Author Archives: Dr Colin Holloway

How do I increase my libido?

How do I increase my libido?’

July 17, 2019 12.40pm AEST

Author

  1. Melissa Kang Associate professor, University of Technology Sydney

Disclosure statement

Melissa Kang does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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University of Technology Sydney

University of Technology Sydney provides funding as a founding partner of The Conversation AU.


Hi I’ve been in a relationship for nearly 4 years now and have gone from having a high libido to a very low one, is there ways that I can change this? – Anonymous

Key Points

  • Our libidos fluctuate. Changes are normal
  • Most relationships start on a high, then libidos can decrease
  • Communication is key to working through these types of issues.

Changes in libido are common throughout life, and affect all genders. This can cause worry, especially when you notice what seems like a dramatic drop. But there are plenty of ways to help!


Read more: ‘Do I need to shave my pubic hair before having sex?’


Your libido isn’t a switch

Libido is your sexual desire or drive and it’s affected by a combination of physical, emotional, psychological and relationship circumstances.

Going through puberty often leads to the first experiences of libido, which helps us understand the importance of certain hormones in triggering the sex drive. In women, oestrogen is responsible for a lot of the sex drive, while in men it’s testosterone.

Some medical conditions and medications as well as commonly used drugs like alcohol can affect hormones and brain chemicals which lower the sex drive – in other words, there is a physical component to a person’s libido.

For example, depression can cause the sex drive to take a dive, and yet so can medication to treat depression.

Similarly, some people experience lower libido on some hormonal contraceptives, while others find it helps. Everyone is different and things can change over time.


Read more: ‘Are Kegel exercises actually good for you?’


Crazy in ‘limerence’

Most importantly, libido is hugely influenced by circumstances and experiences around us, from the past or present. A common scenario is like your own – where libido drops as a relationship gets older.

The early part of a relationship can be full of sex drive and something called limerence. Limerence is an emotional reaction to a new partner or relationship that is intensely romantic – plenty of love songs are written during this phase of a relationship! It’s due to the activation of certain brain chemicals and for some people feels like an addiction or obsession, the feeling of being “madly in love”.

As the relationship continues, limerence declines and sometimes sex drive does too. For some couples, this is fine and doesn’t cause too much concern. For others, having a lower libido creates distress for one or both people. Actually Beyoncé, it’s called limerence.

Communicate, communicate, communicate!

Sometimes simply knowing that a drop in libido can be normal is reassuring. Other times it’s not and it’s worth checking out a few things. Do a quick scan of your general health, including stress and lifestyle (alcohol, drugs, sleep habits, exercise).

Alternatively chat with your partner and look at what’s happening inside and outside the bedroom. Here’s some good questions to ask them (and remember, talk through them honestly with each other):

  • do you have different levels of libido or body clocks (one falls asleep at 9pm the other at 1am)?
  • does your partner want sex much more (or much less) than you do? This can create tension or anxiety which will affect your sex drive
  • over the four years you’ve been together, have you been able to communicate with each other about what gives you pleasure and does that feel mutual?
  • what sort of variety do you like in bed?
  • could there be issues going on outside the relationship, such as financial stress, worry about parents/family or study or work?
  • could there be issues from the past that have been weighing on your mind?

If you’re worried about a medical issue, see your GP to start with. If it’s more likely to be related to stress or your relationship, then you could see a counsellor on your own or as a couple.

You might not need professional intervention – many couples can figure out this stuff with good communication, but don’t hesitate to reach out for help if you want to.

Foods that help you look and feel young

Foods that help you look and feel young

Melissa Sammy, MDLinx | July 11, 2019

The secrets to youth and vitality may be closer at hand than you think—in fact, you need only stroll through your local grocery store, or better yet, take a look in your pantry.

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Capsaicin is an active compound found in chili peppers that has demonstrated anti-cancer and antioxidant properties, protection against some neurodegenerative diseases, and anti-obesity effects. Researchers have found that capsaicin may also limit skin aging and promote satiety and fullness upon consumption.

Each year, people across the globe collectively invest trillions of dollars in the wellness market—purchasing beauty products, anti-aging treatments, and nutritional supplements—in hopes of maintaining their inner and outer juvenescence.

In the United States alone, men and women spent over $16.5 billion on cosmetic procedures in 2018, with wrinkle treatment injections reported as the most frequently performed minimally invasive procedure (about 7.4 million) and facelifts reported as the most expensive ($7,655).

Consider also that the average US adult will likely spend just over $40,000 on dietary health supplements over the course of a lifetime, equating to nearly $56 per month.

While this growing global consciousness of, and dedication to, health and wellness is positive, it doesn’t have to break the bank. Let’s take a closer look at some dietary must-haves that can keep you looking and feeling young and fresh over the long term—and at a fraction of the price of a facelift.

Chili peppers

Capsaicin is an active compound found in chili peppers that has numerous health benefits. In some studies, capsaicin has been shown to have anti-cancer and antioxidant properties, and may even be protective against some neurodegenerative diseases, including Alzheimer’s disease. In one review, researchers suggested that dietary capsaicin may also have anti-obesity effects and play a protective role in metabolic health. Capsaicin may limit some age-related changes that occur in skin cells as well, according to a study published in the Journal of Cutaneous Pathology. In another study, published in Appetite, researchers found that the compound can increase satiety and fullness when added to the diet, and may thus prevent overeating.

