Health & Fitness

Providing your body with optimal hydration in the form of pure water is one of the simplest steps you can take to improve your health. It’s such a powerful tool that research published in the Journal of Clinical Investigation suggests 3 million fewer people in the U.S. would develop degenerative diseases if they improved hydration throughout life.¹

It makes sense, since your body is made up mostly of water. At birth, body weight is 75% water, dropping to 55% in the elderly.² Keeping an optimal balance between water intake and output is essential for survival, which is why if you become dehydrated, your body will activate a number of hormonal and neuroregulatory mechanisms to save your life.

Among them, you’ll begin to feel thirsty, reminding you to drink some water, while your kidneys hold onto water, so your urine output decreases.³

Researchers looked into the effects of long term subclinical hypohydration, or chronically losing more water than you take in, in mice and humans, finding evidence that even subtle changes in hydration levels led to “profound” effects on long-term health, and stating, “[W]e provide evidence from mouse and human studies that maintaining optimal hydration throughout a person’s lifetime provides protection from the development of age-dependent chronic disorders.”⁴

Restricted Water Intake Shortens Lifespan in Mice

For the first part of the study, mice had their water mildly restricted for a lifetime. While they easily adapted to the slightly lower water intake and showed no signs of distress, further testing revealed a state of chronic mild dehydration. Compared to mice with optimal hydration, the water restricted mice had a shortened lifespan and metabolic changes that led to increased food intake and energy expenditure.

During the first 12 to 14 months of life, the study also found that the water restricted mice had increased low-grade inflammation and coagulation, which could accelerate aging and act as indicators of age-related degenerative disease. By 14 months, the water restricted mice had faster declines in motor coordination.⁵ Further, the researchers noted:⁶

“We demonstrate that restricting the amount of drinking water shortens mouse lifespan with no major warning signs up to 14 months of life, followed by sharp deterioration.

Mechanistically, water restriction yields stable metabolism remodeling toward metabolic water production with greater food intake and energy expenditure, an elevation of markers of inflammation and coagulation, accelerated decline of neuromuscular coordination, renal glomerular injury, and the development of cardiac fibrosis.”

Not Enough Water Leads to Accelerated Aging and Degeneration

In the second part of the study, researchers analyzed data from 15,792 adults, using serum sodium concentration as a measure of hydration status and lifelong hydration. Participants whose serum sodium concentration was close to the upper end of normal had increased levels of risk factors for age-related morbidity and mortality.

Further, a strong association was found between serum sodium concentration in middle age and markers of coagulation and inflammation and the development of age-dependent degenerative diseases.

Like mice, humans with less-than-optimal hydration status had increased inflammation and other factors associated with degenerative diseases, including cognitive impairment, dementia, heart failure and chronic lung disease. High blood pressure and diabetes were also associated with hydration status.⁷ According to the study:⁸

“By analyzing disease prevalence, we showed that a serum sodium level below 142 mmol/L greatly reduced the risk for the development of many degenerative diseases including heart failure (HF), dementia, and chronic lung disease (CLD).

These findings indicated that serum sodium levels in the upper half of the ‘normal range’ should be treated as a clinical risk factor that prompts recommendation for modification of water and salt intake.”

Proper Hydration Could Spare Millions From Disease

Maintaining optimal hydration status during your life could lead to significant health benefits, but it’s difficult to define a set hydration level for everyone, since fluid needs vary according to activity levels, nutrition, health status and environment. However, the featured study suggested “a clear threshold of 141.5 mmol/L for serum sodium concentration,” above which the risk of age-related diseases goes way up.⁹

If everyone in the U.S. with sodium concentrations above this level were to decrease them by drinking more water, reaching the 140 to 141.5 mmol/L range, 3 million cases of related diseases could be spared. The researchers noted impressive benefits from improved hydration on a population-wide scale. Specifically:¹⁰

“These calculations predicted that the prevalence of dementia in people aged 70–85 years would decrease by 48%, HF by 24%, CLD by 20%, CKD by 10%, diabetes mellitus by 11%, high BP by 7%, and stroke by 3.1%. To estimate how many people would not develop these diseases as a result of such a preventive strategy, we extrapolated the results … to the whole population of the United States …

The calculations predicted that there would be about 342,000 fewer people with dementia, 353,000 fewer with HF, 597,000 fewer with CLD, 422,000 fewer with CKD, 442,000 fewer with diabetes mellitus, 822,000 fewer with high BP, and 59,000 fewer with stroke, in total decreasing the number of people aged 70–85 years with these diseases by 3,000,000 in the United States alone.”

Mental and Physical Health Risks of Dehydration

Your body needs water for blood circulation, metabolism, regulation of body temperature and waste removal. If you’re dehydrated, even mildly, your mood and cognitive function may suffer. In a study of 25 women, those who suffered from 1.36% dehydration experienced worsened mood, irritability, headaches and lower concentration and perceived tasks to be more difficult.¹¹

A 2013 study in which 20 healthy women in their mid-20s were deprived of all beverages for 24 hours also showed the mental repercussions of too little water. While no clinical abnormalities were observed in the biological parameters (urine, blood and saliva), thirst and heart rate did increase and urine output was drastically reduced (and became darker).

As for mood effects, the authors noted, "The significant effects of [fluid deprivation] on mood included decreased alertness and increased sleepiness, fatigue and confusion.”¹² This may be one reason why, in another study, dehydrated drivers were found to make twice the amount of errors during a two-hour drive compared to hydrated drivers.¹³

The No. 1 risk factor for kidney stones is also not drinking enough water, and there is research showing that high fluid intake is linked to a lower risk of certain types of cancer, such as bladder and colorectal.¹⁴

Even the risk of fatal coronary heart disease has been linked to water intake, with women who drank five or more glasses of water per day reducing their risk by 41% compared to women who drank less. Men, meanwhile, reduced their risk by 54%.^15,16 Other symptoms of mild and severe dehydration include:¹⁷

Mild to Moderate Dehydration	Severe Dehydration
Dry, sticky mouth	Extreme thirst
Sleepiness or tiredness	Irritability and confusion
Dry skin	Sunken eyes
Headache	Dry skin that doesn't bounce back when you pinch it
Lightheadedness	Low blood pressure
Dizziness	Rapid heartbeat
Few or no tears when crying	Rapid breathing
Minimal urine	No tears when crying
Dry, cool skin	Fever
Muscle cramps	Little or no urination, and any urine color that is darker than usual
	In serious cases, delirium or unconsciousness

Are You Drinking Enough Water?

Both children and adults often fail to drink enough water,¹⁸ and it’s estimated that 20% to 30% of older adults are dehydrated,¹⁹ often due to water deprivation and the fact that people naturally have a lower volume of water in their body as they get older.²⁰

How much water is optimal varies depending on your age, health status, activity levels and more, but you might have heard the advice to drink eight 8-ounce glasses of water a day (known as the 8x8 rule).

