wheat can cause diabetes

An abnormal immune response to wheat proteins may contribute to type 1 diabetes, Canadian researchers say.

Their study of 42 people with type 1 diabetes found that nearly half had immune system T-cells that overreacted to wheat. The researchers also identified genes associated with this abnormal immune response.

“The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or overreacting to the environment, and this can be particularly challenging in the gut, where there is an abundance of food and bacteria,” study author Dr. Fraser Scott, a senior scientist at the Ottawa Hospital Research Institute and professor of medicine at the University of Ottawa, said in a hospital news release.

“Our research suggests that people with certain genes may be more likely to develop an overreaction to wheat and possibly other foods in the gut, and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes,” he explained.

The study appears in the August issue of Diabetes.

“These observations add to the accumulating evidence that the gut is an active player in the diabetes disease process,” Dr. Mikael Knip of Finland wrote in an accompanying editorial.

Michael Jackson’s Death: Cardiac Arrest Is Deadlier Than Heart Attack

Iconic pop star Michael Jackson suffered a cardiac arrest and died on Thursday at the age of 50. Details of his death are still emerging, but friends and relatives say they have been concerned about Jackson’s use of prescription painkillers.

Brian Oxman, the Jackson family spokesman and attorney, told CNN that people surrounding Jackson were “enabling” him in his use of medications. Jackson had suffered a number of injuries, including a broken vertebra and a broken leg sustained in a fall on stage, Oxman said.
“If you think the case of Anna Nicole Smith was an abuse, it is nothing in comparison to what we have seen taking place in Michael Jackson’s life,” Oxman told CNN.

“I do not know the extent of the medications that he was taking, but the reports that we have been receiving in the family is that it was extensive,” he said. “This is something which I feared and it is something that I warned about.”

Douglas Zipes, MD, a distinguished professor at the Indiana University Medical Center and past president of the American College of Cardiology, says that drug abuse can contribute to a cardiac arrest.

“Certainly drugs, in someone like Michael Jackson, have to considered,” he says. “We know that drugs like cocaine and amphetamines can trigger a cardiac arrest by themselves, and the summation of multiple drugs could ultimately result in a cardiac arrest.”

Jackson may have been underweight as well. He reportedly weighed 120 pounds in 2003. At 5’10” or 5’11” (reports vary), he would have had a body mass index of 16 or 17, and anything below 18.5 is considered underweight.

In recent months, friends and relatives had described Jackson as even more frail. Filmmaker Bryan Michael Stoller, who visited Jackson in April, told People, “I hugged him and it was like hugging bones.” And a fan who recently met Michael Jackson at a tour rehearsal reportedly wrote in an email this week, “He is a skeleton.”

Extreme weight loss can cause electrolyte abnormalities, according to Dr. Zipes. “Two very important electrolytes, potassium and magnesium, are critically important in maintaining normal electrical activity of the heart,” he says. “[If] one or both electrolytes were very low, they can trigger cardiac arrest.”

Another factor that may have played a role is stress, says Dr. Zipes, who has not treated Jackson.

“He’s been under incredible emotional stress—the legal issues with the accusations of child molestation, the financial debt that he’s incurred, the prospect of a world tour after not performing for years; it would seem to be daunting,” he says. “All of these things would seem to be extremely stressful and stress certainly can play a role in the development of coronary disease and sudden death.”

In general, a cardiac arrest is much more dangerous than a heart attack.
During cardiac arrest, the heart actually stops beating and quivers with uncoordinated contractions. Unless a defibrillator is used to shock the heart back into a normal rhythm, death is inevitable. Someone experiencing a cardiac arrest generally collapses, loses consciousness, and stops breathing.

“[The heart] stops contracting effectively but it’s actually beating—if you take the word beating as an electrical event. The heart rate of the bottom chambers, the ventricles, is 400 to 600 times a minute—that’s ventricular fibrillation,” says Dr. Zipes. (The normal adult heart rate is 70 beats per minute.) “When it increases so dramatically it actually looks like a bag of squiggly worms—there’s no effective contraction.”

Despite dramatic TV portrayals of patients being revived from cardiac arrest, the chances of survival in real life are slim. If a bystander performs cardiopulmonary resuscitation until the heart can be shocked back into a normal rhythm, the chances of survival are much better.
About 95% of people who experience a cardiac arrest die before reaching the hospital. Overall, about 1,000 cardiac arrests occur each day in the United States; that’s roughly 350,000 per year.

A heart attack, on the other hand, is a reduction in blood flow to the heart, which can cause a crushing chest pain known as angina, along with sweating, nausea, a sense of impending doom, and tissue death in part of the heart muscle. In contrast to cardiac arrest, heart attack patients may not lose consciousness. If they get rapid medical treatment, the prognosis is generally better. Heart attacks are about twice as common as cardiac arrests, but a heart attack can progress to a cardiac arrest if not treated.

Heart attacks are more common in those with heart disease, high blood pressure, obesity, and diabetes. (Read more about heart attacks.) Cardiac arrest, on the other hand, can be caused by a wide variety of factors, including heart disease, drowning, electrocution, choking, and traumatic injury.

The American Heart Association recommends that people know the warning signs of cardiac arrest (loss of consciousness, lack of pulse), call 911, and perform CPR until help arrives. Bystanders can even administer chest compressions alone and skip mouth-to-mouth breathing while waiting for emergency help or defibrillation, according to recent guidelines from the American Heart Association.

“I think it’s tragic whenever anybody has a sudden cardiac death, particularly somebody whom you would consider to be relatively young. I don’t think society considers that people in their 50s can die suddenly—I think that adds to the tragedy of the situation,” says Stephen Nicholls, MD, a cardiologist and assistant professor of molecular medicine at the Cleveland Clinic, in Ohio.

“The other thing it highlights is the importance of CPR and the importance of using defibrillators,” he says. There’s been a push in recent years to make sure automated defibrillators are in airports, shopping malls, and sports stadiums.

“The most prompt action to try to restore heart rhythm in that situation gives you the best chance of survival,” Dr. Nicholls says.

The 5 Kinds of Headaches

It's critical to identify which type of headache you suffer from—tension, cluster, sinus, rebound, or migraine—so that the correct treatment can be prescribed. In one 2004 study, 80% of patients with a recent history of self-described or doctor-diagnosed sinus headache—but none of the signs of sinus infection—actually met the criteria for migraine. And two-thirds of those patients expressed dissatisfaction with the medications they were using to treat their headaches. Here's a cheat sheet to help you put a name to your pain.

Tension headaches

Tension headaches, the most common type, feel like a constant ache or pressure around the head, especially at the temples or back of the head and neck. Not as severe as migraines, they are not usually accompanied by nausea and vomiting, and they rarely stop someone from continuing their regular activities.

Over-the-counter treatments, such as aspirin, ibuprofen, or acetaminophen (Tylenol), are usually sufficient to treat tension headaches, which experts believe may be caused by contraction of neck and scalp muscles (including in response to stress), and possibly changes in brain chemicals.

Cluster headaches

Cluster headaches, which affect men more often than women, are recurring headaches that occur in groups or cycles. The headaches appear suddenly and are characterized by severe, debilitating pain on one side of the head often accompanied by a watery eye and nasal congestion or a runny nose on the same side of the face. During an attack, sufferers are often restless and unable to get comfortable and not likely to lay down the way someone with a migraine usually does.

The cause of cluster headaches is unknown, but they may have some genetic component. There is no cure, but medications can reduce the frequency and duration of attacks.