Blueberries

Blueberries are often referred to as a “superfood,” and for good reason. They are rich in antioxidants, folate, and polyphenols, which all work together to boost your mood, reduce oxidative stress, and help prevent disease. Blueberries also contain flavonoids—compounds that possess antioxidative, anti-inflammatory, anti-mutagenic, and anti-carcinogenic properties—which have been shown to inhibit amyloid beta production in Alzheimer’s disease.  In one study published in the European Journal of Nutrition, blueberry consumption resulted in improved cognition in older adults.

Avocados

Avocados are abundant in monounsaturated fat and have been touted to positively affect lipid profiles. In one meta-analysis published in the Journal of Clinical Lipidology, researchers assessed 10 studies representing 229 individuals to investigate the impact of avocado-enriched diets on plasma lipoprotein concentrations. They found that avocado consumption significantly decreased total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels.

In another study, published in Archives of Dermatological Research, investigators noted that polyhydroxylated fatty alcohols found in avocados reduced ultraviolet (UV)-induced cellular damage and inflammation in human skin.

Pomegranates

Researchers have suggested that the antioxidant activity of pomegranate juices may be actually be higher than those found in red wine and green tea, and may thus offer protection from UV rays and help to heal skin damage. Pomegranates have also been hailed as “cosmeceuticals” due to their collagen-stimulating properties. In addition, compounds found in pomegranates—including punicic acid, methanolic seed extract, and pomegranate peel extract—have been shown to reduce fasting blood glucose levels, which could help to manage or even prevent type 2 diabetes in some individuals.

Bone broth

Made from cooking the bones of meat, poultry, or fish for a prolonged period of time, bone broth is rich in collagen, which can help to reduce the signs of aging. Collagen has also been shown to exert beneficial effects on bone health. For example, in a double-blind, placebo-controlled, randomized study, researchers found that collagen peptides may serve as therapeutic agents for the management of osteoarthritis. In another study, investigators found that simultaneous resistance training and collagen peptide supplementation improved body composition and muscle strength in elderly men with sarcopenia.

Cinnamon

Cinnamon has been shown to promote skin firmness and elasticity via collagen production, and reduce skin damage caused by advanced glycation end-products. The spice may also have positive effects on serum glucose levels, according to the results of one recent systematic review and meta-analysis.

Purple sweet potatoes

Though they may be a bit harder to find in your local supermarket, purple sweet potatoes are a powerhouse of nutrition. Also known as Okinawan sweet potatoes, these tubers are high in vitamin A—which is an essential micronutrient for eye, immune, and reproductive health—and anthocyanin, a flavonoid pigment found in plants that has been shown to have cancer-preventive properties. In some studies, mice that were fed a diet consisting of purple sweet potatoes demonstrated a reduction in hyperuricemia and kidney inflammation as well as overall renal damage.

Feverfew

This member of the daisy family, which grows in much of Europe and North America, has long been used as an herbal remedy to treat a myriad of health ailments ranging from headaches and arthritis to inflammation and menstrual cramps. According to some studies, feverfew may also help to reduce damaged skin cells and inflammation, alleviate dermatitis and psoriasis, and improve skin appearance. The medicinal plant is rarely sold in grocery stores; however, you can find fresh and dried forms in many farmers’ markets.

Olive oil

Olive oil is perhaps one of the healthiest fats known to man, and is an integral component of the oft-praised Mediterranean Diet—which has been consistently ranked as one of the best diets to follow due to its plethora of associated health benefits. Like avocados, olive oil is high in monounsaturated fat, and its consumption—especially the extra-virgin variety—has been associated with lower rates of cardiovascular disease and mortality

Tomatoes

Whether you consider them to be fruit or vegetables, tomatoes boast an array of impressive health benefits that are largely attributed to their high lycopene profile. Lycopene is a type of bright red carotenoid with antioxidant properties found in some red fruits and vegetables, such as tomatoes, watermelon, and papaya. Researchers have shown that incorporating ample quantities of tomatoes into the diet can reduce the risk of heart disease, stroke, and prostate cancer; offer dermal protection against UV rays; and reduce wrinkles caused by sun damage.

Can we turn back time?

Aging, unfortunately, is just a natural part of life that we must all contend with. While there’s no way to turn back time, as Cher once lamented, it is possible to improve your inner health and outward beauty. Regularly incorporating some or all of these listed food items into your diet can help you to age gracefully, and look and feel younger for longer. 

Pushing Our Limits to Achieve Health

Pushing Our Limits to Achieve Health

By Emeka Onyedika, MD on July 1, 2019 FacebookTwitterLinkedInEmailShare

The human body is an absolute marvel. The more I learn and experience, the greater my sense of awe. It’s incredible that we have studied our anatomy for years and there are still organs and functions we don’t fully understand. We have yet to create any piece of technology that rivals the body’s efficiency and complexity. This fact is illustrated by those among us who choose to test the perceived limits of our bodies’ capabilities. The account of one such individual has forever altered my life and transformed my view of our innate abilities. 

The man’s name is Wim Hof. He has developed the ability to control his autonomic nervous and immune system. This allows him to perform feats such as withstanding extreme cold and avoiding the sequelae of exposure to endotoxin. I initially thought that he was born with a genetic variant that provided him with these abilities. However, extensive studies and examinations of him and his twin brother have proved otherwise. Furthermore, Mr. Hof has shown that he can teach others to do the same. Check out a documentary on the subject here.

The more I learned about Mr. Hof, the more I wondered, could I use his methods to tap into the human body’s innate ability to persevere and heal?

Pushing my limits

I decided to test my own limits of cold tolerance. Over the past year, I have been experimenting with cold showers. I had heard about the possible benefits of reducing inflammation, improving mood, and strengthening personal mindsets by promoting tolerance to uncomfortable situations. 