This is not necessarily the best amount for everyone, as there is no one-size-fits-all water quota for humans. In fact, in a review published in the American Journal of Physiology, Heinz Valtin of Dartmouth Medical School in Lebanon, New Hampshire, could find no scientific basis for the 8x8 rule, which is more aptly described as a myth.²¹

Toby Mündel, senior lecturer at the School of Sport and Exercise, Massey University, New Zealand,²² recommends another method for monitoring your hydration levels: keeping track of your body weight. First thing in the morning when you get out of bed, weigh yourself for three mornings in a row, then calculate the average of your weights.

This is your normal baseline weight, and you should stay within 1% of that if you’re adequately hydrated (assuming other factors haven’t influenced your weight). Simply using thirst as a guide to how much water you need to drink is another way to help ensure your individual needs are met on a daily basis.

Optimal Hydration May Protect Your Health

You can also use the color of your urine as a guide. If it is a deep, dark yellow then you are likely not drinking enough water. A pale straw color or light yellow is typically indicative of adequate hydration. If your urine is scant or if you haven't urinated in many hours, that too is an indication that you're not drinking enough.

What is clear is that your body depends on a precise fluid balance to stay optimally healthy, and even slight changes in this balance can affect your physical and mental health. Even if you are only skimping on water slightly, it could be leading to accelerated aging or increasing the risk of degenerative disease, if the featured study is confirmed.

That doesn’t mean you need to stress over the proper amounts of water or force yourself to drink large quantities. Just be conscious of replenishing your body with pure water regularly, and definitely take a large drink if you’re feeling thirsty. Keep in mind that during strenuous physical activity, in hot climates and on long airplane flights,²³ you may need more water than normal, so plan to keep your (reusable) water bottle handy.

Further, if you can’t remember the last time you’ve drank a glass of water, especially if you ordinarily reach for soda, energy drinks or fruit juice instead, make a point to switch your fluid of choice to pure water, and enjoy the health gains that follow.

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Conventional medicine still has Type 2 diabetes misidentified as a blood sugar problem. In reality, the condition is rooted in insulin resistance and faulty leptin signaling, caused by chronically elevated insulin and leptin levels. In other words, it’s a diet-derived condition that can be reversed using a cyclical ketogenic diet and fasting.

This is why the medical community’s approach to Type 2 diabetes treatment, which typically involves the administration of insulin, is fatally flawed and professionally irresponsible. Treating Type 2 diabetes with insulin is actually one of the worst things you can do, as it simply accelerates dying from the disease.

Type 1 diabetics, on the other hand, do require a steady supply of insulin for their survival, as their bodies produce little or no insulin at all. Previously called juvenile diabetes, there are actually more adults with Type 1 diabetes than there are children with the condition, with an estimated 1 million to 1.5 million Type 1 diabetics in the U.S. alone.

Type 1 diabetes is an autoimmune disease in which your immune system attacks and destroys your pancreatic cells that produce insulin, which is why it’s also referred to as insulin-dependent diabetes. Tragically, as prices of insulin have skyrocketed, many Type 1 diabetics are now risking their lives by rationing their insulin use.¹

Skyrocketing Costs Force Type 1 Diabetics to Risk Their Lives

In a recent article,² The Washington Post tells the story of Alec Raeshawn Smith, who was diagnosed with Type 1 diabetes in 2015, just shy of his 24th birthday. Two years later, his health insurance coverage under his mother’s policy expired, leaving him with two expensive options: Get his own insurance, which would cost about $450 per month with a $7,000 deductible, or pay for his diabetic supplies out of pocket. The Washington Post continues:

“What Alec soon learned was just how much his insulin would end up costing… The price of insulin — once modest — has skyrocketed in recent years, making the lifesaving medication a significant, even burdensome, expense, especially for the uninsured and underinsured.

The costs are so heavy that they have driven some patients to ration their supplies of the drug in a dangerous gamble with life-threatening consequences. At the time Alec discussed skipping insurance coverage, he told his mother, ‘It can’t be that bad.’ Within a month of going off her policy, he would be dead …

As Nicole [Alec’s mother] cleaned out his cluttered blue car, littered with old prescription receipts, she started to cobble together just how much his insulin and blood sugar testing supplies cost without insurance or discounts. The total, by her count, was nearly $1,300 per month …

That $1,300 was almost $200 more than Alec’s biweekly paycheck. Nicole now believes that Alec was rationing his insulin because of the cost … ‘We realized that he had been taking less insulin and less often than he should, trying to make it stretch until he got his next paycheck.’ He was found dead three days before payday.”

Price Gouging Insulin Should Be a Crime

As noted in the featured article,³ the three researchers (Frederick Banting, Charles Best and James Collip⁴) who in 1921 discovered insulin — thereby transforming diabetic treatment and offering hope for a more or less normal life for Type 1 diabetics, who were previously doomed to die young — sold their patent to the University of Toronto for $1 each.

According to historian Michael Bliss,⁵ these researchers were trying to provide a great humanitarian gift to the world. In the hands of drug companies, however, insulin has become a guaranteed profit center totally isolated from the inventors’ benevolent intentions for the use of their discovery.

The price of insulin tripled between 2002 and 2013,^6,7 and has doubled again since.⁸ At present, the three dominant makers of insulin, Eli Lilly, Sanofi and Novo Nordisk — which control 96% of the insulin market⁹ — all sell their insulin for approximately the same prices, and have raised them in lockstep, raising suspicions of price fixing.¹⁰

Drug makers also continue fine-tuning their formulas to prevent low blood sugar episodes, and while that’s good, it also ensures the drug patents don’t expire, preventing generics from being introduced.¹¹

“For decades, manufacturers improved formulas, first using animal parts, then producing human insulin using bacteria and recombinant DNA. The 1990s saw the advent of insulin analogs, synthetic drugs made to better mimic the body’s own insulin production,” The Washington Post writes.¹²

“Today, critics argue that the price of insulin has far outpaced any innovations … In 1996, when Eli Lilly debuted its Humalog brand of insulin, the list price of a 10-milliliter vial was $21. The price of the same vial is now $275. Those costs can be compounded by the multiple vials that diabetics may require to survive each month.”

Price Hikes Threaten Insulin-Dependent Americans’ Lives

The Washington Post¹³ cites IBM Watson Health data showing Sanofi’s Lantus brand went from $35 per vial when introduced in 2001 to about $270 today, and Novolog, by Novo Nordisk, which started out at $40 per vial when released in 2001, now sells for around $289.

According to a 2016 JAMA study,^14,15 the nondiscounted price for Lantus in the U.S. in 2015 was as high as $372.75, and the discounted price $186.38. Meanwhile, that same drug sold for $67 in Canada, $60.90 in Germany and $46.60 in France.

