Month: July 2017

 
You are never alone.
Everywhere you go, you carry legions of microbes around with you. Your gut is teeming with more than 100 trillion microscopic organisms. The latest research suggests that these ever-present companions engage in an ongoing chemical conversation with your brain that can have intense effects on your emotional life.

Just ask Emeran Mayer, a gastroenterologist and director of the Oppenheimer Family Center for Neurobiology of Stress at UCLA. Mayer has been writing about the mind–gut connection for decades, and he recently wrote a book with a title that will surprise exactly no one familiar with his work. It’s called The Mind-Gut Connection: How the Hidden Conversation Within Our Bodies Impacts Our Mood, Our Choices, and Our Overall Health.
“The gut and the brain are closely linked through bidirectional signaling pathways that include nerves, hormones, and inflammatory molecules,” Mayer writes.
Rich sensory information generated in the gut reaches the brain (gut sensations), and the brain sends signals back to the gut to adjust its function (gut reactions). The close interactions of these pathways play a crucial role in the generation of emotions and in optimal gut function. The two are intricately linked.

If you’ve ever felt a rumble in the pit of your stomach while being rejected by a crush; if you’ve felt a warm glow in your belly while cuddling with a loved one; if your stomach has ever clenched up during a moment of unabashed rage—then you won’t need much convincing to accept Mayer’s point.

And the research uncovering this constant interplay between gut and mind keeps pouring in.

A recent study in the journal Psychosomatic Medicine uncovered a clear connection between the gut microbiome and regions of the brain that are associated with mood and emotion. Research like this has the potential to reframe questions of identity and even the definition of “individuality” itself, and it all starts with poop. Yes, poop.

Researchers began their study by collecting fecal samples from 40 healthy women. They sent the samples off to be tested. They weren’t just being gross; fecal samples are the best way to get a snapshot of an individual’s gut biome, because they contain a lot of the little critters that live in the digestive system.
Meanwhile, the researchers hooked the women up to a functional magnetic resonance imaging (fMRI) machine to watch their brains flash as they reacted to a series of images that were intended to spark deep feeling.

Some of the images were designed to make viewers unhappy, whereas others were more positive. They tracked each woman’s brain behavior when she looked at these images and then compared that data to the microbial zoo in the subject’s gut.
There were two particular groups of microbes that the researchers noticed immediately. Some of the women had more Bacteroides, while others were full of thriving Prevotella populations. When a Prevotella-heavy woman looked at an unhappy image, the parts of her brain associated with processing senses, emotions, and attention lit up. Her hippocampus, which tends to regulate extreme emotional reactions, remained comparatively dim.

Unsurprisingly, then, these women had much stronger negative reactions when shown the negative pictures.

Their counterparts with more Bacteroides in their guts had more active hippocampi and were able to resist getting sucked down into the doldrums just from looking at a sad picture.

Who knows if this means what it seems to mean. This study only showed correlation between gut microbiome contents and emotional response. It will take lots more science before we can assume that Prevotella makes people depressed.
Still, this whole line of research sort of explains why Mayer calls the gut “the little brain” in his book. Gut microbes really do appear to interact with the “big brain” in impactful ways.
“There are receptors throughout our bodies that respond to signals from the microbes or the metabolites they produce,” Mayer said in an interview with the Los Angeles Times.
For example, certain microbes can influence the production of the serotonin molecule, which plays a role in appetite regulation, food intake, well-being, and sleep. That gives the microbes a tremendous ability to influence overall health states.

Also, some microbe signals can activate the vagus nerve endings in the gut, which are like an information highway to the brain. Many of these effects are seen in animal studies. Researchers manipulated the microbes in the guts of mice and saw different behaviors. But these same behaviors were abolished when they cut the vagus nerve.
We have a long way to go before we start to understand the complex relationship between human emotions and the gut microbiome. But we’ve also come a long way from the early view of bacteria as simply “the enemy.”
Science writer Ed Yong explains the growing conception of microbes as natural elements of the human body in his aptly titled book I Contain Multitudes: The Microbes Within Us and a Grander View of Life.

