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.
Procrastination is choosing to delay something you meant to do, even though waiting makes you worse off overall.
Disengaging from the task makes us feel better immediately, explains Fuschia Sirois, PhD, a professor of social and health psychology at Durham University in England.
Think of it like a Band-Aid for any uncomfortable feelings a task brings up (whatever it is — stress, fear, anxiety, or something else). Difficulty with regulating emotions is the underlying cause.
But make no mistake, it’s harmful to use an emotional quick-fix over healthy processing that supports achieving your goals.
8 Tips to Procrastinate Less
“Procrastination, by definition, can never be beneficial,” says Dr. Sirois. Not only does procrastination get in the way of your productivity, it tends to increase stress and anxiety, while lowering self-esteem, erasing any temporary emotional relief that putting things off gave you.
To reduce procrastination, says Sirois, address the reasons behind it by turning down challenging feelings and dialing up helpful ones. These eight evidence-based tips can help.
1. First, Address Stress
When you’re stuck on starting a task, difficulty coping with stress and anxiety is likely to blame.
Stress can make it harder to get organized and prioritize tasks, explains Risa Williams, a licensed marriage and family therapist and clinician specializing in ADHD and time management in private practice in Los Angeles, and author of The Procrastination Playbook for Adults with ADHD: How to Catch Sneaky Forms of Procrastination Before They Catch You. “This is why some days you can’t even make a decision of what sentence to type in an email. Your brain just feels jammed up.”
One study examining academic procrastination found that students who struggled with regulating or coping with their emotions were more likely to procrastinate, which, in turn, made their emotional state worse.
Research suggests that indeed procrastination can sometimes (but not always) be an effect of stress.
Bringing your stress down in the ways you know work for you will make it so that procrastination loses its luster as an emotional relief valve. Try sitting outside, going for a walk, or doing breathing exercises. “Get your body and brain regulated so that you can deal with the hard thing that you have to do next,” she says.
2. Be Mindful of Your Procrastination Warning Signs
“Develop a mindful awareness of what your own procrastination tendencies are,” says Williams.
If you’re impulse shopping or cleaning your kitchen instead of starting that project, notice what you’re doing. If you feel guilty for not focusing, you’re likely procrastinating, she says.
Once you recognize and name what’s happening, respond nonjudgmentally. Williams suggests being a little playful and saying, “Hey, brain, what are you doing? What can I do to get you focused again?”
Research suggests that using mindfulness tactics, such as nonjudgment, nonreactivity, acting with awareness, and describing, help reduce anxiety and procrastination.
3. Practice Self-Compassion
Self-compassion works by shifting your thinking from a self-critical or self-judgmental stance to one that’s more balanced, says Sirois, who is also the author of Procrastination: What It Is, Why It’s A Problem, And What You Can Do About It. Practice self-compassion by reminding yourself that we’re all human, flawed, and make mistakes, Sirois says.
That helps you manage your emotions in a healthy way so you aren’t tempted to deal with them by avoiding your responsibilities.
One study that looked at how to help people stop procrastinating when it comes to exercise, for example, found that being self-compassionate helped people beat procrastination to stick to their workout plan.
Whatever you do, don’t be hard on yourself. It’s counterproductive because it creates more negative emotions, says Sirois. “Don’t beat yourself up over it. Just get on with things.”
4. Find the Bigger Meaning
You’re less likely to procrastinate going to the gym when you believe being active will help you spend time with your grandkids someday, says Sirois.
That’s because meaning helps you see beyond the immediate and connect small tasks with your own big-picture goals and values, she says.
Purpose, direction, and a sense of something larger lead to good feelings. On the flip side, having a reason to tolerate boredom, embarrassment, or other emotional discomfort makes these difficult feelings more bearable, Sirois explains.
