Knowing your BMR or RMR can help you better determine your total daily energy expenditure in order to create a caloric deficit, defined as consuming fewer calories each day than you burn for energy. A caloric deficit is required to lose weight.
But because most people do not have access to state-of-the-art labs to determine BMR exactly, equations are often used to make approximations. The easiest way to measure your metabolic rate is to use an online calculator. You can find many calculators online, and all use varying equations.
Revised Harris-Benedict Equation
The commonly used metabolic equation, called the Harris and Benedict equation, was first designed in 1918 (and updated in 1984). While it was intended to estimate BMR, it actually estimates RMR, according to the National Academy of Sports Medicine. It uses height, weight, biological sex, and age to determine RMR and is based on average lean mass levels.
Below are examples of how to calculate your RMR using the revised Harris and Benedict equation.
Men: (88.40 + 13.40 x weight in kilograms [kg]) + (4.80 x height in centimeters [cm]) – (5.68 x age in years)
For example, if a man is 180 pounds, 5’11”, and 43, his RMR is 1,804 calories.
Women: (447.60 + 9.25 x weight in kg) + (3.10 x height in cm) – (4.33 x age)
For example, if a female is 130 pounds, 5’3″, and 36, her RMR is 1,333 calories.
Mifflin-St Jeor Equation
The Mifflin-St Jeor equation is another equation that uses the same variables but may be more accurate, Church says.
Here’s what the Mifflin-St Jeor equation looks like for men and women:
Men: (9.99 x weight in kg) + (6.25 x height in cm) – (4.92 x age in years) + 5
For example, if a male is 180 pounds, 5’11”, and 43, his RMR is 1,734 calories.
Women: (9.99 x weight in kg) + (6.25 x height in cm) – (4.92 x age in years) – 161
For example, if a female is 130 pounds, 5’3″, and 36, her RMR is 1,249 calories.
Cunningham Equation
Other metabolic equations, such the Cunningham equation, use your total level of lean body mass, which is a primary determiner of BMR and therefore RMR. But calculation requires you to measure your body’s levels of fat versus free-fat mass, Church says. Calipers and smart scales are two popular at-home options, but the most accurate measures are performed in professional and laboratory settings.
Here are examples of how to calculate your RMR using the Cunningham equation:
Men and women: 500 + (22 x lean body mass in kg)
For example, if a man is 170 pounds, 5’11”, 43, and his body-fat percentage is 20 percent, his RMR is 1,857 calories.
If a female is 130 pounds, 5’3″, 36, and her body-fat percentage is 25 percent, her RMR is 1,473 calories.
Depression isn’t the same for everyone: Multiple types exist, and people experience this treatable illness in varying degrees of severity. For some people with depression, nonpharmacological interventions like psychotherapy , lifestyle changes, and self-care may be enough to lift the cloud and improve symptoms. But for many other people, these steps aren’t enough, and medication is needed. About 13 percent of U.S. adults take antidepressants, according to national survey data.e60dc2a1-f33c-4a05-9b50-8e3e8e597629046f2563-a510-401e-a1d4-55c6eb1d75e5 Numerous depression medications are available today. If you’re struggling with depression, talk to your primary care doctor or a mental health professional, such as a psychiatrist, to learn whether an antidepressant may be right for you. Here’s what to know about the types of antidepressants out there.
SSRIs: The Most Frequently Prescribed Antidepressants SSRIs Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. Although it’s not clear how SSRIs treat depression , these drugs are known to inhibit the uptake of serotonin (a kind of chemical messenger called a neurotransmitter that helps regulate mood). This means they prevent the body from breaking down serotonin, which in turn helps increase levels of this neurotransmitter in the body.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299092b253-ed69-4de2-be62-8be204138f04 The following SSRIs are approved by the FDA to treat depression:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294e0f662d-0259-4306-aa03-e61d579c3563 Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac, Sarafem, Symbyax) Paroxetine (Paxil, Paxil CR, Pexeva) Sertraline (Zoloft) Vilazodone (Viibryd) Vortioxetine (Trintellix) The most common side effects of SSRIs include: Nausea and vomiting Dry mouth Weight changes, more commonly weight gain Diarrhea Drowsiness Sexual problems Headache or dizziness Drowsiness or insomnia Agitation, restlessness, or nervousness
SNRIs Work by Blocking Reuptake of Two Brain Chemicals SNRIs Another class of antidepressants, serotonin and norepinephrine reuptake inhibitors (SNRIs), block the reabsorption of the neurotransmitters serotonin and norepinephrine, making them more available to your brain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f9235ebc-bb22-47ab-941a-dacd6824a64d SNRIs that are approved by the FDA to treat depression include: Duloxetine (Cymbalta) Venlafaxine (Effexor, Effexor XR) Levomilnacipran (Fetzima) Desvenlafaxine (Pristiq) The most common side effects of SNRIs include: Dizziness Dry mouth Excessive sweating Headache Nausea Other possible side effects of SNRIs are: Constipation Insomnia Loss of appetite Sexual dysfunction Tiredness
Cyclic Antidepressants: Prone to Causing Side Effects Cyclics Tricyclic and tetracyclic antidepressants are older drugs that work by blocking the reabsorption of serotonin and norepinephrine through a different mechanism than SNRIs.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295b380c04-3850-40ed-bce2-0d8126799874 These drugs are not widely used today because they can cause a range of side effects, some of which may be serious, such as disorientation or confusion, but they are sometimes prescribed when other antidepressants don’t work. Examples of FDA-approved tricyclics are: Amoxapine (Asendin) Amitriptyline (Elavil) Nortriptyline (Aventyl, Pamelor) Desipramine (Norpramin) Doxepin (Sinequan, Silenor) Imipramine (Tofranil) Protriptyline (Vivactil) Trimipramine (Surmontil) The tetracyclic maprotiline (Ludiomil) is also approved by the FDA for the treatment of depression. Common side effects of cyclic antidepressants include: Blurred vision Constipation Drop in blood pressure that can cause lightheadedness when going from a seated position to a standing position Drowsiness Dry mouth Urine retention
