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Tag: headaches

  • Heavy Metal, Headbanging, and Our Health | NutritionFacts.org

    How might we moderate the rare but very real risk of headbanging?

    If you search for heavy metal in the National Library of Medicine database, most of what you find is on heavy metal contamination in fish, which “makes it difficult to establish clearly the role of fish consumption on a healthy diet” and perhaps helps to explain the quintupling of odds of autoimmune diseases, such as juvenile arthritis. But searching for the hazards of heavy metal also pops up entries on the “risks from heavy metal music.” In this study, researchers were talking about traumatic injuries from slamming around “during a moshing session,” but you’re more likely to get injured at an alternative rock concert. (Check out some of the artists below and at 0:50 in my video The Dangerous Effects of Heavy Metal Music.)

    Certainly, music-induced hearing loss is a serious problem, but that can result from any loud music. Clinical recommendations include the “80–90 rule”—no more than 80% of the maximum volume on personal listening devices for no more than 90 minutes a day. That’s not what the science shows, however. “Do not exceed 60% of the maximum volume” may be more evidence-based, but researchers figure teens would just ignore that, so they came up with more “acceptable” advice.

    I assumed I’d see a lot of satanic panic nonsense from the 1980s, when “parents bereaved by suicide…accused Heavy Metal groups of promoting suicidal behaviours and…proceeded to sue musicians.” What kind of evidence did the parents present? There has been “little scholarly research” published until the “The Heavy Metal Subculture and Suicide” paper that tried to correlate the number of statewide heavy metal magazine subscriptions to youth suicide rates. Seriously?

    It got really wild, though, when researchers called psychiatric institutions, pretending to be parents worried because their son started listening to heavy metal music, even though they made it clear that their son didn’t exhibit any symptoms of mental illness, didn’t do drugs or drink alcohol, and was doing fine at school. Ten of the twelve facilities believed the son required psychiatric hospitalization. Imagine what that would do to a kid! Researchers found that, decades later, metalheads “were significantly happier in their youth and better adjusted” than their peers.

    Some studies were strange. Do Parkinson’s patients walk better listening to The Beatles’ “Yellow Submarine” or Metallica’s “Master of Puppets”? (See below and at 2:32 in my video.)

    Others were pretty nondescript. Heavy metal musicians exhibit a higher heart rate than those performing “contemporary Christian,” which isn’t so surprising, as you can see  here and at 2:40.

    Some others were kind of cute, like one that investigated the influence of music on promoting patient safety during surgery—veterinary patients, that is. Kittens got spayed with little earphones on their heads. It turns out that “Adagio for Strings” may be more relaxing than AC/DC.

    A review on music therapy for human patients warned: “Caution should be exercised…when guiding patients in selecting their music. ‘Chaotic music, such us [sic] hip-hop and metal, is not healing to human cells.’” That even had three citations, though two of them don’t say anything and the third is a nursing newsletter merely quoting someone’s opinion. I did some digging, and it turns out that stomach cancer cells like metal. If you play them Cannibal Corpse versus Beethoven, 12 hours of death metal increases their growth in a petri dish, as you can see below and at 3:28 in my video. (That’s so metal.)

    But who puts headphones on their stomach? Or their chests, for that matter? In one study, Mozart killed off one type of breast cancer cell line but not another; in another study, only Beethoven’s 5th Symphony seemed to work, and Mozart flopped when the petri dishes were surrounded by speakers. How does this stuff even get published?

    Anyway, the true danger from heavy metal is headbanging. “Headbanging is a contemporary dance form consisting of abrupt flexion–extension movements of the head to the rhythm of rock music, most commonly seen in the heavy metal genre.” Although the “number of avid aficionados is unknown…some fans might be endangered by indulging excessive headbanging.” Despite headbanging generally being “considered harmless,” several health complications have been attributed to this practice, including ripping your carotid artery, rupturing your lung, whiplash injury, neck fracture, or subdural hematoma. One man reported headbanging at a Motörhead concert, and all that “brisk forward and backward acceleration and deceleration forces” might have ruptured his bridging veins and caused him to bleed into his skull.

    As shown here and at 4:47 in my video, bridging veins bridge the gap between the brain and the covering that lines the inside of our skull, and if the veins tear, blood can build up under our skull and compress our brain.

    This bridging vein rupture has been demonstrated on headbanging cadavers (another very metal study). See below and at 5:02 in my video. It’s been likened to a “pseudo shaken-baby syndrome” in adults.

    The researchers conclude that their “case serves as evidence in support of Motörhead’s reputation as one of the most hardcore rock’n’roll acts on earth,” but I think the real takeaway is that a potentially dangerous complication like subdural hematoma can result from “a seemingly benign activity like head banging.” And some of the brain bleeds can be massive. One man complained of a “headache after headbanging at a party.” Why? As you can see in his CT scan below and at 5:35, circled in red is all blood, squishing over his brain. Amazingly, he survived; another man didn’t, headbanging and losing his life to a fatal subdural hemorrhage.

    We can tear more than just veins. There are two sets of arteries that tunnel into the skull—the carotid arteries in the front and the vertebral arteries in the back—and we can tear both sets. A 15-year-old boy “indulged in headbanging” and ripped his carotid artery, which led to a massive stroke. He presented as half-paralyzed and unable to speak, and he died in a coma within a week.

    What about the vertebral arteries in the back? They’re wedged into our skull, rendering them susceptible to shearing forces from extremes of neck motion, and that’s exactly what appeared to happen when a heavy metal drummer tore the wall of the artery. All of this is really rare, probably afflicting less than one in a thousand or so. What can metalheads do to reduce their risk? “To prevent injury due to such head-banging, the range of head and neck motion should be reduced, slower-tempo music should replace heavy metal rock, the frequency of head-banging should be only on every second beat, or personal protective equipment should be used”—like a neck brace?

    “Little formal injury research has been conducted on the worldwide phenomenon of head banging,” so researchers constructed “a theoretical head banging model” with enough physics terms to make any nerd happy: “angular displacement,” “sinusoidal motion in the sagittal plane,” and “amplitude of the displacement curve.” The study participants? Headbangers. The control group? That’s easy with easy listening music.

    The head injury curves and neck injury curves, based on headbanging tempo and angular sweep, are shown below and at 7:23.

    “An average head-banging song has a tempo of about 146 beats per minute, which is predicted to cause mild head injury when the range of motion is greater than 75º,” so something like what’s seen below and at 7:34 in my video.

    The researchers conclude: “To minimise the risk of head and neck injury, head bangers should decrease their range of head and neck motion, head bang to slower tempo songs by replacing heavy metal with adult-oriented rock, only head bang to every second beat, or use personal protective equipment.”

    “Unfortunately, it is difficult, if not impossible, to change the habits of heavy metal aficionados.” Maybe what we need are metal-studded neck braces.

    Doctor’s Note

    What about the healing potential of music? Check out Music as Medicine and Music for Anxiety: Mozart vs. Metal.

    Michael Greger M.D. FACLM

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  • How To Do A Quick Neck Stretch To Ease Tension & Improve Posture

    Between general poor posture and the dreaded “tech neck” many of us experience neck and shoulder pain, eye strain, and tension headaches—especially at the end of a workday. Thankfully, if your posture could use some work, or you simply want to alleviate some of that tension, neck stretches are always at your disposal.

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  • Fasting and Plant-Based Diets for Migraines and Traumatic Brain Injuries  | NutritionFacts.org

    What effects do fasting and a plant-based diet have on TBI and migraines?