“[We] are continuously built and reshaped by the bacteria inside us,” Yong writes. It’s a symbiotic relationship that stretches back to the very beginning of humanity, and beyond, back into our evolutionary past. Humans and the microbes that live within them evolved together.
Yong underscores this strange fact when he questions the title of his own book.
“Perhaps it is less that I contain multitudes and more that I am multitudes,” he writes.
As we learn more about how the lifeforms that we carry affect the deepest parts of our lives—how they are, in a very real way, part of what we refer to when we say “us”—it seems pretty likely that new frontiers of medicine will open up.

Maybe we’ll even discover new conceptions of selfhood. After all, our microbial companions don’t just live inside our bodies. We breathe them out in a constant cloud, and who’s to say that doesn’t thin the barrier between self and other? Or maybe even dissolve it completely?

In 2013, a 35-year-old pregnant woman walked into a St. Louis hospital and told her doctor she was unusually weak and dizzy.

These symptoms began a month before, and they got worse and worse. By the time the woman went to the hospital, she was 37 weeks pregnant.

But at the hospital, the woman’s troubles only increased. Her heart rate, already irregular, got faster and faster. Doctors admitted her to the intensive care unit and started her on an intravenous drip full of fluids and electrolytes; the woman’s potassium levels were dangerously low.
Potassium is an important electrolyte that’s essential for the normal function of the brain, nerves, and muscles. Low potassium, or hypokalemia, can cause a number of problems, including weakness, cramping, fatigue, constipation, and, in serious cases, heart problems.
The woman’s situation was getting more serious by the hour, as detailed in a case study published in the medical journal Obstetrics & Gynecology. Doctors not only had to figure out what was causing the woman’s symptoms, they had to make sure to save the baby.

It soon became clear that the woman’s heart muscle was weakened, a condition known as peripartum cardiomyopathy. This disorder only occurs in about 1,000 to 1,300 women in the U.S. every year, and no one knows what causes it.

There was no question that the woman had peripartum cardiomyopathy, but that still didn’t explain her terribly low levels of potassium.

Her health care team gave her medications to treat the heart condition and turned their attention to the infant. They induced the woman and she gave birth to a healthy son. He weighed 5 pounds, 4 ounces, and, thankfully, did not appear to have suffered from his mother’s health scare.

Two days later, she provided the clue that explained her entire condition. She had been eating huge amounts of baking soda for years, she explained. This craving proved to be a terrible danger to the woman and her child.
“Eating large amounts of baking soda (which contains sodium bicarbonate) can lead to severe electrolyte disturbances, muscle breakdown and ultimately heart failure or cardiomyopathy,” Miami-based TopLine OBGYN Sarah Bedell, MD, tells HealthyWay.
At first, the sick woman’s box-a-day habit was a self-administered treatment for hiccups, but when she got pregnant, it became a craving.
Anyone who’s ever been pregnant understands that you end up craving some weird foods, but this woman’s pregnancy craving put her life—and the life of her baby—in danger.

Fortunately, once she quit eating baking soda, her potassium levels evened out, and she got healthy enough to go home with her brand new baby boy.
Here’s the thing, though: This woman’s case was not the first of its kind. The literature shows at least two similar cases, in which pregnant women crave baking soda, eventually eating so much of it that they develop health problems.

The condition is called pica, and it’s often associated with pregnancy.

Not everyone who develops pica craves baking soda exclusively. People with pica end up with all sorts of strange cravings for non-food substances.

In many cases, cravings can be difficult to overcome.

“Pica is defined as the persistent eating of non-nutritious substances that are typically not considered food for at least one month,” says Bedell. “Examples of substances commonly consumed with this condition include ice, starch, earth, chalk, charcoal, toilet paper, baby powder and coffee grounds.”

Incidence rates of pica in the United States are between 14 and 44 percent, although that includes every form of the disorder, not just pregnancy-related pica. One study of 128 pregnant women found that 38 percent of the participants developed pica before giving birth.
Pica cravings occur in fewer than 25 to 30 percent of pregnant women, reports the American Pregnancy Association. But one study of 128 pregnant women found that 38 percent of the participants developed pica before giving birth.
Unfortunately, though, many doctors assume that only a fraction of their patients with pica are stepping forward for treatment.
“Compulsive eating, especially of inedible objects, can be a source of considerable embarrassment or ridicule,” points out a chapter in the medical textbook Clinical Methods: The History, Physical, and Laboratory Examinations. “Hence, only a few patients come to the physician complaining of their unusual eating habit.”