MAOIs: The Oldest Antidepressants MAOIs The oldest class of antidepressants, monoamine oxidase inhibitors (MAOIs) , works by blocking the enzyme monoamine oxidase, which breaks down various neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine .e60dc2a1-f33c-4a05-9b50-8e3e8e59762967bdc605-0e6c-4682-9917-12d193c90876 Examples of MAOIs include: Selegiline (Emsam), a skin patch that may cause fewer side effects than MAOIs taken by mouth Isocarboxazid (Marplan) Phenelzine (Nardil) Tranylcypromine (Parnate) Although MAOIs can sometimes help people with depression that does not respond to other antidepressants, they are not widely used today because of their potential side effects and interactions with certain foods and beverages as well as other drugs. For example, for people taking MAOIs, ingesting large amounts of the compound tyramine (found in aged cheeses, cured meats, draft beer, sauerkraut, and fermented soy products like miso, tofu, and soy sauce) could cause your blood pressure to rise to a dangerously high level. You may also experience serious reactions if you take an MAOI with various medications, including: Other prescription antidepressants Certain pain relievers Cold and allergy drugs Herbal supplements On rare occasions, MAOIs and other serotonin-containing drugs can cause a potentially life-threatening condition called serotonin syndrome . You may be at risk if you take too much of a serotonin-containing antidepressant or if you combine an MAOI with another prescription antidepressant, certain pain or headache medications, or St. John’s wort (an herbal supplement sometimes used as a home remedy for depression).
Atypical Antidepressants: Unique Medications That Work in Different Ways Atypical Antidepressants Medications that don’t fit into the classes listed above may also treat depression by altering levels of different neurotransmitters in the brain. A well-known medication called bupropion (Wellbutrin) targets norepinephrine and dopamine and is categorized as a norepinephrine-dopamine reuptake inhibitor. This antidepressant causes fewer sexual side effects than many other antidepressants.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c035726d-bd4f-4b3e-8a82-822316fdea83 Other so-called atypical medications include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762924393f03-7069-492d-a7b0-647e62ea722b Trazodone (Desyrel) Nefazodone (Serzone) Mirtazapine (Remeron) Vilazodone (Viibryd) For most atypical antidepressants, the most common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762900bd35e1-b28c-448d-bd48-81d6f49e8bf2 Blurry vision Constipation Dizziness Drowsiness Dry mouth
N-Methyl D-Aspartate (NMDA) Receptor Antagonists May Offer Quicker Relief NDMAs While many traditional antidepressants affect levels of serotonin, norepinephrine, or dopamine, a newer class of antidepressants called NMDA receptor antagonists work by helping maintain the balance of glutamate and gamma-aminobutyric acid (GABA). These two neurotransmitters have opposite actions in the body, and the brain typically functions best when they’re balanced. NMDA receptor antagonists can help people whose symptoms haven’t improved with typical treatments and usually offer more rapid relief than most antidepressants. The FDA recently approved the following NMDA antidepressants:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cd214539-992a-46bf-9ab6-f544a1331532 Esketamine (Spravato), a nasal spray that’s used in combination with an oral antidepressant Dextromethorphan-bupropion (Auvelity) Common side effects of Spravato may include: Dissociation or feeling drunk Dizziness Feelings of anxiety Lack of energy or drowsiness Increased blood pressure Nausea or vomiting Decreased sensations of touch or other senses Common side effects of Auvelity could include: Dizziness Diarrhea Drowsiness Dry mouth Excessive sweating Headache Sexual problems
Neuroactive Steroids: Another Fast-Acting Option Neuroactive Steroids Neuroactive steroids are a newer class of medicines that are thought to work by affecting levels of the neurotransmitter GABA in the body. Like NMDA receptor antagonists, they tend to work more quickly than most other antidepressants.e60dc2a1-f33c-4a05-9b50-8e3e8e59762943bd5f9b-ce34-4078-90d4-195feec53929 The FDA recently approved the following neuroactive steroids for postpartum depression :e60dc2a1-f33c-4a05-9b50-8e3e8e597629deeb76a5-f3c1-45c6-9358-f1e4108518fa Brexanolone (Zulresso), a continuous infusion administered under medical supervision Zuranolone (Zurzuvae) Zulresso is administered over 2.5 days by a healthcare provider in a certified healthcare facility. It’s only available under a special program because of the side effects it can cause.e60dc2a1-f33c-4a05-9b50-8e3e8e59762952d64fd7-d0a0-45aa-b482-9a075dfc7783 The most common ones are:e60dc2a1-f33c-4a05-9b50-8e3e8e597629955f23b2-f2e0-47d6-ac90-982b23a1bc1c Dry mouth Flushing Loss of consciousness Tiredness or sedation Zurzuvae is an oral medication to be taken with a fat-containing meal once daily in the evening for 2 weeks. The most common side effects of Zurzuvae include: Burning or pain while urinating Cold symptoms like sneezing, sore throat, or stuffy nose Diarrhea Dizziness Weakness, tiredness, or drowsiness
