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By, Dr. Payal Chaudhary, Senior Consultant, Obstetrics and Gynaecology, Rosewalk Healthcare

Thyroid gland is a small organ in the front of your neck that produces hormones that regulate your body’s metabolism and affect vital functions. The relationship between your thyroid health and fertility is an important and sometimes complex part of conception. Thyroid disorders refer to a group of disorders that cause dysregulated functioning of the thyroid gland, resulting in the overproduction (hyperthyroidism) or underproduction (hypothyroidism) of thyroid hormones, triiodothyronine (T3), and thyroxine (T4).

Thyroid disorders are known to affect a person’s body in a number of ways. A undiagnosed thyroid condition can sometimes hamper fertility of a man or woman. It can also cause problems during pregnancy. That is the reason that once a diagnosis of hyperthyroidism (excessive production of thyroid hormone and low TSH value) or hypothyroidism (low thyroid hormones in the blood stream and high TSH value) is made, if a person is planning on pregnancy he or she should seek treatment for the same. Once the over- or underactive thyroid is under control, however, there is no reason why you should not have a successful pregnancy and a healthy baby. Sometimes, the thyroid hormone values may be in the normal range but body may form auto antibodies against thyroid gland and that can also impact fertility.

Hyperthyroidism is condition of excess thyroid hormone production and the most common cause of an overactive thyroid is Graves’ disease. If it is untreated you may irregularity in your periods and the flow may be reduced too. This may lead to difficulty in conception. This happens due to abnormal TSH values hampering ovulation and implantation of the baby to the mother’s uterus lining. After treatment, if you are planning to get pregnant then you should get your thyroid function test done prior to embarking on trial for pregnancy. Fertility can actually return rapidly once thyroid is under control.

If you are pregnant and have (or have had) Graves’ disease it is important to tell your obstetrician about your medical history. Even if your thyroid function has returned to normal and even if you are now taking medication for an underactive thyroid(which can appear after a phase of overactive thyroid), you may still have Graves’ antibodies in your blood and these could affect you and your baby during or after your pregnancy. You should also inform your treating doctor that you are pregnant as soon as possible. Thyroid hormone levels need monitoring throughout pregnancy especially if you are on medication.

In men, hyperthyroidism can cause a marked reduction in sperm count, resulting in reduced fertility. The sperm count usually returns to normal once the thyroid condition has been treated. If treatment is started in the form of thyroid medication, it becomes safe to plan a pregnancy.

Certain changes made in day to day life can help in thyroid gland regulation. Dietary changes include avoiding processed food and artificial additives to the diet. Regular exercise also helps. There are some studies recently in literature, which also highlight the role of Vitamin D supplement especially if you are deficient and also adding Selenium rich foods to diet which includes fruits and nuts.

A more mystical and insightful psychedelic drug experience, according to a new study, may be linked to a long-term reduction in anxiety and depression symptoms. The study was recently published online in the Journal of Affective Disorders. The data from nearly 1,000 survey respondents about their previous non-clinical experiences with psychedelic drugs was analysed using machine learning. People who scored the highest on questionnaires assessing the mystical and insightful nature of their experiences reported consistent improvements in their anxiety and depression symptoms, according to the findings.

The analysis also suggests that a difficult experience while using these substances, one that feels frightening or destabilising, can be beneficial, particularly in the context of mystical and insightful experiences. This could be useful for practitioners as they guide patients through clinical trials testing the therapeutic potential of psychedelics.

“Sometimes the challenge arises because it’s an intensely mystical and insightful experience that can, in and of itself, be challenging,” said senior author Alan Davis, assistant professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work.

“In the clinical research setting, folks are doing everything they can to create a safe and supportive environment. But when challenges do come up, it’s important to better understand that challenging experiences can actually be related to positive outcomes.”

The study is the first to identify and link subtypes of subjective psychedelic experiences to mental health outcomes. The data came from previous research Davis led, which included an anonymous internet-based survey of people who reported having a moderate to strong psychedelic experience in the past and the resulting changes in their anxiety and depression symptoms – regardless of the level of those symptoms prior to the psychedelic experience.