There’s reason to believe the practice may be more widespread than the statistics show. That’s just another reason why, if you develop pica, you shouldn’t feel ashamed about it. But what, exactly, could lead to a craving for dirt or ashes? As the American Pregnancy Association says, “Don’t panic. It happens and is not abnormal.”

Although researchers have yet to pinpoint the cause of pica, most associate it with a little-known vitamin or mineral shortage.

Unfortunately, this condition is part of the mystery of human health, and there isn’t one specific explanation that can tell the whole story.
“Eating clay or soil, which contain several minerals, could provide a way for the body to replenish low levels of these nutrients,” says Bedell. “This theory is imperfect, however, as several consumed substances (ice, toilet paper, etc) have minimal or no nutritional value.”

One article in the Journal of the Academy of Nutrition and Dietetics associates pica with an iron deficiency (also known as anemia). That’s something Bedell has seen in her own practice.
Bedell explains that “pica is often associated with anemia, which results from low blood counts or low iron stores in the body. This makes pregnant patients particularly susceptible, as anemia is commonly seen in pregnancy. Low levels of zinc have also been associated with pica.”
According to Clinical Methods, even slight iron deficiencies, not severe enough to earn the label “anemia,” have been associated with pica.
“In fact,” the book reports, “A pica may be detected in as many as 50 percent of all persons with iron deficiency.”

Pica in pregnancy, as well as cravings in general, are common.

Whether patients lack iron, zinc, or some other mineral—and this probably goes without saying—there are far healthier ways to get enough vitamins and minerals than eating dirt.
In fact, depending on the severity of the pica, sufferers like the woman in the above story can easily place their health at risk. For pregnant women with pica, those health risks also apply to their unborn child.
The American Pregnancy Association warns that “eating non-food substances is potentially harmful to both you and your baby. Eating non-food substances may interfere with the nutrient absorption of healthy food substances and actually cause a deficiency. Pica cravings are also a concern because non-food items may contain toxic or parasitic ingredients.”

However, if you do find yourself giving into odd cravings for dirt or soap while pregnant, don’t think that you’ve completely lost your mind. Remember, that study found a nearly 40 percent rate of pica among pregnant women. It’s not good for you, but you aren’t alone.
“Patients should be reassured that pica in pregnancy, as well as cravings in general, are common,” Bedell reminds us. She continues, “Treatment should focus on safety. Treating possible underlying causes, such as anemia, with iron should be attempted, but may not always stop cravings. Of course, eating dangerous materials should be stopped immediately.”
That’s not always as easy as it seems, though, Bedell explains.
“In many cases, cravings can be difficult to overcome,” she says.

So if you are pregnant and you find yourself craving dirt…

Listen to the American Pregnancy Association when they say: “Don’t panic. It happens and is not abnormal.”

Most women who experience pica for a short period of time do not experience any adverse effects.

So what should you do if you suspect you have pica while you’re pregnant? “If you think you are suffering from pica you should discuss this with your OBGYN as soon as possible, so it can be discussed if what you are consuming is harmful,” Bedell says.

She also recommends contacting “your local Poison Control Center if you think you have consumed something that poses immediate danger.”
A healthcare professional can walk you through the risks of these strange cravings. For many women, that alone is enough to help them beat the temptation to grab a big bite of dirt.
You can also monitor your iron levels and make sure you get enough vitamins and minerals. Introduce dark, leafy greens and lots of beans in your diet. Even white rice supplies a lot of iron. Whatever iron-rich food you prefer, be sure to eat lots of it. Sufficient iron might help to prevent pica from developing in the first place.
You can also provide yourself with alternatives to giving into your cravings. Try carrying sugar-free gum everywhere you go. If you feel a craving coming on, start chewing your gum until the temptation passes.

