Prediabetes

/in /by

What is insulin resistance? 

Prediabetes means you have a higher than normal blood sugar level. It’s not high enough to be considered type 2 diabetes yet. But without lifestyle changes, adults and children with prediabetes are at high risk to develop type 2 diabetes.

If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There’s good news, however. Progression from prediabetes to type 2 diabetes isn’t inevitable.

Eating healthy foods, making physical activity part of your daily routine and staying at a healthy weight can help bring your blood sugar level back to normal. The same lifestyle changes that can help prevent type 2 diabetes in adults might also help bring children’s blood sugar levels back to normal.

Symptoms

Prediabetes doesn’t usually have any signs or symptoms.

One possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits and groin.

Classic signs and symptoms that suggest you’ve moved from prediabetes to type 2 diabetes include:

  • Increased thirst
  • Frequent urination
  • Increased hunger
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the feet or hands
  • Frequent infections
  • Slow-healing sores
  • Unintended weight loss

When to see a doctor

See your health care provider if you’re concerned about diabetes or if you notice any type 2 diabetes signs or symptoms. Ask your health care provider about blood sugar screening if you have any risk factors for diabetes.

Causes

The exact cause of prediabetes is unknown. But family history and genetics appear to play an important role. What is clear is that people with prediabetes don’t process sugar (glucose) properly anymore.

Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters your bloodstream. Insulin allows sugar to enter your cells — and lowers the amount of sugar in your blood.

Insulin is produced by a gland located behind the stomach called the pancreas. Your pancreas sends insulin to your blood when you eat. When your blood sugar level starts to drop, the pancreas slows down the secretion of insulin into the blood.

When you have prediabetes, this process doesn’t work as well. As a result, instead of fueling your cells, sugar builds up in your bloodstream. This can happen because:

  • Your pancreas may not make enough insulin
  • Your cells become resistant to insulin and don’t allow as much sugar in

Risk factors

The same factors that increase the odds of getting type 2 diabetes also increase the risk of prediabetes. These factors include:

  • Weight. Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
  • Waist size. A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
  • Diet. Eating red meat and processed meat, and drinking sugar-sweetened beverages, is associated with a higher risk of prediabetes.
  • Inactivity. The less active you are, the greater your risk of prediabetes.
  • Age. Although diabetes can develop at any age, the risk of prediabetes increases after age 35.
  • Family history. Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
  • Race or ethnicity. Although it’s unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are more likely to develop prediabetes.
  • Gestational diabetes. If you had diabetes while pregnant (gestational diabetes), you and your child are at higher risk of developing prediabetes.
  • Polycystic ovary syndrome. Women with this common condition — characterized by irregular menstrual periods, excess hair growth and obesity — have a higher risk of prediabetes.
  • Sleep. People with obstructive sleep apnea — a condition that disrupts sleep repeatedly — have an increased risk of insulin resistance. People who are overweight or obese have a higher risk of developing obstructive sleep apnea.
  • Tobacco smoke. Smoking may increase insulin resistance and can increase the risk of type 2 diabetes in people with prediabetes. Smoking also increases your risk of complications from diabetes.

Other conditions associated with an increased risk of prediabetes include:

  • High blood pressure
  • Low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol
  • High levels of triglycerides — a type of fat in your blood

Metabolic syndrome

When certain conditions occur with obesity, they are associated with insulin resistance, and can increase your risk for diabetes — and heart disease and stroke. A combination of three or more of these conditions is often called metabolic syndrome:

  • High blood pressure
  • Low levels of HDL
  • High triglycerides
  • High blood sugar levels
  • Large waist size

Complications

Prediabetes has been linked with long-term damage, including to your heart, blood vessels and kidneys, even if you haven’t progressed to type 2 diabetes. Prediabetes is also linked to unrecognized (silent) heart attacks.

Prediabetes can progress to type 2 diabetes, which can lead to:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Kidney disease
  • Nerve damage
  • Fatty liver disease
  • Eye damage, including loss of vision
  • Amputations

Prevention

Healthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family. These include:

  • Eating healthy foods
  • Getting active
  • Losing excess weight
  • Controlling your blood pressure and cholesterol
  • Not smoking

Childhood Obesity

/in /by

Childhood obesity

Childhood obesity is a serious medical condition that affects children and adolescents. It’s particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. Childhood obesity can also lead to poor self-esteem and depression.

One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child’s health now and in the future.

Symptoms

Not all children carrying extra pounds are overweight. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know by how your child looks if weight is a health concern.

The body mass index (BMI), which provides a guideline of weight in relation to height, is the accepted measure of overweight and obesity. Your child’s doctor can use growth charts, the BMI and, if necessary, other tests to help you figure out if your child’s weight could pose health problems.

When to see a doctor

If you’re worried that your child is putting on too much weight, talk to his or her doctor. The doctor will consider your child’s history of growth and development, your family’s weight-for-height history, and where your child lands on the growth charts. This can help determine if your child’s weight is in an unhealthy range.

Causes

Lifestyle issues — too little activity and too many calories from food and drinks — are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well.