The 985 participants whose responses were analysed in this study described substances they had used and filled out questionnaires assessing how mystical (evoking a sense of pure awareness, positive mood, and/or transcendence of time and space that is difficult to describe in words), psychologically insightful (eliciting acute insight into memories, emotions, relationships, behaviours, or beliefs) or challenging their psychedelic experience was. The survey measured depression and anxiety symptom levels, as well as ratings of life satisfaction and psychological flexibility – one’s ability to act in ways that are consistent with their values regardless of any internal or external experience – before and after using the psychedelic.

Users of psilocybin (magic mushrooms), LSD, Ayahuasca, mescaline, peyote cactus, and 5-MeO-DMT, the natural psychedelic substance found in the venom of the Colorado River toad, were included in the study, along with the estimated dose level of the single drug use they recalled.

The data analysis revealed three distinct psychedelic experience subtypes:

• High score, combining high mystical and insightful assessment scores with moderate challenging assessment scores.
• Low to moderate scores on mystical and insightful experiences, as well as low scores on the challenging scale.
• Positive evaluation, with high marks for mystical and insightful experiences and low marks for the difficult assessment.

“The group that had the highest insightful and mystical experiences and low challenging experiences showed the most benefit in terms of remission of anxiety and depression symptoms and other longer lasting benefits to their life,” said first author Aki Nikolaidis, an affiliate of Ohio State’s Center for Psychedelic Drug Research and Education (CPDRE) and a research scientist in the Center for the Developing Brain at the Child Mind Institute.

When the researchers analysed only data from participants who had used psilocybin and LSD, the same patterns emerged: three distinct subtypes that were associated with the same outcomes, including mental health benefits even after a difficult experience. According to Nikolaidis, this replication demonstrates the importance of subjective experience for psychedelic users.

“Identifying subtypes that exist regardless of which psychedelic you take answers an interesting question,” he said. “But the fact that we found that they’re associated with specific outcomes, and replicated that finding, really shows why it’s important to understand the powerful nature of what is happening subjectively and its potential to yield a beneficial outcome.”

A few other trends stood out: Participants in the positive scoring group, whose experience could be considered optimal (high scores on mysticism and insight and low scores on challenges), were younger than those in the other groups. There was a higher proportion of people who had taken large doses of psychedelic drugs among those who scored highest on challenging experiences. Furthermore, the low-scoring subtype had lower psychological flexibility, anxiety, and depression scores prior to the psychedelic experience, as well as lower improvements in those symptoms and life satisfaction than the other two subtypes.

Davis said he’ll be interested to see if these subtypes of experiences are applicable in the clinical setting, where psilocybin-assisted therapy is being studied at Ohio State for the treatment of post-traumatic stress disorder in military veterans.

“Finding the variety of other outcomes that these subtypes might be related to is an interesting next step,” he said. “These could include adaptive or functional outcomes in people’s quality of life or well-being, or a better understanding of their life’s purpose or relationships.”

Fasting, according to a recent study from the Icahn School of Medicine at Mount Sinai, may make it more difficult to fight infections and increase your risk of developing heart disease. The study, which used mouse models, is one of the first to show that skipping meals causes the brain to react in a way that damages immune cells. The findings, which focus on breakfast, were published in the journal Immunity and may help researchers better understand how long-term fasting affects the body.

“There is a growing awareness that fasting is healthy, and there is indeed abundant evidence for the benefits of fasting. Our study provides a word of caution as it suggests that there may also be a cost to fasting that carries a health risk,” said lead author Filip Swirski, PhD, Director of the Cardiovascular Research Institute at Icahn Mount Sinai, adding, “This is a mechanistic study delving into some of the fundamental biology relevant to fasting. The study shows that there is a conversation between the nervous and immune systems.”