“Patients should try to substitute what they are eating with something that has similar qualities but is less harmful. For example, women who crave rubber can try chewing gum instead, and those who crave soil or clay can substitute oatmeal,” says Bedell.
Finally, the American Pregnancy Association recommends telling a friend what you’re going through. That friend can “help you avoid non-food items,” according to the APA website.
“In most circumstances, pica is not dangerous. Most women who experience pica for a short period of time do not experience any adverse effects. However, depending on the type and amount of substance being consumed, pica can lead to serious health consequences,” says Bedell. “Poor outcomes are usually seen if repeated consumption occurs over time.”
Whatever you do, don’t start eating boxes and boxes of baking soda every day. We’ve seen where that path leads, and it is frightening.

For lunch five minutes ago I consumed a LÄRABAR and slices of deli roast beef, medium rare, straight from the bag. Also spironolactone, an androgen-blocking diuretic that the dermatologist prescribed a few days ago for my hormonal acne.

Later today, I may go to the gym for a HIIT session on the treadmill. After I spend hours writing, I need to counteract that feeling I get of being a caged and force-fattened animal destined to spend its entire life immobile in a factory farm.
Most of this would be considered antithetical to “wellness”—the red meat, the nitrates, the steroids, the sitting, the existential unrest—but I feel well enough. My doctor, who just gave me an annual checkup complete with blood work, also reports that I’m perfectly healthy.
Notice that I said “well enough.” See how hesitant I am to embrace my own health, even when I have it completely? “Well enough,” as in, “Fine, but maybe actually not fine at all.”

My ambivalence comes from a penchant for hypochondria, one that imagines ailments both physical and spiritual. This hypochondria tells me that a self-actualized me would not simply be “well enough.”
It—like lifestyle gurus, sci-fi movies, fitness moguls, organized religion, and Tinder—leads me to suspect that there is always better. That there is something subtly, but deeply, wrong. Something that, once discovered, will finally open my eyes to just how wrong I have been all along.
It is the quick reward. It is the constant chatter. It is the refusal to be with “that thing—that empty, forever empty” feeling that sits somewhere deep down.

The promise of something better (read: perfection) is at the heart of everything we buy, whether that’s bee pollen or the Master Cleanse or evangelical Christianity. It’s up to us to manage our expectations of what any of these can realistically deliver. How? By asking questions and making sure the answers are backed by science (not pseudoscience).
What is “wellness,” anyway, and who is defining it? There is no consensus. Let’s just say it’s a new word for an old concept—health—and also a brand that people are using to sell expensive things.

I can’t claim to know what “wellness” is, but I can say what health is not: the habit of wasting resources on empty promises. And the people peddling “wellness,” like the people peddling indulgences, promise a whole lot.
To help you, here’s a list of “wellness”-branded items that are almost certainly bullsh*t, according to science.

Vag Rocks

Have you heard of goop? Not the stuff in your eyes when you wake up, but Gwyneth Paltrow’s lifestyle brand?

Steam Douching

If you’re in LA, there is something that you simply must do, according to goop: get hot air blown into your lady parts.
The “V-steam” goes like this: “You sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus, et al. It is an energetic release—not just a steam douche—that balances female hormone levels.”

Dr. Gunter’s response? “Don’t.” She writes:
“We don’t know the effect of steam on the lower reproductive tract, but the lactobacilli strains that keep vaginas healthy are very finicky about their environment and raising the temperature with steam and whatever infrared nonsense Paltrow means is likely not beneficial and is potentially harmful.
“Some strains of lactobacilli are so hard to cultivate outside of this the very specific vaginal environment that growing them in a lab is next to impossible. There is also the possibility that the ‘steam’ from these plants could contain volatile substances that are harmful to lactobacilli or other aspects of the vaginal ecosystem.”

Juice Cleanses

The glory days of the juice fast have now faded, and here’s why: It actually isn’t very healthy. Sure, it’s fruit and it’s vegetables. But, as The Washington Post puts it, juicing “takes healthy fruits and vegetables and makes them much less healthy.”

You know the seeds, the membranes, the meat of the fruit? You need it. “That is where most of the fiber, as well as many of the antioxidants, phytonutrients, vitamins and minerals are hiding,” reports The Washington Post.
“Fiber is good for your gut; it fills you up and slows the absorption of the sugars you eat, resulting in smaller spikes in insulin. When your body can no longer keep up with your need for insulin, Type 2 diabetes can develop.”
To add to the problem, juice does not register in the stomach the same way that other, whole foods do, meaning that your liquid meal will likely leave you much less satisfied than a solid meal with the same number of calories.

