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May 3

Understanding Low Testosterone: Available Treatment Options – Digital Journal

PRESS RELEASE

Published April 27, 2023

Low testosterone, also known as hypogonadism, is a condition that affects men of all ages. It is characterized by a low level of testosterone, the hormone that plays a key role in male development and sexual function. Symptoms of low testosterone can include decreased sex drive, erectile dysfunction, fatigue, and depression. Fortunately, there are several treatments available that can help to alleviate these symptoms.

The most commonlow t treatmentis testosterone replacement therapy (TRT). This involves the use of testosterone supplements to bring the levels of the hormone back to normal. TRT can be administered in a variety of forms, including injections, patches, gels, and pellets. Your doctor will work with you to determine the best method of administration for your specific needs.

TRT can be highly effective in treating the symptoms of low testosterone, including low sex drive, erectile dysfunction, and fatigue. However, it is not without risks. Testosterone supplementation can increase the risk of certain health problems, such as prostate cancer and heart disease. As a result, it is important to work closely with your doctor to monitor your hormone levels and any potential side effects of treatment.

Another treatment option for low testosterone is clomiphene citrate. This medication works by stimulating the pituitary gland to produce more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn stimulates the production of testosterone. Clomiphene citrate is typically administered in pill form.

Clomiphene citrate is effective in improving testosterone levels in men with low testosterone. It may be a good option for men who do not want to undergo testosterone replacement therapy or who have concerns about the risks associated with TRT. However, like any medication, clomiphene citrate is not without potential side effects, and it is important to work closely with your doctor to monitor your hormone levels and any potential side effects of treatment.

Human chorionic gonadotropin (hCG) is another treatment option for low testosterone. This hormone is similar in structure to LH and can help to stimulate testosterone production. hCG is typically administered via injection.

hCG can be effective in improving testosterone levels in men with low testosterone. However, like TRT and clomiphene citrate, it is not without potential risks and side effects. It is important to work closely with your doctor to monitor your hormone levels and any potential side effects of treatment.

In addition to medical treatments, several lifestyle changes can help to increase testosterone levels naturally. These include:

Exercise: Regular exercise, especially resistance training, can help to increase testosterone levels.

Diet: Eating a healthy, balanced diet that is high in protein and healthy fats can also help to increase testosterone levels.

Sleep: Getting enough quality sleep is important for overall health and can also help to increase testosterone levels.

Stress management: High levels of stress can lead to a decrease in testosterone levels. Engaging in stress-reducing activities such as yoga, meditation, or deep breathing can help to increase testosterone levels.

Low testosterone is a common condition that can have a significant impact on a mans quality of life. Fortunately, there are several treatment options available that can help to alleviate the symptoms of the condition, including testosterone replacement therapy, clomiphene citrate, and human chorionic gonadotropin. Additionally, making lifestyle changes such as exercising regularly, eating a healthy diet, getting enough sleep, and managing stress can also help to increase testosterone levels naturally.

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Understanding Low Testosterone: Available Treatment Options - Digital Journal


May 3

What Is the hCG Diet, and Is it Safe? – EatingWell

According to data from the National Health and Nutrition Examination Survey posted on the National Center for Health Statistics, on any given day, 17.4% of the U.S. adult population over the age of 20 is on a special diet. Of those individuals on a diet, data shows it's more likely to be a low-calorie, low-carbohydrate and weight-loss-focused diet versus the low-fat or low-cholesterol diets that once reigned supreme in the wellness world.

Given the continual interest the public has in finding a quick-fix way to lose weight, popular trending diets like the ketogenic diet and Dukan Diet continue to surface, while others such as the hCG diet have tried to make a name for themselves over the years. While the hCG diet may be new to you, it's actually been around since the early 1950s and is touted to accelerate weight loss in conjunction with a very low-calorie diet. In this article, we'll cover everything you need to know about the hCG diet and what nutrition experts want you to know about its safety.

The hCG diet is a very low-calorie dietusually a range of 500 to 800 calories per daythat is used in conjunction with supplemental hCG (human chorionic gonadotropin) injections as a means to stimulate weight loss. In the early 1950s, a British physician by the name of Albert Simeons began promoting the hCG diet for weight loss. Simeons made claims that the hCG diet allowed participants to burn stored body fat, not muscle mass, with testimonials claiming participants lost 20 to 30 pounds in 40 days without feeling hungry or weak.

Let's make this clear: Science has not proved nor supported any of the claims Simeons made in the 20th century. Additionally, the Food and Drug Administration has not supported the use of hCG for weight loss. While hCG is a hormone that is naturally produced in the body during pregnancy, it has not been approved by the FDA for weight loss nor for use without a prescription for any purpose.

Given the lack of scientific data on the hCG diet, the list of recommended foods allowed on the very low-calorie diet are a bit subjective. According to Lauren Manaker M.S., RDN, LD, a registered dietitian and author of Fueling Male Fertility, "The hCG diet requires that people stick to a low calorie limit spread over two meals a day. Calorie-free drinks that include coffee and tea are approved, and they can be sweetened with stevia or saccharin. Lean protein, certain low-carbohydrate vegetables, berries, citrus, apples and 1 tablespoon of milk is permitted every day."

With these factors in mind, the list of foods allowed on the hCG diet would look like this:

There is a simple and direct answer to this question: no. Women's health experts, Melissa Groves Azzaro, RDN, LD, owner of The Hormone Dietitian, Kendra Tolbert, M.S., RDN, RYT, owner of Live Fertile, and Manaker are all in agreement about this.

Groves Azzaro shares, "While hCG is a hormone naturally produced by the body during pregnancy, we do not know the long-term risks of daily exogenous hCG use. The diet also involves severe calorie restriction, with followers consuming just 500 calories a day, about a quarter of what most people need. While rapid weight loss may occur at first, it would not be sustainable as one's metabolism slows down."

In addition, the hCG diet is very restrictive. Groves Azzaro, Tolbert and Manaker all expressed extreme concern over the potential for nutrient deficiencies. Groves Azzaro writes, "Due to the limited food choices, this raises the risk for multiple nutrient deficiencies because it limits many necessary categories of foods including starchy vegetables, grains, and legumes, which are good sources of B vitamins and fiber, oils and fats, which could lead to deficiencies in many fat-soluble vitamins like vitamins A, D, E and K."

While the hCG diet may appear promising for those interested in losing weight quickly, at this time, there are no scientific studies available supporting its use. In fact, a 2016 article published in the Journal of Dietary Supplements stated that there is no science available to support the efficacy of the hCG diet and use of it actually does more harm than good. Furthermore, registered dietitians interviewed unanimously agree this diet is dangerous and should not be recommended.