Sinus headaches

When a sinus becomes inflamed, usually through an infection, it can cause pain. It usually comes with a fever, and can—if necessary—be diagnosed by MRI or CT scan (which can both detect changes in fluid levels), or by the presence of pus viewed through a fiber-optic scope. Headaches due to sinus infection can be treated with antibiotics, as well as antihistamines or decongestants.

Rebound headaches
Overuse of painkillers for headaches can, ironically, lead to rebound headaches. Culprits include over-the-counter medications like aspirin, acetaminophen (Tylenol), or ibuprofen (Motrin, Advil), as well as prescription drugs.

"Most of the patients we see in a headache center with daily headache have medication-overuse, or rebound, headaches," says Stewart Tepper, MD, director of research at the Center for Headache and Pain at the Cleveland Clinic Neurological Institute.

"They are on a merry-go-round and they can't get off," says Dr. Tepper. "They keep taking more medicine, they keep having more headaches, and so the patient becomes more and more desperate. That's when they end up coming to headache specialists to kind of reset the whole system.

"One theory is that too much medication can cause the brain to shift into an excited state, triggering more headaches. Another is that the headaches are a symptom of withdrawal as the level of medicine drops in the bloodstream.

Migraine headaches

Migraine headaches come from a neurological disorder that can run in families and are defined by certain criteria:
- At least five previous episodes of headaches
- Lasting between four hours and 72 hours
- Having at least two out of four of these features: one-sided pain, throbbing pain, moderate-to-severe pain, and pain that interferes with, is worsened by, or prohibits routine activity
- Having at least one associated feature: nausea and/or vomiting, or, if those are not present, then sensitivity to light and sound

An oncoming migraine attack may, for some, be foreshadowed by an aura, which can include visual distortions (such as wavy lines or blind spots) or numbness of a hand. It's estimated, though, that only 15% to 20% of migraineurs experience this.

new pain cure for woman

You’ve got achy shoulders from carrying the kids, the groceries, or your incredibly heavy handbag. You look for the right pill to pop, but what should you take? Aspirin? Ibuprofen? Or, you’re about to get your period. You know you’ll get killer cramps or that nasty headache any minute now, but nothing you take seems to help once the pain hits.

You’re not alone: Many women have a tough time finding the right kind of relief for their pain—and for good reason: Until recently, experts hadn’t actually studied women’s pain specifically, and most research wasn’t conducted with a woman’s hormones and physique in mind. All that’s changing, though. Docs now know that to banish our aches, they must develop treatments formulated for women’s bodies. What’s more, researchers are also looking for—and finding—ways to head pain off at the pass, so those of us with chronic troubles like migraine, fibromyalgia, or backache don’t have to be hobbled by pain on a daily basis. Here, how the new research will help you live an (almost) pain-free life.

The old way of dealing with pain was to ‘wait until it hurts enough to treat it,’” says Carol A. Foster, MD, director of Valley Neurological Headache and Research Center in Phoenix and author of Migraine: Your Questions Answered. “But in the last few years, there has been a complete turnaround. Now we know that prevention and early intervention are absolutely critical.”

The new thinking has made all the difference for Carolyn Robbins of Petaluma, California, who suffers from chronic back and neck pain, the result of a spinal-disk injury combined with nerve damage from Guillain-Barre syndrome. “If you’ve ever had an exposed nerve in your tooth, you know what it feels like,” says Robbins, who describes her pain as “electrical shocks” in her upper and lower back.

The 45-year-old mother of two doesn’t wait until pain hits her full force before treating it. She now relies on a daily prevention regimen, starting with a hot shower and a double dose of ibuprofen. She swims two to three times a week for strength and mobility, and gets weekly massage and chiropractic treatments. And during those times when things get really bad, she pulls out the stronger painkillers prescribed by her doctor. “I’ve found that it’s not a good idea to try to power through the pain, because other things start to go wrong,” Robbins says. “Pain depletes your system as much as exposure to germs.”

Just five years ago, a “kitchen sink” approach like Robbins’ might have been pooh-poohed by pain-management types, who would have been quick to prescribe hard-core, addictive drugs like oxycontin for such a serious condition. But now the focus has switched. “It used to be, people treated the pain and didn’t always treat the underlying disease,” Foster says.

The problem with such an approach, though, is that it sets up a vicious cycle of dependence. “Giving narcotic pain pills to headache patients is like giving cookies to diabetics,” she adds.
So how do you break the habit of heading straight for the medicine cabinet? No matter what your source of pain, the first step is to get an accurate diagnosis and then set up an early intervention strategy with your doctor, says Neil Kirschen, MD, president of the American Association of Orthopedic Medicine and chief of pain management at South Nassau Community Hospital in New York. “The whole goal of pain management today is to keep pain from becoming chronic,” he says.

The reason? Pain actually causes the brain to fire off a stress response that, over time, makes nerves more and more sensitive—and thus better able to telegraph intense pain to you. In other words, pain actually begets pain.

Nan Weiner, executive editor at San Francisco magazine, is a case in point. When she broke her ankle eight years ago, it never completely healed, and the pain became chronic. What should have been a relatively simple injury became an odyssey that had Weiner visiting specialists all over San Francisco. She finally found a podiatrist who “took a detective-like approach to the problem,” Weiner says, by exploring and treating each joint and tendon in a methodical search for the pain’s source. Thanks to this care, which includes regular pain-preventing cortisone shots, the 55-year-old mother of one has been able to resume her hobby of salsa dancing.



We know that men don’t suffer menstrual pain, but that’s not the only fun they’re missing. “Research is uncovering very dramatic differences in how the genders experience pain,” says Mark Allen Young, a professor at New York College of Podiatric Medicine and author of Women and Pain: Why It Hurts and What You Can Do.

It all starts with hormones. There is no getting around how profoundly hormones like estrogen and testosterone affect the central nervous system, which is responsible for perceiving and transmitting the sensation of pain.

According to experts, this is one reason why conditions such as osteoarthritis, headaches, and irritable bowel syndrome strike women at much higher rates than men.

Our physical differences really matter, too. “We’ve only recently begun to grasp that women’s body architecture is completely different from men’s,” Young says. Because women walk differently, for instance, they put pressure on joints, muscles, and bones in very different ways than men do. “Starting with the knees and hips and working up to the shoulders, spine, and neck, how a person walks can have a huge impact on how pain develops later in life,” Young says. Just last year, one medical-implant maker finally recognized this fact by creating a knee implant just for women.

Women are also more prone to conditions involving the immune system, says Deborah Metzger, MD, an OB-GYN and specialist in integrative pain management in Los Altos, California. Scientists have long known that women have stronger immune systems than men, she says. That strength can backfire, though, leading women to suffer from far more autoimmune disorders—in which the immune system attacks itself—and the host of mysterious diseases thought to sometimes result from an overreactive immune system, such as celiac disease, irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome (CFS), and many types of pelvic pain.

“Women tend to have hyperalert immune systems, which is good,” Metzger says. “But once the immune system gets stirred up, it can turn into a feeding frenzy.” The fired-up immune activity produces inflammatory chemicals that fuel all types of muscle and joint pain; it can also activate nerves in vulnerable spots like the lower back (sciatica), the head (migraines), and the pelvis (endometriosis and pelvic pain).

gastroesophageal reflux disease - Heartburn Triggers

Why am I in pain?

Heartburn is as American as apple pie—more than 60 million people experience it at least once a month. For some people—those with gastroesophageal reflux disease, or GERD—heartburn can be a constant companion.

