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FOR most people, a trip to the GP goes something like this: Symptoms, examination and diagnosis.

But for some patients, that is not their reality.

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Instead, they live each day with an undiagnosed condition and the agony of not knowing can leave them questioning if life is really worth living.

A condition such as endometriosis can take on average seven years to diagnose, while superstar Lady Gaga has opened up about her battle with fibromyalgia which can also be hard to spot.

New BBC series The Diagnosis Detectives, hosted by Dr Michael Mosley, aims to help find answers with the help of 12 experts.

Here, we meet some of their patients.

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WHAT started as just small patches of eczema on his hands soon spread like wildfire around his body and has left Neil Cobb in agony.

The 64-year-olds skin is so itchy, he has scratched off the pigment.

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For four years he has been plagued by red, open sores and he once collapsed unconscious and was left fighting for his life after an infection engulfed his body.

But Neils real torment is having no idea what is causing his pain. He is one of many people living with undiagnosed health conditions.

What makes these peoples illnesses much harder to cope with is the lack of answers and that uncertainty can cause mental as well as physical problems.

Neil tells tomorrow night's episode of new BBC series The Diagnosis Detectives: Im merely existing and suffering as I exist. If no one can help me, I dont think I will be around much longer.

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Dr Michael Mosley, who presents the show, told The Sun the makers were inundated with people desperate for answers when creating the series.

He says: A lot of these people have had undiagnosed conditions for years. They have been around the houses and seen several different doctors.

You look at poor Neil and think, blimey, this has really affected his social life.

But happily, on the show Neil DOES get a diagnosis, and successful treatment, and Dr Mosley says this was life-changing for him.

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He added: This is more emotional than many of the series I have made. There were a lot of tears.

Dr Mosley and 12 other top specialists from various different fields put their heads together to try to crack some of the most puzzling unsolved medical cases.

Their aim is to give their patients the answers they so desperately need, and have often waited years for.

Dr Mosley says: Diagnosis is at the heart of everything we are taught at medical school. You start with a persons medical history, you find out if there is any pain, where it started, and then theres a physical examination.

The reality is, for most people their condition is fairly obvious. But how many people are out there living without a diagnosis? I dont know.

The grim reality is that it is likely the hundreds who applied for the show are just the tip of the iceberg.

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Neil, originally from Missouri, US, moved to England in the 1990s to work as a mechanic at a US Air Force base in Norfolk.

He first noticed symptoms in 2016 and military doctors put it down to an allergic reaction to a chemical in cleaning fluid.

Initially, he was given a steroid cream to treat small patches of irritation on his hands. But the rash then spread like wildfire up his arms and across his body, and he was unable to work.

He tells the show, before his diagnosis: I itch so intensely, I have scratched my pigment off. Indeed, so severe is his scratching that he is left with gaping sores and widespread infection.

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Neil was recently found unconscious, his body consumed by sepsis a deadly immune response to an infection, where the body attacks its own tissues.

He turned to the TV specialists in the hope of finding an answer.

Consultant dermatologist Dr Sharon Wong, who leads the investigation into Neils case, says: Skin is the gateway to the rest of your body and in extreme cases some patients can die from skin disease. So it isnt a superficial problem. It goes a lot deeper than that.

Dr Wong tells viewers Neil recently had a tumour removed from his kidney, so it is possible some cancerous cells were left behind and that could be contributing to his skin problem.

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She says there could also be an underlying blood cancer such as T-cell lymphoma, which can appear on the skin in a way that mimics eczema.

Otherwise, the rash could come down to the initial diagnosis of an allergic form of eczema, which needs to be brought under control.

Dr Wong takes three skin biopsies and sends Neil for a CT scan to rule out anything related to cancer. In the meantime, she prescribes strong steroid cream and tablets, as well as a course of antibiotics.

When Neil returns to her London clinic weeks later, his condition has improved. His skin is much smoother and the flare-ups appear to finally be under control.

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His test results show no evidence of kidney cancer and there was nothing to point to T-cell lymphoma.

After four years, Dr Wong is able to give Neil the diagnosis he has craved he does have a severe case of eczema.

Dr Wong says: Over years, unfortunately, the hand eczema wasnt fully contained and Neil continued to get more and more eczema in other parts of the body.

"Your skin, head totoe, is one organ, so if youve got an inflammatory process like eczema happening on your leg and you dont contain it, just like a wildfire will do, it will continue to spread.

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Given his diagnosis, and the treatment he needed, Neil has now managed to return to work.

Next up on the TV show, hoping for answers, is Katie who has been plagued by health problems since her teens.

The mum-of-threes joints crack and pop, leaving her in constant agony and just walking across a room can cause her heart rate to spike to 140 beats per minute, way above the healthy range of 60 to 100.

More recently, she started experiencing excruciating stomach pain and being sick, which caused her to lose a lot of weight very quickly.

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Mum-of-three Katie, 35, from Lancashire, says: I lost 4st 7lb in 18 months. My appetite went down and down. I had tests done and it turned out that my stomach wasnt emptying properly.

The part-time nursing assistant had a temporary feeding tube fitted to bypass her stomach and deliver nutrients straight into her intestine.

But she continued to lose weight and still doesnt have any answers. She says: If I were to go to my GP with everything that I feel in my body, Id be there for a weeks appointment, not a ten-minute slot.

I was a dress size 12 to 14, I felt good and confident, but now Im heading towards half the person I was.

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Im still fairly young, I have a family, I want to know what the future holds.

Examining her case, the Diagnosis Detectives tell Katie that all her different symptoms could be linked.

Dr Stephanie Barrett, a consultant rheumatologist, suggests she could have Ehlers-Danlos syndrome (EDS), which affects the connective tissues and causes very flexible joints.

Dr Barrett says it could have caused a weakening of the tissues in the stomach, and caused her blood vessels to stretch, causing Katies fast heartbeat.

But this is not the only option they explore. Dr Barbara McGowan suggests Katies symptoms could also be a sign of a tumour in her adrenal glands.

She also notes that Katie had a neck op to remove one of the four parathyroid glands which regulate calcium levels when she was 17.

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The endocrinologist specialising in hormone-related diseases explains that the combination could point to a rare genetic disorder known as multiple endocrine neoplasia (MEN).

It can be life-limiting and is genetic, so could potentially put Katies children at risk.

But after blood tests rule out MEN, Dr Barrett tells Katie she has a rare form of EDS known as hypermobile EDS.

Dr Barrett adds: The painful symptoms youve been getting are to do with the tendons and muscles, which have had micro injuries over the years. So it all fits together.

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Although happy to finally get a diagnosis, Katie says she is concerned that two of her children also have hypermobility.

The medics explain that her type of EDS does not have a gene test yet, but confirm it is hereditary.

Speaking after her appointment, Katie says: Ive seen umpteen different specialists and never really got anywhere and now I finally have an answer.

It will be a massive change for me to now be able to move forward, with just that very clear definition of what is going on.

'Failure to diagnose'

NOT all health conditions present equally, with some typically harder to diagnose.

Failure to diagnose, as it is known medically, can prove upsetting and frustrating for patients, Dr Mosley tells The Sun.

Sometimes it is just a matter of time. The way symptoms manifest can mean the condition becomes more apparent over time. What it shows is how complicated the human body really is.

If these conditions were straightforward, GPs would be able to find the answer easily, all the time.

The range of possibilities can be vast, so we doctors have to narrow them down and go down some blind allies before we can get an answer.

Almost any illness can be mis-diagnosed, but below are some common conditions that are more routinely missed.

AROUND one in every ten women in the UK is plagued by endometriosis, which takes on average seven years to diagnose.

It causes agonising periods, when the tissue that lines the womb grows outside the uterus, on the ovaries or Fallopian tubes, the charity Endometriosis UK explains.

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It is often confused with other conditions which cause pain in the same area, such as ovarian cysts or irritable bowel syndrome.

Scans, blood tests and internal examinations are not a conclusive way to diagnose endometriosis.

The only way to be certain is with laparoscopy, which is when a thin tube with a light and a camera is inserted into the pelvis to check the tissue.

THE likes of Lady Gaga and broadcaster Kirsty Young have spoken out about their battles with fibromyalgia.

It is a long-term condition that causes pain all over the body and again, due to the lack of a specific test, it can prove difficult to diagnose.

