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<h2>What is type 2 diabetes?</h2>
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by elevated blood glucose levels. In T2DM, the body either produces insufficient insulin or its cells become resistant to insulin’s effects. Insulin is the hormone that enables glucose to enter cells for energy. When insulin function is impaired, glucose accumulates in the bloodstream, leading to hyperglycemia.

Type 2 diabetes was once called adult-onset diabetes but now occurs at younger ages due to rising <a data-wpil="url" href="/blog/how-effective-is-survodutide-for-obesity-treatment/">obesity</a> rates. Genetics, lifestyle, and environmental factors all contribute to its development.
<h2>Causes and risk factors</h2>
<ul>
 	<li>Genetic predisposition and family history</li>
 	<li>Overweight and obesity, especially abdominal fat</li>
 	<li>Insulin resistance in muscle, fat, and liver cells</li>
 	<li>Physical inactivity and sedentary lifestyle</li>
 	<li>Diets high in refined sugars, unhealthy fats, and processed foods</li>
 	<li>Low levels of “good” HDL cholesterol and high triglycerides</li>
 	<li>Age (risk rises after age 45)</li>
 	<li>Ethnicity (higher risk in African Americans, Hispanics, Native Americans, Asian Americans, Pacific Islanders)</li>
 	<li>History of gestational diabetes</li>
 	<li>Medical conditions such as polycystic ovary syndrome (PCOS) and metabolic syndrome</li>
 	<li>Certain medications (e.g., corticosteroids, some antipsychotics)</li>
</ul>
<h2>Symptoms</h2>
Type 2 diabetes can develop gradually. Common signs include:
<ul>
 	<li>Increased thirst and frequent urination</li>
 	<li>Unexplained <a class="wpil_keyword_link" href="/conditions/weight-loss" title="Weight Loss" data-wpil-keyword-link="linked" data-wpil-monitor-id="933">weight loss</a> despite increased appetite</li>
 	<li>Persistent fatigue</li>
 	<li>Blurred vision</li>
 	<li>Slow wound healing and frequent infections</li>
 	<li>Tingling or numbness in the hands and feet</li>
 	<li>Darkened skin patches (acanthosis nigricans) in body folds</li>
</ul>
<h2>Diagnosis</h2>
Diagnosis typically involves one or more of the following blood tests:
<ul>
 	<li>Fasting plasma glucose ≥ 126 mg/dL on two occasions</li>
 	<li>Oral glucose tolerance test with 2-hour glucose ≥ 200 mg/dL</li>
 	<li>Random plasma glucose ≥ 200 mg/dL in a person with classic symptoms</li>
 	<li>Hemoglobin A1C ≥ 6.5%</li>
</ul>
Additional tests may include lipid panels, liver and kidney function, and screening for complications.
<h2>Treatment</h2>
Management combines lifestyle changes, monitoring, and medications:
<ul>
 	<li>Healthy eating: Emphasize whole grains, vegetables, lean proteins, and healthy fats</li>
 	<li>Regular physical activity: Aim for at least 150 minutes of moderate exercise per week</li>
 	<li>Weight management: Even modest weight loss can improve insulin sensitivity</li>
 	<li>Blood sugar monitoring: Self-monitoring or continuous glucose monitoring as advised</li>
 	<li>Oral and injectable medications:
<ul>
 	<li>Metformin to reduce liver glucose production</li>
 	<li>Sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, <a data-wpil="url" href="/glp1/">GLP-1</a> receptor agonists</li>
 	<li>Insulin therapy when other agents are insufficient</li>
</ul>
</li>
 	<li>Control of blood pressure and lipids to reduce cardiovascular risk</li>
 	<li>Education and support: Diabetes self-management training and regular follow-up</li>
</ul>
<h2>Complications</h2>
<ul>
 	<li>Heart disease, <a href="/conditions/heart-attack/">heart attack</a>, and <a href="/conditions/stroke/">stroke</a></li>
 	<li>Kidney damage (nephropathy) leading to renal failure</li>
 	<li>Nerve damage (neuropathy) causing pain, numbness</li>
 	<li>Eye damage (retinopathy) and vision loss</li>
 	<li>Foot ulcers and risk of amputation</li>
 	<li>Skin infections and slow wound healing</li>
 	<li>Gum disease</li>
 	<li>Increased susceptibility to infections</li>
</ul>
<h2>Resources</h2>
<ul>
 	<li>American Diabetes Association: <a href="https://diabetes.org/about-diabetes/type-2">Understanding Type 2 Diabetes</a></li>
 	<li>National Institute of Diabetes and Digestive and Kidney Diseases: <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes">Type 2 Diabetes Overview</a></li>
 	<li>Centers for Disease Control and Prevention: Type 2 Diabetes Basics</li>
 	<li>NCBI Bookshelf: <a href="https://www.ncbi.nlm.nih.gov/books/NBK513253/">Type 2 Diabetes</a></li>
</ul>

