These are the most common symptoms you may have if you have an underactive thyroid gland.
Symptoms of Hypothyroidism in Adults
The most common hypothyroid symptoms are fatigue, cold intolerance, constipation, slower metabolism, and dry skin, while more surprising signs may be a slower heart rate, joint and muscle pain, and dry or puffy skin, says Gregory Dodell, MD, an assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. Some people might experience one symptom but not the others. Adults with hypothyroidism may have any of the following signs and symptoms:
High cholesterol
Puffy face
Weight gain
Fatigue
Sensitivity to cold
Constipation
Slowed heart rate
Memory decline
Stiff, swollen, or achy joints
Irregular or heavy periods
Muscle weakness, aches, stiffness, or tenderness
Hoarseness
Hypothyroidism Symptoms in Infants
Babies born without a thyroid gland will develop hypothyroidism while those born with a dysfunctional thyroid gland may develop the condition.
Thyroid function is typically screened at birth. Babies may not immediately have signs or symptoms of the condition, but when they do, they include:
Growth abnormalities
Yellowed whites of eyes or skin (jaundice)
Puffy skin
Constant sleepiness
Constipation
Signs of Hypothyroidism in Children and Teenagers
Like infants, children and teens are also at risk of hypothyroidism. Often, symptoms in this age group mimic those of adults.
In addition to the symptoms that occur in adults, signs of hypothyroidism in this age group include:
Cognitive delays
Short stature
Late development of permanent teeth
Delayed puberty
Weight Gain Is Often One of the First Signs of Hypothyroidism
Gradual weight gain is perhaps one of the first noticeable signs of hypothyroidism. This is related to a slower than normal metabolism. You may find losing weight more difficult, or perhaps you gain weight despite diet and exercise. On top of that, you may also feel bloated from hypothyroid-related constipation.
Fatigue That Persists May Signal Hypothyroidism
Excessive fatigue is another common symptom of hypothyroidism. You may feel extremely tired all the time, no matter how much sleep you get.
Habitual daytime naps or a constant need for caffeine may also be signs of excessive fatigue related to this condition (unfortunately, these practices can also make it more difficult to sleep at night).
Reproductive Changes in Women Could Mean You Have Hypothyroidism
Women are at an increased risk for developing thyroid disease. Women are also more likely to develop thyroid conditions after pregnancy and following menopause.
“Women may experience a change in their menstrual cycle if their thyroid function is off,” says Dr. Dodell. Not only might you experience irregularities in your cycle, but hypothyroidism may also cause periods that are much heavier than normal.
Women who are trying to conceive may have difficulties getting pregnant. “Therefore, women who are trying to get pregnant or are planning to try and get pregnant in the near future should have their thyroid levels checked,” Dodell explains. “We also monitor women who are being treated for hypothyroidism closely during pregnancy, since the dose of medication may need to be adjusted.”
Menopausal women may experience worsening symptoms.
Cold Intolerance Is a Symptom of Hypothyroidism
A slowed-down metabolism from hypothyroidism may also lower your body heat. This can make you more cold intolerant.
Depression and Hypothyroidism Are Comorbidities
A lack of adequate thyroid hormones can make you feel unusually depressed. Aside from feeling depressed, forgetfulness is also common in people with hypothyroidism.
Plant-based proteins like legumes and nuts are a good nutritional choice for people with diabetes. They can help lower blood sugar spikes, improve glycemic control, and they don’t contain the unhealthy saturated fats that many animal proteins do.e60dc2a1-f33c-4a05-9b50-8e3e8e59762917cdad13-aeae-4e80-9e60-1df06a8ac67f “Legumes are rich in protein and fiber, both of which are helpful nutrition tools for managing blood sugar levels,” says Mary Ellen Phipps, MPH, RDN , a registered dietitian-nutritionist in the Houston area and the author of The Easy Diabetes Cookbook . Nutrition authorities agree that most people — including ones with blood sugar issues — should eat more legumes. Beyond being a rich source of protein and fiber, they’re also a good source of vitamins and minerals, and they don’t contain any cholesterol.