In winter, I started gradually by wearing a sport coat instead of a heavy winter coat when outdoors. Eventually, I was able to comfortably go out in a short sleeved polo shirt with scrub pants regardless of the temperature or weather, even in heavy snow. The experience was exhilarating and empowering. 

I had been taught and grew to believe that I needed to protect myself from the cold in order to avoid illness. Though many of us are aware of the fact that cold exposure is not directly associated with respiratory ailments such as the common cold or flu, we still choose to adhere to the habits we learned as children that support comfort rather than health. I echo the sentiment expressed by Wim Hof that our pursuit of comfort and our modern day obsession with it is limiting the resilience of our bodies and our ability to overcome and prevent disease. My experiences, to date, corroborate this. 

Harnessing natural abilities

As discussed by Dr. Lissa Rankin in multiple TED Talks, Dr. Ranjan Chattergee in his book, The Stress Solution, and Dr. Joe Dispenza in his book, Evolve Your Brain, our bodies have the natural ability to deal with essentially every disease and ailment we know of. We simply have to figure out what is interfering with the intrinsic processes and/or develop the ability to maximize their effectiveness. 

Pain management is one I investigated for myself. As I learn more about the shortcomings of pharmaceuticals, I look to minimize or eliminate my reliance on them. Thankfully, the only medication I have taken consistently for most of my life is over-the-counter pain relievers as needed. However, after reviewing the nature of pain and the body’s response to it, I have changed this habit as well. 

As many of you may remember, pain is a neural impulse that the brain receives, signifying an abnormal condition involving the tissue adjacent to the nerves (for example, irritation or injury). Feeling uncomfortable or upset about pain is a learned behavior that actually perpetuates the discomfort. Research shows that neurotransmitters and hormones that promote negative moods slow healing and promote upregulation of pain receptors. In individuals with chronic pain, this cycle gains strength and efficiency to the point that it actually becomes their homeostasis. 

The opposite is true of endorphins and other neurotransmitters, such as dopamine, associated with euphoria and bliss. They are natural opioids and are more potent than their prescribed counterparts. Therefore, they are the best option for pain management and elimination. 

Moving beyond pain

I can attest to this. Over the last six months, I have successfully eliminated severe back and calf pains without medication. Instead, I expressed gratitude for the pain and committed to regular exercise and stretching of the affected areas in order to release endorphins and train my body to do this effectively and efficiently. I believe many of us are capable of this through dedication and discipline. We can use similar habits and practices to manage and eliminate conditions such as hypertension, glucose intolerance and diabetes, depression, and arthritis. The potential benefit is significant. Why remain dependent on medications when the superior therapeutic processes of our bodies can be bolstered and utilized? 

For those of you who are not already convinced or lack the personal experience of the benefits of these methods, I recommend practicing them first for yourself before making suggestions to patients and others. Once you discover the power and wide ranging ability of the incredible machines we call our bodies, you will want to share the knowledge. Let’s stop underestimating and dismissing its ability to self-regulate and maintain in most instances. The might of the body’s internal forces can do without the interference and often unnecessary assistance of many external tools we choose to employ. 

Emeka Onyedika, MD, is a physician evaluator conducting in-home health evaluations. To contact him, please send messages to: cratixhealth@gmail.com

The ABC and Bioidentical HRT

Some of my patients have been concerned about a recent ABC report on BHRT. As I was away in Singapore and have just returned, I will repeat a blog I had some time back when this issue was raised in a local newspaper. Remember, pharmaceutical companies, especially those that produce synthetic HRT, are significant donors to various medical groups and menopause associations. This does not mean that they are swayed or influenced by these donations, as they are all ethical and moral organisations, I am sure. This issue comes up again and again. I have addressed it in many blogs I have posted.

Compounded HRT and the Sunday Newspapers.(part 2)

Nov 14

Posted by Dr Colin Holloway  My blood pressure has settled down since reading the article on HRT (specifically compounded HRT) causing cancer in the Sunday Papers. Those of you who follow my blogs, which should be all of you, will know that I have repeatedly published studies from reputable journals about the safety of the hormones that I use, in the way that I use it. I am also aware that not all doctors have the experience and knowledge that I do, and some do not prescribe bioidentical hormones (BHRT) in a safe or proper manner. Some doctors have jumped aboard the BHRT bandwagon without the required skills. These doctors have given the BHRT a bad name generally. I suspect the article is mostly aimed at these doctors. However, “cowboy”operators occur everywhere, and not only medicine. Oestrogen should never be given to someone who has a uterus, without progesterone.  Oestrogen on its own can cause endometrial cancer. I am surprised at the number of times I have seen women who have not received progesterone, only oestrogen, from their doctors. This is a recipe for disaster. The amount of progesterone also needs to be adequate to have the protective effect. This is best monitored by regular blood testing. Saliva testing is not adequate and part of the poor practices I am talking about. For 25 years I have used Micronised Progesterone (natural progesterone) as being the safest and best form of progesterone. I have been attacked by the medical establishment, at conferences and the media for the use of “”unsafe and untried BHRT.”  Now a commercial Micronised Progesterone is available in Australia, and it has suddenly being hailed as the safest and best form of progesterone. The hypocrisy is amazing. The other issue is how hormones are given. The safest and best way is transdermal, as a troche or a cream. Doctors who give it in any other way risk increasing the cancer rate. Also, the evidence is that BHRT should be continuous ( no week off) as any monthly break from the BHRT can increase the uterine cancer rate. I have repeatedly mentioned that some compounding chemists are not as good as others – just as not all bakeries have the same quality of products.  For this reason it is important that you use one of the recommended pharmacies, because I have found them to have the best services and quality of hormones. As I mentioned yesterday, I have only had one women develop endometrial cancer in the last 25 years, and this can be verified by authorized researchers from my database on my computer of all the women I have treated with BHRT over the last 25 years. Finally, articles like the one on the weekend, do a great disservice to women, as it will scare many women away from taking HRT of any sort. These women will suffer a decreased quality of life, and many a premature death from avoiding HRT. The article below, from the American Journal of Public health and Yale university(how much more prestigious does that get) gives the actual figures, which are very concerning. Am J Public Health. 2013 Sep;103(9):1583-8. doi: 10.2105/AJPH.2013.301295. Epub 2013 Jul 18


Am J Public Health. 2013 Sep;103(9):1583-8. doi: 10.2105/AJPH.2013.301295. Epub 2013 Jul 18.