Type 2 Diabetes

<h2>Weight Loss</h2>
Over 75% of Americans are overweight or obese. An estimated 160 million people are dieting, spending more than $70 billion annually on weight-loss programs, medications, supplements, and other strategies. Sustainable weight loss relies on healthy lifestyle changes—balanced eating, regular activity, and stress management—rather than quick fixes or fad diets.
<h2>What is a healthy weight?</h2>
Body Mass Index (BMI) and waist circumference help screen for health risks. A BMI of 25–29.9 indicates overweight; over 30 indicates obesity. Weight loss is recommended for anyone with BMI over 30, or BMI 25–29.9 plus conditions such as <a title="Type 2 Diabetes" href="/conditions/type-2-diabetes/" data-wpil-monitor-id="110">type 2 diabetes</a>, hypertension, or heart disease. A full health assessment should guide individual goals.
<h2>What causes weight gain?</h2>
<h3>Energy balance</h3>
Consuming more calories than you burn leads to weight gain.
<h3>Environment</h3>
<ul>
 	<li>Lack of safe places to exercise (parks, sidewalks, gyms)</li>
 	<li>Large portion sizes</li>
 	<li>Limited access to affordable fresh produce</li>
</ul>
<h3>Genetics</h3>
Genes may predispose some people to obesity, though lifestyle factors usually play a key role.
<h3>Medications and health conditions</h3>
<ul>
 	<li>Hormone imbalances (<a class="wpil_keyword_link" href="/conditions/hypothyroidism" title="Hypothyroidism" data-wpil-keyword-link="linked" data-wpil-monitor-id="924">hypothyroidism</a>, PCOS, Cushing’s syndrome)</li>
 	<li>Certain antidepressants, anticonvulsants, and corticosteroids</li>
</ul>
<h3>Stress and sleep</h3>
Poor sleep and high stress can disrupt appetite hormones, leading to increased calorie intake.
<h2>How to start losing weight</h2>
<ul>
 	<li>Work with a dietitian or healthcare provider for personalized guidance</li>
 	<li>Adopt regular physical activity (aim for ≥150 minutes of moderate exercise weekly)</li>
 	<li>Consider medication if lifestyle changes alone aren’t enough—options include liraglutide, semaglutide, tirzepatide, orlistat, and bupropion/naltrexone</li>
</ul>
<h2>What’s a healthy diet for weight loss?</h2>
There is no one “best” diet, but most effective plans share these features:
<ul>
 	<li>Plant-based emphasis</li>
 	<li>Whole, minimally processed foods</li>
 	<li>Healthy fats in moderation (olive oil, avocado, nuts, seeds)</li>
 	<li>Limited added sugars and refined carbs</li>
 	<li>Balanced meals: protein, complex carbs, vegetables, and healthy fats</li>
</ul>
Protein sources:
<ul>
 	<li>Legumes and beans</li>
 	<li>Nuts and seeds</li>
 	<li>Fish and lean poultry</li>
 	<li>Low-fat dairy</li>
</ul>
Vegetables: Aim for about 2½ cups daily (leafy greens, bell peppers, tomatoes, squash). Note that starchy vegetables (potatoes, corn) count toward your carbohydrate portion.
<h2>Key points</h2>
<ul>
 	<li>Set realistic, gradual goals (1–2 pounds per week)</li>
 	<li>Track progress and celebrate milestones</li>
 	<li>Combine diet, exercise, and stress management</li>
 	<li>Seek professional support for best outcomes</li>
</ul>
<h2>Resources</h2>
<ul>
 	<li><a href="https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity">NIDDK: Understanding Overweight &amp; Obesity</a></li>
 	<li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321865/">Effects of whole grains on appetite and energy intake</a></li>
</ul>

Weight Loss

Generic semaglutide will not be available until at least 2031 in the U.S., when Novo Nordisk’s patents begin expiring.