What Are Legumes? What Are Legumes? The term legumes is not just a synonym for beans. They are a broader group of plants that are members of the bean family.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299bd07a2c-9182-480c-abc9-ceb5adff8b30 “You may have heard terms like legumes, pulses, or beans sometimes used interchangeably,” says Melissa Joy Dobbins, RDN, CDCES , a registered dietitian-nutritionist and certified diabetes care and education specialist in Chicago and the host of the Sound Bites podcast . “However, while all beans are legumes, not all legumes are beans.” Legumes include: Beans (lima, snap, string, navy, black, kidney, pinto, cannellini) Broad beans (fava beans) Chickpeas Lentils Peanuts Peas Soybeans
What Are the Health Benefits of Legumes? Health Benefits Legumes are generally inexpensive, environmentally friendly, versatile, and fit into both vegan and gluten-free diets. Legumes can help manage diabetes symptoms as well as other related health conditions. Lower Blood Pressure Legumes are beneficial to cardiovascular health. This is extremely important for people with diabetes, since they are twice as likely to develop heart disease or stroke than those without the disease.e60dc2a1-f33c-4a05-9b50-8e3e8e59762957768549-be6e-434a-a540-9e92845d049e Other research shows that people who have type 2 diabetes and high blood pressure (a risk factor for heart disease) who eat three servings of legumes per week had better blood pressure control than those who ate the least.e60dc2a1-f33c-4a05-9b50-8e3e8e59762983d7bc64-bbc4-4ff2-acb7-9e7c740ce114 Healthier Body Weight Weight management is an important component of diabetes treatment for type 2 diabetes. Weight loss can increase insulin sensitivity, helping with blood sugar control and potentially reducing reliance on diabetes medications.e60dc2a1-f33c-4a05-9b50-8e3e8e59762967e3a36f-8000-4a32-8567-68655e68cac5e60dc2a1-f33c-4a05-9b50-8e3e8e5976295cf2885a-1bd0-4202-9753-0505457fc6e3 With their combination of fiber, plant protein, and lower calorie content, legumes are a great addition to a weight loss diet. People who eat legumes regularly gain less weight and have leaner waistlines over time than those who don’t.e60dc2a1-f33c-4a05-9b50-8e3e8e59762904a09d51-e7bc-4b81-b380-d32563190522 Fiber and protein help promote weight maintenance and weight loss because they are so satisfying and help people feel fuller sooner and for longer.e60dc2a1-f33c-4a05-9b50-8e3e8e59762935d294c4-521c-4ef8-8c90-b51cd162c40b Lower Cholesterol Levels Diabetes can lead to elevated triglycerides and LDL cholesterol , while also lowering HDL cholesterol , known as “good” cholesterol.e60dc2a1-f33c-4a05-9b50-8e3e8e59762909025142-8100-4999-b568-7b96676db95d One small study found that eating a cup of canned beans decreased total and LDL cholesterol in adults with high cholesterol, and concluded that doing so is a practical strategy to lower cardiovascular disease risk.e60dc2a1-f33c-4a05-9b50-8e3e8e59762935dc42ed-26a8-4d3b-8302-3c2e25327d92 The benefits can be even larger if you’re using legumes to replace red meat.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d0f8524d-f66f-47db-b73b-d009acde5c2d
Legumes and Blood Sugar Legumes and Blood Sugar Legumes do contain carbohydrates, which means that these tiny nutritional powerhouses can lead to a gradual increase in blood sugar. If you use insulin before meals, you’ll almost certainly need to count the carbs in legumes and dose accordingly. But as far as carbohydrate sources go, you can hardly find healthier options, especially if they’re replacing sugars, refined starches, or ultra-processed foods in your diet. “While it’s important to be aware of and manage your carbohydrate intake, choosing quality carbohydrates, such as legumes, that include fiber, vitamins, and minerals is recommended,” says Dobbins. Legumes are very low on the glycemic index, a scale used to measure how foods affect blood sugar levels.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f675030c-807f-4e72-b63c-728d8aba1dd1 “Foods that are low on the glycemic index scale have less of an impact on blood sugar levels compared to foods that rank as moderate or high on the glycemic index scale,” explains Phipps. “Legumes are low on the glycemic index scale because of their low sugar and high fiber content,” she says. Fiber-rich foods slow digestion, resulting in lower blood sugar spikes after meals. One review of five studies found that people who ate legumes regularly for at least six weeks saw blood sugar benefits, such as decreased fasting blood glucose levels and a reduction in A1C by up to 0.5 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296613baa1-0622-44b3-8680-1795c3fdf430 Phipps says you can incorporate legumes into your diet every day if you’d like — starchy carbohydrates like peas, beans, and lentils can also fit into almost any healthy eating pattern.e60dc2a1-f33c-4a05-9b50-8e3e8e59762944a500d1-ce9d-4054-9f15-f93a2ed6c959