The only instance in which hCGwithout the recommendation of the very low-calorie diethas been recommended or approved for use by the FDA is under medical supervision and with a prescription for the treatment of infertility in certain situations.

Very low-calorie diets, like the 500 to 800 calories recommended on the hCG diet, pose a risk for nutrient deficiencies as mentioned above. A 2022 article published in the Journal of Preventive Medicine and Hygiene explored the concept of nutrient deficiencies and the need for preventive measures to help improve health of individuals at risk. Given that the hCG diet puts individuals who follow the diet at risk of nutrient deficiencies related to inadequate intakes of important macro- and micronutrients, it poses concern for the risk of developing other diseases such as cancer, diabetes and heart disease.

While the hCG diet is not in and of itself a style of intermittent fasting, its reduction in calories and thus minimal eating windows make it strikingly similar to a fasting-style diet. A recent 2022 study published in the journal of Eating and Weight DisordersStudies on Anorexia, Bulimia and Obesity investigated the impact low-carbohydrate diets alongside intermittent fasting have on disordered eating in university students. Findings revealed that compared to non-dieters, dieters experienced a greater preoccupation with food that led to higher levels of binge eating, food cravings and restrictive tendencies towards food and carbohydrates.

A 2017 article published in the journal of Perspectives on Psychological Science explored the concept of weight loss from the lens of reducing calorie intake. While researchers found that lower calorie intakes did result in short-term weight loss, the weight loss was not sustainable and the impact this deficit had on one's metabolism and hormones was unfavorable. Instead, the scientists called for more research exploring the mechanisms that can help with controlling one's weight long-term aside from a reduction in calorie intake.

As tempting as it may be to hop on the "get fit quick" train with a low-calorie diet like the hCG diet, it's not recommended by health care professionals, regardless of your age or life stage. Both Groves Azzaro and Tolbert see red flags throughout this diet, sharing the same sentiment that the risks outweigh any supposed benefits the eating plan advertises. Groves Azzaro goes on to say, "There are much more sustainable ways to lose weight that are backed by scientific evidence and aren't associated with such risks."

Similar to other low-calorie diets, Groves Azzaro notes the side effects of this diet would include fatigue, irritability, depression, nutrient deficiencies, potentially constipation from the lack of fiber, dry skin, hair loss and a huge potential for weight regain. The FDA reports that serious adverse reactions have also been reported, including "cases of pulmonary embolism, depression, cerebrovascular issues, cardiac arrest and death." Both Groves Azzaro and Tolbert also share that the hCG injections bring potential risks as well, including pain, bruising and infection at the injection sites, as well as allergic-type reactions like rash, hives and swelling.

The hCG diet consists of a very low-calorie diet that ranges between 500 and 800 calories per day. These calories come from lean proteins and low-carbohydrate fruits and vegetables.

While diets that promise rapid weight loss like the hCG diet may seem alluring if you're been trying to lose weight unsuccessfully for some time, they are neither safe nor recommended by nutrition experts. The long-term consequences include nutrient deficiencies and potential for development of disordered eating behaviors, and the unknowns of hCG use far outweigh the short-term weight-loss potential. If you're looking for a sustainable approach to build lifelong healthy habits, consult with a health care professional who can work with your individual needs.

Up Next: How to Lose Weight When You Don't Know Where to Start, According to a Dietitian

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What Is the hCG Diet, and Is it Safe? - EatingWell


May 3

Explained: What Is Hypothyroidism, Causes, Symptoms And Treatment – Indiatimes.com

Do I have hyperthyroidism?

Is it hypothyroidism?

Unsplash/Representational image

These are common questions that come into our mind when we look at our thyroid reports. This topic deals with thyroid gland dysfunction especially hyperthyroidism.

Thyroid gland is a butterfly shaped gland which is present in the neck in front of the trachea (windpipe). The main function of this gland is to produce thyroid hormones which are T4 and T3. T4 hormone is produced in excess of T3, however T4 is converted to T3 at tissue levels which is more active than T4.

Thyroid hormone requires iodine, hence adequate iodine in diet is necessary to avoid diseases. Thyroid gland is in turn regulated by pituitary - master gland (present in the brain) by producing TSH hormone. If the T4 or T3 production is not sufficient then the TSH levels in the pituitary goes up. This is seen in hypothyroidism. Similarly, if T4 / T3 levels are high, the TSH level goes down which is commonly seen in hyperthyroidism.

Unsplash/Representational image

Even though both the terms hyperthyroidism and thyrotoxicosis are used interchangeably, both are not the same. Thyrotoxicosis is a lab finding where T4 & T3 are elevated and TSH levels are suppressed. This can be seen in hyperthyroidism, thyroiditis or overtreatment of hypothyroidism.

Hyperthyroidism is a condition where the thyroid gland is over functioning, thus producing increased levels of T4 and T3 hormones, followed by low TSH. In thyroiditis the thyroid hormone storage of 3-6 months is released prematurely into the bloodstream in a short time leading to a similar picture (but the gland is not hyperfunctioning). Luckily hyperthyroidism is much less common than hypothyroidism. The symptoms of thyrotoxicosis are as follows:

Unexplained weight loss

Tremors of hand

Palpitation- healing ones own heart beat

Increased frequency of stools

Generalized weakness

Muscle weakness

Unsplash/Representational image

Goitre (thyroid swelling)

Eye symptoms- redness, irritation, protrusion

Neck pain, fever

Thyrotoxicosis can be seen due to many conditions, which are discussed below

Graves Disease - Graves disease is an autoimmune disease in which auto-antibodies like TRAb (TSH receptor antibody) stimulate the thyroid to over function leading to goiter, high T4 and T3; low TSH. The TRab antibody also affects the eyes causing symptoms like redness, irritation, pain, protrusion and sometimes double vision.

Toxic Multinodular goiter - Subjects with long standing goiter may sometimes develop hyperthyroidism due to autonomy (loss of regulation by pituitary). Usually seen in elderly patients.

Toxic nodule with hyperthyroidism- Sometimes thyroid can have single hyperfunctioning nodule which increases thyroid hormone production. These can be diagnosed with Tc (Technetium) scan or Iodine 123 Scan. Patients respond well to radioactive iodine ablation.

Thyroiditis - Patients can have sudden release of thyroid hormone due to thyroiditis (inflammation of thyroid gland) causing sudden onset of symptoms like weight loss, tremor, palpitation, neck pain or fever. Usually seen after viral infections or after delivery (postpartum thyroiditis). Diagnosis is by combination of lab reports and clinical assessment. Patients respond well to steroids and painkillers.

