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  • Addiction, Trauma, and the Problem of Being Present

    Addiction, Trauma, and the Problem of Being Present

    The Power of Then

    I remember one day in rehab, after a particularly gruelling day of group therapy, the facilitator decided to end with a mindfulness meditation. Feeling exhausted and overstimulated, I welcomed the chance to close my eyes and shut out the world for a little while.

    But as she guided our awareness through the body, I became painfully aware of what was happening inside mine—the tightness in my jaw and throat, my heart pounding, the knot of fear twisting in my stomach. My body didn’t feel like a safe place to be; it felt like a war zone.

    When the meditation ended, she reminded us of how important it is in recovery to live in the now.” And that left me with a burning question that I didn’t dare ask: What if my now feels unbearable?

    When the meditation ended, she reminded us of how important it is in recovery to live in the now.” And that left me with a burning question that I didn’t dare ask: What if my now feels unbearable?

    For many people in recovery, being in the body can feel like stepping onto enemy territory. It’s where we hold the emotional pain, unresolved trauma, and survival responses we’ve spent years trying not to feel. Mindfulness invites us to tune in—to become aware of our bodies and minds, to sit with our emotions and thoughts. 

    To many people, this is a neutral concept. However, for the addict in recovery, it’s also being asked to return to the danger our addiction once protected us from.

    I once heard someone say, “You can’t feel the power of now until you’ve healed the power of then.” That statement really stuck with me. 

    When the nervous system is carrying trauma—when we’re dysregulated, overwhelmed, or trapped in a state of fight/flight/freeze—mindfulness doesn’t always feel supportive. Sometimes it simply heightens our awareness of the pain and discomfort within, without giving us the resources to cope.

    The Root of Addiction

    Many experts in the trauma and addiction field believe trauma sits at the root of addiction. Gabor Mate, one of the most influential voices in this work, invites us to shift the question from, Why the addiction? to, Why the pain? 

    Many of us are working from an outdated idea of what trauma actually is. Trauma isn’t defined by the event. It’s defined by what happens inside of us as a result of the event, the imprint it leaves on our body and mind.

    That reframing, turning the attention toward the suffering beneath the behavior, was one of the most powerful turning points in my recovery.

    You might be reading this and thinking, “This doesn’t apply to me. I don’t have trauma.” Yet many of us are working from an outdated idea of what trauma actually is. Trauma isn’t defined by the event. It’s defined by what happens inside of us as a result of the event, the imprint it leaves on our body and mind.

    Trauma expert Pat Ogden describes trauma as “any threatening, overwhelming experience that we cannot integrate.” When understood this way, it becomes more relatable. It’s not limited to catastrophic events; it also includes the undigested life experiences most of us carry in varying degrees—the moments that shape how safe we feel in the world, in our relationships, and in our own bodies.

    If substances became a way to soothe, regulate, or find relief from the imprint of those experiences, that is the link between trauma and addiction. Addiction doesn’t manifest without reason. It’s your body and nervous system attempting to restore balance—to escape an unbearable now—when nothing else seems to work.

    The Challenges Mindfulness Presents

    Mindfulness isn’t inherently problematic for everyone living with trauma; for some, it’s deeply supportive. The difficulty for some people living with symptoms of trauma is that mindfulness can sometimes intensify those symptoms, and in some cases even cause re-traumatisation.

    Mindfulness eventually became one of my greatest resources. But in the early days, before I was trauma informed, I often pushed through discomfort, believing that was part of the practice. I remember one meditation in particular where I forced myself to sit with an increasingly uncomfortable sensation in the pit of my stomach. I was convinced that if I just stayed with it long enough, I’d eventually reach some blissful state of transcendence. Instead, it sent me into an intense dissociative state which lasted for weeks—something I later learned is not uncommon for trauma survivors. 

    This is why it’s important to understand the potential challenges of mindfulness for some—so that if you do encounter problems, you know it’s not a sign of failure. It’s simply a signal from your nervous system that more safety is needed.

    Here are some primary signals to pay attention to: 

    Focusing on the body or breath can be activating

    Trauma lives in the body as physical sensations, constriction, tension, and survival responses. When we bring awareness to the breath, or to areas that hold this survival energy—the chest, throat, belly—these sensations can feel overwhelming.

    Mindfulness can trigger traumatic memories or flashbacks

    Turning inward creates space for memories, images, or emotions that were previously suppressed to rise to the surface. When they do, the body and mind may react as if the past is happening again. In other words, we start experiencing the power of then.

    Stillness can feel threatening to a dysregulated nervous system.

    For someone who is used to living in a state of fight, flight, or chronic hypervigilance, stillness can feel unfamiliar and unsafe. Even the feeling of calm can feel threatening when the body is used to scanning for danger.

    Self-observation can activate shame or self-judgement

    Turning attention inward can make self-critical thoughts louder, especially for someone whose trauma involved blame, guilt, or a loss of self-worth.

    None of this means mindfulness should be avoided. Far from it. It simply means the practice may need to be approached differently: with more pacing, choice, and with safety at its core.

    Practising Mindfulness Safely

    Safety is the foundation of trauma recovery and one of the cornerstones of trauma-informed mindfulness. David Treleaven, founder of Trauma-Sensitive Mindfulness, emphasises that mindfulness for trauma survivors must be flexible, and adapted to suit an individual’s nervous system and needs. Instead of pushing through discomfort, this approach supports choice, regulation, and autonomy.

    Here are some adjustments you can make to your mindfulness practice when you start to feel activated: 

    1. Start outward. For many people, beginning with external anchors feels more supportive than turning the attention inward. Noticing sounds, feeling your feet on the floor, or gently orienting to your surroundings can help settle the nervous system.
    2. Switch it up. Once a sense of grounding is established, you can then gently approach your inner experience. It can help to move between inner and outer awareness, so that if anything becomes too intense, you can shift your focus back outward, adjust your posture or pause completely. Having a reliable anchor, something that feels supportive to return to, can be especially helpful.
    3. Get mobile. Movement can also be a powerful bridge to presence. Walking, stretching, or gentle swaying may feel more accessible when stillness feels too threatening. You don’t have to sit motionless in a lotus position to be mindful. 
    4. Open your eyes. For some people, closing their eyes means they can’t scan for danger. As people are learning to find safety, practising with eyes open, or with a soft gaze, can also reduce the vulnerability that may come with closing the eyes.
    5. Be gentle with a noisy mind. It’s also worth noting that the mind—even when busy or critical—can feel safer than the body. Understanding this can help reduce frustration when the mind doesn’t quieten in the way we might expect.