Researchers wanted to learn more about how fasting affects the immune system, from a short fast of a few hours to a longer fast of 24 hours. They looked at two groups of mice. The first group ate breakfast immediately after waking up (breakfast is their largest meal of the day), while the second group did not. Blood samples were taken from both groups of mice when they awoke (baseline), four hours later, and eight hours later.

When researchers examined the blood work, they noticed a distinct difference in the fasting group. The researchers noticed a difference in the number of monocytes, which are white blood cells that are produced in the bone marrow and travel throughout the body, where they play a variety of important roles ranging from fighting infections to heart disease to cancer.

All mice had the same number of monocytes at the start. Monocytes in mice from the fasting group, on the other hand, were significantly affected after four hours. Researchers discovered that 90% of these cells vanished from the bloodstream after eight hours, and the number continued to decline. Monocytes in the non-fasting group, on the other hand, were unaffected.

Researchers discovered that in fasting mice, monocytes returned to the bone marrow to hibernate. Concurrently, the bone marrow’s ability to produce new cells decreased. Monocytes in the bone marrow, which have a short lifespan, changed dramatically. They lived longer because they remained in the bone marrow and aged differently than monocytes that remained in the blood.

The researchers fasted the mice for up to 24 hours before reintroducing food. Within a few hours, the cells that had been hiding in the bone marrow were released into the bloodstream. This surge resulted in increased inflammation. Instead of protecting the body from infection, these altered monocytes were more inflammatory, making it less resistant to infection.

This is one of the first studies to establish a link between the brain and these immune cells while fasting. The researchers discovered that specific brain regions controlled the monocyte response during fasting. Fasting causes a stress response in the brain, which is what causes people to feel “hangry” (hungry and angry), and this immediately causes a large-scale migration of these white blood cells from the blood to the bone marrow, and then back to the bloodstream shortly after food is reintroduced.

While there is evidence of the metabolic benefits of fasting, Dr. Swirski emphasises that this new study is a useful advance in the full understanding of the body’s mechanisms.

“The study shows that, on the one hand, fasting reduces the number of circulating monocytes, which one might think is a good thing, as these cells are important components of inflammation. On the other hand, the reintroduction of food creates a surge of monocytes flooding back into the blood, which can be problematic. Fasting, therefore regulates this pool in ways that are not always beneficial to the body’s capacity to respond to a challenge such as an infection,” said Dr. Swirski, adding, “Because these cells are so important to other diseases like heart disease or cancer, understanding how their function is controlled is critical.”

Dementia is a major global public health hazard that currently affects 50 million people and is expected to impact more than 150 million people by 2050. Obesity, as measured by the body mass index, is a persistent global issue (BMI). Obesity in middle age has been linked to an increased risk of dementia in previous studies. However, it is yet uncertain if BMI and dementia risk are linked.

Researchers from Boston University Chobanian & Avedisian School of Medicine and the Chinese Academy of Medical Sciences & Peking Union Medical College have shown that various patterns of BMI changes during a person’s life cycle may be a predictor of dementia risk.

“These findings are important because previous studies that looked at weight trajectories didn’t consider how patterns of weight gain/stability/loss might help signal that dementia is potentially imminent,” explained corresponding author Rhoda Au, PhD, professor of anatomy and neurobiology.

“These findings are important because previous studies that looked at weight trajectories didn’t consider how patterns of weight gain/stability/loss might help signal that dementia is potentially imminent,” explained corresponding author Rhoda Au, PhD, professor of anatomy and neurobiology.

A set of individuals in the Framingham Heart Study were tracked for 39 years and their weight was assessed every 2-4 years. The researchers studied distinct weight trends (stable, growth, loss) between people who became demented and those who did not. They discovered that the general trend of decreased BMI was linked to an increased chance of getting dementia.

Further investigation revealed a subgroup with a trend of first increasing BMI followed by dropping BMI, both happening within midlife, which looked to be key to the declining BMI-dementia connection.
Weight monitoring is generally simple for people, family members, and primary care providers, according to Au.

