Archive for the ‘Hormone Physician’ Category

Physical pain is unpleasant, yet its vital for survival because its a warning that your body is in danger. It tells you to take your hand off a hot burner or to see a doctor about discomfort in your chest. Pain reminds us all that we need to take care of ourselves.

Feeling lonely is the social equivalent to feeling physical pain. It even triggers the same pathways in the brain that are involved in processing emotional responses to physical pain.

Just like feeling physical pain, feeling lonely and disconnected from others is also a signal that we need to take care of ourselves by seeking the safety and comfort of companionship. But what happens when we are unable to find companionship and the loneliness persists?

As scholars at the Center for Healthy Aging at Penn State, we study the impact of stress on the aging body and brain, including how it can worsen cognitive decline and risk for dementia. The social isolation older adults are experiencing now amid the coronavirus pandemic is raising new mental health risks, but there are things people can do to protect themselves.

The health consequences of loneliness

The COVID-19 pandemic has put many older adults social lives on hold, leaving them at greater risk for loneliness. They know they face a higher risk of developing severe symptoms from COVID-19, so many are staying home. Restaurant closures and limits on visitors to assisted living centers have made it harder to see family and friends.

But even prior to the pandemic, public health experts were concerned about the prevalence and health impacts of loneliness in the U.S. Loneliness affects between 19% and 43% of adults ages 60 and older, and many adults ages 50 and over are at risk of poor health from prolonged loneliness.

Research has shown that prolonged loneliness is associated with increased risk for premature death, similar to smoking, alcohol consumption and obesity. Other health consequences are also associated with loneliness, including elevated risk for heart disease and stroke, and it is associated with increased physician visits and emergency room visits.

Loneliness can affect brain health and mental sharpness

Older adults who are socially isolated or feel lonely also tend to perform worse on tests of thinking abilities, especially when required to process information rapidly. And those who feel lonely show more rapid decline in performance on these same tests over several years of follow-up testing.

It is thought that loneliness may contribute to cognitive decline through multiple pathways, including physical inactivity, symptoms of depression, poor sleep and increased blood pressure and inflammation.

Loneliness has also been found to increase the risk of developing dementia by as much as 20%. In fact, loneliness has an influence similar to other more well-established dementia risk factors such as diabetes, hypertension, physical inactivity and hearing loss.

Although the underlying neural mechanisms are not fully understood, loneliness has been linked with the two key brain changes that occur in Alzheimers disease: the buildup of beta-amyloid and tau proteins in the brain. Other indicators of psychological distress, such as repetitive negative thinking, have also be linked with the buildup of beta-amyloid and tau in the brain. Theories suggest that loneliness and other psychological stressors act to chronically trigger the biological stress response, which in turn appears to increase beta-amyloid and tau accumulation in the brain.

How loneliness can contribute to disease

The evidence suggests that prolonged feelings of loneliness are detrimental to health. So, how do those feelings get converted into disease?

Feeling lonely and socially isolated can contribute to unhealthy behaviors such as getting too little exercise, drinking too much alcohol and smoking.

Loneliness is also an important social stressor that can activate the bodys stress responses. When prolonged, that response can lead to increased inflammation and reduced immunity, particularly in older adults. Inflammation is the bodys response to fight off infection or heal an injury, but when it continues unchecked it can have a harmful impact on health. Stress hormones play an important role in making sure that inflammation doesnt get out of control. But, under chronic stress, the body becomes less sensitive to the effects of the stress hormones, leading to increased inflammation and eventually disease.

In healthy older people, loneliness is related to a stress hormone pattern similar to that of people who are under chronic stress. This altered pattern in the stress response explained why people who were lonelier had poorer attention, reasoning and memory ability.

Social activity can buffer against the decline

Maintaining high quality relationships may be a key for protecting brain health from the negative impacts of loneliness.

Older adults who feel more satisfied in their relationships have a 23% lower risk of dementia, while those who feel their relationships are supportive have a 55% lower risk of dementia, compared to those who feel dissatisfied or unsupported in their relationships.

Maintaining social activity also buffers against decline in thinking abilities, even for those who live alone or who have signs of beta-amyloid accumulation in their brain. One reason for these benefits to brain health is that maintaining strong social ties and cultivating satisfying relationships may help people to cope better with stress; people who feel better able to cope with difficulties or bounce back after a stressful event show less buildup of tau protein in their brains.

This is good news because, with the importance of social distancing for controlling the COVID-19 pandemic, how people manage their feelings and relationships is likely more important for brain health than the fact that they are spending time physically apart.

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Strategies for coping with loneliness

Loneliness is a common and normal human experience. An important first step is to recognize this and accept that what you are feeling is part of being human.

Rather than focusing on whats not possible at the moment, try to refocus your attention on what you can do to stay connected and make a plan to take action. This could include planning to reach out to friends or family, or trying new activities at home that you normally wouldnt have time for, such as online classes or book clubs.

During times of high stress, self-care is essential. Following recommendations to maintain regular exercise and sleep routines, healthy eating and continuing to engage in enjoyable activities will help to manage stress and maintain mental and physical health.

Karra Harrington, Postdoctoral Research Fellow, Clinical Psychologist, Pennsylvania State University

Martin J. Sliwinski, Professor of Human Development and Family Studies, Director of the Center for Healthy Aging, Pennsylvania State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Image: Reuters

Read more:
Social Isolation is Raising New Mental Health Risks in Older Adults - The National Interest

There are many different reasons why you may experience nausea. Sometimes it is due to an underlying medical condition. Other times, nausea may occur as a result of motion sickness or eating too much.

In many of these cases, taking anti-nausea medication can help relieve your symptoms quickly. But which medicine you should take depends on what's causing your nausea.

The most common causes of nausea include:

If you know you're going to be nauseous in advance, you can prevent it by taking medication beforehand. So, for example, if you know you're prone to get nausea on airplanes, you should take medication approximately half an hour before your flight takes off.

Here are the most common types of anti-nausea medicine for motion sickness:

Motion sickness medications work best when taken before the activity that may cause motion sickness, Devine says, so it won't help as much to take it after you feel nauseous.

Nausea caused by acid reflux is best resolved by treating the acid reflux itself, Devine says. The two major classes of medication to treat acid reflux are:

These are prescription medications, but some of them are available over-the-counter at lower strength doses. You should contact your doctor if you experience symptoms of acid reflux, like heartburn and nausea, that persist for seven days even with over-the-counter treatment.

Nausea during pregnancy typically subsides in the second trimester, though there are some people who experience it for longer, or who may have an extreme version, known as hyperemesis gravidarum.

Pyridoxine (Vitamin B6) is a common over-the-counter anti-nausea medication deemed safe during pregnancy, Devine says. However, the kind of anti-nausea medication or treatment best suited for a pregnant person depends on the severity of their nausea and other individual factors.

Some anti-nausea medications may impact fetal development, so if you think you may need anti-nausea medication, it's important to discuss options with your obstetrician first.

If you experience severe, recurrent episodes of nausea without a clear underlying cause your doctor may prescribe medications that act on histamine, dopamine, or serotonin receptors in the brain.

These prescription medications can help treat acute episodes of nausea or prevent future episodes. Examples include:

Common side effects of anti-nausea medication include:

Most medications to treat nausea are safe, Devine says, but there are cases where anti-nausea medication may not be a good idea. Some common anti-nausea medications, like those acting on dopamine and serotonin receptors, can affect electrical rhythms of the heart.

These medications are typically not recommended for people with a history of heart conditions or those on other medications with potential side effects of heart rhythm abnormalities.

Talk with your doctor about the best anti-nausea medication for your symptoms. Together, you can develop a treatment plan to prevent and treat your nausea.

"No one should have to suffer with frequent nausea and vomiting," Devine says. "In the overwhelming majority of cases, nausea can be well managed with a combination of lifestyle, dietary, and medication therapies."

For more information, learn about the best home remedies for nausea.

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The best types of medicine for nausea and which is right for you - Insider - INSIDER

When looking into the connection between vitamin D and weight loss, researchers often use supplements in their studies, rather than tracking a subjects sun exposure or food.

Thats because pills are standardized and can be given in high doses to quickly up a study participants vitamin D level. For example, a study published in July 2018 in the International Journal of Preventive Medicine gave subjects who were overweight or had obesity 50,000 IU of vitamin D (an amount well above the recommended limit of 4,000 IU per day, or 28,000 IU per week, per the NIH) each week for six weeks. Researchers found in this small study that the subjects weight, BMI, waist circumference, and hip circumference all decreased significantly, and their vitamin D levels increased significantly, after taking this high vitamin D supplement regime. However, thats not a safe amount of vitamin D to take for weight loss (or any other reason) in the real world.

Although scientists havent done much research on eating vitamin D-rich foods and weight loss, theyre definitely still worth consuming. What we know is that foods high in D tend to be healthy anyways salmon, mackerel, mushrooms, vitamin D-fortified milk, which are part of a healthier diet, versus processed foods so consuming these would likely help with weight loss, says Agarwal.

And while researchers dont typically track sun exposure, getting a little sun the old-fashioned way isnt a bad idea, but its important to not overdose on sun, which can up your risk of skin cancer, according to Harvard Health Publishing.

More:
Can Taking a Vitamin D Supplement Help You Lose Weight? - Everyday Health

Nausea refers to feelings of queasiness often with the urge to vomit. Symptoms of nausea include sweating, a rush of saliva in the mouth, fatigue, and loss of appetite.

While it's often associated with acid reflux and over-eating, nausea can also occur during pregnancy, with motion sickness, or as a side effect of other medical disorders or common illnesses.

There are many anti-nausea medications that can help with severe or persistent nausea. But if your nausea is mild or occasional, there are also a number of effective home remedies that can help relieve your symptoms naturally.

Ginger is an effective remedy for nausea, says Daniel Devine, MD, internal medicine doctor and geriatrician at Devine Concierge Medicine, a primary care practice in Philadelphia.

That's because ginger has anti-inflammatory properties, which can support digestion, and its compounds are also thought to speed up the process of stomach contents moving into the small intestine, which can reduce symptoms of nausea.

A 2014 analysis of six different studies published in the Journal of the American Board of Family Medicine examining the use of ginger in pregnancy found that taking about one gram of ginger once a day for at least five days decreased symptoms of nausea and vomiting in early pregnancy. Studies have also found that ginger can be effective in managing nausea and vomiting symptoms for chemotherapy patients.

Ginger can be taken as a supplement, sold as capsules. You can also add pieces of whole, fresh ginger to your tea, or include it as a spice or seasoning in your food.

Peppermint has long been regarded as a traditional remedy for nausea, though the scientific evidence on its efficacy is not as robust as it is for ginger, Devine says. Still, many people swear by its calming properties.

The main ingredient in peppermint, menthol, is thought to relax the stomach, which can alleviate cramping and nausea.

One small study from 2014 published in the Journal of Perianesthesia Nursing suggested that even the scent of peppermint oil can alleviate nausea, but more research is needed to determine whether it is an effective remedy.

However, if you experience both nausea and vomiting, peppermint may not be very effective, since it is primarily used to treat nausea and not episodes of vomiting.

If you want to give peppermint a try, you can buy it as a tea or diffuse peppermint essential oil for aromatherapy by adding two to three drops of peppermint oil to a diffuser filled with water.

Eating too much can cause nausea, Devine says. That's because when you eat too much, it stretches the stomach, resulting in bloating, heartburn, and excessive digestive movement all of which can lead to nausea.

Eating small, frequent meals and consuming a bland diet without strong flavors can be helpful in reducing episodes of nausea, Devine says. Bland foods are easy to digest and can help settle your stomach.

Bland foods that can help with nausea include:

If you're feeling queasy, you should avoid spicy food and acidic beverages like soda, juice, or alcohol all of which can exacerbate nausea symptoms. You may even want to consider trying the BRAT diet when you feel nauseous.

It may be hard to eat or drink anything when you have nausea including water. But according to Devine, dehydration will only make your nausea worse.

This can be especially important if you're experiencing nausea as a result of extreme heat or humidity. In fact, nausea and vomiting are some of the main symptoms of heat exhaustion and heatstroke.

Overheating causes your blood vessels to dilate as your body tries to cool itself down and this change in blood pressure can manifest as nausea or dizziness. But if you drink lots of water and stay hydrated, it will help you cool down and return to a normal body temperature.

If drinking water is a challenge for you with nausea, you should take small sips throughout the day or try a soothing beverage like warm peppermint tea.

For more information, read about how much water you should be drinking each day to stay hydrated.

When you feel queasy, you might be tempted to lay down, but this actually isn't the best idea. Lying flat while nauseous could lead to vomiting, Devine says.

"It is important to use gravity to your advantage and keep your head inclined above your stomach," Devine says.

By staying upright, gravity helps keep your stomach contents down. Sitting down in an upright position or lying down with your head propped up on a couple pillows is the best choice if you're hoping to relieve nausea.

Acupressure is an alternative medicine practice of applying pressure to certain points on the body, known as meridians. The idea is that by putting pressure on these places, you send a message to the body to turn on its self-healing mechanisms, which may alleviate pain or nausea.

A 2006 review of more than 40 trials published in the journal Autonomic Neuroscience found that acupressure can reduce some symptoms of nausea.

One of the main pressure points for nausea is called the Pericardium 6, or Neiguan, located near your wrist. This pressure point is thought to alleviate nausea because the meridian pathway of this point travels up the arm, into the chest and upper abdomen, near the stomach.

Here's how to locate P6 and use this pressure point:

If nausea is associated with frequent episodes of vomiting, chest pain, or comes with dark stools or dark vomit, you should reach out to your doctor, Devine says. And if nausea persists for more than a couple days, or if the symptoms are quickly worsening, that could also be a sign that something more serious is going on.