    One of the most important things to remember with trauma-sensitive mindfulness is that you have choice and autonomy. Treleaven says, “We want them to know that in every moment of practice they are in control.” So, if things become too much, return to what feels safe. Stay within your window of tolerance, which allows for some discomfort, but not to where it’s overwhelming.

    When practiced with care, mindfulness can be one of the greatest tools for trauma healing and addiction recovery. For me, the benefits were profound, so much so that I wrote a book about it. But the greatest benefit was reconnecting with that part of myself that addiction and trauma never touched: the part that was always there, quietly watching, peaceful and still. My true self!

    Mindfulness doesn’t rewrite the past, but when we can embody a sense of safety, it helps us to hold it differently. So that the power of then no longer overshadows the power of now.



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  • From Stress to Serenity: How Journaling Can Help You Manage Anxiety

    From Stress to Serenity: How Journaling Can Help You Manage Anxiety

    Introduction to Journaling and Stress Management

    In today’s fast-paced world, stress and anxiety have become ubiquitous companions for many of us. The pressures of work, family, and social obligations can leave us feeling overwhelmed and drained. However, there are effective tools that can help manage these feelings and lead us towards a path of serenity. One such powerful tool is journaling. The act of putting your thoughts and feelings down on paper can be incredibly cathartic, allowing you to process your emotions, gain clarity, and develop a greater understanding of yourself. In this article, we will explore how journaling can be a pivotal practice in transitioning from stress to serenity, helping to manage anxiety and cultivate a more peaceful, balanced life.

    Understanding Stress and Anxiety

    Before diving into the benefits of journaling, it’s essential to understand the nature of stress and anxiety. Stress is the body’s natural response to a perceived threat or pressure. It’s what prepares your body to either face the situation head-on (fight) or flee from it (flight). While stress can sometimes motivate us to take action, chronic stress can lead to anxiety, which is a persistent and excessive worry about everyday things, even when there’s no apparent reason to worry. Anxiety can interfere with daily life, causing difficulties in relationships, work, and overall well-being.

    How Journaling Helps

    Journaling is a simple yet powerful technique that involves writing down your thoughts, feelings, and experiences. By committing these to paper, you begin to externalize your internal world, which can offer several benefits in managing stress and anxiety:

    • Clarification of Thoughts and Feelings: Journaling helps you identify and understand your thoughts and emotions better. Often, when we’re stressed or anxious, our thoughts can be muddled and overwhelming. Writing them down allows you to untangle them, making it easier to pinpoint the sources of your stress and anxiety.
    • Emotional Release: The act of journaling can be therapeutic, providing a safe space to express and release pent-up emotions. By putting your feelings into words, you can begin to let go of them, which can be particularly helpful for those dealing with anxiety.
    • Reflection and Insight: Regular journaling encourages reflection on your experiences, helping you to identify patterns and gain insights into your behaviors and emotions. This increased self-awareness can be instrumental in making positive changes and developing coping strategies for stress and anxiety.
    • Mindfulness: The practice of journaling can foster mindfulness, encouraging you to stay present and aware of your current thoughts and feelings, rather than worrying about the future or past.

    Effective Journaling Techniques for Stress and Anxiety

    While journaling can be incredibly beneficial, incorporating certain techniques can enhance its effectiveness in managing stress and anxiety:

    • Morning Pages: Starting your day by writing down your thoughts without editing or censoring yourself can clear your mind and set a positive tone for the day.
    • Gratitude Journaling: Focusing on the things you’re grateful for can help shift your perspective, making you more appreciative and less worried about negative aspects of your life.
    • Prompt-Based Journaling: Using specific prompts related to your anxiety and stress can guide your reflections and help you delve deeper into the root causes of your feelings.
    • Mindfulness Journaling: Combining journaling with mindfulness practices, such as meditation or deep breathing, can enhance the calming effects and promote a greater sense of serenity.

    Overcoming Barriers to Journaling

    Some people may find it challenging to start or maintain a journaling practice due to various barriers:

    • Lack of Time: Finding even a few minutes each day can be challenging, but journaling doesn’t have to be time-consuming. Even a brief reflection can be beneficial.
    • Self-Criticism: The fear of not writing “well” or the belief that your thoughts aren’t worth writing down can be daunting. However, journaling is for your eyes only, and its value lies in the process, not the product.
    • Privacy Concerns: If you live with others, finding a private space to journal might be difficult. Consider using a lockable journal or finding an outdoor spot where you can write undisturbed.

    Real-Life Examples and Testimonials

    Many individuals have found solace and relief from stress and anxiety through journaling. Personal stories and testimonials often highlight the profound impact journaling can have on mental health, showcasing how it can be a turning point in managing anxiety and finding calm in chaotic times.

    Conclusion

    Journaling is a versatile and accessible tool that can be a companion on your journey from stress to serenity. By providing a space to express emotions, clarify thoughts, and gain insights, journaling helps in effectively managing anxiety and cultivating a more peaceful life. It’s a practice that complements other stress management techniques, such as meditation and therapy, and can be tailored to suit individual needs and preferences. Whether you’re dealing with chronic anxiety or occasional stress, incorporating journaling into your daily routine can be a significant step towards a more balanced and serene you.