Low-Carb Legume Options Low-Carb Options Many people with diabetes choose to manage their condition with a low-carbohydrate diet , and may eat few legumes. For committed low-carb eaters, however, there are some options with surprisingly low carbohydrate counts. Green Beans We tend to think of these more as a green, nonstarchy veggie, but green beans fit into the legume family. One cup has 31 calories, 7 grams (g) of carbohydrates, and 3 g of fiber.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eb906d1a-c173-43d7-9728-92b0654d2ac6 Peanuts Dobbins recommends peanuts for people with diabetes, although they are extremely calorie dense. A serving of peanuts is 1 ounce (oz), which contains 166 calories, 6 g of carbohydrates, and more than 2 g of fiber.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299aeaf91f-4213-42db-81db-088cbca7f689 Soybeans When eaten whole, they’re known as edamame, and roughly a half cup of raw green soybeans has 112 calories, 7 g of carbs, and 4 g of fiber.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977560c96-24ef-4872-8024-56545bc55c03 Soybeans are also used to make tofu, tempeh, soy milk, and soy yogurt. And there’s a canned variety of this legume known as black soybeans, which could be used as a substitute for higher-carb black beans or pinto beans. Lupini Beans These Mediterranean beans have been around for centuries, but they’ve only recently made their way into specialty and high-end food stores. They’re typically sold lightly salted in brine and eaten as a snack. A ¼ cup contains only 40 calories, 3 g of carbs, and 1 g of fiber.e60dc2a1-f33c-4a05-9b50-8e3e8e597629983f2fd6-3667-4305-bece-7825e214db5a
Are Peanuts and Peanut Butter Good for Diabetes? Peanuts and Peanut Butter Yes and no. Dobbins says peanuts and peanut butter contain many nutrients that may reduce cardiovascular disease risk, but they are high in calories and can cause weight gain — a known risk factor for type 2 diabetes — if eaten too liberally. “[Peanuts] are high in antioxidants like vitamin E, heart healthy unsaturated fats, and phytonutrients such as resveratrol,” says Dobbins. Resveratrol is a naturally occurring plant compound known for its antioxidant properties.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6ddda17-0461-4fe5-b97c-114127face72 If you choose to snack on peanuts, avoid those that are flavored and excessively sweet. Honey-roasted peanuts are a healthier choice than most junk foods, but you can easily find yourself eating more sugar, fat, and calories than you intended. Sometimes oils and sugars are added to peanut butter to improve the flavor and texture. Choosing a natural variety is the best way to avoid added sugar, since they’re typically just ground peanuts.
How to Incorporate Legumes in Your Diet Incorporating Legumes Into Your Diet Beans, peas, and lentils can all make delicious additions to your diet. But if you’re not sure how to make them a regular part of your meal plan, try these expert tips. Watch the serving size. Aim for a half cup, Phipps recommends. In this amount, you’ll average around 8 g of protein and 8 g of fiber. Swap legumes for animal protein . Legumes can lend a meaty texture and taste to familiar dishes you enjoy. They especially shine as a substitute for ground meat, says Phipps. “Swap out half the meat for cooked beans or lentils,” she suggests. Sprinkle them on other foods. Think salads, veggies, or rice, suggests Dobbins. When you’re cooking, think about adding a few spoonfuls to your recipe. Make them a side dish. Cooked legumes pair well with chicken or fish. Try bean salad, cooked lentils, or some steamed or roasted green beans in place of traditional rice, pasta, or potatoes, says Dobbins. Whip up a dip. Dobbins suggests hummus, which is made with chickpeas, or black or white bean dip. Use low fat and low carb baby cucumbers, mini bell peppers, or carrot slices to scoop it up.
The Takeaway Legumes, which include beans, lentils, and peanuts, are excellent plant-based protein sources that may help manage blood sugar levels due to their high fiber content. Although legumes contain carbohydrates that can impact blood sugar, they still can be a safe dietary choice for many people with diabetes. Peanuts and peanut butter are nutritionally sound but calorie dense. Be mindful of serving sizes when integrating them into meals. People who follow a low-carb diet can try green beans, soybeans, and lupini beans, which offer lower carbohydrate options without sacrificing their nutritional benefits.
Resources We Trust Cleveland Clinic: How to Follow a Diabetes-Friendly DietMayo Clinic: Bean and Legume RecipesHarvard Health Publishing: Love Those Legumes!Johns Hopkins Patient Guide to Diabetes: Getting Started on a Plant-Based DietAmerican Diabetes Association: What Superstar Foods Are Good for Diabetes?