Serotonin Receptor Agonists: A New Antidepressant Class Serotonin Receptor Agonists A new class of antidepressants called serotonin receptor agonists are believed to work by targeting certain serotonin receptors, such as the 5-HT1A receptor, in the brain. These receptors help regulate mood and emotions.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295b074aaf-0dc9-477b-a6aa-b8a95fcc1d6f The FDA recently approved the serotonin receptor agonist gepirone ER (Exxua) to treat depression.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c39c3abb-90a0-45e7-b47a-32952c7673f5 The most common side effects of Exxua are:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294bcf49e7-b7de-4278-a44d-e90e3ac134d1 Dizziness Headache Nausea Sleep problems Stomach pain and upset
Atypical Antipsychotics: Approved for Use With Antidepressants Antipsychotics Atypical antipsychotics aren’t considered antidepressants. However, several atypical antipsychotics are FDA-approved to treat depression in combination with antidepressants. Doctors sometimes prescribe these drugs to people whose depression hasn’t improved with other treatments. They include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976298246c36e-e70a-43e2-96d0-7a8732efb5c0 Brexpiprazole (Rexulti) Aripiprazole (Abilify) Cariprazine (Vraylar) Quetiapine (Seroquel XR) Fluoxetine And Olanzapine (Symbyax) Common side effects of atypical antipsychotics, especially when taken long-term, include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e8e34966-4a8d-4eba-81ad-612b91b14758 Weight gain Metabolic dysfunction Extrapyramidal symptoms (involuntary movements) Tardive dyskinesia
Antidepressant Safety and Side Effects Safety & Side Effects Most antidepressants are generally safe, but some people — especially children, teenagers, and young adults under age 25 — may experience an increase in suicidal thoughts , especially during the first few months of treatment or when their dosage goes up or down.e60dc2a1-f33c-4a05-9b50-8e3e8e59762989524c42-fbe7-4a8d-ac2e-5d7a2b357017 If this happens to you or someone you know, immediately contact a doctor or seek emergency help by contacting the Suicide and Crisis Lifeline (988) or, if the risk is imminent, call 911. As mentioned, many antidepressants come with side effects, which can vary by type. They usually improve after a couple weeks, but if they don’t, let your doctor know. Your doctor could change the timing or dosage of your antidepressant to help lessen side effects, or they may switch you to another antidepressant and see if that works better for you.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298e8665e3-c3f3-458c-9428-9f12bc6870a6 Once you’ve begun taking antidepressants, don’t stop without your doctor’s assistance; discontinuing the medication too soon means your depressive symptoms might come back. When the time is right, your doctor can help you gradually taper your usage. While antidepressants aren’t generally addictive, stopping them abruptly can lead to withdrawal symptoms .e60dc2a1-f33c-4a05-9b50-8e3e8e59762976a795d2-85eb-4cd6-9115-8a59b1a65704
The Takeaway Depression can present differently in different people, and various treatments are available. While many find relief through therapy and lifestyle adjustments, some require medication to manage their symptoms effectively. If you’re exploring different treatments, your doctor can guide you in finding what might work best for you.
Resources We Trust Mayo Clinic: Antidepressants: Selecting One That’s Right for YouCleveland Clinic: AntidepressantsMayo Clinic: Antidepressants: Get Tips to Cope With Side EffectsMedlinePlus: AntidepressantsNational Health Service: Overview — Antidepressants
While the research on psychedelic medicine for mental illness is still considered new and emerging, some studies have shown compelling results.
Psilocybin
In one study published in 2023 that involved a randomized placebo-controlled trial, participants who received a single dose of psilocybin saw a rapid and sustained reduction in major depressive disorder symptoms when compared with a placebo. Participants in both the psilocybin and placebo groups also received psychological support as part of the trial. Additionally, no trial participants experienced serious adverse events as a result of psilocybin treatment. Based on the results, the researchers remarked that psilocybin showed promise as a treatment for depression when used in conjunction with psychological support.
Psilocybin also has potential as a safe and effective treatment for treating mental health conditions among those with life-threatening diseases. In a small study published in 2023, cancer patients with major depressive disorder received a single dose of psilocybin as well as individual and group therapy before, during, and after dosing. As a result, 80 percent of patients saw some form of sustained response to psilocybin treatment, and 50 percent showed full remission of depressive symptoms for at least eight weeks after dosing. There were no serious adverse events related to treatment.
In addition, the National Cancer Institute has several ongoing clinical trials to explore the safety and efficacy of psilocybin treatment for mental health conditions in cancer patients.
According to a double-blind randomized clinical trial published in 2022, psilocybin may be effective at treating alcohol use disorder when used in conjunction with psychotherapy. The researchers found that those who received psilocybin reported a smaller percentage of heavy drinking days after treatment compared with those who received a placebo.
LSD
LSD-assisted psychotherapy — meaning a combined intervention of therapy and medication — may lessen feelings of anxiety among people with life-threatening illnesses who are anxious about their illnesses, according to a small study with 12 participants. Follow-up research with participants one year after treatment found that those decreases in anxiety had lasted.
A review of 11 randomized-controlled clinical trials found that LSD has therapeutic potential, especially in the short term, to reduce symptoms of alcohol use disorder, anxiety, depression, and other psychosomatic diseases. Most of the studies focused on alcohol use disorder, and that is where researchers reported the greatest positive effects of LSD treatment.
