-fat, or whole milk. Since it’s not strained of excess liquid, traditional yogurt tends to have a milkier, thinner texture than strained yogurts like Greek or Icelandic versions.

Greek Yogurt

Greek yogurt is made by straining the traditional kind to remove whey, which makes it thicker and leaves a higher concentration of some nutrients. It typically has twice as much protein (around 15 g) as regular yogurt, says Carrie Lam, MD, with the Lam Clinic of Integrative Medicine in Tustin, California. However, Greek yogurt is lower in calcium than traditional yogurt. Per 8 ounces (oz), it supplies 27 percent of the Daily Value, versus traditional yogurt’s 45 percent.

Greek yogurt also strains the majority of lactose from the cow’s milk, leaving a thick, creamy texture behind that’s easier to digest than some other kinds.

Greek yogurt can be made from nonfat, low-fat, or whole milk.

Icelandic Yogurt

Also known as skyr, this traditional Icelandic fermented dairy product straddles the line between cheese and yogurt. It’s strained more than Greek yogurt, so it’s thicker and even more protein-packed, with around 20 g per cup, and little added fat or sugar.

Traditionally, skyr is made with skim milk.

Its taste is often described as milder than Greek yogurt, and it has naturally low levels of sugar and lactose, says Diana Gariglio-Clelland, RD, CDCES, a Washington state–based registered dietitian with Next Luxury. You can find Icelandic yogurt in the United States marketed under brands such as Siggi’s and Icelandic Provisions.

Australian Yogurt

This unstrained yogurt tends to be creamy and rich, like a high-protein dessert. It’s made with skim milk and cream (or sometimes simply whole milk), and is cooked slower and longer than other yogurts. The brand Wallaby says that Australian yogurt’s smooth texture and mild taste are the result of a slow culturing process.

Noosa Yoghurt, another brand made (and spelled) in the Australian style, contains 150 calories per 4.5 oz, depending on the flavor. Because these tend to be sweeter and have less protein, they’re a good option for a healthier dessert.

French Yogurt

This style is made by a technique known as “pot set,” in which whole milk and live cultures are combined in individual pots and left to ferment for up to eight hours. French yogurt is not strained, so it retains some of its sweetness (and lactose), but is thicker than other unstrained yogurts, like Australian. French yogurt pots tend to be slightly smaller than other varieties, and so may have the advantage of built-in portion control. Several flavors from Oui by Yoplait, for instance, are 170 calories per 5-oz pot.

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Hydration Tips for Managing Rheumatoid Arthritis Symptoms

Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.

Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.

Dr. Biggee graduated cum laude with a bachelor’s degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.

In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed “introduction to clinical medicine” for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.

Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.

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How to Prevent Blood Clots in Pregnancy

Even though pregnancy puts you at higher risk for DVT, you can take steps to protect yourself from blood clots. Above all, talk to your provider about your symptoms as much as you need to. When it comes to protecting yourself from DVT, no question is too small.

Be Aware of Your Risk Factors

The more prepared you are, the better you can prevent DVT in pregnancy. Ask the women in your family if they have had blood clots, and notify your provider of any family history or other risk factors.

Keep Moving

Lack of movement can affect your blood flow and increase your risk for DVT in pregnancy, says Dr. Berens. “So stay active and maintain a healthy weight.” If you have to be on bed rest because of an injury or complication in your pregnancy, your doctor may prescribe blood thinners as a precautionary measure.

Get Up During Travel

“Flying in itself is a risk factor for DVT, so pregnant women who fly are definitely at an increased risk,” Berens says. If you have to fly, get up and move around every hour or two and do ankle roll exercises while you sit.

“Do the same thing if you go on a long car or bus ride,” she adds.

Wear Compression Socks

Because they improve circulation and reduce swelling in the legs, compression socks can lower your risk of DVT in pregnancy, Roshan says.