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Symptoms can be similar to other conditions and, to get a diagnosis, certain criteria usually have to be met:

Doctors will try to rule out conditions such as chronic fatigue syndrome, rheumatoid arthritis and multiple sclerosis before diagnosing fibromyalgia.

THIS is an auto-immune disease where the body attacks its own nerve cells and disrupts the communication between the brain and rest of the body.

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Original post:
From fibromyalgia to eczema do you have an undiagnosed illness like Lady Gaga? - The Sun

Did you know that germs can quickly get from one surface to another in the kitchen? If they get into the food or even on your skin, they can make you ill in no time. Thus, it is crucial to keep the home and kitchen surfaces disinfected to limit the possibility of infection. Coronavirus has brought the focus on hygiene, cleanliness and food safety. Many people have been sanitising all the food products that enter the kitchen to keep the surfaces germ-free. It is imperative to follow proper food safety measures to keep ourselves and our families safe from the looming threat of the virus. Therefore, it is now more important than ever to keep our homes and kitchens clean. The Food Safety and Standards Authority of India (FSSAI) has released three helpful tips to sanitise home and kitchen surfaces effectively during the coronavirus. Wash Your Kitchen CountersKitchen counters can be full of germs. It is the first place where we keep the grocery bags and food products that we bring from the market. We also chop vegetables, meats and other food items on chopping boards placed over the counter, most often without washing our hands promptly after each use. Dirt and dust too easily settle on the kitchen counters. It is vital to keep your kitchen counters clean to avoid contaminating the food with disease-causing germs. As per FSSAI, you should wash the kitchen slabs and counters well with detergent and water at least once every day.

Keep Your Gas Stove CleanIf you check your gas stove after making a meal, you will find that some food particles drop and dry up over it. After a few hours, it becomes a breeding ground for disease-causing bacteria. Therefore, FSSAI advises thoroughly cleaning the gas stoves after preparing each meal. This actively reduces the risk of spreading infection and maintaining necessary cleanliness and hygiene. You can also make a paste with baking soda and water to deeply cleanse your gas stove.

See the article here:
These hacks by FSSAI will help you disinfect your kitchen easily! - Times of India

Sara Ramirez, an actor best known for her role as Dr. Callie Torres on "Grey's Anatomy" came out as nonbinary on Instagram Friday, writing "New profile pic. In me is the capacity to be Girlish boy, Boyish girl, Boyish boy, Girlish girl, All, Neither" and adding the hashtag #nonbinary.

As of Sunday morning, the post had received over 216,000 likes. Miss Peppermint, a Black transgender drag queen starred in Season 9 of "Rupaul's Drag Race" said she was "so proud and happy" on Twitter.

Ramirez's complex portrayal was applauded again by fans of the show after the actor came out as nonbinary Friday.

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Ramirez has long been an advocate for LGBTQ rights, receiving an Ally for Equality Award from the Human Rights Campaign Foundation in 2015. They first came out as queer and bisexual in 2016.

People who are nonbinary may go by the pronouns "they/them" rather than "he/she."

The nonbinary identity is increasingly visible, with a January 2019 Pew Research survey finding that a third of teens and people in their early 20s know someone who uses such gender-neutral pronouns.

Read more:
'Grey's Anatomy' actor Sara Ramirez came out as nonbinary: 'In me is the capacity to be Girlish boy, Boyish gi - Business Insider India

Getty / Tom Werner PCOS Affects as Many as 5 Million Women - Here's How to Know If You're One of Them

PCOS - polycystic ovarian (or ovary) syndrome - is a chronic condition that affects the lives and health of millions of people globally. At least six to 12 percent of people (as many as five million) with female sex organs of childbearing age suffer from PCOS, according to the CDC. As Stephanie Long, MD, told us, if you have PCOS, your ovaries and uterus "don't get the signals in the right way" from your brain, leading to a slew of damaging health effects that impact a patient's everyday life.

We spoke with Alyssa Dweck, MD, a New York gynecologist, about the rise in diagnosis of PCOS. She told POPSUGAR, "I am seeing so many patients with PCOS now," and confirmed that it's on the rise. "I'm not sure whether there's more of it, or if we're realizing we need to recognize it, or if people are more aware of their [symptoms] and bringing that to their doctors."

Either way, it's important to get the information out there so more women get in touch with their bodies, spot symptoms, and treat the issue as soon as possible, as untreated PCOS can lead to deadly disease and infertility.

PCOS is a hormonal disorder that affects six to 12 percent of people with female sex organs. People with PCOS produce more androgen (male hormones) than others who are assigned female at birth, which causes enlarged ovaries with multiple small cysts due to the follicles not maturing into eggs. This creates a lack of ovulation.

There is a spectrum of symptoms, and each person is impacted differently. However, a handful are "telltale signs," as Dr. Dweck said, and they are extremely typical of PCOS. Here's what doctors are looking for and what you should look for if you think you might be at risk.

Hair growth. "On the face, specifically," said Dr. Dweck, and "in male places like sideburns, chin, mustache . . . more than 'you have to pluck a couple.'" If you notice dark, thick hairs growing in those areas, it's an indicator of a hormonal imbalance that may be related to PCOS.

Acne. More than your typical breakout? This is "Not just your typical teenage acne - it's persistent, significant." Acne plus hair growth are "signs of excess male hormone or androgen levels, which is typical of PCOS," Dr. Dweck said.

Weight gain. Whether it's difficulty losing or maintaining weight, Dr. Dweck said many people with PCOS are at a higher weight. She did, however, mention that there are atypical cases referred to as "atypical PCOS." Margaret Nachtigall, MD, clinical associate professor in the Department of Obstetrics and Gynecology at NYU's Grossman School of Medicine, explained that about 25 percent of people with PCOS are "actually extremely thin."

Menstrual irregularity. This is one of the hallmarks of PCOS. "Your menstrual cycle is going havoc." You either have no period, many missed periods, or skip several months at a time. This is due to a lack of or infrequent ovulation, according to Dr. Dweck. Dr. Nachtigall defined an irregular period as one that is more frequent than every 21 days or less frequent than every 42 days.

Difficulty getting pregnant. If you've been struggling with fertility and have any of these other symptoms, it may indicate that you have PCOS. This is definitely a time to check with your healthcare provider.

Male pattern baldness. In addition to that oh-so-pleasant facial and body hair growth, you may also lose the hair you actually want on your scalp, like at your temples.

Intolerance to sugar. PCOS is often linked with insulin resistance and "borderline diabetes," according to Dr. Dweck.

Unfortunately, no two cases of PCOS are the same, although irregular periods are usually the biggest indicator. "One of the things about making the diagnosis of PCOS, because the diagnosis is varied, is that some people will have irregular periods and acne," Dr. Nachtigall explained. "Other people will have irregular periods and hair growth. Other people will have irregular periods and hair loss."

Add to the fact that not everyone with PCOS is at a higher weight, and it may be tough to pinpoint. Dr. Dweck pointed out that there are people who have atypical symptoms, so it's imperative you see a healthcare provider for a proper diagnosis.

Dr. Dweck told us that "there's no foolproof way," but the most accurate way of diagnosis is the most invasive. "A true diagnosis is done by ovarian biopsy," she said, but it's highly aggressive and not the preferred method of diagnosis.

In most cases, your doctor will do a pelvic ultrasound, looking for a typical sign known as "a string of pearls." These are "teeny cysts around the periphery of the ovary that look like a string of pearls," she explained. Additionally, your doctor may run hormone blood tests to see if you have elevated testosterone or DHEAS, as well as low estrogen. These can all be indicators of PCOS as well.

The priority in treatment focuses on "regulating the menstrual cycle and preventing pregnancy to regulate ovulation," she said. Here's the main plan of attack you'll encounter.

Combination birth control pills. The most common treatment for PCOS is a combination birth control pill with both estrogen and progesterone, which "increases a particular protein made by the liver called sex hormone binding globulin." Why is this important? "It binds free testosterone in the bloodstream," meaning all that extra testosterone that's unchecked will be regulated once again. "The testosterone level is lowered, so those signs of high testosterone like hair growth or hair loss on the top of the head or acne will diminish quickly."