Some heartburn triggers are obvious: chili dogs, chocolate cake, Thanksgiving. But heartburn doesn’t stop and start with food alone. If you have constant heartburn, it's time to track down the real culprit.

Smoking
As if anyone needed another reason to quit: Smoking makes GERD worse.

Smoking can weaken the valve between the stomach and esophagus (so stomach acid flows back into the esophagus); cause fat-digesting bile salts to migrate from the small intestine to the stomach; and cut down on saliva, which normally flushes stomach acid out of the esophagus and contains a natural acid-fighter, bicarbonate.

How do you spell heartburn relief? Q-U-I-T.

Pills
Prone to frequent headaches and heartburn? Think twice about reaching for the ibuprofen. When used regularly, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can trigger heartburn.

Some prescription drugs can too, including antibiotics, calcium channel blockers (for high blood pressure), bronchodilators such as albuterol (for asthma and COPD), osteoporosis drugs, and some sedatives.

Consult your doctor if you think your Rx is causing heartburn—don't just decide to stop taking a drug on your own.

Fish oil supplements

Fish oil contains omega-3 fatty acids and has been hailed as a natural way to manage heart disease, depression, and countless other health conditions. However, it can also cause heartburn.

The oil—not the fish—appears to be responsible for gastrointestinal side effects. Fish itself is low in fat and high in protein and is an excellent food for heartburn sufferers when used in a healthy, heartburn-soothing recipe.

Stress

Stress does seem to trigger heartburn, but the relationship is trickier than you might think. Stress does not cause an off-the-charts surge in stomach acid production.

However, a study in the Journal of Psychosomatic Research suggests that a heartburn patient's perception of his symptoms—and not the actual levels of stomach acid—are associated with stress.

In other words, stressed people may be more aware of heartburn symptoms or the neurological effects of stress might ratchet up pain receptors in the esopagus.

Peppermint

Peppermint, like fish oil, is a double-edged sword when it comes to the stomach. Peppermint tea, peppermint-oil capsules, and even peppermint candies are often used to settle upset stomachs—but these remedies can backfire on people with GERD.

The soothing and numbing effect of menthol tends to relax the valve that separates the stomach and esophagus (known as the lower esophageal sphincter), which can cause stomach acids to drift up the esophagus more easily, aggravating heartburn.

Being overweight

The more you weigh, the more likely you are to have heartburn. A 2003 study in the Journal of the American Medical Association found that the risk of acid reflux symptoms increases along with body-mass index (BMI).

The association seems to be stronger in women than men (especially premenopausal women).Explanations vary. Poor diet, excess body fat in the abdomen, and chemicals released by body fat have all been cited as possible culprits.

Your genes

Wondering what’s causing your heartburn? Take a look across the dinner table; your parents, not your plate, may be partly to blame.

In recent years, twin studies have suggested that 30% to 45% of your risk for GERD is dependent on genetic factors. (The rest is up to you: what you eat, whether you smoke, whether you exercise.)

Experts aren’t entirely sure what explains the hereditary nature of GERD. It could be due to inherited physical traits, such as abnormalities in stomach function or a hypersensitivity to stomach acids.

Tea Benefits

Steamy or iced, chai or green, bottled or not:
Tea is hot, and ge tting hotter. Tea drinkers can be as passionate and picky about their drink of choice as the most snobby oenophile is about her wine. There are more and more choices. And annual tea sales in the United States have jumped from nearly $2 billion in 1990 to $5.5 billion last year, says Joseph Simrany, president of Tea Association of the USA Inc.

What you’ll see in restaurants
Chefs across the country are weaving tea into signature dishes and specialty drinks. Munch on tea-smoked chicken at New York City’s Yumcha (“drink tea” in Cantonese), or sip green-tea martinis infused with pear at Jack Falstaff in San Francisco. And the first green-tea liqueur—Zen—hit the U.S. market this summer and is being served up in hot spots like New York’s Sushi Samba.

Even rock stars are getting in on it
After electronic-music king Moby opened his own New York teahouse, Teany, he decided to get even more creative. “He was a mad professor behind the counter,” says partner Kelly Tisdale, experimenting with different flavors and launching the Teany line of chilled bottled teas, like the new white tea with pomegranate, carried in New York and the U.K.

Tea as wine
At the chic tea boutique Le Palais des Thés in Beverly Hills, sections of the store are devoted to teas from different regions, similar to the way most wine shops are organized. Increasing numbers of tea snobs are seeking out teas sourced from a single place, like Darjeeling Puttabong, the first tea estate in the Himalaya and the mother of the Darjeeling tea industry.

The coffee comparison
While many people still want their Starbucks coffee fix, a growing crowd is looking for a leafier sip. “The difference between people who drink coffee and those who drink tea is similar to the difference between beer and wine drinkers,” says Le Palais des Thés’ David Barenholtz. Tea drinkers are looking for a relaxing experience, while coffee drinkers tend to slug coffee for a jolt of energy.

The payoff
Beyond its pure enjoyment, tea is packed with health perks. The heart-health and cancer-preventive benefits of black and green teas are well-publicized. And more research is under way; some studies suggest tea may also increase bone-mineral density, boost immunity, fight cavities, combat diabetes, and reduce body fat.

What makes it so healthy?
Scientists point to a group of natural antioxidants called catechins present in all teas, but not in coffee. Certain antioxidants can protect against exposure to ultraviolet light and its consequences, such as sun damage and skin cancer. And while coffee’s caffeine is known to sharpen concentration, tea has caffeine too, sometimes as much as or more than coffee.

Reiki Healing

The notion that a therapist can pass her hands over your clothed, supine body for an hour or so and successfully coax every iota of stress out of you has a too-good-to-be-true ring about it. But that’s been my experience with Reiki, a Japanese technique said to promote healing.

Nothing sounds odder: According to reiki.org, the official website for the practice, Reiki heals by “flowing through the affected parts of the energy field and charging them with positive energy. It raises the vibratory level of the energy field in and around the physical body where the negative thoughts and feelings are attached. This causes the negative energy to break apart and fall away. In so doing, Reiki clears, straightens, and heals the energy pathways, thus allowing the life force to flow in a healthy and natural way.”

That sounds totally out there in weirdville—even to me. Making it even weirder is the fact that anyone can learn Reiki basics by taking a weekend’s worth of classes; advanced training can be accomplished in a weekend too.

A less woo-woo explanation: Reiki practitioners believe they can transmit healing energy to you through their hands, an ability they learn during Reiki training.

Reiki is on the menu at top hospitalsReiki isn’t considered weird at all by at least 60 hospitals across the country who offer treatments to their patients, often free of charge. Among them are highly respected mainstream establishments, including Memorial Sloan-Kettering Cancer Center in New York City, Children’s Hospital of Boston, Cleveland Clinic Center for Integrative Medicine, Dana Farber Cancer Institute in Boston, and Yale-New Haven Hospital.

Two federally funded clinical trials are currently underway at the Cleveland Clinic. One will look at Reiki’s effects on the physical consequences of acute stress; another will determine whether treatments can lessen anxiety, affect cancer progression, or affect post-surgical pain and urinary symptoms for men with prostate cancer. Both studies will be completed in August.

In a study published last year, however, researchers at the University of Washington in Seattle concluded that Reiki didn’t have any effect on fibromyalgia pain

.
My Reiki experience: deep relaxationI first tried Reiki back in the awful fall of 2001. I was traumatized and fearful after Sept. 11, and decided to see if what I’d heard about Reiki was true—that it could soothe even very disturbed emotional states.