Given its mixed scientific results, cinnamon seems unlikely to make a significant impact on your health, especially in the smaller amounts that most people are likely to add to their meals. But even so, there’s good reason to sprinkle it on toast, add it to tea or coffee, or mix it into oatmeal or yogurt anyway, says Sandra Arévalo, RDN, MPH, CDCES, the director of the Jacob’s Family Pride Wellness Center at Montefiore Nyack Hospital in New York.
“I recommend cinnamon and nutmeg to add flavor to desserts and other sweet treats while reducing the amount of sugar used in the recipe,” she says.
Cinnamon supplements, on the other hand, make it easier to consume larger amounts of it. They can contain as many as 6 g (1¼ tsp) per dose, according to some studies. But taking supplements comes with some risk. Unlike prescription and over-the-counter medications, supplements are not regulated by the U.S. Food and Drug Administration (FDA), and their manufacturers are not required to provide evidence of their safety or efficacy.
If you decide to try cinnamon supplements, Arévalo cautions against consuming too much, since they can cause gastrointestinal issues such as nausea, vomiting, diarrhea, or heartburn.
“There are studies that show cinnamon can also affect the liver when taken in large doses because of the effects of a component in cinnamon called coumarin,” she says. A small percentage of people may be especially sensitive to liver damage from to coumarin consumption.
Check with your doctor to ensure that cinnamon supplements won’t interact with any other medicines or supplements you take. If they won’t, look for a supplement that’s been third-party tested by NSF, ConsumerLab, or U.S. Pharmacopeia (USP).
Women and girls with urinary tract infections (UTIs), especially stubborn ones that tend to recur despite treatment, have a new medication option now that the U.S. Food and Drug Administration (FDA) has approved the oral antibiotic gepotidacin.
The drug, okayed for females 12 years old and up with uncomplicated UTIs (that have not spread beyond the bladder to the kidneys), will be marketed under the brand name Blujepa. It is the first in a new class of UTI antibiotics, and the first to be approved in almost three decades.
“The new antibiotic is a fantastic event, as there is a significant minority of women with UTIs that have become resistant to the current armamentarium of antibiotics. This gives an option to those who would otherwise need intravenous antibiotics,” says Craig Comiter, MD, a professor of urology and urologist at Stanford Health Care in California.
UTIs are the most common type of infection in women, impacting up to 16 million women in the United States annually. Over half of all women are affected by a UTI in their lifetime, and an estimated 30 percent experience recurrent UTIs.
Blujepa Approval Provides ‘Another Important Choice’ for UTI Treatment
Blujepa’s approval is based on positive outcomes from two late-stage clinical trials, EAGLE-2 and EAGLE-3. In these studies, Blujepa was compared with nitrofurantoin, a leading treatment for uncomplicated UTIs.
In the EAGLE-2 trial, Blujepa demonstrated non-inferiority, meaning it was at least as effective as nitrofurantoin, and 50 percent of the women were symptom free and had no microbiological signs of infection, compared with 47 percent for nitrofurantoin.
In the EAGLE-3 trial, Blujepa showed slightly better efficacy, with a success rate of 59 percent compared with 44 percent for nitrofurantoin.
Bluejepa appears to be about as effective as the currently available options, says Dr. Comiter. “But when bacteria are resistant to other antibiotics, choices are limited, and so this gives us another important choice,” says Comiter.
What Are the Side Effects of Blujepa?
Blujepa was generally well tolerated in the clinical trials. As is typical with antibiotics, gastrointestinal side effects were the most common. Diarrhea topped the list, occurring in 14 to 18 percent of participants. Nausea was also noted, at close to 9 percent.
These side effects were mostly mild to moderate, with only a small percentage of patients experiencing more severe symptoms, and there were no life-threatening adverse events.
UTIs Increasingly Involve Drug-Resistant Bacteria
UTIs, also called bladder infections, are most often caused when bacteria that are typically found in the digestive tract migrate to the urinary tract during sex or while wiping after a bowel movement.
A strong urge to urinate that doesn’t go away
Burning and painful urination
Cloudy, red, or pink urine
Pelvic pain
Most UTIs are caused by the bacteria Escherichia coli, and for decades, these infections were easily treated and cured with antibiotics. But that’s changing because of antibiotic resistance, which is when bacteria don’t respond to the medicines used to treat them.
Evidence suggests that more than 90 percent of bacteria that cause UTIs are resistant to at least one common antibiotic, and almost 80 percent are resistant to at least two.