    FAQs

    • Q: Do I need to write in my journal every day?
      A: While consistency can be beneficial, it’s not necessary to write every day. Even journaling a few times a week can have positive effects on your mental health.
    • Q: What if I don’t know what to write about?
      A: Starting with prompts or simply writing about your day can help. As you continue journaling, you’ll find your own rhythm and topics to explore.
    • Q: Is journaling only for people with severe anxiety or stress?
      A: No, journaling can benefit anyone looking to improve their mental health, whether they’re dealing with anxiety, stress, or just seeking a tool for self-reflection and growth.
    • Q: Can I journal digitally, or do I need to use a physical journal?
      A: Both physical and digital journaling have their benefits. Physical journals can offer a tactile experience, while digital journals provide convenience and accessibility. Choose the method that works best for you.
  • Sweat Dreams: How Sleep Impacts Fitness Performance and Athletic Success (Target keywords: sleep, fitness performance, athletic success)

    Sweat Dreams: How Sleep Impacts Fitness Performance and Athletic Success (Target keywords: sleep, fitness performance, athletic success)

    Sleep is a vital component of our daily lives, and its impact on our overall health and wellbeing is well-documented. However, for athletes and fitness enthusiasts, sleep plays a critical role in determining their fitness performance and athletic success. When it comes to achieving peak physical condition, a good night’s sleep is just as important as a rigorous training session or a healthy diet. In this article, we’ll delve into the world of sleep and explore how it affects fitness performance and athletic success.

    The Science of Sleep and Fitness Performance

    When we sleep, our body repairs and regenerates damaged cells, builds bone and muscle, and strengthens our immune system. During this time, our brain processes and consolidates memories, including those related to physical skills and techniques learned during the day. This is especially important for athletes, as it helps them to improve their performance and adapt to new training methods. Research has shown that sleep deprivation can significantly impair athletic performance, leading to decreased speed, strength, and accuracy.

    On the other hand, getting enough sleep has been shown to have a positive impact on fitness performance. Studies have found that athletes who get adequate sleep tend to perform better, with improved reaction times, faster sprinting speeds, and enhanced endurance. This is because sleep helps to regulate the body’s physiological processes, including the release of hormones that aid in muscle recovery and growth. For example, during deep sleep, the body releases growth hormone, which helps to repair and rebuild muscle tissue, making it essential for athletes who engage in high-intensity training.

    The Impact of Sleep on Athletic Success

    Athletic success is not just about physical performance; it’s also about mental toughness and focus. Sleep plays a critical role in both of these areas. When we’re well-rested, we’re more alert, focused, and better equipped to handle stress and pressure. This is especially important for athletes who compete at the highest level, where mental toughness and focus can be the difference between winning and losing.

    Moreover, sleep has been shown to have a positive impact on injury prevention and recovery. When we’re sleep-deprived, our reaction times are slower, and our coordination and balance are impaired, making us more susceptible to injury. On the other hand, getting enough sleep helps to reduce inflammation, which can aid in the recovery process after an injury. This is especially important for athletes who engage in high-impact sports, such as football or rugby, where injuries are common.

    The Consequences of Sleep Deprivation on Fitness Performance

    Sleep deprivation can have serious consequences for athletes and fitness enthusiasts. When we don’t get enough sleep, our body’s ability to recover from exercise is impaired, leading to decreased performance and increased risk of injury. Additionally, sleep deprivation can lead to decreased motivation, making it harder to stick to a training program or diet. This can have a negative impact on athletic success, as a lack of motivation can lead to decreased performance and a lack of progress.

    Furthermore, sleep deprivation can also affect our appetite and metabolism, leading to weight gain and decreased physical performance. When we’re sleep-deprived, our body produces more ghrelin, a hormone that stimulates appetite, and less leptin, a hormone that suppresses appetite. This can lead to overeating and poor food choices, which can have a negative impact on athletic performance and overall health.

    Optimizing Sleep for Fitness Performance and Athletic Success

    So, how can athletes and fitness enthusiasts optimize their sleep to improve their fitness performance and athletic success? The first step is to establish a consistent sleep schedule, going to bed and waking up at the same time every day, including weekends. This helps to regulate the body’s internal clock and can improve the quality of sleep.

    Creating a sleep-conducive environment is also essential. This includes keeping the bedroom cool, dark, and quiet, and investing in a comfortable mattress and pillows. Avoiding caffeine, nicotine, and electronics before bedtime can also help to improve sleep quality. Additionally, avoiding heavy meals close to bedtime and engaging in relaxing activities, such as reading or meditation, can help to wind down and prepare the body for sleep.

    The Role of Sleep in Recovery and Injury Prevention

    Sleep plays a critical role in the recovery process after exercise. When we sleep, our body repairs and regenerates damaged muscle tissue, rebuilds bone density, and strengthens our immune system. This is especially important for athletes who engage in high-intensity training, as it helps to reduce the risk of injury and improve overall performance.

    Moreover, sleep has been shown to have anti-inflammatory properties, which can aid in the recovery process after an injury. When we’re sleep-deprived, our body’s inflammatory response is increased, which can lead to chronic inflammation and decreased performance. On the other hand, getting enough sleep helps to regulate the body’s inflammatory response, reducing the risk of chronic inflammation and improving overall health.

    The Impact of Sleep on Mental Performance and Focus

    Sleep has a significant impact on mental performance and focus, which is essential for athletic success. When we’re well-rested, we’re more alert, focused, and better equipped to handle stress and pressure. This is especially important for athletes who compete at the highest level, where mental toughness and focus can be the difference between winning and losing.

    Moreover, sleep has been shown to improve cognitive function, including attention, memory, and decision-making. When we’re sleep-deprived, our cognitive function is impaired, making it harder to focus and make quick decisions. This can have a negative impact on athletic performance, as split-second decisions can be the difference between winning and losing.

    Conclusion

    In conclusion, sleep plays a critical role in determining fitness performance and athletic success. When we get enough sleep, our body repairs and regenerates damaged cells, builds bone and muscle, and strengthens our immune system. Additionally, sleep has a positive impact on mental performance and focus, which is essential for athletic success. On the other hand, sleep deprivation can have serious consequences, including decreased performance, increased risk of injury, and decreased motivation. By optimizing sleep and establishing a consistent sleep schedule, athletes and fitness enthusiasts can improve their fitness performance and athletic success.

    Frequently Asked Questions

    Q: How much sleep do athletes need?
    A: The amount of sleep athletes need varies depending on the individual and the type of sport they play. Generally, athletes need 7-9 hours of sleep per night to aid in recovery and improve performance.

    Q: Can sleep deprivation affect athletic performance?
    A: Yes, sleep deprivation can significantly impair athletic performance, leading to decreased speed, strength, and accuracy.