“If after a steady increase in weight that is common as one gets older, there is an unexpected shift to losing weight post midlife, it might be good to consult with one’s healthcare provider and pinpoint why. There are some potential treatments emerging where early detection might be critical in the effectiveness of any of these treatments as they are approved and become available,” she added.

The researchers hope this study will illustrate that the seeds for dementia risk are being sowed across many years, likely even across the entire lifespan. “Dementia is not necessarily inevitable and monitoring risk indicators such as something as easy to notice as weight patterns, might offer opportunities for early intervention that can change the trajectory of disease onset and progression.”

According to a large study published in The BMJ, most symptoms or diseases that occur after a mild Covid-19 infection last several months but return to normal within a year.

When compared to unvaccinated people, vaccinated people were at a lower risk of developing breathing difficulties, the most common side effect of mild infection. According to the researchers, while the long covid phenomenon has been feared and discussed since the beginning of the pandemic, the vast majority of mild disease cases do not suffer from serious or chronic long term illness.

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Study reveals most long covid symptoms resolve within a year after mild infection

ANI | Updated: Jan 12, 2023 23:54 IST

Washington [US], January 12 (ANI): According to a comprehensive study published in The BMJ, most symptoms or diseases that occur after mild Covid-19 infection last for several months but recover to normal within a year.

In particular, vaccinated people were at lower risk of breathing difficulties – the most common effect to develop after mild infection – compared with unvaccinated people. These findings suggest that, although the long covid phenomenon has been feared and discussed since the beginning of the pandemic, the vast majority of mild disease cases do not suffer serious or chronic long term illness, say the researchers.

Long covid is defined as symptoms persisting or new symptoms appearing more than four weeks after initial infection. In March 2022, an estimated 1.5 million people in the UK (2.4 pc of the population) reported long covid symptoms, mainly fatigue, shortness of breath, loss of smell, loss of taste, and difficulty concentrating.

But the clinical effects of long covid one year after mild infection and their association with age, sex, covid-19 variants, and vaccination status are still unclear.

To address this, researchers compared the health of uninfected individuals with those who had recovered from mild covid-19 for a year after infection.

They used electronic records of a large public healthcare organisation in Israel, in which almost 2 million members were tested for covid-19 between 1 March 2020 and 1 October 2021. Over 70 long covid conditions were analysed in a group of infected and matched uninfected members (average age 25 years; 51% female).

They compared conditions in unvaccinated people, with and without covid-19 infection, controlling for age, sex and covid-19 variants, during early (30-180 days) and late (180-360 days) time periods after infection. Conditions in vaccinated versus unvaccinated people with covid-19 were also compared over the same time periods.

To ensure only mild disease was assessed, they excluded patients admitted to hospital with more serious illness. Other potentially influential factors, such as alcohol intake, smoking status, socioeconomic level, and a range of pre-existing chronic conditions were also taken into account.

Covid-19 infection was significantly associated with increased risks of several conditions including loss of smell and taste, concentration and memory impairment, breathing difficulties, weakness, palpitations, streptococcal tonsillitis and dizziness in both early and late time periods, while hair loss, chest pain, cough, muscle aches and pains and respiratory disorders resolved in the late period.

For example, compared with non-infected people, mild covid-19 infection was associated with a 4.5-fold higher risk of smell and taste loss (an additional 20 people per 10,000) in the early period and an almost 3-fold higher risk (11 per 10,000 people) in the late period.

The overall burden of conditions after infection across the 12-month study period was highest for weakness (an additional 136 people per 10,000) and breathing difficulties (107 per 10,000).

When conditions were assessed by age, breathing difficulties were the most common, appearing in five of the six age groups but remaining persistent throughout the first year post-infection in the 19-40, 41-60, and over 60 years age groups.

Weakness appeared in four of the six age groups and remained persistent in the late phase only in the 19-40 and 41-60 age groups.

Male and female patients showed minor differences, and children had fewer outcomes than adults during the early phase of covid-19, which mostly resolved in the late period. Findings were similar across the wild-type, Alpha and Delta covid-19 variants.