    An uncontrolled and unpublished study purported to show a beneficial effect of fasting on migraine headaches, but fasting may be more likely to trigger a migraine than help it. In fact, “skipped meals are among the most consistently identified dietary triggers” of headaches in general. In a review of hundreds of fasts at the TrueNorth Health Center in California, the incidence of headache was nearly one in three, but TrueNorth also published a remarkable case report on post-traumatic headache.

    The U.S. Centers for Disease Control and Prevention (CDC) estimates that more than a million Americans sustain traumatic brain injuries (TBIs) every year. Chronic pain is a common complication, affecting perhaps three-quarters of those who suffer such an injury. There are drugs, of course, to treat post-traumatic headache. There are always drugs. And if drugs don’t work, there is surgery, cutting the nerves to the head to stop the pain.

    What about fasting and plants? A 52-year-old woman presented with a highly debilitating, difficult-to-manage, unremitting, chronic post-traumatic headache. And when I say chronic, I mean chronic; she experienced pain for 16 years. She then achieved long-term relief after fasting, followed by an exclusively plant-foods diet, free of added sugar, oil, or salt.

    Before then, she had tried drug after drug after drug after drug after drug—with no relief, suffering in constant pain for years. Before the fast, she started out in constant pain. Then, after the fast, the intensity of the pain was cut in half, and though she was still having daily headaches, at least there were some pain-free periods. Six months later, she tried again, and eventually her headaches became mild, lasting less than ten minutes, and infrequent. She continued that way for months and even years, as you can see below and at 1:45 in my video Fasting for Post-Traumatic Brain Injury Headache. 

    Now, of course, it’s hard to disentangle the effects of the fasting from the effects of the whole food, plant-based diet she remained on for those ensuing years. You’ve heard of analgesics (painkillers). Well, there are some foods that may be pro-algesic (pain-promoting), such as foods high in arachidonic acid, including meats, dairy, and eggs. So, the lowering of arachidonic acid—from which our body makes a range of pro-inflammatory compounds—may be accomplished by eating a more plant-based diet. So, maybe that contributed to the benefit in the fasting case, since many plant foods are high in anti-inflammatory components. In terms of migraine headaches, more plant foods and less animal foods may help, but you don’t know until you put it to the test.

    Researchers figured a plant-based diet may offer the best of both worlds, so they designed a randomized, controlled, crossover study where those with recurrent migraines were randomized to eat a strictly plant-based diet or take a placebo pill. Then, the groups switched. During the placebo phase, half of the participants said their pain improved, and the other half said their pain remained the same or got worse. But, during the dietary phase, they almost all got better, as you can see here and at 3:11 in my video.

    During that first phase, the diet group experienced significant improvements in the number of headaches, pain intensity, and days with headaches, as well as a reduction in the amount of painkillers they needed to take. In fact, it worked a little too well. Many individuals were unwilling to return to their previous diets after they completed the diet phase of the trial, thereby refusing to complete the study. Remember, the participants were supposed to go back to their regular diets and take a placebo pill, but they felt so much better on the plant-based diet that they refused. We’ve seen this with other trials, where those trying plant-based diets felt so good, they often refused to abandon them, harming the study. So, plant-based diets can sometimes work a little too well.

    All my videos on fasting are available in a digital download here.  

    Michael Greger M.D. FACLM

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  • Suffer From Headaches? You Could Be Missing This Key Nutrient, Study Finds

    Plus what to do about it.

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  • A Functional Eye Doctor’s Tip To Test Your Blue Light Glasses

    It’s no secret screen time has soared during the pandemic1. Especially for those able to work from home, you might oscillate from virtual meetings to online happy hours to a feel-good TV series on Netflix. And repeat. With all this skyrocketed screen time, the thought might have crossed your mind once or twice: Should I invest in a pair of blue-light-blocking glasses? These lenses, meant to filter out the blue light in your surroundings, are practically exploding in popularity as we continue to bombard our retinas with LED-backlit screens—you can snag a pair for anywhere from $12 to $95. 

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  • Should We Drink Kombucha  | NutritionFacts.org

    What are the risks versus benefits of drinking kombucha?

    Is Kombucha Tea Good for You? is one of my first videos. It was featured in a blog entry entitled “NutritionFacts.org: the first month,” where I marveled the video had reached nearly 100,000 people. You can see it below and at 0:20 in my video Kombucha’s Side Effects: Is It Bad for You?. I’m honored to say that we now reach more than 100,000 people a day.

    In that first kombucha video, I profiled a report published in the Journal of Intensive Care Medicine of “a case of kombucha tea toxicity” in which a young man ended up in an acidotic coma. The authors concluded, “While Kombucha tea is considered a healthy elixir, the limited evidence currently available raises considerable concern that it may pose serious health risks. Consumption of this tea should be discouraged, as it may be associated with life-threatening lactic acidosis.” And this was just one of several case reports of “serious, and sometimes fatal, hepatic [liver] dysfunction and lactic acidosis within close proximity of ingestion.”

    For example, there were two cases in Iowa of severe metabolic acidosis, including one death. There was also a triggering of a life-threatening autoimmune muscle disease that required emergency surgery and was “probably related to the consumption of a fermented Kombucha beverage.” Another patient presented with shortness of breath, shaking, and a movement disorder “after consumption of tea and no other medications,” and a middle-aged woman complained of xerostomia, dizziness, nausea, vomiting, headache, and neck pain,” and her symptoms recurred on reingestion of the tea. There was another case of severe metabolic lactic acidosis, as well as a case of hepatotoxicity (liver toxicity) that resolved after stopping kombucha.

    Why these sporadic cases? Maybe some unusual toxins developed in a particular batch. I mean, it is a fermented product, so it’s possible there was just some contamination by a bad bug, like the time people smeared kombucha on their skin because they were told it had “magical healing power.” What it had instead was anthrax. So, even though such reports were rare, I concluded ten years ago that we should probably stick to foods that haven’t put people in a coma. But what about its risks versus benefits? Maybe kombucha is worth it. After all, it’s “reputed to cure cancer,” “eliminate wrinkles,” “and even restore gray hair to its original color”—as “marketed by alternative and naturopathic healers throughout the United States.”

    “Currently, kombucha is alternately praised as ‘the ultimate health drink’ or damned as ‘unsafe medicinal tea.’” It’s been “claimed to be a universal wonderful drug…a potion which improves awareness and concentration, slimming, also purifying, regenerating and life extending.” Which is it? Is it “potion or poison?

    Back in the 1920s, 1930s, and 1940s, there were several medical studies conducted by recognized physicians confirming all sorts of beneficial effects, as you can see below and at 2:55 in my video. 

    I couldn’t wait to read them. Dufrense and Farnworth were cited, and when I went to that paper, I saw the same claim, citing Allen 1998. When I went to that source, I saw the citation is for a random kombucha website, as shown below, and at 3:10 in my video. And guess what? That website’s been defunct since 2001, and “much of the Kombucha information” posted came from comments on some mailing list.

    Finally, in 2003, a systematic review of the clinical evidence that had been published was conducted. “The main result of this systematic review, it seems, is the total lack of efficacy data…No clinical studies were found relating to the efficacy of this remedy.” We just have these cautionary tales, these case reports. So, based on these data, it was concluded that the largely undetermined benefits do not outweigh the documented risks of kombucha. It can therefore not be recommended for therapeutic use.” That was back in 2003, though. How about a 2019 systematic review of the empirical evidence of human health benefit?

    “The nonhuman subjects literature claims numerous health benefits of kombucha,” with “nonhuman” meaning mice and rats. We need human clinical trials, yet there is still not a single controlled human study. (I did find one uncontrolled study purporting to show a significant reduction in fasting and after-meal blood sugars among individuals with type 2 diabetes, though, as seen below and at 4:19 in my video.)

