A new study by researchers at the University of Limerick in Ireland and at Iowa State University has demonstrated the impact resistance exercise training can have in the treatment of anxiety and depressive symptoms.
The new study provides evidence to support the benefits resistance exercise training can have on anxiety and depression and offers an examination of possible underlying mechanisms.
The research, published in the Trends in Molecular Medicine journal, was carried out by Professor Matthew P Herring at the University of Limerick and Professor Jacob D Meyer at Iowa State University.
The researchers said there was “exciting evidence” that resistance exercise training may be an accessible alternative therapy to improve anxiety and depression-like more established therapies while also improving other important aspects of health.
Dr. Herring explained, “Anxiety and depressive symptoms and disorders are prevalent and debilitating public health burdens for which successful treatment is limited.”
“The healthful benefits of resistance exercise training, or muscle-strengthening exercise involving exerting force against a load repeatedly for the purpose of generating a training response, are well-established,” said Dr. Herring, Associate Professor in the Physical Activity for Health Research Centre, Health Research Institute, and Department of Physical Education and Sport Sciences within the Faculty of Education and Health Sciences in UL.
“However, the potential impact of resistance exercise training in the treatment of anxiety and depressive symptoms and disorders remains relatively understudied. Moreover, the plausible psychobiological mechanisms, which help us to better understand how and why resistance exercise training may improve these mental health outcomes, are poorly understood.”
The researchers argue that, while the available studies in this area are focused on relatively small sample sizes, there is sufficient evidence from previous and ongoing research at UL and the research with Dr. Meyer and colleagues at Iowa State University to suggest that resistance exercise training does improve anxiety and depressive symptoms and disorders—though disorders themselves are scarcely studied.
“There is a critical need for confirmatory, definitive trials that adequately address limitations, including small sample sizes, but the limited evidence available to us provides initial support for the beneficial effects of resistance exercise training on these mental health outcomes, including increased insulin-like growth factor 1, cerebrovascular adaptations, and potential neural adaptations influenced by controlled breathing inherent to resistance exercise,” Dr. Herring explained.
“We are tremendously excited to have what we expect to be a highly cited snapshot of the promising available literature that supports resistance exercise training in improving anxiety and depression.”
“Notwithstanding the limitations of the limited number of studies to date, there is exciting evidence, particularly from our previous and ongoing research of the available studies, that suggests that resistance exercise training may be an accessible alternative therapy to improve anxiety and depression.”
“A more exciting aspect is that there is substantial promise in investigating the unknown mechanisms that may underlie these benefits to move us closer to maximizing benefits and to optimizing the prescription of resistance exercise via precision medicine approaches,” Dr. Herring added.
Professor Meyer, a co-author of the study, said, “The current research provides a foundation for testing if resistance training can be a key behavioral treatment approach for depression and anxiety.”
“As resistance training likely works through both shared and distinct mechanisms to achieve its positive mood effects compared to aerobic exercise, it has the potential to be used in conjunction with aerobic exercise or as a standalone therapy for these debilitating conditions.”
“Our research will use the platform established by current research as a springboard to comprehensively evaluate these potential benefits of resistance exercise in clinical populations while also identifying who would be the most likely to benefit from resistance exercise.”
Aspartame — the ubiquitous artificial sweetener sold under the brand names NutraSweet, Equal, and Sugar Twin — has sparked controversy for decades, but in 2023 a leading health watchdog for the first time officially labeled it as a possible carcinogen.
The International Agency for Research on Cancer (IARC), a body of the World Health Organization (WHO), ruled that the faux sugar may cause liver cancer in humans.
The IARC based its conclusion on observational studies connecting the consumption of artificially sweetened drinks to an increase in cases of the cancer.
Other organizations rushed to refute this finding, however. “Our results do not indicate that occasional consumption should pose a risk to most,” Francesco Branca, MD, director of the WHO Department of Nutrition and Food Safety, said at a press conference. Still, he added, people who consume large amounts of aspartame should consider switching to water or other unsweetened drinks.
The U.S. Food and Drug Administration (FDA) and the American Beverage Association (ABA) continue to maintain that aspartame is safe to consume. The ABA cited the Department of Nutrition and Food Safety announcement, which described the evidence for aspartame causing cancer in humans as “not convincing.”
The FDA, which approved aspartame in 1974, stated it “disagrees with IARC’s conclusion that these studies support classifying aspartame as a possible carcinogen to humans.”
The agency has previously set the acceptable daily intake of aspartame at 50 mg per kilogram of a person’s body weight. So, for a 150-pound person, approximately 3,400 mg a day is deemed safe. A 12-ounce can of diet soda contains around 200 mg of aspartame.
To be sure, a healthy diet, physical activity and stress management are still, and for the foreseeable future, the best insurance we can get to support a long, vigorous life. But researchers are continuing to chip away at the biological mechanisms that explain how and why we age, and account for the physiological changes that make us “old,” and ultimately lead to our demise. If we now know a good bit about this biology – I’ve written about a number of these topics — a question naturally comes up. Aren’t we at a point where we can develop treatments that attack aging head-on? And the answer is (sorry, if this doesn’t completely satisfy), we seem to be getting very close by the day. In fact, we may have already done so on a few fronts, but only now are we starting to put the pieces together.
One treatment that’s somewhat unintentionally made the biggest longevity splash is the widely-prescribed medication metformin, which was first discovered, in its natural form, in the 1920s, first synthesized and prescribed (in France) in the late ‘50s, and readily available in the U.S. since 1995. Though for decades, its primary job has been to help millions of people manage their type 2 diabetes, in addition, metformin may be the key to slowing the aging process for millions more. Here’s what you need to know:
A longer, healthier life may be metformin’s superpower.