Ketamine and Esketamine
Research published in 2023 on the long-term safety and efficacy of esketamine nasal spray found that participants’ scores on a common depression symptom rating scale decreased by an average of 12.8 points after four weeks of treatment. (The average depression rating at the beginning of the study was a little less than 30 points.) After almost four years of treatment, this average decrease in symptom severity was maintained, with about 46 percent of patients in remission. Throughout the study, participants were also prescribed an antidepressant medication.
And in a study published in 2022, researchers found that among 537 people who received intravenous ketamine therapy in a clinical setting between 2016 and 2020, more than half experienced improvement in their symptoms, and nearly 30 percent achieved remission. And 73 percent of people with suicidal thoughts and behaviors saw a decrease in these symptoms. The researchers noted that 8 percent of people experienced worsened depression after starting ketamine therapy, and 6 percent reported increased suicidal thoughts or behaviors.
MDMA
Some of the most compelling results for MDMA as a treatment for mental illness have come from clinical trials involving people with PTSD. A randomized, placebo-controlled trial published in 2023 studied 104 participants with moderate or severe PTSD for three treatment sessions over 18 weeks. It found that 71 percent of those who received MDMA-assisted therapy no longer met common diagnostic criteria for PTSD at the end of treatment compared with 48 percent of those who received a placebo in conjunction with therapy. In addition, 46 percent of those who received MDMA achieved remission compared with 21 percent of the placebo group.
That said, almost all participants in both groups experienced at least some adverse side effects, the most common of which were muscle tightness, nausea, decreased appetite, and excessive sweating. About 9 percent of the MDMA group and 4 percent of the placebo group experienced a severe adverse event due to treatment (defined as being unable to perform normal daily activity). No recorded adverse event was life-threatening or required inpatient hospitalization.
Supportive Therapy Is Essential, Too
Although the research on psychedelic medicine is promising, it’s important to note that these studies involved very careful administration of these drugs in a clinical setting under the supervision of doctors. Currently available research consists of very small, short-term studies, many of which are performed in specific groups of patients (such as people with life-threatening illnesses, for instance). This means that the findings from these studies may not apply to everyone being considered for psychedelic therapies.
In addition, most studies also included supportive care in the form of psychotherapy.
“For clinical indications, psychotherapy appears to be necessary to support and facilitate change,” says Danovitch.
He adds that therapy protocols typically involve the following phases:
Assessment Phase During this phase, a mental health professional and the patient set goals for therapy.
Preparation Phase This phase is intended to get patients physically and emotionally ready for treatment.
Experience Phase During this phase, health professionals monitor patients carefully as they take the medication.
Integration Phase This phase focuses on helping patients reflect and learn from the experience after treatment with the psychedelic has ended.
O’Donnell says this type of support, including preparing the patient for what will happen when taking the medication, is vital for successful treatment.
“If someone has no idea what they’re in for and someone gives them a psychedelic, that can be a really traumatic experience,” O’Donnell says. “A lot of people have the idea that it’s a one-and-done and your life is transformed forever, and that’s really not the case. That takes it out of the context of a therapeutic relationship, which is so important.”
Green tea may help manage type 2 diabetes in a few key areas, including blood sugar, weight, and inflammation.
Blood Sugar Regulation
Green tea may help regulate blood sugar levels by improving insulin sensitivity, allowing the body to use insulin more effectively. Some experts believe that this may help prevent type 2 diabetes.
Researchers in Japan looked at L-theanine levels and green tea consumption and found that green tea drinkers were significantly less likely to develop type 2 diabetes over seven years.
A study of over half a million people in China found that daily green tea drinking was associated with a lower risk of developing type 2 diabetes and a low risk of premature death from any cause in people who already had diabetes.
Dr. Bruno conducted a trial using green tea extract gummies that included 40 people: 21 with metabolic syndrome and 19 healthy adults. Metabolic syndrome includes several conditions that increase the likelihood of developing heart disease, stroke, and type 2 diabetes. All participants consumed green tea gummies for 28 days. The daily dose was equivalent to five cups of green tea. After a one-month break from consuming any green tea products, the participants were given placebo gummies, also for one month. Researchers found that fasting blood glucose levels for all participants were significantly lower after taking the green tea gummies compared with levels after taking the placebo.
Weight Management
Maintaining a healthy weight can help manage type 2 diabetes, though the evidence on green tea and weight loss is mixed.
Some studies have shown that the polyphenols in green tea — antioxidants that may improve metabolism and reduce fat absorption — can promote weight loss, but other research does not support these results.
A study of over 10,000 middle-aged adults found that women who drank at least four cups of green tea a week were less likely to have abdominal obesity than women who didn’t drink it, though the same benefits weren’t found in their male counterparts.
A review of the effects of green tea supplements on obesity found that there could be some modest improvements in weight or waist circumference in people who took the supplements for three months or longer.
The bottom line, says Dr. Tan, is that the effects of green tea on weight control are not proven, and how it could help shed pounds remains unclear.
Cardiovascular Benefits
People with type 2 diabetes are at a higher risk of cardiovascular disease, including heart disease. Some studies suggest that green tea may offer cardiovascular protection by improving levels of LDL (“bad”) cholesterol as well as total cholesterol.
A meta-analysis of five studies totaling over 600,000 people concluded that those who drank two to four cups of green tea a day lowered their risk of stroke between 21 and 24 percent. One theory is that the flavonoids in green tea open blood vessels and keep them flexible, helping blood flow more freely.
Green tea is also associated with lowering chronic high blood pressure. A meta-analysis of randomized, placebo-controlled trials found that green tea lowered both systolic and diastolic blood pressure.
Anti-Inflammatory Effects
Chronic inflammation is common in people with type 2 diabetes and is believed to play a role in insulin resistance.