Drink Lots of Water

Good hydration during pregnancy helps prevent clots by keeping the blood from getting too thick, Roshan says. Experts recommend that pregnant women drink 8 to 12 glasses of water every day.

Use Prescribed Medication

If you have a DVT, you will probably be treated with a blood thinner like enoxaparin (Lovenox), which is safe during pregnancy. “We treat the clot with a therapeutic dose for a few months and then lower it to a prophylactic (preventive) dose,” says Roshan.

If your provider prescribes medication for you, it’s very important you take it as instructed. If you’re not sure how to take it, or have questions about it, let your provider know right away.

“We usually monitor women taking blood thinners throughout their pregnancies because as the pregnancy progresses, they sometimes need higher doses,” Roshan says. “For women with a family history of DVT but no personal past history, we sometimes prescribe baby aspirin and tell them to be particularly cautious about symptoms.”

Overall, erring on the side of caution with blood clots can help prevent or catch any potential complications early. “Deep vein thrombosis in pregnancy can be life-threatening, so if you see any signs, don’t hesitate to go to your doctor to get checked,” Roshan says.

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What Is the A1C Test for Diabetes?

An A1C test, also known as a hemoglobin A1C or HbA1C test, is a simple blood test that estimates your average blood sugar levels over the last three months. People who don’t have diabetes may be given this test at a wellness visit to screen for prediabetes or diabetes. People who have diabetes may use an A1C test to monitor how well their disease is being managed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291b44ab7c-c0e3-4d99-a769-d0953c8b89cd
Who Typically Needs an A1C Test? Who Needs an A1C Test? A1C tests are performed routinely on people with and without diabetes. People With Diabetes If you already have diabetes, your initial diagnosis may have been given based on the results of an A1C test. Regular A1C tests are also one of the most important health markers for people with diabetes after a diagnosis. Measuring A1C levels is perhaps the best tool your healthcare providers have for monitoring the progression of your diabetes and the success of your treatment. Your A1C measurement gives a clinician or diabetes educator a single snapshot of how high or low your blood sugar levels have been over the past several months. Your A1C results will help determine whether your diabetes management plan — including diet, exercise, medication, and other lifestyle changes — needs adjustment. Most people with diabetes are advised to get new A1C checks every three to six months.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297e3c2371-3d81-4840-a637-5472e3924dcd People Without Diabetes An A1C test is also one of the most common and reliable ways of diagnosing prediabetes and diabetes:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2baa345-ed0b-4a51-8950-1c5eea4ca717
If your A1C result is in the diabetic or prediabetic range, your clinician may choose to administer another test, such as a fasting blood glucose test or an oral glucose tolerance test, to confirm your diagnosis. If you are experiencing some of the symptoms of high blood sugar — such as frequent urination, intense thirst, or blurry vision — your doctor may give you an A1C test to check for diabetes. Others will receive an A1C test as a matter of routine during a checkup or wellness visit. And some healthcare professionals will choose to screen adults with certain risk factors for diabetes. The U.S. Preventive Services Task Force recommends diabetes screening for all adults over the age of 35 who are overweight or who have obesity, and it suggests that doctors screen people at an even earlier age if they have one of the following additional risks:e60dc2a1-f33c-4a05-9b50-8e3e8e5976298162fcd1-5d51-4e28-a8a1-307d235b9c92 A family history of diabetes A personal history of gestational diabetes Polycystic ovary syndrome