    “Nonetheless,” despite no controlled trials, “significant commercial shelf space is now dedicated to kombucha products, and there is widespread belief that the products promote health.” So, we are left with this extreme disparity between science and belief: “There is no convincingly positive clinical evidence at all; the [health] claims for it are as far-reaching as they are implausible; the potential for harm seems considerable. In such extreme cases, healthcare professionals should discourage consumers from using (and paying for) remedies that only seem to benefit those who sell them.”

    Doctor’s Note:

    Friday Favorites: What Are the Best Beverages? Watch the video to find out. 

    Michael Greger M.D. FACLM

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  • Suffer From Headaches? You Could Be Missing This Key Nutrient, Study Finds

    Suffer From Headaches? You Could Be Missing This Key Nutrient, Study Finds

    Plus what to do about it.

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  • Headache and Migraine Relief from Foods  | NutritionFacts.org

    Headache and Migraine Relief from Foods  | NutritionFacts.org

    Plant-based diets are put to the test for treating migraine headaches.

    Headaches are one of the top five reasons people end up in emergency rooms and one of the leading reasons people see their doctors in general. One way to try to prevent them is to identify their triggers and avoid them. Common triggers for migraines include stress, smoking, hunger, sleep issues, certain foods (like chocolate, cheese, and alcohol), your menstrual cycle, or certain weather patterns (like high humidity).

    In terms of dietary treatments, the so-called Father of Modern Medicine, William Osler suggested trying a “strict vegetable diet.” After all, the nerve inflammation associated with migraines “may be reduced by a vegan diet as many plant foods are high in anti-inflammatory compounds and antioxidants, and likewise, meat products have been reported to have inflammatory properties.” It wasn’t put to the test, though, for another 117 years.

    As I discuss in my video Friday Favorites: Foods That Help Headache and Migraine Relief, among study participants given a placebo supplement, half said they got better, while the other half said they didn’t. But, when put on a strictly plant-based diet, they did much better, experiencing a significant drop in the severity of their pain, as you can see in the graph below and at 1:08 in my video. 

    Now, “it is possible that the pain-reducing effects of the vegan diet may be, at least in part, due to weight reduction.” The study participants lost about nine more pounds when they were on the plant-based diet for a month, as shown below, and at 1:22. 

    Even just lowering the fat content of the diet may help. Those placed on a month of consuming less than 30 daily grams of fat (for instance, less than two tablespoons of oil all day), experienced “statistically significant decreases in headache frequency, intensity, duration, and medication intake”—a six-fold decrease in the frequency and intensity, as you can see below and at 1:44 in my video. They went from three migraine attacks every two weeks down to just one a month. And, by “low fat,” the researchers didn’t mean SnackWell’s; they meant more fruits, vegetables, and beans. Before the food industry co-opted and corrupted the term, eating “low fat” meant eating an apple, for example, not Kellogg’s Apple Jacks.  

    Now, they were on a low-fat diet—about 10 percent fat for someone eating 2,500 calories a day. What about just less than 20 percent fat compared to a more normal diet that’s still relatively lower fat than average? As you can see below and at 2:22 in my video, the researchers saw the same significant drops in headache frequency and severity, including a five-fold drop in attacks of severe pain. Since the intervention involved at least a halving of intake of saturated fat, which is mostly found in meat, dairy, and junk, the researchers concluded that reduced consumption of saturated fat may help control migraine attacks—but it isn’t necessarily something they’re getting less of. There are compounds “present in Live green real veggies” that might bind to a migraine-triggering peptide known as calcitonin gene-related peptide, CGRP. 

    Drug companies have been trying to come up with something that binds to CGRP, but the drugs have failed to be effective. They’re also toxic, which is a problem we don’t have with cabbage, as you can see below and at 3:01 in my video. 

    Green vegetables also have magnesium. Found throughout the food supply but most concentrated in green leafy vegetables, beans, nuts, seeds, and whole grains, magnesium is the central atom to chlorophyll, as shown below and at 3:15. So, you can see how much magnesium foods have in the produce aisle by the intensity of their green color. Although magnesium supplements do not appear to decrease migraine severity, they may reduce the number of attacks you get in the first place. You can ask your doctor about starting 600 mg of magnesium dicitrate every day, but note that magnesium supplements can cause adverse effects, such as diarrhea, so I recommend getting it the way nature intended—in the form of real food, not supplements.  

    Any foods that may be particularly helpful? You may recall that I’ve talked about ground ginger. What about caffeine? Indeed, combining caffeine with over-the-counter painkillers, like Tylenol, aspirin, or ibuprofen, may boost their efficacy, at doses of about 130 mg for tension-type headaches and 100 mg for migraines. That’s about what you might expect to get in three cups of tea, as you can see below, and at 4:00 in my video. (I believe it is just a coincidence that the principal investigator of this study was named Lipton.) 

    Please note that you can overdo it. If you take kids and teens with headaches who were drinking 1.5 liters of cola a day and cut the soda, you can cure 90 percent of them. However, this may be a cola effect rather than a caffeine effect. 

    And, finally, one plant food that may not be the best idea is the Carolina Reaper, the hottest chili pepper in the world. It’s so mind-numbingly hot it can clamp off the arteries in your brain, as seen below and at 4:41 in my video, and you can end up with a “thunderclap headache,” like the 34-year-old man who ate the world’s hottest pepper and ended up in the emergency room. Why am I not surprised it was a man? 

    I’ve previously covered ginger and topical lavender for migraines. Saffron may help relieve PMS symptoms, including headaches. A more exotic way a plant-based diet can prevent headaches is by helping to keep tapeworms out of your brain.

    Though hot peppers can indeed trigger headaches, they may also be used to treat them. Check out my video on relieving cluster headaches with hot sauce. 

    Michael Greger M.D. FACLM

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  • The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    Are there any safe and effective dietary supplements for weight loss?

    In a previous discussion, I noted that an investigation found that four out of five bottles of commercial herbal supplements bought at major U.S. retailers—GNC, Walgreens, Target, and Walmart—didn’t contain any of the herbs listed on their labels, instead “often containing little more than cheap fillers like powdered rice, asparagus and houseplants…”

    You might hope your supplement just contains houseplants. Weight-loss supplements are infamous for being “adulterated with prescription and over-the-counter” drugs. In a sampling of 160 weight-loss supplements that “were claimed as 100% natural,” more than half were tainted with drugs and active pharmacological ingredients, ranging from antidepressants like Prozac to erectile dysfunction medications like Viagra. Diuretic drugs are frequent contaminants, which makes sense. In my previous videos on ketogenic diets, I talk about rapid water loss being “the $33-billion diet gimmick” that has sold low-carb diets for more than a century. But why the Viagra?

    At least the spiked Viagra and Prozac are legal drugs. Researchers in Denver tested every weight-loss supplement they could find within a ten-mile radius. Alarmingly, they found that a third were adulterated with banned ingredients. The most common illegal adulterant of weight-loss supplements is sibutramine, which was sold as Meridia before it was yanked off the market back in 2010 for heart attack and stroke risk. Now, it is also blamed for cases of slimming supplement–induced psychosis.

    An analysis of weight-loss supplements bought off the internet that were advertised with claims like “purely natural products,” “harmless,” or “traditional herbal” found that a third of them contained high doses of the banned drug sibutramine and the rest had caffeine. Wouldn’t you be able to tell if caffeine was added to a supplement? Perhaps not, if it also had temazepam, a controlled substance (benzodiazepine) “downer” sedative found in half of the caffeine-tainted supplements.