Hyperemesis gravidarum - Pregnant women have increased HCG hormone levels which can stimulate the thyroid leading to transient thyrotoxicosis. Usually associated with vomiting in early pregnancy and resolves within 12 weeks of pregnancy.

Other causes - Some drugs like amiodarone, lithium, etc. can interfere with thyroid function or can interfere with the lab testing giving spurious results. Other rare causes of hyperthyroidism are TSH producing pituitary tumors and HCG producing tumors (germ cell tumors, choriocarcinoma)

Thyroid profile- TSH, T4 (total or free), T3 (total or free)

TSH receptor antibody (TRAb) - positive in Graves disease

Tc (Technetium scan) or I123 scan- Positive in Graves, toxic multinodular goiter and toxic nodule. Negative in thyroiditis

Ultrasound thyroid and FNA thyroid - in patients with nodular goiter

Anti-thyroid drugs- Methimazole, carbimazole, Propylthiouracil

Drugs to control symptoms and heart rate: Beta blockers or diltiazem

Radioactive iodine ablation- Patients with graves, toxic nodule, toxic multinodular goiter can be given radioactive Iodine which releases Gamma radiation which kills the overactive thyroid cells making the patient hypothyroid, which can be managed more easily

Surgery- in patients with large goiter patients who are not fit for anti-thyroid drugs and radioactive iodine.

Steroids + anti-inflammatory drugs for patients with thyroiditis

Patients require close follow up every 1-2 months initially to monitor symptoms and thyroid profiles. Once the initial control is achieved a longer interval can be prescribed. Some patients achieve long term remission with antithyroid drugs. However, patients advised against use of anti-thyroid drugs without supervision because complications can develop in unregulated treatment.

About the author: Dr. Shrinath P Shetty is an Endocrinologist at KMC Hospital, Mangalore. All views/opinions expressed in the article are of the author.

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Explained: What Is Hypothyroidism, Causes, Symptoms And Treatment - Indiatimes.com


Apr 25

The 5 Worst Fad Diets That Actually Do Nothing For Weight Loss, According To Nutritionists – SheFinds

The Cabbage Soup Diet

While some people claim that they lost as much as 10 pounds on this diet, experts like Bradley don't recommend this crash diet for substation weight loss. Just like the name says, this very low-calorie diet involves consuming fat-free cabbage soup two to three times a day while restricting other food groups. "While it may result in short-term weight loss, it is nutritionally imbalanced and lacks essential nutrients such as protein, healthy fats, and carbohydrates," Bradley explains. "It can lead to nutrient deficiencies, muscle loss, and low energy levels, making it unsustainable and potentially harmful to overall health." Yikes!

Juice cleanses have become popular on the dieting scene in recent years. This diet involves avoiding solid foods and only consuming fruit and vegetable juices for a few days or a week. Some people do a juice cleanse to help lose weight, eliminate "toxins" from the body, and give the digestive system a break. While fruits and vegetables undeniably provide important vitamins and nutrients, drinking only juice may not be as good for you as it sounds.

"While juices can be a good source of vitamins and minerals, they are usually high in sugar and low in protein and fiber, which can lead to unstable blood sugar levels, muscle loss, and slowed metabolism," Bradley says. "Juice cleanses also lack essential nutrients and are not a sustainable approach to long-term weight loss." Even though juice cleanses can be good for your body once in a while, they should not be done consistently and you should be careful about the amount of sugar each juice contains.

You may not have heard of this diet, but it is gaining popularity. The Food and Drug Administration (FDA) has warned against this fad diet. They advise consumers to steer clear of over-the-counter weight-loss products that contain HCG. HCG is human chorionic gonadotropin, a hormone produced during pregnancy. It's used mainly to treat fertility issues and it's not approved for over-the-counter use. It also has not been proven to work for weight loss.

"This diet involves taking human chorionic gonadotropin (HCG) hormone supplements, often in the form of injections, while following a very low-calorie diet (VLCD) of 500-800 calories per day," Bradley warns. "Despite claims of rapid weight loss, there is no scientific evidence to support the effectiveness of HCG in weight loss, and VLCDs can be dangerous and lead to nutrient deficiencies, muscle loss, and metabolic slowdown." The HCG diet can have potentially dangerous side effects and it's not sustainable in the long term.

Sometimes referred to as the ketogenic diet, the keto diet is a high-fat, low-carbohydrate diet that, Bradley says, "aims to induce a state of ketosis in the body, where it primarily burns fat for fuel instead of carbohydrates." He continues. "While it may result in short-term weight loss, the long-term effects and safety of this diet are still debated among experts. It can be difficult to sustain due to severe carbohydrate restrictions, and it may lead to nutrient deficiencies, constipation, and an increased risk of heart disease due to the high intake of saturated fats." Nobody wants that!

Similarly, the raw food diet is not ideal for sustainable weight loss in the long run. "This fad promotes eating only raw, uncooked foods, typically fruits, vegetables, nuts, and seeds, while avoiding all cooked and processed foods," Bradley notes. "While raw foods can be nutritious, this diet can be challenging to follow and may result in nutrient deficiencies, especially in protein, vitamin B12, and calcium." And, the raw food diet can also be dangerously low in calories. This, he says, could lead to "inadequate energy intake and difficulties in meeting nutrient needs."

So, if you're considering trying any of these fad diets, think again and be sure to consult your doctor to guarantee that it's safe for your weight loss journey. Instead of these fad diets, Bradley suggests opting for the Mediterranean diet instead. "The Mediterranean diet," he explains, "has been associated with numerous health benefits, including weight loss, due to its balanced and nutrient-rich approach to eating." He cites the diet's emphasis on whole, minimally processed foods, healthy fats, lean proteins, and flexibility. Learn how to meal prep on a Mediterranean diet, or, try the green Mediterranean diet!

Link:
The 5 Worst Fad Diets That Actually Do Nothing For Weight Loss, According To Nutritionists - SheFinds


Apr 17

Hyperemesis Gravidarum: Symptoms and Treatment | Metropolis … – Metropolis Healthcare

For most pregnant women, undergoing some degree of nausea or morning sickness is quite common. Usually, it occurs during the first 3 months of pregnancy. The exact cause ofHyperemesis Gravidarum is not known. Although mild morning sickness is usual during pregnancy. Hyperemesis Gravidarum is not so common and can be very severe. Women who face this condition usually get extremely nauseous during pregnancy. It can be so severe that it can result in a loss of more than 5% of body weight.