Metformin is the most commonly prescribed drug to treat type 2 diabetes. It’s generic and hence relatively cheap, and it’s remarkably good at making the body more sensitive to insulin — it helps diabetics clear glucose from the bloodstream with the less-than-normal amounts of insulin their bodies produce. None of this should be news. But bolder claims for the therapeutic power of metformin have been advanced, especially by one influential researcher, Dr. Nir Barzelai at the Albert Einstein College of Medicine. He took his inspiration from studies that showed that older type 2 diabetics taking metformin lived longer than a comparison group, not diabetic, not taking metformin. Further positive results from animal research bolstered his theory that the therapeutic effect of the drug went beyond blood sugar control, beyond even the reduction in cardiovascular disease that you might expect. (Diabetics have a much higher risk of heart attack and stroke.) He surmised that the drug was altering some basic mechanisms of aging, molecules like mTOR and AMK, that regulate, at a deep level, how the body operates.
Reprogramming the human machine.
When we’re young, our bodies are programmed to get bigger and stronger and to reach sexual maturity. After our prime reproductive years, evolution doesn’t care what happens to us (we’ve already passed our genes down to the next generation, or had the chance to), and that same pro-growth strategy slowly poisons us. We get less good at taking out the trash that builds up inside the cells (autophagy); energy-burning generates more waste (“free radicals”); cells get damaged and hang around, gumming up the works; inflammation keeps increasing. Barzelai, and others, suspect that metformin is dialing down growth and dialing up cell maintenance, which would account for the metformin group seeming to suffer from less disease across the board and, on average, living longer. In other words, it might be helping the drug-takers become more like the centenarians he had famously studied. Not only did the centenarians live much longer than average, but more significantly, they stayed healthy for decades longer, until they hit some internal age limit and then died relatively quickly, i.e., the end that most of us would choose. Could metformin be the ticket, or a ticket, for the rest of us who weren’t born with those fortunate genes?
Shouldn’t we know the answer by now?
The answer is yes. Barzilai has had a research trial ready to go for some years now, a study that will look at two groups of 1,500 older subjects, one on metformin, one not, nobody diabetic, to see if the drug group, on average, develops the common “diseases of aging” (heart disease, dementia, cancer) more slowly than the non-drug group over the course of six years. The NIH has given its tentative blessing but, frustratingly, the funding is still not in place. As virtually everyone in the anti-aging field has pointed out, the medical establishment is so locked into the traditional mindset of researching diseases one by one that the idea of treating the aging process, the thing that underlies all the severe chronic diseases, gives them the willies. Even in the case of metformin which has successfully been prescribed for one condition, diabetes, for over sixty years and has an excellent safety record.
Cause for optimism.
Admittedly, some of the older studies that suggested that metformin slowed down disease, for diabetics and non-diabetics alike, had design flaws and we simply don’t know how or if the positive results from the animal research will translate to humans. Still, the research landscape is, at the least, promising. One meta-analysis of over fifty studies found that diabetics on metformin had fewer deaths, from any disease, than non-diabetics not taking the drug. In one pilot study of a group of people with mild cognitive impairment, taking metformin for only eight weeks was associated with better cognitive performance. Another study found a 51% decrease in the risk of cognitive impairment, with the biggest benefit seen in patients who’d been on the drug for more than six years. The metformin-cancer connection is far from pinned down but one large meta-analysis (a study of the existing studies) found that people with diabetes on metformin suffered 34% fewer cancer deaths than would otherwise have been predicted.
Metformin and the microbiome can play well together.
“Healthy gut, healthy life,” that’s a message I’ve been delivering to my patients and readers for years. So, I’m particularly gratified by research that suggests that one way metformin improves health is through the gut microbiome. Specifically, taking the drug is associated with higher levels of a particular bacteria, Akkermansia muciniphila, which can do a number of fine things inside the gut, including helping to build up the lining of the gut wall, to prevent inflammation-promoting “leaky gut.” Some of the work has been done on animals – metformin has been shown to have an anti-inflammatory effect on mice with ulcerative colitis and, in another study, it improved cognitive performance by aged mice by reducing inflammation. In a human study, the researchers found evidence to suggest that the drug’s effect on the microbiome contributed to its ability to tamp down blood sugar levels – so there’s likely a fair amount of good news associated with this decades old medication.
Nothing is perfect.
As interesting and promising as metformin is, it does have its downsides. GI side-effects like nausea are common but for most people, they’re temporary. The drug can also interfere with the absorption of B-12. That could be more serious since B-12 levels decrease with age anyway, leaving some seniors fatigued and/or suffering from brain fog. If you’re on metformin, have your levels checked. It also may be the case that taking metformin blunts some of the body’s positive adaptation to healthier physical activity and diet, so more effort may be required to get results. However, these minor drawbacks don’t come close to off-setting the significant benefits of metformin if you’re type 2 diabetic (in which case, you’re probably already on it) and, if you’re pre-diabetic, you may want to have a conversation with your doctor about the pros and cons of metformin therapy. As for the rest of us, stay tuned.
The future of metformin.
The research that’s in the pipeline could tell us that metformin is poised to be the first all-purpose, broadly embraced anti-aging drug, which has been tested over decades, is generally well-tolerated, widely available and inexpensive. Even if the blue-sky anti-aging scenario doesn’t quite unfold, the roughly half of adult Americans who are pre-diabetic may still benefit from metformin. But the drug’s greatest contribution, as its most ardent boosters freely admit, is to open the minds of the medical establishment to the limitations of its “whack-a-mole” approach to treating disease and open the door to a new generation of anti-aging drugs that will prove to be more effective than metformin itself.
Over 5 million Americans have been diagnosed with Alzheimer’s. Another 10,000,000 suffer with severe dementia and Parkinson’s. Even more struggle with age-related mild cognitive impairment. Here are 7 natural ways to defend your brain.
Alzheimer’s disease affects about 5.3 million Americans. It’s the leading cause of dementia and the 6th leading cause of death in the U.S. And it’s growing at an alarming rate. Already 13% of people over 65 have been diagnosed with the disease. An astounding 43% of those over the age of 85 are victims.[i]
Alzheimer’s has been called the defining disease of the boomer generation. Its victims are expected to triple by the year 2050.