The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years.

Sarrel PM1, Njike VY, Vinante V, Katz DL.

Author information

1 Departments of Obstetrics and Gynecology and Psychiatry, Yale University School of Medicine, New Haven, CT, USA. philip.sarrel@yale.edu

Abstract

OBJECTIVES:

We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years.

METHODS:

We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women’s Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011.

RESULTS:

Over a 10-year span, starting in 2002, a minimum of 18 601 and as many as 91 610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET).

CONCLUSIONS:

ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall. Our data indicate an associated annual mortality toll in the thousands of women aged 50 to 59 years. Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency


FDA admit no adverse report on Bioidentical HRT

Aug 26

Posted by Dr Colin Holloway

One of the criticisms of Bioidentical HRT is that it is not FDA approved. It does not need to be, as it is not synthetic. It is interesting however that there has never been a complaint of an adverse event to the FDA – yet there are numerous adverse event report about the synthetic HRT. Here is part of a transcript from a recent Press conference run by the FDA.

The FDA had a press conference on BHRT. They generally were negative about BHRT.Here is one of the questions put to Kathy Anderson of the FDA (USA):

“Anna Matthews(Reporter): Hi. Couple of questions; one is have you guys received any reports of adverse events or other harm to patients from these products?

Kathy Anderson: Sorry, this is Kathy Anderson. With your respect to your question about whether we received any adverse event reports, we have not.”

Furthermore, the article did not mention the amount of damage done by synthetic HRT :

Prempro Causes Breast Cancer  and Loses Court Case with Huge Punitive Damages

by Jeffrey Dach MD

A 112 million dollar punitive is a very loud statement.  It states that the jury was outraged by the “wanton and reckless” conduct by Wyeth.  112 Million Dollars in punitive damages was awarded to two breast cancer victims who took Wyeth’s synthetic hormone, Prempro, all the while thinking it safe. The jury was outraged that Wyeth ignored and suppressed evidence that Prempro causes breast cancer. Wyeth paid consultants and ghostwriters of medical journal articles to play down concerns about breast cancer, and declined to study known risks. Once again, company profit was placed ahead of patient safety. This is the tip of the iceberg, as another ten thousand cases are waiting for their day in court.

Premrpro is similar to premarin or premia, as used in Australia. I have been using these compounded products for the last 25 years, and have had 1 case of uterine cancer in that time. She was cured by a hysterectomy and is still fine today.Endometrial thickening can occur in women, with or without hormones, and, as the article stated, may be caused by obesity.

You can’t get influenza from a flu shot – here’s how it works

You can’t get influenza from a flu shot – here’s how it works

June 25, 2019 6.11am AEST

Authors

  1. Allen Cheng Professor in Infectious Diseases Epidemiology, Monash University
  2. Katherine Kedzierska Academic, Microbiology and Immunology, University of Melbourne

Disclosure statement

Allen Cheng receives funding from the Commonwealth Government and holds research grants with the National Health and Medical Research Council. He is the Chair of the Advisory Committee for Vaccines and the Co-Chair of the Australian Technical Advisory Group on Immunisation.

Katherine Kedzierska receives funding from the National Health and Medical Research Council, and from the Australian Research Council.

Partners

Monash University
University of Melbourne
Victoria State Government

Influenza is a moving target for vaccines. Each year, up to four different strains circulate, and they are constantly evolving to escape our immune system.

So rather than childhood jabs giving long lasting immunity, we need annual flu shots to provide optimal protection against influenza.

But while you might sometimes get sick after having a flu shot, it’s a myth that having a flu shot can give you the flu.

A quick history of the flu vaccine

Influenza vaccines were first developed in the 1930s and 1940s, starting with the isolation of the influenza virus.

Back then, we learned there were many different influenza strains. To be effective, early research showed the vaccine needed to be matched to the circulating strains, and to be able to stimulate a response from the immune system.


Read more: When’s the best time to get your flu shot?


The process to produce modern influenza vaccines now occurs on a much more refined and industrial scale. Hundreds of thousands of influenza viruses are collected by hundreds of national influenza centres around the world.

From these, four strains are selected for the annual flu vaccine, based on the viruses that are circulating at that time, how well the vaccines activate the immune system, how the strains are evolving, and the effectiveness of previous vaccines.

Modern flu vaccine development is slow and labour-intensive process. hotsum/Shutterstock

Most modern vaccines are manufactured by growing large quantities of live virus – mostly in chicken eggs or less commonly animal cells – which are then purified, deactivated and split into smaller components. These vaccines are inactive and cannot replicate.

There are also two new “enhanced” vaccines that are used in older people, who don’t tend to respond as strongly to vaccines: Fluzone High Dose and Fluad, which is designed to better stimulate immunity and draw immune cells to the site of vaccination.