Diet and exercise. When dealing with PCOS patients who are at a higher weight, Dr. Dweck told us that regulating diet is imperative. Since many people with PCOS are also insulin resistant, maintaining a low-sugar and low-carb diet is key. Exercise is also important, not only to lose weight, but also to regulate insulin levels. "Exercise, independent of weight loss, just regular exercise will improve insulin sensitivity," explained Eduardo Grunvald, MD, program director at UC San Diego's Weight Management Program, in a previous article.

Hormonal IUD. This form of treatment has "no impact on the testosterone levels at all" (and she noted that a rare group of women get acne from the hormonal IUD), but "it keeps the uterine lining very thin - that's protective against uterine cancer," and it's "excellent for birth control." This is important for someone who doesn't know when they're ovulating, so they would have no idea if they were or weren't pregnant. It also "lightens the period or eliminates it," without creating uterine buildup by "chemically cleansing." Keep in mind that the hormonal IUD only contains progesterone, no estrogen.

It's important to note that your doctor will create a treatment plan that is specific to your body, your symptoms, and your needs.

If left untreated, PCOS has a serious impact, and can lead to:

Diabetes.

Implications of being at a higher weight (and all the health problems that come with it, including heart disease and mortality).

Uterine cancer (thanks to "unopposed estrogen and build-up of the uterine lining").

Short answer: no. Dr. Dweck referred to PCOS as like "a chronic disease," but the glimmer of hope is that "it's very treatable." And it's true - we've heard from multiple doctors that it's one of the most correctable forms of infertility and that there are several avenues and combinations for treatment. Arm yourself with knowledge and pick your all-star healthcare team to set yourself up for success. You can learn more from Dr. Dweck in her book, The Complete A to Z For Your V, (which outlines PCOS) on Amazon.

- Additional reporting by Christina Stiehl

Gallery: 11 COVID Symptoms No One Talks About But Should (ETNT Health)

Go here to see the original:
PCOS Affects as Many as 5 Million Women - Here's How to Know If You're One of Them - MSN Money

Early in the pandemic, anecdotal reports started filtering through that COVID-19 could cause loss of smell.

At first, it was hard to know how much weight to give these stories after all, anyone who's had a headcold or the flu knows you can lose smell for a couple of days while your head's blocked up.

But pretty quickly, experts realised the smell loss associated with COVID-19 went beyond simple nasal congestion, and it's now officially recognised as a symptom of the disease.

A global group of researchers, including Australians, is now taking a close look at how coronavirus can lead to smell loss.

"Not only is the impact on smell stronger than with other infectious diseases, but it's also much longer lasting, potentially," says Eugeni Roura, a nutritional chemosensing scientist from the University of Queensland who is involved in the global study.

What Professor Roura and his colleagues are finding may explain why it seems to take some people so long to get their smell back after recovering from the disease and they say it might even be a useful, non-invasive screening tool.

But first, how does smell and taste work when your body's healthy and working normally?

"They're gatekeeper sensors," says Alex Russell, a senior postdoctoral research fellow at CQUniversity, who has studied smell.

"The idea is to keep rotten food or poisonous things out of our bodies."

Taste is relatively straightforward your tongue is coated in bundles of sensory cells called taste buds, which recognise sweet, sour, salty, bitter and savoury or umami.

There's also chemesthesis, which has to do with how we experience spiciness.

Smell, which also plays into the flavours we recognise in food, is separate to this.

When air flows over the mucous membranes in your nose, chemicals in the air dissolve into your mucous and are detected directly by receptors in the cells that line your nasal cavity (scientists call this the olfactory epithelium), which send signals to your brain.

"The olfactory epithelium essentially is hardwired into our brain," Dr Russell says.

"With vision, the signals that we get from our eyes undergo quite a bit of processing before we start thinking 'what is the thing that I'm seeing'. But with smell, it's hardwired directly into parts of our brain like memory and emotion. So that's why smells are pretty good at bringing up a blast from the past."

Breaking down the latest news and research to understand how the world is living through an epidemic, this is the ABC's Coronacast podcast.

The reason you lose smell when you have a garden variety cold or flu, is congestion.

You need airflow over those mucous membranes to pick up smells, Dr Russell says.

"If you're all blocked up, you're not going to get the molecules into your nose," he says.

"One of the other things is that you need the molecules to dissolve into the mucus. So if you're particularly dry at a particular time, then you're not going to pick up as much there either."

But Professor Roura says COVID-19-related smell loss isn't caused by congestion.

"COVID-19, appears to get deeper. It crosses the mucosa and it gets deeper into the neurons themselves that will carry the smell to the brain," he says.

It looks like the virus can cause death in the olfactory neurones, possibly indirectly, through inflammation in the surrounding cells.

"That's the reason why it takes so long for some people to get the sense of smell back, because it's deep inside that the virus affects the conductivity of the signals to the brain."

One participant in Professor Roura's study has had COVID-19-related smell loss for four months.

The World Health Organisation lists loss of smell as a symptom that only affects some patients, but Professor Roura says a large majority of his study respondents have reported it.

"There's probably 80 per cent of the patients that we have identified that lose smell, but on top of that, how big of an impact is in the loss of smell it's huge," Professor Roura says.

When people with a cold or flu are asked to rate their smell loss out of 10, where 10 is what they experience when they're healthy, they rate it around 5.

But people with COVID-19 rate their smell loss as less than 3 out of 10.

What's more, it doesn't necessarily track with other symptoms either.

Some people get smell loss as an early COVID-19 symptom. In others it comes after the other symptoms have cleared, Professor Roura says.

"There's obviously variation of how each one of us will respond to the virus," he says.

"But there seems to be a common mechanism that the virus is able to challenge the defence mechanism that we have in these mucosas and get deeper, affecting some of the nervous system and neurones. And that causes a slower recovery."

Loss of smell isn't just a curiosity it can have real effects on people's quality of life.

"[Smell loss] is strongly associated with depression," Dr Russell says.

"You'd be surprised how much joy we take from smell."

It could also slow people's recovery from the virus, Professor Roura points out.

"If we lose the sense of sensing the flavour of foods, we lose the appetite," he says.

"Then people who might have been affected by COVID-19 will have a tougher time recovering from COVID-19 because they lose appetite and that's partially linked to [the ability to] absorb smell."

But there could be an upside to this situation.

Professor Roura says it could be used as a non-invasive screening tool.

Get the latest health news and information from across the ABC.

At the moment, some places require temperature checks before you can enter. But fever is a symptom in lots of different diseases, and many people with COVID-19 don't have fever.

"The impact of COVID-19 on smell is fairly unique in the sense that there's very few diseases that have such a big impact on losing the sense of smell," Professor Roura says.

"Obviously, you would need a defined standard smell. It could be mint, could be a lemon smell or whatever. There's actually hundreds of potential standard smell cues that we could target."

Who knows, you might be asked to sniff something and identify a scent before you can enter a premises sometime soon.

Go here to see the original:
Why COVID-19 loss of smell can last so long, and how the symptom could help with coronavirus screening - ABC News

By Hannah Weinberger/Crosscut.com

When Dr. Holly Fearnbach and Dr. John Durban noticed the bodies of two female southern resident orcas widening just behind their dorsal fins, they knew it could mean only one thing: babies.

On July 26, they announced that a killer whale identified as L72 was pregnant. Soon after, they delivered news that Tahlequah, whose traumatic journey with her dead calf captured international attention two years ago, is also expecting. The world erupted in celebration. Adding newborn whales to the endangeredsouthern resident population, which has dwindled to 73 animals, would be a big deal, and Fearnbach said she can now confirm there are pregnancies in all three pods that make up the population. But Fearnbach, marine mammal research director of Sealife Response, Rehabilitation and Research, and many whale researchers like her hesitate to celebrate.

There are always pregnant whales in the population, but most pregnancies are not successful, Fearnbach said, either because the pregnant whale miscarries or the calf dies. Fecal sample studies from the University of Washington show that 69 percent of pregnant southern resident whales lose their babies before birth or soon after. To the best of our limited knowledge, between 37 percent and 50 percent of calves don't survive their first year. Scientists usually avoid announcing pregnancies at all, but Fearnbach and Durban felt the announcement could reinforce their call to give whales more space and inspire more formal requests from management agencies.

Knowing about an orca pregnancy means holding your breath. Orcas having one of the longest gestation periods of any mammal, and the southern residents have very low birth rates. There have been only two births in the three southern resident pods since Tahlequah lost her calf.