When Will Generic Semaglutide Be Available?

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Universal Drugstore

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Jamie Winn, Pharm D.

Semaglutide is the generic name for several brand-name drugs, including Ozempic, Wegovy, and Rybelsus.

What is Semaglutide Generic For?

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Betahistine is prescribed to treat vertigo, dizziness, tinnitus, and hearing loss associated with Ménière’s disease and other inner ear disorders.

What is Betahistine For?

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What is Insomnia?

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Key Takeaways Insomnia is a common sleep disorder that can [&hellip;]

In this guide, we’ll explore the key signs and symptoms that distinguish insomnia from normal sleep problems, when you should call your doctor

How Do You Know If You Have Insomnia?

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The common side effects reported are similar to GLP-1 agonists, and include nausea, vomiting, diarrhea, abdominal discomfort, bloating, and constipation

What side effects are reported with Retatrutide?

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Retatrutide is an investigational medication for obesity that is currently in development from Eli Lilly. It is considered a triple hormone agonist that works on 3 different receptors:

What is the mechanism of action of Retatrutide?

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Those taking retatrutide lost up to 17.5%, or 41 lb of their baseline body weight at 24 weeks. This was compared to 1.6% in those taking the placebo

How much weight can you lose with Retatrutide?

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After successful Phase 2 trials for obesity and type 2 diabetes, orforglipron is currently in several Phase 3 trials further testing its safety and efficacy

When will Orforglipron be approved?

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With the ease of taking a pill and not having to worry about storing it in the fridge, this could provide an exciting new option for people with obesity and type 2 diabetes.

Does Orforglipron work as well as injections?

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Why is Retatrutide called the ‘triple hormone’ drug? It is nicknamed the “triple G” drug because it mimics 3 hunger-regulating hormones

Why is Retatrutide called the ‘triple hormone’ drug?

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The conditions treated during Phase 2 trial was type 2 diabetes and In Phase 3 trial of ecnoglutide it was adults who were obese or overweight

What conditions does ecnoglutide treat?

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Clinical trials with ecnoglutide have looked at various doses (e.g., 0.4 mg, 0.8 mg, 1.2 mg, 1.8 mg, and 2.4 mg) given as subcutaneous injections once a week.

How often is ecnoglutide taken?

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Yes, ecnoglutide is a new GLP-1 receptor agonist under development as a possible alternative to Ozempic (semaglutide). While they share a lot of similarities, there are a few differences between these 2 drugs.

Is ecnoglutide similar to Ozempic?

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Yes, if Eli Lilly's orforglipron is eventually approved by the FDA, it will be the first oral GLP-1 drug specifically indicated for weight loss.

Is Orforglipron the first GLP-1 weight loss pill?

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Orforglipron is an investigational oral GLP-1 medication that is being developed by Eli Lilly as a possible treatment for obesity and type 2 diabetes

What are the pros and cons of taking Orforglipron?

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It is a first-in-class, long-acting, cyclic adenosine monophosphate (cAMP)-biased GLP-1 receptor agonist.

How does ecnoglutide work?

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Numan

Did you know Advair HFA is NOT a rescue inhaler and cannot treat sudden shortness of breath or asthma attacks.

Is Advair HFA a Rescue Inhaler?

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FDA approved oral semaglutide (Rybelsus) as the first oral GLP-1 receptor agonist to reduce major adverse cardiovascular events in adults with type 2 diabetes at high risk.

Rybelsus Gets FDA Approval to Reduce Heart Risk in Adults with Diabetes

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You can choose any time of the day to take your prescribed dose. Whether you prefer morning, afternoon, or evening dosing, Spiriva provides 24-hour symptom relief regardless of timing.

When Should You Take Spiriva?

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Advair Diskus and Advair HFA inhalers contain the same active ingredients (fluticasone propionate and salmeterol) but use different delivery systems

Is Advair Diskus the Same as Advair HFA?

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Understanding why you should only purchase weight loss medication from licensed pharmacies could literally save your life.

Why You Should Only Buy Weight Loss Medication from Licensed Pharmacies

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How to Take Prilosec

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Key Takeaways Prilosec is typically taken once daily, preferably on [&hellip;]

Take Prilosec on an empty stomach, ideally 30 to 60 minutes before your first meal of the day. This ensures the medication is absorbed in the parietal cells before food triggers

How Does Prilosec Work?