    Doesn’t the FDA demand recalls of adulterated supplements? Yes, but they often just pop back up on store shelves. Twenty-seven supplements were purchased at least six months after recalls were released, and two-thirds still contained banned substances. That’s 17 out of 27 with the same pharmaceutical adulterant found originally, and 6 containing one or more additional banned ingredients. Aren’t the manufacturers penalized for noncompliance? Yes, but “the fines for violations are small compared to the profits.”

    One of the ways supplement makers can skirt the law is by labeling them as “not intended for human consumption because it shifts the responsibility from the seller to the user”—for example, labeling the fatal fat-burner DNP as “an industrial- or research chemical.” This is how designer street drugs can be sold openly at gas stations and convenience stores as “bath salts.” Another way is to claim synthetic stimulants added to slimming supplements are actually natural food constituents, like listing the designer drug dimethylamylamine (DMAA) as “geranium oil extract.” The FDA banned it in 2012 after it was determined that DMAA “was not found in geraniums.” Who eats geraniums anyway? Despite being tentatively tied to cases of sudden death and associated with hemorrhagic stroke, DMAA has continued to be found in weight-loss supplements with innocuous names like Simply Skinny Pollen made by Bee Fit with Trish.

    There is little doubt that certain banned supplements, like ephedra, could help people lose weight. “There’s only one problem, and it’s a big one: This supplement may kill you,” wrote a founding member of the American Board of Integrative Medicine.

    Are there any safe and effective dietary supplements for weight loss? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, when popular slimming supplements were put to the test in a randomized placebo-controlled trial, not a single one could beat out placebo sugar pills. “A systematic review of systematic reviews” of diet pills came to a similar conclusion: None appears to generate appreciable impacts “on body weight without undue risks.” That was the conclusion reached in a similar review out of the Weight Management Center at Johns Hopkins, which ended with: “In closing, it is fitting to highlight that perhaps the most general and safest alternative/herbal approach to weight control is to substitute low-energy density [low-calorie] foods for high-energy density and processed foods, thereby reducing total energy intake.” In other words, eat more whole plant foods and fewer animal foods and junk. “By taking advantage of the low-energy density [low-calorie] and health-promoting effects of plant-based foods, one may be able to achieve weight loss, or at least assist weight maintenance without cutting” down on the volume of food consumed or compromising its nutrient value.

    Learn more about the risks of supplements in my video Are Weight Loss Supplements Safe?.

    I referred to a keto diet video I did, check out the related posts below the links to other videos and blogs in that series.

    Learn more about optimal weight loss in my book, How Not to Diet. 

    Michael Greger M.D. FACLM

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  • The Safety of Weight-Loss Supplements  | NutritionFacts.org

    The Safety of Weight-Loss Supplements  | NutritionFacts.org

    Only 2 out of 12 supplement companies were found to have weight-loss products that were even accurately labeled.

    According to a national survey, one-third of adults who have made serious attempts at weight loss have tried using dietary supplements, for which Americans spend billions of dollars every year. Most people mistakenly thought that over-the-counter appetite suppressants, herbal products, and weight-loss supplements had to be approved for safety by a governmental agency, like the U.S. Food and Drug Administration (FDA), before being sold to the public or at least include some kind of warning on the label about potential side effects. Nearly half even thought they had to demonstrate some sort of effectiveness. None of that is true.

    As I discuss in my video Friday Favorites: Are Weight Loss Supplements Safe and Effective?, the “FDA has estimated that dietary supplements cause 50,000 adverse events annually,” most commonly liver and kidney damage. Of course, prescription drugs don’t just have adverse effects; they kill more than 100,000 Americans every year. But, you at least notionally have the opportunity to parse out the risks versus benefits of prescription drugs, thanks to testing and monitoring requirements typically involving thousands of individuals.

    When the manufacturer of Metabolife 356, a supplement containing ephedrine, had it tested on 35 people, only minor side effects were found, such as dry mouth, headache, and insomnia. However, once unleashed on a broad population, nearly 15,000 adverse effects were reported, including heart attacks, strokes, seizures, and deaths, before it was pulled from the market.

    Given the lack of government oversight, there is no guarantee that what’s on the label is even in the bottle, as you can see in the graph below and at 1:55 in my video. FDA inspectors have found that 70 percent of supplement manufacturers violated so-called Good Manufacturing Practices, which are considered the minimum quality standards. This includes things like basic sanitation and ingredient identification. Not 7 percent in violation, but 70 percent.

    DNA testing of herbal supplements across North America found that most could not be authenticated. In a significant percentage of the supplements tested, the main labeled ingredient was missing completely and substituted with something else. For example, a so-called St. John’s wort supplement contained nothing but senna, a laxative that can cause anal blistering. Only 2 out of 12 supplement companies had products that were accurately labeled.

    This problem isn’t limited to fly-by-night phonies in some dark corner of the internet either. The New York State Attorney General commissioned DNA testing of 78 bottles of commercial herbal supplements sold by Walgreens, Walmart, Target, and GNC “and found that four out of five…did not contain any of the herbs on their labels.” Instead, the capsules “often contained little more than cheap fillers like powdered rice, asparagus and houseplants…”

    What about weight-loss medications? See Are Weight Loss Pills Safe? and Are Weight Loss Pills Effective?. Also, see related posts below.

    Take a deep dive into the best way to lose weight with my book How Not to Diet. 

    Michael Greger M.D. FACLM

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  • Study: Vaporizing CBD/THC Cannabis Blend Effective for Sustained Migraine Relief | High Times

    Study: Vaporizing CBD/THC Cannabis Blend Effective for Sustained Migraine Relief | High Times

    It’s estimated that at least 39 million Americans live with migraines, though the number is likely higher due to lack of diagnosis or proper treatment. And those who experience migraines are well aware of how debilitating they can be, especially those who experience migraines on a consistent basis.

    Cannabis is already known to be beneficial for those who suffer from migraines, as it appears as a qualifying condition for a number of state medical programs. But of course, we’re still catching up on research surrounding cannabis as a whole, and there’s a lot we’re continuing to learn about cannabis and how it can work to treat specific conditions like migraines.

    A pilot study published by the National Library of Medicine took a closer look at the relationship between cannabis and migraines found that inhalation of flower with both CBD and THC may be key to providing migraine relief. The data has not yet been peer reviewed.

    First-of-its-Kind Study to Assess Cannabis for Migraine Relief

    Authors note the existing preclinical and retrospective studies suggesting that cannabinoids could be effective in treating migraines, though there are still no randomized clinical trials to assess efficacy.

    Additionally, they note the prevalence of acute treatments for migraines, like acetaminophen or ibuprofen, though rates of treatment optimization in this regard tend to be low with high rates of discontinuation. 

    To examine how cannabis may help to curb migraine symptoms, researchers from the University of California, San Diego (ECSD) conducted a randomized, double-blind, placebo-controlled crossover trial with herbal cannabis, the first of its kind according to the study. The trial involved 92 patients with persistent migraines.

    Participants were randomly assigned one of four cannabis chemotypes: 6% THC, 11% CBD, 6% THC and 11% CBD or a placebo. Upon each migraine attack onset, participants were instructed to open a smartphone application, which would prompt participants with questions surrounding whether or not the attack met the criteria for cannabis administration (if more than seven days had elapsed since the last administration, if it was less than four hours from headache onset, gauging the severity of pain, other symptoms associated with the migraine and that no acute treatments had been used since the attack onset). 

