Health Journal Online

Category: Family Health

  • What makes urine yellow? The answer lies in your gut

    What makes urine yellow? The answer lies in your gut

    Ever wonder why urine is yellow or why skin looks yellow in people with jaundice? Scientists have known for more than a century that urobilin is the chemical responsible for that yellow color. But the enzyme responsible for making urobilin was a mystery…until recently. Researchers at the National Library of Medicine (NLM) found the answer in an unexpected place: the gut microbiome. Their findings can help us better understand certain health conditions, how our bodies work, and why some babies get jaundice.

    Why does urine look yellow?

    When your body replaces old red blood cells, it creates bilirubin. This substance then moves to your gut, where it either gets absorbed back into the bloodstream or is broken down into a chemical called urobilinogen. Your kidneys then turn urobilinogen into urobilin—this makes your urine yellow.

    While researchers knew about this process, one piece of the puzzle was still missing: What causes bilirubin to break down into urobilinogen? But researchers at NLM and the University of Maryland Hall Lab recently found the missing puzzle piece—a key enzyme called bilirubin reductase.

     

    bilirubin. urobilinogen. urobilin. stercobilin. conjugated bilirubin.

    When the body breaks down red blood cells, bilirubin is produced. Bilirubin moves to the gut, where it’s either absorbed into the blood again or turned into urobilinogen. This urobilinogen is sent to the kidneys and converted to the waste product urobilin, which makes urine yellow.

    How did researchers discover this?

    Their first step was to find a group of bacteria that could reduce bilirubin. Many gut bacteria need low-oxygen environments to survive. This is hard to do in a lab setting, so the scientists also used computer experiments to look at the genomes of multiple bacteria at a time. A genome is the entire set of DNA instructions found in a cell. is the entire set of DNA instructions found in a cell.

    Then from the bacterial genomes, researchers waded through all that bacterial data to find the gene that encoded the enzyme that breaks down bilirubin.

    “We were able to confirm their functions and then look at bigger picture trends, like the relationship of that gene to different kinds of diseases,” said Keith Dufault-Thompson, Ph.D., a staff scientist in NLM’s Division of Intramural Research (DIR).

    Why does this research matter?

    Most of the time, our bodies break down bilirubin every day without any issues. But when something goes wrong, bilirubin can build up in the blood. This can lead to health problems such as jaundice, in which your skin and the whites of your eyes turn yellow. Jaundice is common in infants and people with liver disease. It can lead to pain, fevers, hearing loss, and even brain damage in severe cases.

    Researchers wanted to see how the bilirubin reductase enzyme affects our health. After their discovery, they analyzed data from past studies on the gut microbiome (the ecosystem of bacteria and other microbes that live in the intestines). They took genetic samples from the microbiomes of healthy adults, young infants, and patients with inflammatory bowel disease (IBD) and searched for the gene that produces bilirubin reductase. Xiaofang Jiang, Ph.D., a principal investigator in the NLM DIR, and her team found that about 70% of infants don’t have the bacterial gene key to producing bilirubin reductase in their first month of life. This may explain why jaundice affects many newborns—their gut microbiomes aren’t as developed. The study also showed that more than 30% of adults with IBD don’t have the bacterial gene present, either.

    This new research may lead to better outcomes for infants and other people with these conditions. It can also teach us more about the gut microbiome’s role in overall human health.

     

    What’s next for this research?

    Since the bilirubin reductase discovery, the research team went back to look at previous data on gut microbiomes. They want to understand how the enzyme evolved in the gut environment.

    Dr. Dufault-Thompson said this work could help us understand bilirubin-reducing bacteria and pave the way for new treatments. Thanks to this study, the team can better understand what kind of functions gut bacteria can do and how they affect our bodies. These include how microbes metabolize (break down) artificial sweeteners and different types of hormones.

    “These projects have helped us broaden our understanding of the impact of microbes on human health and demonstrate the wide range of functions that our microbiomes carry out,” he said.

    *This article was adapted from the NLM Director’s Musings from the Mezzanine blog. Read the original article to learn more about this study and the researchers behind it.

    Image credit: Getty Images, National Library of Medicine

    January 03, 2025

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  • A new vaccine is here to protect you and your loved ones from RSV this winter

    A new vaccine is here to protect you and your loved ones from RSV this winter

    December and January are peak months for respiratory syncytial virus (RSV) infections. While anyone can get RSV, severe infections are more common in young children and older adults. Fortunately, new vaccine approvals by the U.S. Food and Drug Administration (FDA) mean there are more options to avoid getting sick this winter.

    In the spring of 2024, FDA licensed a new RSV vaccine, called MRESVIA, for adults 60 years of age and older. There are now three RSV vaccines recommended by the Centers for Disease Control and Prevention (CDC) for older adults—the other two are ABRYSVO and AREXVY.