The takeaway? Drink less juice, more water.

Detoxing in General

By now, you have heard about all the toxins you’re ingesting daily. These toxins, though difficult to define, are literally everywhere. They’re in your bar soap, on your food, in your dog’s food, in your face lotion with SPF…you get the picture.

Many products advertise their ability to “detox” or “cleanse” your body, sometimes targeting specific organs like the liver. But what exactly are they accomplishing?
Nothing good, according to experts. “There is something to be said for doing ‘food resets.’ That is, going back to the basic tenets of healthful eating (mainly eating whole, minimally processed, largely plant-based foods) to reaccustom the taste buds to more subtle flavors,” registered dietitian Andy Bellatti tells Lifehacker.

But this is different from a cleanse, during which your body is more likely to be breaking itself down because of insufficient macronutrients like protein.
“Nutrition and health is about the big picture,” Bellati says. “What you do for five or seven days out of the year is pretty inconsequential.”

So: Cut out the cleanses, and eat more fruits and vegetables every day instead. But you already knew this, somewhere deep down.

One night a handful of years ago I was texting with this guy. I don’t remember what we were texting about. For some reason I want to say we were texting about pizza?

Anyway, let’s say it was pizza. We were just having a normal conversation, and then suddenly everything changed. His texts became strange. Words were poorly spelled. Some sentences were pure gibberish. I wondered if he’d overdone it at a party—while we were talking. I wondered if he was having a stroke.
It occurred to me then that these texts were from a different person entirely. Someone had clearly broken in his home and stolen his phone. I imagined him lying on the carpet near his couch, maybe on the kitchen tile, knocked out, the door wide open, some youth texting me.

Then the texts stopped. I think I tried to call him, and nobody picked up. I fretted. Should I alert the police? What if he was just sick, or being weird, or one of his friends or even a random child—but whose?—had taken his phone? How embarrassing would it be if I treated this like an emergency when it was not, in fact, an emergency?
In the end, I chose sleep.
Thankfully, my intuition (and not my worst-case-scenario imagination) had been solid: Apparently he, too, had chosen sleep, only the Ambien-induced kind. In the morning he apologized and said it had kicked in while he was still awake, causing the wonky texts.

But that’s not even the weirdest thing this medicinal sleep aid can make you do. Read on for five of the strangest medication side effects, including more Ambien-induced weirdness.

1. Eating in Your Sleep

As Sarah Fazeli writes for xoJane in “I Just Sabotaged My Perfect Weight Watchers Week By Sleep-Eating on Ambien,” consuming food while asleep is a real thing that happens to some people who take the magical sleeping elixir also known as Ambien.

(“If you take Ambien and miss the ‘window’ for falling asleep, you run the risk of Ambi-texting, Ambi-binging, Ambi-dialing, and Ambi-ing any other activity…” she writes. “Kind of scary.”)
Fazeli says she doubled up on the dosage of the sedative–hypnotic med during a visit to her parents’ home, hoping the extra Ambien would counteract a change in time zone. (Though upping from 5 mg to 10 mg, this was still within the prescribed range.)

That night, she had a vivid dream featuring Toll House chocolate chips, lemon cookies, and Butterfinger-flavored Slim Fast bars.
“All dressed and ready for the day, I went downstairs and that’s when I saw it: a menagerie of packaged food products, open and strewn about the kitchen floor!” she writes. “There were foil and clear plastic wrappers scattered in and around the trash can, and dirty bowls and plates in the sink.”

Fazeli isn’t alone. In 2006, the New York Times ran a piece confirming what many likely had already learned from firsthand experience:
“…Ambien seems to unlock a primitive desire to eat in some patients, according to emerging medical case studies that describe how…users sometimes sleepwalk into their kitchens, claw through their refrigerators like animals and consume calories ranging into the thousands.”