Risk factors

Many factors — usually working in combination — increase your child’s risk of becoming overweight:

  • Diet. Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices and sports drinks, as culprits in obesity in some people.
  • Lack of exercise. Children who don’t exercise much are more likely to gain weight because they don’t burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem. TV shows also often feature ads for unhealthy foods.
  • Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn’t encouraged.
  • Psychological factors. Personal, parental and family stress can increase a child’s risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents might have similar tendencies.
  • Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they might buy convenience foods that don’t spoil quickly, such as frozen meals, crackers and cookies. Also, people who live in lower income neighborhoods might not have access to a safe place to exercise.
  • Certain medications. Some prescription drugs can increase the risk of developing obesity. They include prednisone, lithium, amitriptyline, paroxetine (Paxil), gabapentin (Neurontin, Gralise, Horizant) and propranolol (Inderal, Hemangeol).

Complications

Childhood obesity often causes complications in a child’s physical, social and emotional well-being.

Physical complications

Physical complications of childhood obesity may include:

  • Type 2 diabetes. This chronic condition affects the way your child’s body uses sugar (glucose). Obesity and a sedentary lifestyle increase the risk of type 2 diabetes.
  • High cholesterol and high blood pressure. A poor diet can cause your child to develop one or both of these conditions. These factors can contribute to the buildup of plaques in the arteries, which can cause arteries to narrow and harden, possibly leading to a heart attack or stroke later in life.
  • Joint pain. Extra weight causes extra stress on hips and knees. Childhood obesity can cause pain and sometimes injuries in the hips, knees and back.
  • Breathing problems. Asthma is more common in children who are overweight. These children are also more likely to develop obstructive sleep apnea, a potentially serious disorder in which a child’s breathing repeatedly stops and starts during sleep.
  • Nonalcoholic fatty liver disease (NAFLD). This disorder, which usually causes no symptoms, causes fatty deposits to build up in the liver. NAFLD can lead to scarring and liver damage.

Social and emotional complications

Children who have obesity may experience teasing or bullying by their peers. This can result in a loss of self-esteem and an increased risk of depression and anxiety.

Prevention

To help prevent excess weight gain in your child, you can:

  • Set a good example. Make healthy eating and regular physical activity a family affair. Everyone will benefit and no one will feel singled out.
  • Have healthy snacks available. Options include air-popped popcorn without butter, fruits with low-fat yogurt, baby carrots with hummus, or whole-grain cereal with low-fat milk.
  • Offer new foods multiple times. Don’t be discouraged if your child doesn’t immediately like a new food. It usually takes multiple exposures to a food to gain acceptance.
  • Choose nonfood rewards. Promising candy for good behavior is a bad idea.
  • Be sure your child gets enough sleep. Some studies indicate that too little sleep may increase the risk of obesity. Sleep deprivation can cause hormonal imbalances that lead to increased appetite.

Also, be sure your child sees the doctor for well-child checkups at least once a year. During this visit, the doctor measures your child’s height and weight and calculates his or her BMI. A significant increase in your child’s BMI percentile rank over one year may be a possible sign that your child is at risk of becoming overweight.

Mental illness and Mental Health

/in /by

Mental illness

Mental illness, also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).

Symptoms

Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors.

Examples of signs and symptoms include:

  • Feeling sad or down
  • Confused thinking or reduced ability to concentrate
  • Excessive fears or worries, or extreme feelings of guilt
  • Extreme mood changes of highs and lows
  • Withdrawal from friends and activities
  • Significant tiredness, low energy or problems sleeping
  • Detachment from reality (delusions), paranoia or hallucinations
  • Inability to cope with daily problems or stress
  • Trouble understanding and relating to situations and to people
  • Problems with alcohol or drug use
  • Major changes in eating habits
  • Sex drive changes
  • Excessive anger, hostility or violence
  • Suicidal thinking

Sometimes symptoms of a mental health disorder appear as physical problems, such as stomach pain, back pain, headaches, or other unexplained aches and pains.

When to see a doctor

If you have any signs or symptoms of a mental illness, see your primary care provider or a mental health professional. Most mental illnesses don’t improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems.

If you have suicidal thoughts

Suicidal thoughts and behavior are common with some mental illnesses. If you think you may hurt yourself or attempt suicide, get help right away:

  • Call 911 or your local emergency number immediately.
  • Call your mental health specialist.
  • Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
  • Seek help from your primary care provider.
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone else in your faith community.

Suicidal thinking doesn’t get better on its own — so get help.

Helping a loved one

If your loved one shows signs of mental illness, have an open and honest discussion with him or her about your concerns. You may not be able to force someone to get professional care, but you can offer encouragement and support. You can also help your loved one find a qualified mental health professional and make an appointment. You may even be able to go along to the appointment.

If your loved one has done self-harm or is considering doing so, take the person to the hospital or call for emergency help.

Causes

Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

  • Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
  • Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression and other emotional disorders.

Risk factors

Certain factors may increase your risk of developing a mental illness, including:

  • A history of mental illness in a blood relative, such as a parent or sibling
  • Stressful life situations, such as financial problems, a loved one’s death or a divorce
  • An ongoing (chronic) medical condition, such as diabetes
  • Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head
  • Traumatic experiences, such as military combat or assault
  • Use of alcohol or recreational drugs
  • A childhood history of abuse or neglect
  • Few friends or few healthy relationships
  • A previous mental illness

Mental illness is common. About 1 in 5 adults has a mental illness in any given year. Mental illness can begin at any age, from childhood through later adult years, but most cases begin earlier in life.

The effects of mental illness can be temporary or long lasting. You also can have more than one mental health disorder at the same time. For example, you may have depression and a substance use disorder.