The low birth rate in general is very concerning, so I'm not going to downplay that, but in general, wild mammals have a high calf loss rate just because it's so hard, especially for first-time moms, said Dr. Dawn Noren, a physiological ecologist and a research fishery biologist with the National Oceanic and Atmospheric Administration.

Each stage of early orca motherhood comes with physical and emotional hurdles, and negative human impacts on Puget Sound make things even dicier.

One doesnt want to be a Negative Nancy, said Dr. Deborah Giles, a researcher with the University of Washington Center for Conservation Biology. But theres a lot of trepidation mixed in.

Expectant orcas gestate for 18 months, with six-month trimesters. I think it has to do with the complexity of their brain, but a lot of it is simply that they're big animals, Giles said.

Most knowledge of pregnancy comes from the veterinary study of captive orcas. Detecting early pregnancy requires blood- and urine-based hormone tests on animals in captivity, or taking breath or fecal hormone samples in the field from 6,000- to 8,000-pound females.

Just being able to get a blood test from an orca is huge, said clinical veterinarian Dr. Hendrik Nollens, who tracked three complete gestation periods in his 13 years as a clinical veterinarian at SeaWorld and now works on conservation medicine with the Pacific Marine Mammal Center.

NOAA's Noren said, We rely on chance, and it's hard and getting harder when they're not around as much.

Keeping up with a pregnancy in the wild is difficult, largely because researchers cant count on taking regular samples from whales on the move or even seeing them. Orcas reach sexual maturity at age 12, and while they can get pregnant at any point in the year into their 40s, they tend to conceive in the spring.

Researchers like Nollens say healthy orcas are more likely to become pregnant, but a few elements need to be present: A male orca of reproductive age; a cycling female orca thats receptive to him and doesnt have reproductive diseases; and quiet space and time to conceive.

After conception, things quiet down for the first trimester. Everything that happens happens internally, Nollens said. It is really not a terribly taxing period. You could walk past a pregnant orca and not realize it.

Within three weeks of conception, researchers can confirm pregnancies with hormone tests, Nollens said. But it's entirely based on laboratory results. There's nothing else that you would pick up on.

At approximately four months, researchers can identify pregnancies from ultrasounds. At approximately six months, a pregnant orca will display that widening bump, whichcan be identified as a pregnancy from the air. This is how Fearnbach and Durban identified the pregnancies of L72 and Tahlequah, by analyzing drone images.

Over the next year, the fetus continues to develop into a 350-pound calf, and the mothers progesterone levels decrease as she continues gaining between 500 and 600 total pounds a fraction of her 6,000 to 8,000-pound weight.

The two pregnant southern resident orcas are likely in their second or third trimester, Nollens said. Van Ginneken suggests the pregnancies are late stage.

In the past two months of a cetacean pregnancy, he said, you can start to see signs that mama's feeling a little blah: Decrease in appetite, discomfort and possible bacterial infections like bursella that cause late-term miscarriages in other cetacean species. But compared with everything that can go wrong at or following conception or birth, the odds that something will go wrong with these two pregnant animals in the next few months is more limited, he said.

But if the mother does lose her calf, she and the entire orca community must overcome the emotional loss. Whales are highly family bonded, and the UW's Giles said their family members may know of a pregnancy through echolocation. Its like living with moving and breathing ultrasound [machines] all around you, called your mom and brother and sister, she said. It's physically taxing, It's medically taxing and dangerous, And then it's emotionally taxing for these individuals to continuously get pregnant, Giles said.

In some pregnancies, late-term calves can become ticking time bombs in their mothers bodies. If a grown calf dies, gets stuck and releases bacteria in the birth canal, the mother can die.

Calves that do make it through the birth canal need to swim to the surface and take their first breath immediately. The calves flukes and dorsal fins are floppy in utero, but calves come out tails first over one to two hours so their fins have time to harden in the cold water. Calves can be successful when they're born head first, but they don't have that functional paddle, Nollens said, noting calves usually get assistance from other females.

Throughout this process, theres another threat on the perimeter: Male orcas, which can become aroused during childbirth and act aggressively toward the calf if females dont keep them away. Nollens said hes heard reports of newborns with rake marks, and thinks its likely theyre from males thattried to get access to a mom or calf during birth.

Of all the stress points in a whales pregnancy, lactation and weaning require the most work. Pregnancy is cheap it's lactation that is hard, NOAAs Noren said.

When orcas give birth, their caloric needs skyrocket, Nollens said, which means they must work harder to feed themselves and provide 40 percent fat whale milk to help their newborn grow quickly. If a killer whale has unlimited access to food, the food intake within days will go up 50 percent, Nollens said.

This responsibility can be overwhelming. Most of these females already have other offspring that they also need to support, so it is a huge demand to support themselves, nurse their young calf and help support other offspring and family members, Fearnbach said.

It can take two to three years, depending on whom you ask, to gradually wean a calf, which is entirely dependent upon its mother until it learns to forage. Dr. Astrid van Ginneken of the Center for Whale Research notes that where fish are scarce, weaning takes longer because calves have fewer fish to supplement their nutrition.

Dozens of researchers, policymakers and stakeholders have spent the past few years coordinating a $1.1 billion plan to save Puget Sounds orcas from low food availability, as well as ocean disturbance and pollution. While all southern residents suffer from the effects of these factors, its especially pronounced for mothers and their newborns.

All of those threats compound each other, and researchers are split on which ones are worse. I know some people are really about, 'It's only the prey, only the prey,' and other people are, you know, anti-boats, I think it's not that simple, Noren said.

In my opinion, to save these whales, we have to be laser focused on the food issue, and then secondarily the toxicants issue, Giles counters.

The nearby transient orca populations, which prefer more polluted yet more abundant sea mammals (like Steller sea lions, gray whales, minke whales) over salmon but get more to eat, still have low calf mortality and smaller intervals between females pregnancies, which some researchers think supports the idea that food availability is the prime issue. If the whales had enough to eat, the toxicants would not be as much of a problem, Giles said.

To stay pregnant, an orca needs to eat up to 300 pounds of fish a day; this amount increases during pregnancy and lactation. Southern resident orcas evolved to prey on plentiful 100-pound chinook, but the average size of those salmon today is 10 to 15 pounds, and there are fewer of them.

But ocean disturbance from vessels makes foraging harder. Echolocating whales need quiet and space to be able to forage effectively, especially when their pods are spread out and they need to communicate.

Whales and dolphins will stop eating when there's too much noise and too many vessels around or close approaches, and that is a problem I feel like could really have a detrimental effect on a lactating female, Noren said.

Thats the time when orca mothers need to put their energy into protecting and feeding their calf. Calves nurse from out of their mothers lines of sight, and mothers might not let calves nurse if they think they need to protect them, Nollens suggests.

If they dont have good access to fish, or spend a lot of time disturbed by boats, they start relying on bodyfat to make milk. Wild whales lose weight rapidly, and oftentimes wind up skinny.

And then you add the layer of pollution, Nollens said. It really is an uphill battle.

Every miscarriage is traumatic, but there is a silver lining. Orcas have better chances at a healthy calf when they conceive soon after a miscarriage, Giles said.

Many of the legacy pollutants that pose threats to whales physical and neurological health are lipophilic, meaning they can stow away in that fatty blubber. The presence of those pollutants doesnt seem to matter for a calf in utero, possibly because of the placental barrier, but it matters a lot during lactation.

When a whale mom metabolizes blubber to make milk, those legacy pollutants become milk ingredients. For first-time moms, that might mean offloading a significant portion of pollutants collected over 12 years into their babys systems.

However, if they gestate their calf for a long time, lose it, and conceive again quickly, they have less time to accumulate toxicants before nursing a second calf.

In a way, getting pregnant and giving birth is a cleansing thing for the mom, because she's just gotten rid of all the toxicants, which is kind of a creepy, weird thing to think, Giles said.

For whales like Tahlequah and L72, which have both given birth before, that could be a good thing. Im hopeful that [Tahlequahs] baby, because of how pregnant she is, must have been conceived fairly shortly after she let go of her other baby. And therefore shehasn't had very much time to bioaccumulate toxicants, Giles said.