    So long as participants met the set criteria, the app would then instruct them to vaporize cannabis, inhaling for five seconds, holding their breath for 10 seconds and then waiting 45 seconds before repeating the process four times. The app then pushed surveys to participants at one, two, 24 and 48 hours following application to gauge efficacy.

    THC/CBD Blend Most Effective in Treating Migraines

    Ultimately, the study concluded that the vaporized cannabis containing THC and CBD was most effective in treating migraines. It also found that the THC/CBD blend was superior to the placebo when it came to relieving migraine-related photophobia, or light sensitivity, and phonophobia, sound sensitivity.

    “Vaporized 6% THC+11% CBD cannabis flower was superior to placebo for pain relief, pain freedom, and MBS [most bothersome symptom] freedom at 2 hours as well as 24-hour sustained pain freedom and sustained MBS freedom and 48-hour sustained MBS freedom,” authors reported, emphasizing that this blend was the only one to provide sustained benefit versus the placebo. 

    The study found that blends dominant in THC and CBD showed no difference from the placebo surrounding 24- or 48-hour sustained pain and MBS freedom.

    Regardless of the type of cannabis consumed, there were no serious adverse effects reported by participants. However, the THC-dominant blend provided the most euphoria, cognitive impairment and subjective highness, followed by the THC/CBD blend and then the CBD-dominant flower.

    Gaps in Research and Looking Ahead

    The study did not assess repeated administration or regular, long-term treatments, though researchers note a small body of literature that has found improvements on patient-reported outcomes when using cannabis-based medicinal products on regular, longer-term or preventative basis. 

    The study also only looked at single potencies of THC and CBD and a single THC:CBD ratio, and minor cannabinoids and terpenes were also left out of the study.

    In the study’s conclusion, researchers still cited the need for further research to include multicenter and long-term studies of benefits and risks regarding repeated use of cannabis to treat migraines.

    Keegan Williams

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  • A Look at the 5:2 Diet and the Fasting-Mimicking Diet  | NutritionFacts.org

    A Look at the 5:2 Diet and the Fasting-Mimicking Diet  | NutritionFacts.org

    What are the effects of eating only five days a week or following a fasting-mimicking diet five days a month? 
     
    Instead of eating every other day, what if you ate five days a week and fasted for the other two? As I discuss in my video The 5:2 Diet and the Fasting-Mimicking Diet Put to the Test, the available data are similar to that of alternate-day fasting: About a dozen pounds of weight loss was reported in overweight men and also reported in overweight women over six months, with no difference found between participants on the 5:2 intermittent fasting regimen and those on a continuous 500-calories-a-day restriction. The largest trial to date found an 18-pound weight loss within six months in the 5:2 group, which isn’t significantly different from the 20 pounds lost in the continuous calorie restriction group. Weight maintenance over the subsequent six months was also found to be no different.
     
    Though feelings of hunger may be more pronounced on the 5:2 pattern than on an equivalent level of daily calorie cutting, it does not seem to lead to overeating on non-fasting days. One might expect going two days without food may negatively impact mood, but no such adverse impact was noted for those fully fasting on zero calories or sticking to just two packets of oatmeal on each of the “fasting” days. (The oatmeal provides about 500 calories a day.) Like alternate-day fasting, the 5:2 fasting pattern appeared to have inconsistent effects on cognition and on preserving lean mass, and it also failed to live up to the “popular notion” that intermittent fasting would be “easier” to adhere to than daily calorie restriction. 
     
    Compared to those in the continuous-restriction control group, fewer subjects in the 5:2 pattern group expressed interest in continuing their diet after the study was over. This was attributed to quality-of-life issues, with 5:2 fasting participants citing headaches, lack of energy, and difficulty fitting the fasting days into their weekly routine. However, as you can see below and at 1:53 in my video, there has yet to be a single 5:2 diet study showing elevated LDL cholesterol compared with continuous calorie restriction at six months. Nor has it been shown for a year. This offers a potential advantage over alternate-day regimens. 

    Instead of 5:2, what about 25:5, spending five consecutive days a month on a “fasting-mimicking diet” (FMD)? Longevity researcher Valter Longo designed a five-day meal plan to try to simulate the metabolic effects of fasting by being low in protein, sugars, and calories with zero animal protein and zero animal fat. By making the diet plant-based, he hoped to lower the level of the cancer-promoting growth hormone IGF-1. He indeed accomplished this goal, along with a drop in markers of inflammation, after three cycles of his five-days-a-month program, as you can see below and at 2:33 in my video. 

    One hundred men and women were randomized to consume his fasting-mimicking diet for five consecutive days per month or maintain their regular diet the whole time. As you can see in the graph below and at 2:47 in my video, after three months, the FMD group was down about six pounds compared to the control group, with significant drops in body fat and waist circumference, accompanied by a drop in blood pressure. 

    Those who were the worst off accrued the most dramatic benefits, as seen in the graph below and at 3:04 in my video. What’s even wilder is that three further months after completion, some of the benefits appeared to persist, suggesting the effects “may last for several months.” It’s unclear, though, if those randomized to the FMD group used it as an opportunity to make positive lifestyle changes that helped maintain some of the weight loss. 


    Dr. Longo created a company to market his meal plan commercially, but, to his credit, says “he does not receive a salary or a consulting fee from the company…and will donate 100% of his shares to charity.” The whole diet appears to be mostly dehydrated soup mixes, herbal teas like hibiscus and chamomile, kale chips, nut-based energy bars, an algae-based DHA supplement, and a multivitamin dusted with vegetable powder. Why spend 50 dollars a day on a few processed snacks when you could instead eat a few hundred calories a day of real vegetables? 
     
    How interesting was that? All-you-can-eat above-ground vegetables for five days would have the same low amount of protein, sugars, and calories with zero animal protein or animal fat. But we’ll probably never know if it works as well, better, or worse because it’s hard to imagine such a study ever getting done without the financial incentive. 

    To learn more about IGF-1, see my video Flashback Friday: Animal Protein Compared to Cigarette Smoking.
     
    In this series on fasting, I’ve covered several topics, including the basics of calories and weight loss, water-only fasting, and the types of alternate-day fasting, see them all in the related videos below. 
     
    I close out the series with videos on time-restricted eating: Time-Restricted Eating Put to the Test and The Benefits of Early Time-Restricted Eating. 
     
    If you want all of the videos in one place, I’ve done three webinars on fasting—Intermittent Fasting, Fasting for Disease Reversal, and Fasting and Cancer—and they’re all available for download now. 

    Michael Greger M.D. FACLM

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  • The Safety of Fasting to Lose Weight  | NutritionFacts.org

    The Safety of Fasting to Lose Weight  | NutritionFacts.org

    Why should fasts lasting longer than 24 hours and particularly for three or more days only be done under the supervision of a health professional and preferably in a live-in clinic? 
     
    Fasting for a week or two can actually interfere with the loss of body fat, as shown at the start of my video Is Fasting for Weight Loss Safe?. But, eventually, after the third week of fasting, fat loss starts to overtake the loss of lean body mass in obese individuals, as seen in the graph below and at 0:14 in my video. Is it safe to go that long without food? 

    Proponents speak of fasting as a cleansing process, but some of what is being purged from our bodies are essential vitamins and minerals. People who are heavy enough can fast up to 382 days without calories, but no one can go even a fraction of that long without vitamins. Scurvy, for example, can be diagnosed within as few as four weeks without any vitamin C. Beriberi, deficiency of thiamine (vitamin B1), may start even earlier in fasting patients. And, once it manifests, it can result in brain damage within days, which can eventually become irreversible.  
     