Complications

Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include:

  • Unhappiness and decreased enjoyment of life
  • Family conflicts
  • Relationship difficulties
  • Social isolation
  • Problems with tobacco, alcohol and other drugs
  • Missed work or school, or other problems related to work or school
  • Legal and financial problems
  • Poverty and homelessness
  • Self-harm and harm to others, including suicide or homicide
  • Weakened immune system, so your body has a hard time resisting infections
  • Heart disease and other medical conditions

Prevention

There’s no sure way to prevent mental illness. However, if you have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control. Follow these steps:

  • Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends to watch for warning signs.
  • Get routine medical care. Don’t neglect checkups or skip visits to your primary care provider, especially if you aren’t feeling well. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication.
  • Get help when you need it. Mental health conditions can be harder to treat if you wait until symptoms get bad. Long-term maintenance treatment also may help prevent a relapse of symptoms.
  • Take good care of yourself. Sufficient sleep, healthy eating and regular physical activity are important. Try to maintain a regular schedule. Talk to your primary care provider if you have trouble sleeping or if you have questions about diet and physical activity.

Compulsive sexual behavior

/in /by

 

Compulsive sexual behavior is sometimes called hypersexuality or sexual addiction. It’s an intense focus on sexual fantasies, urges or behaviors that can’t be controlled. This causes distress and problems for your health, job, relationships or other parts of your life.

Compulsive sexual behavior may involve different kinds of commonly enjoyable sexual experiences. Examples include masturbation, sexual arousal by using a computer to communicate, multiple sexual partners, use of pornography or paying for sex. But when these sexual behaviors become a major, constant focus in your life, are difficult to control, cause problems in your life, or are harmful to you or others, that’s likely compulsive sexual behavior.

No matter what it’s called or the exact nature of the behavior, untreated compulsive sexual behavior can damage your self-esteem, relationships, career, health and other people. But with treatment and self-help, you can learn to manage compulsive sexual behavior.

Symptoms

Some signs that you may have compulsive sexual behavior include:

  • You have repeated and intense sexual fantasies, urges, and behaviors that take up a lot of your time and feel as if they’re beyond your control.
  • You feel driven or have frequent urges to do certain sexual behaviors, feel a release of the tension afterward, but also feel guilt or deep regret.
  • You’ve tried without success to reduce or control your sexual fantasies, urges or behavior.
  • You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress.
  • You continue to engage in sexual behaviors in spite of them causing serious problems. These could include the possibility of getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work, financial issues, or legal problems.
  • You have trouble making and keeping healthy and stable relationships.

When to see a doctor

Ask for help if you feel you’ve lost control of your sexual behavior, especially if your behavior causes problems for you or other people. Compulsive sexual behavior tends to get worse over time without treatment, so get help when you first notice a problem.

As you decide whether to seek professional help, ask yourself:

  • Can I manage my sexual impulses?
  • Am I distressed by my sexual behaviors?
  • Is my sexual behavior hurting my relationships, affecting my work or causing serious problems, such as getting arrested?
  • Do I try to hide my sexual behavior?

Getting help for compulsive sexual behavior can be difficult because it’s such a deeply personal and private matter. Try to:

  • Set aside any shame or embarrassment and focus on the benefits of getting treatment.
  • Remember that you’re not alone — many people struggle with compulsive sexual behavior. Mental health professionals are trained to be understanding and not judge people. But not all mental health providers are experienced in treating this condition. Look for a provider who has experience in diagnosing and treating compulsive sexual behavior.
  • Keep in mind that what you say to a health care or mental health provider is private. But providers are required to make a report if you tell them that you’re going to hurt yourself or someone else. They also are required to report if you give information about sexual abuse of a child or abuse or neglect of someone who is vulnerable, such as an elderly or disabled person.

Causes

Although the exact causes of compulsive sexual behavior are not clear, possible causes may include:

  • Changes in brain pathways. Compulsive sexual behavior, over time, might cause changes in the brain’s pathways, called neural circuits. This may happen especially in areas of the brain that are related to reinforcement. Over time, more-intense sexual content and stimulation are usually needed to get satisfaction or relief.
  • An imbalance of natural brain chemicals. Certain chemicals in your brain called neurotransmitters — such as serotonin, dopamine and norepinephrine — help control your mood. When these are out of balance, your sexual desire and behavior could be affected.
  • Conditions that affect the brain. Certain health conditions, such as dementia, may cause damage to parts of the brain that affect sexual behavior. Also, treatment of Parkinson’s disease with certain medicines may cause compulsive sexual behavior.

Risk factors

Compulsive sexual behavior can happen in both men and women, though it may be more common in men. It can affect anyone, regardless of sexual orientation. Factors that may increase the risk of compulsive sexual behavior include:

  • How easy it is to get sexual content. Advances in technology and social media give people easy access to intense sexual images and information.
  • Privacy. The secret and private nature of compulsive sexual activities can allow these problems to worsen over time.

Also, the risk of compulsive sexual behavior may be higher in people who have:

  • Problems with alcohol or drug use.
  • Another mental health condition, such as depression, anxiety or a gambling addiction.
  • Family conflicts or family members with problems such as addiction.
  • A history of physical or sexual abuse.

Complications

Compulsive sexual behavior can cause many problems that affect both you and others. You may:

  • Struggle with feelings of guilt, shame and low self-esteem.
  • Develop other mental health conditions, such as depression, severe distress and anxiety. You also may think about or attempt suicide.
  • Neglect or lie to your partner and family, harming or destroying important relationships.
  • Lose your focus or engage in sexual activity or search internet pornography at work, risking your job.
  • Have financial problems from buying pornography, internet or telephone sex, and sexual services.
  • Get HIV, hepatitis or another sexually transmitted infection, or pass a sexually transmitted infection to someone else.
  • Have problems with drugs and alcohol, such as using recreational drugs or drinking too much alcohol.
  • Get arrested for sexual offenses.