In one study that looked at revenge sleep procrastination (when people put off going to sleep so they can enjoy some extra downtime, even knowing they won’t get enough sleep as a result), four sessions of motivational interviewing (a short-term therapy that helps you link your behaviors and values) reduced bedtime procrastination significantly more compared with the group that didn’t receive treatment.
5. Script Yourself for Success
“When something feels hard for us, we need to soothe ourselves into doing it, not beat ourselves up into doing it,” says Williams.
Extreme self-talk, like “this is the worst” or “I hate this,” amps up stress, she says. “We have to be really careful about how we’re talking about the thing we have to do and our ability to do it.”
When you tell yourself that you’re interested in a task and believe you can do what it takes to achieve it, you’re less likely to procrastinate, research suggests.
Having trouble finding a kind internal monologue? Try talking to yourself like you would a friend or your own kid, suggests Williams.
6. Make Big Tasks Smaller
If you’re overwhelmed with a large project and find yourself procrastinating, break it down.
“Make the first step forward so easy sounding to your brain that it almost feels ridiculous not to do it,” says Williams.
When a client procrastinated on creating a painting for a big art show, Williams told her to start by putting the paintbrushes in the middle of the dining room table. That little nudge was enough to bust through her creative block so she could meet her deadline.
Try giving yourself time limits to complete various tasks or parts of tasks. Designating those time frames can transform a project from downright overwhelming (finish the project by Friday) to doable (work 30 minutes today).
7. Get the Clarity You Need
Ambiguity is kryptonite for productivity. If you can’t break a project down into doable tasks, get clarity on what those more specific steps should be. Step one might be: Figure out how to get started.
In one study on academic procrastination, those who didn’t know what to do were more likely to put things off.
“It’s always good to get clarity,” says Sirois. If you feel uncertain about a project, ask questions or do research (or both). In a professional setting, managers can help, too. Reduce workplace procrastination by making sure that your colleagues have enough guidance and support on what they’re supposed to do, she says.
8. Team Up
When you pair up, you procrastinate less, according to new research on workplace procrastination. In the study, colleagues procrastinated the least when they worked cooperatively with a partner rather than alone or in a competitive duo.
Buddies are great procrastination busters from an emotional-regulation perspective, says Sirois. “Doing things together is emotionally pleasant,” she says. But competing? That just increases negativity. And being alone leaves you to face negative thoughts by yourself, she explains.
The Takeaway
The reason people procrastinate is to quickly regulate emotions by avoiding a task.
The best tools for procrastination address why people procrastinate and help regulate emotions in healthier ways.
Research shows that the most effective techniques to combat procrastination help you cope with task-related stress and anxiety and boost positive feelings.
Living with a chronic disease often means monitoring and tracking your symptoms, such as fatigue. This allows you to identify triggers, such as food and stress. It can also help you detect relapses early when the disease is inactive or in remission.
When Crohn’s disease fatigue is getting in the way of your daily life, here are some of the ways you can manage it:
Rule out underlying anemia
Take the necessary supplements as directed by your healthcare provider
Treat flare-ups
Switch medications
Manage sleep
Manage stress
Eat well
Exercise regularly
Budget your energy
1. Assess Anemia
About 1 in 3 people with Crohn’s have anemia.
A blood test can determine whether or not you’re anemic. At its most severe, anemia is life-threatening. Iron supplements given orally or through an IV (intravenously) can also help with iron deficiency. According to the American Society of Hematology, blood transfusions can be a temporary solution if there is severe anemia.
While blood transfusions improve your blood levels, you will need to take other steps to address or prevent anemia.
2. Take a Supplement
You might need more than iron supplements to make up for any nutritional deficiencies in your diet. Studies have also reported a higher risk of folic acid deficiency in patients with IBD.
Crohn’s patients may also have low vitamins B12 and D, Rao adds. Dr. Choudhary says she often recommends that Crohn’s patients take a multivitamin and have frequent blood tests to check for nutrient deficiencies. Consider talking with a dietitian who specializes in Crohn’s disease or your doctor before taking any new supplements.