Even more telling is a 2018 study¹⁶ showing the estimated cost of manufacturing a 12-month supply of analog insulin is between $78 and $133 per patient, and $48 to $71 per patient per year for biosimilars. Why are patients having to pay as much as $24,000 a year for insulin that costs less than $133 to manufacture?

In response to growing outcry and lawsuits over insulin prices, Eli Lilly introduced Lispro, a less expensive generic version of its insulin Humalog, in May 2019.^17,18 Lispro is said to sell at about half of the list price of Humalog.

According to a company statement,¹⁹ “The people who are most likely to benefit from Insulin Lispro Injection are Medicare Part D beneficiaries, people with high-deductible health plans and the uninsured who use Humalog.”

Lack of Competition, Payment Incentives Drive Prices

Why the dramatic increase in insulin prices? A November 2018 congressional caucus report,^20,21 “Insulin: A Lifesaving Drug Too Often Out of Reach,” sought to identify the reasons behind these literally life threatening price hikes. As noted in this report:²²

“Every day 7.5 million Americans rely on insulin [my note: over 6 million of these are Type 2 diabetics and should not be taking insulin] to manage their blood sugar levels and prevent debilitating, even deadly complications.

This lifesaving drug, however, has become increasingly unaffordable. Its average price has nearly doubled since 2012, putting an enormous financial burden on millions of patients.

For more than a year, Representatives Diana DeGette (D-CO) and Tom Reed (R-NY), the co- chairs of the Congressional Diabetes Caucus, have conducted a bipartisan inquiry to uncover the sources of this dramatic price increase.

This culminating report provides an overview of the insulin supply chain, discusses the drivers behind rising insulin prices, and recommends policy solutions to lower costs …

Many of the complicating reasons will be detailed further in this inquiry, including the myriad steps that insulin takes from manufacturer to patient, the perverse payment incentives and methodologies, the lack of transparency in pricing and outdated patent regulations, among other things.

These market failures have allowed a handful of players along the insulin distribution pipeline from manufacturers to health insurers to capitalize on their strategic positions, driving up the price of insulin and minimizing competition.

Congress should pursue a handful of legislative actions to increase price transparency, promote competition among insulin makers, and encourage the use of value-based contracts. Congress should also consider working on targeted patent reforms to prevent anti-competitive practices and streamline the drug approval process at the Food and Drug Administration for biosimilar insulins.”

While 1 in 4 patients gambles with their lives by rationing their insulin supplies by what they can afford,²³ others have taken to illegally importing insulin from other countries where prices are more reasonable.

The Washington Post²⁴ recounts testimony from one father who told senators a 90-day supply of insulin for his son costs $1,489.46 through insurance with a high deductible. He’s resorted to buying insulin from a Canadian pharmacy, from which he can get the same amount of insulin for $350 including shipping.

According to the article, while this is technically illegal, “the Food and Drug Administration generally doesn’t prosecute individuals if it’s a short-term supply for personal use.”²⁵ Many others have turned to GoFundMe to raise donations for their insulin purchases.

Why Rationing Your Insulin Is a Dangerous Gamble

For Type 1 diabetics, whose bodies can’t make insulin, getting a steady supply is crucial for their health. Taking lower doses, or skipping doses, can be immediately life threatening and in the long term can result in even more costly health problems. As noted in the featured article:²⁶

“Poor glycemic control can lead to blindness, kidney failure, amputation, heart disease and stroke. In the short term, patients who stop taking enough insulin can lapse into diabetic ketoacidosis, a condition where blood sugars get too high and the body’s blood becomes acidic. It can become fatal in just hours or a few days.”

While not an ideal solution, The Washington Post points out an alternative solution: older versions of insulins, available at Walmart for approximately $25 per vial.

While there’s some evidence showing these older formulas, which came out in the 1980s, are more likely to trigger dangerously low blood sugar and are typically thought to be safer for Type 2 diabetics than Type 1 diabetics, the doctors interviewed by The Washington Post agree it’s better than nothing.

Similarly, in the information sheet, “Diabetes Meds on a Budget,”²⁷ Beverly Thomassian, a registered nurse and president of Diabetes Education Services, points out:

“The older insulins are regular and NPH. They are available as Humulin R and N (Eli Lilly) and Novolin R and N (Novo Nordisk). These biosynthetic insulins take longer to start working and the NPH peaks at 4 - 10 hours.

ReliOn Brand — Walmart sells Novolin insulin Regular, NPH and 70/30 (biphasic insulin) under the ReliOn label at discounted prices … Newer insulins are referred to as analogues. The amino sequence of these insulins has been slightly rearranged through genetic engineering to make them more rapidly available or take longer to absorb …

Given these pricing disparities, please consider reading this article²⁸ published in Diabetes Care, 2009 — that describes the effective use of NPH and Reg to manage Type 2 diabetes.

The authors research shows that for type 2s, NPH and Regular insulins are as effective as the newer analogues in getting glucose to goal. The main drawbacks are well known; the peak of NPH slightly increases risk of hypoglycemia and patients will get better post prandial glucose control by taking regular insulin 30 minutes before meal (vs at meals with the analogs).”

Insulin Makers Sued

As mentioned, the surprisingly similar price hikes by all three makers of insulin have raised suspicions that the companies are in collusion. It wouldn’t be the first time. In February 2010, Mexico fined Eli Lilly and three Mexican drug companies $1.7 million each for colluding to eliminate competition by agreeing to take turns in placing winning bids for insulin, thereby artificially raising prices.²⁹

In January 2017, a class action lawsuit³⁰ was filed against Sanofi, Novo Nordisk and Eli Lilly in Massachusetts federal court, claiming the companies are in violation of the Racketeer Influenced and Corrupt Organizations Act.³¹ The New York Times reported:³²

“The lawsuit … accuses the companies of exploiting the country’s opaque drug-pricing system in a way that benefits themselves and the intermediaries known as pharmacy benefit managers.

It cites several examples of patients with diabetes who, unable to afford their insulin treatments, which can cost up to $900 a month, have resorted to injecting themselves with expired insulin or starving themselves to control their blood sugar.

Some patients, the lawsuit said, intentionally allowed themselves to slip into diabetic ketoacidosis — a blood syndrome that can be fatal — to get insulin from hospital emergency rooms.”

In October 2018, the attorney general of Minnesota, Lori Swanson, also filed a lawsuit against the three insulin makers, charging them with deceptive and misleading price increases.³³ As reported by The Hill:³⁴

“The lawsuit alleges that there is a deceptive difference between the sticker price of these insulins and the actual price that insurers pay after negotiators known as pharmacy benefit managers (PBMs) get discounts.