In addition, it’s estimated that 10,000,000 others suffer with severe dementia and Parkinson’s disease.
But even if you escape these debilitating and life-threatening diseases, you may be among millions more who suffer from mild cognitive impairment (MCI or what is frequently called “age-related cognitive dysfunction”) and normal “age-associated memory impairment.” These conditions are what many of us have experienced as “senior moments.” The symptoms include memory loss, as well as a decline in the ability to think and reason.
Some of these problems are a result of the natural aging of our brains. But others arise from poor nutrition and exposure to environmental toxins.
Drugs have shown little promise and serious side effects. But here are seven proven methods to keep your brain young and sharp.
1. Bacopa Boosts Cognition
Bacopa monnieri (L.) is a traditional herb used for centuries in Ayurvedic medicine. It is prescribed as a memory and learning enhancer, a sedative, and anti-epileptic. In Australia, it is a popular memory aid for people over 60 years old.
Bacopa grows in the wet tropics and is also commonly known by its English name, water hyssop.
In a rigorous study published in the Journal of Complementary and Alternative Medicine, researchers found that Bacopa has positive effects on several measures of cognitive performance. In a randomized, double-blind, placebo-controlled clinical trial, they gave participants either 300 mg of Bacopa daily or a placebo pill. The subjects were 54 volunteers, 65 or older, without clinical signs of dementia. [ii]
After 12 weeks, those taking Bacopa improved their delayed recall memory, their reaction times and their ability to ignore irrelevant information. Placebo recipients saw no change.
In addition Bacopa recipients showed a decrease in heart rate, depression and anxiety while placebo recipients saw increases.
Three other double-blind, randomized, placebo-controlled studies support Bacopa’s benefits in verbal learning abilities, delayed recall of word pairs, and age-associated memory impairment.[iii],[iv],[v]
Bacopa’s memory-enhancing effects have been attributed in part to saponins. Other ways Bacopa may work include its antioxidant effects, protein synthesis in the brain, and modulation of brain stress hormones.
Other studies show Bacopa extracts also ameliorate neurotoxic effects of nicotine and aluminum, and reduce β-amyloid plaque levels in animals.
2. Ginkgo Biloba Improves Memory
For years gingko biloba has been linked to memory improvement. It acts as a free radical scavenger, protecting neurons from oxidation. It also improves microcirculation in the brain and reduces platelet aggregation.
Human studies show taking gingko biloba regularly can improve mental health, cognition, motor skills and quality of life.[vi]It’s particularly helpful for memory loss, attention, alertness, vigilance, arousal and mental fluidity.[vii]
In 2005 researchers put gingko biloba up against Pfizer’s $4 billion a year prescription drug donepezil (trade name Aricept) in a 24-week randomized, double-blind study. [viii] An extract of gingko biloba (160 mg per day) was found to be just as effective as the drug for mild-to-moderate Alzheimer’s disease. The researchers concluded there were no relevant differences in the efficacy of gingko biloba and donepezil, and use of both substances can be justified.
In a more recent double-blind trial gingko biloba was found to be significantly better than placebo in improving cognitive function and behavioral symptoms in 400 patients with Alzheimer’s disease or vascular dementia.[ix]
3. Tea, Wine and Chocolate Improve Thinking Skills
As we get older, a diet high in some flavonoid-rich foods may help with better thinking skills.
Researchers examined the relation between 3 common foods that contain flavonoids (chocolate, wine, and tea) and cognitive performance. They followed 2,031 participants aged 70 to 74 years from the Hordaland Health Study in Norway.[x]
People who consumed chocolate, wine, or tea had significantly better scores on cognitive tests and lower rates of poor cognitive performance.
Those who ate all three foods had the best test scores and the lowest risks for poor test performance.
The good results were dose dependent. The best performance maxed out at 10 grams per day of chocolate and 75-100 ml per day of wine. The effect was most pronounced for wine and modestly weaker for chocolate.
Other research shows that resveratrol, found in wine and chocolate, has the ability to neutralize the toxic effects of proteins linked to Alzheimer’s disease.
In a study published in the Journal of Biological Chemistry researchers showed that resveratrol selectively targets and neutralizes clumps of peptides or proteins that are bad and have been linked to Alzheimer’s, but leaves alone those that are benign.[xi]
Resveratrol is a chemical compound in plants that acts as an antibiotic to fight off both bacteria and fungus. Besides grapes and cacao, it is found in raspberries, mulberries, blueberries, and cranberries. It’s also in peanuts, pine trees and Japanese knotweed, the source of most resveratrol supplements.
4. Antioxidants Decelerate Brain-Aging
It’s clear that people eating a diet high in fruits and vegetables have fewer age-related diseases like Alzheimer’s. Eating more high-antioxidant foods such as berries, Concord grapes, and walnuts may enhance cognitive and motor function in older people.[xii]
Studies show supplementing with fruit or vegetable extracts high in antioxidants (e.g. blueberries, strawberries, walnuts, and Concord grape juice) helps decrease the vulnerability to oxidative stress that occurs in aging. That can lead to improvements in behavior.
Fruits and vegetables can also enhance communication between neurons and decrease stress signals induced by oxidation and inflammation.
Other studies indicate that blueberry or Concord grape juice supplementation in humans with mild cognitive impairment increases verbal memory performance.
5. Intermittent Fasting Regenerates Brain
Overeating is a risk factor for many age-related diseases including cognitive impairment.
Experimental models of Alzheimer’s disease, Parkinson’s disease, Huntington’s disease and stroke show that dietary restriction (reduced calorie intake) can beef up the resistance of neurons in the brain to dysfunction and death.
How? Dietary restriction stimulates the expression of ‘stress proteins’ and neurotrophic factors. Neurotrophic factors may protect neurons by increasing production of proteins that suppress oxidation and free radicals.
In addition, dietary restriction increases the number of newly-generated neural cells in the adult brain. In other words, it may increase the brain’s capacity for plasticity and self-repair.