    Even though fasting patients report problems such as nausea and indigestion after taking supplements, all of the months-long fasting cases I’ve discussed previously were given daily multivitamins and mineral supplementation as necessary. Without supplementation, hunger strikers and those undergoing prolonged fasts for therapeutic or religious purposes (like the Baptist pastor hoping “to enhance his spiritual powers for exorcism”) have ended up paralyzed, become comatose, or worse. 
     
    Nutrient deficiencies aren’t the only risk. After reading about all of the successful reports of massive weight loss from prolonged fasting in the medical literature, one doctor decided to give it a try with his patients. Of the first dozen he tried it on, two died. In retrospect, the two patients who died had started out with heart failure and had been on diuretics. Fasting itself produces pronounced diuresis, meaning loss of water and electrolytes through the urine, so it was the combination of fasting on top of the water pills that likely depleted their potassium and triggered their fatal heart rhythms. The doctor went out of his way to point out that both of the people who died started out “in severe heart failure, complicated by gross obesity; but both had improved greatly whilst undergoing starvation therapy.” That seems like a small consolation since they were both dead within a matter of weeks. 
     
    Not all therapeutic fasting fatalities were complicated by concurrent medication use, though. One researcher writes: “At first he did very well and experienced the usual euphoria…His pulse, blood pressure, and electrolytes remained satisfactory, but in the middle of the third week of treatment, he suddenly collapsed and died. This line of treatment is certainly tempting because it does produce weight loss and the patient feels so much better, but the report of case-fatalities”—the whole part about killing people—“must make it a very suspect line of management.” 
     
    Contrary to the popular notion that the heart muscle is specially spared during fasting, the heart appears to experience similar muscle wasting. This was “described in the victims of the Warsaw ghetto” during World War II in a remarkable series of detailed studies carried out by the ghetto physicians before they themselves succumbed. In a case entitled “Gross Fragmentation of Cardiac Fiber After Therapeutic Starvation for Obesity,” a 20-year-old woman successfully “achieved her ideal weight” after losing 128 pounds by fasting for 30 weeks. “After a breakfast of one egg,” she had a heart attack and died. On autopsy, as you can see below and at 3:44 in my video, the muscle fibers in her heart showed evidence of widespread disintegration. The pathologists suggested that fasting regimens “should no longer be recommended as a safe means of weight reduction.” 
    Breaking the fast appears to be the most dangerous part. After World War II, as many as one out of five starved Japanese prisoners of war tragically died following liberation. Now known as “refeeding syndrome,” multiorgan system failure can result from resuming a regular diet too quickly. This is because there are critical nutrients such as thiamine and phosphorus that are used to metabolize food. Therefore, in the critical refeeding window, if too much food is taken before these nutrients can be replenished, demand may exceed supply. Whatever residual stores you still carry can be driven down even further, with potentially fatal consequences. This is why rescue workers are taught to always give thiamine before food to victims who have been trapped or otherwise unable to eat. Thiamine is responsible for the yellow color of “banana bags,” a term you might have heard used in medical dramas to describe an IV fluid concoction often given to malnourished alcoholics to prevent a similar reaction. (You can see a photo of them below and at 4:53 in my video.) Anyone “with negligible food intake for more than five days” may be at risk of developing refeeding problems. 
    Medically-supervised fasting has gotten much safer now that there are proper refeeding protocols. We now know what warning signs to look for and who shouldn’t be fasting in the first place, such as those who have advanced liver or kidney failure, porphyria, uncontrolled hyperthyroidism, and pregnant and breastfeeding women. The most comprehensive safety analysis of medically supervised, water-only fasting was recently published by the TrueNorth Health Center in California. Out of 768 visits to its facility for fasts up to 41 days, were there any adverse events? There were 5,961 of them! Most of these were mild, known reactions to fasting, such as fatigue, nausea, insomnia, headache, dizziness, upset stomach, and back pain. Only two serious events were reported, and no fatalities. You can see the chart below and at 5:58 in my video. 
    “Fasting periods lasting longer than 24 hr, and particularly those lasting 3 or more days, should be done under the supervision of a physician and preferably in a [live-in] clinic.” In other words, don’t try this at home! This is not just legalistic mumbo-jumbo. For example, normally, your kidneys dive into sodium conservation mode during fasting, but should that response break down, you could rapidly develop an electrolyte abnormality that may only manifest with non-specific symptoms, like fatigue or dizziness, which could easily be dismissed until it’s too late. 
     
    The risks of any therapy must be premised on the severity of the disease. The consequences of obesity are considered so serious that effective therapies could have “considerable acceptable toxicity.” For example, many consider major surgery for obesity to be a justifiable risk, but the keyword is effective. 
     
    Therapeutic fasting for obesity has largely been abandoned by the medical community not only because of its uncertain safety profile but its questionable short- and long-term efficacy. Remember, for a fast that only lasts a week or two, you might be able to lose as much body fat or even more on a low-calorie diet than a no-calorie diet. 
     
    Fasting for a week or two can actually interfere with the loss of body fat. For more background on this, see Is Fasting Beneficial for Weight Loss? and Benefits of Fasting for Weight Loss Put to the Test.
     
    If you’re wondering what the best way to lose weight is, I wrote a whole book about it! Check out How Not to Diet. 
     
    Interested in learning more about fasting? See related videos below. 

    Michael Greger M.D. FACLM

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  • Marijuana Reduces Migraine Pain

    Marijuana Reduces Migraine Pain

    They are incredibly disablitating, migraines occurs most often among people aged 20 – 50 years, and are 3 times more common with women.  Roughly 10% of the population will get one.  Around 95% of the population will get a headache.  The most common headaches include tension-type headaches (must frequent), cluster headaches, and persistent headaches (NDPH). This doesn’t include alcohol and food related headaches.  A migraine  differed stands out since it is neurological condition causing a variety of symptoms, most notably a throbbing headache on one side of your head. Migraines often get worse with physical activity, lights, sounds or smells. They usually last at least four hours or even days.

    Data suggests marijuana may reduce migraine pain and be the best over the counter relief. More research needs to be done, but early studies show promise. Published in The Journal of Pain, the first study to utilize big data in analyzing the role cannabis plays in managing pain from headaches and migraines. Using archival data from the Strainprint—an app in which patients track their symptoms before and after using medical marijuana—scientists determined inhaled marijuana reduced the severity of self-reported pain 47.3% for headaches and 49.6% for migraines.

    “We were motivated to do this study because a substantial number of people say they use cannabis for headache and migraine, but surprisingly few studies had addressed the topic,” said study lead author Carrie Cuttler, an assistant professor of psychology at Washington State University.

    RELATED: What You Need To Know About The Healing Benefits Of Marijuana’s CBG

    Instead of documenting the before and after data points in real time, previous research asked patients to recall how marijuana affected the severity of past headaches. A clinical trial, as Science Daily first reported, found that cannabis could be more effective at reducing headache pain than ibuprofen, though the researchers used nabilone, a synthetic cannabinoid drug, in the trial.

    Photo by gradyreese/Getty Images

     

    However, in the Washington State study, 1,300 patients who used the app more than 12,200 times submitted information about their headache before and after marijuana use, while 653 patients used the app over 7,400 times to track their changes in migraine pain.

    More conventional treatments can cause an “overuse headache,” which can cause patients’ headaches to worsen over time. But researchers found no such result in patients using cannabis. They did, however, find patients consuming more marijuana over time, indicating they may be developing a tolerance to the plant. In addition, the study reported a difference in headache reduction between genders, with significantly more sessions involving men (90%) than women (89.1%).