    Q: How can athletes optimize their sleep?
    A: Athletes can optimize their sleep by establishing a consistent sleep schedule, creating a sleep-conducive environment, and avoiding caffeine, nicotine, and electronics before bedtime.

    Q: Does sleep affect injury prevention and recovery?
    A: Yes, sleep plays a critical role in injury prevention and recovery. When we’re sleep-deprived, our reaction times are slower, and our coordination and balance are impaired, making us more susceptible to injury. On the other hand, getting enough sleep helps to reduce inflammation, which can aid in the recovery process after an injury.

    Q: Can sleep improve mental performance and focus?
    A: Yes, sleep has a significant impact on mental performance and focus. When we’re well-rested, we’re more alert, focused, and better equipped to handle stress and pressure.

    sweat-dreams-how-sleep-impacts-fitness-performance-and-athletic-success-target-keywords-sleep-fitness-performance-athletic-success

  • Craniopharyngioma | Nemours KidsHealth

    Craniopharyngioma | Nemours KidsHealth

    What Is a Craniopharyngioma?

    A craniopharyngioma is a rare type of benign (not cancerous) brain tumor. These tumors usually form close to the
    and do not spread to other areas.

    Doctors usually can remove these tumors with surgery. In some cases, complete removal is not possible and radiation may be needed.

    What Happens With a Craniopharyngioma?

    A craniopharyngioma (kray-nee-oh-fair-in-jee-OH-muh) can grow and push on the things around it, including:

    • the pituitary gland
    • the optic tracts
    • the third ventricle of the brain

    Each of those parts help a child grow and thrive:

    • The pituitary gland makes hormones that help a child’s body:
      • grow well
      • change from a child into an adult
      • maintain the right blood pressure
    • The optic tracts connect the optic nerves from the eyes to the brain, so a child can see.
    • The third ventricle of the brain is a fluid-filled space that connects with other fluid-filled spaces in and around the brain. The fluid in these spaces:
      • protects the brain from jolts and hits to the head
      • carries nutrients and gets rid of waste

    When a craniopharyngioma pushes on these parts, they don’t work well, so a child starts to have symptoms.

    What Are the Signs & Symptoms of a Craniopharyngioma?

    When a craniopharyngioma grows and presses on the areas around it, a child might:

    • have headaches
    • have trouble seeing things to the far left and far right
    • have poor balance or trouble walking
    • have nausea and vomiting

    The child also may:

    • need to drink more than usual
    • need to pee more often than usual
    • not go through the usual changes of puberty
    • grow slowly or not grow
    • not start having periods (menstruation)
    • have low blood pressure
    • be more tired than usual or sleep a lot
    • act differently (have a personality change)

    What Causes Craniopharyngioma?

    Experts think that craniopharyngiomas grow from leftover pieces of tissue that didn’t disappear as expected in early pregnancy when the baby’s head, face, and brain are forming.

    Who Gets Craniopharyngioma?

    Most craniopharyngiomas happen in kids 5 to 14 years old. But they can affect people of any age.

    How Are Craniopharyngiomas Diagnosed?

    Usually, parents notice one or more of the symptoms of a craniopharyngioma and take their child to a doctor. Other things can cause similar symptoms, so the doctor will:

    • ask questions about the symptoms and other medical problems (medical history)
    • do an exam
    • order blood tests to measure mineral and hormone levels
    • do imaging tests, including CAT scan or MRI

    Other tests done can include:

    How Is Craniopharyngioma Treated?

    A team of specialists works together to treat a craniopharyngioma. They include experts in:

    Surgeons usually remove the tumor as the first step in treatment. In many cases, surgery is done without any external incisions, using a camera on a thin tube passed into the nose. Rarely, the tumor is removed through a temporary hole cut in the skull.

    The surgeon will put a drain tube (shunt) in at the time of surgery if the child has water on the brain (hydrocephalus). If the surgeon can’t completely remove the tumor, the child may also need radiation therapy.

    Doctors continue looking for new ways to treat craniopharyngiomas. Some patients might be candidates for a clinical trial. If your child has a craniopharyngioma, talk to the doctor about whether this might be a good treatment option.

    What Else Should I Know?

    After surgery to remove a craniopharyngioma, the pituitary gland may have some permanent injury. A child may have to take medicines to replace some hormones for life.

    Radiation therapy can make the pituitary gland stop working several years after treatment. So children who had this treatment should see a hormone specialist (an endocrinologist) every year.

    After treatment, doctors will do follow-up MRIs for several years to check if the tumor has come back.

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  • Who Should Take Them and Safe Iron Deficiency Treatment Tips for Anemia

    Who Should Take Them and Safe Iron Deficiency Treatment Tips for Anemia

    Iron supplements play an important role in maintaining healthy red blood cells and supporting oxygen transport throughout the body. When used appropriately, they can be an effective part of iron deficiency treatment and anemia management, but unnecessary use can cause side effects and even serious health risks.

    Understanding who needs them and who should avoid them helps readers make safer, more informed decisions.

    What Are Iron Supplements?

    Iron supplements are products designed to increase iron levels in the body when diet alone is not enough. They are commonly used to support iron deficiency treatment and to help manage anemia caused by low iron stores.

    Most over-the-counter iron supplements contain forms such as ferrous sulfate, ferrous gluconate, or ferrous fumarate, often available as tablets, capsules, or liquids. These forms differ slightly in how much elemental iron they deliver and how well they are tolerated.

    In many cases, healthcare professionals choose the specific type and dose based on blood test results, existing health conditions, and how severe the anemia is.

    Who Really Needs Iron Supplements?

    Not everyone benefits from taking iron supplements, and starting them without medical guidance can be risky. In general, people who need them have documented low iron levels or clear signs of iron deficiency anemia confirmed through laboratory testing.

    Individuals with diagnosed iron deficiency usually have low ferritin (the body’s iron storage protein) and may also have low hemoglobin or hematocrit. In such cases, iron supplements become a central part of iron deficiency treatment to restore iron stores and support normal red blood cell production.