Prevention

Because the cause of compulsive sexual behavior isn’t known, it’s not clear how to prevent it. But a few things may help you keep control of problem behavior:

  • Get help early for problems with sexual behavior. Identifying and treating early problems may help prevent compulsive sexual behavior from getting worse over time. Getting help also may prevent shame, relationship problems and harmful acts from getting worse.
  • Seek treatment early for mental health conditions. Depression, anxiety or other mental health conditions can make compulsive sexual behavior worse.
  • Get help for problems with alcohol and drug use. These can cause a loss of control that leads to poor judgment and sexual behaviors that aren’t healthy.
  • Avoid risky situations. Don’t risk your health or that of others by putting yourself into situations where you’ll be tempted to engage in risky sexual activities.

Migraine

/in /by

What is a migraine? 

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

Symptoms

Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

  • Constipation.
  • Mood changes, from depression to euphoria.
  • Food cravings.
  • Neck stiffness.
  • Increased urination.
  • Fluid retention.
  • Frequent yawning.

Aura

For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes.

Examples of migraine auras include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light.
  • Vision loss.
  • Pins and needles sensations in an arm or leg.
  • Weakness or numbness in the face or one side of the body.
  • Difficulty speaking.

Attack

A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

  • Pain usually on one side of your head, but often on both sides.
  • Pain that throbs or pulses.
  • Sensitivity to light, sound, and sometimes smell and touch.
  • Nausea and vomiting.

Post-drome

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches.

Even if you have a history of headaches, see your health care provider if the pattern changes or your headaches suddenly feel different.

See your health care provider immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

  • An abrupt, severe headache like a thunderclap.
  • Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke.
  • Headache after a head injury.
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
  • New headache pain after age 50.

Causes

Though migraine causes aren’t fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.

Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Migraine triggers

There are a number of migraine triggers, including:

  • Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.
    Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.
  • Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
  • Stress. Stress at work or home can cause migraines.
  • Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells — such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
  • Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.
  • Physical strain. Intense physical exertion, including sexual activity, might provoke migraines.
  • Weather changes. A change of weather or barometric pressure can prompt a migraine.
  • Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
  • Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.
  • Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Risk factors

Several factors make you more prone to having migraines, including:

  • Family history. If you have a family member with migraines, then you have a good chance of developing them too.
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
  • Sex. Women are three times more likely than men to have migraines.
  • Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications

Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen (Tylenol, others) and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Liver Disease

/in /by

The liver is an organ that sits just under the rib cage on the right side of the abdomen. It can weigh up to 4 pounds (1.8 kilograms). The liver is needed to help digest food, rid the body of waste products and make substances, called clotting factors, that keep the blood flowing well, among other tasks.

Liver disease can be passed through families, called inherited. Anything that damages the liver also can cause liver problems, including viruses, alcohol use and obesity.

Over time, conditions that damage the liver can lead to scarring, called cirrhosis. Cirrhosis can lead to liver failure, a life-threatening condition. But early treatment may give the liver time to heal.

Symptoms

Liver disease doesn’t always cause symptoms that can be seen or felt. If there are symptoms of liver disease, they may include:

  • Yellowing of the skin and the whites of the eyes, called jaundice. Yellowing of the skin might be harder to see on Black or brown skin.
  • Belly pain and swelling.
  • Swelling in the legs and ankles.
  • Itchy skin.
  • Dark urine.
  • Pale stool.
  • Constant tiredness.
  • Nausea or vomiting.
  • Loss of appetite.
  • Bruising easily.

When to see a doctor

Make an appointment with your healthcare professional if you have any lasting symptoms that worry you. Seek medical help right away if you have belly pain that is so bad that you can’t stay still.

Causes

Liver disease has many causes.

Infection

Parasites and viruses can infect the liver, causing swelling and irritation, called inflammation. Inflammation keeps the liver from working as it should. The viruses that cause liver damage can be spread through blood or semen, bad food or water, or close contact with a person who is infected.

The most common types of liver infection are hepatitis viruses, including:

  • Hepatitis A.
  • Hepatitis B.
  • Hepatitis C.

Immune system condition

Diseases in which the immune system attacks certain parts of the body are called autoimmune diseases. Autoimmune liver diseases include:

  • Autoimmune hepatitis.
  • Primary biliary cholangitis.
  • Primary sclerosing cholangitis.

Genetics

A changed gene from one or both parents can cause substances to build up in the liver. This can cause liver damage. Genetic liver diseases include:

  • Hemochromatosis.
  • Wilson’s disease.
  • Alpha-1 antitrypsin deficiency.

Cancer and other growths

Examples include:

  • Liver cancer.
  • Bile duct cancer.
  • Liver adenoma.

Other

Other common causes of liver disease include:

  • Long-term alcohol use.
  • Fat that builds up in the liver, called nonalcoholic fatty liver disease or metabolic-associated steatotic liver disease.
  • Certain prescription or other medicines.
  • Certain herbal mixes.
  • Being in contact often with toxic chemicals.

Risk factors

Factors that can increase the risk of liver disease include:

  • Ongoing moderate or heavy alcohol use.
  • Obesity.
  • Type 2 diabetes.
  • Tattoos or body piercings.
  • Shared needles to inject drugs.
  • Blood transfusion before 1992.
  • Contact with other people’s blood and body fluids.
  • Sex without protection.
  • Contact with chemicals or toxins.
  • Family history of liver disease.