Hyperemesis Gravidarum can occur in any pregnancy. But it is more likely if you are pregnant with twins or multiple babies. A similar problem in a previous pregnancy or affinity to motion sickness may further put you at a higher risk of developing this condition.

Usually, morning sickness is behind decreased appetite in pregnant women. This comes along with low levels of nausea or vomiting. However, you will still be able to eat and drink food at most times of the day. And it will mostly be without facing any major outcomes.

However, the symptoms of Hyperemesis Gravidarum can be very severe. Typically, they include the following:

Severe and persistent nausea and vomiting during the pregnancy period

Increased salivation in the mouth

Noticeable weight loss

Visible signs of dehydration, including darker urine, feeling of lightheadedness and weakness

Constipated stomach

Lacking in intake of enough fluids and nutritional foods

The condition is likely to occur during the first trimester of your pregnancy. Thus, usually, if you are vomiting more than 3 to 4 times in a day such that it is causing you to lose weight and become dehydrated, it mightHyperemesis Gravidarum Treatment.

Some doctors believe that the condition may result due to rapidly rising levels of estrogen and HCG (Human Chorionic Gonadotropin). These are some of the topHyperemesis Gravidarum Causes.The occurrence of the condition might be an indicator that you are carrying multiple babies. In rare cases, it can also indicate a hydatidiform mole, which is abnormal tissue growth and not a true pregnancy.

Risk factors can increase your chances of getting a condition such as this. They do not necessarily mean that you will always develop the condition due to that. Typical risk factors associated with Hyperemesis Gravidarum are as follows:

1. Presence of the condition during an earlier pregnancy

2. Being overweight

3. Presence of multiple pregnancies

4. Becoming a first-time mother

5. Trophoblastic disease, which involves the growth of abnormal cells inside the uterus

It is necessary to get a proper diagnosis for Hyperemesis Gravidarum. Usually, a healthcare provider will enquire about the symptoms of the condition and your medical history, before conducting a physical examination. In some cases, your doctor may ask you to take certain tests to help diagnose the condition.

Hyperemesis Gravidarum Treatmentand management depend on the severity of the condition that you face. Here are some of the possible treatments that may be administered to you during this time.

Consuming small frequent meals your doctor may recommend a diet involving dry foods, consumed with small but frequent meals. You may be prescribed a variety of meals for this purpose.

Administering Intravenous Fluids intake is very important if you are facing Hyperemesis Gravidarum. If you continue to vomit throughout your pregnancy, your doctor may have to administer intravenous fluids to maintain your body fluids. In very severe cases, doctors may have to recommend hospitalization for the administration of IV fluids. It can only be stopped if you can consume fluids by mouth.

Total Parenteral Nutrition in the most severe cases of Hyperemesis Gravidarum, doctors may have to prescribe the administration of complex and balanced solutions of nutrients through IV. This process is called total parenteral nutrition.

Constant vomiting can pose certain risks to the mother and the baby. A doctor may prescribe medicines if you are facing persistent vomiting. They may have to be consumed either orally or through an IV. A few useful and common medicines for this purpose are droperidol, Promethazine and meclizine.

Other than these methods of treatment, doctors may suggest preventive measures to help control motion sickness. You may have to consume certain oral supplements such as Vitamin B6 or ginger to control the frequency of vomiting.

There is no known way to avoid Hyperemesis Gravidarum. If you are suffering from the condition, there are a few ways to control its intensity and stop it from getting worse.

Some of them are as follows:

Since the symptoms of Hyperemesis Gravidarum and morning sickness are quite similar, it can be difficult to identify which one of them you are facing. The following differences will be of help.

If you are facing the problem of Hyperemesis Gravidarum, it might be a good idea to consult your doctor at the earliest and take their recommended treatment. Give yourself enough rest and consume the requisite medicines. This will help to control the condition to avoid any fatality to your baby.

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Hyperemesis Gravidarum: Symptoms and Treatment | Metropolis ... - Metropolis Healthcare


Apr 6

Ozempic and the dark history of weight-loss drugs – Dazed

Welcome to Beauty School, the corner of Dazed Beauty dedicated to learning. From guides to histories, this is where we shed light on past subcultural movements and educate our readers on current trends and various goings-on.

Everybody looks so great, Jimmy Kimmel told the audience while hosting the Oscars earlier this month. When I look around this room, I cant help but wonder Is Ozempic right for me?

Ozempic is everywhere; on the cover of magazines and splashed across New Yorks subway, its the subject of countless memes and jokes, and, the stories are true, coursing through the veins of everyone in Hollywood and Manhattan who can get their hands on it. If weight loss were a religion, Ozempic would be its god, the haunting Oh, oh, oh, Ozempic heard in its TV ad a sinister reimagining of Pilots 1974 anthem Magic its hymn. Much like the diet-entrenched, skinny-obsessed culture we live in, talk of Ozempic is everywhere.

Ozempic is the branded name for semaglutide, which is also sold under the labels of Wegovy and Mounjaro among others. A drug used to treat type 2 diabetes, it helps regulate blood sugar levels by mimicking the action of glucagon-like peptide-1 (GLP-1). It also greatly suppresses appetite and slows the rate at which the stomach empties, which has made it an extremely popular off-label medication for those wishing to shed some pounds.

Semaglutide has garnered a lot of traction over a very short period of time, so much so that diabetics are now struggling to get their hands on it thanks to consumer demand. Kim Kardashian ever a barometer for Western beauty standards is rumoured to have used Ozempic to fit into Marilyn Monroes dress at the Met Gala. While she denies the claims, she is undeniably thinner than recent years, and as the BBL era is declared over, its clear that body ideals have swung back from slim-thick and returned to just slim.

But really, when has slim ever not been in? Diet pills and weight loss medication are nothing new they have been around for over a century because women have always been pressured to conform to restrictive beauty ideals. Ozempic may be being hailed a silver-bullet weight loss miracle, but so was fen-phen in the 80s. Until it was found that the drug could cause untreatable and often fatal heart conditions. To look back over the history of diet pills and weight loss drugs, is to understand the deadly pressures to be thin that have long existed in our image-obsessed culture.

The story of dinitrophenol goes back to World War I, explains Dr Frank Greenway, chief medical officer and professor at Pennington Biomedical Research Centre. One of the first weight-loss drugs, dinitrophenol was first used in munitions factories as an explosive but after workers who came into contact with it were seen to lose weight, in the 1930s it was sold as antiobesity therapy. Not long after, however, dinitrophenol was shown to be incredibly unsafe at high doses, causing blindness and neuropathy; at very high doses, came death. By 1938, the FDA stated that it was extremely dangerous and not fit for human consumption and it was removed from the market. Its presence in diet pills in the UK is currently illegal, and is to be reclassified in 2023 as poison, such is its high toxicity.