    Those at higher risk include pregnant people, infants and children in rapid growth phases, individuals with heavy menstrual bleeding, frequent blood donors, and people with chronic blood loss from conditions such as ulcers or gastrointestinal disorders.

    Some groups are more prone to iron deficiency even when they try to eat well. Vegetarians and vegans may not get enough highly absorbable heme iron from animal sources and can be more vulnerable to low iron over time if intake is not carefully planned.

    People with gastrointestinal conditions such as celiac disease, inflammatory bowel disease, or those who have had bariatric surgery may have poor absorption and may rely on iron supplements as part of their long-term anemia management.

    Athletes, especially endurance athletes, can also have increased iron needs because of higher red blood cell turnover and losses through sweat and minor gastrointestinal bleeding.

    Signs That Someone Might Need Iron Supplements

    Iron deficiency and anemia can be subtle at first, but they often share a cluster of recognizable symptoms. Common signs include persistent fatigue, weakness, pale or sallow skin, shortness of breath with mild exertion, and feeling unusually cold. Some people develop headaches, dizziness, brittle nails, or hair thinning as their iron levels drop.

    Cognitive and neurological symptoms can also appear with iron deficiency anemia. Difficulty concentrating, irritability, and restless legs, particularly at night, may be linked to insufficient iron, according to the World Health Organization.

    Because these symptoms can mimic other conditions such as thyroid problems, chronic fatigue, or depression, self-diagnosis is unreliable. Iron supplements should not be started solely based on symptoms without confirming iron deficiency through blood tests like ferritin, serum iron, transferrin saturation, and a complete blood count.

    A proper evaluation for potential iron deficiency treatment usually includes a health history that covers diet, menstrual patterns, digestive symptoms, blood loss, and existing medical conditions.

    This assessment helps determine whether iron supplements are appropriate, whether dietary changes might be enough, or whether another underlying cause needs attention.

    How Iron Supplements Are Used in Iron Deficiency Treatment

    In iron deficiency treatment and anemia management, supplements are often used for a defined period rather than indefinitely. Once a healthcare professional confirms iron deficiency anemia, an oral iron preparation is usually prescribed with a specific dose and schedule.

    For many people, energy levels start to improve within a few weeks as hemoglobin begins to rise, but full replenishment of iron stores often takes several months.

    Iron supplements are generally more effective when taken on an empty stomach because food can reduce absorption. However, this approach can increase stomach upset for some individuals.

    To balance comfort and absorption, many people are advised to take iron with a small amount of food or to adjust the timing. Vitamin C, whether from a supplement or a glass of orange juice, may help enhance iron absorption when taken at the same time as the iron tablet.

    Dietary strategies are usually recommended alongside supplements. Including iron-rich foods such as lean red meat, poultry, fish, beans, lentils, tofu, and fortified cereals can support the body’s recovery from anemia.

    Pairing plant-based iron sources with vitamin C–rich foods like citrus fruits, strawberries, or bell peppers can help improve non-heme iron absorption. At the same time, limiting tea, coffee, and calcium-rich foods around supplement time can prevent interference with absorption.

    Side Effects, Risks, and Overdose

    Even when used properly, iron supplements can cause side effects. Common complaints include constipation, nausea, stomach discomfort, diarrhea, or dark stools.

    These reactions are not necessarily dangerous but can be uncomfortable enough for some people to stop treatment prematurely, which can slow or reverse the progress of iron deficiency treatment.

    To reduce side effects, healthcare professionals may adjust the dose, switch to another type of iron supplement, or recommend taking the supplement with food despite the slight reduction in absorption, as per the National Institutes of Health.

    Sometimes, lower but more frequent doses are better tolerated. Slow-release formulations might be suggested for specific cases, although their absorption characteristics can differ.

    Taking too much iron is particularly dangerous for children, as accidental ingestion of adult iron supplements can lead to poisoning and requires urgent medical care. In adults, chronic overuse of iron supplements without monitoring can gradually lead to iron overload.

    This excess iron may accumulate in organs such as the liver, heart, and pancreas, potentially contributing to conditions like cirrhosis, heart arrhythmias, or diabetes in susceptible individuals. This risk reinforces the importance of using iron supplements only when they are truly needed.

    Alternatives and When Intravenous Iron Is Considered

    For some people, oral iron supplements are not effective or not tolerated despite adjustments in dose and timing. Individuals with severe anemia, ongoing blood loss, very poor iron absorption, or significant digestive side effects may require a different approach.

    In these situations, healthcare professionals sometimes consider intravenous (IV) iron as part of more intensive anemia management.

    Intravenous iron delivers iron directly into the bloodstream, bypassing the digestive tract. This method can replenish iron stores more quickly, especially when rapid correction is needed or when oral iron simply does not work.

    However, IV iron is usually given in clinical settings due to the need for monitoring during infusion and the small risk of allergic reactions.

    In mild cases or early stages of deficiency, dietary strategies alone may be enough without supplements. Addressing underlying causes, such as treating heavy menstrual bleeding, managing gastrointestinal conditions, or improving overall nutrient intake, can help prevent recurring anemia.

    Regular monitoring through blood tests allows adjustments over time and helps determine whether iron supplements can be safely stopped once iron levels have normalized.

    Frequently Asked Questions

    1. Can someone take iron supplements long term for energy?

    Long-term use of iron supplements just for “energy” is not advised without confirmed deficiency and medical supervision. Excess iron can build up over time and increase the risk of organ damage, so duration and dose should be guided by blood tests.​

    2. Is it safe to take iron supplements together with other vitamin or mineral supplements?

    Iron supplements can be used with many vitamins, but nutrients like calcium may reduce iron absorption if taken at the same time. Spacing iron away from high-calcium products and checking for individual interactions with a healthcare professional is generally recommended.​

    3. How often should iron levels be checked while on iron deficiency treatment?

    Iron levels are often checked after several weeks to a few months of iron deficiency treatment to see if anemia is improving. Once levels normalize, testing can be less frequent, and supplements may be reduced or discontinued to avoid unnecessary long-term use.​

    4. Can dietary changes alone reverse mild anemia without iron supplements?

    Mild anemia from low intake may improve with more iron-rich foods and better absorption strategies, such as pairing plant iron with vitamin C. More significant anemia, blood loss, or absorption problems usually require iron supplements or other medical treatment in addition to diet changes.​



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  • The Hidden Costs of Bariatric Surgery

    The Hidden Costs of Bariatric Surgery

    Weight regain after bariatric surgery can have devastating psychological effects.