Ultimately, a mothers work is never done, Nollens said, and each calf adds to her workload. Calves may become nutritionally independent at three years of age, but they're still socially dependent on mom, he said. They still rely on her for guidance and protection.

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Pregnant orcas have researchers excited, but is it too soon to celebrate? - Blaine Northern Light

The best weight gainer or mass gainer is a heaven-sent for many people, mostly for men, who find it difficult to bulk up properly. Eating enough to gain weight when you also actively work out can be challenging as it is, but eating correctly can seem pretty much impossible for many. Mass gainer supplements can help you add more calories to your diet.

Shop weight gainers at Amazon UK Shop weight gainers at Amazon US

This is where weight gainers come in handy: they contain high amounts of calories, as well as carbs and protein, making them a perfect meal replacement for people with quick metabolism. Not only that, but weight gainers are most usually low on fat and sugars, relatively speaking, but definitely compared to the amount of calories they contain.

Fancy something high protein but maybe a bit more savoury? We have the list of the best jerky options, both beef and veggie/vegan.

Ready yo build some muscles? Find the best weight gainer for your needs below.

Weight gainer is a protein powder variety that contains high amount of calories and protein as well as being low in sugars and fat. Weight gainers can effectively replace a meal or can be used in addition to your diet to add clean calories to your bulking diet.

The actual amount of calories per serving and even servings sizes vary wildly from one manufacturer to another. Some products contain less than 400 kcal per serving while others can have as much as 1250 kcal per serving, so it's always a good idea to read the label before you buy.

A few things to check before you buy your first (next?) bag of weight gainer: if you are lactose intolerant, you might want to go for the vegan varieties, they are least likely to contain lactose, although as mentioned before, always read the label before you buy. It is also beneficial to check what other supplements have been included in the mix, apart from oats and protein.

For example, if the weight gainer contains creatine, you don't have to take creatine monohydrate supplement separately. Same goes for BCAAs: if there is any leucine or glutamine included in the mix, no need for you to buy additional BCAA tablets. As long as you take the weight gainer, of course.

This could be you: it only takes discipline and hard work to achieve this level of buffness (and probably a few years' worth of gym workouts)

(Image credit: USN)

First of all, before you start guzzling down weight gainers and three servings of protein powder a day, it is recommended to evaluate what do you eat as it is. If you would like to save yourself from having to log your food manually, there are many apps out there, like MyFitnessPal, that takes the hassle out of food tracking.

These apps have many food items already added to their huge library, all you have to do is scan the barcode of the food item with your phone's camera and mark how much you eat. The app will then calculate the macronutrient (carb, fat and protein) percentages, as well as other useful stats, like how much sugar, salt and fibre you have consumed.

Once you got into the habit of logging, you can set goals for your daily intake: let's say you want to cover your daily energy needs from 65% carbs, 25% protein and 20% fats. The app will tell you how many grams of carbs, protein and fat does this translate to.

This is where weight gainers come into play: when you see you're under your protein and carb goal, you can check how consuming weight gainers will up your daily macro numbers.

It might sound a bit confusing but it really isn't all that difficult in real life. You do need to be a bit more mindful of your diet, sure, but you should be anyway if your aim is to gain lean muscle mass effectively.

For the best results, use the recommended serving and if you want clean gains, mix the weight gainer powder with water as opposed to milk/milk substitute. You could potentially use milk/milk substitute should you want to, but 500 ml of milk will not only add an extra 200 calories, it will also add 25 grams of sugar to your daily intake. It is just unnecessary, especially because weight gainer powder makes a thicker shake as it is.

(Image credit: Optimum Nutrition)

Two meals' worth of calories in each serving

Serving size: 334g

Energy: 1258 kcal

Carbs: 251g

Protein: 53g

Fat: 4.4g

Sugars: 22g

+All the calories you need+High protein content+Many flavours to choose from

-Will go through the 5 kg bag in half a month

Optimum Nutrition recommends taking its Serious Mass weight gainer "between meals, after exercises or before bed." Now, we don't think many people like to go to bed with a full stomach, but even just one portion of the Optimum Nutrition Serious Mass will fill you right up. If you wish to take this supplement before bedtime, have half a portion only, that's still over 600 calories.

Even if you have 3600 calories a day, which would imply that you are hitting the gym 4-5 days a week, having a serving of Optimum Nutrition Serious Mass would still cover one-third of your calorie intake.

The Optimum Nutrition Serious Mass contains no added sugar but it does contain 24 vitamins and minerals per serving. All the better, it comes in many different flavours, so you will get bored with the taste less quickly.

Given the huge amount of calories and protein involved with Serious Mass, we recommend taking it in two half-portions, ideally at the beginning and the end of the day.

(Image credit: The Protein Works)

All the flavours of the rainbow

Serving size: 265g

Energy: 974 kcal

Carbs: 163g

Protein: 52g

Fat: 12g

Sugars: 38g

+Blends really well+So many flavours

-Higher sugar content

For whatever reason, The Protein Works recommends 1-3 servings a day of its Total Mass Matrix Extreme weight gainer. Three servings of this product contains a whopping 3000 calories, and we'd recommend covering that many calories from a variety of sources, not just three shakerfuls of weight gainer.

Saying that, Total Mass Matrix Extreme is a great weight gainer mix and contains a good balance carbs and protein. What it also has, though, is fairly higher amounts of sugar, so be mindful of that when introducing it into your diet.

Other than that, we can wholeheartedly recommend the Total Mass Matrix Extreme, if for nothing else, for all the great flavours, which include Tiramisu, Cinnamon Cereal Milk and White Choc Peanut Sundae.

(Image credit: Bulk Powders)

Zero animal cruelty, maximum lean muscle gains

Serving size: 100g

Energy: 367 kcal

Carbs: 43.6g

Protein: 31g

Fat: 6g

Sugars: 2.5g

+Soya free+Gluten free+Lactose free

-Moderate protein and calorie amounts

The Bulk Powders Vegan Mass Gainer is not only vegan and therefore 100% animal cruelty free, it also contains no gluten the oats used to bump up the carb numbers are gluten free it is also soya and lactose free, so it caters for people with a range dietary restrictions.

On the downside, the Bulk Powders Vegan Mass Gainer has less calories and protein than other weight gainers on this list. The blend used in this supplement is a combination of pea protein isolate, brown rice protein, pumpkin seed protein, flaxseed powder and quinoa flour. One can say it is a very healthy mix of ingredients.

As well as being high in fibre low on sugar, the Bulk Powders Vegan Mass Gainer contains no artificial sweeteners, colourings or flavourings either.

(Image credit: USN)

This is one lean weight gainer

Serving size: 150g

Energy: 564 kcal

Carbs: 77g

Protein: 55g

Fat: 3g

Sugars: 26g

+Carb to protein ratio is 1.4:1+Caramel popcorn flavour+Good for post-workout

-Contains egg, milk and wheat

You can count on the USN Muscle Fuel Anabolic tasting good, although it is at least partially due to the amount of added sugar this product contains. In fact, one-third of the carbs found in the USN Muscle Fuel Anabolic comes from sugars. It is not ideal, but just to put it in context, a 36-gram bar of Mars contains 20 grams of sugar, so you are definitely better off with the USN Muscle Fuel Anabolic.

USN states that the Muscle Food Anabolic "should not be used by persons under the age of 18 years nor should it be used for weight loss." Also, "It is only for bodybuilders and athletes or individuals on a mass gaining plan." So now you know. If you are trying to lose weight, don't take weight gainers. In case it wasn't clear.

Given the moderate calorie content, the USN Muscle Fuel Anabolic can be used as a port-workout drink. 500+ calories is still a decent amount, so please be mindful of that and should you have a smaller frame, take only a half portion at a time.

(Image credit: MyProtein)

Halfway between a protein powder and a weight gainer

Serving size: 100g

Energy: 388 kcal

Carbs: 50g

Protein: 31g

Fat: 6.2g

Sugars: 2.6g

+Very low on sugar+Can be used post workout

-Only standard flavours-Moderate calories and protein

The MyProtein Weight Gainer Blend can most certainly be used post workout, given the moderate amount of calories this protein powder contains. Even better, it is super low on sugar, so you don't have to worry about going over your daily limit either.