In the 1940s, the amphetamine Benzedrine became the diet pill of choice. Originally sold as a decongestant, Benzedrine salts were then discovered to be powerful stimulants and when World War II came, the military in the US, Germany, UK and Japan placed large orders of the pills to keep soldiers going on the battlefield. As the war came to an end, pharmaceutical company Smith, Kline, and French shifted focus to a different demographic: housewives to whom they marketed amphetamines for weight loss. This was only the beginning of an amphetamine-fuelled race to thinness.

Next, in the 50s came human chorionic gonadotropin (HCG) a hormone produced in the placenta of pregnant women after boys with pituitary tumours werent going through puberty. In order to stimulate the process of going on the golden elevator to adolescence, they were given HCG, and were found to lose fat and gain muscle. After that came a study from Dr Albert T. W. Simeonswhich found that, if combined with a strict, low-calorie diet, people could lose 20lbs in six weeks. But due to scepticism that the HCG was effective, there were several clinical trials that compared a diet with saline shots with a diet with HCG shots, Dr Greenway explains. It showed that both groups lost 20lbs in six weeks, and that HCG was unnecessary. The FDA now has as part of the label for the HCG shots that it is not indicated or effective for treating obesity.

In 1960, Obetrol a formulation of amphetamine mixed salts, including methamphetamine and dextroamphetamine was approved by the FDA to treat obesity. Evidence that demonstrated the adverse side effects of amphetamines had been steadily accumulating thanks to the Benzedrine salts, and it didnt take scientists long to figure out meth was incredibly harmful. By 1965, the FDA banned the inhalers completely and limited amphetamines to prescription use only. But, having been approved as a weight-loss drug, vast quantities of amphetamines like Obetrol started to be dispensed by diet doctors. Civilian use went through the roof and by 1970, 5 per cent of Americans (or roughly 9.7 million) were using some kind of prescription amphetamine, the so-called rainbow diet pills.

As well as weight loss, many people were using pills like Obetrol as recreational drugs. In 1963, Andy Warhol received a prescription for Obetrol and it became his drug of choice (Warhol was on his way to the drug store to pick up his prescription Obetrol on the morning he was shot by Valeria Solanas). By now, widespread consumption helped to illuminate not just how truly addictive amphetamines were, but also their negative health effects, like psychosis, hallucinations and death. Not that it mattered. Profits were astronomical; one dispensing diet doctor paid $71 for 100,000 amphetamine-containing tablets and sold them for $12,000. Although not banned by the FDA, Obetrol underwent reformulations, eventually rebranding and sold as Adderall, of which has never received FDA approval for weight loss.

Then came 1985: the year when the National Institutes for Health declared obesity to be a chronic disease and, as such, required chronic treatment. It was also the year that fen-phen came onto the market. The latter (phentermine) and the former (fenfluramine) were shown to help people lose weight and a lot of it. But, due to regulations, it wasnt supposed to be used for longer than 12 weeks; the women who did, developed cases of heart valve abnormalities. Due to the way in which serotonin was affecting the body, it was suspected that fenfluramine was to blame, and unsurprisingly, this led to it being taken off the market. In 1999, American Home Products (now Wyeth) agreed to pay up to $3.75 billion to settle the numerous lawsuits the drug faced in the USA, in what was believed to be the largest legal settlement ever against a pharmaceutical company at the time. Its estimated that Wyeth has since spent $10 billion in total damages.

1999 brought the next iteration of a weight-loss drug: orlistat, often sold under the brand Xenical. Though understood to be safe and is still FDA-approved Xenical inhibits the digestion of fat, leading to 30 percent of the fat in the diet passing out in the stool as oil. People can develop anal leakage, pass oil when they think it is air, and sometimes lose control of their bowels, explains Dr Greenway. This is not dangerous, but it can be very socially embarrassing. While orlistat is approved for children and adolescents, overweight children are stigmatised, and if they have faecal accidents, it just makes the stigmatisation worse and so it hasnt been prescribed much.

In the 00s came lorcaserin, which was marketed under the brand name Belviq. It was approved by the FDA in 2012, but within a mere eight years, the FDA requested that its manufacturer voluntarily withdraw the drug from the US market because a safety clinical trial showed an increased occurrence of cancer. And now we have semaglutide, alongside a range of weight loss jabs available from the high street.

The long-term effects of semaglutide are as yet unknown, particularly when it comes to weight-loss purposes, although the history of weight-loss drugs counsels extreme caution. But its rapid rise in popularity says a lot about where we as a culture are right now when it comes to attitudes around weight. Thin is purportedly in again, but given societys rapid embrace of a size-zero aesthetic and our repeated willingness to try weight-loss drugs, did coveting thinness ever really go away? Despite the body positivity movement from the last few years, there is still a long way to go before we move past the fatphobia that is so pervasive in our obesogenic lives. In New York Magazines cover story about Ozempic, Aubrey Gordon is quoted as saying that the hype around the drug boils down to: Can we finally be rid of fat people? Can we finally stop having fat people around so I dont have to look at them anymore?

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Ozempic and the dark history of weight-loss drugs - Dazed