For example, conditions like pancreatitis, bowel obstructions, or even a heart attack can cause nausea and will require medical attention.

Some people are also more prone to nausea due to certain conditions. These include:

Nausea can feel uncomfortable, but it is generally very manageable with the right approach. If you can't get rid of nausea with these natural home remedies, check in with your doctor, who can work with you to develop a treatment plan.

More here:
6 natural home remedies to get rid of nausea - Insider - INSIDER

The advent of gene expression assays has provided predictive insight into chemotherapy benefit that can be combined with prognostic information yielded by gene expression profiling to better target patients with breast cancer who are at higher clinical risk for the use of adjuvant chemotherapy, according to Joseph A. Sparano, MD.

The notion of precision medicine in breast cancer is not a new concept; it dates back to the 1970s when we began using ER and PR protein expression initially by ligand-binding assay and then by immunohistochemistry to identify patients who would benefit from adjuvant endocrine therapy, said Sparano, a professor of medicine and womens health at Albert Einstein College of Medicine, in a presentation during the 19th AnnualInternational Congress on the Future of Breast Cancer West, a virtual program by Physician Education Resource (PER).1

We then entered the second generation using gene amplification for HER2/neu via FISH testing to identify women who could benefit from adjuvant trastuzumab (Herceptin), an anti-HER2based therapy, added Sparano. Fifteen years into the third generation [we use] gene expression profiles to guide the use of adjuvant chemotherapy and endocrine therapy. We're currently pretty far into the fourth generation of assays in terms of mutational profiling, which can identify individuals who could benefit from targeted therapies.

In his presentation, Sparano, who is also an associate chairman in the Department of Oncology at Montefiore Medical Center, provided insight into advances made with gene expression profiles, the clinical utility of available assays, as well as future directions in this area.

Gene expression profiles first emerged in the breast cancer paradigm about 15 years ago based on unsupervised analyses, which indicated that breast cancer was a heterogenous disease, that there were distinct subtypes, and that prognosis could vary by subtype, according to Sparano. The unsupervised work resulted in the PAM50 assay (Prosigna), which can be used to identify the distinct breast cancer subtypes that exist.

The next generation of gene expression assays were based on supervised analyses, which evaluated genes associated with a better or worse prognosis. This research led to the development of various prognostic assays, which included the 21-Gene recurrence score assay (Oncotype DX) and the 70-Gene signature test (MammaPrint), among others.

One important point is that theres a lack of concordance in the prognostic classification provided by these assays, said Sparano.

Prospective Validation

The first trial to show that a gene expression assay could provide independent prognostic information was the B14 trial, which included archival samples from a total of 668 patients with estrogen receptor (ER)positive, node-negative breast cancer who had received treatment with tamoxifen for 5 years.

Fifty-one percent of patients fell into the low-risk group, which was defined as a recurrence score (RS) of less than 18, 22% of patients were in the intermediate-risk group (RS of 18-30), and 27% were in the high-risk group (RS of 31 or greater). The 10-year risk of distant recurrence was 7%, 14%, and 31%, respectively, for each of these groups.2

Further data revealed a statistically significant association for RS that was independent of age and tumor size, said Sparano. As such, RS was not a surrogate marker for these other factors; it provided independent prognostic information.

Results from another study, referred to as B20, went on to demonstrate prediction of benefit with these assays.3 A total of 651 patients with ER-positive, node-negative breast cancer were randomized to receive tamoxifen or tamoxifen plus chemotherapy. For the entire cohort you see approximately a 4% improvement in distant relapse-free survival for patients who received chemotherapy, noted Sparano. However, there was a very large benefit for patients who had a RS of 31 or higher; the absolute benefit was in the range of about 25% in the group with the highest RS, suggesting that one can identify, using this assay, a subpopulation of patients who are deriving all of the benefit from chemotherapy.

The prospective TAILORx trial included women with hormone receptorpositive, HER2-negative, and axillary node-negative breast cancer and they were randomized to treatment based on their RS.

Of the 10,273 women enrolled on the trial, 1629 who had a low RS of 0 to 10, were assigned to receive endocrine therapy alone (arm A). Women with a high RS of 26 to 100 were assigned to endocrine therapy plus chemotherapy (arm D). Those in the midrange who had a RS of 11 to 25 were randomized to receive either endocrine therapy plus chemotherapy in the standard arm (arm C), versus endocrine therapy alone in the experimental arm (arm B).

The study had a noninferiority design with invasive disease-free survival (iDFS) as the primary end point, and full information is expected after 835 iDFS events were reported.

We modified the mid-range group for several reasons. The TAILORx population excluded HER2-positive disease and we know that the 21-gene assay includes a HER2 module that drives the RS up and is associated with a higher score, but we know that most HER2-positive tumors have a higher RS, explained Sparano.5 As such, if you use the assay in a HER2-negative population, youll have a different RS distribution.

Additionally, the RS assay is used selectively in practice in situations where there is therapeutic equipoise, which is typically intermediate-grade tumors that are 1 cm to 2 cm; this results in more tumors having a score in the mid-range group, according to Sparano. The trial really needed to be designed to address that group, he said.

Moreover, the RS range was adjusted to preserve prediction in the highest-risk group and minimize the potential for undertreatment in the low-risk group, Sparano added.

Initial data from the low-risk group showed that at 5 years, the rate of freedom from recurrence of breast cancer at a distant site was 99.3% (95% CI, 98.7%-99.6%).4 This information was subsequently integrated into the American Joint Committee on Cancers Cancer Staging Manual, noted Sparano.

After a median of 7.5 years, results from the intent-to-treat population (arms B and C) were released and showed that the primary end point for iDFS was met (HR, 1.08; 95% CI, 0.94-1.24; P = .26), demonstrating noninferiority of endocrine therapy compared with the standard.6 Endocrine therapy alone was also found to be noninferior to chemoendocrine therapy with regard to freedom of recurrence of breast cancer at a distant site (HR, 1.10; 95% CI, 0.85-1.41; P = .48).

Investigators then examined whether any patients with a mid-range score were still deriving benefit from the chemotherapy. No benefit was observed with regard to increasing tumor size or grade, but statistically significant chemotherapy treatment interactions were observed between age, RS, and chemotherapy benefit. Patients who had a higher RS and a higher clinical risk within this younger group seemed to derive benefit, explained Sparano.

At 9 years, in those with a RS of 16-20, a 1.6% absolute benefit from chemotherapy was observed versus a 6.5% absolute benefit in those with RS ranging from 21 to 25, added Sparano.

An exploratory analysis looking at the impact of age and menopausal status on chemotherapy benefit in patients with a RS ranging from 16 to 25 showed that there was no benefit in older women with an increasing score. However, curves began to separate for younger women with a RS of less than 25, noted Sparano.

When examining absolute differences in 9-year distant recurrence rates by chemotherapy use in women 50 years or younger with RS of 16 to 25 stratified by RS and clinical risk, investigators noted that the estimated absolute benefit of chemotherapy in women with a RS of 16 to 20 who were not stratified by clinical risk was +1.6%. The estimated absolute chemotherapy benefit stratified by clinical risk was -0.2% in those with low clinical risk (n = 671) and a RS between 16 and 20 and +6.5% in those with high clinical risk (n = 215).7

When looking at the impact of age on chemotherapy benefit, investigators observed that women who were closer to menopause, aged 46 to 50 years, experienced the greatest benefit. Interestingly, younger women really had no benefit, suggesting that some of the effect that was seen with chemotherapy in these younger patients who had higher RS might have been due to a castration effect, explained Sparano.

At 9 years, a 3% distant recurrence with endocrine therapy alone was observed in patients with an RS of 0 to 10 (arm A). An overall 5% distant recurrence rate was reported in those with an RS between 11 and 25 (arms B and C). Between arms B and C, a less than 1% difference was observed for all end points. In those with a RS between 26 and 100 (Arm D), a 13% distant recurrence was observed, despite chemotherapy plus endocrine treatment.

MINDACT

The MINDACT trial included 6,693 patients who were assigned to a clinical risk or a genomic risk. Patients who had discordance in their clinical and genomic risks were randomized to receive either no chemotherapy or chemotherapy.8 The primary end point of the trial was distant metastasis-free survival at 5 years for those with high clinical risk and low genomic risk without chemotherapy.

No effect with chemotherapy was observed in older women, but there was a 5% benefit from chemotherapy in younger women, which is very similar to what we saw in TAILORx, said Sparano.

The phase 3 Plan B trial used the Oncotype DX Recurrence Score to define a genomically low-risk subset of patients with clinically high-risk pN0-1 early breast cancer for adjuvant treatment with endocrine therapy alone. A total of 3198 patients were enrolled on the trial and chemotherapy was omitted in 86.1% of eligible patients with a RS of 11 or less.

At a median follow-up of 5 years, DFS in the patients treated with endocrine therapy alone who had a RS of 11 of less was 94% versus 94% in those with an RS between 12 and 25 and 84% in those with an RS of greater than 25 (P < .001). In patients who received chemotherapy, the 5-year overall survival was 99% versus 97% versus 93%, respectively (P < .001).

This provided a limited amount of level 1 evidence supporting the use of the Oncotype assay in patients with low-volume disease, noted Sparano.

Future Directions

With all of the data yielded thus far, it is clear that gene expression assays provide prognostic information, that the 21-gene assay offers predictive information, and that the 70-gene assay provides prognostic information, according to Sparano.

Its important to remember that these assays are not interchangeable, and theres a lack of concordance in risk classification which needs to be considered when deciding which assay to use and what to do with the information yielded, concluded Sparano. Future plans involve integration of the clinical and gene expression profile information to recalibrate existing tools in an effort to provide more refined information regarding prognosis as well as an estimation of chemotherapy benefit.

Read more:
Sparano Shares Progress Made in the Molecular Guided Management of Breast Cancer - OncLive

If youve noticed patchy or thinning spots on your scalp or a surplus of hair strands on your hairbrush or in the shower, you're not alone. More than half of all women will experience noticeable hair loss, according to the Cleveland Clinic. In order to put a stop to shedding, though, you have to figure out the root of the problem. Hair loss is not a diagnosis, says Yolanda Lenzy, M.D., M.P.H.,board-certified dermatologist and licensed cosmetologist in Chicopee, Massachusetts. Hair loss is a symptom. Once you get a specific diagnosis, then you can know the causes associated with that diagnosis.

For starters, know that the term alopecia refers to all kinds of hair loss. There are two main types of alopecia, and then a variety of forms of hair loss within those two categories. In cases of non-scarring or temporary hair loss, the missing hair will eventually grow back. With scarring or permanent hair loss, permanent damage is done to the hair follicles so they wont grow back. With scarring hair loss, the goal is not for it to grow back, but to stop the progression, says Dr. Lenzy. Below, are seven different kinds of alopecia knowing which one youre suffering from will help determine the proper treatment.

When people talk about male or female pattern hair loss typically a receding hair line in men or thinning at the crown in women thats androgenetic alopecia. Its the most common form of hair loss among all people. In fact, research shows that more than 50% of women will develop androgenetic alopecia by the age of 80. It can come from either side of the family in men or women, skip a generation, and start earlier in the next generation that the one before it, says dermatologist Carolyn Goh, M.D., Health Sciences Assistant Clinical Professor at the David Geffen School of Medicine and Director of the Hair and Scalp Disorder Clinic at UCLA. However, some people have pattern hair loss without a family history of it. While some women start showing signs of androgenetic alopecia in their teenage years, others wont experience it until their 50s or 60s. When nearing menopause, the decrease of estrogen means you have unopposed testosterone, says Dr. Lenzy. That elevated testosterone can convert to a hormone called dihydrotestosterone (DHT), which contributes to the thinning of the hair follicles the follicles actually get smaller in this particular form of hair loss.

Telogen effluvium is just a fancy name for excessive hair shedding an annoyance that many people will experience at some point in their life. A common cause is stress, usually meaning major life stressors or physical stressors like surgery, medication (including over the counter ones and supplements), weight loss, or a death in the family, to name a few, says Dr. Goh. It usually starts three to six months after a stressor and then lasts for three to six months. Hypothyroidism and iron deficiency can also trigger telogen effluvium. The beautiful thing about it is 70% of your hair strands are still in the anagen or growing phase, adds Dr. Lenzy. Because the hair follicles work in a cycle, you wont go bald.

This type of hair loss affects about 2% of people and usually appears as round smooth circles anywhere on the head without any redness, itching, or pain. Alopecia areata is thought to be caused by an autoimmune process, says Dr. Lenzy. The bodys immune system makes some mistakes and produces T cells that attack hair follicles.

Thinning and bald patches at the temples or where hair is frequently pulled tight can indicate traction alopecia. This very common form of hair loss is caused by haircare and hairstyle practices practices which place excessive tension or weight on the follicles like braids, ponytails, hair extensions, or locs.

Central centrifugal cicatricial alopecia tends to start on the top of the head with breakage and thinning, and often with some tenderness of the scalp, says Dr. Goh. It gradually spreads outward and can cause permanent hair loss. CCCA is especially common among Black women. Some recent studies have found that about 25% of people with this form of hair loss have a genetic mutation in one of the proteins thats responsible for the formation of the hair follicle, says Dr. Lenzy. On top of that, she notes that the same haircare practices that create tension and cause traction alopecia also contribute to CCCA.