Researchers suggest that limiting calories may reduce both the incidence and severity of neurodegenerative disorders in humans.[xiii]
Intermittent fasting is not as difficult as it sounds. It doesn’t involve just drinking water. Most intermittent fasting plans cut calories to 25% of normal amounts. That’s about 600 calories for men and 500 calories for women on one or two days of the week.
6. Sleep Cleans Out Brain Toxins
A University of Oregon study shows middle-aged or older people who get six to nine hours of sleep a night think better than those sleeping either fewer or more hours.[xiv]
Researchers used data involving more than 30,000 subjects in six countries. They found that individuals sleeping less than six hours and more than nine hours had significantly lower cognitive scores compared to those in the intermediate group.
The researchers used five standard cognitive tests involving immediate recall of a list of words, delayed recall of those words later, forward and backward recall of long lists of numbers, and a verbal fluency test in which they listed as many animals as possible without repetition, the use of proper nouns or descriptors.
One reason a good night’s sleep works is the brain’s trash removal system. During sleep the brain works 10 times as hard to remove toxic proteins like the ones responsible for Alzheimer’s damage.[xv] If you’re not asleep, the brain can’t get rid of plaques so easily.
7. Curcumin Clears Alzheimer’s Plaques
The incidence of Alzheimer’s among adults in India is about 4.4 times less than that of Americans.[xvi]
Researchers in Singapore suggest the reason might be curry and the spice turmeric. They looked at curry consumption and brain performance in 1,010 Asians between 60 and 93 years of age. Those who ate curry occasionally (less than once a month) and often (more than once a month) performed better than those who rarely or never ate curry.[xvii]
Over 30 studies in the GreenMedInfo data base deal with the promise of curcumin, the active compound in turmeric, in the treatment and prevention of Alzheimer’s disease. According to one study, turmeric showed remarkable results in Alzheimer patientsin just three months.
A 2006 UCLA study found curcumin may help clear the amyloid plaques found in Alzheimer’s disease. One way it works is by boosting the work of macrophages. These cells in the immune system help the body fight foreign proteins.
Researchers took macrophages from the blood of Alzheimer’s patients and healthy controls. They treated some of the macrophages with curcumin. The treated macrophages showed improved ingestion of the beta-amyloid proteins. The researchers concluded that curcumin may support the immune system to clear amyloid plaques.[xviii]
And in animal studies low doses of curcumin led to 40% less beta-amyloid than in those not given the spice.[xix]
Studies indicate low doses of turmeric over a long period of time are most effective. That’s a good reason to add turmeric to your daily diet. It’s great in curry sauces, scrambled eggs, deviled eggs, mustard sauces or salad dressings.
Are you or a loved one constantly battling the frustrating symptoms of seasonal or year-round allergies? You are not alone; millions around the globe are affected by sneezing, itchy, watery red eyes, stuffy, runny noses, and headaches. Avoidance of triggers and medications may provide temporary relief, but for those seeking a longer-lasting or more natural solution, immunotherapy (IT) can be life-changing. IT provides sustained benefits of decreased symptoms and medication use for years after treatment completion. Additionally, a full course of IT may prevent the development of future allergies and asthma. Despite these compelling benefits, most patients choose to use medications, even though studies have shown superior effects and cost savings from IT.
The reality is that traditional allergy shots (subcutaneous immunotherapy, or SCIT) are not a practical solution for many patients. A course of SCIT requires dozens of office visits (and injections) over 3 to 5 years. Alternatively, sublingual immunotherapy (SLIT) can be administered daily at home. When I first began offering this in my clinical practice around seven years ago, I thought that this would be the perfect fit for patients who lived far from the clinic or had needle phobias. Perhaps it’s not terribly surprising to learn that most people have a really hard time taking a daily allergy treatment. Studies have demonstrated similarly poor long-term adherence for both SCIT and SLIT. For years, allergists have been searching for the holy grail of treatments. Ideally, this option would be quick, easy, relatively painless, low risk, sustainable, and effective. We may finally be on the horizon with intralymphatic immunotherapy (ILIT).
Intralymphatic immunotherapy represents a significant advancement in allergy treatment. Unlike traditional allergy shots given under the skin, ILIT involves injecting small doses of allergens directly into the lymph nodes under ultrasound guidance. This approach aims to retrain the immune system more efficiently, reducing the allergic response in the long term. By targeting the lymph nodes, where a significant part of the immune response is coordinated, ILIT delivers allergens directly to the heart of the immune system. This direct approach leads to a fast and effective desensitization using small doses of the relevant allergens.
One of the most exciting aspects of ILIT is its potential benefits:
Fewer injections = less pain: ILIT typically involves ~3 injections compared to dozens, making it a much more convenient and an overall less painful option.
Cost savings: ILIT is calculated to have an overall lower cost of care compared to cost estimates for traditional allergy shots and multiple daily medications.
The initial studies investigating ILIT began nearly 20 years ago in Europe, and since that time, we have seen a slow but growing body of clinical trial data supporting safety, tolerability, and effectiveness. The clinical adoption of ILIT has been slowed due to a number of factors within the insurance-driven U.S. health care system. That said, ILIT is beginning to become available outside research protocols for aeroallergies, including those to trees, grasses, weeds, molds, dust mites, and pets. When it comes to venom and food allergies, ILIT remains a promising treatment modality under investigation. Current studies are exploring its efficacy and safety, and while initial results are encouraging, more extensive clinical trials are needed. The future of ILIT could revolutionize how we approach allergy treatments.
Hard training exacts harsh bodily punishment – just ask any competitive athlete. Yet a little-known natural proteolytic enzyme called bromelain, derived from pineapple stems and fruit, shows great promise easing sports recovery and maintaining masculine vitality
In a rigorous 2016 randomized, double-blind, placebo-controlled trial, researchers from New Zealand tested bromelain’s impacts on muscle damage and testosterone levels in highly trained cyclists during consecutive days of intense competition.1 They discovered the supple pineapple enzyme slashed multiple markers of exercise-induced trauma while beneficially preserving testosterone concentrations.