Green tea’s effect on inflammation in the body is less clear than the benefits for weight loss and blood sugar, says Bruno.
“However, it should be noted that inflammation is a complex interplay that involves many aspects of the immune system, and it is difficult to generalize effects regarding inflammation because there are many different inflammatory proteins that, when at appropriate levels, support health and well-being, but when dysregulated — either too high or too low — can be harmful to health. That being said, recent evidence indicates that green tea may reduce specific indicators of gut inflammation,” says Bruno.
MASH, which was previously known as non–alcohol related steatohepatitis (NASH), is often asymptomatic or leads to nonspecific symptoms, making progression to more severe stages of liver disease possible before you’re even aware you have it. That’s why it’s so important to educate yourself about MASH as soon as you receive a diagnosis — and take steps to protect your liver from further harm. These resources are at your disposal.
1. American Liver Foundation
Founded in 1976, the American Liver Foundation (ALF) is one of the leading proponents of education, support, and research for all things liver health. Their goal is to help advance efforts that seek to prevent, treat, and find a cure for chronic liver diseases, including MASH.
The ALF offers a variety of help for people living with MASH, including online resources and printable educational handouts. Additionally, the ALF hosts a Facebook Support Group for MASH to help you connect with others to share stories, seek advice, and feel less alone in your journey.
For more information, you can also contact the ALF’s help center by calling the toll-free helpline at 1-800-GO-LIVER (1-800-465-4837) or through live chat on their website. You can also connect with the ALF on:
2. Fatty Liver Alliance
The Fatty Liver Alliance is a Canadian nonprofit organization dedicated to spreading awareness about how early diagnosis and treatment of fatty liver diseases (including MASH) can prevent complications later on.
The Fatty Liver Alliance’s website provides educational information on fatty liver disease, including video content featuring experts discussing the latest topics and trends in the field. The Alliance is also often involved in petitions that advocate for increased access to potential MASH treatments specifically for Canadians.
Keep in touch with the Fatty Liver Alliance through:
3. Global Liver Institute
Since 2014 the Global Liver Institute (GLI) has been working to improve the lives of those affected by liver diseases such as MASH.
This nonprofit organization is home to the Fatty Liver Disease Council, which champions fatty liver diseases, such as MASH, as a prominent health concern. The GLI is home to the Liver Action Network, which helps unite advocates to work toward the goal of advancing liver health initiatives at the local, state, national, and global levels. Additionally, the GLI provides advocacy training to help people become more effective advocates for liver health. They also offer information specifically for veterans about liver disease.
Since 2018 GLI has also hosted Global Fatty Liver Day every June to help raise awareness about the risks of fatty liver disease, promote lifestyle changes to support liver health, and encourage screening.
Keep in touch with the GLI by calling (800) 845-5910, emailing info@globalliver.org, or following them on:
4. Community Liver Alliance
The Community Liver Alliance (CLA) has been working since 2013 to provide awareness and educational opportunities for people with liver disease, while also supporting research and advocacy efforts.
This Pittsburgh-based organization offers videos encouraging people to stay active and eat healthy. They also develop educational materials, host workshops, coordinate support groups, and facilitate medical care for people affected by liver diseases, such as MASH. You can also find information on their website about upcoming clinical trials.
Check out the CLA’s calendar of upcoming programs and events or stay in touch through:
5. MyMASHteam
If you’re looking for social support, MyMashteam has you covered. Sign up for free to access educational materials, Q&As, and a community that offers emotional support and solidarity for people living with MASH. To stay on top of the latest from myMASHteam, get their newsletter delivered straight to your inbox.
If you have diabetes, you probably know the condition is linked to a greater risk of several health problems, including heart disease, kidney disease, nerve damage, and more. But one risk you may not be as familiar with is metabolic dysfunction–associated steatohepatitis (MASH).
MASH is typically linked to metabolic syndrome, a group of conditions associated with the development of heart disease and type 2 diabetes, such as high blood pressure. “The most prominent associated risk factor for MASH is obesity,” says Jonathan Jennings, MD, an internist at Medical Offices of Manhattan in New York City. “Researchers suspect chronic inflammation from the excessive fat plays a prominent role in the development of MASH.”
Having type 2 diabetes is also linked to MASH. Among adults over age 50 with type 2 diabetes and MASH, about 14 percent may be candidates for MASH treatment, which is currently indicated for liver fibrosis stages 2 and 3 (fibrosis is staged from 0 [none] to 4 [cirrhosis]).
Here’s what you should know about MASH if you have diabetes.
1. Insulin Resistance Increases Your Risk of MASH
Type 2 diabetes is characterized by insulin resistance, a condition where the body is unable to respond to insulin — a hormone that plays a crucial role in regulating blood sugar. This leads to elevated blood sugar levels (hyperglycemia).
“Over time, insulin resistance and hyperglycemia lead to damage in the liver through an accumulation of fat and inflammation,” says Michele Yeung, MD, an endocrinologist at the Innovative Center for Health and Nutrition in Gastroenterology at Weill Cornell Medicine in New York City.
2. Other Health Issues Can Also Increase Your MASH Risk
Obesity is the top risk factor for MASH, but there are others, which are also often tied to type 2 diabetes. These include:
High blood pressure
High cholesterol
Polycystic ovary syndrome
Underactive pituitary gland
Underactive thyroid
Being over age 40
Being postmenopausal
3. MASH Is Often Found Through Routine Screenings
MASH usually has no symptoms, so “Many people are often diagnosed incidentally through screening imaging studies like an ultrasound,” says Dr. Jennings. Blood work may also help identify this common liver disease.