Lichen planopilaris can result in patchy spots of hair loss as well as redness, itching, burning, or pain in the scalp. Its a form of alopecia thats found more commonly among caucasian women. LPP is thought to be autoimmune-related and but research is still being done to figure out the exact cause. Theres some research that shows individuals with this form of hair loss have decreased activity of a very essential enzyme called PPAR-gamma, says Dr. Lenzy. PPAR-gamma is responsible for how our scalps metabolize lipids on the scalp so when individuals dont have that active, they can develop LPP. One particular form of LPP called frontal fibrosing alopecia (FFA) is becoming increasingly common in postmenopausal women, according to Dr. Goh. In FFA, the hairline recedes gradually from the front and sides and sometimes the back of the scalp, she says. Eyebrows are often lost and sometimes eyelashes and other body hair.

Lupus of the scalp is another form of scarring alopecia thats autoimmune, says Dr. Lenzy. Its common, especially in women of color. It shows up as red, scaly, thick lesions that dont usually hurt or itch.

Holger ScheibeGetty Images

Trichorrhexis nodosa is the official name for hair breakage. It takes place mid-shaft while hair loss occurs at the scalp. For instance, if you see little hairs on the floor of different lengths, thats a sign of breakage, says Dr. Lenzy. But with shedding, the hair is coming out from the root so you will see long strands the entire length of your hair. Hair color, excessive heat during styling, and chemical straighteners can all dry out hair strands, making them more likely to break. If your haircare practices are the culprit, youll see breakage throughout your hair. However, isolated breakage in one spot can be a sign of alopecia areata or CCCA.

The cause of your particular form of hair loss will point you toward the right treatment. For stress-related telogen effluvium, time is usually the best solution as hair should grow back six to nine months after the excessive shedding occurs. However, if your telogen effluvium is caused by an underlying health issue such as a thyroid problem or low iron levels, your hair should grow back after you address the underlying problem.

Topical minoxidil (Rogaine) is the only FDA-approved treatment for hair loss in women, says Dr. Goh. Its technically approved for androgenetic alopecia, but its used for many types of hair loss, and its available over the counter. A common reason people dont try minoxidil is because they have heard you have to keep using it forever, says Dr. Goh. While it is true that minoxidil only works while you use it, it is also true of all treatments for hair loss as long as the underlying hair loss is chronic. It can become a routine like brushing your teeth. Finasteride (Propecia) is FDA-approved for male pattern androgenetic alopecia and is quite effective, especially when combined with minoxidil. Its often prescribed off-label for women, but can cause birth defects so its usually used in women after child-bearing age, notes Dr. Goh. Spironolactone is another medication often used for women with female pattern hair loss that can cause birth defects so women are advised to use proper contraception while taking it.

If you have one of the forms of scarring alopecia that is inflammatory, such as CCCA, we often use antibiotics to decrease inflammation around the hair follicle, says Dr. Lenzy. Topical or injection cortisones can also be helpful in reducing inflammation in CCCA as well as in alopecia areata. There are a lot of new treatments on the horizon that are currently being studied in clinical trials for extensive forms of alopecia areata, adds Dr. Lenzy. Some of the treatments that are coming down the pike, we currently use off-label even though theyre not yet approved. In general, many of the treatments for hair loss are experimental because theres just not a lot of FDA-approved treatments. But those of us who specialize in hair loss, we have a lot of effective therapies that we use.

Be cautious about vitamins, supplements, and shampoos that claim to help hair loss, advises Dr. Goh. None of these have been studied thoroughly and they often cost a lot of money. Theres also little regulation of these products by the FDA so theres no guarantee that they are both safe and effective.

In particular, you should steer clear of supplements that contain large amounts of biotin as there is little proof that it is helpful in people who have normal biotin levels which is most people. About two years ago, the FDA issued a warning that mega doses of biotin can alter many of your lab results, including your thyroid function tasks and cardiac enzymes, says Dr. Lenzy. People think just because something is natural or a vitamin then it cant be harmful, but that couldnt be farther from the truth. If you happen to take a multivitamin that contains a smaller amount of biotin, stop taking it two to three days before having any bloodwork conducted to ensure that your results are accurate.

While other purported natural treatments like castor oil might be benign, Dr. Lenzy doesnt recommend them because they may not be effective. If you have a form of scarring alopecia, the most important thing is for you to get an early diagnosis, she says. This is permanent hair loss so if you spend six months to a year trying castor oil, youre losing precious follicles that whole time that you wont be able to get back. She says the best thing you can do is get a proper diagnosis from a doctor: These are actual medical conditions just like high blood pressure or diabetes. I see so many people suffering and trying different things and if they had only come in sooner, their result would be so much better.

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Everyones shedding pattern is a little different so theres no standard amount of hair loss that warrants a call to your dermatologist. Some people shed very little and some people shed a lot at baseline, says Dr. Goh. We say losing 100 to 200 hairs per day can be normal and people usually shed more on a shampoo day than a non-shampoo day. She points out that many people stop washing their hair when they see it falling out, but you should continue to wash your hair every 1 to 2 days to keep your scalp healthy to promote hair growth. Keep in mind that a receding hair line and thinning hair can both occur without visible shedding. I would recommend seeing a doctor if there are clearly visible bald spots, itching or burning of the scalp, or the hair loss has been going on for longer than six months, says Dr. Goh. Also, if there is a significant family history of hair loss, it may be a good idea to come in sooner than later.

The key is to find the right doctor. Seek out a board-certified dermatologist who specializes in hair loss and will be aware of newer treatments currently being studied. Keep track of any other symptoms like fatigue or joint pain, says Dr. Goh, as those pieces of the puzzle may help your physician identify underlying conditions. Along those same lines, dont be afraid to get a second opinion. Ive had people whove seen me after three or four opinions and they were told nothing could be done because they had a form a scarring alopecia, says Dr. Lenzy. But theres always something that can be done. If you do nothing, in five years you may have 25% or 50% of the hair you have now, but with treatment you may be able to slow the hair loss process down substantially. The goal in some conditions is not to get the hair to grow back, emphasizes Dr. Lenzy. The goal is stabilization and help is available.

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SAN DIEGO: Being HempTM, the makers of THC-free CBD products formulated doctors to specifically address women's unique health, wellness and beauty needs, launched a line of products designed to deliver pure, powerful results for female consumers - an anti-aging skin care system, five condition-specific tinctures, and the first-ever apple cider vinegar gummies featuring high-absorption Nano CBD.

There is a big difference between marketing existing CBD products to women and creating physician-formulated products that meet women's specific needs, said Liz Gagnon, Director of Communications for Being Hemp. As we looked at the landscape of CBD products, we found that women are looking for CBD products that speak directly to their concerns and that they can trust to work as advertised. We're confident that Being Hemp products will deliver the pure, powerful results that women expect and deserve.

Product Launch Summary

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The Being Hemp Anti-Aging Skin Care System This doctor-formulated, three-product system utilizes the most advanced dermatological science plus proven natural ingredients to achieve timeless results for women of every age and skin type. All three clean label products are hypoallergenic, sulfate-free, and synthetic fragrance-free, and include superior-absorbing Nano CBD to restore cellular balance and reduce puffiness, as well as Hyaluronic Acid to hydrate and reduce lines and wrinkles.

Beautiful Age-Defying Serum, a light, silky cream to leave skin looking youthful and healthy with real and lasting benefits that start at the cellular level to fuel regeneration and visibly defy the signs of aging. The serum features Collagen to dramatically improve skin elasticity; Saw Palmetto to trigger enzyme production; and, Vitamins A and B support to cell rejuvenation.Beautiful Day Creme, a superior moisturizer that protects skin from the damage caused by sun exposure and airborne free radicals without leaving an oily residue or clogging pores. Formulated to give make-up incredible staying power, it features Vitamin E and Rose Hip Oil to improve elasticity and minimize the signs of aging, as well as Titanium Oxide to naturally protects against harmful UVA and UVB rays.Beautiful Night Creme, a skin-pampering formulation to reverse daytime damage. Made with a relaxing lavender scent and a hint of vanilla, it features Vitamin A to fuel cell regeneration and Rosehip Oil to improve elasticity and minimize the signs of aging.All three products are packaged in an innovative, airless pump jar that protects product purity and integrity while providing 1-finger dispensing convenience.

Being Hemp Tinctures These five, condition-specific, gluten-free formulations deliver 50 mg of Nano CBD per 1ml serving. Each includes Omega 3-6-9, Vitamins C and D, Zinc and Theanine, a Green Tea extract.

Restful, a sleep formula with Melatonin and Lavender;Immune, an immune booster with Turmeric and Elderberry;Serene, a stress and anxiety formula with Bacopa and Limonene;Centered, a PMS/mood formula with Ashwagandha and Evening Primrose; andHarmony, a hormone balance formula with St. John's Wort and Black Cohosh Root.

All Being Hemp products are crafted in GMP-certified facilities to ensure consistency, safety, quality control and reliability for every batch. The company uses only the most reputable third-party testing labs to verify all product ingredients and potencies for every batch. The Certificate of Analysis (COA) for any Being Hemp product can be viewed online.

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Being Hemp Launches Proprietary Nano CBD Products Specifically Formulated to Target Womens Health, Wellness and Beauty Needs-NK#137011 - New Kerala

Arguably, one of the most life-altering medical procedures that a woman can undergo is a hysterectomy. For those who are not familiar with hysterectomies, they are surgical procedures that entail removing a womans uterus and, in some cases, other reproductive organs. When this happens, her menstrual cycles will stop, and she will lose the ability to get pregnant. According to a study published by the Centers for Disease Control and Prevention (CDC), an estimated 600,000 hysterectomies are performed in America every year, with the average woman getting one around the age of 42.

The success rate for hysterectomies is quite high for women who undergo them to combat specific health problems, some of which include fibroids, pelvic pain, endometriosis, and a prolapsed uterus. Hysterectomies are also sometimes recommended to women diagnosed with cancer of the uterus or cervix.

When it comes to hysterectomies, the end of a womans menstrual cycles and an inability to get pregnant represents only a part of what she can expect after surgery. Before detailing the additional side effects that a woman is likely to encounter, lets take a moment to go over the three types of hysterectomies that a physician might recommend depending on the health condition their patient is facing:

Partial hysterectomy This surgical procedure entails removing a womans uterus while leaving her cervix intact.

Standard hysterectomy This surgical procedure entails removing both the uterus and cervix.

Total hysterectomy This surgical procedure involves removing the uterus and cervix. Additionally, the surgeon will also remove one or both ovaries as well as the fallopian tubes.

Regardless of the type of hysterectomy procedure a woman undergoes, she will likely encounter an array of short-term side effects afterward. Some of these short-term side effects can include the following:

Although short-term side effects will typically resolve themselves, women who undergo a total hysterectomy may encounter long-term side effects that sometimes require additional medical treatment. A few of these long-term side effects, which are also commonly associated with menopause, include the following:

Many women who undergo a hysterectomy often find themselves struggling with hormonal deficiencies. And this is especially true following a total hysterectomy. According to Science Daily, an online aggregator of science-related press releases, total hysterectomies can increase the risk of early menopause in younger women by nearly two-fold. In short, this means that women who undergo these types of hysterectomies, in addition to hot flashes, insomnia, night sweats, vaginal dryness, and low libido, may experience hormonal imbalances as well. In fact, some women who undergo a hysterectomy that includes the removal of one or both ovaries experience a sharp decline in estrogen and progesterone production. This decline is triggered by a severe drop in human growth hormone production, which, unfortunately, is yet another side effect of undergoing a hysterectomy for many women.

To combat many of the side effects that follow a hysterectomy, many women turn to human growth hormone (HGH) replacement therapy. This form of therapy, administered by injection, provides the same level of symptom relief to women following a hysterectomy that it does to menopausal women. Considering that low growth hormone levels often lead to low estrogen and progesterone levels, it makes sense that many physicians are recommending growth hormone replacement therapy alongside traditional treatments consisting of estrogen and progesterone replacement therapies. Some physicians are even recommending growth hormone replacement therapies over estrogen and progesterone since they are less likely to result in complications.

For reference, a study published by the National Cancer Institute found that estrogen replacement therapies can increase a womans chances of developing blood clots, gallstones, or suffering a stroke. Further, when combined with progesterone or another bioidentical hormone, such as progesterone, can increase the risk of developing breast cancer.

When it comes to hormone replacement therapy involving the use of growth hormones to combat the side effects of a hysterectomy, the long and short of it is that these treatments help return a womans growth hormone levels to a healthy and normal state. In response, her estrogen and progesterone levels return to a normal and healthy state as well. Once her growth hormones, estrogen, and progesterone levels are normalized, the side effects that follow a hysterectomy, such as night sweats, low libido, hot flashes, and low bone density, for example, will start to subside. Further, her chances of developing breast or uterine cancer will also decrease. Some of the more commonly prescribed HGH-based medications that physicians prescribe to women following a total hysterectomy include the following:

If youre thinking about starting HGH-based replacement therapy to relieve side effects following your hysterectomy, youre probably interested in knowing how long it will take to see results. If so, you will be happy to know that, for most women, these treatments begin to work almost immediately. However, long-term improvement of symptoms can take anywhere from 3 to 6 months.

In summary, even though human growth hormone replacement therapy is a relatively new approach to combating side effects brought on by a hysterectomy, there is evidence that proves it is just as effective as estrogen hormone replacement therapy. More than that, it is significantly safer by comparison, according to most physicians.

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HGH and Hysterectomy: How Does Hormone Therapy Help? Read more / Skip - eTurboNews | Trends | Travel News

Periods are just one of the amazing functions of the female body. And while we're all probably familiar with what a period is, you might not know quite so much about a withdrawal bleed (AKA a period you have while taking hormonal contraception)? So, whether you've had a withdrawal bleed before, or you're considering starting on birth control, here's everything a doctor wants you to know about withdrawal bleeding.