That’s why new antibiotics are necessary, explains Comiter. “Resistance is acquired, generally ascribed to overuse of antibiotics, but it is a natural part of bacterial evolution and may be unavoidable,” he says.
Blujepa will be most appropriate for people with UTIs caused by resistant bacteria, commonly called ESBL (extended spectrum beta-lactamase) or MDR (multidrug resistant) strains, says Comiter.
“This approval will also help patients everywhere who have multiresistant infection,” he says.
When Will Blujepa Be Available and How Much Will It Cost?
Blujepa is expected to be available in the United States sometime this summer, says Lyndsay Meyer, the director of U.S. Corporate Media Relations at GSK.
“Details are forthcoming,” on how much a round of the antibiotic will cost and insurance coverage, she says.
Given that most antibiotics are generic, and Blujepa will be a new branded option, will cost be a consideration in prescribing to patients?
“Cost is always a consideration, and this treatment should be ‘saved’ for those bacteria that are known to be resistant to current antibiotics,” says Comiter.
When it comes to treating migraine, it’s important that you discuss with your medical provider what medications are safe during pregnancy.
“Acetaminophen is considered first-line medication therapy for headache in pregnancy,” says Dao. “Second-line agents include a class of migraine medications called triptans, which have shown to be effective, with growing evidence that they are relatively safe during pregnancy. There is growing evidence of other migraine medications that have been deemed safe during pregnancy, so it is always important to talk to your doctor regarding your options.”
Triptans
Triptans cannot prevent your migraine attacks, but they can stop the pain by altering blood circulation in the brain and changing how your brain processes the pain.
Your doctor may recommend sumatriptan, as it has been used most commonly in the past, without adverse effects.
A few other triptans, such as rizatriptan, zolmitriptan, and eletriptan, have been logged by major pregnancy studies, and were found to have no increased risk of birth defects.
Occipital Nerve Blocks
Occipital nerve blocks are a pain relief treatment that injects local anesthetic, such as lidocaine, near the occipital nerve on the back of the head. Sometimes, this is combined with a steroid injection.
Anti-Nausea Medications
Your doctor might also choose to prescribe anti-nausea medication if you experience additional nausea with migraine attacks. This might include cyclizine, ondansetron, or prochlorperazine. Discuss all potential side effects and any plans for breastfeeding with your doctor, as some anti-nausea medications, like promethazine, can affect milk production. Others, such as ondansetron, which is connected to heart-rhythm problems, may not have enough history of proven use during pregnancy to be categorized as safe.
Doctors diagnose EPI using a range of stool tests, blood tests, and sometimes scans. But a diagnosis may be challenging. No single test can do it, and doctors often use the results of multiple tests as part of an overall clinical picture that includes symptoms and signs of malabsorption and malnutrition. Testing is just one part of the EPI puzzle that your healthcare team will have to solve, but it still provides essential information.
Stool Tests
A stool, or fecal elastase-1 (FE-1), test is often the first performed for EPI given the hallmark symptom of steatorrhea. The healthcare provider gives you a container for a stool sample, and you’ll need to provide a semisolid or solid stool. This tests levels of the pancreatic enzyme elastase, which supports protein digestion, in the intestines. This enzyme survives passing through the digestive system, so it shows up in stools. Low levels in the stool suggests you may have EPI.
FE-1 testing is accurate at showing severely impaired pancreas function, such as for children with cystic fibrosis. But while FE-1 isn’t as expensive or invasive as other tests, it often gives false-positive or false-negative results. For example, it’s also unsuitable for use when a person has particularly watery stools, because the FE-1 content may be diluted, potentially giving a false-positive result. An FE-1 test also isn’t effective at detecting mild EPI. A doctor may elect to start PERT without this type of test, especially if a person has underlying pancreas issues and symptoms like steatorrhea.
Measuring the fat content of stools through a fecal fat test may show how much fat the body is unable to digest. But doctors rarely recommend this test during routine screening for EPI, because a person needs to eat a specific, moderate-fat diet containing definite fat content for five days beforehand. This places a high burden on the patient.
Fecal fat testing plays a role in clinical research more than in practical medicine. But doctors might suggest a fecal fat test if a person isn’t showing a good response to PERT.
Blood Tests
Healthcare professionals may collect a blood sample to check levels of the fat-soluble nutrients A, D, E, and K and other minerals. People with EPI have difficulty processing fats, so these levels may be lower for them. These tests may help doctors identify malnutrition.