Since the MyProtein Weight Gainer Blend is low on carbs compared to the rest of the entries on this list it represents a good balance between regular protein powders and weight gainers. If you would like to immerse yourself into the world weight gainers gently, definitely go with this one.

Given the very low sugar content, this weight gainer is the best for mixing with other ingredients, like peanut butter or milk, although we don't recommend using more than 500 ml of it. The MyProtein website suggests adding "3 1/3 large scoops (100g) [of MyProtein Weight Gainer Blend] to 500-1000 ml of water or milk", but for us, a litre milk sounds a bit excessive, so either take it with 500 ml of milk (maximum) or a litre of water, if you want a very thin shake.

Round up of today's best deals

Optimum Nutrition Serious...

THE PROTEIN WORKS Total Mass...

BULK POWDERS Vegan Mass...

USN 100 g Anabolic Chocolate...

Myprotein Weight Gainer, 2500...

Originally posted here:
Best weight gainer 2020: these mass gainer supplements will bulk you up real fast - T3

Its pretty normal to feel full of energy for exercise some days, and as though you cant be bothered on other days.

For women, theres a physiological explanation behind this. While mens hormone levels do change over a lifetime, day-to-day they remain quite stable. Women, however, experience fluctuating levels of sex hormones daily.

Scientists havent yet worked out the complete picture when it comes to how the menstrual cycle affects exercise. But we know different phases of the menstrual cycle, due to the fluctuation of hormones, can affect metabolism and recovery from exercise, particularly for women participating in endurance activities.

Understanding the rise and fall of hormones during the menstrual cycle can allow women to adapt their exercise routines, and optimise their chances of succeeding with any training or weight loss goals they may have.

A womans cycle, which is generally 28 days, can be broken up into two main stages: the follicular and luteal phases.

The follicular phase days 1 to 14 starts on the first day of a womans period. During this phase, levels of oestrogen (the primary female sex hormone) progressively increase and progesterone (the other female sex hormone released from the ovaries, which stimulates the uterus to prepare for pregnancy) stays stable.

At this time, women are physiologically similar to men in their metabolism and recovery. Training will feel easier and you will recover more quickly than during the luteal phase, which well get to shortly.

Read more: Childhood, adolescence, pregnancy, menopause, 75+: how your diet should change with each stage of life

This ease of training and speed of recovery become more pronounced during the later part of the follicular phase.

Around day 12, levels of oestrogen and another type of hormone, the luteinising hormone, surge, triggering ovulation. Youre likely to experience an increase in energy and strength at this time, allowing you to put even more effort into your workouts.

So the follicular phase, particularly at the end, is the time to train hard: to incorporate new exercises and train at higher intensities. This is particularly relevant for women trying to lose weight.

The luteal phase represents the second half of a womans cycle.

During this phase progesterone levels peak, resulting in an increase in resting heart rate, and decreases in aerobic capacity and ability to tolerate heat. Exercise may feel like an uphill struggle and you will tire more quickly.

The body burns more fat during the luteal phase, as the peak in oestrogen and progesterone suppress gluconeogenesis (the making of sugar from protein and fat).

This increase in fat burning may seem like good news from a weight loss perspective, but it makes it harder for the body to access sugar. This means exercise will feel harder.

So during this phase, the focus should be on incorporating lower-intensity cardio and strength sessions, and active recovery sessions such as walking, yoga and stretching.

Read more: Period pain is impacting women at school, uni and work. Let's be open about it

Progesterone also breaks down muscle, so you wont enjoy the same gains from your workouts, and recovery is slower.

Finally, the hormonal changes during this phase result in a shift of fluid from your blood plasma to your cells, resulting in bloating or fluid retention. Coupled with pre-menstrual symptoms such as headaches and fatigue, exercise is likely to seem harder than usual, so its not a time to be smashing your goals.

At this time your metabolism peaks (an increase by 5-10% from the lowest point one week before ovulation), and so can your appetite. The best way to manage all of this is with exercise just of the low-intensity variety.

Eating carbohydrates and protein within a couple of hours of exercise also helps as it reduces your reliance on making glucose from other sources. This results in increased energy levels and quicker recovery.

You could try chopped fruit with 100% nut butter, some wholegrain bread with 100% fruit spread, or a serve of dairy, such as yoghurt.

And make sure to surround yourself with plenty of foods naturally high in sugar and fat such as fruit, avocado, nuts and seeds. These foods release the same pleasure response in the brain as the processed and packaged foods you might be craving.

It seems counter-intuitive, but when your period starts, you will start to feel normal again, as hormone levels return to baseline.

A well-planned food and exercise program will allow you to work with your cycle, not against it. This is worth thinking about even if you dont usually experience menstrual symptoms these hormonal changes are happening in your body regardless.

Start by tracking your menstrual cycle. Circle the first and last days of your period and count the days between the first days of two consecutive periods to determine cycle length. Or you might choose to use an app.

By recognising these phases of the menstrual cycle, women are better placed to deal with common pre-menstrual symptoms, and achieve their health, training and weight loss goals.

Read more: Four common myths about exercise and weight loss

Read the original:
From energy levels to metabolism: understanding your menstrual cycle can be key to achieving exercise goals - The Conversation AU

Get the most out of your workouts. By now, weve all gotten the message that we should be exercising more

Get the most out of your workouts.

By now, weve all gotten the message that we should be exercising more for better health and well-being. But did you know that there are certain things you can do to make your workouts even more effective and efficient? The following 12 strategies can help you make the most of your time working out.

1. Set goals.

I think the first thing you want to do with any workout plan is to set goals, says Dr. D. Harrison Youmans, a sports medicine physician with Orlando Health in Florida. If youre training for an event, you want to make sure youve got the goal in mind and that youre trying to build toward that.

Working with a coach or trainer can help you establish the right goals and build a smart and sustainable plan for achieving them.

2. Stay hydrated all the time.

Staying hydrated throughout the day is important, Youmans says, both for helping you feel good and so you can perform well during a workout. He encourages his patients to take in 16 ounces of water before starting a workout and drinking to thirst during the workout.

3. Rehydrate after.

You also need to put back what you may have lost during the workout through sweat, says Dan Daly, coach, trainer and co-creator of the Equinox Group Swim Program EQXH2O in New York City. One way to make sure youre getting enough water is to weigh yourself just before and after the workout. The difference in weight is nearly all water weight, so put back that same amount of water.

One cup of water weighs just over a half a pound, so if youve lost two pounds during the workout, you should drink four cups, or 32 ounces of water, to replenish what youve lost. Plain water is typically best, but if youve been sweating a lot, you can consider adding an electrolyte replacement drink that will put back some of the sodium and other electrolytes youve lost while sweating.

4. Eat something before.

Not everyone likes to work out on a full stomach, but Youmans says its important to make sure you have some calories on board. But it may take some trial and error to find the right pre-workout snack for you.

Many people like to have a banana or another piece of fruit beforehand. Others prefer a slice of toast with peanut butter. Generally speaking, a mix of carbs and protein can be helpful for making sure youve got adequate nutrition to perform well during your workout. Limiting fat intake is generally a good idea before a workout, as it takes longer to digest and could cause an upset stomach if youre working out hard. Experiment to find the right pre-workout snack for you.

5. Eat after your workout.

While many people believe that theres a window of time 30 minutes or so after a workout when its most optimal to eat, Daly says this theory of meal timing post-workout may be overstated. However, within a few hours, it helps to replenish glycogen stores, particularly after workouts lasting more than an hour.

Glycogen is a type of sugar thats stored in the muscles and the liver and is the primary fuel your muscles use when youre exercising. When you deplete your stores of glycogen, that can negatively impact your ability to perform when working out.

Daly recommends eating complex carbohydrates within your caloric and macronutrient needs and consuming some protein to provide amino acids for muscle and cellular repair.

Youmans agrees that eating a meal after a workout is important. After the workout, we want to balance some carbohydrate and some protein because protein is going to help the muscles recover, but we also need to replenish those energy stores with the carbohydrates.

Scrambled eggs with veggies and avocado, salmon and sweet potatoes or yogurt with nuts and berries can all make excellent post-workout meals.

6. Stretch.

After a workout, stretching can facilitate a rest and digest state in the nervous system, initiating the recovery process, Daly says. And this can help promote faster muscle healing.