If you have risk factors for MASH, it’s important to stay on top of your regular checkups, so your doctor can monitor you for signs of liver disease. If your doctor suspects MASH, “The most definitive way to make the diagnosis is with a small tissue biopsy of the liver,” he adds. But with the emergence of accurate noninvasive tests, such as a FibroScan or blood-based biomarker tests, biopsies are becoming less common.
4. MASH Symptoms May Not Be Obvious
Although most people with MASH don’t experience symptoms, the most common complaints include:
Fatigue
Itching
Loss of appetite
Stomach pain
Weakness
It can be hard to pinpoint the cause of these symptoms, because they are common in so many diseases. That said, experiencing other symptoms, such as changes in the color of your eyes and skin, may suggest the liver has sustained more significant damage. In that case, you should call your doctor, says Jennings.
5. Early Stages of MASH Can Sometimes Be Reversed
“Routine screening is important, because early stages of MASH can be reversible in some cases,” Dr. Yeung notes. “Therefore, early diagnosis and intervention is critical for long-term management.” So if you have diabetes or other health conditions that increase your risk of MASH, it’s important to stay on top of your scheduled checkups to monitor your liver health. The American Association of Clinical Endocrinology recommends that all adults with diabetes be screened for MASLD/MASH, using sequential testing with blood work, followed by a FibroScan.
6. Undiagnosed and Untreated MASH Can Affect Your Overall Health
MASH itself isn’t life threatening, but when it occurs along with other risk factors, it can increase the risk of progression to end-stage liver disease, which is terminal. It can also increase your risk for liver cancer and heart disease.
7. Taking Steps to Manage Diabetes Can Help Reduce Your MASH Risk
The good news? The steps you may already take to manage diabetes can help lower your risk for MASH, too. These steps can include:
Losing weight: Specialists recommend a 10 percent reduction in body weight to reduce the amount of liver fibrosis. But just a 5 percent reduction in weight can lower inflammation or fat in the liver, Jennings notes.
Eating healthy and exercising: The best way to lose weight — and keep it off — is through a nutritious diet and regular exercise. Your doctor may refer you to a registered dietitian or exercise professional and recommend other resources to help you get started.
Avoiding alcohol: Because your liver is already taxed from MASH, it’s important to abstain from alcohol to avoid further injury to your liver. This is especially important if you have stage 2 liver fibrosis or more advanced disease.
Taking all medications as prescribed: Follow all directions for any treatments you’re prescribed, including for diabetes and other health conditions you’re managing. If you have moderate-to-advanced liver scarring from MASH, your doctor may prescribe a treatment for that, too.
“The silver lining is, because type 2 diabetes and MASH are so interconnected, both conditions can be treated together,” says Yeung. “Work together with your treatment team to decide on the best approach.”
The Takeaway
People who have type 2 diabetes are at greater risk of developing MASH, a form of steatotic liver disease.
MASH often has no symptoms, but it can be detected through routine screenings. So it’s important to stay on top of routine doctor visits to monitor your liver health.
Early diagnosis is key, as MASH may be reversible if caught early. Left untreated, it can lead to severe liver damage.
Following a healthy lifestyle — eating a balanced diet, staying active, maintaining a healthy weight — and staying on top of diabetes management can also help lower your risk of developing MASH.
As far as physical symptoms, MASH can present as mild pain on the right side of the abdomen (where the liver is located) or general fatigue, says Ali. But more often than not, people don’t experience symptoms at all — or at least none that can easily be directly attributed to liver disease.
“Most patients don’t even realize they have it,” Ali says. “The liver doesn’t make itself known until it’s progressed beyond mild inflammation. If someone’s experiencing symptoms, their MASH tends to be advancing.”
For this reason, the first signs of MASH usually show up on routine blood work that you might get during an annual physical or as part of an ER visit. It’s called a comprehensive metabolic panel, which includes liver enzymes. “If results are abnormal, it usually warrants further investigation,” he explains.
From there, your doctor may order imaging studies, such as an ultrasound, CT scan, or MRI scan, which can uncover some liver changes. For a definitive diagnosis, a biopsy used to be done. Now, newer, noninvasive tests, such as a FibroScan or blood-based biomarker test, are often used instead.
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.
She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).
First of all, it’s important to understand the limitations of psychedelic therapy. Much more research needs to be done, says Dr. Grob. “Until very recently, it was unacceptable to even consider psychedelics as having treatment potential. There is still a lot to learn and a lot of work to do,” he says.
With that in mind, here are some potential health benefits.
May Alleviate Depression
Ketamine is usually used as an anesthetic, but research indicates that when administered at lower levels, it can help treat depression. One meta-analysis and review of 28 studies found that a single ketamine infusion decreased depressive symptoms within hours, though the effects of the dose tended to peter out within seven days. Current practice is for people to be given a short course of several treatments, followed by maintenance treatments, which may help prevent a depression relapse. Authors of the study highlight the need for more long-term research.
Ketamine is indicated for treatment-resistant depression, or someone who has “failed” conventional treatments, like SSRI medication, says Mailae Halstead, a therapist with Behavioral Wellness Clinic in Tolland, Connecticut, who specializes in ketamine-assisted therapy and psychedelic integration. “Ketamine [may] alleviate depressive symptoms so that patients might be able to do the things they need to do to keep depression at bay, such as a regular movement practice or cognitively reframe negative biases and self-talk,” she explains.
Ketamine also appears to be effective as a treatment method for people with a high risk of suicide, which often correlates with depression.