Blood tests can also measure trypsinogen, the pancreatic enzyme that converts to trypsin. This can be a helpful way for doctors to check how you’re responding to PERT treatment, as FE-1 levels don’t change when you take pancreatic enzymes from outside the body, but trypsin levels do.
Pancreatic Function Tests
An endoscopic pancreatic function test (ePFT), also known as a secretin pancreatic function test, is the most accurate way to directly test how the pancreas is working. A gastroenterologist inserts a flexible telescope into a person’s mouth while they’re under anesthesia and passes it down through the digestive system; this process is known as an endoscopy. The gastroenterologist administers a hormone called secretin that usually triggers the release of digestive enzymes, then collects pancreatic juice every 15 minutes for an hour to measure the concentration of a compound called bicarbonate. A pancreas will make enough bicarbonate if it is working well.
Despite its accuracy, ePFT is infrequently done and usually limited to specialized centers because it’s complex and time-consuming. The American Gastroenterological Association says that direct pancreatic function tests (ePFTs included) are promising but not widely available in the United States. The American Pancreatic Association further states that these tests are great at diagnosing early chronic pancreatitis but are often saved for patients being evaluated for chronic abdominal pain and suspected chronic pancreatitis.
Imaging Tests
These can’t directly diagnose EPI, but doctors will often carry out a range of imaging tests to rule out or identify underlying pancreatic problems, such as pancreatic cancer, advanced pancreatitis, or a shrinking pancreas. These may include a computed tomography (CT), magnetic resonance imaging (MRI) scan, or endoscopic ultrasound (EUS).
During an EUS, along with capturing imaging of the pancreas, the gastroenterologist may also collect a biopsy using a fine needle attached to the end of the scope if they find any tumors or cysts.
Kayli Anderson has over a decade of experience in nutrition, culinary education, and lifestyle medicine. She believes that eating well should be simple, pleasurable, and sustainable. Anderson has worked with clients from all walks of life, but she currently specializes in nutrition therapy and lifestyle medicine for women. She’s the founder of PlantBasedMavens.com, a hub for women to get evidence-based, practical, and woman-centered guidance on nutrition and cooking, hormone health, fertility, pregnancy, movement, mental well-being, nontoxic living, and more.
Anderson is board-certified in lifestyle medicine and serves as lead faculty of the American College of Lifestyle Medicine’s (ACLM) “Food as Medicine” course. She is past chair of the ACLM’s registered dietitian member interest group, secretary of the women’s health member interest group, and nutrition faculty for many of ACLM’s other course offerings. She is the coauthor of the Plant-Based Nutrition Quick Start Guide and works with many of the leading organizations in nutrition and lifestyle medicine to develop nutrition content, recipes, and educational programs.
Anderson frequently speaks on the topics of women’s health and plant-based nutrition and has coauthored two lifestyle medicine textbooks, including the first one on women’s health, Improving Women’s Health Across the Lifespan.
She received a master’s degree in nutrition and physical performance and is certified as an exercise physiologist and intuitive eating counselor. She’s a student of herbal medicine and women’s integrative and functional medicine. She lives with her husband in the Colorado Rocky Mountains, where you’ll find her out on a trail or in her garden.
Most likely, you’ll take elderberry as a supplement. You’ll find these in gummies, liquids or juices, syrups, lozenges, dried, and in capsule form.
You can buy elderberry jelly, jam, and wine online and in some stores. The taste is sweet and tart and, overall, enjoyable. But note that most research studies have focused on supplements and pure extracts, and not on other forms of elderberry like juices and jams.
Elderberry Supplements
Elderberry gummies are tasty, but they do have added sugar. When you’re buying elderberry, you’ll frequently find supplements that include a mix of elderberry and potential immune supportive supplements like zinc and vitamin C.
Other supplements may include only elderberry as the active ingredient. Choose the formula that suits your needs the best, and read the ingredients label to know what active and inactive components each contains.
Elderberry Jam
Certain country stores and online outlets sell elderberry jelly and jam; use and store it as you would other jellies and jams.
Elderberry Juice
You can find elderberry juice online. Note that for elderberry juice to be tasty and not too tart, sugar is added to the mix. One cup has about 150 calories and 34 grams (g) of sugar (much of this is natural sugar from the fruit).
Elderberry Wine
While it’s unclear whether wine offers the same potential benefits of elderberry extract, elderberry in this form is common. You can find elderberry wine at some wineries and their associated online stores, where the winemakers may feature wine made from only elderberries or blends with other berries.