Read more: High-dose, immune-boosting or four-strain? A guide to flu vaccines for over-65s


How the immune system fights the flu

The human immune system has several strategies to protect against infection. For viral infections such as influenza, the key strategy is known as adaptive immunity. This part of the immune system can “remember” previous exposure to pathogens.

When you get an influenza infection, the virus enters and hijacks the machinery of the host cell to replicate itself, before releasing these copies to infect more cells.

T lymphocyte cells of the immune system can recognise this viral incursion. T cells protect against further spread of the virus by activating pathways that cause infected cells to trigger a “suicide” process.

Another strategy the body uses is to produce antibodies, which are molecules produced by B cells that recognise components of the viral capsule. These antibodies work by sticking to the surface of the influenza virus to prevent it spreading and facilitating disposal.

Flu shots help mount a quicker defence

On a first exposure to a pathogen, our B cells take at least two weeks to ramp up production of antibodies. However, on subsequent challenges, antibody production occurs much more quickly.

Influenza vaccines harness this arm of the immune system, known as “humoral” immunity. By “practising” on viral components, vaccines allow the immune system to react more quickly and effectively when faced with the real virus.

The flu shot takes about two weeks to start protecting you against influenza. DonyaHHI/Shutterstock

So why do you sometimes get sick after a flu shot?

There are several reasons why you might feel a bit off after getting your flu shot.

First, your flu shot only protects you against influenza and not other respiratory illness which might causes similar cold or flu symptoms. This includes RSV (respiratory syncytial virus), which is common in late autumn and early winter.


Read more: Sick with the flu? Here’s why you feel so bad


Second, stimulating the immune system can result in symptoms similar to that of influenza, although much milder and short-lived. These include local inflammation (redness, pain or swelling at the site of the vaccine) and more general symptoms (fever, aches and pains, tiredness).

Third, vaccine-induced protection isn’t complete. In some years, the vaccine is not well matched to circulating strains. Usually this is due to mutations that may develop in circulating strains after the vaccine strains are selected.

The flu vaccine also doesn’t “kick in” for two weeks after vaccine administration. In some people, particularly those who are older and those who have weakened immune systems, antibody production is not as strong, and the level of protection is lower.

Despite this, studies have consistently shown that vaccinated people are less likely to get influenza or complications from the flu than those who aren’t vaccinated.


Read more: Flu vaccine won’t definitely stop you from getting the flu, but it’s more important than you think


A better way to protect against the flu

A problem with current vaccines is the reliance on eggs, which results in a relatively slow and labour-intensive production process.

Current work is aiming to speed up this process by using different technologies so that vaccine manufacturers can react more quickly to changes in circulating viruses.

The “holy grail” for influenza vaccines is to stimulate an effective immune response to a component of influenza that doesn’t change each year, so annual vaccination is not required.

These efforts have proved elusive so far.


Read more: The Holy Grail of influenza research: a universal flu vaccine


A better strategy might be to harness T cell immunity. Recent work has shown that a type of T cell, known as “killer” T cells, can recognise other parts of the influenza virus, and therefore can provide broad protection against seasonal and pandemic strains.

But while we wait for a better alternative, getting an annual flu shot is the best way to avoid the flu.

Can I prevent food allergies in my kids?

Can I prevent food allergies in my kids?

With the rise in food allergies over the last ten to 20 years, parents are understandably concerned about what – if anything – can be done to reduce the chances of their child developing a food allergy. Expectant mums often ask whether there’s anything they should eat, or avoid eating, to reduce the risk of food allergy in their child.

In the past, some guidelines recommended mums avoid eating “allergenic” foods (foods that commonly cause reactions in individuals with food allergy) during pregnancy and breastfeeding. This advice has now been removed because it hasn’t prevented food allergies in the child. So what do we know (and not know) about the link between foods eaten during pregnancy and food allergies in children?


Read more – Curious Kids: How do we get allergic to food?


What is a food allergy?

There are many different types of reactions to foods. Those involving the immune system are classified as allergies.

The type of allergy most studied is called “IgE-mediated” food allergy (IgE refers to immunoglobulin – the antibodies produced by our immune system). In IgE-mediated food allergy, the immune system responds to a particular food or foods in the same way it would respond to something dangerous. It causes symptoms that we call an allergic reaction. Food allergy can occur to a wide range of foods, but common culprits are peanut, tree nuts, egg, milk, soy, wheat, fish and shellfish.

For people with this type of food allergy, reactions generally occur rapidly, sometimes within minutes of ingesting the food. Common symptoms include hives (raised wheals that resemble mosquito bites), vomiting, and swelling of the lips, eyes, or face. Less commonly, reactions can involve the airways or circulation, resulting in potentially life-threatening symptoms like difficulty breathing, wheezing or collapse.

Peanuts should be introduced before one year of age. from http://www.shutterstock.com

In Australia, IgE-mediated food allergy now affects around one in every ten babies, and around one in 20 older children. It usually develops in infancy or early childhood, and can be lifelong.


Read more: Food allergies linked to overactive immune system at birth


Can we prevent children from developing food allergy?

The normal response to eating a food is “tolerance”. In other words, the immune system sees the food as harmless and does not mount a response. Interventions to prevent food allergy aim to promote the development of tolerance.

Ten years ago, no one knew how this could be achieved. Since then, there have been major advances. Perhaps the most important is the recent discovery by researchers in the UK that peanut allergy can be prevented in some children who are at high risk of developing it.

In a study in which 600 children with eczema or egg allergy were randomly assigned to either eat or avoid peanut, those who started eating peanut earlier (before they were one year old) were less likely to have peanut allergy at age five than those who avoided peanut. Studies have also shown eating egg earlier may protect against egg allergy, although this protective effect does not appear to be as strong as for peanuts.