The human body requires adequate testosterone for proper metabolic and reproductive functioning. But extreme physical exertion often depletes circulating testosterone, contributing to fatigue, loss of vigor and impaired adaptive response.2 The enzyme bromelain displays established anti-inflammatory properties and previously reduced soreness in athletes.3 Researchers therefore theorized bromelain might also mitigate testosterone decreases following exhaustive training bouts when muscle breakdown runs high.
Fifteen top-tier male cyclists entering a six-day professional stage race volunteered for the study. For supplementation, eight riders received 1,000 milligrams of bromelain each day, while seven Controls took visually identical placebos. Cyclists faced over 500 kilometers of grueling competition through variable weather and courses.
Blood samples were drawn before racing began and following days three and six – when cumulative demands peaked. Researchers analyzed the blood for muscle damage indicators creatine kinase (CK), lactate dehydrogenase (LDH) and myoglobin along with total testosterone levels.
As expected, CK, LDH and myoglobin concentration spiked by days three and six, signaling significant muscle trauma from consecutive all-out efforts. However testosterone plunged by day six in the placebo group, indicating stressful overtraining.
Remarkably, the bromelain-supplemented cyclists maintained testosterone concentrations throughout competition. Additionally, their fatigue ratings were significantly lower than controls by day four, when glycogen depletion and muscle breakdown take a toll.
This rigorous investigation proves the power of a little known natural enzyme – bromelain – to alleviate hard training’s bodily blowback. Counteracting exercise-induced immunological and hormonal disruption, bromelain enhanced resilience and recovery across successive days of extreme exertion.
For competitive athletes facing overtraining, bromelain boosts the ability to rebound day after day at peak intensity. But anyone engaged in demanding recreation from weekend warriors to new gym goers may benefit. Additionally, bromelain’s protective effects on testosterone make it attractive for any man seeking to preserve vitality and function during intense life stresses or advancing age.
At last, science confirms pineapple’s ancient cultural status as an esteemed medicinal fruit. Much more than a tasty snack, consuming its proteolytic enzymes directly via supplementation looks to enhance athleticism, virility and quality of life. Those recovering from injury or illness may also gain from bromelain due to improved protein breakdown and anti-inflammatory action.4
So do as top cyclists now discover – give bromelain a try to ease soreness, lift fatigue and maintain your edge. Let pineapple power propel you onward.
Hypoglycemia occurs when blood sugar drops below expected ranges. When hypoglycemia develops, several symptoms can appear. However, other conditions can also cause similar symptoms.
Hypoglycemia is a condition that occurs when levels of blood sugar, which is also known as blood glucose, fall below a suitable range. Glucose is a simple form of carbohydrate. Along with protein and fat, the body uses glucose for energy.
If blood glucose levels drop too low, the body does not have the fuel source it needs to function optimally. Hypoglycemia can cause a variety of symptoms depending on how low blood sugar drops. However, the symptoms of hypoglycemia can also occur with several other conditions.
The article below looks at the signs of hypoglycemia and what other conditions can have similar symptoms.
The body, including the brain, needs a steady amount of glucose to function correctly. When levels drop too low, various symptoms may develop.
Not everyone responds the exact same way to low blood sugar. Symptoms may also range from mild to severe, depending on how low these levels drop. Possible symptoms include:
In some cases, other conditions may cause symptoms that mimic hypoglycemia. Although symptoms may appear similar, blood sugar levels are within a typical range.
Conditions that may cause symptoms similar to hypoglycemia include the below.
Anxiety is a feeling of dread, uneasiness, or fear. It can sometimes produce some hypoglycemia symptoms. According to the National Institute of Mental HealthTrusted Source, anxiety can sometimes include symptoms, such as restlessness, headaches, and a fast heartbeat, which appears similar to low blood sugar.
Migraine attacks are a type of headache that involves recurrent moderate to severe pain, often in one side of the head. In addition to pain, they can cause other symptoms, such as lightheadedness and nausea.
Although migraine episodes do not cause hypoglycemia, a connection may exist. A 2022 review involving a database search found that hypoglycemia may trigger or worsen migraine.
Doctors define menopause as 12 monthsTrusted Source after a female’s last menstrual period. Menopause involves a decline in certain hormones, including estrogen and progesterone. The change in hormone levels can cause a range of symptoms. Some symptoms, such as dizziness, headache, and fatigue, appear similar to hypoglycemia.
Hyperthyroidism means the thyroid gland overproduces thyroid hormones. Anyone can develop hyperthyroidism, but it is more commonTrusted Source in females and people older than 60.
An overactive thyroid can cause several symptoms, some of which may mimic hypoglycemia. SymptomsTrusted Source may include nervousness, shakiness, fatigue, and sweating.
Hypotension refers to low blood pressure. A typical blood pressure level for most adults is less than 120/80 millimeters of mercury (mm Hg)Trusted Source. Doctors refer to a blood pressure measurement of less than 90/60 mm Hg as hypotension. Several factors can lead to hypotension, such as blood loss, heart problems, and pregnancy.
Many symptoms of hypotension may appear similar to hypoglycemia and may include:
Other conditions may also mimic symptoms of hypoglycemia. For example, dehydration can also cause some symptoms that occur with hypoglycemia. While dehydration may affect blood sugar levels, it usually increases them. However, the symptoms may mimic hypoglycemia, such as confusion, dizziness, and headache.
Heat exhaustion may also cause symptoms that occur with hypoglycemia. It can happen when the body loses excessive salt and water, most often through excessive sweating. SymptomsTrusted Source may include weakness, headache, and nausea.
Salt deficiency, also called hyponatremia, occurs when the amount of salt in the blood is lower than expected. Having sufficient sodium helps balance the water level in the body. When a salt deficiency develops, it can lead to symptoms such as nausea, confusion, and headache, which are similar to hypoglycemia.
Hypoglycemia is when levels of blood glucose, or blood sugar, go below expected ranges. The body needs adequate levels of glucose to function properly. Doctors classify blood sugar of less than 70 milligrams per deciliter as hypoglycemia.