How Is an A1C Test Performed? How It’s Performed An A1C test uses a simple blood sample and doesn’t require any special preparation. During an office visit, a nurse or phlebotomist will take a blood sample from a vein or finger and send it to a lab to be analyzed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293eddf7bd-22c9-4e53-9544-2396860a523c An A1C test doesn’t require fasting. You can eat and drink normally prior to the test, unlike with a fasting glucose or cholesterol test, and the results will not be significantly affected if your blood sugar happens to be unusually high or low at the time of the test.e60dc2a1-f33c-4a05-9b50-8e3e8e59762905f973bc-26f6-4f81-bd9a-84fe5698fbcb Blood tests pose very little risk. It’s possible that there may be some bruising or soreness in the area where the needle was inserted, but it typically goes away quickly. You may also want to avoid lifting heavy objects for 24 hours after the test.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c318ef5-b3b5-4a66-af44-c2a764f26203 It is also possible to purchase an at-home A1C test, although these products are probably less reliable than a test conducted by a certified laboratory.e60dc2a1-f33c-4a05-9b50-8e3e8e59762945f42bbe-06a3-47f6-9b05-d0b30e60e46d
What Do My A1C Results Mean? Results A1C results are reported as a percentage in the United States. To find your average blood sugar level over the past several months, you can convert the number into the same measurement that your blood sugar meter or continuous glucose monitor uses:e60dc2a1-f33c-4a05-9b50-8e3e8e59762995024c4d-82b0-48c0-8f61-68d792eef3d2
Some lab reports will also list this second number, which may be labeled “estimated average blood glucose (eAG).” In many other countries, A1C and blood sugar measurements are given in different units.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294eacd01e-63a4-4462-8d2c-049e57f0c1a3
What’s Next? What’s Next Your A1C test results will help a clinician to determine the recent history of your blood sugar levels, which are an important aspect of your metabolic and overall health. If you’ve never been diagnosed with prediabetes or diabetes, the results of your A1C test will help your healthcare provider determine whether you have either of those conditions, or it could indicate that you are at risk of developing them in the future. You may be asked to try to lose weight, change your diet or exercise habits, or take a new medication. If you have already been diagnosed with diabetes, your A1C result will help determine how well your treatment has been working. High A1C results, which indicate that your blood sugar has been chronically elevated above a healthy range, are strongly correlated with the complications of diabetes , including vision loss, nerve damage, kidney failure, and cardiovascular disease. People with diabetes who can keep their A1C below 7 percent, the target set for most nonpregnant adults by American health authorities, have a significantly reduced risk of diabetic complications.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296cbcb6c7-7516-4284-9e28-7913470ec85be60dc2a1-f33c-4a05-9b50-8e3e8e597629370de45b-d73a-4154-b296-c1017662b0fc If your A1C result is above the target set by your healthcare provider, you may be asked to increase your diabetes management efforts. This could include making new changes to your diet and exercise habits or to how frequently you check your blood sugar. You may also be prescribed new diabetes medications or larger doses of your existing medications.
The Takeaway The A1C test measures average blood sugar levels over the past three months and is an essential part of diagnosing and managing diabetes. An A1C test uses a standard blood draw, and it doesn’t require any special preparation or recovery. It is recommended that most adults with diabetes keep their A1C below 7 percent; higher numbers are associated with a greater risk of diabetes complications. Your healthcare provider should use your A1C results to make recommendations about the way you manage your diabetes or prediabetes, including changes to your medication or your diet, exercise, and lifestyle habits.
Resources We Trust Cleveland Clinic: How to Reverse Prediabetes Mayo Clinic: Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar Mass General Brigham: How to Control Blood Sugar With Diet American Diabetes Association: Understanding Your A1C Test Centers for Disease Control and Prevention: Diabetes Testing

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Insomnia Risk Goes Up the More You Use a Screen in Bed

Is your phone your constant companion, all the way through bedtime? It might be messing with your sleep. A new study from Norway found that more screen time in bed significantly raised the likelihood of insomnia.

Specifically, an hour of in-bed screen time increased insomnia risk by nearly 60 percent, and lowered sleep duration by about a half hour.

“We were particularly interested in whether social media — because of its interactive and potentially emotionally stimulating nature — would have a stronger association with poor sleep outcomes than other screen activities,” says the study author Børge Sivertsen, PhD, a senior researcher at the Norwegian Institute of Public Health in Bergen.