A withdrawal bleed is essentially the period that you have while you're on hormonal birth control. But how does it work? Here are the basics:

"Many types of contraception work by altering your bodys hormones, preventing your ovaries from releasing an egg each month," explains Dr Samantha Wild, a GP and Primary Care Physician at Bupa Health Clinics. A lot of these hormonal birth controls, like the pill, patches and vaginal rings, work on a 21-day cycle, giving you a week off taking hormones which is when you have the withdrawal bleed. And there's a purpose to this intermittent bleeding. "A 'withdrawal bleed' happens as a result of this drop in hormones when you have the week off, and the body releases some of the blood and mucus from the lining of the uterus," Dr Wild explains.

For all intents and purposes, you might think a withdrawal bleed is the same as a period - it looks the same, anyway. But it's not. "Withdrawal bleeding isnt the same as a regular period. This is because the hormones from the contraception affect your endometrium the lining of your uterus preventing it from thickening, so theres less discharge," notes the doctor.

"Similarly, the hormones also prevent you from ovulating, meaning there is no egg for your body to get rid of. As such, withdrawal bleeds are typically lighter and have less pronounced symptoms to a standard period, Dr Wild adds.

It's not just the pill that can cause withdrawal bleeding. Other kinds of hormonal contraception usually contain the same hormones and have the same effect - they're just inputted into the body in a different way.

"Contraceptive patches work in the same way as the pill and contain the same hormones, oestrogen and progestogen, and the same goes for the contraceptive vaginal ring which is inserted in the vagina," Dr Wild explains. "But pills, patches and vaginal rings are the only types of contraception which may cause withdrawal bleeding. You wont experience one when using the coil," she advises.

This is because, on the copper coil (IUD), you still get your normal monthly period. "The IUD doesnt contain any hormones. Your regular period may be heavier, longer or more painful especially in the first 3-6 months after it is put in," says the doctor. "The Intrauterine System (IUS) wont cause a withdrawal bleed either. This is a small plastic T-shaped device that releases the hormone progestogen into the womb to stop you getting pregnant. It can make your periods lighter, shorter or stop altogether. These arent withdrawal bleeds though, as the progestogen is provided constantly so theres a no break in the cycle." So there you have it.

As with 'normal' periods, withdrawal bleeds vary from person to person, and everyone's cycle is different. However, they will usually average at just under a week. "Withdrawal bleeding happens when you are having one week with no hormones," explains Dr Wild, "but the bleed will usually last for less than a week as it can take a couple of days to start after the hormones have stopped going into your system."

"You might still experience some symptoms similar to those you get around your 'normal' menstruation, but they are usually less severe," says Dr Wild. So, hopefully, even if you've still got cramps they won't be as tough as usual.

Plus, hormonal contraception like the pill is actually often prescribed as a treatment for PMS because the symptoms are milder, Dr Wild adds, so if you're struggling with PMS then switching to hormonal contraception with a withdrawal bleed could actually be a good option. But, of course, speak to your doctor first.

Ashley Armitage / Refinery29 for Getty ImagesGetty Images

Although pill packets are usually designed to give you a break (and therefore a withdrawal bleed) once a month, you actually don't need to take one. "It's not medically necessary to have a withdrawal bleed every month," Dr Wild explains. "Early pill regimes were designed like this to mimic a natural menstrual cycle, but it's safe to take them for longer before having a break."

Taking pill packets back to back without having a break will mean your withdrawal bleeds become less frequent. And if you do still experience symptoms during your withdrawal bleeds, then you most likely won't have any of these symptoms while taking packets without a break.

However, Dr Wild advises speaking to your GP before you make any changes to how you take your pill, as you'll need to make sure it's right for you.

The short answer is yes. "A withdrawal bleed is still a sign that you're not pregnant," says Dr Wild. And on the flip side, "if you don't bleed when you expect to then you should do a pregnancy test, if there is a chance that you could be pregnant."

However, some people don't have withdrawal bleeds, adds Dr Wild, and if you're not having a pill break then you won't have one either - so you won't be able to use bleeding/not bleeding as an indication. Other first signs of pregnancy include "breast tenderness, nausea or fatigue," says Dr Wild, but if you suspect you could be pregnant then still take a test.

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Withdrawal bleeding - what is a withdrawal bleed? - cosmopolitan.com

Around menopause, many women have at least occasional difficulties when it comes to sleep. Experts often attribute this to changing hormones or to the stress and anxiety that may accompany midlife.

A new study adds another potential factor to the mix: endocrine-disrupting environmental chemicals (EDCs), especially phthalates.

Related:11 Natural Insomnia Aids That Will Give You Sweet Dreams

This study is important because endocrine-disrupting chemicals are everywhere, says Stephanie Faubion, MD, a womens health physician at the Mayo Clinic in Jacksonville, Florida, and the medical director for the North American Menopause Society (NAMS). It provides additional evidence of potential sex differences in endocrine disrupting chemical exposure (in this case, phthalates) and impact on health.

The study was published on July 29, 2020, in the NAMS journal Menopause.

RELATED:10 Ways to Beat Menopausal Belly Fat

Researchers at the University of Illinois used information from the Midlife Womens Health Study. This major clinical trial was conducted between 2006 and 2015 with women ages 45 to 54 in the Baltimore region, to assess risk factors for hot flashes in women not taking hormone therapy. Because the women were tracked closely for so many years, others researchers have subsequently mined its health data to shed light on other issues surrounding menopause.

For this study, data from 760 premenopausal and perimenopausal women were assessed. Questions the women had answered about sleep, among other things, were matched with concentrations of chemical phthalates in their urine.

The scientists focused on phthalates because a previous study had suggested increased exposure to the chemicals significantly increases a womans risk of hot flashes. Animal studies have also shown its influence on hormones associated with sleep.

Related: Fight Menopausal Sleep Problems With Light Therapy, Study Suggests

The results confirmed that the frequency of sleep disruptions in midlife women is associated with higher concentrations of phthalates in the body.

The relationship proved to be complex, however, and may be affected by other factors, especially smoking. Because smoking is known to impact both sleep and hormones, women with the same levels of chemicals who were former smokers reported different effects on their sleep than nonsmokers. This suggests that smoking history influences the relationship between phthalates and self-reported frequency of disrupted sleep, the authors write.

Still, anything that sheds light on possible reasons for sleep disturbances will be welcomed by many midlife women.

Up to 60 percent of women in their menopause transition report sleep issues, the study authors note. They also point out that women who have trouble falling asleep are at increased risk of developing depression.

Because this was an observational study and not a randomized clinical trial, and because of the confounding influence of smoking, additional study is needed investigating the complex relationship between endocrine disrupting chemicals, hormones, and sleep, mood, and menopause symptoms, Dr. Faubion says.

She also notes that other factors known to impact sleep were not measured in the study, including caffeine intake and stress, which may have influenced the results.

Whats more, the underlying mechanisms by which EDC exposure impacts sleep in midlife women still need to be uncovered, the researchers write.

RELATED: Why Sleep Is an Important Womens Health Issue

Even before that research is done, though, experts say its smart for all women, including those in midlife, to minimize phthalate exposure as much as possible. The chemicals appear to concentrate more in women than men, the study authors note.

Phthalates are common EDCs that are used in a wide array of industrial products to increase their performance, explains Nneka Leiba, MPH, vice president of healthy living science at the nonprofit Environmental Working Group in Washington, DC.

RELATED: 10 Toxic Household Items You Should Throw Away Now

They can be found in plastics and food packaging, Leiba says. A key way midlife women come into contact with them is through skin-care products.

Phthalates are used as ingredients in personal care products, including skin-care products, perfumes, and colognes, she says. And since they are typically part of any products fragrance mixtures, you are also likely to encounter them in anything with an aroma, from candles to detergents to trash bags, she says.

Black women may be at higher risks than white women for exposure to these chemicals. EWGs research indicates that Black women use more personal care products than other demographics, and there are fewer productsmarketed specifically to Black womenthat are free from chemicals, Leiba says.

RELATED: What Are 'Natural' Skin-Care Products, and Are They Actually Better for You?

Due to their pervasiveness, it isnt possible to avoid phthalates completely. Even limiting your exposure would mean knowing which products theyre hiding in, something that is difficult because manufacturers are not required to label these ingredients, Leiba says.

Given that phthalates are often used in fragrances, Leiba suggests avoiding products that bear the catch-all label of fragrance. Instead choose products that disclose specific fragrance ingredients. You can even contact a manufacturer to ask about their use of phthalates in your favorite products, she advises.

EWGsSkin Deep database identifies many skin-care options without these and other ingredients of concern.

For any product, if you come across a brand labeled phthalate-free, choose it to help lower your risk of EDCs, advises the medical organization the Endocrine Society.

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Can Toxic Chemicals Trigger Sleep Trouble? - Everyday Health

Federal officers deploy gas to disperse crowds of protesters near the Mark O. Hatfield federal courthouse in Portland, Ore., July 20, 2020.

Jonathan Levinson / OPB

After more than 50 days of nightly protests against racism and police violence, demonstrators in Portland are intimately familiar with the immediate effects of tear gas: blurry eyes, burning skin, choking, coughing, crying, retching.

But some protesters believe the gas is doing more than causing red eyes and seething skin. OPB interviewed 26 protesters, ranging in age from 17 to 43, who said they believe regular exposure to tear gas has caused irregularities within their menstrual cycle.

Related: 60+ days of tear gas leaves behind 'a stew of pollutants'

The experiences range. Some protesters reported getting their period multiple times in a single month. Others reported debilitating cramps at least one that ended in a hospital visit and blood clots the size of half a fist. Trans protesters who had stopped menstruating since taking testosterone said they have seen their cycles restart.

There are two common threads between the experiences of the 26 protesters: All said what they were experiencing was abnormal for their bodies. And all believed the tear gas, which law enforcement has been using against demonstrators for two months, was at fault.

Related: 60-plus days of tear gas leaves lingering questions about environmental impacts

There has been little scientific research into whether tear gas can affect a persons hormones and experts warn against extrapolating a solid medical conclusion from anecdotal evidence. But while the science remains thin, the troubling stories have mounted as the release of the chemical has become a near-nightly occurrence.

Lindsey Smith, a 26-year-old preschool teacher who has been live-tweeting the protests since mid-June, said shes noticed a pattern: If she inhales a significant amount of gas in the night, shell have her period the next morning. She said this has happened at least three times in two months even though the hormonal birth control shes on makes it so shes only supposed to menstruate four times a year.

On July 12, after another night that saw federal officers blanket the crowd with tear gas, Smith tweeted to ask if anyone else was menstruating after being exposed to the gas. She received nearly 30 responses from protesters with their accounts of irregular periods: cramping within hours of exposure, periods that stretched for nearly a month, or arrived weeks early.

She was also met with some trolls.

When I posted that, there were a lot of alt-right people screenshot-ing it and reposting it and a lot of them are saying, Good, I hope after this youre sterile, she said. That was the first time that the thought occurred to me: I dont know what this is going to do. And I dont think anyone really knows long-term.

Within the small body of research that does exist on tear gas, the question of what effect it could have on a persons reproductive health, if any, has been left unanswered.

Sven Eric Jordt, an associate professor at the Duke University School of Medicine who has extensively studied tear gas agents, said its possible the gas impacts hormones. He pointed to a 2010 study that showed burning the agent in CS gas, a common type of tear gas, could generate chemicals potentially toxic enough to affect hormonal homeostasis. Researchers in Chile raised concerns tear gas might cause miscarriages in 2011, leading the government to temporarily ban its use. In Bahrain, Physicians for Human Rights documented accounts of pregnancy loss among civilians gassed during anti-government protests.

But no one can say with certainty if theres a link.

Theres really no data on this. Its entirely possible that some of these chemicals that if you inhale them at high levels can have effects, Jordt said. But its really hard to say.

Intense stress could be another culprit. Rising levels of cortisol, the bodys primary stress hormone, are known to upend normal menstrual cycles, And the policing tactics common among local and federal officers including tear gas, impact munitions, and flash bangs could all be fairly described as cortisol-inducing. Not to mention the new unusual rituals that could potentially alter someones usual menstrual cycle: bedtimes pushed to the early morning, a diet of snacks and energy drinks, nightly sprints away from gas and police.

But some protesters in Portland are convinced that stress alone cant explain their experiences.

While many nights are traumatic, protesters are not breathing lungfuls of the chemical every single evening. And some report its only in the aftermath of these hazy nights, during which theyve inhaled for minutes without a mask, that they notice the irregularities.

Alissa Azar, 29, has been protesting downtown at least five nights a week since the demonstrations began. She said shes been caught in the thick of a cloud of gas six times. On two of these occasions, her period started immediately after. The other four times, it started within a few days.

Obviously were experiencing a significant amount of stress right now physically, mentally, emotionally. It would be naive to believe that doesnt have an effect. However, I definitely think theres a correlation between menstruation and tear gas, she said. The timing has been too spot-on.

She said the periods are different than what she expects. Each one lasts for four or five days. The cramps are more like the contractions she had when she gave birth, inducing nausea and severe back pain. A dozen other protesters interviewed had similar accounts of cramps that felt like sharp rocks being cradled in their stomachs.

Were not paranoid. This isnt a coincidence. Somethings going on, Azar said. Within 15 minutes of a gas attack, myself and others will have to take a break from how bad the cramps are.

For some, the experience goes beyond physical pain. Five transgender individuals taking testosterone, which typically stops menstruation after a matter of months, told OPB theyd seen their cramps and bleeding return after attending demonstrations.

These protesters say these unexpected periods were accompanied by a sense of gender dysphoria, the clinical term for the discomfort and distress people feel when their bodies dont align with their gender.

Its definitely a back and forth feeling. Im still pretty early in my transition, and Ive waited a really long time to be able to do this, said Lester Lou Wrecksie, a nonbinary transmasculine person who has been taking testosterone since September.