The attorney general says drug companies are raising the sticker price ever higher so that they can give larger discounts to the PBMs, which helps them secure more favorable coverage of their products relative to their competitors in insurance plans.

The problem, Swanson says, is that the spiking sticker prices hurt people who don’t have insurance or who have high deductibles they have to pay before insurance kicks in.

‘The lawsuit alleges that the list prices the drug companies set are so far from their net prices that they are not an accurate approximation of the true cost of insulin and are deceptive and misleading,’ the attorney general’s office says.”

Biohackers Make Their Own Insulin

Aside from rationing, extended fasting, insulin sharing, using expired insulin, setting up GoFundMe campaigns or illegally importing insulin from other countries, some Type 1 diabetics are taking insulin production into their own hands.

In a recent Elemental Medium article,³⁵ Dana Smith talks about the Open Insulin Project, “a biohacker collective that is trying to produce the lifesaving drug and provide it to people with diabetes for free, or close to it.” She writes:

“The group was founded in 2015 by Anthony Di Franco, a computer scientist with Type 1 diabetes, and a longtime member of the California hacker scene … He and his collaborators think one solution to the pricing crisis lies in enabling patients and hospitals to create insulin themselves.

The group works out of Counter Culture Labs in the trendy Temescal neighborhood of Oakland … ‘If we can make this stuff in our janky lab on a $10,000 a year budget, there’s no way it should cost this much,’ says Thornton Thompson, a molecular biologist who is part of Open Insulin.

‘One of the big goals of the project is just to demonstrate that.’ Scientists make insulin by inserting a gene that codes for the insulin protein into either yeast or bacteria. These organisms become mini bio-factories and start to spit out the protein, which can then be harvested, purified, and bottled.

Scientists at Genentech were the first to synthesize insulin this way back in 1979 from the bacterium E. coli, and drug manufacturers have been using the method ever since. Open Insulin’s goal is to develop a similar way to generate insulin that doesn’t infringe on any patents and can be made publicly available.”

The Open Insulin Project

To produce insulin, the group uses yeast rather than E. coli. A French biochemist named Yann Huon de Kermadec joined the Open Insulin Project about a year-and-a-half ago. He took charge of the manufacturing process and obtained the appropriate insulin gene, which is then inserted into the DNA of the yeast, thereby producing a small amount of insulin protein.

They’ve not yet been able to extract high-enough amounts to move on to the purification stage, so at present they’re still working on increasing the yield. “If they succeed, they will go through the final steps of purifying and testing the protein. Once they’re confident that what they’ve produced really is pure insulin, Di Franco will serve as the group’s first guinea pig,” Smith writes.

According to Open Insulin, 10 liters of yeast culture are enough to make insulin for 10,000 individuals, with a startup cost as low as $1 per person. Indeed, as noted earlier, insulin manufacturing is pretty darn inexpensive — at most around $133 per person per year for an analog, and as low as $48 per person per year for a biosimilar.

Once a well-working insulin has been developed, the group hopes to make the recipe open-source, allowing hospitals and other patient groups make it for themselves. Thompson told Smith:

“What we’re interested in medium- and long-term is to try to organize networks of production and distribution centers that work by a fundamentally different model. We want to partner with hospitals, free health care clinics, patient organizations, diabetes groups. What if you could set up a small-scale production center in the back of a hospital?”

Di Franco adds, “Economically, I think it’s much better to do it in this decentralized way. A very small investment from each patient could fulfill the patient’s needs and make insulin very close to free for everyone who needs it with this kind of technology.”

As you’d expect, others are less than excited about such a prospect, not because it would create much-needed competition, but because of safety concerns. For example, Dr. Eric Topol, chair of innovative medicine and executive vice president at the Scripps Research Institute, told Smith:

“There are so many things that could go wrong in the process: the sterilization, the efficacy, the safety. It’s like Murphy’s law, here. These are potent drugs that can have serious side effects. I just don’t see that that is a safe or practical route.”

Millions of Americans Get Their Medications Outside the US

At present, there are no easy solutions for insulin-dependent diabetics. What’s clear is that it shouldn’t cost thousands of dollars a month for an essential drug required to keep these people alive.

If you’re in this boat, consider talking to your doctor about the possibility of using the older biosynthetics, Humulin R and N, or Novolin R and N, available for about $25 at Walmart. It may not be ideal (you can read about some of the concerns in this Insulin In Nation article³⁶) but it’s probably still better than nothing. Even better, however, especially for Type 1 diabetics, is getting your insulin from overseas — or even just next door, north or south of the U.S. border.

Research published in 2015 shows that 952,000 Californians cross into Mexico every year for lower-priced health care, including prescription drugs.³⁷ From the northern border, a random survey of Americans showed that 8% of respondents or someone they knew had imported their medications from Canada.

In numbers, that adds up to 19 million individuals — with estimates that the numbers are probably much higher — crossing into Canada just to be able to afford medications they may very well not be able to live without.³⁸ But is this legal? And if it is, how do you do it? And if you’re not near the southern or northern U.S. borders, is there anywhere else to go? According to the FDA:

“In most circumstances it is illegal for individuals to import drugs or devices into the U.S. for personal use because … [they] have not been approved for use or sale in the U.S. … The FDA cannot ensure the safety and effectiveness of medicine purchased over the internet from foreign sources, storefront businesses that offer to buy foreign medicine for you, or during trips outside the U.S.”

The FDA does make exceptions for certain medications under specific situations, but even so, the amounts can’t be for more than a three-month supply. That said, Kaiser Health Network³⁹ reports that personal use purchases for drugs not considered a risk by the FDA — such as insulin — in 90-day supplies are not being prosecuted.

And just how much are Americans saving by crossing the border? Kaiser Health gave an example of a woman vacationing in Canada who visited a local pharmacy for an emergency insulin refill for her daughter: The pack of insulin pens, which cost $700 in the U.S., was a mere $65.

The same box costs $73 in Germany; $57 in Israel; $51 in Greece; $61 in Rome and $40 in Taiwan. It’s no wonder millions of Americans are getting prescriptions by mail order overseas! Yet, even though they’re not prosecuting people for it, the FDA is clamping down on mail orders by going after them at international mail facilities.

According to online journalism group Tarbell,⁴⁰ the FDA intercepted 10,731 prescription drug packages in 2017; by May 2018, they’d confiscated 19,318. Their goal is to intercept 100,000 a year.

So, what can you as a consumer do, if you can’t afford the outrageous — bordering on criminal — pricing and you’re not brave enough to test the system and try to take a vacation out of the country or order by mail? One way to begin could be to study the FDA’s personal importation guidelines to see if there is some way you can qualify for an exception so you can get your insulin from out of the country legally.

Guidelines for Insulin-Dependent Diabetics

Also remember that your lifestyle will have an impact on your blood sugar control. Ways to help manage your glucose levels include the following. Just be sure to consult your physician before making any drastic changes to your lifestyle habits and dietary plan, to avoid wild blood sugar fluctuations.