I was ushered into the basement rec room of the Reiki practitioner’s utterly ordinary suburban home—I remember that she was a golfing enthusiast, which I thought was an odd fit for an esoteric healer. There was a standard-issue massage table onto which I climbed, fully clothed except for my shoes.

As I lay there, her hands glided over my body, skimming, sometimes gently touching, sometimes just hovering over a particular spot. I felt—or at least, I think I did—a warmth emanating from her hands, and I know I felt a deep sense of relaxation. So deep, in fact, that I remember thinking I might be in a trance-like state. It was extremely pleasurable, and when the session ended, I remember feeling aglow with energy, as if I’d just recharged my body’s battery. I went back to her time after time, and after each treatment, I experienced the same wonderful feelings.

A Reiki treatment generally costs about as much as a typical day-spa massage, and a large day spa will often have a Reiki practitioner. To learn more about Reiki, visit reiki.org.

Low your stress to reverse aging

Stress can do a real number on your skin and make you look older. It decreases blood flow and nourishment to the skin, sometimes causing a sallow appearance, hair loss, or brittle nails, says dermatologist and clinical psychologist Richard Fried, MD, PhD, a fellow of the American Academy of Dermatology.

Stress also leads to the release of inflammatory chemicals that can worsen acne. The good news: Stress-management techniques (like guided imagery, deep breathing, or progressive muscle relaxation) can help your skin look younger.

Fried recommends square-box breathing: Inhale for four seconds, hold for four seconds, exhale for four seconds, then rest for four seconds; repeat four times.

Make your home pest free with natural remedies

Want to rid pests out of your house?
Are you trying to get rid of insects (or worse) without harmful chemicals? Here are a few ways to vanish those pesky problems with a some easy and natural remedies.


All-natural repellent
Who says you need harmful pesticides to get rid of bugs?
Repellex Bug-A-Tak ($13.50) relies on natural mint, clove leaf, and rosemary essential oils to deter and kill beetles, mites, whiteflies, and other insects.


Gotcha!
Unless you’re the Karate Kid, you’ll need more than chopsticks to catch pesky flies.
Try the Fred Flare Black Fly Swatter ($10), which has an extra-large square head.


Human Best Friend
The mere smell of a cat (or dog) sends mice packing.
Furry pals are great to have around—and they’re good for you, too.
So why not adopt a pet?
Go to www.aspca.org to find an animal shelter near you;
fees typically are $75 for an adult cat or dog.



Patio protection
Reclaim your yard from yellow jackets and wasps with the Oak Stump Yellow Jacket and Wasp Trap ($15.99).
Put the lure (included) and water in this glass trap, hang it in a tree, and you can barbecue without having to bat away stinging insects.

Closet Case

The amazing-smelling blend of lavender, cedar chips, and citronella in Purple Ranch Pest Away Sachets ($3 each) keeps moths at bay without the harmful chemicals found in mothballs.

Storage for your food

One way to get rid of bugs: starve them. Keep cookies, cereal, and other munchies in sealed containers, like The Conran Shop Varon Jars ($12 and up). Made of recycled glass with snug-fitting cork lids, they’re good-looking enough to go right on the counter.

Do It Yourself Repellents

Keep persistent household pests away with these natural, do-it-yourself remedies from Annie B. Bond, green-living expert and author of Better Basics for the Home.

Ants.

They hate the smell of citrus, so mix 1/4 cup citrus solvent (like Citra Solv) with 2 cups water; spray mixture in ant-traffic areas.

Roaches.

Tea tree oil, garlic, peppermint, bay leaves, and hot peppers all work against roaches. Choose one oil or herb, mix 2 teaspoons oil or fresh, crushed herbs (2 tablespoons dry, ground herbs) into 2 cups water; spray infested areas.

Fleas.

“The limonene and linalool in citrus-peel extract kill all stages of the flea’s life cycle,” Bond says. Try this dog rub (cats don’t like the smell): Cut up 4 lemons and simmer for 1 hour in 1 quart water, adding water as needed; cool, strain, and massage mixture into Fido’s coat.

Healthy Diet to help Psoriasis

Losing weight may help
Though many patients find that certain diets help clear their skin, or that certain foods aggravate it, no studies have established a definitive link between nutrition and psoriasis, says Neil Korman, MD, clinical director of the Murdough Family Center for Psoriasis in Cleveland Heights, Ohio. “There’s no ‘Psoriasis Diet,’ but people with psoriasis should try to eat a healthy diet,” he says. “We do know that people who are obese are at increased risk for psoriasis, and that losing weight may help improve your psoriasis.”

“Achieving a healthy weight and eating more healthfully in general” are the goals when working with psoriasis patients, says Brenda Walsh, RD, an outpatient clinical dietitian at the Murdough center. Psoriasis is an inflammatory disease, she says, and “we know that weight loss can decrease levels of C-reactive protein (CRP), which is produced by the body in response to inflammation.” Increasing activity levels and dropping pounds can help lower CRP levels.



What should you eat?


Emphasizing foods that contain antioxidants, such as fruits, vegetables, whole grains, and beans, which can reduce inflammation, may also help, says Deirdre Earls, RD, a dietitian in private practice in Austin, Texas.

A chronic psoriasis sufferer herself, Earls says she has had minimal outbreaks since she started following a diet based on the University of Michigan Integrative Medicine Clinic’s Healing Foods Pyramid six and a half years ago.



The diet has also helped her patients, Earls reports.Even if you can’t make all the changes, small tweaks (eating more vegetables, trading white bread and rice for whole grains, eliminating processed food) can improve your health. “Proceed at your own pace and focus on the positive choices you make,” advises Earls.



Fruits and vegetables
How much:
Two to four servings of fruits and a minimum of five servings of vegetables (or more if you want) every day.



Why:
Fruits and vegetables are loaded with antioxidants that help control inflammation naturally, says Earls.

“I recommend my patients select a variety of deeply pigmented fruits and vegetables when choosing antioxidant-rich foods,” says Walsh. “Some examples are red bell peppers, pineapple, spinach, raspberries, blueberries, and carrots. I always recommend obtaining antioxidants from food, rather than in supplement form. This allows you to obtain all the benefits available in that food, not simply what happens to be extracted and packaged into a pill.”



What's a serving:
One apple, orange, or medium banana; 3/4 cup of berries; 1/2 cup of raw or cooked vegetables.


Grains
How much:
Four to 11 daily servings of grains, preferably whole grains (whole-grain bread, cereal and pasta, oatmeal, and brown rice).

Why:
Whole grains contain a variety of inflammation-fighting antioxidants, says Earls. They are also high in fiber, which is associated with decreased inflammation levels.

What’s a serving:
One slice whole-grain bread, 1/3 cup pasta, 3/4 cup cereal, 1/3 cup rice.

Beans and lentils
How much:
One to three servings a day of beans, peas, lentils, or peanuts.

Why:
They are all great sources of protein, and also contain tons of antioxidants and have high levels of fiber.

What’s a serving:
1/2 cup cooked beans or lentils.





Soy
How much:
One to two servings a day of edamame, soy milk, soy nuts, and tofu.

Why:
A number of studies have linked decreased inflammation with eating soy, says Earls. In addition, soy is an excellent source of protein and contains isoflavones, which are thought to help reduce inflammation.

What’s a serving:
1/2 cup edamame, 1 cup soy milk, 1 ounce soy nuts, 1/2 cup tofu.