3. Treat Flare-Ups
When symptoms reappear or worsen, you may be in a flare-up. Stress, smoking, and taking certain medications can all contribute to Crohn’s flare-ups. This is when symptom monitoring becomes especially handy — it allows you to identify potential causes of flares, which you can relay to your doctor.
Make sure you’re following all of the necessary steps to avoid and treat your Crohn’s flares. This means taking prescribed medication according to your doctor’s instructions in addition to maintaining a healthy lifestyle.
4. Switch Medications
Certain medications can contribute to Crohn’s flares. Nonsteroidal anti-inflammatory medicines (NSAIDs), for example, may exacerbate inflammation of the bowel and worsen Crohn’s symptoms. If fatigue is a side effect of one of your medications, you might need to switch. Do so only with your doctor’s supervision.
5. Manage Sleep
Talk with your doctor about ways to improve life with Crohn’s so you can get some shut-eye, especially if symptoms are keeping you up at night.
Also review your entire sleep hygiene routine to make sure you’re giving yourself a chance to get enough good-quality sleep. The Crohn’s & Colitis Foundation recommends going to sleep and waking up at the same time everyday and using fewer electronics closer to bedtime.
You should also create a bedtime routine that’s conducive to quality sleep, such as creating a calming environment in your bedroom, Rao adds.
6. Manage Stress
Yes, Crohn’s is stressful. Stress in itself is tiring and can interfere with sleep.
You’ll want to identify your stressors as part of an overall strategy to reduce stress, says Rao. The Crohn’s & Colitis Foundation advises patients to take up cognitive behavioral therapy (CBT), mindfulness, and meditation to relieve emotional stress if it’s impacting your life — your gastroenterologist can refer you if this is needed. Taking a warm bath before bed or having a cup of chamomile tea can help set a relaxing mood.
It may take time to settle into a stress management routine — living with Crohn’s for over 30 years has helped Domilici gain some perspective and discover strategies to cope with the emotional and psychological challenges. Some examples include managing iron and vitamin deficiencies, reducing psychological and emotional stress, and improving your sleep routine.
7. Eat Well
There isn’t a one-size-fits-all diet for Crohn’s disease, but food can still play a role in symptom and disease management.
For starters, people with Crohn’s disease may have food triggers that worsen their symptoms or contribute to flares. High-fiber foods, coffee, alcohol, sweeteners, dairy, and spicy foods are all examples of potential food triggers.
Keeping a food or symptom log can help you identify which foods and drinks are more likely to trigger Crohn’s symptoms so you can limit or avoid them. You should also aim to follow a balanced, nutrient-dense diet that includes fruits, vegetables, healthy fats, whole grains, and leafy greens. Working with a nutritionist is key to understanding how diet can impact your gastrointestinal health.
8. Exercise
“It’s important for Crohn’s patients to find a form of exercise that they enjoy and can sustain,” Rao says. “Regular physical activity can help reduce stress, anxiety, depression and improve overall well being especially in patients who have chronic medical conditions.” The general recommendation is to aim for at least 150 minutes of moderate aerobic exercise per week.
But check with your doctor before starting a fitness plan, Choudhary advises. If you have severe anemia, working out may make you feel even more fatigued. “If you are over 65, have low hemoglobin, exercise can put a strain on the heart,” she says. Also, if you’re experiencing flare-ups, it’s better to let the body rest before exercising.
9. Budget Your Energy
When you have limited energy, you’ll need to use it wisely. Consider the concept of treating your energy levels like money and budgeting it appropriately.
“It’s a matter of being good at prioritizing and delegating,” Domilici says. “Look at your week and have a sense of what you can manage and not manage.” If your day is overbooked, cut some of your commitments.
Crohn’s patients may even need to take time off from school or work obligations or obtain necessary accommodations from their physician as needed, Dr. Dibba says.