“Surprisingly, we found that it’s the overall screen time in bed that matters most, not the type of activity,” Dr. Sivertsen says.

Sleep Troubles Grow as Screen Time Increases

Sivertsen and his colleagues analyzed survey responses from more than 45,000 adults ages 18 to 28.

Participants were asked whether they used screens after going to bed, for how long, and for how many nights per week. Then they identified their common screen activities: watching shows or movies, gaming, social media, surfing the internet, listening to audio such as podcasts, or reading.

The survey also asked when participants typically went to bed, when they got up in the morning, and how long it typically took them to fall asleep. Participants indicated how often they had trouble falling or staying asleep, how often they felt sleepy during the day, and how long their sleep problems persisted.

Insomnia was defined as having trouble sleeping and experiencing daytime sleepiness issues at least three times a week for at least three months.

The results showed that a one-hour increase in screen time in bed was linked to a 59 percent greater risk of insomnia and 24 fewer minutes of total sleep on average.

Sivertsen stresses that insomnia symptoms and reduced sleep duration were associated with an increased amount of screen use.

He adds that the findings are limited in that they are observational, relying on preexisting self-reported data from a narrow population (young adult Norwegians) that did not include scientific sleep measurements.

Why You Should Avoid Your Phone Before Bed

Many health authorities, including the Sleep Foundation, recommend avoiding computers and smartphones entirely in the hour leading up to bedtime.

“Screen time at bedtime activates the mind,” says Vishesh Kapur, MD, MPH, the director of sleep medicine at the University of Washington in Seattle, who was not involved in the study. “If the individual is consuming content that is very interesting, they may delay going to sleep, or if the content is disturbing or anxiety-inducing, this could make it hard to fall asleep.”

Blue light from screens may also promote wakefulness.

“Blue light from screens suppresses melatonin production, a hormone essential for initiating sleep,” says Nitun Verma, MD, a sleep physician and spokesperson for the American Academy of Sleep Medicine.

Tips to Break the Bedtime Screen Habit

Dr. Verma, who was not involved in the research, offers the following tips to prevent wakeful effects from smartphones and get better sleep:

Avoid screens 30 to 60 minutes before bedtime.
If you must use screens, keep brightness to a minimum.
Use built-in phone features like Night Shift, which reduces blue light, and Do Not Disturb, which silences notifications, calls, and alerts.
Replace screen time with a relaxing bedtime ritual such as reading a physical book or gentle stretching.
Consider an old-fashioned alarm clock instead of setting an alarm on your phone to reduce the temptation to go online.

“Our study shows that even small reductions [in screen time] could improve sleep quality and duration,” says Sivertsen. “It’s not about quitting screens entirely — it’s about being mindful of how and when we use them, especially at night.”

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Certain Kinds of Coffee Could Be Sabotaging Your Cholesterol

On-demand coffee machines are becoming more common in the workplace, but new research suggests that drinking coffee brewed this way could contribute to higher “bad” cholesterol levels.

The oil in coffee beans is rich in compounds called diterpenes. Decades ago, scientists found that these substances were high enough in unfiltered coffee to strongly raise “bad” LDL cholesterol and slightly reduce “good” HDL cholesterol in humans.

Later research showed that diterpenes were significantly higher in unfiltered boiled and French press coffee than in paper-filtered coffee.

“Coffee from workplace machines, however, had not been examined until now,” says study author David Iggman, PhD, a researcher at Uppsala University in Sweden. “We found the levels of these substances are much higher in coffee from these machines than from regular drip-filter coffee makers.”

Based on their results, Dr. Iggman and colleagues estimated that replacing three cups of brewing-machine coffee with paper-filtered coffee five days per week could lower LDL cholesterol by 13 percent over five years, or 36 percent over 40 years.

Paper Filters May Make a Difference

For the analysis, the study authors measured two kinds of diterpene — cafestol and kahweol — in coffees made in 14 different types of conventional self-serve coffee makers found in break rooms and different work spaces.