Wrecksie, 43, said on most nights they stay in the back of protests, largely out of the way of gas. But on June 21, they got knocked down and ended up getting caught in the chemical for longer than usual. Two days later, Wrecksie said their cycle returned for the first time in half a year.

Its unsettling to be like, I can go out into the air with chemicals and have it basically undo part of what Im trying to do for myself, they said.

A few protesters said they were concerned enough with the period irregularities that they scheduled a call with the local Planned Parenthood. Paula Bednarek, the medical director for Planned Parenthood Columbia Willamette, said clinicians had not noticed an uptick in patients reporting unusual menstruation since the protests began.

But enough reports linking period irregularities and tear gas have cropped up nationwide in the last few months that another branch of Planned Parenthood has taken note. An epidemiologist with Planned Parenthood North Central States, which supports reproductive health in Iowa, Minnesota, Nebraska, North Dakota, and South Dakota, crafted a research proposal after putting out a call for reports from protesters whod spontaneously menstruated after being tear-gassed. A handful of online outlets have also done write-ups this summer questioning a possible connection between the chemical and periods.

Dr. Rohini Haar, a medical expert for Physician for Human Rights, said while these experiences should be acknowledged, she believed there is danger in overreporting a potential link without the hard scientific evidence to back it up.

Haar, an expert in crowd control weapons who has studied the health consequences of tear gas up close among Palestinian refugees, said shed only started hearing these anecdotal reports of tear gas affecting menstruation a few weeks ago. She worried these new accounts could genderize protests and lead to a narrative that protesting is only safe for people without ovaries.

This may be an issue, but its certainly not enough of an issue to intimidate people away from protesting especially women, she said. Its not the situation where you should tell your teenager, This definitely injures your reproductive tract, you are not allowed to go. There is no evidence to say that.

Dr. Jordt said he thought it would be worth trying to find out. He suggested a local or state health department in Oregon should initiate a study, taking health data from protesters and residents and following up with them over the long term.

Jordt estimates there are currently five or six of these sorts of studies that look at long-term effects of tear gas on people who have been exposed repeatedly, most coming from the Middle East during the Arab Spring. But he said governments in these countries often hampered the efforts of the doctors leading these studies, making it difficult to follow up with civilians over long periods of time.

One of the most comprehensive studies within the United States was conducted on recruits for the U.S. Army in 2014. Researchers found recruits exposed to CS gas as part of a training exercise were at a higher risk for developing respiratory illnesses, including influenza, pneumonia and bronchitis.

They were exposed to the gas just once.

Jordt pointed to two reasons why learning the long-term health effects of repeated exposure to tear gas has yet to become a top concern of health experts in the United States: The first is that its rarely used at the levels the country has seen this summer. While its been used en masse on protesters before in Ferguson, Missouri, in 2014, during the Occupy Wall Street movement in 2011, during the Vietnam War protests in the 60s and 70s he said the chemical hasnt been pervasive enough to become a top priority among health experts.

Nor is it top of the list for law enforcement agencies. Jordt said theres a strong belief among law enforcement that teargas is their safest option for controlling crowds. He suspects they will not be the ones leading the charge for a deeper study.

The lack of concrete studies has left some protesters feeling like guinea pigs, scouring Google for answers on whats happening to their bodies with no satisfying results.

We dont know the long term effects of this, said Elisa Blackman, 24, who said she got her period five times between June 2 and July 5. She tried to search for an explanation, but the hits she got on the internet focused on effects you could expect in the minutes after being gassed, not weeks or years.

Its like theyre testing it on us.

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'It's like they're testing it on us': Portland protesters say tear gas has caused irregularities with their periods - OPB News

The most up to date shrouded weapon in your wellbeing stockpile may simply be the kelp you ventured over to get into the sea the last time you were at the sea shore. Ocean greenery has been around since the seas previously lapped the shore, yet its getting a charge out of a flood in notoriety, on account of its incredible invulnerable boosting supplements. Ocean greenery is plentiful in common minerals, high in iron and cancer prevention agents that make it an inside and out insusceptibility promoter and weight reduction help, which is the reason organizations are gathering it from sea shores as far away as Ireland and the Caribbean, and purchasers are adding it to everything from smoothies to acai bowls and rice and beans.

It is difficult to distinguish one specific plant that has all the nutrients and minerals your body needs, however ocean greenery approaches. It contains over 90% of the supplements your body needs and can be utilized as a characteristic medication to treat or lessen influenza like side effects. This is the reason the little ocean plant is regularly called Natures Multi-Vitamin.

Ocean Moss, otherwise called Irish Moss, is a kelp, is a large scale green growth. It is sold in packs that look simply like the clear yellow ocean growth youd discover appearing on sea shores along the Atlantic seaboard and the Caribbean. Ocean greenery originates from both natural gathering and man-made pools, and where its developed influences the organization of the plant and its medical advantages. Crucial Vegan accepts that wildcrafted ocean greenery from the sea is better, so they just collect their ocean greenery from the Caribbean, explicitly Jamaica.

Under two centuries prior, ocean greenery was utilized as a wellbeing treatment of tuberculosis and pneumonia. Its likewise been utilized as a food to sustain individuals who worked in potato fields since it was a modest wellspring of supplements. Since it was utilized by helpless ranchers, the kelp was thought of as a poverty food, and overlooked by wellbeing searchers, because of the negative affiliation. Dr. Sebi, the notable botanist with the clique like after, took ocean greenery back to the consideration of his adherents and prescribed it to his patients to treat ceaseless diseases. Presently standard, ocean greenery is accessible at wellbeing markets and online through organizations that develop it in sea pools and reap it to sell.

Creator and veggie lover botanist Paul Otote clarified the medical advantages of ocean greenery and why this kelp is viewed as a powerhouse food. The Beet recorded his six motivations to eat ocean greenery, so you can completely comprehend why this supplement thick food is valuable for generally speaking wellbeing.

1. Ocean Moss Contains Iron and Can Help You Have More Energy.

Ocean greenery is loaded with iron, which many plant-based eaters need since its generally found in creature nourishments like meat, poultry, and fish. Ocean greenery contains around 9 milligrams of iron for every 100 grams, which implies ocean greenery has multiple times more iron than chicken. At the point when youre feeling exhausted or low vitality, it might be on the grounds that your iron levels are low, since iron enables your body to make red platelets to move oxygen from your lungs to your cells. On head of taking a sound iron enhancement, take a stab at including ocean greenery in a gel structure to your smoothies and check whether you start to see the distinction in your vitality. In the event that you have ever been determined to have mellow weakness, ocean greenery could work to enable your body to get the iron you need.

2. Ocean Moss Contains More Tha 90% of Nutrients Our Bodies Need.

The small winding yellow ocean growth is amazingly supplement thick, its practically similar to natures multi-nutrient. Otote clarifies that sea moss has 92 of the 110 minerals the body is made from, and he considers it the powerhouse. Sea greenery contains beta-carotene, nutrient B, nutrient C, and sulfur just as minerals like magnesium, manganese, calcium, phosphorus, and zinc. All these add to solid cell working in the body.

3. Ocean Moss Promotes Healthy Weight Loss.

Ocean Moss contains elevated levels of iodine, a mineral found in a constrained measure of nourishments. Our bodies need this mineral with some restraint to create thyroid hormones. These hormones control the bodys metabolism and many other important functions. The body also needs thyroid hormones for proper bone and brain development during pregnancy and infancy, as per an examination by the National Institute of Health. The key is to get the perfect sum, in any case, and not all that much.

Ocean Moss contains the indispensable thyroid hormone precurses that are significant for solid thyroid capacity and your bodys digestion. So if your thyroid isnt working appropriately they can be valuable and help in weight reduction. In any case, before you use ocean greenery to support thyroid hormones or as a weight reduction supplement, check with your primary care physician since you would prefer not to over-do these hormone forerunners either. Control is the most significant thing with thyroid capacity.

4. Ocean Moss Can Help You Build Strong, Lean Muscles.

The ocean growth is wealthy in protein with 6 grams of protein for each 100 grams of ocean greenery. In particular, it contains an amino corrosive called taurine, which enables the body to consume fat and assemble muscle. Taurine has the ability to make the body burn fat instead of carbs during cardio, Otote says.

5. Ocean Moss Strengthens the Immune System and Helps to Prevent Sickness.

Ocean Moss likewise enables the body to retaliate against regular maturing and irritation, in what could be classified the antis: Anti-provocative, hostile to maturing, against bacterial, and against viral. Its utilized as a treatment to help forestall and soothe cold and influenza like side effects, in powdered structure. It can be used to prevent colds but also help you heal and recover from sickness, Otote says. Ocean greenery contains potassium chloride, which enables the body to lessen irritation and individuals take it to bring down their danger of contaminations as a result of its positive effect on the invulnerable framework. Otote summarizes it as a no-lose added substance: Sea moss when youre ill is a win, and sea moss when youre healthy is a win, its a win-win.

Ocean greenery can be taken in a gel fluid structure to add to your smoothies, acai bowl, or even applied legitimately to your skin or hair as a lighting up treatment. The kelp can likewise be utilized as a preparing subsite for eggs, which makes is a simple method to get minerals into your eating routine through heating so use ocean greenery when you heat treats, cakes, and biscuits. You can likewise utilize it as a roux or a thickening gel in grains like rice or quinoa, farro, or when making beans.

Greg Mulligan is a well-known author and publisher. He published few article on his career. His secret ambition on arriving in Paris was to become a successful writer. Mulligan is winning multiple awards for his excellent writing, In addition to his regular contributions to English journals and articles. Presently he is working on Broadcast Cover.

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Most of us have a cabinet full of supplements that at some point, get neglected. Whether it's because you fell out of your routine or you forgot why you even started it in the first place, there's one that most Americans could benefit from adding back into their regimen: magnesium.

Studies show that the majority of the population is at risk for magnesium deficiency due to a variety of lifestyle factors, including a diet high in processed food. Certain illnesses or health conditions, including Type 2 diabetes or alcohol dependency, can make you susceptible to low magnesium levels, too. A 2013-2016 analysis from the National Health and Nutrition Examination Survey found that 48% of Americans don't get adequate magnesium in their diets.

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Magnesium supplements have become popular in the wellness space recently, and many experts are recommending them for helping with sleep, stress, anxiety and more. But do these claims hold up? Below, I give an overview of the science on magnesium, and I also talked to registered dietitian Amy Gorin to find out more on why magnesium is important and how to know if a supplement may be right for you.

Magnesium requirements vary based on a person's age, gender and other health factors (like pregnancy), but the average recommendation is around 300mg per day.

"Magnesium is important for so many aspects of health. The mineral is involved in more than 300 enzymatic reactions in the body. It's important for bone health, helping to keep your blood sugar levels stable, helping your muscles and nerves to properly function, and keeping your blood pressure at healthy levels," Gorin says.

Magnesium levels also affect your brain and your mood, which is why low levels of magnesium are associated with mood disorders, although more research needs to be done to determine just how important it is for your emotional or mental health.

If you've ever asked a health expert about the best supplements for stress, chances are magnesium is on the list. Why? First of all, according to Gorin, magnesium helps the brain cope with stressors. "Research has shown that magnesium supplementation may affect the brain functions that help lower stress and anxiety," Gorin says.

It works by helping your body kick into the "rest and digest" state, or by activating your parasympathetic nervous system. When you are stressed, your body is likely in the sympathetic nervous system for prolonged periods, which over time can make you feel run down and tired. Studies also showed that magnesium intake helped improve heart-rate variability (HRV) scores, which are representative of how well your body can adapt to stress.

Likewise, magnesium can help you sleep better, since the mineral can have a calming effect on your body. Magnesium helps regulatethe hormone melatonin, which is involved with controlling your circadian rhythm. Your circadian rhythm regulates many things in your body, including when you feel tired and how well you sleep.

Many activities and habits can throw off your circadian rhythm, including exposing your eyes to blue light at night. If you are trying to optimize your circadian rhythm, or are trying to get better sleep with melatonin supplements, you should check that your magnesium levels are optimal since they work together to help you get better rest.

A 2017 study reviewed the connection between magnesium and exercise performance, and found that the more active you are, the more your body needs magnesium. Some claim that it can help you recover faster from workouts, but the evidence on magnesium specifically for workout recovery is limited.

We do know that your muscles need adequate magnesium to function well and avoid cramping, so it makes sense that optimal magnesium levels can facilitate better recovery from workouts.

Grains and seeds contain naturally occurring magnesium.

Vitamin D is crucial for your overall well-being and especially for your immune system health. But even if you think you're getting enough vitamin D through supplementation or sun exposure, you could still be low if your magnesium levels are not optimal.

According to the American Osteopathic Association, low magnesium levels can make vitamin D ineffective. That means that even though you are taking in vitamin D from food, supplements or sunlight exposure, your body can't use it or benefit from it unless you have sufficient magnesium levels.

Magnesium is found naturally in food, like leafy vegetables, whole grains, nuts, seeds and milk, but it's usually in smaller amounts and it can be difficult to get the full 300 mg or more that is needed per day. Plus, scientistspredict that only about 30% to 50% of the magnesium that you take in is actually absorbed in the body. For these reasons, many people turn to a supplement to ensure they are meeting their daily needs.

There are several different types of magnesium supplements that can help specific issues.

If you walk into a vitamin or health food store and look for magnesium supplements, you will likely find several different types. You can get magnesium supplements in powder form (like the popular Natural Vitality Calm supplement) that can be dissolved in water or you can take the mineral in a capsule or tablet.