A recent White House executive order is focusing national attention on medications used to treat attention deficit hyperactivity disorder (ADHD) and raising concerns among mental health experts about possible future restrictions.
References to ADHD medications are included in the White House executive order from February 13 establishing the Make America Healthy Again (MAHA) commission created to investigate “the growing health crisis in America.” The order calls for the commission to produce a new report on children’s health that offers “fresh thinking” on several factors including the “overreliance on medication and treatments” to address the “childhood chronic disease crisis.”
The order included a mandate for the MAHA commission to “assess the prevalence of and threat posed by” several prescription medications, including stimulants used to treat ADHD in adults and children, within the next 100 days.
Department of Health and Human Services Secretary Robert F. Kennedy Jr., who is chairing the commission, raised similar concerns about ADHD medications during his confirmation hearings.
“With this recent executive order, along with other comments that have been made, people are worried that it may become more difficult to get ADHD medication. Patients of mine, the parents of patients of mine, have stated their concerns about being able to access medications that are helpful for their children,” says Max Wiznitzer, MD, a pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland and co-chair of the Professional Advisory Board at CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder).
Executive Order Alone Can’t Restrict Access to ADHD Meds
Despite the executive order, restricting access to any medication would require action by the U.S. Food and Drug Administration (FDA) or the Drug Enforcement Agency (DEA), says Dr. Wiznitzer.
Also, Congress has procedures that must be followed to change the way a drug is administered.
If the MAHA commission determines that ADHD drugs (or any drugs on its radar) shouldn’t be prescribed in the way that their current approval allows, it’s still very unlikely drug approval would be revoked, says Diana Zuckerman, PhD, president of the National Center for Health Research in Washington, DC.
An effort to revoke approval would take many public meetings and would likely take years, she says.
“If the appointed commission has questions or concerns about the safety, long-term use, or dosing of these medications, the most likely scenario is that they would ask for more long-term studies to be performed. But the drugs would still be available while those studies were carried out,” says Dr. Zuckerman.
Wiznitzer says the way the executive order is written — and the use of the phrase “threat posed by” — raises concerns about the objectivity of any future MAHA report.
“We already know the pros and cons of the medications, and so it’s perplexing to us as to why they have to get a new panel and review it again,” he says.
How Many Kids Take ADHD Drugs?
In his confirmation hearing, Kennedy said that 15 percent of American children take Adderall, a type of ADHD medication. However, data suggests only about 5 percent of children are prescribed any type of ADHD medication.
An estimated seven million children — that’s 11.4 percent of U.S. children ages 3 to 17 — have been diagnosed with ADHD, according to a national survey.
A study published in 2024 found that, in the previous 12 months, among children with an ADHD diagnosis:
54 percent took an ADHD medication
44 percent received behavior treatment (with some children receiving both medication and therapy)
30 percent didn’t receive any ADHD-specific treatment
For children younger than 6, behavior therapy is recommended as first line treatment. For kids 6 and older, the American Academy of Pediatrics recommends behavior therapy and medication, preferably together.
Is ADHD Medication Safe?
Stimulants, the most commonly prescribed medications for ADHD, can have negative side effects such as stomachache, weight loss, irritability, decreased appetite, and insomnia.
Some stimulants may increase the risk of developing heart problems or psychiatric problems like anxiety or depression. Particularly in teens and adults, there is a risk of misuse of these medications, including taking too much, inappropriately using them, or sharing them with friends.
However, when taken under the care and supervision of a doctor, stimulant medications are safe, mental health experts say.
Wiznitzer explains the benefits of medication (along with evidence-based behavior interventions and strategies) to parents of children with ADHD this way:
“Children with ADHD are running a race with their peers, but the starting line for them is 50 to 100 yards behind their peers, and they’re supposed to run the 100-yard dash. It’s going to be very difficult for them to keep up. Medication moves the starting line closer to where their peers are starting, but medication doesn’t run the race — the child still has to run the race,” he says.
Kids with ADHD still need to learn life skills, and the medication gives them the opportunity to learn to avoid bad habits and impulsivity, to have better social interactions, and more, says Wiznitzer.
Untreated, ADHD is a chronic condition that can have severe negative consequences on physical and mental health throughout a person’s life, including low self-esteem, chronic stress, and a higher risk of substance abuse, depression, and accidents.
Some Parents of Kids With ADHD Worry About Restricted Access
Many parents have seen how ADHD treatment — both medication and behavior therapy — helped their children learn the skills to thrive, says Wiznitzer.