Apr 6

Genetics And Genomics: Game Changer In Identifying And Treating … – Cityairnews

Authored by:Dr. Ameet Sattur, Consultant Interventional Cardiologist, HCG Suchirayu Hospital HubliCardiovascular Disease (CVD) refers to a group of conditions that affect the heart and blood vessels, such as coronary artery disease, hypertension, heart failure, and stroke. Although lifestyle factors such as diet, exercise, and smoking are crucial in the development of CVD, genetics and genomics also play a significant role in the disease's pathogenesis.Genetics refers to the study of individual genes and their impact on health and disease. Genomics, on the other hand, is a broader field that investigates how all the genes in an individual's DNA interact with each other and with the environment. Advances in genetics and genomics have revolutionised our understanding of CVD and are helping to pave the way for new and more effective treatments.How Genetics And Genomics Are Used To Study CVDIdentifying risks through genetic variants: One of the primary ways genetics and genomics are used to study CVD is through genome-wide association studies (GWAS). GWAS is a method that analyzes the entire genome of a large population to identify genetic variations that may increase or decrease the risk of developing a specific disease. In 2018, a GWAS discovered a new genetic variant linked to a higher risk of developing coronary artery disease. This variant was found to regulate the production of an enzyme that contributes to inflammation and atherosclerosis, a condition characterized by the accumulation of fatty deposits in the arteries, which can lead to stroke or heart attack.Developing personalised medicine: Genetics and genomics are also crucial in the advancement of personalized medicine for CVD. This approach involves considering an individual's genetic profile, lifestyle factors, and other clinical characteristics to customize treatments for that person. By understanding a person's genetic predisposition to CVD, doctors can develop personalized prevention and treatment plans that are more effective and have fewer adverse side effects.One of the most exciting areas of personalised medicine in CVD is the use of genetic testing to identify rare genetic mutations that cause inherited forms of the disease. These mutations, which are often passed down through families, can cause CVD at a much younger age than is typical for the general population. Identifying these mutations through genetic testing can help doctors diagnose CVD earlier and develop personalised treatment plans that are more effective in managing the disease.Gene therapy: Genetics and genomics not only aid in understanding CVD, but they also have a significant impact on the development of new treatments. Gene therapy is a promising area of research in CVD, particularly for inherited forms of the disease. The technique involves introducing healthy copies of a defective gene into the body to replace or repair the defective gene, and early-stage clinical trials have shown promise in treating heart disease.New drug treatments: Another area of CVD research that is benefitting from genetics and genomics is the development of new drug treatments. By understanding the genetic and genomic mechanisms that underlie CVD, researchers can identify new drug targets and develop more effective treatments. For example, a drug called evolocumab, which targets a specific gene involved in cholesterol metabolism, has been shown to reduce the risk of heart attack and stroke in high-risk patients.Genetics and genomics have revolutionized our understanding and treatment of CVD, providing personalized medicine, gene therapy, and innovative drug treatments that enhance patient outcomes and reduce the impact of CVD. With appropriate regulation and oversight, genetics and genomics hold great potential for uncovering novel complexities in CVD and developing effective treatment strategies. For more information on the vital role of genetics and genomics in your treatment plan, please speak to a cardiologist.

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Genetics And Genomics: Game Changer In Identifying And Treating ... - Cityairnews


Mar 29

High-Normal Blood Pressure in Young Adults – An Impending Risk … – Cityairnews

Authored by:Dr. Ameet Sattur, Consultant Interventional Cardiologist, HCG Suchirayu hospital Hubli

Cardiac health is a crucial aspect of overall well-being, and recent research has shown that even "high-normal" blood pressure in young adults can spell risk for heart failure later in life. High blood pressure, also known as hypertension, is a leading risk factor for heart disease and stroke, and can lead to a host of serious health complications if left untreated. High-normal blood pressure is defined as a systolic blood pressure (the top number) between 130-139 mmHg or a diastolic blood pressure (the bottom number) between 85-89 mmHg. This is higher than the standard normal range of less than 120/80 mmHg, but not high enough to be classified as hypertension. This condition is becoming increasingly common among young adults and it is important to understand the symptoms, risk factors, treatment and prevention of high-normal blood pressure.Signs and risk factors of high-normal blood pressure

One can have high blood pressure (hypertension,) for years without any symptoms. Even without symptoms, damage to blood vessels and heart continues and can be detected. Uncontrolled high blood pressure increases the risk of serious health problems, including heart attack and stroke. It is often called the silent killer, as it does not usually cause any symptoms until it is at a more advanced stage. However, some people may experience signs such as headaches, fatigue, and shortness of breath.Risk factors of high-normal blood pressure include family history, obesity, smoking, unhealthy diet, lack of physical activity, stress, and excessive alcohol consumption. Individuals who are overweight or obese, have a family history of hypertension, or have an unhealthy diet, are at an increased risk of developing high-normal blood pressure.

High normal blood pressure and its impact on the young adultsYoung adults, particularly those in their 20s and 30s, may not consider themselves at risk for heart disease, but research has shown that high-normal blood pressure in this age group can lead to a much higher risk of heart failure later in life. High-normal blood pressure is considered to be related to the gradual damage to the heart and blood vessels over time. High blood pressure can lead to the thickening and stiffening of the heart, which can make it harder for the heart to pump blood effectively. It can also damage the blood vessels, making them more prone to blockages and ruptures.

Treating high-normal blood pressureTreatment of high-normal blood pressure is often focused on lifestyle changes, such as maintaining a healthy diet and regular exercise, which can help to lower blood pressure. Maintaining a healthy weight, reducing salt intake and increasing potassium intake, and limiting alcohol consumption can also help to lower blood pressure. Medications may also be prescribed by a doctor if lifestyle changes alone are not sufficient to lower blood pressure. Some common medications used to lower blood pressure include diuretics, ACE inhibitors, beta blockers, and calcium channel blockers.

Preventing high-normal blood pressure

Lifestyle changes, such as maintaining a healthy diet and regular exercise, can be effective in managing blood pressure. Maintaining a healthy weight, reducing salt intake and increasing potassium intake, and limiting alcohol consumption can also help to lower blood pressure. It's also important to note that regular check-ups with the doctor can help to monitor blood pressure, and any signs of hypertension. Early detection and treatment can prevent further health complications and can lead to a better quality of life.

In conclusion, high-normal blood pressure in young adults can spell risk for heart failure later in life. Young adults should be aware of the risks and take steps to lower their blood pressure to prevent heart failure later in life. By making healthy lifestyle choices and monitoring blood pressure regularly, individuals can reduce their risk of developing high-normal blood pressure and prevent further health complications.

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High-Normal Blood Pressure in Young Adults - An Impending Risk ... - Cityairnews


Mar 12

On this World Kidney Day, 8 of the best Nephrologists & Urologists … – Ahmedabad Mirror

New Delhi (India), March 10: Dr. Abhishek K. Shirkande,DNB Nephrology MD Medicine, Gold Medalist, Consultant Nephrologist & Kidney Transplant Physician, S.L. Raheja-Fortis Hospital, K.J. Somaiya Hospital, Holy Family Hospital, Mumbai

As we celebrate World Kidney Day 2023, I'd like to take a moment to applaud, highlight, and support all efforts around the world to raise awareness and emphasise the importance of kidney diseases. Although we live in a world divided into 195 countries, kidney diseases have no citizenship, and no borders, and are a growing public health challenge worldwide.

Chronic kidney disease (CKD) is regarded as a silent killer.

Did you know that a person can lose 90% of their kidney function without showing any symptoms?

Fatigue, loss of concentration, decreased appetite, swollen feet, breathlessness with exertion, and foamy or red urine are all symptoms of kidney disease.