Coffee samples were taken from two types of office machines:

Machines that mixed hot water with the ground coffee and then passed the liquid through a metal filter
Machines that mix a liquid coffee concentrate with hot water

For comparison, the researchers also analyzed samples of coffee made with a paper filter, a percolator, and a French press, as well as by coffee made by boiling ground beans with water (a method popular in Sweden).

In addition, they examined four espresso samples made in three cafeterias and one laboratory workplace coffee machine.

They discovered that most coffees from workplace brewing machines contain higher diterpene concentrations than paper-filtered coffee.

Ranking Brew Styles From Best to Worst

The researchers measured diterpenes in terms of milligrams per liter (mg/L). For all workplace coffee machines, the median range of cafestol and kahweol was 174 and 135 mg/L, respectively, compared with 11.5 mg/L of cafestol and 8.2 mg/L for kahweol in paper-filter drip coffee.

Diterpene concentrations in French press (87 mg/L cafestol and 69 mg/L kahweol) and percolator coffee (91 mg/L cafestol and 69 mg/L kahweol) fell in the middle between coffee machine and paper filter levels.

Boiled coffee (939 mg/L cafestol and 678 mg/L kahweol) and espresso (1,059 mg/L cafestol and 621 mg/L kahweol) had the highest diterpene content. The study authors noted, however, that there was considerable and “unexplained” variation in espresso samples with cafestol levels ranging from 35.6 to 2,446.7 mg/L.

Because espresso is made by forcing hot water through very finely ground coffee under high pressure without a filter, it makes sense that this brew has the highest potential to raise cholesterol levels.

The findings here correspond with previous research showing a significant association between espresso consumption and higher measure of bad cholesterol in the blood.

“Keeping espresso to a minimum will lower risks,” says Melissa Prest, DCN, RDN, a spokesperson for the Academy of Nutrition and Dietetics, who was not involved in the study. She recommends limiting espresso to one or two shots per day at most.

Overall, coffee brew styles ranked as follows in order of best to worst for cholesterol are:

Paper filter
Filtered boiled
French press
Workplace coffee machine
Percolator
Boiled without filtering
Espresso

Study Does Not Address the Impact on Heart Disease Risk

For Gregory Katz, MD, a cardiologist at NYU Langone Heart in New York City, these study results are limited in that experiments were not conducted to see the actual impact on LDL levels or endothelial function (the functioning of cells that line the inside of blood vessels).

“They certainly didn’t test different brewing methods and then see how that impacted things like heart attack and stroke,” says Dr. Katz. “The study tells us zero information about how this impacts the risk of cardiovascular disease.”

Coffee Has Many Health Benefits

While cafestol and kahweol in excess may raise LDL cholesterol, research suggests that these compounds may also come with benefits. “The benefits of these two substances with regular consumption of coffee includes anti-inflammatory properties and its links to reducing the risk of type 2 diabetes,” says Julia Zumpano, RD, with the Cleveland Clinic Center for Human Nutrition, who was not involved in the new study.

She adds that the negative effects may be significantly lowered through filtering.

Coffee also offers the following health benefits:

Micronutrients like vitamin B2 and B3, potassium, and magnesium
Antioxidants, which protect cells from damage and may lower the risk of certain cancers
Phenols, which play key roles in immunity and protecting the body from inflammation
Caffeine, which may offer potential support for brain health, blood flow, and blood pressure.

Coffee Add-Ins May Pose a Higher Risk Than Coffee Itself

Maya Vadiveloo, PhD, RD, chair of the American Heart Association’s Lifestyle Nutrition Committee and an associate professor of nutrition and health sciences at the University of Rhode Island in Kingston, suggests that the ingredients we add to coffee may be more damaging than the coffee itself.

“Both excess added sugar and saturated fat found in high fat dairy products like cream adversely affect cardiovascular health,” says Dr. Vadiveloo, who was not involved in this study.