Various symptoms can develop with hypoglycemia, some of which can become severe. Symptoms may include lightheadedness, headaches, and hunger.
Several other conditions can mimic the symptoms of hypoglycemia, such as hypotension, anxiety, and hyperthyroidism. The most accurate way to determine if symptoms are due to hypoglycemia or one of the above conditions is to measure blood glucose levels.
Micronutrients refer to essential nutrients that humans require in small amounts. They include vitamins and minerals. The exact amount of micronutrients people require will vary between the different types.
Suitable nutrition is essential for supporting good health. People can separate essential nutrients into two groups: macronutrients and micronutrients.
Macronutrients are the nutrients humans require in the largest amounts. These include carbohydrates, proteins, and fats. Micronutrients describe nutrients that people need in smaller amounts, such as vitamins and minerals.
Micronutrients play a vital role in supporting health. People may wish to consume a suitable amount of these vitamins and minerals through a healthful diet and supplements.
MicronutrientsTrusted Source describe vitamins and minerals that the body requires in very small amounts. Although the body only needs small quantities, micronutrients are vital for supporting health.
It is important that a person’s diet includes appropriate amounts of micronutrients through both food and supplements. People who consume too little or too much micronutrients may experience health problems.
To help consume a suitable amount, health experts provide guidelines for how much micronutrients to consume. They may use terms such as “recommended dietary allowance (RDA)” and “adequate intake (AI)” to help describe micronutrient requirements.
Just as micronutrients refer to nutrients that people require in smaller amounts, macronutrients describe nutrients that people need in larger quantities.
In general, macronutrients refer to the following:
Usually, people will measure the amount of macronutrients they need in grams (g) and the quantity of micronutrients in either milligrams (mg), micrograms (mcg), or international units (IU).
People can split micronutrients into vitamins and minerals. They can then further classify them into the following groupsTrusted Source:
Water-soluble vitamins
Water-soluble vitamins refer to those that must dissolve in water before the body can absorb them. As such, the body cannot store these types of minerals. The body excretes any water-soluble vitamins it does not use through urine.
Examples of water-soluble vitamins include:
Vitamin B1 (thiamine):Vitamin B1 helps convert nutrients into energy.
Vitamin B2 (riboflavin):Vitamin B2 is necessary for energy production, cell function, and fat metabolism.
Vitamin B3 (niacin):Vitamin B3 helps drive the production of energy from food.
Vitamin B5 (pantothenic acid):Vitamin B5 is necessary for the synthesis of fatty acids.
Vitamin B6 (pyridoxine):Vitamin B6 helps release sugar from carbohydrates that the body stores for energy and to create red blood cells.
Vitamin B9 (folate):Vitamin B9 is essential for proper cell division.
Vitamin B12 (cobalamin):Vitamin B12 is necessary for red blood cell formation, as well as nervous system and brain function.
Vitamin C (ascorbic acid): The body requires vitamin C to produce neurotransmitters and collagen.
The recommended amounts of water-soluble vitamins are as follows:
Nutrient
Sources
Recommend amount (daily RDA or AI for adults)
Vitamin B1
whole grains, fish, meat
1.1–1.2 mg
Vitamin B2
organ meats, milk, eggs
1.1–1.3 mg
Vitamin B3
meat, salmon, brown rice, fortified cereals
14–16 mg
Vitamin B5
meat, fish, mushrooms, lentils
5 mg
Vitamin B6
fish, milk, potatoes, carrots
1.3–1.7 mg
Vitamin B7
eggs, sweet potatoes, spinach, almonds
30 mcg
Vitamin B9
beef, liver, spinach, asparagus,
400 mcg
Vitamin B12
meat, milk, nutritional yeast
2.4 mcg
Vitamin C
citrus fruits, strawberries, tomatoes
75–90 mg
Fat-soluble vitamins
As the name suggests, fat-soluble vitamins dissolve in fat instead of water. It is advisable to combine a source of fat when eating foods rich in fat-soluble vitamins. As these vitamins dissolve in fat, the body can store them in the liver and fatty tissues.
Examples of fat-soluble vitamins include:
Vitamin A: Some people may refer to vitamin A as retinoids or carotene. This vitamin is necessary for organ function and vision.
Vitamin D: Also known as calciferol, vitamin D plays a vital role in immune function and helps with calcium absorption and bone growth.
Vitamin E: Also known as alpha-tocopherol, vitamin E assists with immune function and acts as an antioxidant.
Vitamin K:Vitamin K is essential for proper blood clotting and bone development. Different forms of vitamin K include phylloquinone, menaquinone, and menadione.
The recommended amounts of fat-soluble vitamins are as follows:
Nutrient
Sources
RDA or AI for adults
Vitamin A
organ meats, dairy, fatty fish, carrots, pumpkin, sweet potatoes
700–900 mcg
Vitamin D
fatty fish, egg, milk, sunlight
600–800 IU
Vitamin E
seeds, nuts, green vegetables
15 mg
Vitamin K
collard greens, spinach, soybeans
90–120 mcg
Macrominerals
Minerals refer to inorganic elements that the body requires for many different functions. Macrominerals describe minerals that the body needs in larger amounts. Examples of macrominerals includeTrusted Source:
Calcium:Calcium is necessary for bone and teeth health. This mineral also assists in muscle function and blood vessel contraction.
Chloride: Chloride helps maintain fluid balance and aids in producing digestive juices.
Magnesium:Magnesium plays important roles in various enzyme reactions.
Phosphorus:Phosphorus assists with bone and cell membrane structure.
Potassium:Potassium maintains the fluid status in cells. This electrolyte also helps with nerve transmission and muscle function.
Sodium: Sodium also plays a role in fluid balance and helps maintain blood pressure.
Sulfur: Sulfur helps build and fix DNA and protect cells from damage.