The article tells the story of one woman, Ms. Evans, who was recovering from back surgery when her son came to visit. “The first night her son was there, he found her standing in the kitchen, body cast and all, frying bacon and eggs,” writes Stephanie Saul. “The next night he found her eating a sandwich, Ms. Evans said, and sent her back to bed.”
Honestly sounds exactly like me during college on Friday nights after going out, but I can only imagine how much more disconcerting this would be when you could have sworn you’d ended your night in bed.

2. A Black Hairy Tongue

Let’s say you did some late-night binging, possibly even as you thought you were asleep. How might you counteract the next day’s inevitable stomach discomfort?

Pepto-Bismol, right? It’s one of the most familiar treatments for “nausea, heartburn, indigestion, upset stomach, diarrhea,” with that friendly pink color to boot. But what if the bubble-gum color was masking a sinister side effect, like black hairy tongue?
Yes, black hairy tongue is real, and it’s terrifying. (Okay, so it actually isn’t that terrifying; it’s apparently “harmless” and “easily remedied by good old-fashioned oral hygiene.”)

The scary-sounding condition is caused by an overgrowth of bacteria or yeast in the mouth, which can be a side effect of medications containing bismuth, such as good old Pepto-Bismol.

3. Compulsive Gambling

Ropinirole, or Requip, is used by people with Parkinson’s disease or restless legs syndrome.

Some of the side effects sound run of the mill—constipation, dizziness, increased sweating, lightheadedness, loss of appetite, nausea, vomiting, weakness—but then you get to some…different sounding ones.
For example, “Falling Asleep During Activities of Daily Living,” as listed in the medication’s guide.
Frightening and dangerous as it may sound to randomly fall asleep while driving, this is not so out of the ordinary as one of Requip’s other possible side effects: compulsive gambling.

“Researchers monitored the medical records of 267 patients who were taking Ropinirole between July 1, 2004, and June 30, 2006, and found that…nearly 20 percent of the subjects were documented with hypersexuality as well as experiencing the new-onset of compulsive gambling,” reports Men’s Health on findings published in the Mayo Clinic Proceedings.

4. A British Accent

Okay, so technically this is a side effect from a medical procedure rather than medicine, but it’s too wild not to include. Imagine going in for a jaw surgery with a Southern accent and waking up with a British one.

Though it sounds like something out of a science-fiction movie, that’s exactly what happened to Lisa Alamia last year. The Texan woman of Mexican descent had a distinct drawl before being operated on. After surgery, you might have guessed she was from the U.K.
“I didn’t notice it at first,” Alamia told CNN. “But my husband told me I was talking funny. My surgeon thought it was just a physical result of the surgery and that it would go away as I healed.”

Foreign-accent syndrome is an extremely rare condition that’s been observed in around 100 people over the last century.
The trigger can be neurogenic, psychogenic, or some combination of the two, Julie Beck writes in The Atlantic—neurogenic referring to some kind of traumatic brain injury, and psychogenic meaning caused by a psychiatric disorder such as schizophrenia or bipolar disorder.

5. Blue Pee

Your pee says a lot about you.
If it’s dark, cloudy, or strong smelling, you probably aren’t drinking enough water. Or maybe you’re just consuming a lot of asparagus, coffee, and McDonald’s cheeseburgers with onions.
(According to WebMD’s symptom checker, the stank could be from a more serious cause like a urinary tract or kidney infection. And although dark urine likely just means you’re dehydrated, be aware that it might indicate a liver problem.)

If the liquid you leave in the toilet looks more like a softly brewed green tea or a watered-down original-flavor Gatorade, you’re in the clear. Congratulations!
In some cases, however—as happens with certain medications—your urine can take on other less typical shades. Rifampin or phenazopyridine, which treat tuberculosis and urinary problems, respectively, can cause red urine. Laxatives created from senna leaves and cascara bark can cause black urine.

Promethazine (for allergies and motion sickness), cimetidine (for ulcers and acid reflux), amitriptyline (an antidepressant), metoclopramide (for gastroesophageal reflux disease, aka GERD), and indomethacin (a nonsteroidal anti-inflammatory pain reliever) have all been associated with green urine.
But by far the most aesthetically thrilling surprise color for urine to be, in my opinion, is blue. This can be caused by amitriptyline, indomethacin, or the anesthetic propofol (aka Diprivan).
Pretty far out, as far as side effects go. Is anyone else craving Kool-Aid?