    Different RSV immunizations are recommended based on age, risk factors, and pregnancy. CDC recommendations are different from FDA approvals. Always check with your health care provider about what is right for you.

     

    What is RSV?

    RSV is a highly contagious common respiratory virus. Individuals of any age can get infected. It usually causes mild, cold-like symptoms.

    RSV spreads from person to person directly, such as kissing the face of a child who has RSV, or indirectly, such as through the air by coughing and sneezing. You can also catch it by touching an object or surface with the virus on it before touching your mouth, nose, or eyes.

    In the United States, RSV infections usually occur from fall through spring. People with RSV are generally contagious for three to eight days. But sometimes infants and people with weakened immune systems can continue to spread the virus for as long as four weeks.

    While most cases are mild, it can cause serious lung infections in certain groups at higher risk, including:

    • Infants
    • Older adults, especially those ages 65 and older
    • People with chronic medical conditions such as heart or lung disease
    • People with weakened immune systems

    What are the symptoms?

    Symptoms of RSV infection usually start about four to six days after infection and may mimic the common cold:

    • Runny nose
    • Decrease in appetite
    • Cough
    • Sneezing
    • Fever
    • Wheezing
    • Trouble breathing

    These symptoms usually appear in stages instead of all at once. In very young infants, the only symptoms may be irritability, decreased activity, and trouble breathing. RSV can also cause more severe infections, especially in people at high risk. These infections include bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. If symptoms get worse over time, see a doctor right away.

    How is it diagnosed?

    A doctor can diagnose RSV. They can do tests, such as X-rays and blood or urine tests, to check for complications in people with severe infections. A doctor can also order lab tests, but they are usually for people with severe infections.

     

    Young child wearing a respirator

    Young children and infants with severe RSV infections may require hospitalization.

    How is RSV treated?

    There is no specific treatment for RSV, but most people get better on their own in a week or two. Drink lots of fluid to prevent dehydration. You can take over-the-counter pain relievers for fever or pain, but do not give aspirin to children. And do not give cough medicine to children younger than 4 years old.

    How is RSV prevented?

    To avoid catching RSV, wash your hands often with soap and water for at least 20 seconds or use sanitizer hand gel that contains at least 60% alcohol. Getting one of the available vaccines if you are eligible is also an effective way to lower your risk of RSV disease.

    RSV can survive for many hours on hard surfaces, such as tables and crib rails. It typically lives on soft surfaces, such as tissues and hands, for shorter amounts of time.

    The CDC recommends everyone ages 75 and older (and adults ages 60 to 74 who are at increased risk of severe infection) get an RSV vaccine. Pregnant people during their 32nd through 36th week of pregnancy are also advised to get the ABRYSVO vaccine. Young infants whose mothers did not receive one during pregnancy can receive a protective RSV antibody (different from a vaccine). Talk with your health care provider about the best time to get your vaccine. If you have already gotten an RSV vaccine, you do not need to get another one.

    RSV vaccines are usually covered by private health insurance, the Children’s Health Insurance Program, Medicare Part D, Medicaid, and TRICARE for military. CDC’s Vaccines for Children program also provides free immunizations for children at participating doctor’s offices, pharmacies, and health clinics.

    Image credit: Getty Images

    January 02, 2025

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  • Working Out to Stay Sharp

    Working Out to Stay Sharp

    January 2025

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    Can Exercise Keep Your Brain Healthier?

    We’ve all heard that exercise is good for us. Experts recommend getting at least 150 minutes of moderate-intensity aerobic activity each week. This can include brisk walking, biking, playing tennis, or even pushing a lawnmower. Strength training exercises, like lifting weights, push-ups, or sit-ups, are recommended at least two days a week.

    Many benefits of exercise are well-known. Aerobic exercise can help you maintain a healthy weight by burning fat. It can also keep your heart healthy. Strength training can help to build muscle mass and strengthen your bones. Stretching can improve flexibility and range of motion. And balance exercises can prevent falls. Scientists are finding out that exercise may also improve our brain health.

    Research has shown that when you exercise, many different molecules are released into your bloodstream. These molecules travel to different organs and tissues, where they trigger changes that help your cells withstand the physical stress of exercise.

    “You’re basically telling your body, ‘You need to prepare for something,’” explains Dr. Saul Villeda, who studies the aging brain at the University of California, San Francisco. In
    preparing to withstand exercise, cells also seem to get better at withstanding the effects of aging.

    As we age, our Related to the ability to think, learn, and remember.
    cognitive     abilities often start to decline. We may have difficulty with learning and memory. That’s because our brains undergo cellular changes as we get older. The protective barrier around the brain also changes, altering which substances can get into your brain. Some of these have potentially harmful effects.