Fats
How much:
Three to nine daily servings of olive oil, peanut oil, canola oil, nuts, avocado, seeds, or nut butters.

Why:
Good fats can help the body fight inflammation. But avoid margarine and shortening that contain trans fats, which can have the reverse effect.

What’s a serving:
1 teaspoon of oil, 1/2 tablespoon nut butter, 2 walnuts.


Fish and seafood
How much:
Two to four servings per week, with an emphasis on fish with a high omega-3 fatty acid content (salmon, anchovies, mackerel, tuna, and sardines, especially wild varieties).

Why:
There is strong evidence that omega-3s help reduce inflammation, says Earls. If you’re not a fish eater, you may want to consider an omega-3 supplement. She recommends two high-quality brands: Pharmax and Nordic Naturals.

What’s a serving:
4 to 6 ounces of fish.


What should you limit?

Foods that may contribute to inflammation should be eaten in more limited quantities or eliminated. These include processed and fast food, foods that are high in saturated and trans fats, and refined starches and sugar.


“When you have an inflammatory condition, it's especially important to avoid fatty meats and fried foods, which promote inflammation,” says Michael Traub, a naturopathic physician in Kailua Kona, Hawaii. “If you’re eating them once a month, that's probably OK. But once a week is not.”


Meats
How much:
Eat up to three 2- to 3-ounce servings per week, choosing lean cuts such as white-meat chicken or turkey, flank steak, sirloin, or pork loin. Higher-fat cuts contain more saturated fat, which may contribute to inflammation.


Sugar
How much:
Try to avoid sweets as much as possible. “Sugar promotes inflammation in the body,” says Traub.


Alcohol
How much:
Limit your intake as much as possible, at least until symptoms clear. Although the exact mechanism remains unknown (inflammation is one possibility), alcohol is believed by some to trigger psoriasis outbreaks.


The gluten connection
Some researchers believe that there may be an increased frequency of celiac disease among people with psoriasis, explains Earls. People who have celiac disease cannot properly digest a protein called gluten that’s found in wheat, rye, and barley. Eating these foods can damage the lining of the small intestine, often resulting in chronic diarrhea as well as malnutrition. (Some people with celiac disease have no symptoms, though.)


If you believe that gluten intolerance may be an issue for you, ask your doctor if you should be screened for celiac disease. If you are gluten intolerant, your psoriasis may improve if you follow a super-strict gluten-free diet (avoiding anything containing wheat, rye, or barley). “It does take real commitment,” says Earls. “But what was disabling psoriasis [for me] has been in remission for six years without any negative side effects."

The Myths about Cholesterol

Even if you think you know everything there is to know about cholesterol, there may be a few more surprises in store. Check out these common myths about high cholesterol; find out who’s most likely to have it, what types of food can cause it, and why—sometimes—cholesterol isn’t a bad word.

Myth 1: Americans have the highest cholesterol in the world

One of the world's enduring stereotypes is the fat American with cholesterol-clogged arteries who is a Big Mac or two away from a heart attack. As a nation, we could certainly use some slimming down, but when it comes to cholesterol levels we are solidly middle-of-the-road.

According to 2005 World Health Organization statistics, American men rank 83rd in the world in average total cholesterol, and American women rank 81st; in both cases, the average number is 197 mg/dL, just below the Borderline-High Risk category. That is very respectable compared to the top-ranked countries: In Colombia the average cholesterol among men is a dangerous 244, while the women in Israel, Libya, Norway, and Uruguay are locked in a four-way tie at 232.

Myth 2: Eggs are evil

It's true that eggs have a lot of dietary cholesterol—upwards of 200 mg, which is more than two-thirds of the American Heart Association's recommended limit of 300 mg a day. But dietary cholesterol isn't nearly as dangerous as was once thought. Only some of the cholesterol in food ends up as cholesterol in your bloodstream, and if your dietary cholesterol intake rises, your body compensates by producing less cholesterol of its own.While you don't want to overdo it, eating an egg or two a few times a week isn't dangerous. In fact, eggs are an excellent source of protein and contain unsaturated fat, a so-called good fat.

Most people think high cholesterol is a problem that's strictly for the middle-aged. But guess what? Research has shown that atherosclerosis—the narrowing of the arteries that leads to heart attacks—can start as early as age eight. In July 2008, the American Academy of Pediatrics released guidelines on kids and cholesterol that recommended that children who are overweight, have hypertension, or have a family history of heart disease have their cholesterol tested as young as two years of age.

Children with high cholesterol should be on a diet that restricts saturated fat to 7% of calories and no more than 200 mg per day of dietary cholesterol, according to the guidelines. Fiber supplements and more exercise are also recommended.

While the guidelines prompted a bit of an outcry from parents worried that doctors would be pushing cholesterol-lowering drugs for kids, a new study suggests that less than 1% of adolescents aged 12 to 17 would be considered candidates for medication.

Myth 4: Food is heart-healthy if it says "0 mg cholesterol"

The Cholesterol portion of the nutritional label refers to dietary cholesterol, which is only one of the things found in food that can cause your cholesterol to go sky-high. (A bigger contributor to elevated cholesterol? A high-fat diet.) It's also believed to be the least important. Saturated fat (found in animal foods and dairy products) and trans fats (found in packaged foods) appear to have a far greater impact on low-density lipoprotein (LDL), the so-called bad cholesterol that causes atherosclerosis, than dietary cholesterol.

Myth 5: Cholesterol is always a bad thing

When most people hear "cholesterol" they think "bad." Like most things in life, the reality is more complex. High cholesterol can be dangerous, but cholesterol itself is essential to various bodily processes, from insulating nerve cells in the brain to providing structure for cell membranes. That's why your body makes the white, waxy substance (about 75% of the cholesterol in your blood is made by the liver and cells elsewhere in your body).

The role of cholesterol in heart disease is often misunderstood. Cholesterol is carried through the bloodstream by low-density and high-density lipoproteins (LDL and HDL). LDL, known as bad cholesterol, and not the cholesterol it carries per se, is responsible for atherosclerosis.

Botox - Warnings from FDA

Reports of deaths among people using popular anti-wrinkle injections such as Botox to treat muscle spasms have prompted a change in labeling.

Botox and similar products will now be required to carry boxed warnings, the most serious type of label warning, the U.S. Food and Drug Administration announced Thursday.

Most cases involved children given the drug to control muscle spasticity associated with cerebral palsy and adults using it to treat muscle spasticity, migraines and cervical dystonia.

“The hospitalizations are very few, deaths are very rare, but they have been reported,” said Dr. Ellis F. Unger, acting deputy director of the FDA’s Office of Drug Evaluation, said during a teleconference.

“We don’t want to discourage use of these drugs as patients taking them have significant disability and the drugs are effective to relieve important problems,” he said. “But people just need to understand the risks that are involved so they can make informed, risk-benefit decisions.”

Other side effects include muscle weakness, difficulty breathing, loss of bladder control and pneumonia. Some people have required feeding tubes.

Unger said the deaths have not been clearly attributable to injection of the drugs, as everyone who died also suffered from other conditions.

None of the cases so far reported have been associated with use of botulinum products in cosmetic or dermatological procedures, such as clearing furrows between the eyebrows, according to the FDA. Botulinum toxins are not approved by the FDA to treat severe arm and leg muscle spasms, although they are approved for dermatological indications as well as cervical dystonia.

Officials believe that most of the problems occurred when one product was substituted for another without corresponding dose adjustments.