The recommended amounts of macrominerals are as follows:
Nutrient
Sources
RDA or AI for adults
Calcium
dairy, tofu, leafy greens
1,000–1,200 mg
Chloride
table salt, seaweed, tomatoes
1,800–2,300 mg
Magnesium
almonds, spinach, cashews
310–420 mg
Phosphorus
meats, seafood, seeds, nuts
700 mg
Potassium
apricots, lentils, prunes
4,700 mg
Sodium
salt, processed foods, canned soup
2,300 mg
Sulfur
garlic, onions, Brussels sprouts, eggs, mineral water
None established
Microminerals
Also known as trace minerals, these are minerals a person requires in lower quantities than macrominerals. Examples of microminerals includeTrusted Source:
Copper:Copper plays a role in connective tissue formation, as well as brain and nervous system function.
Fluoride:Fluoride is necessary for bone and teeth development.
As the name implies, people only require a small amount of micronutrients. However, micronutrients play an essential roleTrusted Source in healthy development, disease prevention, and general well-being. For example, micronutrients perform a range of functions, such asTrusted Source the production of hormones, enzymes, and other important substances.
Micronutrient deficiencies can have severe consequences and can result in dangerous health conditions.
People who do not consume enough micronutrients may develop micronutrient malnutritionTrusted Source. This may lead to several health problems, such as poor growth, intellectual impairment, reproductive problems, and degenerative diseases.
Evidence suggestsTrusted Source that globally, iron, folate, zinc, iodine, and vitamin A are among the most occurring micronutrient deficiencies.
Just as deficiencies might cause health problems, consuming too many micronutrients may also cause health issues. However, toxicities are much less common than deficiencies. They could occur from a person consuming too many supplements or eating produce from soil containing too many nutrients.
An excessive intake of micronutrients may causeTrusted Source a variety of adverse health effects. These can include hormonal problems, a higher risk of cancers, and major organ failure.
Micronutrients describe vitamins and minerals that people require in small amounts. Along with macronutrients, these vitamins and minerals are essential nutrients that people need to support good health.
Health guidelines can provide information on the amount of micronutrients that people require. It is important for people to consume a suitable amount of micronutrients, as eating too much or too little can result in health problems.
Alpers disease is a genetic and progressive neurodevelopmental syndrome. The gene mutation responsible for Alpers disease causes dysregulation and depletion of the mitochondria in a person’s cells.
Mitochondria are energy-producing organelles, small structures inside the body’s cells. They use the nutrients in food and oxygen to create adenosine triphosphate (ATP). This compound provides cellular energy for various essential functions, such as muscle contraction and nerve impulse generation.
Mitochondria have their own genome known as mitochondrial DNA (mtDNA), which contains 37Trusted Source genes necessary to produce ATP. As Alpers disease affects a person’s mtDNA, it influences ATP production and causes dysfunction in areas of the body that require a lot of energy, such as the brain, muscles, and liver.
This article discusses Alpers disease, its symptoms, causes, risk factors, diagnosis, treatment, and outlook.
progressive neuronal degeneration of childhood with liver disease
Alpers diffuse degeneration of cerebral gray matter with hepatic cirrhosis
diffuse cerebral degeneration in infancy
progressive cerebral poliodystrophy
poliodystrophy cerebral progressive
Does it affect a person’s life expectancy?
Alpers disease significantly shortens a person’s lifespan. Most peopleTrusted Source with this condition do not live past their first decade.
A person’s life expectancy may be fewer than 4 yearsTrusted Source after the initial appearance of symptoms. Common causes of death are liver failure and brain dysfunction (encephalopathy).
According to the National Institute of Neurological Disorders and StrokeTrusted Source, 80% of people with Alpers disease develop symptoms in the first 2 years of life. For 20% of people, symptoms develop between the ages of 2 and 25. The age of symptom onset is related to the genetic pattern of inheritance.
Alpers disease is a genetic condition. A mutation in the POLG1 gene causes Alpers disease. This mutation reduces the effectiveness of polymerase gamma, an important part of mitochondrial DNA.
People can inherit Alpers disease in an autosomal recessive pattern. A person can develop an autosomal recessive condition if they inherit the mutated gene from each parent. There is also more than one type of gene mutation that can cause the disease.
There are twoTrusted Source ways a person can inherit a POLG1 mutation that leads to Alpers disease:
Heterozygous: This means a person inherits two different versions of a gene, one from each parent. The symptoms usually begin in the early years of life, between 2 and 4 years of age.
Homozygous: This means a person inherits two of the same version of a gene, one from each parent. Symptoms are usually milder and develop later, around 17 to 24 years of age.
A person born to two people who carry the gene but do not have symptoms of the condition will have:
a 25% likelihood of inheriting two copies of the mutated gene and developing the condition
a 50% likelihood of inheriting one mutated and one unaffected gene, becoming a carrier
a 25% likelihood of inheriting two copies of the unaffected gene
Seizures are often the first noticeable symptom. In the early stages, liver disease may be minimal or not yet present.
Gene sequencing
Doctors can confirm the presence of Alpers disease using polymerase gamma gene sequencing and a liver biopsy.
Additional clinical findings
Tests such as brain imaging, biopsies, and cerebrospinal fluid analysis can help doctors identify markers of Alpers disease.
Some of the signs they look for include:
increased protein in the cerebral spinal fluid
reduced mtDNA in muscles or the liver
cerebral volume loss
vision loss
brain activity abnormalities
Family history
If a person has a full sibling already diagnosed with Alpers disease, this indicates that both their biological parents are carriers. This means the person has a 25% chance of having Alpers disease like their sibling.
There is no cure for Alpers disease. Instead, the goal of treatment is to provide support and comfort and to reduce the impact of symptoms where possible.
Clinicians can adapt treatment to the needs of the individual and weigh the benefits against potential risks, such as how much stress some medications might put on the liver.
Clinical trials are research studies to help medical professionals learn more about preventing and treating disease.
In the studies, participants test new treatments to see how well they work. Often, researchers assign the treatments randomly. Participants do not know whether they have received the treatment being studied or a placebo.