Vaccinated people who became infected had a lower risk of breathing difficulties and similar risk for other conditions compared with unvaccinated infected patients.

The researchers point to some limitations, such as incomplete measurement within medical records, so data might not fully reflect diagnoses and outcomes reported. And they can’t rule out the possibility that covid-19 patients may use healthcare services more frequently, resulting in higher reporting and increased screening for potential covid-related outcomes in these patients.

Nevertheless, this was a large detailed analysis of health records across a diverse population, representing one of the longest follow-up studies in patients with mild covid-19 to date. And findings should apply to similar western populations worldwide.

“Our study suggests that mild covid-19 patients are at risk for a small number of health outcomes and most of them are resolved within a year from diagnosis,” say the researchers.

• “Importantly, the risk for lingering dyspnoea was reduced in vaccinated patients with breakthrough infection compared with unvaccinated people, while risks of all other outcomes were comparable,” they add.

While increasing physical activity, eating better, and meeting new people are all excellent habits, new CU Boulder study shows that gardening can have a substantial impact. The first-ever, randomised, controlled trial of community gardening, funded by the American Cancer Society, discovered that people who began gardening ate more fibre and got more physical activity—two recognised strategies to lessen the risk of cancer and chronic illnesses. They also saw a considerable reduction in tension and anxiety. The findings were reported in the Lancet Planetary Health journal.

“These findings provide concrete evidence that community gardening could play an important role in preventing cancer, chronic diseases, and mental health disorders,” said senior author Jill Litt, a professor in the Department of Environmental Studies at CU Boulder.

Filling a research need Litt has devoted most of her career looking for low-cost, scalable, and long-term approaches to minimise illness risk, particularly in low-income populations. Gardening seemed like a good place to start. “No matter where you go, people say there’s just something about gardening that makes them feel better,” said Litt, who is also a researcher with the Barcelona Institute for Global Health.

But solid science on its benefits is hard to come by. Without evidence, it’s hard to get support for new programs, she said.
Some modest observational studies have discovered that gardeners consume more fruits and vegetables and maintain a better weight. However, it has been unclear whether healthy people just plant more or whether gardening impacts health.
Only three studies have used the randomised controlled trial, the highest standard of scientific research, to investigate the pastime. None have explicitly examined communal gardening.

Litt recruited 291 non-gardening people from the Denver region, with an average age of 41. More than one-third were Hispanic, and more than half were from low-income families. After the final spring frost, half of the participants were assigned to the communal gardening group, while the other half were assigned to a control group that was instructed to wait one year before beginning gardening.

Through the nonprofit Denver Urban Gardens programme and a research partner, the gardening club got a free community garden plot, seeds and seedlings, and an introductory gardening workshop.
Both groups completed surveys about their food consumption and mental health, had their bodies measured, and wore activity trackers on a regular basis.

An increase in fibre
By the autumn, individuals in the gardening group were consuming 1.4 grammes more fibre per day than the control group, a 7% increase. The authors highlight that fibre has a significant impact on inflammatory and immunological responses, impacting everything from how we metabolise food to the health of our gut flora to our susceptibility to diabetes and certain malignancies.

The average adult consumes less than 16 grammes of fibre per day, despite doctors’ recommendations of 25 to 38 grammes.
“An increase of one gramme of fibre can have huge, good benefits on health,” said co-author James Hebert, director of the cancer prevention and control programme at the University of South Carolina. The gardening group also increased their weekly physical activity by roughly 42 minutes. Public health organisations suggest at least 150 minutes of physical exercise each week, which only one-quarter of the US population meets. Participants satisfied 28% of the criteria by visiting the community garden two to three times each week.

Many DUG participants reside in places where access to inexpensive fresh fruits and vegetables is otherwise severely restricted. Some are low-income immigrants who now live in flats; having a garden plot helps them to cultivate food from their native country and pass on traditional recipes to their family and neighbours.
The social link is also enormous.