“There are now three products approved in the U.S., each with different units, and the units cannot be interchanged,” Unger said. “Switching patients from one to another runs the risk of underdosing or, more important, overdosing.”

The three approved products are Botox, Myobloc and Dysport, which was approved this week. Officials said there have been no post-marketing reports of similar problems with the newest drug.

The injections, which temporarily “paralyze” muscles, are intended to have a localized effect but can pose problems if the compound spreads to other parts of the body.

“When given in a particular place, they spread locally, meaning they move into adjacent structures,” Unger explained. “We have known that for years, and it can be annoying and somewhat of a significant problem for given patients but does not result in disability or harm.”

“The real concern is when there is distant spread,” he said. “It is injected at one point and spreads to areas not adjacent.”

The FDA issued an “early communication” in February 2008, warning of these adverse reactions. The month before, the watchdog group Public Citizen petitioned the agency to add a black-box warning to the two drugs then on the market in the United States, describing 180 “adverse event cases” related to the drugs, including 16 deaths, four in people younger than 18.

Between early 2008 and now, the FDA became “more certain about the cases,” Unger said. “We felt we really needed to nail down the scope of the problem before we placed a boxed warning, which is something we take very seriously.”

The FDA will also require manufacturers to put in place what it calls a risk evaluation and mitigation strategy — in essence, a comprehensive patient safety guide.

“Updating labeling will help patients and health-care professionals better understand the risks and benefits,” Unger said. “These drugs have benefits, but they also can cause serious problems.”

More information

Swine Flu - Questions & Answers

Will swine flu end up sweeping the globe in a flu pandemic? The Centers for Disease Control and Prevention announced that it’s taking some aggressive precautions—just in case.The federal agency reported Monday that there were 40 confirmed U.S. cases of swine flu, which were mostly mild infections seen in New York, Ohio, Kansas, Texas, and California. There are 26 confirmed cases in Mexico, but there are thought to be hundreds more not yet confirmed (including reports of 149 deaths). There have also been six cases in Canada and one in Spain.

It sounds scary. But it doesn’t mean it’s time to panic. Experts have long been searching for new flu viruses because they are known to periodically appear and sweep the globe; for example, there were at least three pandemics in the 20th century and as many “pandemic threats.” The last pandemic was the 1968 Hong Kong flu, so researchers say we’re overdue for one and are on high alert for potential candidates.

All this preparation is a good thing. Better surveillance most likely picked up the swine flu cases early. And one reason the government declared a public health emergency is to free up huge stockpiles of antiviral medication. (About 11 million courses of antiviral medication were shipped to affected states). “There’s been tremendous planning that’s been going on around the country over the past number of years,” said Richard Besser, MD, the acting director of the CDC, at a press briefing.

While it’s not time to panic, it is a good time to become more informed about swine flu and to contemplate “what if?” scenarios, including what you plan to do if your child’s school is closed or you can’t go to work, according to the CDC.

“It’s time for businesses to review their plans and think about ‘What would I do if some of my workers couldn’t come to work? How would my business function?’” said Dr. Besser. “Think about that.”

The good news is that there is a wealth of information about swine flu online, and it’s constantly being updated. For example, you can follow current cases on Google maps and get CDC updates via Twitter, as well as find information on the CDC’s and the World Health Organization’s Web sites.

Health.com talked with Brian Currie, MD, vice president and medical director for research at Montefiore Medical Center in the Bronx, N.Y., to get the facts about swine flu. Dr. Currie is an expert in disaster and bioterrorism preparedness. Here are his responses to some frequently asked questions.

Are we in the midst of a global flu pandemic?

I wouldn’t exactly call it a pandemic yet. A pandemic implies a huge spread across the world. Experts have been anticipating something like this would happen and we are somewhat prepared for it, but probably not ideally at the moment. This is a new strain that’s just been discovered, so there’s no vaccine for it—which is usually the most effective way to control dissemination. However, we do have a surveillance system and it looks like it was picked up very early, and we do have stockpiles of antiviral medications that are available if we need them.

Where did the virus come from, and why are experts concerned?

What you have is a swine flu virus that has picked up parts of human flu and mutated to incorporate them so that it can infect humans and it can cause human-to-human transmission as well. It’s made a lot of the changes it would need to become a pandemic. Unlike what’s happening in Mexico, where there’s been a lot of mortality, all of the cases that have occurred in the United States have been relatively mild disease. So it looks like as it spreads, it’s attenuating or become less virulent, so that would the saving grace here.

Isn’t avian flu supposed to be the big risk in terms of a global pandemic?

We knew it was going to be avian flu or swine flu that made the jump into humans and we’ve always been concerned about flu viruses that infect swine, birds, and humans; there are 30 or so in total. Some of the strains that can infect other species cannot typically infect humans. Human strains can infect pigs, so what happens is that pigs get infected with swine flu and human flu at the same time. They recombine the genetic material, so when they produce new viruses it’s got part of the human and part of the pig; you worry that if it gets enough of the human virus, it will be able to bind to human receptors.

Can I get swine flu from eating pork?

Absolutely not. It can’t be transmitted though the food chain. You’re not going to get it from eating pork.

Some of the swine flu cases have included symptoms like diarrhea or vomiting. What symptoms should I look for?

Typically what you are looking for is a sore throat, runny nose, high fever, and aching all over your body—a real good case of flu knocks people right on their backs.

I was sick a week ago—could I have had swine flu?

Unless you had contact with pigs or people from Mexico, it’s probably unlikely, although anything is possible.

Should I wear a mask in public? What’s the best way to avoid swine flu?

At the moment [wearing a mask in public] is a bit much. Basically you should practice good hand hygiene, and try to avoid contact with people coming from areas where there are known cases.
Read CDC recommendations regarding the use of respirators and face masks and the best ways to avoid the flu.

Should I keep my children home from school?

There’s only one school [in the New York area] where they have found cases and it’s limited to that school so far, so there is really no reason not to send your children to school at this point.

Should I cancel travel plans?

[The United States is] one of the sites people are worried about coming to now; Europe is telling people no unnecessary travel to Mexico and United States, so we’re being targeted rather than targeting other people. The caution would be, if you really don’t have to go, then put [trips] off and wait until we have more information.
Read the travel advisory issued by the CDC, which recommends delaying any non-essential travel to Mexico.

Should I get a flu shot?

No. In fact, it’s pretty unlikely that a flu shot will protect you against this strain.

I think I’m getting sick. Should I take an antiviral drug?

Currently what they are suggesting is if you are young and healthy, just go home and wait it out. That way we can keep the Tamiflu for people who have other chronic illnesses that put them at high risk, for example, those who are pregnant or the elderly. Those are people we are likely to test; then if they are positive, we’ll treat them.

Read CDC recommendations on what to do if you get sick.

I have to fly. Should I take any special precautions when traveling in a plane?

No, just stay away from people who look overtly ill. (And airports are generally screening people for symptoms.)

Should I go to the grocery store and stockpile food in the case of a quarantine?

No, just stay calm. The story is unfolding very rapidly and we’ll have more information shortly. But signs are encouraging so far, at least for what’s here in New York. If what’s happening in Mexico occurs someplace else, it could be another issue. Every U.S. case has been mild, so that’s in our favor. At the same token, there have been almost 200 [reported] deaths in Mexico.

Technorati Profile

Swine Flu

The number of confirmed cases of swine flu in the United States has doubled to 40, with all the new cases coming from a New York City high school that had previously reported eight cases of the infectious disease, U.S. health officials said Monday.