“That’s why they are now very concerned. They do not want the government to tell them how to take care of their children. They do not want the government to limit the access to medications that have helped their children be successful, to help their children function much better,” he says.
Many parents are initially resistant to their kids taking these medications, and when they start improving, they often ask, “When can we stop the medicine?” says Wiznitzer.
“This isn’t a situation where the parents or the providers are ‘gung ho’ about the idea of kids taking medication. The risk of overprescribing is not what it’s being made out to be,” he says.
Girl Scouts of America has been sued over allegations that its cookies contain pesticides and heavy metals like aluminum, arsenic, cadmium, lead, and mercury.
The lawsuit alleges that cookies sold by the Girl Scouts and produced by two companies that are licensed to do so — ABC Bakers and Ferrero USA’s Little Brownie Bakers — contain heavy metals and pesticides that may be harmful to human health, according to documents filed on March 10 in a federal district court in New York.
Amy Mayo, the consumer who brought the lawsuit, says in the court filings that she wouldn’t have bought Girl Scout cookies — or would have purchased them only at lower prices — if she had been aware that they contained what the case alleges are “dangerous toxins.”
Do Girl Scout Cookies Contain Heavy Metals and Pesticides?
As evidence of toxins, the lawsuit cites a study commissioned by the advocacy groups Moms Across America and GMO Science, which tested Girl Scout cookies for the herbicide glyphosate and for five metals: aluminum, arsenic, cadmium, lead, and mercury.
The study wasn’t published in a scientific journal or peer reviewed. Peer review means independent experts in the same field review research before publication to ensure academic quality.
This study tested 25 cookie samples purchased in California, Iowa, and Louisiana and found that every single sample contained glyphosate and one or more metals. Overall, 88 percent of the samples tested positive for all five metals examined in the study.
According to the study, amounts of metals found in the cookies often exceeded limits set by the Environmental Protection Agency (EPA) for drinking water. But the government body responsible for overseeing contaminants in cookies, the U.S. Food and Drug Administration (FDA), doesn’t set limits for metals in foods.
The amounts of metals found varied by type of cookie.
Thin Mints, for example, tested positive for all five metals. One cookie sample had:
3.85 parts per billion of arsenic
14.7 parts per billion of cadmium
6.18 parts per billion of lead
0.32 parts per billion of mercury
15.1 parts per billion of aluminum
The highest arsenic level was found in Toffee Tastic Gluten Free cookies, at 33.3 parts per billion. Peanut Butter Patties had the highest cadmium level, at 42.5 parts per billion, the most lead, at 23.3 parts per billion, and the highest aluminum level at 27.5 parts per billion. Caramel Delites had the highest mercury level, at 21.9 parts per billion.
Should You Be Worried About Eating Girl Scout Cookies?
While the presence of heavy metals in cookie samples sounds alarming, the amounts detected in this study are incredibly small and in line with what you might expect based on trace amounts naturally occurring in the soil where ingredients are grown, says Jaymie Meliker, PhD, a professor of public health at Stony Brook University in New York who wasn’t involved in the lawsuit or the study cited in the litigation.
“I would not be worried at all,” Dr. Meliker says. “We regularly eat Girl Scout cookies in our house as part of our diverse diet.”
For its part, Girl Scouts said in a February 6 blog post that its cookies are “safe to consume and are manufactured in accordance with all food safety regulations.”
“Environmental contaminants — which can include heavy metals — can occur naturally in soil,” Girl Scouts said in its blog post. “This means that nearly all foods using plant-based ingredients, including organic foods, may contain trace amounts. This does not mean that these foods are harmful to consume.”
You’d Have to Eat an ‘Obscene’ Amount of Girl Scout Cookies to Face Any Health Issues, Experts Say
It’s hard to say exactly how many cookies you would need to eat to be exposed to enough metals or pesticides to have health problems, but it’s definitely “an obscene amount,” says Toby Amidor, RD, a registered dietitian and the author of The Family Immunity Cookbook.
“No one should be eating one or several boxes of cookies to begin with,” says Amidor, who wasn’t involved in the lawsuit or the study cited in the litigation. “Cookies are a special treat, not a food that should be consumed in large amounts.”
Meliker agrees, and estimates that it might take thousands of cookies — or hundreds of boxes of cookies a day — to be exposed to enough metals or pesticides to cause any health issues.
“Clearly there would be acute effects from other things first if someone ate this many cookies,” Meliker says.