Complications

Complications of liver disease depend on the cause of the liver problems. Without treatment, liver disease may progress to liver failure. Liver failure can be fatal.

Prevention

To prevent liver disease:

  • If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
  • Avoid risky behavior. Use a condom during sex. If you get tattoos or body piercings, pick a shop that’s clean and safe. Seek help if you shoot illicit drugs. Don’t share needles to shoot drugs.
  • Get vaccinated. If you’re at increased risk of getting hepatitis, talk with your healthcare professional about getting the hepatitis A and hepatitis B vaccines. This also is true if you’ve been infected with any form of the hepatitis virus.
  • Be careful when taking medicines. Take prescription and other medicines only when needed. Take only as much as directed. Don’t mix medicines and alcohol. Talk with your healthcare provider before mixing herbal supplements or prescription or other medicines.
  • Stay away from other people’s blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or poor cleanup of blood or body fluids.
  • Keep your food safe. Wash your hands well before eating or making foods. If traveling in a resource-poor country, use bottled water to drink, wash your hands and brush your teeth.
  • Take care with aerosol sprays. Make sure to use these products in an open area. Wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the maker’s instructions.
  • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask so that chemicals don’t get on your skin.
  • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease, now called metabolic-associated steatotic liver disease.

Genital herpes

/in /by

Genital herpes is a common sexually transmitted infection (STI). The herpes simplex virus (HSV) causes genital herpes. Genital herpes can often be spread by skin-to-skin contact during sexual activity.

Some people infected with the virus may have very mild symptoms or no symptoms. They can still able to spread the virus. Other people have pain, itching and sores around the genitals, anus or mouth.

There is no cure for genital herpes. Symptoms often show up again after the first outbreak. Medicine can ease symptoms. It also lowers the risk of infecting others. Condoms can help prevent the spread of a genital herpes infection.

Symptoms

Most people infected with HSV don’t know they have it. They may have no symptoms or have very mild symptoms.

Symptoms start about 2 to 12 days after exposure to the virus. They may include:

  • Pain or itching around the genitals
  • Small bumps or blisters around the genitals, anus or mouth
  • Painful ulcers that form when blisters rupture and ooze or bleed
  • Scabs that form as the ulcers heal
  • Painful urination
  • Discharge from the urethra, the tube that releases urine from the body
  • Discharge from the vagina

During the first outbreak, you may commonly have flu-like symptoms such as:

  • Fever
  • Headache
  • Body aches
  • Swollen lymph nodes in the groin

Differences in symptom location

Sores appear where the infection enters the body. You can spread the infection by touching a sore and then rubbing or scratching another area of your body. That includes your fingers or eyes.

Sore can develop on or in the:

  • Buttocks
  • Thighs
  • Rectum
  • Anus
  • Mouth
  • Urethra
  • Vulva
  • Vagina
  • Cervix
  • Penis
  • Scrotum

Repeat outbreaks

After the first outbreak of genital herpes, symptoms often appear again. These are called recurrent outbreaks or recurrent episodes.

How often recurrent outbreaks happen varies widely. You’ll usually have the most outbreaks the first year after infection. They may appear less often over time. Your symptoms during recurrent outbreaks usually don’t last as long and aren’t as severe as the first.

You may have warning signs a few hours or days before a new outbreak starts. These are called prodromal symptoms. They include:

  • Genital pain
  • Tingling or shooting pain in the legs, hips or buttocks

When to see a doctor

If you suspect you have genital herpes, or any other STI, see your health care provider.

Causes

Genital herpes is caused by two types of herpes simplex virus. These types include herpes simplex virus type 2 (HSV-2) and herpes simplex virus type 1 (HSV-1). People with HSV infections can pass along the virus even when they have no visible symptoms.

HSV-2

HSV-2 is the most common cause of genital herpes. The virus can be present:

  • On blisters and ulcers or the fluid from ulcers
  • The moist lining or fluids of the mouth
  • The moist lining or fluids of the vagina or rectum

The virus moves from one person to another during sexual activity.

HSV-1

HSV-1 is a version of the virus that causes cold sores or fever blisters. People may be exposed to HSV-1 as children due to close skin-to-skin contact with someone infected.

A person with HSV-1 in tissues of the mouth can pass the virus to the genitals of a sexual partner during oral sex. The newly caught infection is a genital herpes infection.

Recurrent outbreaks of genital herpes caused by HSV-1 are often less frequent than outbreaks caused by HSV-2.

Neither HSV-1 nor HSV-2 survives well at room temperature. So the virus is not likely to spread through surfaces, such as a faucet handle or a towel. But kissing or sharing a drinking glass or silverware might spread the virus.

Risk factors

A higher risk of getting genital herpes is linked to:

  • Contact with genitals through oral, vaginal or anal sex. Having sexual contact without using a barrier increases your risk of genital herpes. Barriers include condoms and condom-like protectors called dental dams used during oral sex. Women are at higher risk of getting genital herpes. The virus can spread more easily from men to women than from women to men.
  • Having sex with multiple partners. The number of people you have sex with is a strong risk factor. Contact with genitals through sex or sexual activity puts you at higher risk. Most people with genital herpes do not know they have it.
  • Having a partner who has the disease but is not taking medicine to treat it. There is no cure for genital herpes, but medicine can help limit outbreaks.
  • Certain groups within the population. Women, people with a history of sexually transmitted diseases, older people, Black people in in the United States and men who have sex with men diagnosed with genital herpes at a higher than average rate. People in groups at higher risk may choose to talk to a health care provider about their personal risk.