But not all magnesium supplements are the same, which is why it's important to not only seek a health professional's guidance on which supplement may be best for you, but also understand that different forms of magnesium can have different side effects. For example, magnesium carbonate is one form of magnesium that, if you overdo it, you can end up with stomach upset and diarrhea.

Popular forms of magnesium that are available in supplements:

Magnesium glycinate:"This is a common form of magnesium in supplement form. You might also see it used in heartburn treatments," Gorin says. Magnesium glycinate is often recommended by experts since it's absorbed well in the body and tends to cause less stomach discomfort or upset.

Magnesium oxide: "This form of magnesium can be used as an antacid for heartburn relief, as a short-term laxative, or as a dietary supplement when you're not taking in enough magnesium from food," Gorin says.

Magnesium citrate: "This form of magnesium is sometimes used as a stool softener or laxative," Gorin says.

Magnesium L-threonate:"This is a specific type of magnesium that's been proven to have cognitive benefits. It was discovered by MIT researchers, and you can get it in supplement form. Research suggests that it may help improve brain plasticity, which may have positive effects on memory, learning and cognition," Gorin says.

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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

More:
Magnesium: Why you need this mineral for better sleep, mood and more - CNET

References

1. Ahmed A. Am J Cardiol 2007;99:54953.

2. Taylor JC et al, 2016. Australian Family Physician; 45 (11): 823-827.

3. Calvert MJ et al. Eur J Heart Fail 2005;7:24351.

4. Moser DK et al. Heart Lung 2010;39:37885.

5. Cowie MR et al. ESC Heart Failure 2014;1:11045.

6. Chandra A et al. JAMA Cardiol. 2018 Jun; 3(6): 498505.

7. Desai AS et al. Eur Heart J 2015; 36: 1990-1997.

8. Okumura N et al. Circulation 2016; 133: 22542262

9. McMurray JJ et al. N Eng J Med 2014; 371(11): 993-1004.

10. ENTRESTO New Zealand Data Sheet.

11. Pharmaceutical Schedule Pharmac http://www.pharmac.govt.nz.

Abbreviations

ACEi Angiotensin Converting Enzyme inhibitor, NYHA New York Heart Association, ARB Angiotensin Receptor Blocker, HF Heart Failure, LVEF Left Ventricular Ejection Fraction, ECHO - Echocardiogram, HFrEF Heart Failure with reduced Ejection Fraction, BNP - B-type natriuretic peptide, NT-proBNP - N-terminal (NT)-pro hormone BNP, eGFR - estimated Glomerular Filtration Rate

Minimum Prescribing Information

PRESCRIPTION MEDICINE. Entresto 24mg/26mg, 49mg/51mg, 97mg/103mg (sacubitril/valsartan) film coated tablets. Consult full Data Sheet before prescribing, available from http://www.medsafe.govt.nz. Entresto is fully funded under Special Authority Criteria, please refer to http://www.pharmac.health.nz.

Indication: Treatment of chronic heart failure (NYHA Class II-IV) with reduced ejection fraction. Contraindications: Hypersensitivity to sacubitril, valsartan, or excipients. ACE inhibitors (ACEi). Do not administer within 36 hours of switching from or to an ACEi. Angioedema related to previous ACEi or ARB therapy. Use with aliskiren in Type 2 diabetes (T2D). Severe hepatic impairment, biliary cirrhosis and cholestasis. Pregnancy. Precautions: Caution switching from ACEi or while co-administering with aliskiren in T2D (see Contraindications). Should not be co-administered with an ARB. May cause symptomatic hypotension, especially in those 75 years old, renal disease and systolic BP <112 mmHg or patients with an activated RAAS. Initiation not recommended in systolic BP <100 mmHg. Monitor BP when initiating therapy or during dose titration. If hypotension occurs, dose adjustment of diuretics, antihypertensives, and consider treatment of other causes of hypotension. If hypotension persists, consider dose reduction or temporary interruption. Correct sodium and/or volume depletion before starting treatment. May be associated with decreased renal function; assess renal function before initiation and during treatment. Monitor serum creatinine, and down-titrate or interrupt if a clinically significant decrease in renal function develops. May increase urea and creatinine levels in patients with renal artery stenosis. Not recommended with end-stage renal disease. Should not be initiated and consider discontinuation if the serum potassium level is >5.4 mmol/L. Monitor serum potassium periodically and treat appropriately, especially in patients with risk factors, dosage reduction or interruption may be required. Caution with medications known to raise potassium levels. If clinically significant hyperkalaemia occurs, consider adjusting the dose of concomitant medications. If angioedema occurs, immediately discontinue, and provide appropriate therapy and monitoring until complete and sustained resolution; black patients or patients with a prior history of angioedema may be at higher risk. Caution in NYHA Class IV or in moderate hepatic impairment or with AST/ALT >2X ULN. Use in lactation not recommended. Use contraception during treatment and for 1 week after last dose. Interactions: Aliskiren in T2D, ACEi/ARB. Caution with statins, sildenafil, lithium, potassium-sparing diuretics including mineralocorticoid antagonists, potassium supplements, or salt substitutes containing potassium, NSAIDs including selective COX-2 Inhibitors, frusemide, inhibitors of OATP1B1/B3, OAT3 or MPR2 and metformin. Dosage: Target dose one tablet of 97 mg/103 mg twice daily. Starting dose one tablet of 49 mg/51 mg twice daily. Starting dose one tablet of 24 mg/26 mg taken twice daily recommended for ACEi/ARB naive patients, those with severe renal impairment, moderate hepatic impairment, and in those 75 years old. Double every 2-4 weeks to the target dose. Adverse effects: Very common ( 10%): Hyperkalaemia, hypotension, renal impairment. Common (1 to 10%): Cough, dizziness, renal failure, diarrhoea, hypokalaemia, fatigue, headache, syncope, nausea, asthenia, orthostatic hypotension, vertigo. Uncommon (0.1 to 1%): Angioedema, dizziness postural. Unknown: Hypersensitivity (including rash, pruritus, and anaphylaxis).

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Dr. Taz Bhatia, an immune support and wellness physician, offers seven tips parents can follow to help keep their kids healthy:

Add foods high in vitamin C:

Citrus fruits and vegetables rich in vitamin C like: oranges, grapefruits and beets support and help build a strong immune system. With children, we really want them to get their vitamins through food, so the earlier you can establish some of these healthy eating habits, the better for their overall health, Bhatia says.

Make chicken soup a weekly option:

Another immune-supporting food for kids is chicken soup. It isnt just an option when children are sick. Its a great food to bring in maybe a couple of times a week to keep the immune system primed and supportive, she explains. Chicken soup produces collagen that helps keep skin, hair and bones strong. It also has antiviral and antibacterial properties.

Check out the video above for more tips.

TAZ BHATIA: Hi, there. It's Dr Taz again, and if you're like me, you're worried about keeping your children healthy. Well, here are some foods and habits to keep your children's immune system right where it needs to be.

We know that high-vitamin-C foods, especially our citrus fruits like oranges, grapefruit, and vegetables like beets have tons of vitamin C in it that really support and help the immune system. With children, we really want them to get their vitamins through food, so the earlier you can establish some of these healthy eating habits, the better for their overall health.

Another immune-supporting food for kids is chicken soup. Chicken soup actually produces collagens and other amino modulators that keep the immune system primed and actually act as an antiviral and an antibacterial.

My next tip is all about sugar. Are they drinking too many sweet drinks, too any juices in a given day? And how much of their sugar is refined sugar or sugar from convenience foods or packaged foods versus natural sugars that we find in things like fruits? The more we can lower sugar, the healthier they will be.

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Aromatherapy is also beneficial for our kids, and it's really easy. Rosemary, eucalyptus, and even tea-tree oil are some of my favorite oils to use in children. You typically want to rub them on their wrist, maybe on the sides of the nose, or you can diffuse them or they can steam with them to help get all the therapeutic benefits of these essential oils.

We know that most children need about 10 hours sleep a night. That's 10 hours of continuous sleep. The younger ones need 12 hours, and even those teenagers and adolescents, they shouldn't be skimping below 10.

Children need exercise probably even more than adults do. The daily dose is critical for the immune system. We know that when they're active, when they're running around, it also helps to produce chemicals, cytokines, that support the immune system rather than fight against it.

Teaching children to wash their hands has now, more than ever, become so important. So teaching your children some of these habits to where it becomes routine is going to help them as we come out of this pandemic.

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Foods and habits that can help strengthen your child's immune system - Yahoo Lifestyle

More than a third of Americans arent getting enough sleep, according to the Centres for Disease Control and Prevention.

For optimal health, adults need at least seven hours of sleep each night. But depending on your age, you might need even more:

If you consistently lack sleep, it can pose serious health risks. In the short-term, staying awake for 17 to 19 hours straight can impair your reaction time as much as a blood-alcohol level of 0.05%, which is considered legally drunk. Long-term, a consistent lack of sleep may also increase your likelihood for a heart attack or mental illness.

Here are 6 ways a lack of sleep can negatively impact your health:

Insufficient sleep can affect your mood and increase your stress levels.

In fact, people with insomnia are 17 times more likely to develop clinical anxiety than people who arent sleep deprived. Non-depressed people who have insomnia may be twice as likely to develop depression than people who sleep well.

This could be due to the impact that a lack of sleep has on the brains ability to regulate emotions, which can lead to mood disturbances and negative thinking.

For example, a study published in Current Biology in 2007 examined healthy participants who were deprived of sleep for 35 hours. When the sleep deprived patients were shown negative images, they had more activity in the amygdala the area of the brain that regulates emotions and anxiety levels than participants who werent sleep deprived.

In addition, research has found that 65% to 90% of adults with depression have sleep problems. While a lack of sleep can affect your mental health, depression can also cause insomnia, leading to a vicious cycle.

Researchers have found that just five hours of lost sleep in a 24-hour period can cut off the connection between neurons in the hippocampus, the area of the brain associated with memory.

In one small study published in the journal Neuroscience in 2005, 12 healthy college-aged participants were taught a sequence of finger movements and asked to repeat it 12 hours later as an MRI measured their brain waves.

Researchers found that the cerebellum, the area of the brain that controls accuracy, was more active in participants who had slept during that time period. This suggests that while you sleep, memory is shifted to more efficient storage areas in the brain.

A lack of sleep may also impair the brains ability to flush out beta-amyloid, a toxic protein in the fluid between brain cells that has been linked to memory loss and Alzheimers disease.

Not sleeping enough at night will make it more difficult for you to learn or remember things later, says Raman Malhotra, MD, a sleep medicine physician and associate professor of neurology at Washington University School of Medicine. Sleep helps imprint memories or things you are studying to try and remember in the future.

Not getting seven to eight hours of sleep each night can activate your bodys endocannabinoid (eCB) system, which increases your appetite for pleasurable but unhealthy foods, like candy and chips.

In one small study of 14 healthy young adults, published in the journal Sleep in 2016, researchers found that participants who got insufficient sleep for four nights had higher eCB levels in the afternoons than those who got a good nights sleep. The elevated eCB levels increased their appetites and their cravings for snacks.

It can increase your urge to eat by altering the normal release and levels of different hormones responsible for hunger and satiety, Malhotra says. Research has also found that a lack of sleep increases the release of ghrelin, the hormone that stimulates your appetite, and decreases the release of leptin, the hormone that makes you feel full.

In addition, if youre not getting enough sleep, you may feel fatigue and not have the energy to exercise regularly, which can also contribute to weight gain. A small study of 15 healthy men, published in the American Journal of Clinical Nutrition in 2009, found that fewer hours of sleep for two nights in a row resulted in significantly decreased daytime physical activity.

Getting less than seven hours of sleep each night can increase your risk of heart disease, heart attack, or stroke regardless of your age, weight, and whether or not you smoke or exercise, according to the National Sleep Foundation.

High blood pressure, or hypertension, is one of the major risk factors for heart disease. While youre getting a good nights sleep, your blood pressure should decrease about 10% to 20%, which is known as nocturnal dipping. But if you dont get the sleep you need, your blood pressure wont dip at night and research has found that even small increases in your nighttime blood pressure level can lead to an increased risk of heart disease.

A consistent lack of sleep can also affect your bodys ability to regulate stress hormones, and this chronic stress may contribute to a heart attack over time.

In 2017, there were an estimated 91,000 police-reported car crashes involving drowsy drivers in the US about 50,000 people were injured and nearly 800 were killed.

Driving while drowsy is similar to driving under the influence. It slows down your reaction time and awareness of hazards, and reduces your ability to pay attention to what youre doing.

According to a study published in the journal Sleep in 2018, drivers who had fewer than four hours of sleep in the preceding 24-hour period were 15.1 times more likely to be responsible for a car crash than drivers who slept seven to nine hours during the same period.

Many work-related accidents are also attributable to insufficient sleep. Sleep-deprived workers are 70% more likely to have accidents on the job and twice as likely to die from those accidents than well-rested workers.

A lack of sleep can also result in poor judgment. This may be because sleep deprivation affects your brains prefrontal cortex, the area that controls logical thinking. Examples include:

Sleep deprivation might also affect your moral judgment, because it impairs your brains ability to use emotion and cognition to help you make decisions. Examples include:

The adverse health effects of a single sleepless night can usually be mediated if you get better consistent sleep over the next few nights, Malhotra says. However, if youve been experiencing a chronic lack of sleep over multiple weeks, months, or years, you may be at a great risk of health problems that are more difficult to reverse.

Some sleep disorders, like insomnia or sleep apnea, will require medical treatment in order to fully resolve your sleep issues. If you think you are not getting enough sleep, consult with a physician or sleep specialist who can discuss treatment options.