    How Sustainable Is the Weight Loss After Bariatric Surgery? I explore that issue in my video of the same name. Most gastric bypass patients end up regaining some of the fat they lose by the third year after surgery, but after seven years, 75% of patients followed at 10 U.S. hospitals maintained at least a 20% weight loss.

    The typical trajectory for someone who starts out obese at 285 pounds, for example, would be to drop to an overweight 178 pounds two years after bariatric surgery, but then regain weight up to an obese 207 pounds. This has been chalked up to “grazing” behavior, where compulsive eaters may shift from bingeing (which becomes more difficult post-surgery) to eating smaller amounts constantly throughout the day. In a group of women followed for eight years after gastric bypass surgery, about half continued to describe episodes of disordered eating. As one pediatric obesity specialist described, “I have seen many patients who put chocolate bars into a blender with some cream, just to pass technically installed obstacles [e.g., a gastric band].”

    Bariatric surgery advertising is filled with “happily-ever-after” fairytale narratives of cherry-picked outcomes offering, as one ad analysis put it, “the full Cinderella-romance happy ending.” This may contribute to the finding that patients often overestimate the amount of weight they’ll lose with the procedure and underestimate the difficulty of the recovery process. Surgery forces profound changes in eating habits, requiring slow, small bites that have been thoroughly chewed. Your stomach goes from the volume of two softballs down to the size of half a tennis ball in stomach stapling and half a ping-pong ball in the case of gastric bypass or banding.

    As you can imagine, “weight regain after bariatric surgery can have a devastating effect psychologically as patients feel that they have failed their last option”—their last resort. This may explain why bariatric surgery patients face a high risk of depression. They also have an increased risk of suicide.

    Severe obesity alone may increase the risk of suicidal depression, but even at the same weight, those going through surgery appear to be at a higher risk. At the same BMI (body mass index), age, and gender, bariatric surgery patients have nearly four times the odds of self-harm or attempted suicide compared with those who did not undergo the procedure. Most convincingly, so-called “mirror-image analysis” comparing patients’ pre- and post-surgery events showed the odds of serious self-harm increased after surgery.

    About 1 in 50 bariatric surgery patients end up killing themselves or being hospitalized for self-harm or attempted suicide. And this only includes confirmed suicides, excluding masked attempts such as overdoses classified as having “undetermined intention.” Bariatric surgery patients may also have an elevated risk of accidental death, though some of this could be due to changes in alcohol metabolism. When individuals who have had a gastric bypass were given two shots of vodka, their blood alcohol level surpassed the legal driving limit within minutes due to their altered anatomy. It’s unclear whether this plays a role in the 25% increase in prevalence of alcohol problems noted during the second postoperative year.

    Even those who successfully lose their excess weight and keep it off appear to have a hard time coping. Ten years out, though physical health-related quality of life may improve, general mental health can significantly deteriorate compared to pre-surgical levels, even among those who lost the most weight. Ironically, there’s a common notion that bariatric surgery is for “cheaters” who take the easy way out by choosing the “low-effort” method of weight loss.

    Shedding the weight may not shed the stigma of prior obesity. Studies suggest that “in the eyes of others, knowing that an individual was at one time fat will lead him/her to always be treated like a fat person.” And there can be a strong anti-surgery bias on top of that—those who chose the scalpel to lose weight over diet or exercise were rated more negatively (for example, being considered less physically attractive). One can imagine how remaining a target of prejudice even after joining the “in-group” could potentially undercut psychological well-being.

    There can also be unexpected physical consequences of massive weight loss, like large hanging flaps of excess skin. Beyond being heavy and uncomfortable and interfering with movement, the skin flaps can result in itching, irritation, dermatitis, and skin infections. Getting a panniculectomy (removing the abdominal “apron” of hanging skin) can be expensive, and its complication rate can exceed 50%, with dehiscence (rupturing of the surgical wound) one of the most common complications.

    “Even if surgery proves sustainably effective,” wrote the founding director of Yale University’s Prevention Research Center, “the need to rely on the rearrangement of natural gastrointestinal anatomy as an alternative to better use of feet and forks [exercise and diet] seems a societal travesty.”

    In the Middle Ages, starving peasants dreamed of gastronomic utopias where food just rained down from the sky. The English called it the Kingdom of Cockaigne. Little could medieval fabulists predict that many of their descendants would not only take permanent residence there but also cut out parts of their stomachs and intestines to combat the abundance. Critics have pointed out the irony of surgically altering healthy organs to make them dysfunctional—malabsorptive—on purpose, especially when it comes to operating on children. Bariatric surgery for kids and teens has become widespread and is being performed on children as young as five years old. Surgeons defend the practice by arguing that growing up fat can leave “‘emotional scars’ and lifelong social retardation.”

    Promoters of preventive medicine may argue that bariatric surgery is the proverbial “ambulance at the bottom of the cliff.” In response, proponents of pediatric bariatric surgery have written: “It is often pointed out that we should focus on prevention. Of course, I agree. However, if someone is drowning, I don’t tell them, ‘You should learn how to swim’; no, I rescue them.”

    A strong case can be made that the benefits of bariatric surgery far outweigh the risks if the alternative is remaining morbidly obese, which is estimated to shave up to a dozen or more years off one’s life. Although there haven’t been any data from randomized trials yet to back it up, compared to non-operated obese individuals, those getting bariatric surgery would be expected to live significantly longer on average. No wonder surgeons have consistently framed the elective surgery as a life-or-death necessity. This is a false dichotomy, though. The benefits only outweigh the risks if there are no other alternatives. Might there be a way to lose weight healthfully without resorting to the operating table? That’s what my book How Not to Diet is all about.

    Doctor’s Note

    My book How Not to Diet is focused exclusively on sustainable weight loss. Check it out from your library or pick it up from wherever you get your books. (All proceeds from my books are donated to charity.)