May Ease Trauma Responses in Those With PTSD
A phase 3 randomized controlled clinical trial of 91 participants published in May 2021 in Nature Medicine examined the effect of MDMA therapy on those who had severe PTSD. Participants were first given a form of psychotherapy that followed guidelines from the Multidisciplinary Association of Psychedelic Studies (MAPS). They then received treatment with either MDMA or a placebo. After treatment, the MDMA group experienced a nearly twofold reduction in their score on a scale measuring PTSD symptoms.
Researchers found that MDMA potentially enhanced the beneficial effects of this specific form of therapy more than the placebo-therapy group, but the placebo group showed benefits too, meaning results are not conclusive. The FDA ultimately rejected the use of MDMA as a treatment for PTSD following these trials, due to safety concerns, and the notion that it was hard to tell if participants benefited more from the MDMA itself, or the accopanying psychotherapy.
May Be Effective in Treating Alcohol Use Disorder
Some research indicates that psilocybin (magic mushrooms) may be beneficial in the treatment of alcohol use disorder. A study featuring of 93 people found that when taken in combination with talk therapy, psilocybin may significantly decrease the percentage of heavy drinking days in the eight months after treatment.
May Assist in Eating Disorder Recovery
Research into the use of psychedelics as treatment for eating disorder treatment is at its very early stages. Brain imaging studies show that the same pathways activated by psilocybin are the very same as those affected in anorexia nervosa. Research suggests psilocybin may be able to spark changes in the connections in these brain networks to induce healing. This authors point out the critical nature of these findings, as up to half of people with anorexia never recover, and the illness greatly increases their risk of dying early.
In 2022, Xpira Pharmaceuticals announced that they were granted approval from the FDA for an “investigational new drug” designation for psilocybin in anorexia therapy, and they will begin a phase 2a clinical trial. This trial is specifically designed to assess how much psilocybin should be given. Until more is known, this remains an emerging treatment.
A more recent 2023 study also showed positive results, with authors stating that weight concerns and body shape concerns of participants decreased significantly overall. But they also note that the effects of the treatment varied greatly between participants.
May Play a Role in End-of-Life Care
The experience of death, or the idea of it, can be uncomfortable and distressing for some, and psychedelics may help soothe a patient’s end-of-life journey by alleviating anxiety and existential dread. According to a review published in 2021, some research shows that among people with potentially fatal illnesses, those who received high doses of LSD under supervision had less anxiety than those given an active placebo.
Research also shows that patients given a life-threatening cancer diagnosis and administered a high dose of LSD reported higher levels of well-being and less anxiety and depression than those who took a low dose.
Finally, there is also some preliminary research suggesting psilocybin could be supportive for patients with life-threatening or life-limiting illnesses distress.
May Improve General Well-Being
While some controlled trials evaluate psychedelics for specific healthcare uses, psychedelics may also promote general well-being, according to some research. In an online survey of 2,500 adults who have used psychedelics (legally or illegally) at some point in their lives, these drugs were associated with improved symptoms of depression and anxiety, and better emotional well-being.
Ayahuasca was specifically linked to enhanced emotional well-being compared with other hallucinogens, even among those who had used it just once. Participants claimed that psychedelics led to transformative experiences and insights that shifted their mindsets and attitudes, as well as leading to enhanced selflessness and a drive to help others. The authors point out that these substances appear to be most effective in infrequent doses to initiate change within one’s self, rather than taking them long term to level out one’s mood. Of course, not all outcomes seemed positive. One in eight people reported experiencing harm from psychedelics, and it’s important to note this is survey data based on self-reporting, rather than an actual experimental or clinical trial.
It is also worth noting that the American Psychiatric Association (APA) ethical recommendation is for psychedelic prescriptions (as they become approved by the FDA and DEA) to be limited to clear clinical and diagnosable conditions for which the psychedelic was studied in clinical trials, and not for general well-being or self-enhancement.
Belly button pain is sometimes caused by digestive issues and may include other symptoms like heartburn, gas, and bloating. Bloating and gas can create pressure, leading to a feeling of fullness. Eating something that didn’t agree with you might cause indigestion, which sometimes can be felt as discomfort in the abdomen.
These symptoms can be part of a condition known as chronic indigestion (functional dyspepsia), which can also cause cramp-like pain that comes and goes, especially after meals or when you’re constipated.
Treatment might involve lifestyle changes, such as eating smaller meals to prevent bloating, as well as eating more high-fiber foods to help soften stools, which makes them easier to pass. Over-the-counter (OTC) medications like antacids or gas relievers can help, too.
See your healthcare provider if your symptoms worsen or don’t improve after two weeks of home treatment.
2. Infections
Some infections can cause pain around the belly button.
Urinary tract infections (UTIs), for example, can cause pain due to the infection irritating the bladder. This can happen when bacteria, usually E. coli, get into the urinary system, causing an infection in the bladder, urethra, or kidneys. Other UTI symptoms include frequent urination, a burning feeling when you urinate, or cloudy, foul-smelling urine.
Call your healthcare provider if you experience symptoms of a UTI. They will likely prescribe antibiotics to get rid of the infection. However, call your doctor if your symptoms worsen with treatment — they may prescribe a different medication. Seek emergency care if you develop fever, back pain, or vomiting.
Skin infections — such as yeast or bacterial infections — can also develop in the belly button due to its moist, damp environment. The folds of skin in this area often trap sweat, oils, and moisture, making it easier for bacteria and fungi to grow. These infections can cause swelling, pain, and sometimes a foul odor or discharge.