• Limiting your net carb intake (total carbs minus fiber) — When you eat high-carb foods, your body converts the starches and sugars into glucose, which will enter your bloodstream and increase your blood glucose levels. Make sure you monitor your carbohydrate intake to avoid hyperglycemia.
• Timing your meals appropriately — Meal timing is crucial to the treatment and management of Type 1 diabetes, since it may affect the efficiency of your insulin intake. The best time to eat your meal depends on the type of insulin that you’re taking. For example, regular insulin should be taken 30 minutes before a meal.⁴¹
• Eating only nutritious foods — Avoid eating foods that contain sugar, preservatives, trans fat, refined flour and other unhealthy ingredients. Rather, fill your plate with wholesome foods rich in vitamins and minerals. You should also consume foods that are high in healthy fats and probiotics, since these may help you gain better control of your blood glucose levels.
• Exercising regularly — Following an active lifestyle will help regulate your blood sugar levels, as it allows your body to use insulin more efficiently, and can help you avoid long-term complications associated with Type 1 diabetes, such as heart disease.⁴²

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Scientists have conducted an experiment using thermal imaging and wearable sensors to better understand the stress and performance patterns of so-called knowledge workers.

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Imagine not being able to drive, shower alone or even work because you are never quite sure when the next seizure will leave you incapacitated. Hope may be on the horizon for epilepsy patients who have had limited success with seizure drugs.

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Scientists have uncovered new molecular drivers of Parkinson's disease using a sophisticated statistical technique called multiscale gene network analysis (MGNA). The team was also able to determine how these molecular drivers impact the functions of genes involved in the disease. The results may point to potential new treatments.

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2019 has been a particularly deadly year in the U.S. for eastern equine encephalitis (EEE), a mosquito-borne illness. As of November 12, 36 confirmed cases of EEE had been reported by eight states; 13 of these cases were fatal.

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In recent years, the nail polish industry has been transformed by the development of longer-lasting polish techniques. As dermatologists, we are often asked about the effects of these various products on nails. Here we review the main types of polish, and consider the pros and cons of each with an eye toward nail health and safety.

Traditional nail polish

Classic nail polish is painted onto the nail plate, usually in multiple coats, and then air-dried. Conventional nail polish is a polymer dissolved in a solvent. During the drying process, the solvent evaporates, and the polymer hardens. “Hybrid” polish is similar; it is applied and removed the same way as regular polish, but is intended to be longer-lasting.

Pros:

• Quickly and easily removed with an acetone-based nail polish remover. Because acetone can be harsh, drying, and damaging, less contact time may mean less damage to the nail plate, skin, and cuticles.

Cons:

• Some colors, especially darker colors, can cause nonpermanent discoloration of the nails.

The verdict: Dermatologist approved. We do recommend taking intermittent breaks from polish, and keeping nails and cuticles well-moisturized between manicures. Always remove polish before an appointment with your dermatologist so he or she can examine your nails.

“Non-toxic” nail polish

When it comes to cosmetics, the term “non-toxic” can be difficult to decipher. With regard to nail polish, a commonly used term is “five-free.” Five-free refers to polishes that do not contain five specific ingredients: formaldehyde, toluene, dibutyl phthalate, formaldehyde resin, and camphor. There are also brands that market themselves as being free of more substances, such as 7-free or 10-free.

Formaldehyde is a preservative that has been recognized by the National Cancer Institute as a potential cancer-causing substance. It is also among the most common substances that cause allergic contact dermatitis. Formaldehyde resin, dibutyl phthalate, and toluene can also cause allergic contact dermatitis. Camphor is an oil that has been long used as a topical remedy for various conditions, but can be toxic if consumed by mouth.

Studies have shown that chemicals in nail polish can be absorbed into the body. But the exact amount of absorption, and whether it is enough to have negative health effects, are not well established. In general, the question of whether “natural” cosmetic products are safer and healthier still remains, as discussed in an editorial published in JAMA Dermatology.

Pros:

• easy removal process akin to regular polish
• contains fewer chemicals that can cause contact dermatitis; may be a good option for those with sensitive skin.

Cons:

• There is no strong research data regarding whether the chemicals excluded from non-toxic polishes have harmful health effects at the concentrations present in traditional nail polish.

The verdict: This may be a good alternative to conventional polish for those wishing to avoid those particular chemicals, although the health benefits are uncertain.

Gel polish

Gel polish is painted on and then “cured” under a lamp, which dries and hardens the polish almost instantly. Curing of nail polish means photopolymerization, which is a process during which a liquid absorbs energy from UV or visible light and undergoes cross-linking to become a solid. Most curing lamps emit ultraviolet A light, which is a known cause of cellular damage and aging and increases risk of skin cancer. There are some alternative lamps available that emit LED light; however, they may still emit some UV light.

Pros:

• longer lasting

Cons:

• exposure to UV light
• Removal process of gel polish can be destructive to nails. Removal involves soaking in acetone, and aggressive buffing, scraping, and peeling of polish, which can injure the nail plate.
• Wearing gel polish for long periods may result in severe brittleness and dryness of the nails.

The verdict: Gel polish is unlikely to have long-term negative effects on nail health if used sporadically or for special occasions. Remind your nail technician to avoid aggressive buffing (always avoid electric buffing), and not to scrape the nail plate forcefully. Never peel or pick off gel polish; doing so may peel off layers of the nail plate along with the polish, resulting in brittleness. Apply sunscreen 20 minutes prior to the UV treatment, or wear fingerless gloves while under the lamp.

Powder dip polish

This manicure entails application of a bonding polish (composed of a resin that is often made up of chemicals used in superglue) that serves as an adhesive for the polish. Next, a finely milled acrylic powder is applied, either by dipping the nail into the powder or brushing it onto the nail. Finally, an activator is applied. This is a liquid containing chemicals that induce polymerization of the resin-containing bonding polish, leaving a hard shell.

Pros:

• No drying lamp needed, therefore no UV exposure.

Cons:

• Sanitation is the major potential issue here. Communal jars of powder may be used for multiple people, which could become a reservoir for bacteria, fungi, and viruses.
• Harsh removal process similar to that of gel, often with use of an electric file, can damage the nail plate and cuticle.

The verdict: Unless a salon is transferring the powder into smaller, individual containers for each client, or using a clean brush to apply the powder, we recommend avoiding this type of manicure.

Follow us on Twitter @KristinaLiuMD and @JanelleNassim

The post A look at the effects of nail polish on nail health and safety appeared first on Harvard Health Blog.

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According to a new study, the share of children and adolescents consuming sugar-sweetened beverages (SSBs) and the calories they consume from SSBs declined significantly between 2003 and 2014.