While light therapy is not typically the first line of defense for people with eczema (moisturizers and corticosteroids are usually the first step), it could be a good option, especially for people who are trying to reduce the amount of creams and ointments they apply, says Page.
This is backed up by research: Studies designed to evaluate how well light therapy works in a “real-life” setting showed “high and long-lasting” effects and that it allowed people to use less topical steroids, oral steroids, and antihistamines.
Dr. Piliang and Page also say light therapy may be a good option for the following circumstances:
If you don’t want to take injections
If you don’t like the side effects of a medication
If you are targeting eczema in a particular area, like the hands or feet
If you’re targeting widespread eczema and want to reduce your usage of prescription creams
Is Light Therapy Right for Your Eczema Treatment Plan?
For some people, light therapy is the “backbone of their care,” says High. But it typically isn’t the only aspect of an eczema treatment plan, he says. There is really no eczema therapy that doesn’t require other medications or lifestyle recommendations.
“We might still use topical therapies like corticosteroids. We always recommend skin moisturizers and gentle bathing practices,” he says.
Light therapy for eczema is not the same as basking in the sun all day or using a tanning bed. “Natural sunlight can help relieve symptoms of eczema, but artificially produced UV light is best for eczema treatment because it can be controlled and given under supervision,” says Page.
This medical route is different from a tanning bed, says Piliang. Medical light boxes filter out some UV wavelengths, making this therapy a safer option. The U.S. Food and Drug Administration approves medical UV phototherapy — it does not approve indoor tanning devices, according to the American Academy of Dermatology Association.
What to Expect at Your Light Therapy Appointment
At the light therapy appointment, you’ll moisturize your skin, then stand undressed (except for underwear) in a light box, with goggles on to protect your eyes. “The box is kind of like a tanning bed, but you stand up instead of lying down. At first, the session will be very short — maybe only 15 or 20 seconds,” says High.
People usually go to light therapy appointments two or three times a week, and you need to skip at least one day in between sessions, he says.
“Each time you come back for light therapy, you get a little tiny bit longer ‘dosage’ until eventually you might end up getting three or four minutes of light therapy at a time,” says High.
Once people have an adequate treatment response — maybe after 10 to 12 weeks — the sessions are spaced farther apart until they are eventually stopped, he says.
“Eventually, you do what’s called ‘riding the remission,’ where their eczema symptoms have improved, and their skin is in good shape. At that point, you see how long they can just use topical medicines and moisturizers,” says High.
A person can always do a round of light therapy again when they need it, but because additional ultraviolet light can be a risk factor for skin cancer, you don’t want to do it indefinitely for the rest of your life, he says.
Experts say the direct relationship between antidepressants and blood sugar is complex and not yet fully understood.
“Research shows that different antidepressants influence glucose levels to varying degrees,” says Elizabeth A. Beverly, PhD, a professor at Ohio University in Athens and a researcher in psychosocial issues related to diabetes. “The effects on glucose depend on the specific antidepressant, dosage, duration of use, and individual factors, since everyone’s body responds differently to medications.”
Dr. Beverly says that some research shows beneficial effects on glucose levels with SSRIs, but that some noradrenergic antidepressants, a class of drugs that treat depression by increasing the levels of norepinephrine in the brain, may have a negative impact on blood sugar management.
“The choice of antidepressant should be individualized to the person with diabetes and their values, preferences, and needs,” says Beverly. “Encouraging healthy eating patterns, regular physical activity, glucose monitoring, adequate sleep, eliminating substance use, and behavioral healthcare can help mitigate the potential adverse effects of antidepressants on glycemia.”
Wadsworth says when someone with diabetes is selecting an antidepressant, it’s important to align the medication’s side effect profile with the patient’s symptoms.
“This ensures that any adverse effects are not only manageable but potentially beneficial,” says Wadsworth. “For example, bupropion (Wellbutrin) is a strong option for patients with type 2 diabetes, since it is weight neutral or even associated with weight loss.”