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Photo credit: The Cheesecake Factory

From Delish

The Cheesecake Factory is loved for its extensive menu, and while the insane amount of entrees available is impressive enough, it's the wild amount of cheesecake that really keeps people coming back. There are over 30 flavors with new ones always being introduced, including the latest: Chocolate Caramelicious Cheesecake made with Snickers.

Here at Delish we love a food mashup, so Snickers and cheesecake already seems like a perfect match. Just like the classic candy bar, this cheesecake is made with peanuts, caramel, nougat, and milk chocolate, so you're getting the same taste of a Snickers in a new, creative way.

The cheesecake starts off with a brownie crust and is made with original cheesecake swirled with Snickers so you'll get crunch in every bite. On top of the cheesecake is a layer of caramel and peanuts. Then, there's a layer of chocolate that is all topped with caramel and chocolate drizzle, chunks of Snickers, and heaping piles of whipped cream.

The Chocolate Caramelicious Cheesecake made with Snickers will be available at The Cheesecake Factory starting July 30. If you need more convincing that this Snickers cheesecake belongs in your life, ordering it will benefit a good cause. The Cheesecake Factory is donating $1 to Feeding America for each cheesecake ordered on July 30.

From there, for every slice of Snickers cheesecake ordered from July 31, 2020 to July 29, 2021, 25 cents will be donated to Feeding America, so this flavor really is the gift that keeps on giving.

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A New Cheesecake Is Coming To The Cheesecake Factory And Snickers Lovers Will Lose Their Minds For It - Yahoo Lifestyle

I have never been a fan of canned tuna. As a child, I would reach for the pimento cheese or slap together a quick PBJ anytime tuna salad was in the works. Tuna aside, though, I always have canned proteins on hand for quick meals: mackerel (definitely), Spam (anytime), sardines (into them), octopus (yes, octopus!). But some of these ingredients, perhaps, miss the most appealing aspect of cooking with canned tuna: affordability.

So when our former editor Rhoda Bonne introduced this recipe using budget-friendly canned salmona product I hadn't previously triedI was stoked. In it, Rhoda turns canned salmon into burger patties that she loads up with roasted red peppers and various other pantry staples. The burgers (which clock in at a bit over $2 each) are slightly sweet, salty, and rich, and since they're cooked in a pan on the stove, they're a great option if you're without a grill this summer.

You can also form the salmon mixture into smaller patties and tuck them into lettuce wraps, or pile them into rice bowls. These versions are especially good if you happen to have some ripe avocado and shaved radish to slide in there, too.

The salmon (at $4.68 for four servings) and red peppers are the most expensive part of these burgers, but there are a few ways to curb that cost, if you'd like. First, you could marinate your own peppers (buy them on sale and make a big batch to have on hand for salmon burgers, romesco, or one of these other 14 dinner ideas). Second, if you have leftover grilled, roasted, or poached salmon that you haven't factored into your meal plan already, this is a great opportunity to use it: just flake it up and let it take the place of the canned stuff. And finally, always toss the ends of bread or the crusts that the kids don't eat into the freezer and turn them into homemade breadcrumbs instead of buying the canister.

The Breakdown

Canned Salmon: $4.68, Lemon: $.89; Roasted Red Peppers: $.85; Mayonnaise: $.80; Hamburger Buns: $.48; Mustard Seeds: $.30; Capers: $.29; Breadcrumbs: $.16; Vegetable Oil: $.06; ; Total: $8.51 ($2.13 per serving). For more on how Epicurious prices out recipes, click here.

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Use It Up

The canned salmon is usually available in 14.75-ounce cans, but you'll need 18 ounces for four patties. You could use the remainder of the second can to make at least two more patties, if you'd like, bumping up the other ingredients accordingly; or you could flake the remaining salmon into your favorite canned tuna recipe. You'll also have four buns leftover from an eight-pack. I highly recommend turning them into breakfast sandwiches. As for those extra capers, this riff on puttanesca is a great way to make your pantry items earn their keep.

Originally Appeared on Epicurious

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Photo credit: Thinx

From Best Products

Managing your period can be a hassle that takes some trial and error to figure out, but we've found that Thinx Period Panties make the process a whole lot easier. From their full-bottom briefs to shape-flattering thongs, Thinx offers a wide array of underwear types that are perfect for that time of the month. Now you can add that extra security and comfort to your nighttime routine with Thinxs newest period-management product: Sleep Shorts.

At first glance, the Thinx Sleep Shorts might remind you of your favorite cozy pair that youd wear to bed or while lounging around your home. But what makes these shorts a period-management must-have are the built-in organic cotton Super Hiphugger undies that reach from the front all the way up your backside, offering you 360 degrees of leakage protection.

Designed with Thinx innovative technology that can securely hold up to four tampons worth of your flow about 36 milliliters you can easily replace your usual nighttime disposable period products. Made of luxuriously soft and comfortable micro-modal fabric, youll actually look forward to wearing them at bedtime instead of worrying about leaks throughout the night.

Lets be honest sleeping with thick, bulky pads can be very uncomfortable, and it limits your range of sleeping positions. Snoozing through 8 hours with a tampon can be both unreliable and highly questionable when it comes to vaginal health and wellness. Both options can lead to stain-causing leaks that are super tough to scrub out of your sheets, undies, and PJs. Thinx Sleep Shorts offer anyone who has periods the assuredness of ultimate, full-coverage protection during that pesky time of the month without compromising on comfort.

The shorts are available in black with white button accents as well as heather gray with black button accents, and range in sizes from extra-small to extra-large. The best part is that the shorts have actual, functioning pockets, which is obviously a must-have for proper lounging!

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For $50, you can get back to sleeping like a log, even when your Aunt Flo shows up for her monthly visit.

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Photo credit: Ben Watts

From Women's Health

Naomi Watts felt pretty good going into 2020. After spending the holidays in Australiawhere the 51-year-old actress spent part of her childhood and where some of her family still liveseating and drinking whatever her heart desired, she embarked on an anti-inflammation diet shes relied on numerous times in the past as a sort of reset. She cut out wheat, sugar, dairy, and alcohol. She worked out three to five times a week, alternating between boutique fitness classes, yoga, and personal-training sessions. After one month, she felt so good, she continued with the routine. She planned to keep it up through April, when she was due to start filming the first of three projects she had lined up for the year.

We all know what happened next. COVID came, and I was like, Nah, Im gonna have a glass of wine when I want, she says. Im stealing the kids Oreos. I never stop eating pasta. Were baking cakes, banana breadI dont ever want to see another piece of banana bread after this. She also started eating bacon again. I was closer to vegan before [this situation], she says.

Naomi has been homebound for six weeks when she FaceTimes me from Long Island, New York. Sitting in a directors chair, wearing a cream-colored sweatshirt, chunky-framed, cool-girl eyeglasses, and a blunt-cut bob, she looks every bit the leading woman in control. But shes the first to admit shes not, and shes fine with that.

These weeks have given the star of The Loudest Voice time to think about anxiety, uncertainty, and how to make the best of thingsthat is, when shes not homeschooling her children, Sasha, 13, and Samuel Kai, 11; cooking for the family; or finding ways to work with basically all film and television production shut down. All bets are off, she says, and I think thats just fine. Whatever you need to do, you do.

For Naomi, that means counterbalancing baked goods with sweat sessions, often in the form of The Class, an hour-long workout that merges calisthenics and plyometrics with a soundtrack of all-the-feels music and self-help guided instruction by creator Taryn Toomey. (Among Naomis fave messages: Start showing up. Breathe into yourself. What do you say when the road gets rough? When the sh*t hits the fan?) Taryn Toomey sometimes directs her students to shake their bodies and scream, to vocalize any tension they have stuck inside.

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Ive always liked to be physical, says Naomi, who grew up running and dancing. Im an active person. But I also love the outlet that Taryn creates. Its a get your freak on kind of thing. It doesnt feel like a traditional workout. You get to move your body, but you also get to shift your mind in a way thats really cathartic. She currently tunes in to livestreams about four times a week from an empty area [in the house] with a good-size mirror.

Naomi also does strength-training sessions created for her by her longtime Los Angelesbased personal trainer, Keith Anthony. Her go-to move: squats. I dont know all their names, she says, getting up out of her chair, but I just did this one the other day, where youre on one leg; can you see me? Indeed, I can: She demonstrates a pistol squat, in jeansa move that, after three sets of eight on each leg, renders her almost unable to walk up and down the stairs. Other loves: goblet squats with a 25-pound weight (three sets of 20, until I get to failure, she says) and jackknife crunches with a stability ball. Weve been told the endorphins keep you going and are great for anxiety and depression, she says. That all sounded good, but now, we really get to experience that.

She relies on other strategies for mental wellness too. Naomi has been open about seeking therapy: To prepare for the 2017 miniseries Gypsy, in which she plays a cognitive behavioral therapist who infiltrates the lives of her patients, Naomi did numerous sessions with, you guessed it, a cognitive behavioral therapist. I found the research very interesting, she says. It felt like a practical way of dealing with and managing specific issues within a certain time frame. Being able to improve or change your behavior by breaking patterns makes it tangible and beneficial. She also dug deep during the time she spent with her own therapist, whose guidance was particularly helpful during her separation from Liev Schreiber, her partner of 11 years and the father of her two children. Additionally, she uses meditation to help manage anxiety. More specifically, she practices a form of it called transcendental meditation (or TM), which involves repeating certain mantras to achieve a state of pure awarenessand shoots for 20-minute sessions every day. I try to keep it consistent. It 100 percent always makes me feel better.

Settling into the unknown (and pivoting) is becoming natural to her. The three projects she planned to shoot in 2020 remain up in the air, and shes hesitant to talk about them because she doesnt know what will be viable once its possible to gather the many necessary peoplecast, crew, hair, makeup, lightingon a set again. Two years ago, though, she branched out and invested in a business outside the entertainment industry: Naomi is a partner in Onda (wave, in Spanish), a nontoxic-skin-care store.

She first got interested in the concept when she went to visit a friend, former mag editor Larissa Thomson, and forgot to bring her toiletry bag. Thomson let Naomiwhose skin had suddenly become sensitive and prone to itchy, red, dry patchesborrow her face washes and creams, and she was blown away by the results. I think it was the combination of long workdays with lots of makeup applications, the chemicals in the products I was using at the time, and the hormonal changes I was going through, she says. Using clean products made an immediate difference.

Ideas and connections ensued, and Naomi introduced Thomson to longtime pal Sarah Bryden-Brown, thinking the two would make a good team. About a year after they launched Onda, a one-stop shop, Naomi joined the pair. I never planned to be in the day-to-day business of things, but over time, Ive gotten more involved, she says of testing new products and weighing in on how to grow the brand. Her role, however, has not come with a fussy 17-step skin-care routine. I dont cleanse in the morning, she says, though she does double-cleanse at night.

I just add moisturizer and serum, or a moisturizer with sunscreen.

And after face food, theres food food. Its three cups of coffee; an avocado toast around 11 a.m.; a big, crunchy salad for lunch (her go-to is arugula, feta, olive, tomato, cucumber, and avocado with a homemade dressing of garlic, olive oil, lemon, mustard, and vegenaise); and something hearty for dinner, like a Moroccan chickpea couscous or pasta puttanesca.

Of course, in her current world, theres also been a lot of mac and cheese and potato chips. And while shes not normally a dessert person, theres been a lot of cake too. Baking is an activity that shes found keeps her children happy even when theyre homebound. (Back to that love-hate relationship with banana bread!)

I got a few cake box mixes, she says. Normally, Ill go, Okay, now do this, dont let that go there, watch the eggs, be careful when youre separating, but now, Im like, Experiment. Do it. Make all the mess you want.

One upside of sheltering at home (besides endless cake-making) has been that the kids see more of both parents. Weve spent plenty of time together, she says, adding that she and Schreiber remain amicable by keeping the same goal in mind, which is the kids health and well-being.

Theres been a lot of family bonding, latelyNaomis brother, the photographer Ben Watts, shot her for the cover of this issue, in part because they were quarantining together. Naomi changed in the back of his truck and acted as her own glam squad. I FaceTimed with a hair and makeup person, she says, and mimes dusting her face with a brush. Im sitting there going, Okay, so where do I put this?

Ironically, in not putting too much pressure on herself right now, Naomi seems to have figured out how to be comfortable in her own skin in a very uncomfortable time. Im very impressed with these people who are saying, I cleaned out the pantry and color-coded my bookshelves and watched this documentary series and read this book, she says. Im finding that its hard to get through a lot of things. My attention span is just not as good as it could be, but I have had days where Ive had creative moments and conversations with people where weve actually come up with ideas.

There are ups and downs, she says, but the world is united for the first time in our lifetime. Thats a significant feeling. Its an optimistic sentiment that sheand the rest of uscan hold on to as we look toward the future. Leave it to Naomi to find the silver linings.

Photographed by Ben Watts Styled by Gabriela Langone Hair consultation: Ryan Trygstad using Rahua and Dyson tools. Makeup consultation: Katey Denno at The Wall Group.

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So, youve hired a nanny. Unlike your 15-year-old niece who charges you $10 an hour and as much of the ice cream in the fridge as she wants to watch your kid for an evening, your nanny is a professional and should be paid as such. That means accounting for payroll items such as taxes and benefits. This provides long-term protections and bonuses for both you and the person youre employing. The nanny gains access such benefits as Medicare and Social Security, while you know that you have everything buttoned up including nanny taxes come April 15th.

So how do you pay a nanny the right way and what paperwork needs to be filled out? Heres what you need to know.

If youre planning to pay your nanny more than $2,200 year or an average of at least $183 per month you need to pay taxes. And, yes, you should pay them. In fact, both you and your nanny are in a better position when you pay and report taxes with tax breaks for you and benefits for them. Its also the law.