Stay fit, being active, and eating a healthy diet are all preventive measures for kidney disease. Check and control your blood sugar and blood pressure; drink plenty of fluids; avoid over-the-counter medications and excessive painkiller use; and have your kidney function checked on a regular basis.

Dr. Nitin Sonavane, Senior Consultant Nephrologist and Kidney transplant physician, Sunshine Hospital, Borivali East - Wockhardt Hospital, Mira Road Gokuldham Medical Centre, Goregaon S L Raheja Hospital, Fortis Associate, Mahim, Mumbai

Kidneys perform multiple functions.

Filters the blood and removes the toxins from our body, excreting them in urine. Maintains sodium, potassium, phosphorus, and calcium levels in the blood to promote normal functions of other organ systems. Kidneys maintain and control blood pressure. Kidneys produce the hormone erythropoietin required to make red blood cells, while the bone marrow makes them. Kidneys make active Vitamin D3, required for calcium, phosphorus, and bone metabolism.The two most common illnesses affecting the kidneys are uncontrolled diabetes and hypertension. Optimal blood sugar and hypertension control would significantly reduce the burden of kidney diseases in the community.

Dr. Hasit Patel,Nephrologist and Transplant Physician, DNB Nephrology (Apollo Chennai),At present attached with HCG hospital, Ahmedabad

India is considered a new hub for chronic kidney disease. Poorly controlled diabetes, hypertension, obesity, and excessive use of pesticides are the main reasons for kidney failure in India.

Eat healthy foods, including fruits and vegetables. Monitor and control blood pressure and sugar levels. Restrain from smoking and alcohol and avoid self-medication. Even the rise of creatinine (a kidney function test) to a level of 1.4 is an early sign of kidney dysfunction, so don't ignore it.

Dr. Bhanu Mishra, MBBS MD DrNB ISN ANIO CNC (USA) Nephrologist And Transplant Physician, BLK Max Superspeciality Hospital, Delhi

"World Kidney Day is a reminder that our kidneys are vital organs that play a crucial role in maintaining our overall health and well-being. It is a day to raise awareness about the importance of preventing kidney disease, promoting early detection, and managing the condition effectively. By taking care of our kidneys, we can reduce the risk of developing chronic kidney disease and other related health problems. Let us use this day to commit to healthy lifestyle choices, regular check-ups, and supporting research efforts to improve kidney health for all."

Dr. Umesh Godhani, MD DM (Nephro), Gold medalist, Consultant Nephrologist and Transplant Physician, Devasya Kidney Hospital and SAL Hospital, Ahmedabad

A kidney transplant is the best treatment for patients with kidney failure. It gives longer survival with a good quality of life. However, the number of patients receiving transplants is less than 1% of all kidney failure patients. One of the factors for fewer numbers transplants is not the availability of blood group-matched donor in the family.

Now renal transplantation can be done without blood group matching by way of

1. Swap kidney transplant

2. ABO-incompatible kidney transplant

Dr. Umesh Godhani, senior nephrologist and transplant physician of Ahmedabad, and his team recently performed a successfulSWAP kidney transplantat SAL hospital for the first time in the private sector of Ahmedabad in the last 810 years. So an A group donor from Pair 1 donated to an A group recipient from Pair 2, and a B group donor from Pair 2 donated to a B group recipient from Pair 1. The challenges were to match both pairs in donor age, donor GFR, and renal anatomy.

Dr. Aakash Shingada,MBBS, DNB (Med), DNB (Nephro), MRCP (London), FASN (USA), SCE Nephro (UK),Nephrologist and Transplant PhysicianDirector - Kidney Associates Pvt. Ltd., attached to Namaha Healthcare, Jaslok hospital, Nanavati Max Hospital, Mumbai

With modernization and the adoption of western habits, lifestyle diseases are on an exponential rise and India has become the diabetes capital of the world. Diabetes, hypertension, and obesity ultimately lead to organ damage and increase the incidence of kidney diseases.

COVID caught us unawares and taught us the importance of health, and on this World Kidney Day, we focus on being prepared for the unexpected. A lot of work is being done in the field of Nephrology and the last few years have seen a lot of options coming forward for preventing the worsening of kidney function, especially because of diabetes. But the key is to pick these kidney illnesses early in life so that treatment options can be utilised to prevent irreparable damage. I recommend all those who are at high risk of kidney diseases (Elderly, Diabetics, patients with high BP, stone disease, those who had high BP during pregnancy, those with a family history of kidney diseases) to get routine screening done for kidney diseases and pick the illness early, thereby preparing ourselves from unexpected diagnosis at advanced stages.

I recommend everyone eat a healthy balanced diet, avoid unnecessary supplements, over-the-counter pain meds and regular exercise to prevent damage to our internal organs and not just to live longer, but to live better meaningful lives.

Dr Sundar Sankaran,MD DNB FRCP FISOT, Nephrologist & Program Director Aster Institute of Renal Transplantation Whitefield, Bangalore

The World Kidney Day 2023 theme is

"Kidney Health for All: Preparing for the Unexpected and Supporting the Vulnerable!".Kidneys are amazing organs, and by following a proper diet and making lifestyle modifications, we can keep our kidneys healthy. Less salt, less sugar, less stress, and no smoking can keep our kidneys healthy.On this day, we should take a pledge to be an organ donor and save lives.

Dr. Waheedu Zzaman, MBBS, MS (Gen Surgery),MCh (Urology), DNB (Urology), MNAMS.DIP LAP Urology (Strasbourg, France), Robotic Urology Training, Roswell Park Institute, Buffalo (NY, USA) - Director Urology and Renal transplant, Max Super Speciality Hospital, Shalimar Bagh, NEW DELHI

As we commemorate World Kidney Day in 2023, I want to take a moment to recognise, support, and applaud all initiatives to increase awareness of kidney diseases around the globe. Although there are 195 countries in the world, kidney diseases have no citizenship, and no boundaries, and are undoubtedly a growing public health concern on a global scale. Fatigue, a lack of focus, a decrease in appetite, swollen feet, breathlessness with exercise, and foamy or red urine are symptoms of kidney disease.

Keep active, eat a healthy diet (low salt, low sugar), check your blood pressure and sugar levels, drink enough fluids, avoid over-the-counter medications and excessive painkiller use, and have your kidney function checked regularlythese are all preventive measures to lower your risk of kidney disease.

Chronic kidney disease, or CKD, is known as a silent killer. You might not be aware that a person can lose 88%of their kidney function prior to showing any signs.