    RELATED: Consuming Medical Marijuana Is Proven To Help Migraine Sufferers

    Patients received no additional benefits when using cannabis strains with higher or lower THC and CBD concentrations. As the plant contains more than 100 cannabinoids outside THC and CBD, researchers believe this indicates other cannabis elements like terpenes could be playing a factor. The study did report concentrates, like oil, elicited stronger decreases in headache severity than marijuana flower.

    “I suspect there are some slight overestimates of effectiveness,” Cuttler said. “My hope is this research will motivate researchers to take on the difficult work of conducting placebo-controlled trials. In the meantime, this at least gives medical cannabis patients and their doctors a little more information about what they might expect from using cannabis to manage these conditions.”

    Amy Hansen

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  • How CBD Might Help Reduce Holiday Stress

    How CBD Might Help Reduce Holiday Stress

    While the holiday season is filled with excitement and fun, it can be a hard on the mind and body.Holiday fare is typically very high in calories. While pleasing to the palate, these foods can slow down digestion, reflux, bloating and other tummy issues.  Everyone, at some points gets a bit stressed with the additional to-do list.

    Recover from Holiday Mania

    One’s mind can easily go into on overdrive from too much holiday frenzy. CBD can have a calming effect allowing one to turn one’s mind off and get adequate sleep. Along those lines, CBD can be a very effective tool in helping one stay focused while engaging in relaxation techniques such as meditation, yoga, or exercise. 

    Photo by Matthew Henry via Burst

    Survive the Rigors of Holiday Travel

    For those traveling over the holidays, CBD’s anti-inflammatory properties can help combat the mood swings, headaches, and stiff muscles often accompany the stress of travel especially if one is traveling for more than a few hours at a stretch. 

    RELATED: Great Fall Whiskeys

    Maintain The Holiday Glow

    A CBD-infused topical can help keep one’s skin and subtle thus making one appear to be relaxed. As CBD is an antioxidant, it can help combat the free radicals which can produce visible signs of aging. Also, the anti-inflammatory properties of CBD can help reduce skin redness and irritation often caused during the winter months. 

    Photo by JGI/Jamie Grill/Getty Images

    Stay Social and Sober

    When attending holiday events, CBD can be invaluable in helping one stay calm with attending stressful holiday parties. Also, adding CBD to an alcoholic drink or consuming a CBD-infused beverage in lieu of a cocktail can prevent one from consuming too much alcohol. Furthermore, anecdotal evidence seems to suggest consuming CBD with alcohol can reduce hangovers. 

    RELATED: How To Add Weed To Your Friendsgiving Celebration

    Help with Digestion

    CBD can help with the stressors from consuming too much holiday fatty foods. Along those lines, CBD works as a digestive aid by helping control IBS symptoms, as well as helping reduce holiday weight gain by regulating insulin levels and converting fat. 

    Smoking Marijuana
    Photo by Sofie Delauw/Getty Images

    Reduce Headaches

    The anti-inflammatory properties present in CBD can help one deal with any headaches caused from too much stress. 

    A CBD tincture taken sublingually or a CBD-infused drink will enter the bloodstream the quickest for those looking for more immediate relief. When consuming edibles, be mindful of the sugar content of a given CBD product so one does not get a sugar high which will only add to one’s stress. Topicals can also provide immediate relief, and are particularly helpful for introducing CBD into an anti-stress regime for those wary of trying any CBD product.

    Becky Garrison

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  • Study Finds Link Between Headaches, Migraine & Circadian Rhythm

    Study Finds Link Between Headaches, Migraine & Circadian Rhythm

    Namely, 71% of people who experienced cluster headaches had circadian patterns to their headaches, with attacks peaking in the late evening to early hours of the morning, and more attacks during spring and fall. For migraines, 50% of people showed a circadian pattern to their attacks, with the time of day ranging a bit wider, from late morning to early evening.

    In terms of hormonal patterns, those with cluster headaches had higher cortisol levels and lower melatonin levels than those without cluster headaches, and those dealing with migraines had lower levels of melatonin in their urine than people without migraines, as well as lower melatonin levels during a migraine attack.

    As study author Mark Joseph Burish, M.D., Ph.D. explains in a news release, “The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache,” adding that these findings reinforce the importance of our circadian rhythm and its role in cluster headaches and migraines.

    “These results raise the potential for using circadian-based treatments for headache disorders. This could include both treatments based on the circadian rhythm—such as taking medications at certain times of the day—and treatments that cause circadian changes, which certain medications can do,” Burish adds.

    Sarah Regan

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  • East Palestine residents worry rashes, headaches and other symptoms may be tied to chemicals from train crash | CNN

    East Palestine residents worry rashes, headaches and other symptoms may be tied to chemicals from train crash | CNN



    CNN
     — 

    Some residents of East Palestine, Ohio, say they have developed rashes, sore throats, nausea and headaches after returning to their homes this week, and they’re worried these new symptoms are related to chemicals released after a train derailment two weeks ago.

    The February 3 incident caused a massive fire and prompted officials to evacuate hundreds of people who lived near the site because of fears that a hazardous, highly flammable material might ignite. To prevent a potentially deadly explosion, toxic vinyl chloride gas was vented and burned, releasing a plume of black smoke over the town for days.

    Other chemicals of concern at the site include phosgene and hydrogen chloride, which are released when vinyl chloride breaks down; butyl acrylate; ethylene glycol monobutyl ether acetate; and 2-ethylhexyl acrylate, according to the US Environmental Protection Agency. All these chemicals can change when they break down or react with other things in the environment, creating a stew of potential toxins.

    Residents were given the all-clear to return to their homes February 8 after air monitoring in East Palestine did not detect any elevated chemicals of concern.

    Officials say further testing of indoor air in about 500 homes has also not shown any hazards. Tests of tap water from the municipal system didn’t show any chemicals at levels that would pose a health hazard, although officials are still testing water from rivers, streams and residential wells in the area.

    These test results have failed to reassure some residents, who say something is making them sick – even if officials can’t find it.

    “When we went back on the 10th, that’s when we decided that we couldn’t raise our kids here,” Amanda Greathouse said. There was a terrible, lingering smell that “reminded me of hair perming solution.”

    Greathouse said she was back in their house, about a block from the crash site, for 30 minutes when she developed a rash and nausea.

    “When we left, I had a rash on my skin on my arm, and my eyes were burning for a few days after that,” said Greathouse, who has two preschool-age children.

    She and her husband have returned to their home only twice since the derailment, to pick up paperwork and clothing.

    “The chemical smell was so strong that it made me nauseous,” Greathouse said. “I just wanted to quickly pick up what I needed and leave. I only took a few pieces of clothes because even the clothes smelled like chemicals, and I’m afraid to put them on my kids.”

    She says she’s also kept her children out of preschool since the derailment. Even though her son’s teacher has promised her that students are using only bottled water, she’s worried about other types of contamination.

    “I don’t want to take my son out of the preschool they’re in because I really like the teachers he has, but I’m still scared. Some teachers have even expressed their concerns about the air quality,” Greathouse said.

    “We are very fortunate that we rent our home. Didn’t think I would ever say that. I feel awful for my landlord, but I just can’t risk my family’s health.”

    Ohio Gov. Mike DeWine said a request for medical experts from the US Department of Health and Human Services has been granted, and officials should be arriving early next week to help prop up a clinic for patients.

    “We know the science indicates that this water is safe, the air is safe. But we also know very understandably that residents of East Palestine are concerned,” he said Friday.