    This is the final segment in a four-part series on bariatric surgery, which includes:

    This blog contains information regarding suicide. If you or anyone you know is exhibiting suicide warning signs, please get help. Go to https://988lifeline.org for more information.



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  • Mark Bouzyk’s 2006 Genomics Predictions

    Mark Bouzyk’s 2006 Genomics Predictions

    In 2006, a forward-thinking article profiled the emerging field of medical genomics and its potential to transform healthcare. The piece, written by Mark Bouzyk, was published in Emory’s Momentum Magazine and focused on the establishment of biobanks, the falling costs of genetic sequencing, and the promise of personalized medicine. Looking back from 2025, it’s striking how many of those predictions have not only come true but have exceeded even the most optimistic expectations of that era.

    The Cost Revolution: Even More Dramatic Than Expected

    In 2006, the article highlighted that “the costs of sequencing and genotyping have dropped considerably” and that “high-throughput genetic analysis is within the budget of many typical NIH RO1 research grants.” At the time, this represented a significant breakthrough; genetic analysis was finally becoming accessible to mainstream researchers.

    The reality of 2025 has far surpassed those predictions. What cost thousands of dollars per genome in 2006 now costs mere hundreds, and in some cases even less. Whole genome sequencing, once requiring years and billions of dollars, can now be completed in days for under $1,000. Some companies offer consumer genetic testing for under $100. The drop in cost wasn’t just considerable—it was revolutionary, falling by factors of thousands rather than incremental improvements.

    Personalized Medicine: From Concept to Clinical Reality

    The 2006 article described pharmaceutical companies exploring how “genetic variations indicate which people are better candidates for a particular drug.” This concept, known as pharmacogenomics, was largely theoretical at the time, with companies beginning to “identify who has the most potential to do well on a drug” to better select clinical trial participants.

    Fast forward to 2025, and pharmacogenomics has become standard practice in many therapeutic areas. Oncology leads the way, with genetic testing routinely determining which cancer patients will respond to specific targeted therapies. Medications for cardiovascular disease, mental health conditions, and many other disorders now come with companion diagnostics that test patients’ genetic profiles before prescribing. Bouzyk ‘s vision of using genetic analysis “to benefit whole populations of people” has materialized through population-level genetic studies that have identified risk factors for diseases ranging from Alzheimer’s disease to diabetes, enabling preventive interventions that were impossible in 2006.

    The Biobank Revolution: Prediction Becomes Reality

    Perhaps the most prescient aspect of the 2006 article was its discussion of biobanks, large-scale repositories of biological samples linked to demographic and health information. The piece noted that “medical centers across the country are scrambling to find ways to harvest the genetic data” and that successful centers “enjoy a distinct advantage when it comes to seeking federal support and other research funding.”

    This prediction proved remarkably accurate. Today, biobanks have become cornerstones of genetic research worldwide. The UK Biobank, launched in 2006, now contains genetic and health data from 500,000 participants and has contributed to thousands of scientific discoveries. The NIH’s All of Us Research Program aims to gather data from one million Americans. China’s National Genebank stores billions of biological samples. Virtually every major medical center now maintains biorepositories, precisely as the article foresaw.

    The concern about “grappling with issues such as IT, sample information, distribution status, and consent” proved equally prophetic. These ethical and logistical challenges have dominated discussions of biobanks for two decades, leading to new frameworks for informed consent, data-sharing agreements, and privacy protections.

    SNPs and Disease: Knowledge Explosion

    The 2006 article discussed single-nucleotide polymorphisms (SNPs). It noted that “more than 10 million SNPs have been identified and mapped on the human genome,” suggesting that studying these variations “can yield important information about genetic predisposition to disease.”

    This prediction wildly understated what would occur. Genome-wide association studies have since identified hundreds of thousands of genetic variants associated with diseases and traits. Databases now catalog over 100 million SNPs. The field has moved beyond simple associations to the use of complex polygenic risk scores that combine information from thousands of variants to predict disease risk with increasing accuracy.

    Health Disparities Research: Complex Reality

    The article mentioned interest in examining why African Americans experience higher rates of disorders like stroke and heart disease, suggesting that understanding “possible genetic factors that might play a role in such disparities” was important.

    This area has revealed greater complexity than anticipated. Research has shown that health disparities are primarily attributable to social determinants of health, environmental factors, and healthcare access rather than to genetic differences. While some genetic variants show different frequencies across populations, the medical community now recognizes that focusing heavily on genetic explanations can obscure the more significant roles of systemic racism, poverty, and unequal care access.

    Modern genomics has also addressed the troubling reality that most genetic studies historically focused on populations of European descent, creating biases in databases. Efforts to increase diversity in genetic research have accelerated, though significant gaps remain.

    Clinical Translation: Faster Than Expected

    The 2006 article described plans to “rapidly translate new genetic knowledge into new diagnostic tools,” envisioning that “if we find that a gene is linked to a particular disease or condition, then we can develop a diagnostic test and pass it down the corridor.”

    This bench-to-bedside pipeline has indeed materialized, but faster than anticipated. Genetic tests for thousands of conditions are now clinically available. Newborn screening panels test for dozens of genetic disorders. Carrier screening for prospective parents has become routine. Prenatal genetic testing has advanced to comprehensive whole-exome sequencing. Cancer patients routinely receive tumor genetic profiling to guide treatment decisions.

    Information Sharing: Largely Realized

    The vision that biobank information “could be shared via the Internet, enabling researchers from around the world to find samples that would potentially aid their research” has essentially come to pass. Platforms like dbGaP and the European Genome-phenome Archive now enable global data sharing among qualified researchers.

    However, the openness initially envisioned has been tempered by privacy concerns and recognition that participants must have meaningful control over how their genetic information is used. The balance between open science and participant protection remains an active policy area.

    The Verdict: Remarkably Accurate

    Looking back across twenty years, the 2006 article’s predictions about the future of genomics were strikingly accurate. The falling costs of sequencing, the rise of personalized medicine, the importance of biobanks, and the translation of genetic discoveries into clinical tools have all mainly materialized as envisioned.

    If anything, the article was too conservative in its optimism. The genomics revolution has moved faster, penetrated deeper into clinical practice, and generated more data than even forward-thinking experts of 2006 might have imagined. The “enormous untapped potential for clinical genetics” described two decades ago has been substantially realized, though enormous potential indeed remains.