Call your healthcare provider if you notice symptoms of a belly button skin infection. Treatment involves the use of antifungal or antibiotic creams along with keeping the area clean and dry to prevent future infections.
3. Hernia
An umbilical hernia occurs when abdominal tissue (which includes muscles, fat, and connective tissue) bulges through an opening in the abdominal muscles around the belly button, causing pain or pressure, says David D. Clarke, MD, a board-certified internal medicine and gastroenterology physician in Portland, Oregon, and the president of the Association for Treatment of Neuroplastic Symptoms, a nonprofit that addresses the chronic pain epidemic.
This often happens due to increased pressure from pregnancy, obesity, or frequent heavy lifting, which strains the area around the belly button.
The pain associated with a hernia is usually sharp and sudden, and you may have swelling around the belly button. See a doctor if you notice a bulge that’s getting bigger, experience nausea, vomiting, constipation, or bloody stool, or if the bulge feels firm, darkens, or changes color.
An umbilical hernia that causes symptoms often requires surgery to repair the weak spot in the abdominal wall, particularly if the hernia becomes strangulated, which occurs when blood flow is cut off to the bulging tissue.
4. Surgical Complications
Belly button pain can be a side effect of abdominal surgery, such as a laparoscopic surgery or C-section (cesarean section).
Laparoscopic surgery involves making small incisions in the abdomen to insert tools and perform procedures, which can cause temporary discomfort near the navel. This pain resolves on its own as your body heals, usually within a few weeks.
Similarly, after a C-section, you may have some temporary pulling near the belly button as your incision heals.
Keep in mind that belly button pain may worsen if an incision doesn’t heal properly. So it’s important to follow your doctor’s postsurgery instructions for a smooth recovery. These may include temporarily not wearing tight clothing around the navel area as well as avoiding strength training, heavy lifting, and scratching the wound.
On average, you might need to limit these activities for at least four weeks to prevent wound reopening and possible infection.
Call your healthcare provider if you experience fever, chills, redness or swelling around your incisions, abnormal discharge or bleeding, vomiting, or trouble urinating, as these are signs of infection.
5. Pregnancy-Related Pain
Pregnancy can also cause pain around the belly button. An expanding uterus can put pressure on surrounding tissue and lead to discomfort in the navel area. This creates a stretching or pulling sensation, especially during the second trimester.
The pain is generally harmless and goes away by the third trimester. However, you should see your doctor if you don’t find relief from resting or changing positions, if you experience vaginal bleeding or contractions, or if the pain becomes severe.
6. Appendicitis
Appendicitis is a serious condition that occurs when the appendix (a small organ attached to the large intestine) becomes inflamed and infected. This often happens when excess stool (and, sometimes, a tumor) blocks the opening inside the appendix. The blockage traps bacteria, resulting in swelling and pain.
The infection can initially cause pain around the belly button before it moves to the lower right side of the abdomen, explains Dr. Clarke. Appendicitis is also usually accompanied by nausea, vomiting, and a loss of appetite.
Seek immediate medical care if you suspect appendicitis because an untreated appendix can burst and cause a life-threatening infection (sepsis). Appendicitis is often treated with surgery to remove the appendix.
7. Pancreatitis
Pancreatitis is painful inflammation of the pancreas, an organ in the abdomen. It can have several causes, but the most common include a blockage in the bile duct caused by gallstones (hardened deposits of bile in the gallbladder) and alcohol use.
Pancreatitis can be acute or chronic. Acute pancreatitis lasts for a short time, causing pain in the upper belly that may radiate to the back, fever, upset stomach, vomiting, and rapid pulse. Chronic pancreatitis, on the other hand, is inflammation that comes and goes over time and causes pain in the upper belly that may feel worse after eating.
Visit urgent care if belly pain appears suddenly or doesn’t improve. Treatment typically involves a hospital stay to allow the pancreas time to rest and heal. You may be given pain medicine, antibiotics, intravenous (IV) fluids, and a tailored diet.
8. Crohn’s Disease or Other Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBD) is a group of chronic conditions that cause inflammation in the digestive tract. The two main types are Crohn’s disease and ulcerative colitis, which can lead to symptoms like abdominal pain, diarrhea, and fatigue, particularly during flare-ups (when symptoms appear suddenly), notes Clarke.
IBD treatment plans usually include prescription medications to reduce inflammation as well as minimizing other triggers for flare-ups.
9. Endometriosis
Endometriosis is a chronic condition that may affect more than 11 percent of U.S. women between the ages of 15 and 44. It occurs when tissue lining the uterus grows outside of it, which can cause sharp, cramp-like pain around the belly button. The pain often worsens during menstruation.
See your healthcare provider if you have endometriosis symptoms, such as pelvic pain and long menstrual periods. Treatment often involves pain management with OTC or prescription medications, hormonal birth control or another type of hormone therapy to slow the growth of endometrial tissue, and, in some cases, surgery to remove abnormal tissue.
10. Diverticulitis
Sharp pain in the lower left area of the abdomen is a common symptom of diverticulitis, a condition that develops when small pouches form in the wall of the large intestine and become inflamed.
Many people develop these small pouches (known as diverticula) as they age, though most don’t have issues. But sometimes the diverticula can get infected and tear, causing abdominal pain that’s usually moderate to severe. The pain may appear suddenly or build up over a few days. The pain may also be accompanied by other symptoms, including fever, nausea and vomiting, constipation, and even rectal bleeding.
Visit urgent care if you have symptoms of diverticulitis. If your symptoms are mild, your healthcare provider may recommend antibiotics and a liquid diet until symptoms improve. More severe symptoms may require a hospital stay.