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According to a new study, the share of children and adolescents consuming sugar-sweetened beverages (SSBs) and the calories they consume from SSBs declined significantly between 2003 and 2014.

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New research raises questions about hiring algorithms and the tech companies who develop and use them: How unbiased is the automated screening process? How are the algorithms built? And by whom, toward what end, and with what data?

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As your "second brain," the state of your gut has been shown to play an important role in your neurological health. Importantly, studies have shown probiotics (beneficial bacteria) can help decrease pathological hallmarks of Alzheimer's disease (AD), including amyloid plaques and tangles.¹

One of the most impressive of these studies² was published in Frontiers in Aging Neuroscience in 2016. Sixty elderly patients diagnosed with Alzheimer's received either a placebo or a probiotic milk product containing Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum and Lactobacillus fermentum for 12 weeks.

At the beginning and end of the study, participants underwent a standardized cognitive assessment and a highly sensitive c-reactive protein test, which is a powerful marker of inflammation. As reported by neurologist Dr. David Perlmutter:³

"The results of the study were stunning. The placebo group showed an increase in hs-CRP, the inflammation marker, by an impressive 45 percent. In the group taking the probiotic, on the other hand, hs-CRP … declined by 18 percent, indicating a dramatic reduction in inflammation.

But here's the truly exciting news. Over the 12 weeks, the patients in the placebo continued to decline mentally, as you might expect … But the group on the inflammation reducing probiotics actually demonstrated … improvement, with their MMSE [mini mental state examination] scores going from 8.67 up to 10.57, and that's a huge improvement.

Again, not only was their mental decline stopped in its tracks, these individuals regained brain function! The message here is that inflammation is directly determined by the health and diversity of our gut bacteria, and this has major implications in terms of brain health, function, and disease resistance."

Your Gut and Brain Are Linked

Since then, several other studies have been published, showing probiotics can help improve cognitive function and ward off dementia, including Alzheimer's. While this may seem all too simple to be true, it makes perfect sense when you consider the deep connections that exist between your gut and your brain. As explained by Harvard Health:⁴

"Research shows that the gut and brain are connected, a partnership called the gut-brain axis. The two are linked through biochemical signaling between the nervous system in the digestive tract, called the enteric nervous system, and the central nervous system, which includes the brain.

The primary information connection between the brain and gut is the vagus nerve, the longest nerve in the body. The gut has been called a 'second brain' because it produces many of the same neurotransmitters as the brain does … What affects the gut often affects the brain and vice versa.

When your brain senses trouble—the fight-or-flight response—it sends warning signals to the gut, which is why stressful events can cause digestive problems like a nervous or upset stomach. On the flip side, flares of gastrointestinal issues like irritable bowel syndrome (IBS), Crohn's disease, or chronic constipation may trigger anxiety or depression."

Probiotic Prevents Amyloid-Beta-Induced Dysfunction

According to a 2017 study⁵ in Scientific Reports, the Bifidobacterium breve strain A1 may be of particular use in Alzheimer's treatment. Using Alzheimer's disease model mice, the researchers were able to confirm that daily oral administration of B. breve A1 reduced the cognitive dysfunction normally induced by amyloid beta. According to the authors:

"We also demonstrated that non-viable components of the bacterium or its metabolite acetate partially ameliorated the cognitive decline observed in AD mice.

Gene profiling analysis revealed that the consumption of B. breve A1 suppressed the hippocampal expressions of inflammation and immune-reactive genes that are induced by amyloid-β. Together, these findings suggest that B. breve A1 has therapeutic potential for preventing cognitive impairment in AD."

One of the mechanisms behind these protective effects was found to be suppression of amyloid-beta-induced changes in gene expression in the hippocampus. In short, the bacterium had an ameliorating effect on amyloid-beta toxicity.

Interestingly, B. breve A1 did not actually alter the composition of the animals' gut microbiota to any significant degree; rather, many of the benefits appear to be related to significantly raised blood levels of acetate, a byproduct of fermentation by gut bacteria. As explained by the authors:⁶

"One of the main functions of gut microbiota is the fermentation of dietary fibers in the gut and produce short-chain fatty acids (SCFAs), mainly acetate, propionate, and butyrate, which are the major end products of carbohydrate metabolism in Bifidobacteria."

When looking at SCFA levels in the animals' blood, the mice treated with B. breve A1 had significantly higher levels of acetate, but not propionate or butyrate, compared to controls.

Other microbiota-derived SCFAs may also play a role, however. A 2019 study⁷ found that rats given both probiotics and prebiotics performed significantly better on spatial memory tests, and this improvement was attributed to increased levels of brain-derived neurotrophic factor (BDNF).

Butyrate — a SCFA produced when gut bacteria ferment fiber — activates the secretion of BDNF. According to the authors, the improvement also correlated with "decreased levels of pro-inflammatory cytokines and better electrophysiological outcomes in the hippocampi."

This led them to conclude that "the results indicated that the progression of cognitive impairment is indeed affected by changes in microbiota induced by probiotics and prebiotics."

Probiotics Have Preventive and Therapeutic Potential for AD

The 2018 paper,⁸ "Probiotics for Preventing Cognitive Impairment in Alzheimer's Disease," points out that probiotics can inhibit the progression of neurodegeneration by:

• Modulating the inflammatory process⁹
• Counteracting oxidative stress¹⁰
• Modulating CNS functions mediated by bacteria-derived metabolites such as short-chain fatty acids¹¹
• Ameliorating pathogenesis via alteration of gut microbiota composition¹²

Inflammation and oxidative stress modulation are primarily accomplished through the gut microbiota's effects on your gut-brain axis, which in addition to your central nervous system (CNS) and enteric nervous system (ENS) also includes your autonomic nervous system, neuroendocrine system and immune system.¹³

These in turn are connected to various pathways involved in the regulation of immune function and metabolic homeostasis. These pathways include your vagus nerve and hypothalamic-pituitary adrenal pathway. According to "Probiotics for Preventing Cognitive Impairment in Alzheimer's Disease:"¹⁴

"Accumulating evidence suggests that gut microbiota alterations can influence the progression of neurological disease and may be a major factor in the development of AD.

For instance, a recent preclinical study revealed a remarkable shift in the gut microbiota of APP transgenic mice as compared to healthy, wild-type mice … It was strongly advocated that a distinct microbial constitution in AD mice may contribute to amyloid deposition …

In addition, a clinical study characterizing the gut microbiota composition of AD subjects reveals decreased microbial diversity and changes in bacterial abundance compared with controls; these changes include decreased levels of Firmicutes and Bifidobacterium and increased levels of Bacteroidetes."

The researchers speculate that gut microbiome alterations allowing for the colonization of pathogens that increase gut permeability can perturb the gut-brain axis, thereby raising your risk of Alzheimer's. They cite research¹⁵ in which Enterobacteria infection was found to exacerbate the progression of Alzheimer's as an example of this theory.