    The vision articulated in 2006 has become a reality in 2025, validating the investments in genomics infrastructure, biobanks, and translational research. As we look forward to the next twenty years, the foundation laid by pioneers in this field promises even more dramatic advances in our understanding of human genetics and our ability to prevent, diagnose, and treat disease based on each individual’s unique genetic blueprint.

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  • ClinicalTrials.gov: Small Cell Lung Carcinoma

    ClinicalTrials.gov: Small Cell Lung Carcinoma

    Source: National Institutes of Health – From the National Institutes of Health
    Related MedlinePlus Pages: Lung Cancer

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  • Why Mental Health Should be a Priority

    Why Mental Health Should be a Priority

    Introduction

    Mental health is a vital aspect of our overall well-being, and it’s essential to prioritize it in our daily lives. With the increasing demands of modern life, it’s easy to neglect our mental health, but doing so can have severe consequences. In this article, we’ll explore why mental health should be a priority and provide tips on how to maintain good mental health.

    The Importance of Mental Health

    Mental health affects every aspect of our lives, from our relationships and work performance to our physical health and overall happiness. Good mental health enables us to cope with stress, make healthy choices, and enjoy life to the fullest. On the other hand, poor mental health can lead to anxiety, depression, and other mental health disorders that can significantly impact our quality of life. According to the World Health Organization (WHO), mental health disorders are among the leading causes of disability and illness worldwide.

    The Consequences of Neglecting Mental Health

    Neglecting mental health can have severe consequences, including decreased productivity, strained relationships, and poor physical health. When we don’t prioritize our mental health, we may experience increased stress, anxiety, and depression, which can lead to a range of physical health problems, such as headaches, digestive issues, and a weakened immune system. Furthermore, poor mental health can also affect our relationships, leading to conflict, social isolation, and feelings of loneliness.

    The Benefits of Prioritizing Mental Health

    Prioritizing mental health has numerous benefits, including improved relationships, increased productivity, and better physical health. When we take care of our mental health, we’re more resilient to stress, and we’re better equipped to handle life’s challenges. Good mental health also enables us to make healthy choices, such as regular exercise, healthy eating, and adequate sleep, which can improve our overall well-being. Additionally, prioritizing mental health can also lead to increased self-awareness, self-esteem, and confidence, which can have a positive impact on our personal and professional lives.

    How to Prioritize Mental Health

    Prioritizing mental health requires a proactive approach, and there are several strategies that can help. One of the most effective ways to prioritize mental health is to practice self-care, which includes activities such as meditation, yoga, and spending time in nature. Regular exercise is also essential for good mental health, as it releases endorphins, which can help reduce stress and anxiety. Additionally, getting enough sleep, eating a healthy diet, and staying connected with friends and family can also help support mental health.

    The Role of Self-Care in Mental Health

    Self-care is a critical component of mental health, and it involves taking care of our physical, emotional, and mental needs. Self-care activities, such as meditation, yoga, and spending time in nature, can help reduce stress and anxiety, improve mood, and increase self-awareness. Self-care can also involve setting boundaries, prioritizing activities that bring us joy, and taking breaks when needed. By incorporating self-care into our daily routine, we can improve our mental health and overall well-being.

    The Impact of Social Media on Mental Health

    Social media can have a significant impact on mental health, and it’s essential to be aware of the potential risks. Social media can create unrealistic expectations, promote comparison, and foster a sense of competition, which can lead to feelings of inadequacy, low self-esteem, and anxiety. Additionally, social media can also be a source of stress, as it can create a sense of constant connectedness and pressure to present a perfect online image. To mitigate the negative effects of social media on mental health, it’s essential to use social media mindfully, set boundaries, and prioritize real-life connections.

    The Importance of Seeking Help

    Seeking help is a critical aspect of maintaining good mental health, and it’s essential to recognize when we need support. If we’re experiencing persistent feelings of sadness, anxiety, or hopelessness, it’s essential to reach out to a mental health professional. Seeking help can involve talking to a therapist, joining a support group, or seeking online resources. By seeking help, we can get the support we need to manage our mental health and improve our overall well-being.

    Conclusion

    In conclusion, mental health should be a priority in our daily lives. By prioritizing mental health, we can improve our relationships, increase productivity, and enjoy better physical health. It’s essential to be proactive in maintaining good mental health, and this can involve practicing self-care, getting enough sleep, eating a healthy diet, and staying connected with friends and family. Additionally, seeking help when needed is critical, and it’s essential to recognize the signs of poor mental health and take action. By taking care of our mental health, we can live a happier, healthier, and more fulfilling life.

    FAQs

    Q: What is mental health?
    A: Mental health refers to our emotional, psychological, and social well-being, and it affects how we think, feel, and behave.

    Q: Why is mental health important?
    A: Mental health is essential for our overall well-being, and it affects every aspect of our lives, from our relationships and work performance to our physical health and happiness.

    Q: What are the consequences of neglecting mental health?
    A: Neglecting mental health can lead to decreased productivity, strained relationships, and poor physical health, as well as increased stress, anxiety, and depression.

    Q: How can I prioritize mental health?
    A: Prioritizing mental health involves practicing self-care, getting enough sleep, eating a healthy diet, staying connected with friends and family, and seeking help when needed.

    Q: What is self-care, and why is it important?
    A: Self-care involves taking care of our physical, emotional, and mental needs, and it’s essential for maintaining good mental health and overall well-being.

    Q: How can I seek help for mental health issues?
    A: Seeking help can involve talking to a therapist, joining a support group, or seeking online resources, and it’s essential to recognize when we need support and take action.

    Q: Can mental health issues be treated?
    A: Yes, mental health issues can be treated, and seeking help is the first step towards recovery. With the right treatment and support, it’s possible to manage mental health issues and improve overall well-being.

    Q: How can I support a loved one with mental health issues?
    A: Supporting a loved one with mental health issues involves being understanding, patient, and supportive, and encouraging them to seek help when needed. It’s also essential to take care of our own mental health to avoid burnout and compassion fatigue.