The officials also said they were tightening their travel advisory to Mexico — believed to be the source of the outbreak that continues to reach around the world — recommending that all nonessential travel to that country be avoided.

“This situation is evolving very quickly, it is changing quickly,” Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, said during an afternoon teleconference. “We are officially reporting 40 confirmed cases in the United States. The only change from yesterday is 20 confirmed cases in New York City. These are associated with the same school outbreak and really represent additional testing in that group and not an ongoing spread.”

All 40 U.S. patients — 28 in New York, seven in California, two in Texas, two in Kansas and one in Ohio — have either recovered or had mild infections, Besser said.
“Later today, we will be releasing a new travel advisory for Mexico,” he added. “This is out of an abundance of caution, and we will be recommending that nonessential travel to Mexico be avoided.”

Mexico is reporting as many as 1,900 possible swine flu infections and as many as 149 deaths.
Earlier Monday, President Barack Obama said the threat posed by the swine flu outbreak was a cause for concern but “not a cause for alarm.”

“The Department of Health and Human Services has declared a public health emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively,” Obama told a gathering of scientists at the National Academy of Sciences, amid increasing worries worldwide about a possible pandemic, the Associated Press reported.

Besser said that he “expects that we will see [swine flu] cases in other parts of the country, and I would fully expect that we will see a broader range in terms of the severity of infection. Thankfully, so far we have not seen severe disease in this country as has been reported in Mexico.

Besser said the United States will step up checks of people entering the country by air, land and sea, looking for signs of infection, and the CDC will begin distributing “yellow cards at ports of entry.”

“These will provide information on swine flu, so that people coming into the United States will have information about this outbreak — what to do if they become sick, what things they can do to prevent the likelihood that they will become sick,” he said.

He also said U.S. officials were questioning border visitors about their health, looking for signs of possible infection.

The fast-unfolding events in the United States — where all 40 cases have been relatively mild and there have been no deaths — came in response to some 1,900 swine flu infections and as many as 149 deaths in neighboring Mexico.

Officials in other nations around the globe responded to the threat of a possible pandemic. China, Taiwan and Russia considered quarantines, and several Asian countries scrutinized visitors arriving at their airports, the AP reported.

The European Union on Monday advised against nonessential travel to the United States and Mexico. Early Monday, Spain confirmed that a man hospitalized in the eastern part of the country had tested positive for swine flu, in what’s believed to be Europe’s first case of the disease. Health authorities were also testing 17 other possible cases in Spain, a major travel link between Mexico and Europe, The New York Times reported.

Responding Monday to the EU’s travel advisory, the CDC’s Besser said, “Based on the situation in the United States right now, I think it is premature to put travel restrictions on people coming to the United States. As the situation changes, that needs to be evaluated by different countries.”

On Sunday, U.S. health officials declared a public health emergency in response to the swine flu outbreak.

Homeland Security Secretary Janet Napolitano said the declaration was a precautionary measure and did not mean that the threat posed by the outbreak was worsening. But, the move allows federal and state governments easier access to flu tests and medications, she said.

Napolitano said the federal government had 50 million doses of the antiviral flu medication Tamiflu, and a quarter of those doses were being released to states, if needed, “particularly prioritizing the states where we already have confirmed incidence of the flu.”

Napolitano also said Sunday that the Department of Homeland Security had started “passive surveillance protocols to screen people coming into the country.”

“All persons entering the United States from a location of human infection of swine flu will be processed by appropriate CDC protocols,” she said. “Right now, these are passive. They are looking for people and asking about: ‘Are you sick? Have you been sick?’ and the like. And if so, they can be referred over for further examination. Travelers who do present with symptoms will be isolated.”

Speaking at a Sunday press conference, Dr. Anne Schuchat, the CDC’s Interim Deputy Director for Science and Public Health Program, said that U.S. health officials had numerous tools to fight the illness’ spread and protect the health of Americans. The swine flu viruses found in the United States are resistant to two antiviral medications — amantadine and rimantadine — but are susceptible to the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza), Schuchat said.

Schuchat said steps were already being taken to devise a vaccine against this strain of swine flu, although the process takes time. “We are taking the initial steps in terms of preparing the seed virus to hand off to the industry partners, to produce large quantities. But you know it takes months to produce a vaccine,” she said.

Besser said there are steps people can take to help prevent catching and spreading the flu, including frequent hand-washing. “If you are sick, it is very important that people stay at home. If your children are sick, have a fever and flu-like illness, they shouldn’t go to school. And if you are ill, you shouldn’t get on an airplane or another public transport. Those things are part of personal responsibility in trying to reduce the impact,” he said.

Meanwhile, in Mexico, authorities continued to take dramatic steps — including suspending school and public gatherings — to try to contain the outbreak that officials say has killed as many as 149 people, and sickened more than 1,900 others in that country.

Some of the U.S. cases involved people who had recently returned from trips to Mexico, Schuchat said Sunday. The two cases reported in Kansas involved a husband and wife who had recently been to that country, she said. And The New York Times reported that some of the students at St. Francis Preparatory School, in Queens, had recently come back from Mexico as well.

Also on Sunday, Canadian officials confirmed four “very mild” cases of swine flu at a school in Nova Scotia, and two other cases in British Columbia. According to the AP, a provincial health official said that the infection that sickened the students in Nova Scotia “was acquired in Mexico, brought home and spread.”

Swine flu is a respiratory disease of pigs caused by type A influenza. Swine flu does not normally infect humans. However, human infections do occur, usually after exposure to pigs. Symptoms resemble those of the regular flu, including sore throat, coughing and fever.

8 Causes of Chronic Cough

You've been coughing for weeks.
How do you know if it's just a hard-to-shake cold or something more serious?

A chronic cough, defined as lasting more than eight weeks, is not uncommon. Up to 40% of nonsmokers in the United States and Europe have reported a chronic cough at some point, and coughing is one of the five most common reasons for a doctor's visit.Only a doctor can tell for sure what's behind your endless hacking.

However, in a 2006 study of women with an average age of 48 who had a cough lasting for six months, 39% were found to have asthma, 9% had chronic upper airway cough syndrome (commonly known as postnasal drip), and 9% had gastroesophageal reflux disease (GERD).In addition, another 11% had chronic obstructive pulmonary disease (COPD), a serious, progressive disease that includes both emphysema and bronchitis.

While not all people who develop COPD are smokers, people who smoke are at higher risk. Overall, 24 million Americans—about 1 in 12 people—have COPD, although half don't know they have the disease.Read more about COPD and some common (and relatively uncommon) culprits in chronic cough.

1. Asthma and allergies

Asthma is a chronic lung disease in which the airways in the lungs are prone to inflammation and swelling. Along with chest tightness, shortness of breath, and wheezing, coughing is a characteristic symptom of asthma, one which tends to intensify at night or in the early morning.

When the symptoms of asthma flare up suddenly, it’s known as an asthma attack.Although it can begin at any age, asthma usually develops in childhood. Asthma triggers are different for everyone, and they can include exercise, colds, cigarette smoke and other airborne irritants, and certain foods.

Asthmatics usually also have allergies.Even in people without asthma, inhaling pollen, dust, pet dander, and other airborne irritants can trigger allergic rhinitis, an allergic reaction that can cause coughing, along with symptoms such as stuffy nose and sneezing.

You may be able to determine whether your cough is caused by allergies by keeping track of whether it comes and goes in certain situations.

If your coughing magically stops when you step into an air-conditioned room on a dry, pollen-heavy day, or if gets worse every time you pet Mittens, you probably have allergies.