Immune Activation and Systemic Inflammation in AD

Many studies have suggested immune activation and low grade systemic and intestinal inflammation are important factors in Alzheimer's, which can help explain why probiotics appear so beneficial. As noted in a 2018 publication:¹⁶

"… several different fecal and serum inflammation markers in correlation to intestinal bacterial strains were investigated in our recent study on the role of gut microbiota in patients with cognitive decline …

From a subgroup of 23 patients … out of 55 consecutive outpatients with symptoms of cognitive decline, intestinal bacterial taxa and immune system as well as inflammation biomarkers in serum and stool specimens were investigated.

Confirming our earlier findings … signs of immune activation could be detected … Most interestingly, a close correlation was found between fecal S100A12 and serum neopterin … indicating coincident low grade systemic and intestinal inflammation …  

There was no influence of gender. These findings again underline the role of gut inflammation as a possible pathogenic cofactor in cognitive deterioration and dementia. In an earlier study … the potential role of pro-inflammatory … proteins in the pathogenesis of AD was described.

Circulating CRP, known to affect cognition negatively, was elevated in our series without clinical signs of acute infection … further indicating low grade inflammation … in this group of patients. We found pro-inflammatory Clostridium Cluster I significantly correlated with anti-inflammatory Faecalibacterium prausnitzii.

In a recent paper … the stool abundance of selected bacterial stool taxa including F. prausnitzii and the blood levels of pro- and anti-inflammatory cytokines in cognitively impaired patients and in a group of controls was measured.

Amyloid positive patients showed higher levels of pro-inflammatory cytokines compared with both controls and with amyloid negative patients. A possible causal relation between gut microbiota related inflammation and amyloidosis was suspected in this study …

All these findings together may indicate changes in the microbiota-gut-brain-axis correlated to neuroinflammation during cognitive decline. Because neuroinflammation is an early event in the pathogenesis of dementia, these markers may be important in the very beginning of this devastating process."

The authors speculate that the increase in immune activation and inflammation seen in Alzheimer's patients may be due to changes in microbiota that tends to occur with age.

They also note that "the role of probiotics in preventing dementia seems promising" and that further studies should be done to further tease out the exact mechanisms by which probiotics protect against neurodegeneration.

Alzheimer's Prevention and Treatment Beyond Probiotics

While optimizing your gut microbiome is an important part of Alzheimer's prevention and treatment, it needs to be part of a more comprehensive plan. Dr. Dale Bredesen, director of neurodegenerative disease research at the UCLA School of Medicine, discusses treatment alternatives in his book, "The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline."

Bredesen has identified dozens of variables that can have a significant influence on Alzheimer's, and developed a treatment program based on those findings, called ReCODE.

In 2014, Bredesen published a paper detailing how leveraging 36 healthy lifestyle parameters reversed Alzheimer's in 9 of 10 patients. This included the use of exercise, ketogenic diet, optimizing vitamin D and other hormones, increasing sleep, meditation, detoxification and eliminating gluten and processed food. You can download Bredesen's full-text case paper online, which details his program.¹⁷

You can also find helpful guidance in my previous article, “Top Environmental Risk Factors for Dementia Identified.” As the prevalence of Alzheimer’s disease continues to climb, it’s important to realize that this disease is primarily driven by preventable lifestyle factors, and that conventional drug treatments are ineffective — or worse.

As noted in a December 2018 article¹⁸ by Perlmutter, the largest class of medications prescribed for Alzheimer’s, called cholinesterase inhibitors, which break down acetylcholine, have actually been shown¹⁹ to accelerate cognitive decline! This, clearly, is the last thing you want, which means making lifestyle changes are all the more important, and the earlier you make them, the better.

As for how to nourish your gut microbiome, your best bet is to make your own fermented vegetables, which will provide plenty of beneficial bacteria for a fraction of the cost of a supplement. Instructions and helpful tips can be found in “Tips for Fermenting at Home.”

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Anxiety disorders represent the most common mental illness in the U.S., with 40 million U.S. adults affected.¹ Meanwhile, one-third of U.S. adults usually do not get enough sleep² — a factor that can make mental health, including anxiety, worse.

It may seem overly simplistic, or even cliché, to suggest that getting proper sleep could help relieve the sometimes-debilitating effects of anxiety, but research continues to show that the connection is not only relevant but significant. In fact, if you struggle with anxiety, tending to your sleep should be a primary part of your treatment plan.

'Overanxious and Underslept' — Poor Sleep Affects Anxiety

Writing in the journal Nature Human Behaviour, researchers with the University of California (UC), Berkeley, delved into the connections between sleep and anxiety, finding many strong links. In their study, "Overanxious and Underslept," it's noted:³

"Here, we investigate the basic brain mechanisms underlying the anxiogenic [anxiety-causing] impact of sleep loss. Additionally, we explore whether subtle, societally common reductions in sleep trigger elevated next-day anxiety. Finally, we examine what it is about sleep, physiologically, that provides such an overnight anxiety-reduction benefit."

For the first part of the study, brain scans were conducted on 18 young adults as they watched emotional videos, both after a good night's rest and a sleepless night.

Questionnaires were used to gauge anxiety levels in the study participants, while the brain scans revealed that lack of sleep dampened activity in the medial prefrontal cortex (mPFC), a brain area known to help quell anxiety, and amped up emotional centers.⁴

Meanwhile, those who slept well demonstrated notable declines in anxiety, with slow wave nonrapid eye movement (NREM) sleep appearing particularly beneficial. It's during slow-wave NREM deep sleep that neural oscillations become synchronized and heart rate and blood pressure drop.

"Deep sleep had restored the brain's prefrontal mechanism that regulates our emotions, lowering emotional and physiological reactivity and preventing the escalation of anxiety," Eti Ben Simon, the study's lead author, said in a news release.⁵

The results were confirmed in a second set of experiments involving another 30 people, and an online survey of 280 people, which asked questions about sleep and anxiety levels over a period of four consecutive days, and further revealed that even minor sleep disruptions could affect anxiety.

"Of societal relevance," the researchers wrote, "we establish that even modest night-to-night reductions in sleep across the population predict consequential day-to-day increases in anxiety."⁶

Deep Sleep Inhibits Anxiety

If you've ever had a poor night's rest, you're probably familiar with the heightened emotional state it can contribute to the following day. The featured study revealed one reason for this may be due to the anxiety-relieving effects of deep sleep. Speaking with UC Berkeley News, senior study author Matthew Walker, a UC Berkeley professor of neuroscience and psychology, explained:⁷

"We have identified a new function of deep sleep, one that decreases anxiety overnight by reorganizing connections in the brain … Deep sleep seems to be a natural anxiolytic (anxiety inhibitor), so long as we get it each and every night."