Before you undertake a stretching routine, its best to understand what your range of motion is in each joint and if any joints are tight or inflexible. In all cases, approach stretching gently and consider consulting a fitness trainer or physical therapist for assistance in developing the right stretching and mobility routine for your specific needs.

7. Mix it up.

For general wellness, fitness and weight loss, most people would benefit from moving most days of the week for 30 to 60 minutes, Daly says. But you shouldnt only do one type of exercise. Youll get better results if you mix up your workouts with aerobic exercise, which gets you sweating and your heart rate up, and with strength training, which can build stronger muscles and bones and improve your ability to balance and perform daily tasks. The two types of exercise complement each other and will help you achieve gains across the board.

Daly recommends focusing two or three workouts per week on a full-body strength routine, and two or three workouts per week on cardio, with a mix of steady state, low-intensity volume (long distances), middle-distance race pace intensities and short all-out high-intensity intervals.

These variations in length of workout and intensity can be done with virtually any aerobic exercise, from running and swimming to rowing, walking and working out on an elliptical machine.

8. Add some caffeine.

Caffeine is a stimulant found in coffee, tea, cola and chocolate. Many people find that it perks them up and makes them feel more alert, which could help you have a better workout.

Caffeine has been widely researched as a legal ergogenic (or performance boosting) aid for exercise and performance, Daly says. Drinking a cup of coffee before a workout could boost your performance and alertness during the activity.

But caffeine might help after a workout too. According to one 2008 study, the primary fuel used by the muscles during exercise glycogen replenished more quickly when participants consumed carbohydrates and caffeine following intense exercise. The study found that athletes who had ingested caffeine and carbs after a strenuous workout had 66% more glycogen in their muscles 4 hours later compared to athletes who had only carbs after their workout.

The faster your muscles can rebuild their glycogen stores, the faster your muscles can repair themselves and adapt to the training youve completed. This is good for strength gains and being ready to go for your next workout sooner.

9. Consider supplements.

Though some fitness professionals say that supplementing your diet with certain nutrients might help you perform your best, Daly says its best to consult with a licensed nutritionist, particularly a sports nutritionist, before considering adding supplements. Supplements are generally 1% of the equation, in terms of improving your fitness and performance. There are many things most individuals could focus on that would have a much greater return on their progress.

But if you suspect you have a vitamin or mineral deficiency that could be impacting fitness, work with your doctor to verify the deficiency with bloodwork and devise a plan for correcting it with dietary changes, supplements or medications.

One widely used supplement that does have some evidence backing its use for improved sports performance and recovery from workouts is creatine.

Creatine is the most researched sports supplement ever, with a lot of evidence supporting improvements in sport, particularly high intensity, short duration activities, like sprinting and weight lifting, Daly says. Nevertheless, you should check with your doctor before taking creatine or any other supplement to ensure its safe for you to do so.

10. Sleep consistently.

Getting plenty of sleep is very important for recovery, Youmans says. Daly agrees. Sleep is one of the most anabolic, or tissue building, windows we have.

Its during sleep that your body repairs itself and can make the positive adaptions intended by the workout. So get consistent with a set bedtime and set wake time and establish a bedtime routine that lets you wind down and be ready for sleep when its time to get into bed.

Youmans also recommends trying to complete sleep cycles if you can, rather than waking up to an alarm clock. Sleep cycles typically last about 90 minutes to two hours. The alarm clock can be difficult because it might wake you in the middle of the sleep cycle, and then youll feel groggy. Or if you wake up on your own an hour before youre planning to get up and go back to sleep for an hour, youll be in the middle of a sleep cycle again.

Youmans encourages his patients to establish a set bedtime and keep it consistent. Over time, youll naturally find the best waking time for you and may be able to do away with the alarm clock all together.

11. Be consistent.

One of the best ways to ensure you continue to make good progress towards your fitness goals is by committing to workout out consistently. Whether thats two, three four or more times a week may be guided by your goals, but sticking with the frequency you choose can help you make each workout even more effective.

When you stop and start a fitness plan, youll lose what gains you may have made and have to rebuild from square one when you start again. Being consistent means the adaptations youre working towards with training will come about sooner and be more likely to endure.

12. Stay healthy.

Lastly, Youmans says that if youre new to a fitness routine, its best to check in with your primary care physician prior to getting started. Once youre cleared to get moving, do your best to establish a consistent plan, but dont get discouraged if you feel some aches and pains initially or progress slower than youd hoped. Theres certain things you can kind of manage through, such as muscle soreness.

That said, there are some red flag symptoms that you shouldnt push through, Youmans says. Especially with joint pain or if you get mechanical symptoms like catching or locking. If you get swelling in a joint that you havent had before, or if a joint feels unstable. And any pain thats worsening instead of getting better as you try to work through it those are all reasons youd want to seek help to try to figure out what the issue is and how to correct it.

12 Workout Tips to Improve Your Results

1. Set goals.

2. Stay hydrated throughout.

3. Rehydrate after.

4. Eat something before your workout.

5. Eat after your workout.

6. Stretch.

7. Mix it up.

8. Add some caffeine.

9. Consider supplements.

10. Sleep consistently.

11. Be consistent.

12. Stay healthy.

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12 Before and After Workout Tips to Boost Results originally appeared on usnews.com

Continued here:
12 Before and After Workout Tips to Boost Results - WTOP

2020 has been remarkably stressful from the fear of nuclear war to a presidential impeachment to a pandemic that has killed more than 186,000 Americans as of September 3. And lets not forget the record unemployment, the school closures, the police killing of George Floyd and other people of color, the months of protests against police brutality and systemic racism, and accelerating climate change.

Many Americans are understandably feeling anxious about this cascade of events on top of any stressors they may have already been dealing with. The technical term is, Its a lot, says Linda Goler Blount, president and CEO of the Black Womens Health Imperative.

A Centers for Disease Control and Prevention survey of 5,412 people in late June found that 31 percent were experiencing symptoms of anxiety and depression, about three times the number of respondents who said the same in the first two quarters of 2019. Another 26 percent reported symptoms of a trauma- or stressor-related disorder. Eleven percent of people said they had seriously considered suicide in the previous 30 days.

Now some researchers are asking if stress especially chronic stress might be another preexisting condition that makes Covid-19 infections worse.

Our bodies have evolved to respond in the moment to stressful situations, both physical and emotional. This is often called the fight-or-flight response, and it helps us react quickly to danger. But when this becomes a long-term response, these involuntary reactions can be harmful.

There isnt a single agreed-upon definition of what chronic means, though some researchers think stress that persists for weeks or months likely qualifies. Generally, People thinking about something consistently over time qualifies as a chronic stressor, says Paula Braveman, director of the Center on Social Disparities in Health at the University of California San Francisco.

Other researchers say an important feature of chronic stress is its instability, of not knowing whether or when the stressor will end. (The pandemic seems to fit the bill.) Still others define it as the bodys inability to return to base level amounts of important hormones, often developing a new, elevated normal for stress hormones such as cortisol.

Cortisol is an important part of the stress response, and new research suggests cortisol levels appear to impact the severity of Covid-19. Theres still a lot we dont understand about the relationship between the two, but clinical trials of a Covid-19 treatment using dexamethasone a drug that reduces the bodys natural cortisol production, as well as inflammation has been found to help critically ill patients.

High levels of cortisol are associated with poor [Covid-19] outcomes, and drugs that block the hormone seem to improve outcomes, says Kavita Vedhara, a University of Nottingham professor of health psychology who is conducting an ongoing study on Covid-19 and stress. Vedhara says that while further research is needed, she wouldnt be surprised if chronic stress was found to be a risk factor for a severe case of Covid-19. It fits with what we know about psychological stress generally, and in particular the evidence on stress and other viral infections, she added.

Understanding how stress impacts Covid-19 could hold clues for preventing or reducing the severity of infections, as well as responding to the inequities that put some racial and minorities groups at greater risk.

Fifty years of research on stress suggests it has a profound effect on the body, influencing everything from memory to the way the body stores fat. Its even been found to cause structural changes in the brain.

In general, Chronic stress wears the body down, says Kathryn Freeman Anderson, a sociology professor at the University of Houston. Over time, stress keeps the body locked into a heightened response, resulting in damage somewhat similar to an engine idling for too long.