As a result of this study, parents are now advised to introduce foods like peanut and egg to infants before one year of age.


Read more: Introduce eggs and peanuts early in infants’ diets to reduce the risk of allergies


Although this is an important advance in knowledge, the research also showed this isn’t effective for everyone. Some children develop food allergy very early in life, too early to benefit from being given foods like peanut before one year.

It’s also clear infant diet isn’t the only factor that determines whether a child develops a food allergy, since most children do not develop food allergy regardless of the age when foods like peanut and egg are first given. And some children develop food allergy even with an optimal diet.

Maternal diet and food allergy

Immune responses to foods like egg and peanut can be detected in some infants in the first few months of life, before these foods are introduced into the infant diet. This means food allergy prevention might need to start earlier than previously thought.

A recent study in mice reported that milk from mothers exposed to egg protein protected offspring from developing allergic reactions to egg. This protection was strongest when the mothers were exposed to egg proteins during both pregnancy and breastfeeding. At the moment it’s not known whether this is also the case in people.


Read more: What are allergies and why are we getting more of them?


The Australasian Society of Clinical Immunology and Allergy does not recommend excluding allergenic foods during pregnancy or breastfeeding.

We don’t know yet whether eating more of foods like peanuts or eggs in pregnancy can reduce the risk of the child developing a food allergy. But answers should be available soon. A study led by researchers at the University of Western Australia is about to look in detail at how the amount of egg and peanut eaten by mums relates to their child’s risk of having an egg or peanut allergy.

This is a large study which will take several years to complete, but hopefully we will be able to provide evidence-based advice for maternal diet, the same way we can for infant diet, very soon.

Sick with the flu? Here’s why you feel so bad

Sick with the flu? Here’s why you feel so bad

June 14, 2019 6.16am AEST You might feel terrible. But your runny nose, sore throat and aches are signs your body is fighting the flu virus. And that’s a good thing. from www.shutterstock.com

Author

  1. Stephen Turner Professor, viral immunology, Monash University

Disclosure statement

Stephen Turner receives funding from the National Health and Medical Research Council of Australia, the Australian Research Council and the National Institutes of Health Centre of Excellence for Influenza Research and Surveillance.

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Monash University
Victoria State Government

“You never forget the flu”. This is the title of the Victorian health department’s current campaign, which highlights people’s recollections of having the flu.

‘The flu knocked me out for weeks’, part of the Victorian health department’s winter flu campaign. Vic Dept Health & Human Services

Phrases include “I’ll never forget the pain of the fever”, “the flu flattened me”, “the flu knocked me out for weeks”.

This gives the impression that when you have the flu, you know you have it. What makes the flu so memorable is the severe symptoms. These include fever, aches and pains, a sore throat, runny nose, cough, and feeling weak and lethargic.

But what causes the flu? And why are the symptoms so severe?


Read more: Health Check: how long should you stay away when you have a cold or the flu?


What causes the flu?

Influenza is caused by a virus, a small microbe that needs to enter our cells to replicate and produce more viruses. The influenza virus infects cells that line our airways and so is easily transmitted via the spread of droplets released when we sneeze or cough.

Coughs, sneezes and the other symptoms we feel after getting the flu, are largely due to our bodies fighting the infection.


Read more: I’ve always wondered: why is the flu virus so much worse than the common cold virus?


The immune response is a double-edge sword

When you are infected with the flu virus, your innate immune system kicks in. Special receptors recognise unique parts of the virus, triggering an alarm system to alert our bodies that an infection is under way.

This produces a rapid but non-specific response — inflammation.


Read more: Explainer: what is the immune system?


Inflammation results from the action of small proteins called cytokines. A primary role of cytokines is to act locally in the lung to help limit the initial infection taking hold.

They can also make their way into the circulation, becoming systemic (widespread in the body) and act as a “call to arms” by alerting the rest of the immune system there is an infection.

Unfortunately, your body’s inflammatory response, while trying to fight your infection, results in the flu symptoms we experience.

Inflammation can trigger increased mucus production. Mucus (or phlegm) is a sticky substance that helps capture virus in the lungs and upper airways. The increased amount of mucus in the airways can trigger coughing and/or sneezing, and can lead to a runny nose. This helps expel the virus from our body before it can infect other airway cells.


Read more: Health Check: what you need to know about mucus and phlegm


Inflammation also results in an increase in body temperature or fever, which creates an inhospitable environment for the flu virus to replicate.

While an increased body temperature helps fight the infection, it also results in you feeling colder than usual. That’s because you feel a greater temperature difference between your body and the outside environment.

This can induce rapid muscle contractions in an effort to heat you up. This is why you can feel like you can’t stop shivering while at the same time burning up.


Read more: Monday’s medical myth: feed a cold, starve a fever


Finally, some of these inflammatory molecules act directly on infected cells to stop the virus replicating. They can do this by either interfering with the replication process directly, or alternatively, by actually killing the infected cell.

One of these factors is tumour necrosis factor alpha (TNF-alpha). While its actions limit where the flu virus can replicate, its side effects include fever, loss of appetite and aching joints and muscles.

Calling in the big guns

Inflammation induced by the innate response also helps alert the adaptive immune system that there is an infection.

While innate immunity provides an immediate, albeit non-specific, response to viral infection, it is the adaptive immune response that can efficiently clear the infection.

The adaptive immune system consists of specialised white blood cells called T and B cells that when activated provide a highly specific response to infection.