If you’re not sure what’s triggering your allergic cough, your doctor can give you a skin test or blood test to pinpoint the allergy.

2. Chronic obstructive pulmonary disease (CPOD)
One condition that can cause a nagging cough is COPD, a lung condition that includes chronic bronchitis and emphysema.

COPD occurs when the airways and air sacs in the lungs become inflamed or damaged, most often due to smoking, and is more common after age 45. In COPD, the lungs produce excess mucus, which the body reflexively tries to clear by coughing.

COPD-related tissue damage can also make it particularly difficult to expel air from the lungs, which can make you feel short of breath.Your doctor may check you for COPD (particularly if you have risk factors, such as smoking), after ruling out other common causes of cough. To determine if you have COPD, your doctor is likely to conduct some tests, including spirometry, which involves inhaling as deeply as you can and then exhaling into a tube.

3. Gastroesophageal reflux disease
GERD is an ailment of the stomach and esophagus that occurs when stomach acid backs up into the esophagus due to a weak valve. The main symptoms? Killer heartburn. But coughing is another common symptom of GERD, along with chest pain and wheezing. In fact, GERD is a fairly common, and unrecognized, cause of a chronic cough.

4. Respiratory tract infection
Coughing is one of the most common symptoms of colds and flu and other respiratory tract infections. The other symptoms that accompany colds and flu, such as stuffy nose and a fever, are telltale signs that a viral infection is causing your cough.

However, a cough can outlast all those other symptoms, perhaps because the air passages in your lungs remain sensitive and inflamed.When this occurs, it's called chronic upper airway cough syndrome (or postnasal drip).

A more serious respiratory tract infection is pneumonia, which can be caused by bacteria or viruses. A cough, often producing a greenish or rust-colored mucus, is one of the characteristic symptoms of the illness, along with fever, chills, chest pain, weakness, fatigue, and nausea.

These symptoms may present differently depending on your age; older adults may not experience a fever, for instance, or they may have a cough but no mucus.Pneumonia is treated with antibiotics and generally clears up within two or three weeks. As with the cold and flu, however, the cough can linger for much longer.A form of pneumonia known as mycoplasma, or walking pneumonia, shares the symptoms of pneumonia (including cough) and is more common in people under the age of 40.

People who have COPD can be more susceptible to such respiratory tract infections, and may experience exacerbations—episodes of potentially life-threatening shortness of breath—when they catch a cold or breath in air pollution or other irritants.

5. Air pollution
Various pollutants and irritants in the air can cause a persistent cough. Even short-term exposure to fumes (such as diesel exhaust) can result in cough, phlegm, and lung irritation, for instance. Fumes can also exacerbate the symptoms of allergies or asthma.

Similarly, mold spores found in and around homes can cause wheezing and coughing when inhaled.

In the wake of Hurricane Katrina, New Orleans reported a sudden spike in persistent cough complaints among returning residents. This so-called Katrina cough was believed to stem from the mold caused by the flooding, as well as by dry weather and the construction dust that was then ubiquitous in the city.

6. Acute bronchitis
If you’re on the verge of recovering from a cold and suddenly develop a hacking, mucus-y cough, you probably have acute bronchitis, a condition in which the passageways in your lungs become infected and inflamed.

In addition to coughing and chest congestion, bronchitis can produce fever, chills, aches, sore throat, and other flu-like symptoms. These symptoms usually disappear within a few days, but the cough can persist for weeks.

If your cough doesn’t go away, or if you develop acute bronchitis frequently, it may be a sign of a more serious condition.

Acute bronchitis—acute means short-term—is different from chronic bronchitis. Chronic bronchitis is a condition in which the lungs produce excess mucus due to ongoing irritation, and is considered a form of COPD.

7. ACE inhibitors
ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. (Check out this list of common brand-name and generic drugs that are ACE inhibitors.) About 42 million prescriptions for ACE inhibitors are written each year, and about 1 in 5 people who take the drugs develop a dry cough.

In some people, the cough can persist for weeks after they stop taking the medication; women, African Americans, and Asians may be at greater risk of developing an ACE inhibitor cough than other people.

You should never stop taking a prescribed medication without consulting with your doctor, and ACE inhibitors are important medications for lowering blood pressure (a more serious condition than a cough.) Consult your doctor if you think your cough is related to a medication.

8. Pertussis
Also known as whooping cough, pertussis is a bacterial disease with symptoms that include a slight fever, a runny nose, and, most notably, a violent cough that can make breathing difficult.

Attempting to inhale air into the lungs between coughs can produce a distinctive, high-pitched whooping sound. After the initial stage, many people do not have a fever, but the chronic cough that accompanies pertussis can last for many weeks.

Most infants receive a pertussis vaccine, but its effectiveness subsides after about 10 years. Inadequate vaccination for pertussis (which is the “P” in the DPT shot) is one reason why the bacteria are making a comeback. Once a very rare cause of chronic cough, the number of pertussis cases in the United States has risen alarmingly in recent years, especially among adolescents and adults. However, pertussis is still a relatively uncommon cause of chronic cough.

3 kind of drugs that kill sex drive

If you're having sex drive issues, check your medicine cabinet. Several varieties of prescription medication can dampen desire.

Birth control
Some hormonal birth control methods such as pills and patches can increase women's levels of sex-hormone-binding globulin (SHBG), which drops the amount of testosterone that's floating around freely in the bloodstream.

A small but alarming 2006 Boston University study, authored by Irwin Goldstein, MD, director of San Diego Sexual Medicine and editor in chief of The Journal of Sexual Medicine, found the Pill to have a long-term effect on libido in some women. The level of SHBG was twice as high in women who had taken the Pill—four months after they'd stopped taking the medication—as those who never had.

That kind of long-term effect is pretty rare, however, according to Hilda Hutcherson, MD, an ob-gyn professor at Columbia University. She finds that birth-control-related sex drive problems usually go away when her patients switch pill formulations. "It's the progestin that seems to affect libido," Dr. Hutcherson says. "Some progestins have an androgen [male hormone] effect, and those tend to have less effect on libido."

Or try another form of birth control completely. With most women Dr. Hutcherson has seen in practice, she says she's found that "if you take them off the Pill, their sex drive comes back."

Antidepressants
Selective serotonin-reuptake inhibitors (SSRIs) such as Prozac are supposed to cheer you up, but they can interfere with one potential source of happiness: sexual pleasure. Some doctors will keep the SSRI but add Wellbutrin, which increases dopamine and acts as an "antidote to the SSRIs," according to Dr. Goldstein. For others, a doctor might switch the patient to Wellbutrin and cut the SSRI.

Everyone's body reacts differently to drugs, however, and for some, depression itself is more of a sex drive dampener than the SSRIs are. For still another set of patients, notes Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School, "When you give them SSRIs, they get a libido and can be sexually functional when they weren't able to be before."

Diabetes drugs
Both diabetes and the medicine used to treat it can diminish desire, arousal, and orgasm. And those changes, in turn, can affect sexual interest. As Dr. Hutcherson puts it, "Who wants it if it's not fun?"

What if you need the medicine?
Sometimes simply switching to another type of medicine, or even a different formulation of the same medicine, can solve the sex drive side effect. But if it does not, and you need the medication, and your regular provider isn't coming up with any new ideas, don't despair. "Go see a sexual medicine expert who can work with the physician prescribing the medicine to figure out other strategies," advises Alan M. Altman, MD, an assistant clinical professor at Harvard Medical School and a specialist in menopausal issues and midlife sexuality.