    Studies in mice and rats have shown that exercise can partially offset these changes. And it can prevent at least some of the cognitive decline that occurs with age. These benefits haven’t just been seen in mice, either. Research has also shown a link between aerobic exercise and better memory in people.

    Certain exercise-induced molecules have been shown to boost cognitive functions in mice. Villeda and colleagues are studying one called GPLD1. They’ve found that it’s at least partly responsible for why exercise improves new brain cell formation, learning, and memory in aged mice.

    Villeda’s team has also shown that more active older adults have more GPLD1 in their blood. This suggests that GPLD1 may have a similar function in people. GPLD1 production has shown effects similar to exercise in the brains of mice. So, Villeda hopes that one day GPLD1 can help improve the health of people who aren’t able to exercise.

    Don’t be discouraged if the recommended amount of exercise seems overwhelming. It’s okay to start small. “A little bit goes a long way,” Villeda says. “Even just moving a few minutes extra that you wouldn’t have done already has a benefit.” He notes that his research findings have motivated him to start exercising, which he didn’t do before. “Even though I’m dealing with mice, the benefits that I can physically see in them have compelled a couch potato [like me] to actually get up and start exercising.”

    See the Wise Choices box for tips on getting exercise in your day.

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  • Health Consequences of Early Exposure to Sugar

    Health Consequences of Early Exposure to Sugar

    January 2025

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    Experts recommend that kids eat no added sugars before age 2. Yet most kids are exposed to added sugars at a very early age, even before birth through their mother’s bloodstream.

    Scientists studied the long-term health effects of sugar exposure in the womb and early childhood. To do this, they looked at the health of adults in the United Kingdom who were conceived or born around the end of sugar rationing. The rationing had begun during World War II. The amount of sugar allowed for each person was within today’s U.S. dietary guidelines. After rationing ended, sugar intake nearly doubled.

    The researchers looked at data from more than 60,000 people born in the U.K. between October 1951 and March 1956. Those born before July 1954 likely had reduced exposure to sugar due to rationing. Those born in July 1954 and later didn’t experience sugar rationing. As a result, they were born into a more sugar-rich environment.

    Kids exposed to less sugar early in life had a lower chance of getting diabetes or high blood pressure decades later. Health benefits increased with longer exposure to rationing. For those with reduced sugar exposure for at least 19 months after birth, the risk of getting diabetes dropped by about 35%. The risk of high blood pressure dropped by about 20%.

    “It is hard to find situations where people are randomly exposed to different nutritional environments early in life, and follow them for 50 to 60 years,” says Dr. Tadeja Gracner of the University of Southern California, who led the study. “The end of rationing provided us with a novel natural experiment to overcome some of these challenges.” 

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  • Mobius Syndrome

    Mobius Syndrome

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Birth Defects, Facial Injuries and Disorders

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  • Piriformis Syndrome

    Piriformis Syndrome

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Neuromuscular Disorders, Sciatica

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  • Neuroleptic Malignant Syndrome

    Neuroleptic Malignant Syndrome

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Drug Reactions, Psychotic Disorders

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  • Incontinentia Pigmenti

    Incontinentia Pigmenti

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Skin Pigmentation Disorders

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  • Melkersson-rosenthal syndrome

    Melkersson-rosenthal syndrome

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Facial Injuries and Disorders, Mouth Disorders

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  • Wernicke-Korsakoff Syndrome | National Institute on Alcohol Abuse and Alcoholism (NIAAA)

    Wernicke-Korsakoff Syndrome | National Institute on Alcohol Abuse and Alcoholism (NIAAA)

    Wernicke-Korsakoff (WK) syndrome is a serious brain condition that is usually, but not exclusively, associated with chronic alcohol misuse and severe alcohol use disorder (AUD). The prevalence of WK syndrome across populations is not well established, and researchers estimate that it may remain undiagnosed in approximately 80 percent of patients.1,2,3

    What Causes WK Syndrome?

    WK syndrome involves two different brain disorders that often occur together: Wernicke’s disease and Korsakoff’s psychosis. They result from brain damage associated with AUD, combined with vitamin B1 (thiamine) deficiency. In people with severe AUD, poor nutrition decreases the ability of the gut to absorb thiamine from food and, therefore, increases the chance of developing WK syndrome. Without treatment, WK syndrome can be disabling, produce permanent memory loss, and be life-threatening.1,2

    Image

    Graded brain-volume deficits in wernicke-korsakoff syndrome (T1-weighted MRI scans). Three images of brain scans showing a normal brain and three images of brain scans showing wernicke-korsakoff syndrome..

    Magnetic resonance imaging (MRI) scans of a healthy male (top) compared to a male of the same age with WK syndrome (bottom). The WK brain has less brain volume and larger cavities within the brain (called ventricles).