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On this World Kidney Day, 8 of the best Nephrologists & Urologists ... - Ahmedabad Mirror


Mar 12

Are your hormones wreaking havoc on your gut health? – Stylist Magazine

Hormonal balance and gut health are two buzz phrases that have certainly been hitting the headlines in recent years. It seems that every other day, another wellness influencer or brand is promoting another way to better balance hormones or improve the state of out gut microbiome.

Interestingly, however, the connection between the gut and hormones hasnt been as loudly shouted about despite an emerging body of research showing that the two areas of health are inextricably linked.

So, whats the connection and what does it mean for those of us trying to work towards better gut or hormonal health?

Our hormones are clever chemical messengers that have an important role to play in lots of our bodily functions, including digestion.Its the role of specific hormones to tell us when were hungry (ghrelin) and when were full (leptin), but even those not obviously associated with digestion have a key relationship with our gut.

Some vital hormones are actually produced by the bacteria present in our gut, explains registered nutritionist Rhiannon Lambert,author of The Science of Nutrition.

For example, did you know that 95% of serotonin (AKA our happy hormone) is produced there? Lambert says. Serotonin is also involved in the conversion of melatonin (our sleep hormone) and helps regulate our circadian rhythms. There is evidence that suggests our gut microbiome is involved in the regulation of oestrogen too, one of the main female sex hormones.

And lets not forget that the gut also has a key role to play in absorbing nutrients from our food and supporting the elimination of toxins. If your natural detox system goes off-piste, that can cause hormonal imbalances. On top of this, our GI tract also houses around 70-80% of our immune system and if this becomes disrupted, it can cause issues with our hormone levels.

If youre thinking this all sounds incredibly interconnected, thats because it is. Put simply, it means that if your gut isnt working as effectively as it should, hormone production can be impacted which has a knock-on effect on your mental and physical health.

Of course, it works the other way, too. High or low levels of certain hormones can impact the way our digestion works, leading to problems such as bloating, constipation, nausea or diarrhoea. You may have felt sick when stressed, or know only too well how fluctuations in our sex hormones can affect your bowel habits (yes, period poo really is a thing!).

Weve talked briefly about how serotonin and melatonin are impacted by gut health, but many more key hormones are also connected to the gut

Research shows there are microbes working in our gut that can tweak the amount of oestrogen in our bodies. This part of our microbiome is called the estrobolome and its a collection of bacteria in the gut capable of breaking down and changing the levels of circulating oestrogen in the body, explains DrFedericaAmati, a medical scientist and nutritionist at Imperial College London and personalised nutrition company ZOE.

On the other side, oestrogen and progesterone levels can also have a direct impact on our digestive system in terms of gut motility (how quickly food moves through our digestive system) and the composition of our microbiome.

High progesterone is associated with a slowing of gut movement, says Dr Amati. This is very useful in pregnancy when progesterone levels are high, as it gives our body more time to extract as many nutrients as possible from our food in order to help progress the pregnancy. But this can also cause constipation, so drinking plenty of water and eating fibre is very important during pregnancy and towards the second half of our menstrual cycle, when this hormone is also heightened.

High levels of cortisol and adrenalin have two main effects on our gut, explains Dr Amati. First, they drive us to prefer easy-to-absorb carbohydrates that require little effort to absorb for maximum energy. Second, they divert blood flow from our gut to our limbs, prioritising our ability to run away from the threat over the process of digesting a big meal.

That might sound pointless in an age of laptops and concrete, but it was an absolutely vital mechanism back in the day when we used to face imminent threats. Its less useful if we are in a state of chronic high stress due to perceived dangers such as being late for a deadline, Dr Amati says.

In fact, increased stress hormones have been linked to many digestive problems.Research suggests it can change the make-up of your microbiome, resulting in an increase in harmful bacteria. It can also affect gut motility and permeability (the ability of the gut lining to act as a barrier and stop bacteria and toxins from leaking into the bloodstream).

Its no wonder, then, that high levels of stress hormones have been linked to conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease.

Interestingly, however, a healthy gut can have a beneficial impact on these hormones. If our gut is functioning properly, it can help to regulate our stress response and reduce anxiety.

Recent research has shown there are key differences between male and female gut microbiomes, and its even been given a name the microgenderdome. For example, studies have shown that irritable bowel syndrome and autoimmune diseases are much more common in women, and data indicates that our guts can show sex-specific responses to exactly the same diet. The main reason for that? The different hormone levels between the two sexes.

If youre in the habit of tracking your gut health, you might have noticed that your period coincides with symptoms like loose stools, tummy pain and bloating, says Laura Tilt, a registered dietitian and ambassador for probiotic supplement brand Symprove.

In one study of healthy women, 73% reported at least one gut symptom just before or during their period, most often abdominal pain and diarrhoea. The trigger for these symptoms is believed to be the drop in ovarian hormones which takes place just before your period. At the same time, theres a spike in prostaglandin hormones which cause the uterus to contract, and which causes the gut to contract too.

Hormonal shifts in our body caused by other events such as pregnancy can also impact our digestive system.

Gut health can be massively impacted by the changes in our body that happen during pregnancy, says Lambert. For example, as your baby grows, digestion slows down and the chance of constipation increases as a result.

During pregnancy there are also huge fluctuations in hormone levels. These changes, especially the increase in human chorionic gonadotropin (HCG) in early pregnancy, can cause nausea. This may lead to lack of appetite and therefore less diversity in the diet, which we know is associated with poorer gut health.

Theres the menopause to think about, too. Changes to levels of oestrogen and progesterone in the body at this time may cause slower digestion, which could lead to bloating or constipation.

Its important to remember that our hormones and gut are part of a much bigger system and are impacted by many things in our body (as well as each other). However, science shows they are key parts of the puzzle so how can we help our guts and hormones work in synergy andstay balanced?

While there is still much research to be done looking at the direct link between our guts and hormones, making sure we have a balanced and varied diet is important for many aspects of our health, including our gut and hormone health, says Lambert.

Its also important to make sure were getting good-quality sleep and managing our stress levels as this can have an impact on how our gut functions and our hormone levels.

Dr Amati adds that understanding and living in tune with how your body works can support your wellbeing.

Responding to our bodys hunger, tiredness and social signals and getting to know how we respond to food and hormonal changes is the first step in being able to live more intuitively, she says.

Working closely with women through major shifts in fertility, pregnancy and the menopause, I can see there is huge power in knowing how your body responds to fluctuations in our hormones and learning to harness your own existing biological power to maximise health, wellbeing and energy.

Amen to that.

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