Complications

Complications associated with genital herpes may include:

  • Other sexually transmitted infections. Having genital sores raises your risk of giving or getting other STIs, including HIV/AIDS.
  • Newborn infection. A baby can be infected with HSV during delivery. Less often, the virus is passed during pregnancy or by close contact after delivery. Newborns with HSV often have infections of internal organs or the nervous system. Even with treatment, these newborns have a high risk of developmental or physical problems and a risk of death.
  • Internal inflammatory disease. HSV infection can cause swelling and inflammation within the organs associated with sexual activity and urination. These include the ureter, rectum, vagina, cervix and uterus.
  • Finger infection. An HSV infection can spread to a finger through a break in the skin causing discoloration, swelling and sores. The infections are called herpetic whitlow.
  • Eye infection. HSV infection of the eye can cause pain, sores, blurred vision and blindness.
  • Swelling of the brain. Rarely, HSV infection leads to inflammation and swelling of the brain, also called encephalitis.
  • Infection of internal organs. Rarely, HSV in the bloodstream can cause infections of internal organs.

Prevention

Prevention of genital herpes is the same as preventing other sexually transmitted infections.

  • Have one long-term sexual partner who has been tested for STIs and isn’t infected.
  • Use a condom or dental dam during sexual activity. These reduce the risk of disease, but they don’t prevent all skin-to-skin contact during sex.
  • Don’t have sex when a partner with genital herpes has symptoms.

Pregnancy precautions

If you are pregnant and know you have genital herpes, tell your health care provider. If you think you might have genital herpes, ask your provider if you can be tested for it.

Your provider may recommend that you take herpes antiviral medicines late in pregnancy. This is to try to prevent an outbreak around the time of delivery. If you have an outbreak when you go into labor, your provider may suggest a cesarean section. That is a surgery to remove the baby from your uterus. It lowers the risk of passing the virus to your baby.

Breast cancer

/in /by

Breast cancer is a kind of cancer that begins as a growth of cells in the breast tissue.

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. But breast cancer doesn’t just happen in women. Everyone is born with some breast tissue, so anyone can get breast cancer.

Breast cancer survival rates have been increasing. And the number of people dying of breast cancer is steadily going down. Much of this is due to the widespread support for breast cancer awareness and funding for research.

Advances in breast cancer screening allow healthcare professionals to diagnose breast cancer earlier. Finding the cancer earlier makes it much more likely that the cancer can be cured. Even when breast cancer can’t be cured, many treatments exist to extend life. New discoveries in breast cancer research are helping healthcare professionals choose the most effective treatment plans.

Types

  • Angiosarcoma
  • Ductal carcinoma in situ (DCIS)
  • Inflammatory breast cancer
  • Invasive lobular carcinoma
  • Lobular carcinoma in situ (LCIS)
  • Male breast cancer
  • Paget’s disease of the breast
  • Recurrent breast cancer

Symptoms

Signs and symptoms of breast cancer may include:

  • A breast lump or thickened area of skin that feels different from the surrounding tissue.
  • A nipple that looks flattened or turns inward.
  • Changes in the color of the breast skin. In people with white skin, the breast skin may look pink or red. In people with brown and Black skin, the breast skin may look darker than the other skin on the chest or it may look red or purple.
  • Change in the size, shape or appearance of a breast.
  • Changes to the skin over the breast, such as skin that looks dimpled or looks like an orange peel.
  • Peeling, scaling, crusting or flaking of the skin on the breast.

When to see a doctor

If you find a lump or other change in your breast, make an appointment with a doctor or other healthcare professional. Don’t wait for your next mammogram to see if the change you found is breast cancer. Report any changes in your breasts even if a recent mammogram showed there was no breast cancer.

Causes

The exact cause of most breast cancers isn’t known. Researchers have found things that increase the risk of breast cancer. These include hormones, lifestyle choices and things in the environment. But it’s not clear why some people who don’t have any factors get cancer, yet others with risk factors never do. It’s likely that breast cancer happens through a complex interaction of your genetic makeup and the world around you.

Healthcare professionals know that breast cancer starts when something changes the DNA inside cells in the breast tissue. A cell’s DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.

The DNA changes that lead to breast cancer most often happen in the cells that line the milk ducts. These ducts are tubes designed to carry milk to the nipple. Breast cancer that starts in the ducts is called invasive ductal carcinoma. Breast cancer also can start in cells in the milk glands. These glands, called lobules, are designed to make breast milk. Cancer that happens in the lobules is called invasive lobular carcinoma. Other cells in the breast can become cancer cells, though this isn’t common.

Risk factors

Factors that may increase the risk of breast cancer include:

  • A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk of breast cancer is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don’t have a family history of the disease.
  • A personal history of breast cancer. If you’ve had cancer in one breast, you have an increased risk of getting cancer in the other breast.
  • A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ, also called LCIS, and atypical hyperplasia of the breast. If you’ve had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
  • Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
  • Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
  • Being female. Women are much more likely than men are to get breast cancer. Everyone is born with some breast tissue, so anyone can get breast cancer.
  • Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts can make it harder to detect breast cancer on a mammogram. If a mammogram showed that you have dense breasts, your risk of breast cancer is increased. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
  • Drinking alcohol. Drinking alcohol increases the risk of breast cancer.
  • Having your first child at an older age. Giving birth to your first child after age 30 may increase the risk of breast cancer.
  • Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.
  • Increasing age. The risk of breast cancer goes up as you get older.
  • Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most well-known changes are called BRCA1 and BRCA2. These changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
  • Menopausal hormone therapy. Taking certain hormone therapy medicines to control the symptoms of menopause may increase the risk of breast cancer. The risk is linked to hormone therapy medicines that combine estrogen and progesterone. The risk goes down when you stop taking these medicines.
  • Obesity. People with obesity have an increased risk of breast cancer.
  • Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is higher.