“Even if you come to the garden looking to grow your food on your own in a quiet place, you start to look at your neighbour’s plot and share techniques and recipes, and over time relationships bloom,” said Litt, noting that while gardening alone is good for you, gardening in the community may have additional benefits. “It’s not just about the fruits and vegetables. It’s also about being in a natural space outdoors together with others.”

Litt said she hopes the findings will encourage health professionals, policymakers and land planners to look to community gardens, and other spaces that encourage people to come together in nature, as a vital part of the public health system. The evidence is clear, she said.

Strokes are a major source of morbidity and mortality in the United States and around the world. A number of environmental and biological factors have been identified as influencing stroke risk and outcome.

A new study sponsored by Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, examined the cerebral blood flow (CBF) modulation of stroke patients. The researchers discovered that cerebral autoregulation (CA), one of the fundamental processes for maintaining adequate blood flow to the brain, had a daily rhythm in stroke patients, with more deteriorated regulation during the night and morning hours compared to the afternoon hours.

Their results, which are published in the Journal of Cerebral Blood Flow and Metabolism, are relevant for health care planning during stroke recovery.

“The care and course of actions done after a stroke are essential for optimal rehabilitation. Our study suggests that the daily rhythm of CBF regulation in stroke patients may be highly relevant to managing an individual’s activity and stroke recovery,” said senior author, Kun Hu, PhD, of the Medical Biodynamics Program in the Brigham’s Division of Sleep and Circadian Disorders.

Kun added, “Exercise and surgery post-stroke could be more optimal when scheduled during afternoon hours, as this is when dynamic CA functions more effectively. These results may improve our understanding of a vulnerable time window for the cerebrovascular system and help guide daily activity and personal care during stroke recovery, which could improve health outcomes for patients who have had a stroke.”

Stable CBF is a necessary component for normal brain function. Dramatic changes in CBF can cause increased cranial pressure and brain tissue damage. Thus, a process like CA, which helps maintain relatively stable CBF through constriction and dilation of blood vessels in the brain, particularly during changes in an individual’s blood pressure (BP), is crucial.

Currently, there is a gap in knowledge concerning the daily variance of CA in stroke patients. Generally, the daily rhythms of physiological functions can be controlled by external behaviors like food intake, sleep, and exercise, as well as the internal circadian clock. This study is among the first to examine the potential variation of CA in the stroke population.

The research team observationally studied 28 participants being treated in a hospital in Sao Paulo, Brazil after experiencing a stroke. They received thrombolysis within 5 hours of the onset of their symptoms. After undergoing this procedure, the participants’ CA was assessed over the course of 48 hours at various time points by examining the relationship between temporal changes in blood pressure and cerebral blood flow velocity of the middle cerebral artery.

Analysis of the results showed evidence of differing cerebral blood flow regulation during various times of the day, especially when cerebral blood flow and pressure fluctuated at large time scales or low frequencies < 0.05 Hz. In particular, a more degraded regulation motif was seen during the nighttime and morning hours when compared to the afternoon. This dysregulation interval coincides with the increased prevalence of recurrent and first-ever stroke events during morning times.

While these results are promising, the researchers identified future avenues to assist in creating a greater understanding of the regulation mechanism.

“Interestingly, the daily rhythm of CA was present in both stroke and non-stroke sides of the brain, suggesting the factor(s) driving the rhythm should affect CBF regulation globally,” said first author Daniel Abadjiev, of the Medical Biodynamics Program in the Brigham’s Division of Sleep and Circadian Disorders. “To better understand underlying mechanisms, future studies should consider more frequent assessments across the 24-hour cycle, an increase in patient sample size, the inclusion of non-stroke controls, and monitoring of the daily activity rhythms like sleep and exercise as well as intrinsic circadian rhythm among the participants.”

“This study demonstrates that a daily rhythm does exist for stroke patients,” said Hu. “Rehab plans should look to identify the daily rhythm and design a strategy that makes use of optimal CA. The long-term goal is to see if we can further control the rhythm of CA by manipulating an individual’s daily behavioral cycles or endogenous circadian clock in order to deliver more personalized medicine and improve their recovery.”