Your flu symptoms are likely the result of your body fighting off infection with the the tiny flu virus. from www.shutterstock.com

Activation of flu-specific T and B cells in tissues called lymph nodes results in the generation of hundreds of thousands of clones, all specific for the flu virus. These can migrate into the lungs and specifically target the virus and its ability to replicate.

This enormous expansion of T and B cell numbers in response to infection results in swelling of the lymph nodes, which you can feel under your armpits or chin, and which can become sore.

Flu-specific T cells are also a source of the inflammatory molecule TNF-alpha and help fight influenza infection by killing off virus-infected cells. Both actions can contribute to the flu symptoms.

Why can flu become a serious problem?

Our ability to see off a flu infection requires a coordinated response from both our innate and adaptive immune responses.

If our immune system function is diminished for some reason, then it can prolong infection, lead to more extensive damage to the lung and extended symptoms. This can then result in secondary bacterial infections, leading to pneumonia, hospitalisation and eventually death.

Then there are people whose immune system doesn’t work work so efficiently who are particularly susceptible to the flu and its complications. These include:

  • the very young, whose immune system is still yet to mature
  • the elderly, whose immune system function wanes with age
  • people with other conditions where immune function might be compromised, or be taking medication that might suppress the immune system.

Preventing the flu

Washing your hands and covering your mouth when coughing and sneezing are simple things we can all do to reduce the chance of catching the flu in the first place.

And getting the flu vaccine activates your adaptive immune response to induce the sort of immunity efficient at protecting us from infection.

With the flu season well under way, prevention is our best bet that you won’t be saying “Remember the time I got the flu”.

Knee osteoarthritis and menopausal hormone therapy in postmenopausal women

Another one of the benefits of oestrogen to menopausal women. I have known and repeatedly told my patients that oestrogen is good for all joints, and helps to slow down the natural deterioration that occurs with age. There are other studies like this one which show the same thing. Combing oestrogen with fish oil, turmeric and cinnamon all have advantages for joints. Using them and keeping them active also slows down the onset of osteoarthritis.

Knee osteoarthritis and menopausal hormone therapy in postmenopausal women

a nationwide cross-sectional study

Jung, Jae Hyun, MD, PhD1,2; Bang, Cho Hee, RN, MS3; Song, Gwan Gyu, MD, PhD1,2; Kim, Cholhee, PT, MS4; Kim, Jae-Hoon, MD, PhD1,2; Choi, Sung Jae, MD, PhD1,5Menopause: June 2019 – Volume 26 – Issue 6 – p 598–602 doi: 10.1097/GME.0000000000001280 Original Articles Buy

Objective: The incidence of osteoarthritis (OA) increases after menopause, and may be related to hormonal changes in women. Estrogen deficiency is known to affect the development of OA, and menopausal hormone therapy (MHT) is suggested to be related to the development of OA. However, the relationship between knee OA and MHT remains controversial. The association between knee OA prevalence and MHT was investigated using large-scale national data.

Methods: Data were collected from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012). MHT was defined as regular hormone medication for ≥1 year, and demographic and lifestyle variables were compared between the MHT and non-MHT groups. Knee OA was defined according to symptoms and radiographic findings.

Results: In the multiple logistic regression models, the OA odds ratio was 0.70 for the MHT group (95% confidence interval 0.50-0.99), compared with the non-MHT group.

Conclusions: The prevalence of knee OA was lower in participants with MHT than in those without MHT.

Is it time to remove the cancer label from low-risk conditions

Is it time to remove the cancer label from low-risk conditions?

Many people associate the word cancer with major illness or death. Shutterstock

Over the past few decades, our understanding of cancer has changed. We now know some cancers don’t grow or grow so slowly that they’ll never cause medical problems.

But the way we label disease can harm. The use of more medicalised labels, including cancer, can increase levels of anxiety and the desire for more invasive treatments.

Given this growing evidence, my colleagues and I argue in The BMJ today that it may be time to stop telling people with very low-risk conditions that they have “cancer” if they’re unlikely to be harmed by it.

Our understanding of cancer has changed

Cancer screening for people who have no symptoms and the use of increasingly sensitive technologies can lead to overdiagnosis – a diagnosis that causes more harm than good. Overdiagnosis is most common in breast, prostate and thyroid cancer.


Read more: Most people want to know risk of overdiagnosis, but aren’t told


Thyroid cancer diagnoses, for example, have dramatically increased in developing countries. This has mainly been driven by an increase in the detection of papillary thyroid cancers. These are a sub-type of thyroid cancer which are often small (less than 2cm in size) and slow-growing.

But death rates from thyroid cancer remain largely unchanged. And tumour growth and spread in patients with small papillary thyroid cancer who choose surgery are similar to those who just monitor their condition.

In fact, autopsy studies spanning over 60 years show thyroid “cancers” have always been common but often went undetected and didn’t cause harm.

Impact of the cancer label

Many people associate the word cancer with major illness or death. It can be frightening to hear. This association has been ingrained by public health messaging that cancer screening saves lives.

Although this promotion has had the best of intentions, it has also induced feelings of fear and vulnerability in the population. It has then offered hope, through screening.

After decades, this messaging has resulted in highly positive attitudes towards cancer screening and early treatment. It has also led to an increased, sometimes unwarranted, desire for surgery.

Several studies show the cancer label, and the use of medicalised labels in various other conditions, leads to higher levels of anxiety and perceived severity of the condition, as well as a greater preference for invasive treatments.

The increased desire for more aggressive treatments has been shown clinically in ductal carcinoma in situ (DCIS) of the breast (sometimes known as stage O breast cancer). Women are increasingly choosing mastectomy and bilateral mastectomy (removal of one or both breasts) rather than lumpectomy (removal of the lump), even though these treatments do not change their odds of dying of breast cancer.