Clinical trial participation is voluntary. Researchers will only consider participants for a trial if they meet inclusion criteria. People interested in participating may wish to discuss it with their primary care doctor.
The National Library of Medicine maintains the website ClinicalTrials.gov, a searchable database of studies. People can look for studies that are in progress and recruiting or find information about complete studies.
Living with Alpers disease involves symptom management and quality of life support.
Learning about the condition may help involved individuals feel more connected to the treatment plan. Reaching out for mental health support may also be of benefit.
The National Organization for Rare Disorders (NORD) has assistance programs that may help with the following:
NORD also has a directory of patient organizations included in their Programs & Resources where patients and family members can look for information and support.
Alpers disease is a progressive genetic condition. It causes mitochondrial damage and leads to dysfunction in organs that require cellular energy, such as the brain and the liver.
There is no cure for Alpers disease. Treatment is supportive and palliative and designed to make the person comfortable.
Drugs such as Ozempic used to aid weight loss may help reduce the likelihood of depression, research finds.
GLP-1 medications such as Wegovy and Ozempic were associated with a reduction in diagnoses of depression and anxiety in a new report.
The report observed the connection in the medical records of over three million people with diabetes and nearly one million taking GLP-1 drugs for weight loss.
The results of the report suggest a mental health benefit for this class of drugs beyond diabetes health and weight control.
GLP-1 agonist diabetes drugs have found a second use as weight-loss medications. Now, a new study from electronic medical records company Epic reports that their use also corresponds to a reduction in depression and anxiety.
Five GLP-1 drugs were linked to reduced depression and anxiety in people with diabetes, compared with people who were not taking GLP-1 medications.
This group of medications is based on related compounds, all of which are glucagon-like peptide-1 (GLP) receptor agonists that mimic the natural GLP-1 intestinal hormone. In doing so, they produce insulin after eating, helping to reduce blood sugar. They also slow the emptying of the stomach and promote a sensation of being full, leading to a reduction in appetite.
The medications are generally injectable, although oral versions are also available.
The most well-known GLP-1 drugs, Wegovy and Ozempic, are based on semaglutide. Other GLP-1 agonist compounds tested in the study are liraglutide, dulaglutide, and exenatide, as well as tirzepatide that mimics a second intestinal hormone, gastric inhibitory polypeptide, or GIP, in addition to GLP-1.
People with diabetes taking tirzepatide were 65% less likely to be diagnosed with depression and 60% less likely to have anxiety, compared to people not taking GLP-1 drugs. People with diabetes who were taking semaglutide were 45% less likely to be diagnosed with depression, and 44% less likely to have anxiety.
Two of the drugs, semaglutide and liraglutide, were assessed as regards depression and anxiety in people without diabetes.
For people who do not have diabetes, only semaglutide was associated with a reduction in depression and anxiety, compared to people who were not on GLP-1 medications.
There was no statistically significant improvement for people taking liraglutide.
The study was undertaken by Epic Research, an investigative branch of Epic, one of the largest holders of electronic medical records in the U.S. Two teams of in-house researchers analyzed anonymized patient data, coming to the same conclusions.
The study analyzed patient records for 3,081,254 people with diabetes and 929,174 without diabetes, who were taking the drugs for weight loss. The researchers factored in a range of variables to eliminate confounding influences on their results.
“The results suggest a potentially new therapeutic benefit of GLP-1 medications beyond their established use for glucose control and weight management,” said general practitioner with Zava, Dr. Kathryn Basford, who was not involved in the research.
Dr. Crystal Wyllie, also a general practitioner with Zava, who was also not involved in the research, noted that the study “goes some way in addressing concerns raised by the FDA [U.S. Federal Food and Drug Administration] about depression and suicidal ideation associated with semaglutide, as it suggests that these concerns may not be directly linked to these specific weight-loss treatments.”
“Our preliminary evaluation has not found evidence that use of these medicines causes suicidal thoughts or actions,” the agency concluded.
Dr. Mir Ali, medical director at the MemorialCare Surgical Weight Loss Center, who was not involved in the study, was not surprised by the findings, saying, “There were only a few case reports and there’s hundreds of thousands of patients on these medications.”
One question left unanswered for now is whether the reduction in depression and anxiety diagnoses are a direct result of the medication.
Dr. Basford said the study “doesn’t definitively clarify whether these improvements are due to the biochemical effects of the medicines or are a result of improved self-esteem. I would be interested to see further research in this area.”
With acknowledged benefits for people with diabetes, having first been approved for use in 2005, GLP-1 drugs for weight loss may re-position overweight and obesity in a clearly medical context, with the potential of reducing the historical stigma associated with these conditions.
“It’s a paradigm shift that we’re thinking of obesity not as a failure on the patient’s part to control their habits, but more of a chronic disease, and treating it like any other chronic disease such as diabetes or high blood pressure, arthritis, or other diseases that people readily will say is not the patient’s fault,” Dr. Ali said.
“My hope is that these treatments will allow patients to live healthier, happier lives — whatever weight they finally achieve,” said Dr. Wyllie.
“We need to recognize obesity as a multifaceted condition that requires interventions that address both the physical and psychological needs of the patient,” Dr. Basford added.
Of the 13 GLP-1 medications listed by the FDA, only three, Wegovy (semaglutide), Saxenda (liraglutide), and Zepbound, (tirzepatide), are officially listed as approved for weight loss. However, they are commonly prescribed “off-label” for this purpose.
Dr. Ali explained that the lack of official approvals in this case may be less than they seem. “That’s just a drug company strategy for getting a broader indication for these medications — rebranding them and marketing them for weight loss.”
The cost of a GLP-1 medication may be intimidating in that one needs to remain on the drug long-term to maintain its effect for diabetes, weight loss, or perhaps a reduction in depression and anxiety.
Dr. Ali noted that “It is difficult to get it covered by most insurance companies,” but said many will pick up the tab if the individual meets medical qualifications. For weight loss, for example, one needs a Body Mass Index of 30 or above to obtain coverage from some insurance carriers.
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