Lack of sleep could increase anxiety levels by up to 30%, the study found, with Walker noting, "Without sleep, it's almost as if the brain is too heavy on the emotional accelerator pedal, without enough brake."⁸ If you regularly feel emotionally off-kilter, too little sleep could be to blame. In a separate study, Walker and colleagues revealed that sleep deprivation fuels feelings of loneliness, for instance.⁹

In short, the more sleep-deprived you are, the less social you become, and others pick up on this largely subconscious cue to be left alone, essentially turning people into "social lepers" and fueling an epidemic of loneliness, as Walker put it.¹⁰

Lack of Sleep Can Make You Rude

A short temper and unwanted behaviors such as rudeness can also be the result of a poor night's rest. Research conducted by Laura M. Giurge from Rotterdam School of Management, Erasmus University in the Netherlands, found that even one night of too little sleep may lead to unwanted behavior at work the next day.¹¹

Giurge conducted the study by sending out text messages to employees, who rated their sleep quality and reported on unwanted behaviors at work, such as acting rude toward co-workers, going home early without notifying their boss or taking a longer lunch break than allowed.

Sleep quality was found to influence behavior at work the next day, especially in people with a low "moral identity." These people put less value on moral traits like fairness and kindness overall, and were also more likely to engage in unwanted behaviors at work after a night of poor sleep.

" … [D]isplay of unwanted behavior is not a fixed character trait," said Giurge, adding that such behaviors can vary from day to day. Poor sleep may make it harder for people to stop engaging in such behaviors, as well as to overcome feelings of failure when displaying the undesirable behaviors. In turn, Giurge said, "This can lead into a possibly destructive cycle."¹²

It could be that poor sleep lessens a person's self-control, which in turn increases the rate of selfish impulses leading to unwanted behaviors — even workplace theft.¹³ According to the Rotterdam School of Management, employees' "misbehaving" at work adds up to the tune of $200 billion a year in the U.S. alone.¹⁴

Sleeplessness May Shorten Your Life

In the video above, you can view Walker, who also wrote the book "Why We Sleep: The New Science of Sleep and Dreams," share reasons why lack of sleep is easily one of the greatest public health challenges, one that is causing premature death and disability.

I read Walker's book and strongly agree that sleep is profoundly important — perhaps even more so than diet and exercise. There are practical consequences to too little sleep, such as an increased risk of motor vehicle accidents and falls, and sleeplessness has also been shown to contribute to chronic illnesses such as dementia, including Alzheimer's disease, cancer, diabetes, heart disease and obesity.

As for its effects on your brain, lack of sleep heightens anxiety and may contribute to depression. It's also known to affect areas of the brain involved with concentration and problem-solving, making them sluggish.¹⁵

Further, in one animal study, sleep-deprived mice lost neurons located in their locus coeruleus, a nucleus in the brainstem associated with wakefulness and cognitive processes.¹⁶ The research also showed that "catching up" on sleep on the weekend will not prevent this damage.

In the video, Walker further highlighted sleep's connections to mental health, stating, "We are now finding significant links between sleep disruption and depression, anxiety (including post-traumatic stress disorder), schizophrenia and, tragically, suicide as well. In fact, we cannot find a single psychiatric condition in which [the subject's] sleep is normal." He also cites the following brain-related effects from lack of sleep:

• Due to your hippocampus shutting down, you will experience a 40% deficit in your brain with respect to its ability to make new memories
• Your emotional and mental health become destabilized because the emotional circuits in your brain become hyperactive and irrational due to lack of sleep
• Your amygdala, one of your brain's centerpiece regions for generating strong emotional reactions, including negative ones, becomes about 60% more reactive than usual, resulting in increased emotional intensity and volatility

Sleeping Your Way to Better Mental Health

Making sleep a priority is the first step to better mental health. It's truly a necessity, not a luxury, and if you struggle with anxiety, sleeping for a solid eight hours or so could make a major difference in your quality of life. If racing thoughts are problematic and you find yourself in bed unable to shut them off, try keeping a journal nearby and writing down the thoughts as they come.

Paying attention to sleep hygiene — items like darkness and proper temperature in your bedroom and shutting off electronics early — is also important. For instance, avoiding exposure to blue light, including LEDs, after sunset can help you get a good night's rest and is easily achievable by wearing blue-blocking glasses after sunset.

If you need help improving your sleep hygiene, check out my "33 Secrets to a Good Night's Sleep" for tips to help you fall asleep and stay asleep all night. In the short term, natural sleep remedies, such as melatonin, valerian root, chamomile, cannabidiol (CBD) oil and 5-hydroxytryptophan (5-HTP) can also be helpful.

However, stay away from prescription sleep aids including benzodiazepines (Valium, Ativan) and "Z-drugs" (Ambien, Sonata, Lunesta), which are associated with an increased risk of hip fracture, one of the most serious fall injuries, in older adults¹⁷ along with other health risks.

Got Anxiety? Natural Strategies May Help

While sleep is emerging as an essential tool in the fight against anxiety, it's only one component of a comprehensive treatment plan.

There are many natural strategies that can help, including lavender aromatherapy, which has a calming effect. "Several animal and human investigations suggest anxiolytic [anxiety reducing], mood stabilizer, sedative, analgesic and anticonvulsive and neuroprotective properties for lavender," researchers explained.¹⁸

What's more, lavender is also an effective sleep aid. One study showed orally administered lavender oil is effective in the treatment of subsyndromal (or preclinical) anxiety disorder, improving sleep quality and duration along with general mental and physical health, without causing any unwanted sedative or other side effects, making it doubly useful.¹⁹

Anxiety is a normal response to stress, but in some people the anxiety becomes overwhelming and difficult to cope with, to the point that it affects their day-to-day living.

Another strategy for dealing with this is to reframe anxiety as excitement — an emotion that's not that different from anxiety, although it's generally regarded as a positive emotion instead of a negative one, like anxiety. Harvard Business School professor Alison Wood Brooks conducted a series of experiments in 2014 to evaluate reappraising anxiety as excitement, writing in the Journal of Experimental Psychology:²⁰

"Compared with those who attempt to calm down, individuals who reappraise their anxious arousal as excitement feel more excited and perform better.

Individuals can reappraise anxiety as excitement using minimal strategies such as self-talk (e.g., saying 'I am excited' out loud) or simple messages (e.g., 'get excited'), which lead them to feel more excited, adopt an opportunity mind-set (as opposed to a threat mind-set), and improve their subsequent performance."

Using a combination of natural tools, along with tending to your body's sleep needs, may resolve anxiety for many people. However, if your anxiety is so severe that it's interfering with your daily life, speak with a holistic health care provider who can help you develop a comprehensive plan for healing.

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