    Credit: Adapted from a figure by A. Pfefferbaum, SRI International

    What Are the Symptoms?

    In WK syndrome, damage occurs in a variety of brain regions, most notably the thalamus, hippocampus, hypothalamus, and cerebellum. These areas contribute to a wide range of functions such as vision, movement, language, sleep, memory, and motivation.1,2,3

    Symptoms of Wernicke’s disease include: 

    • Confusion 
    • Lack of energy, hypothermia, low blood pressure, or coma
    • Lack of muscle coordination that can affect posture and balance and can lead to tremors (i.e., involuntary movements in one or more parts of the body)  
    • Vision problems such as abnormal eye movements (e.g., back and forth movements called nystagmus), double vision, misaligned or crossed eyes, and eyelid drooping

    Although some symptoms of Wernicke’s disease such as muscle and vision problems are reversible with prompt thiamine treatment, other symptoms may respond more slowly or may not be completely reversible. Without prompt treatment, Wernicke’s disease can progress to Korsakoff’s psychosis, which is not reversible.2

    Symptoms of Korsakoff’s psychosis include those listed above, as well as: 

    • Potentially severe, irreversible memory impairments, including problems forming new memories (called anterograde amnesia) and recalling memories2
    • Making up inaccurate stories about events (i.e., confabulation) or remembering events incorrectly
    • Experiencing hallucinations (i.e., seeing or hearing things that are not really there)
    • Repetitious speech and actions1,2
    • Problems with decision making as well as planning, organizing, and completing tasks2
    • Lack of motivation and emotional apathy2

    How Is WK Syndrome Diagnosed?

    WK syndrome is clinically diagnosed based on a patient’s history and the presence of the above-mentioned symptoms. When clinicians identify possible cases of WK syndrome, they may be able to confirm the diagnosis through magnetic resonance imaging (MRI) scans of the brain. It is noteworthy that WK syndrome may result from other conditions that involved malnutrition and B1 deficiency, such as cancer, AIDS, excessive vomiting (often associated with pregnancy), anorexia nervosa, hemodialysis, and gastrointestinal or bariatric surgery.1 However, these cases are far less prevalent than cases associated with severe AUD. 

    How Is WK Syndrome Treated?

    If you are concerned about someone with WK syndrome, talk to your primary care physician or a specialist—such as an internist, psychiatrist, addiction psychiatrist, addiction medicine physician, or neurologist.

    Early symptoms of Wernicke’s disease can be reversed if detected and treated promptly and completely; therefore, Wernicke’s disease should be considered a medical emergency. Doctors treat Wernicke’s disease with intravenous administration of vitamin B1 and glucose. Treatment may also consist of addressing co-occurring symptoms in the short term.1

    Without adequate treatment, Wernicke’s disease can progress into Korsakoff’s psychosis. In Korsakoff’s psychosis, severe memory loss and other damage could become permanent. Treatments for Korsakoff’s psychosis include intravenous vitamin B1 replacement therapy and oral supplements for several weeks, as well as proper nutrition, hydration, and other medications to manage specific symptoms. Aside from B1 therapy in the short term, there is no one optimal treatment—treatment often varies depending on symptoms, severity, and other co-occurring deficits such as psychosis or other major psychiatric disorders. Memory rehabilitation therapies—similar to those provided for various forms of dementia—can be effective in lessening the symptoms, but severe cases often require residential care.1

    Caution: Alcohol Withdrawal

    Abstaining from alcohol use is critical to prevent and reduce additional brain damage at all stages of WK syndrome.1,2 Please note that when someone who has been drinking heavily for a prolonged period of time suddenly stops drinking, the body can go into a painful or even potentially life-threatening process of withdrawal. Individuals should seek medical help to plan a safe recovery.

    For more information about how alcohol affects the brain, please visit Alcohol and the Brain. For more information about available evidence-based treatments for AUD, please visit the NIAAA Alcohol Treatment Navigator.

     

    1 Oscar-Berman, M.; and Maleki, N. Alcohol dementia, Wernicke’s encephalophathy, and Korsakoff’s syndrome. In: Alosco, M.L.; and Stern, R.A., eds. The Oxford Handbook of Adult Cognitive Disorders. Oxford University Press, 2018. https://doi.org/10.1093/oxfordhb/9780190664121.013.33

    2 Koob, G.F.; Arends, M.A.; McCracken, M; and Le Moal, M. Chapter 5.4.4. Neurological disorders. Neurobiology of Addiction. Vol. 3. Academic Press, 2021.

    3 Oscar-Berman, M. Function and dysfunction of prefrontal brain circuitry in alcoholic Korsakoff’s syndrome. Neuropsychol Rev 22:154–169, 2012. https://doi.org/10.1007/s11065-012-9198-x

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