We do it not just to follow the law but because it is the morally right thing to do, says father and employment law expertMichael Oswalt, Associate Professor at Northern Illinois University College of Law. Nannies are employees, not independent contractors.

Because all of our employment protections hinge on employment status, Oswalt adds, misclassifying a nanny denies them the few safety net protections that exist. In-home care work is already precarious and often poorly paid, he says. Misclassification compounds the vulnerability. Why do that to anyone especially to someone caring for your child?

Paying nanny taxes qualifies your nanny for healthcare subsidies, unemployment benefits should they lose their job due to no fault of their own (i.e. a pandemic), verifiable employment history for applying for loans, and Social Security and Medicare for when they retire.

In addition to potential tax savings, paying nanny taxes lets you rest easy that the IRS wont come knocking. If you get caught for not paying like when your former nanny applies for unemployment after your kid enters school full-time and the unemployment office sees you havent paid any taxes you can expect an audit, back taxes plus penalties and interest, and potentially tax evasion charges.That doesnt end well for anyone.

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Now that youre convinced you should pay nanny taxes, theres a bit of paperwork to tackle. While it depends, the most likely scenario is that paperwork is needed for both Federal and State taxes.

Many employment laws vary by state, so the protections provided by employee status can differ, Oswalt says. For instance, in Illinois where Oswalt resides, he is required to provide their nanny with paid sick leave. Thats not true elsewhere.

A service likeCare.coms HomePaywill take care of most of the details (direct deposit, generating the W-2, apportion all the taxes, tell you if you need to buy workers comp, etc.), but if youre going the DIY route, its important to follow these steps:

1. Get an EIN and Fill Out an I-9, a W-4, and a State Withholding Form

As your nannys employer, you need a federal Employer Identification Number (EIN).Apply for one online.Your nanny should fill out anI-9, afederal W-4 form (PDF), and a state withholding form if your state collects income tax.

2. Pay Your Nannys Salary

Tally your nannys hours, multiply it by their hourly rate, and add overtime pay to get the gross (pre-tax) amount you owe. Subtract Social Security and Medicare taxes, income taxes, and any other state or local taxes that may apply generally about 10 percent of gross pay. The net is your nannys take-home pay, so cut that check.

3. Pay Nanny Taxes

What you deducted from your nannys pay is what you need to send to the IRS and your states tax agency.Pay your estimated federal taxes (1040) online or by maildo it every three months to avoid underpayment penalties and interest. Your states requirements may differ, so double check them and pay that, too, if necessary.

4. Prep for Tax Filing

Once the year ends, youll need to complete a few more forms for Aprils tax deadline. Provide your nanny aW-2 for their income tax returns andfile a W-2 Copy A and W-3 with the Social Security Administration. You may also need to fill out an Annual Reconciliation Form if your state requires it. Finally, youll need to submit aSchedule H, which allows you to report household employment taxes, with your federal income tax return.

Are you using a nanny share service to split childcare costs with another family? Youll both need to follow the steps above to establish yourselves as household employers with the IRS and your state, pay the nanny separately, and withhold and remit the appropriate taxes to the IRS and state. And make sure the combined rates youre paying add up to the minimum wage in your area.

Following the rules when it comes to paying a nanny or caretaker fairly and by the books ensures that they receive all the legal benefits of the work they do. These employees often become members of the family; its important to see that they are given the most you can give.

The post How to Pay a Nanny the Right Way appeared first on Fatherly.

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From Oprah Magazine

Lin-Manuel Miranda's hit musical Hamilton is available to watch on Disney+.

It depicts the animosity, rivalry, and subsequent duel between Alexander Hamilton and Aaron Burr, two instrumental figures in the founding of the United States.

In the film (and the original run of the play) Burr is played by Leslie Odom Jr., for which he won a 2016 Tony Award.

The rivalry between Alexander Hamilton and Aaron Burr is one of the animating forces of Lin-Manuel Miranda's Hamilton, now streaming on Disney+, culminating in the duel that takes Hamilton's life in Act II. But there's much more to Burr's story after those fateful shots were fired on July 11, 1804.

The two Founding Fathers had longstanding bad blood due to their political differences. Their mutual disdain affected both of their political careers and led not only to the end of Hamilton's life, but irrevocable changes to Burr's.

As Hamilton explores in detail, Burr and Hamilton's relationship was highly contentious. They were both rising political stars and Revolutionary War heroes, but saw eye-to-eye on little.

Burr, a member of the Democratic-Republican Party had more progressive polices than Hamilton, who was a Federalist. The former supported immigrant and women's rights, as well as a broader voting franchise. But Hamilton felt Burr was politically unprincipled and willing to change his beliefs based on what was most personally advantageous, according to History.com.

The two clashed in elections, as Burr beat Hamilton's father-in-law to secure a Senate seat in 1791, and Hamilton worked to undermine Burr's presidential run in 1800. With Burr and Thomas Jefferson tied at the ballot, Hamilton petitioned for Congress to go with Jefferson, which they ultimately did (though it's unclear what, if any, effect Hamilton's actions actually had).

When Burr became aware he would not be picked as Thomas Jefferson's vice president for his reelection campaign, he ran for Governor of New York, another election he lost in part due to criticism from Hamilton.

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After exchanging confrontational letters, a duel was organized between the two in Weehawken, New Jersey on July 11. Burr hoped that winning the duel would reinvigorate his stagnant political career, according to PBS, and was also incensed over a "despicable opinion" Hamilton shared about him to guests at a dinner party.

Though impossible to confirm, many believe that Hamilton missed his first shot of the duel deliberately, while Burr shot to kill from the very beginning. That helped turn the public sentiment against Burr, as historian David Hosack noted.

Per History.com, deaths in these sorts of duels were rare, and the public was upset by the passing of a figure as instrumental as Hamilton. Burr was able to serve the remainder of his term as vice president, despite being charged with two counts of murder.

When Burr left the vice presidential office in 1805, he was disgraced, and in his desperation came up with an elaborate scheme to establish a new country by taking control of the Louisiana territory, a move now known as The Burr Conspiracy. He collaborated with Army General James Wilkinson, who was also Governor of Northern Louisiana, and contacted several European countries to see if they would support his plan with money and manpower.

Burr's daughter, Theodosia, who is the subject of the Hamilton song "Dear Theodosia," and her husband Joseph Alston went to assist Burr in forming this new colony, and the plan was for Theodosia to eventually succeed her father as its leader, Atlas Obscura reports.

The plan crumbled, as Wilkinson eventually bowed out in order to preserve his career, and rumors about Burr's treasonous ways spread to the newspapers. Burr was apprehended just north of New Orleans at Bayou Pierre, and he eventually faced trial for treason in 1807.

Thomas Jefferson testified against Burr, saying his "guilt is placed beyond all measure." Still, Burr was not found guilty, despite both the Jefferson testimony and the presentation of a coded letter describing the plan that he sent to Wilkinson (known as the Cipher Letter). The acquittal was due in large part to Supreme Court Justice John Marshall's rigid definition of what counted as treason.

Fearing more legal charges in states around the country, Burr spent several years in Europe, apparently attempting to get England or France to participate in a North American invasion. Theodosia apparently was instrumental in getting him out of the country.

He returned to the States in 1812, becoming a lawyer in New York and living out his days in relative obscurity. Burr was briefly remarried to Eliza Jumel in 1833, but was divorced because he was reportedly recklessly spending her money on land speculation. The divorce was granted on the very day Burr died in 1836, and Jumel used Alexander Hamilton, Jr. as her lawyer.

When Burr died, he was partially paralyzed.

In his final years, Burr was financially dependent on his friends, and he suffered multiple strokes that ultimately left him partially paralyzed. He finally died in September 1836 at the age of 80 in the care of a cousin on Staten Island, New York.

Though some have lobbied for the public to celebrate Aaron Burr's life and accomplishments, his legacy was forever altered by the murder of Hamilton and his subsequent treasonous actions.

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Is it a bird? Is it a plane? No, its Codecasas new Jet 2020, which takes aviation-inspired design and applies it to a 230-foot superyacht. The latest creation from the Italian shipyard is the epitome of cross-pollination design in the 21st century.

Due to begin construction later this year, the 230-footer will become the shipyards new flagship. The project is the brainchild of Fulvio Codecasa, who has owned the Viareggio-based shipyard for the past 40 years. The Codecasa family, in fact, has been in the boat-building business since 1825.

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While the shipyard is known for its custom designs, the Jet 2020 is unlike any other yacht it has ever built. By applying an aircrafts lines to a yachts hull, Codecasa said he wants to set a unique example that he hopes will ignite a trend.

Aeronautical design features include the rounded forward section of the yacht, with a helm area that resembles an airplanes cockpit. The central section of the superstructure is more akin to a fuselage with a sundeck, while the aft end ticks up to echo the tail of an aircraft. The main benefit of this aviation-inspired shape is large internal volume, says Codecasa, describing the interior as huge.

The aft beach club at sea level is possibly the most stylish section of the yacht. It has an elevator and is connected to a sky lounge. With floor-to-ceiling windows in the main salon and dining area, the views promise to be unrivaled. A helipad sits atop, so the owners can indulge in real flight, too. When heading ashore, a double tender area with the look of a jet engine is located along the side of the yacht.

The bow area on the main deck is dedicated to the owners suite. There are four guest cabins on the lower deck. For those looking to maximize outdoor time, the sundeck is a massive 66 feet by 33 feet, with a covered gym, sunbathing pads and a 20-foot recessed swimming pool.

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While the majority of the yachts technical information has yet to be revealed, Codecasa says the Jet2020 will have other aviation-inspired tech features, like radar antennas installed inside a carbon-fiber dome. He said they will be designed in the typical style of the AWACS aircraft, the Boeing E-3 Sentry.

The Jet2020 will be built to Lloyds and MCA standards, so it can be registered under the most important international certification flags.

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NEW YORK (AP) The last few weeks I spent in New York City, the soundtrack of my days went like this: police helicopters circling, firecrackers startling, uniform chants for justice rising into the air.

The noise was constant particularly following what had been months of silence as the city that never sleeps went into a deep slumber. Since mid-March, the only sound we'd heard came from ambulances carrying the thousands of people who would become victims to a startling virus as the city became the epicenter.

I had dreamt of living in New York City since I was 13. I had come here from Southern California for the first time with my middle school choir class. We stayed in a hotel near Times Square, and I remembered the noise the constant, looping sound of a city in motion. The subway rumbled underneath our feet as New Yorkers existed outside, creating a cacophony.

It was beautiful. I remember thinking: This is what life must sound like.

Now, more than a decade later, my time with New York is limited but also, somehow infinite. The days now have no beginning or end. We are not working from home but, rather, living at work. And now I find myself with too much time to recollect about a whirlwind romance with the only place I have ever felt at home.

In a 1967 essay, Goodbye to All That, Joan Didion wrote: I am not sure that it is possible for anyone brought up in the East to appreciate entirely what New York, the idea of New York, means to those of us who came out of the West and the South.

In many ways, I am so lucky. I got to have New York City for three beautiful and challenging years. For some, that may seem short, but I came alive here. I moved into a 300-square-foot apartment in the East Village in the summer of 2017, and life as I knew it changed.

I attended my dream school in New York. I met the girl who is now my best friend at a coffee shop near Washington Square Park. I fell in love for the first time while waiting for a table on the Upper West Side. I had my first national byline on the third floor of 30 Rock. I experienced my first heartbreak in an apartment deep in Bushwick. I graduated with my masters on a blistering hot summer day at Yankee Stadium.

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I moved to four apartments in three years. I cried on every train line in the city's subway system but one. I truly lived in New York. And now, as the city is battered and broken down, as buildings remain closed and most stores are boarded up, I am leaving. Not because of the virus, but to start a new job.

Like many, I have spent these past three months mourning the life we had before this virus. The memories and lives lost. But I am also mourning the noise of a city in motion. And now, I wonder, will the sidewalks of New York ever be filled to the brim again? Will there be a day when the neighborhood barber shops, restaurants, and dive bars are busy again?

I dont know. But I know one thing. The other night, as protests erupted in each of the citys five boroughs, a beautiful sound poured into the corners and crevices of my Brooklyn neighborhood. It interrupted the chants, the helicopters and the fireworks. It was the sound of Martin Luther King Jr.s I Have A Dream speech.

It echoed off the brownstones and spilled into the bodegas. It was the new soundtrack of a city in motion.

___

Virus Diary, an occasional feature, showcases the coronavirus pandemic through the eyes of Associated Press journalists around the world. Farnoush Amiri works for the AP/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow her on Twitter at http://twitter.com/FarnoushAmiri

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Photo credit: Burger King; Peep THIS Out!

From Best Products

As much as wed like to drink a giant dessert every day, we know thats not what our bodies need. Thats why were onboard for Burger Kings new Mini Shakes. Theyre the perfect size for treating yourself and satisfying your sweet tooth without risking a serious stomachache.

The Mini Shakes appear to be rolling out at the fast food spot, as spotted by Peep THIS Out!, a YouTube channel that mostly reviews fast food items. The host is based in Southern California and was among the first to find the Oreo Mint McFlurry, which was later unveiled as the Oreo Shamrock McFlurry. So we have hope that the Mini Shakes will roll out across the country.

The new summer sip comes in chocolate, vanilla, and strawberry flavors, which are already on the menu in regular sizes. The 9-ounce cups are filled with a mix of soft-serve and syrup, and are topped with whipped cream, as described by Peep THIS Out!. The best part is that each Mini Shake is just $1, making it a cant-refuse deal.

If youve already had a milkshake from Burger King, then you know how tasty they are. So its nice to have the option of getting a miniature one for the days where you dont want that much sweetness. Or, if you cant decide which flavor to get, now theres no reason not to get two!

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