Prevention

Things you can do to lower your risk of breast cancer

Making changes in your daily life may help lower your risk of breast cancer. Try to:

  • Ask about breast cancer screening. Talk with your doctor or other healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.
  • Become familiar with your breasts through breast self-exam for breast awareness. You may choose to become familiar with your breasts by occasionally inspecting them during a breast self-exam for breast awareness. If there is a new change, a lump or something not typical in your breasts, report it to a healthcare professional right away.
    Breast awareness can’t prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you’ll notice if something changes.
  • Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day, if you choose to drink. For breast cancer prevention, there is no safe amount of alcohol. So if you’re very concerned about your breast cancer risk, you may choose to not drink alcohol.
  • Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven’t been active lately, ask a healthcare professional whether it’s OK and start slowly.
  • Limit menopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with a healthcare professional about the benefits and risks of hormone therapy.
    Some people have symptoms during menopause that cause discomfort. These people may decide that the risks of hormone therapy are acceptable in order to get relief. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
  • Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.

Medicines and operations for those a high risk of breast cancer

If you have a high risk of breast cancer, you might consider other options to lower the risk. You might have a high risk if you have a family history of breast cancer. Your risk also might be higher if you have a history of precancerous cells in the breast tissue. Talk about your risk with your healthcare team. Your team might have options for lowering your risk, such as:

  • Preventive medicines. Using estrogen-blocking medicines can lower the risk of breast cancer in those who have a high risk. Options include medicines called selective estrogen receptor modulators and aromatase inhibitors. These medicines also are used as hormone therapy treatment for breast cancer.
    These medicines carry a risk of side effects. For this reason, they’re only used in those who have a very high risk of breast cancer. Discuss the benefits and risks with your healthcare team.
  • Preventive surgery. If you have a very high risk of breast cancer, you may consider having surgery to lower the risk of breast cancer. One option might be surgery to remove the breasts, called prophylactic mastectomy. Another option is surgery to remove the ovaries, called prophylactic oophorectomy. This operation lowers the risk of breast cancer and ovarian cancer.

 

Migraine

/in /by

What is a migraine? 

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

Symptoms

Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

  • Constipation.
  • Mood changes, from depression to euphoria.
  • Food cravings.
  • Neck stiffness.
  • Increased urination.
  • Fluid retention.
  • Frequent yawning.

Aura

For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes.

Examples of migraine auras include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light.
  • Vision loss.
  • Pins and needles sensations in an arm or leg.
  • Weakness or numbness in the face or one side of the body.
  • Difficulty speaking.

Attack

A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

  • Pain usually on one side of your head, but often on both sides.
  • Pain that throbs or pulses.
  • Sensitivity to light, sound, and sometimes smell and touch.
  • Nausea and vomiting.

Post-drome

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches.

Even if you have a history of headaches, see your health care provider if the pattern changes or your headaches suddenly feel different.

See your health care provider immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

  • An abrupt, severe headache like a thunderclap.
  • Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke.
  • Headache after a head injury.
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
  • New headache pain after age 50.

Causes

Though migraine causes aren’t fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.

Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Migraine triggers

There are a number of migraine triggers, including:

  • Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.
    Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.
  • Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
  • Stress. Stress at work or home can cause migraines.
  • Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells — such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
  • Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.
  • Physical strain. Intense physical exertion, including sexual activity, might provoke migraines.
  • Weather changes. A change of weather or barometric pressure can prompt a migraine.
  • Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
  • Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.
  • Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Risk factors

Several factors make you more prone to having migraines, including:

  • Family history. If you have a family member with migraines, then you have a good chance of developing them too.
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
  • Sex. Women are three times more likely than men to have migraines.
  • Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications

Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen (Tylenol, others) and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Alcohol use disorder

/in /by

Alcohol use disorder is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol or continuing to use alcohol even when it causes problems. This disorder also involves having to drink more to get the same effect or having withdrawal symptoms when you rapidly decrease or stop drinking. Alcohol use disorder includes a level of drinking that’s sometimes called alcoholism.

Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male has five or more drinks within two hours or a female has at least four drinks within two hours. Binge drinking causes significant health and safety risks.

If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.

Symptoms

Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:

  • Being unable to limit the amount of alcohol you drink
  • Wanting to cut down on how much you drink or making unsuccessful attempts to do so
  • Spending a lot of time drinking, getting alcohol or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfill major obligations at work, school or home due to repeated alcohol use
  • Continuing to drink alcohol even though you know it’s causing physical, social, work or relationship problems
  • Giving up or reducing social and work activities and hobbies to use alcohol
  • Using alcohol in situations where it’s not safe, such as when driving or swimming
  • Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
  • Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms

Alcohol use disorder can include periods of being drunk (alcohol intoxication) and symptoms of withdrawal.

  • Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more likely you are to have bad effects. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, poor judgment, slurred speech, problems with attention or memory, and poor coordination. You can also have periods called “blackouts,” where you don’t remember events. Very high blood alcohol levels can lead to coma, permanent brain damage or even death.
  • Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to 4 to 5 days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

What is considered 1 drink?