    DeWine said he plans to set up a clinic where HHS officials and others will answer questions, evaluate symptoms and provide medical expertise.

    The Agency for Toxic Substances and Disease Registry, part of the US Centers for Disease Control and Prevention, also says it expects to have a team on site Monday, according to a CDC spokesperson who requested that they not be named because they weren’t authorized to share the details. The team will conduct an Assessment of Chemical Exposure investigation, which surveys the impact of a chemical release on people and the community.

    The volatile organic compounds released by the controlled explosion can cause symptoms similar to those reported by some East Palestine residents, including headache, sore throat, and nose and eye irritation, but experts say it’s extremely difficult to connect chemical exposures to health effects.

    “That is a major challenge,” says Erin Haynes, chair of the Department of Epidemiology and Environmental Health at the University of Kentucky.

    “The community is now exposed to a mixture of numerous petroleum-based volatile organic compounds, so it may not just be one, it could be the mixture of them,” Haynes said.

    Haynes, who has experience investigating toxic exposures in communities, says she is seeking approval from her university’s Institutional Review Board to start a study in East Palestine to help give residents more information on their chemical exposures in air, water and soil.

    “They need all the help they can get,” she said. “This is a major emergency. This is a major disaster. They need all the assistance that we all can provide.

    “The evidence of a toxic exposure could very well be the rashes,” she said.

    Audrey DeSanzo would like some answers, too.

    “How safe is it, really?” said DeSanzo, who lives about half a mile from the derailment with her two grade-school-age children. “It’s not in all these people’s heads that are getting rashes, that are having the conjunctivitis, the pinkeye, from chemicals.”

    “You have a sore throat when you’re staying here. It smells out here.”

    After the derailment, DeSanzo evacuated with her kids just over the state line in Pennsylvania, where her uncle had an empty duplex. They slept on the floor and the couch.

    When she came home this week, DeSanzo says, she aired out her house, changed the furnace filter and washed their sheets and clothes. Even so, she says, they all recently went to a local immediate care clinic because her kids were coughing, and “our throats were raw.”

    Tests for strep throat were negative. The doctor prescribed cough medicine for the kids and told DeSanzo that the chemicals were probably to blame.

    The doctor said she had seen a number of East Palestine residents with similar symptoms, DeSanzo said, and advised them to call poison control and go to the local hospital for a blood test. She hasn’t gotten the blood test yet.

    Debbie Pietrzak, a spokesperson for Salem Regional Medical Center, which runs the clinic DeSanzo went to, confirmed that it has treated a small number of residents with symptoms like sore throats and respiratory problems. The hospital’s emergency room has seen fewer than 10 patients from East Palestine, she said.

    “Our facilities and primary care providers stand ready to help anyone who is seeking medical attention, and we are working closely with the County’s Health Department and other local, state and federal agencies, which are monitoring the situation,” Pietrzak said in an email.

    Natalie Rine, a pharmacist who directs the Central Ohio Poison Center, said the state’s poison control centers are getting calls from East Palestine residents, too. Experts who staff the help lines are trained in toxicology and can help if chemicals are a health concern.

    DeSanzo says she wants to leave but can’t afford to. Her mortgage is about $400 a month, less than half of those of other homes she’s found in the area that are farther from the accident site.

    “I make $14 an hour. Where am I supposed to go?” she said. “I don’t want to be here now with with my kids.”

    Ayla and Tyler Antoniazzi and their two daughters have been living in East Palestine since April. After the train crash, they weren’t sure about moving out, Ayla says, but they’re now considering it.

    The Antoniazzis returned to their house less than a mile from the accident site the day after the evacuation notice was lifted.

    “Before bringing my kids back home, I washed all the linen and a bunch of clothes, cleaned surfaces and aired the house out,” Ayla said. “But the next day when they woke up, they weren’t themselves. My oldest had a rash on her face. The youngest did too but not as bad. The 2-year-old was holding her eye and complaining that her eye was hurting. She was very lethargic, so I took them back to my parents’ home.”

    Ayla says her daughters are staying with her parents in Leetonia, about 20 minutes west of East Palestine, until the couple is able to make sure their home is safe.

    The kids’ symptoms got better in Leetonia, she said, but one got another rash when she returned to school in East Palestine on February 13.

    Ayla Antoniazzi's 4-year-old daughter developed a rash after going back to school in East Palestine.

    “I did allow my 4-year-old to return to preschool, which is in the East Palestine Elementary School. She went back for two days and developed another rash on her hands and started complaining of itching, so I pulled her back out,” Ayla said.

    Ayla has scheduled a medical appointment with her daughters for next week to discuss their symptoms and testing options, she said.

    That’s the right thing to do, says Dr. Kari Nadeau, an allergist and chair of the Department of Environmental Health at Harvard’s TH Chan School of Public Health.

    Nadeau says rashes, sore throat, and headaches can be clinical signs of a chemical sensitivity.

    “There are people that are highly sensitive to chemicals and can feel it before necessarily a monitor can pick it up,” Nadeau said. “There’s not a great diagnostic pathway for chemical sensitivities. A lot of it is based off clinical symptoms, including rashes.”

    Nadeau and other environmental health experts advise people who are having symptoms to see a health care provider, primarily for medical care but also so their case can be documented.

    “So that if there is a cluster, or if there’s a group of people that all of a sudden have complained about a rash or given symptoms, that really helps doctors come together with institutions like the CDC and do a little bit more fact-finding,” she said.

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  • Why A Magnesium Deficiency Could Be Behind Your Constant Fatigue

    Why A Magnesium Deficiency Could Be Behind Your Constant Fatigue

    Magnesium is an essential mineral that helps keep our bodies functioning at their best, and when you aren’t getting enough of it, you’ll definitely notice a difference (even if you don’t realize it’s the lack of magnesium behind your symptoms).

    As registered dietitian nutritionist, Natalie Butler, RDN, L.D., previously wrote for mindbodygreen, fatigue and exhaustion are generalized symptoms of a magnesium deficiency. “You may attribute your tiredness to stress, poor sleep, or a host of other reasons and not realize just how much nutrition is playing a role,” she says, adding, “This is because magnesium is required for the production of energy. If the body has inadequate access to magnesium, then energy production suffers, leaving you prone to fatigue.”

    Not to mention, magnesium also plays an essential role in managing the body’s normal inflammatory response. “When magnesium intake is low, inflammatory biomarkers such as high-sensitivity C-reactive protein (hs-CRP), interleukin-6, and fibrinogen1 are significantly affected,” Butler notes.

    To that end, chronic inflammation is associated with fatigue as well, furthering the importance of making sure your magnesium levels are adequate to keep both inflammation and fatigue in check.

    Sarah Regan

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  • Study Finds Inadequate Fiber Could Be The Cause Of Your Migraines

    Study Finds Inadequate Fiber Could Be The Cause Of Your Migraines

    For this study, researchers from China wanted to look at how dietary fiber impacted the prevalence and severity of migraines and headaches in participants. To do so, they analyzed existing data on fiber and headaches from the National Health and Nutrition Examination Survey.

    And based on their findings, it would appear fiber might play more of a role in headaches than we previously thought. Namely, the researchers saw that there was a significant association between the two, with more dietary fiber leading to a decrease in severe headaches and migraines.

    For every increase of 10 grams of fiber per day, there was an 11% decrease in the prevalence of headaches and migraines, the researchers observed.

    “To the best of our knowledge, no previous study has examined the relationship between dietary fiber and severe headache or migraine,” the study authors note in their research, adding, “Increasing the intake of fiber-rich foods might protect from severe headache or migraine.”

    Sarah Regan

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