She advises consumers to drink coffee in moderate amounts, but filter it whenever possible to reduce the risk of elevated LDL cholesterol.

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What Is IV Nutrition Therapy — and Does It Work?

Medical IV therapy is administered by a trained healthcare professional in a hospital, medical clinic, or home.

Your healthcare team (which may include doctors, nurses, nutritionists, and pharmacists) will collaborate to prescribe the cocktail of IV nutrition therapy at doses suited to your needs.

Then, your healthcare provider will attach the IV bag to your catheter, a thin, flexible tube inserted into a vein using a needle that delivers IV fluids to your bloodstream. It typically takes 10 to 12 hours for the contents of the bag to fully enter your body.

Meanwhile, medical spas, integrative medicine physicians’ offices, and drip bars (wellness clinics that provide IV nutrition therapy on-site or deliver infusions to homes, offices, or hotel rooms) may offer nonmedical IV nutrition therapy.

It’s often administered by a nurse or physician’s assistant.

But there’s no guarantee that you’ll get a licensed medical professional, because there isn’t federal oversight on who prescribes, prepares, and administers the solution for nonmedical IV therapy.

A reputable clinic has medical oversight from a physician or a nurse practitioner. Your vitals will be checked, and you’ll be asked to complete a health screening or questionnaire before you receive IV therapy, says Steve Rallis, a doctor of chiropractic medicine, doctor of naturopathy, and the chief medical officer for the DRIPBaR Canada. Then, the IV is administered by a nurse.

The nutrient solution will be made according to your needs, Rallis says. You’ll receive a steady supply of the solution through the IV while you sit, with sessions lasting approximately 20 to 60 minutes. You should be monitored during the session, and your vitals should be rechecked once the injection is completed, Rallis says.

Many IV drip companies recommend coming once every two weeks, though this depends on the person and their reasons for going in the first place, Rallis says. Expect to go more than once. “If it’s for fatigue, as an example, you’re unlikely to see the benefit until you’ve done around six to eight IVs,” Rallis says.

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Research, Potential Benefits, and Myths

Most experts agree that the best way to get omega-3 fatty acids is by eating fatty fish, which contain the highest amounts of EPA and DHA. These fish include salmon, mackerel, and trout. Fish oil supplements are not thought to be as beneficial.

“Whole fish provides additional nutrients and bioavailability advantages over supplements,” says Avena.

Dr. Yassine notes that, overall, fish oil supplementation trials have been inconclusive. “Fish is complex. Even the actual DHA and EPA in fish is not the same as what is present in supplements,” he says

For people who don’t eat fish, Avena says algal oil is the best plant-based source of DHA and EPA, as it’s derived from the same marine algae that fish consume.

Flaxseeds, chia seeds, hemp seeds, and walnuts contain alpha-linolenic acid (ALA) which can be converted into EPA and then to DHA in the body, but not very efficiently, which is why consuming marine food sources is preferable.

How Much Fish Oil Should I Take?

The 2020–2025 Dietary Guidelines for Americans recommend that adults eat 8 ounces (oz) of fish per week. The average size of a main portion fish filet is around 8 oz when raw and 6 oz when cooked (use the size of your hand as guide to portion size), so it’s best to aim for at least one serving a week or more.

But even if you’re only getting one serving of fish per week, the brain may benefit.

“Research shows that when comparing people who are consuming one or more servings of fish per week to those who are eating less, fish eaters experience less cognitive decline over the years,” Dr. Agarwal says.

“That should be encouraging, because this is a simple lifestyle modification to maintain brain health,” Agarwal says.

For those who prefer supplements, Rizzo says most fish oil supplements are 1,000 milligrams (mg). There are no universal recommendations for omega-3 supplements, but the U.S. Food and Drug Administration specifies that the labels of dietary supplements should not recommend a daily intake of EPA and DHA higher than 2 grams (g).

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