The National Institute on Alcohol Abuse and Alcoholism defines one standard drink as any one of these:

  • 12 ounces (355 milliliters) of regular beer (about 5% alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7% alcohol)
  • 5 ounces (148 milliliters) of wine (about 12% alcohol)
  • 1.5 ounces (44 milliliters) of hard liquor or distilled spirits (about 40% alcohol)

When to see a doctor

If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.

Because denial is common, you may feel like you don’t have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem with drinking but has stopped.

If your loved one needs help

Many people with alcohol use disorder hesitate to get treatment because they don’t recognize that they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you’re concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person.

Causes

Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder.

Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones.

Risk factors

Alcohol use may begin in the teens, but alcohol use disorder occurs more frequently in the 20s and 30s, though it can start at any age.

Risk factors for alcohol use disorder include:

  • Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder.
  • Starting at an early age. People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder.
  • Family history. The risk of alcohol use disorder is higher for people who have a parent or other close relative who has problems with alcohol. This may be influenced by genetic factors.
  • Depression and other mental health problems. It’s common for people with a mental health disorder such as anxiety, depression, schizophrenia or bipolar disorder to have problems with alcohol or other substances.
  • History of trauma. People with a history of emotional trauma or other trauma are at increased risk of alcohol use disorder.
  • Having bariatric surgery. Some research studies indicate that having bariatric surgery may increase the risk of developing alcohol use disorder or of relapsing after recovering from alcohol use disorder.
  • Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcohol use disorder. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it’s OK to drink too much. For young people, the influence of parents, peers and other role models can impact risk.

Complications

Alcohol depresses your central nervous system. In some people, the initial reaction may feel like an increase in energy. But as you continue to drink, you become drowsy and have less control over your actions.

Too much alcohol affects your speech, muscle coordination and vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma or death. This is of particular concern when you’re taking certain medications that also depress the brain’s function.

Impact on your safety

Excessive drinking can reduce your judgment skills and lower inhibitions, leading to poor choices and dangerous situations or behaviors, including:

  • Motor vehicle accidents and other types of accidental injury, such as drowning
  • Relationship problems
  • Poor performance at work or school
  • Increased likelihood of committing violent crimes or being the victim of a crime
  • Legal problems or problems with employment or finances
  • Problems with other substance use
  • Engaging in risky, unprotected sex, or experiencing sexual abuse or date rape
  • Increased risk of attempted or completed suicide

Impact on your health

Drinking too much alcohol on a single occasion or over time can cause health problems, including:

  • Liver disease. Heavy drinking can cause increased fat in the liver (hepatic steatosis) and inflammation of the liver (alcoholic hepatitis). Over time, heavy drinking can cause irreversible destruction and scarring of liver tissue (cirrhosis).
  • Digestive problems. Heavy drinking can result in inflammation of the stomach lining (gastritis), as well as stomach and esophageal ulcers. It can also interfere with your body’s ability to get enough B vitamins and other nutrients. Heavy drinking can damage your pancreas or lead to inflammation of the pancreas (pancreatitis).
  • Heart problems. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause serious irregular heartbeats (arrhythmia) called atrial fibrillation.
  • Diabetes complications. Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin or some other diabetes medications to lower your blood sugar level.
  • Issues with sexual function and periods. Heavy drinking can cause men to have difficulty maintaining an erection (erectile dysfunction). In women, heavy drinking can interrupt menstrual periods.
  • Eye problems. Over time, heavy drinking can cause involuntary rapid eye movement (nystagmus) as well as weakness and paralysis of your eye muscles due to a deficiency of vitamin B-1 (thiamin). A thiamin deficiency can result in other brain changes, such as irreversible dementia, if not promptly treated.
  • Birth defects. Alcohol use during pregnancy may cause miscarriage. It may also cause fetal alcohol spectrum disorders (FASDs). FASDs can cause a child to be born with physical and developmental problems that last a lifetime.
  • Bone damage. Alcohol may interfere with making new bone. Bone loss can lead to thinning bones (osteoporosis) and an increased risk of fractures. Alcohol can also damage bone marrow, which makes blood cells. This can cause a low platelet count, which may result in bruising and bleeding.
  • Neurological complications. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, disordered thinking, dementia, and short-term memory loss.
  • Weakened immune system. Excessive alcohol use can make it harder for your body to resist disease, increasing your risk of various illnesses, especially pneumonia.
  • Increased risk of cancer. Long-term, excessive alcohol use has been linked to a higher risk of many cancers, including mouth, throat, liver, esophagus, colon and breast cancers. Even moderate drinking can increase the risk of breast cancer.
  • Medication and alcohol interactions. Some medications interact with alcohol, increasing its toxic effects. Drinking while taking these medications can either increase or decrease their effectiveness, or make them dangerous.

Prevention

Early intervention can prevent alcohol-related problems in teens. If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:

  • Loss of interest in activities and hobbies and in personal appearance
  • Red eyes, slurred speech, problems with coordination and memory lapses
  • Difficulties or changes in relationships with friends, such as joining a new crowd
  • Declining grades and problems in school
  • Frequent mood changes and defensive behavior

You can help prevent teenage alcohol use:

  • Set a good example with your own alcohol use.
  • Talk openly with your child, spend quality time together and become actively involved in your child’s life.
  • Let your child know what behavior you expect — and what the consequences will be for not following the rules.