Read more: Treating ‘stage 0’ breast cancer doesn’t always save women’s lives so should we screen for it?


Similarly, in localised prostate cancer, active surveillance has been a recommended management option for a number of years, which means monitoring the condition and not providing immediate treatment. But men are only beginning to avoid immediate treatment and follow active surveillance at similar rates to men who choose surgery or radiation.

There is also evidence and informed speculation that melanoma in situ (also called stage 0 melanoma), small lung cancers, and some small kidney cancers may similarly be considered low risk and subject to overdiagnosis and overtreatment.

A strategy to reduce overdiagnosis and overtreatment

Removing the cancer label is one strategy that has been proposed in recent years by international cancer experts to reduce overdiagnosis and overtreatment in some low-risk conditions.

The cancer label has previously been removed when there was clear evidence the condition was low-risk and very unlikely to cause harm. In 1998, “papilloma and grade 1 carcinoma of the bladder” was re-labelled to “papillary urothelial neoplasia of low malignant potential”. The word carcinoma, which is another way of saying cancer, was dropped.

More recently, reference to “cancer” was removed from a sub-type of papillary thyroid cancer, which is identified after surgery. This was done to eliminate the need for ongoing follow-up and reduce any potential patient anxiety.


Read more: Informed Aussies less likely to want a prostate cancer test


It’s vital we learn from these past examples. We also need to establish a formal evaluation of the impact that removing the cancer label will have on clinical practice and patient outcomes, to drive effective reform.

Ultimately, removing the cancer label will create controversy and take time. But the end result should better support appropriate evidence-based care for both future and current patients

Heading back to the office? Bring these plants with you to fight formaldehyde (and other nasties)

Heading back to the office? Bring these plants with you to fight formaldehyde (and other nasties)

Humans have built high-rises since ancient Roman times, but it wasn’t until the 20th century that they became the default work space for a significant slice of the world’s workers. While these buildings are certainly efficient, they can cause real health issues.

Office buildings, where many Australians spend much of their time, are even worse than apartment buildings. Cubicles in offices usually consist of partitions made of particle board and vinyl carpet, synthetic flooring, a particle board desk and plastic or synthetic office chair, mostly lit by artificial lighting. The lucky few get natural light and a view from a window, but poor ventilation still spreads germs.


Read more: Why apartment dwellers need indoor plants


One excellent way to combat both sick days and stress is by filling your office with plants. Ideally, you want plants that will “scrub” the air of pathogens, improve the office’s mix of bacteria, and survive in low light with little care.

Fight formaldehyde (and other nasty chemicals)

One of the many chemical compounds given off by synthetic office furnishings is formaldehyde, which can irritate the mucous membranes of the eyes, nose and throat, and also cause allergic contact dermatitis.

Irritation of the eyes and upper respiratory tract, as well as headaches, are the most common reported symptoms of exposure to formaldehyde toxins. Other harmful chemicals in the office may include benzene, ethylbenzene, toluene and xylene, and even ammonia from cleaning products. High levels of carbon dioxide breathed out by a roomful of colleagues can give the room that “stuffy” feeling, particularly if there is no air conditioning.

Indoor plants will purify the air, reducing volatile organic compounds, including formaldehyde.

A NASA clean air study tested common indoor plants for the ability to filter pollutants, and found many are very effective at removing multiple kinds of organic compounds from the air (this chart is very handy for finding high performers).

To best remove indoor pollutants, try for one medium-sized plant per 2.2 square metres. Look for species with large leaves (the more leaf surface area, the more efficient it is).

Improve indoor bacteria balance

There are already trillions of bacteria in high-rise offices, but only a limited amount come in through open windows and air conditioning from the outdoor environment. Most of the bacteria, fungi and viruses come from people; we leave behind a microbial cloud from our skin wherever we go.

The office environment then creates new habitats for microbial communities that may be quite foreign to human skin, and may not be good for your health.

Beneficial bacteria on indoor plants and in their soil are an important addition to the office, stabilising the ecology of the built synthetic environment.

Plant-associated bacteria could also help to avoid outbreaks of pathogens by enhancing microbial biodiversity and balancing the complex network of the ecosystem. A wholesome balance may reduce the incidence of viral illness and the number of sick days among staff.

It’s not just the size of the plant that’s important here. Larger pots mean more root mass and soil surface for helpful bacteria and root microbes.

Beat stress

Over the past 30 years, research has shown that green spaces promote public health, and that contact with nature can shift highly stressed people to a more positive emotional state. One study identified eight ways people perceive green urban spaces (described as Serene, Space, Nature, Rich in Species, Refuge, Culture, Prospect, and Social) and confirmed the importance of considering plant life when creating public places.

Offices, particularly those with many people, poor ventilation or low natural light, should also consider plants and green spaces a necessity.

There are a few basic principles for a good office plant. It must be hardy and easy to maintain, and able to survive without water over weekends (or when the regular plant-carer goes on holiday). Many plants will do the most good in cubicles and spaces away from windows, so they need to be adapted to low light.

It’s also a good idea to avoid plants that flower extravagantly, which may cause allergic reactions. Check with your colleagues before introducing new plants.


Read more: Hay fever survival guide: why you have it and how to treat it


Some of the best all-rounders across these categories are Devil’s Ivy, Bamboo Palm, Kentia Palm, Variegated Snake Plant (also known as mother-in-law’s tongue), and the Peace Lily, but there are many beautiful plants that will improve your atmosphere and mood.

So if you’re heading back to work in an office soon (or know someone who is), why not bring along an indoor plant?