Prolonged stress also weakens the immune system. In 1991, scientists studying the relationship between psychological stress and immune response intentionally exposed 394 healthy participants to one of five respiratory viruses, including a coronavirus. The subjects were then quarantined and monitored. Even after controlling for factors like age, sex, education, weight, and prior antibody status, the researchers found that a persons underlying stress levels were associated with an increased risk of getting sick. Since then, dozens of studies have shown that chronic stress increases the risk of not only catching the common cold but also developing conditions such as asthma and Alzheimers disease, among others.

Chronic stress can also make vaccines less effective. One study compared the vaccine responses of 32 caregivers of a spouse with dementia a role associated with chronic stress against 32 subjects in a control group. After vaccinating both groups against influenza, the researchers found that the caregivers stress was associated with a lowered antibody response, meaning less protection against the flu.

Conversely, in 2018, Vedhara designed an experiment for 138 older adults to see whether a positive mood could have a protective effect. For two weeks before and four weeks after their annual flu shot, participants self-reported how they felt using a diary. Vedhara found that psychological influences, including stress and mood, influenced participants antibody response. (Stress responses are often measured by observing specific emotional states.)

Vedhara found that if participants felt unstressed and upbeat, particularly on the day they were vaccinated, the vaccine worked better. The effect on antibody production was about as large as the effect of statins on cardiovascular events. These are very tangible, very profound effects, Vedhara says.

Similar results have also been seen in young people: A 2018 study of 83 undergraduates found that people with a positive affect feelings of happiness and positivity had better antibody responses to a vaccination. Affects, or observable emotions, are impacted by stress, both for better and worse.

One study found that people who had a negative affect in response to daily stressors over the course of a week meaning they dont recover well from daily stress had poorer physical health in the long term. Another study of 8,542 participants found that a positive affect not only helped reduce the damaging effects of stress but was also associated with lower mortality rates. Further research is needed into what actually causes these differences. It may be for both behavioral and neurobiological reasons; when stressed, people might behave in ways that hurt the immune system, such as by drinking alcohol or not getting enough sleep.

But stress also influences the concentration of many hormones, including cortisol, that impact the production of antibodies. During the fight-or-flight response, the brain activates a network that includes the pituitary and adrenal glands. These glands release cortisol and other hormones that keep the body on high alert. But cortisol also turns out to have a surprising place in the immune system: Most immune cells also have a receptor for it. This means theres a direct mechanism by which cortisol can regulate immune cells and our immune system, Vedhara says.

When people have chronically high levels of cortisol from being stressed, they end up with lots of inflammatory cytokines. High levels of cytokines have also been noted in severe cases of Covid-19, as have lower levels of lymphocytes, the white blood cells that help fight infections.

Scientists are looking for other direct relationships between chronic stress and Covid-19. Besides cortisol, other important hormones, including one called Ang-II, are impacted by stress; Elevated levels of Ang-II have already been associated with severe Covid-19 cases.

Although most of us have experienced more stress this year, chronic stress, like so much else, tends to affect some individuals, like people of color, more than others.

In April, during the early stages of Covid-19, Vedhara found that Black, Asian, and other ethnic minorities in the UK reported feeling more stressed than white people, even after accounting for age, gender, and working situation. These same communities also reported disproportionate deaths from Covid-19.

According to CDC data, Blacks, Native Americans, and Latinos all have age-adjusted hospitalization rates around 4.7 times higher than the rate of white people. A Black person with Covid-19 is almost four times more likely than a white person to die from it.

Goler Blount says its frustrating that the data is often reported without context. Its not because theyre Black, its because of the experience of being Black, Goler Blount says.

Discrimination doesnt stay in the realm of mental health, says Anderson. We can actually measure the physical impact on the body. In the 1990s, public health researcher Arline Geronimus studied what the experience of racism does to the body and found that racial inequalities not explained by poverty existed across a range of biological systems. She called the health consequences of the large and small stresses caused by racism weathering and this kind of erosion is more than a metaphor.

Multiple studies show that an experience of discrimination increases cortisol levels, and the effects accumulate over a lifetime.

Chronic stress can start damaging health and affecting gene expression even before birth. A number of studies have linked stress with shorter telomeres, a protective casing at the end of DNA strands that is diminished each time a cell divides. Shortened telomeres have been linked to increased disease and shorter lifespan.

Though telomeres can be repaired by an enzyme called telomerase, stress and cortisol exposure reduces the bodys supply of the enzyme. One study found that the higher a mothers prenatal anxiety, the shorter her babys telomeres were, raising questions about whether stress risks can be inherited. If true, this might amplify the disproportionate effect chronic stress has on people of color.

Another line of research has shown that if young people experience systemic discrimination, it can trigger higher levels of cytokines, magnifying the impact of future stress on their health. A study by the Yale School of Public Health found that by middle age, women who had frequent experiences with discrimination had significantly higher levels of visceral fat, putting them at higher risk for serious conditions such as heart disease and diabetes (two risk factors for severe Covid-19). In older adults, stress changes the levels of hormones involved with blood pressure and contribute to hypertension, another risk factor for Covid-19.

Its not just the experience of discrimination, but also the fear and anticipation of racism that cause harm. The vigilance, the concern itself is a strain on the body, says Brenda Major, a professor and social psychologist at the University of California Santa Barbara. She says the recent videos and other coverage of police killings and protests against police brutality are themselves a source of stress. Reading about people like you being shot and killed can itself heighten concern, fear, and vigilance, says Major.

UCSFs Braveman says chronic stress is also structural, tied to how we track people into unhealthy places and expose them to unhealthy conditions over their lifetimes. She says the US culture perpetuates racism and its stress even when there is not a particular individual intending to discriminate.

We dont have to look far for examples of how communities of color are disproportionately exposed to environmental pollutants like cancer-causing chemicals and fine particulate matter that can cause respiratory illnesses, as well as a higher risk of natural disasters environments that are often sources of stress themselves, as well as an indirect stress when friends and family become ill. This is literally the environmental impact on us, and its how our bodies are responding, says Goler Blount.

To better understand how stress both recent and long-term might be impacting individuals risk for Covid-19, many researchers are conducting experiments.

Following up on her April survey of almost 4,000 people in the UK and New Zealand, Vedhara is now asking participants to send in a small hair sample. Shell use this to measure cortisol, investigating how self-reported mental health over the course of the pandemic results in measurable physical changes. Shell also look to see whether cortisol levels are associated with being infected with Covid-19 and the severity of illness.

Already, other research suggests that cortisol is tied to worse Covid-19 outcomes. In a recent study of 535 people published in The Lancet those with confirmed cases of Covid-19 had much higher levels of cortisol than those who did not. After taking measurements within 48 hours of being admitted to the hospital, the scientists found that a doubling of cortisol concentration was associated with a 42 percent increase in mortality.

More research is needed, but in the meantime, Vedhara notes that while the known risk factors for severe Covid-19 cases age, ethnicity, and preexisting conditions are largely out of our control, there are ways to improve mental health. We dont know yet how much reducing stress might help protect against severe Covid-19, but there may be measures that can be used now to reduce anxiety overall.

Understanding the source of stress can be helpful in figuring out how to manage it. The first step is to understand what is giving rise to those negative feelings, Vedhara says. Some stress is emotion-focused like the ongoing uncertainty of when the pandemic will end and can be reduced through skills like mindfulness. For instance, when patients with colorectal cancer meditated at the beginning of chemotherapy treatments, it improved their cortisol response.

But changing personal behavior cannot combat structural sources of stress. (Meditation is certainly not a cure for the stress of systemic discrimination.)

One of the most striking features of [self-reported stress in April], Vedhara says, is that it was strongly related to how much people were worried about contracting Covid-19.

A recent study suggests the high numbers of Black, Latinx, and Asian people dying from Covid-19 might actually be an underestimate. Goler Blount says a Black Womens Health Imperative analysis found that in the next three years, every Black person in the US will lose someone they know to Covid-19 or its long-term consequences. Vedhara suggests this demonstrates a need for more effective public health interventions, rather than psychological ones.

As the pandemic continues to take thousands of American lives each day and as other economic, safety, and logistical stresses mount Goler Blount says stress is only accumulating. All these things are connected. We are here, all in the middle of this, grieving.

Lois Parshley is a freelance investigative journalist. Follow her Covid-19 reporting on Twitter @loisparshley.

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