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Prilosec reduces approximately 65% of your stomach acid production. You can safely take antacids with Prilosec for additional relief from indigestion

What Does Prilosec Do?

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When it comes to the side effects of lisinopril, a dry cough is the one that most people know about. It isn’t a minor throat clearing.

What is the Biggest Side Effect of Lisinopril?

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Yes, lisinopril commonly causes a persistent dry cough in 2.5% to 35% of people taking this ACE inhibitor.

Does Lisinopril Cause Coughing?

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Lisinopril is primarily used to treat high blood pressure (hypertension) in adults and children 6 years of age and older.

What is Lisinopril Mainly Used For?

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When both medications are used together, there’s an increased risk of low blood pressure, especially in elderly patients or those taking other medications that lower blood pressure.

Can I Take Lisinopril and Amlodipine Together?

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German drugmaker Boehringer Ingelheim is hoping that survodutide can be launched in 2027 or 2028, but this is dependent on how well the drug performs in these new trials.

Is survodutide available yet?

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Yes, survodutide is currently being studied as a potential treatment for metabolic-associated steatohepatitis (MASH), a severe form of fatty liver disease

Can Survodutide be used for fatty liver or MASH?

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The most common side effects of survodutide seen were GI-related and include nausea, vomiting, diarrhea, constipation and indigestion.

What are the common side effects of Survodutide?

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Novo Nordisk originally planned on seeking approval at the end of this year, but that has been pushed back to early 2026.

When will CagriSema be approved and available in the US?

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While CagriSema may be better for some people when compared to Ozempic or Wegovy, it does not appear to be the gamechanger

Is CagriSema better than Ozempic or Wegovy?

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If you experience fever, headaches, or back pain during your pregnancy, you will typically reach for Tylenol (acetaminophen).

Is Tylenol Safe to Take While Pregnant?

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Does Tylenol Cause Autism?

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Does Tylenol Cause Autism? Current Research and Medical Evidence Key [&hellip;]

Xopenex HFA is a prescription drug approved to treat asthma and to treat bronchospasm in patients with reversible obstructive airway disease.

How Does Xopenex HFA Work?

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Betahistine improves blood flow to your inner ear and reduces vertigo symptoms by acting on histamine receptors

What does Betahistine do to you?

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Betahistine is not a strong antihistamine in the usual sense. While it does interact with histamine receptors

Is Betahistine a Strong Antihistamine?

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Prednisone begins working relatively quickly after taking it by mouth. Most patients will begin noticing effects within 1-4 hours of taking their first dose

How Prednisone Works

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This blog will explain everything you need to know about prednisone, including how it works, what conditions it treats,

Is Prednisone a Steroid?

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<h2>What is menopause?</h2>
<a data-wpil="url" href="/blog/your-guide-to-menopause-all-your-menopause-questions-answered/">Menopause</a> is a natural biological process that marks the end of a woman’s reproductive years. It occurs when the ovaries gradually produce less estrogen and progesterone, the hormones regulating menstruation. Menopause is diagnosed after a woman has gone 12 consecutive months without a menstrual period. In the United States, the average age of natural menopause is around 51 years. When menopause occurs before age 45, it is called early menopause; before age 40, it is considered premature menopause.

The transition leading up to menopause, called perimenopause, may last several years and is characterized by menstrual irregularities and symptoms such as hot flashes. Common symptoms of menopause include hot flashes, night sweats, mood changes, sleep disturbances, vaginal dryness, and increased risk of <a class="wpil_keyword_link" href="/conditions/osteoporosis" title="Osteoporosis" data-wpil-keyword-link="linked" data-wpil-monitor-id="976">osteoporosis</a>. Menopause can also be induced surgically or by certain medical treatments.
<h2>What causes menopause?</h2>
Menopause results primarily from the natural decline in ovarian hormone production. Other causes include:
<ul>
 	<li>Oophorectomy: Surgical removal of the ovaries causes immediate menopause and often severe symptoms due to abrupt hormonal changes.</li>
 	<li>Chemotherapy and radiation therapy: Treatments for cancer can induce menopause during or shortly after therapy.</li>
 	<li>Primary ovarian insufficiency (POI): In about 1% of women, ovarian function fails before age 40, often for unknown or genetic reasons.</li>
 	<li>Hysterectomy: Removal of the uterus alone does not immediately cause menopause; however, removal of both uterus and ovaries does.</li>
</ul>
<h2>What are the signs and symptoms of menopause?</h2>
<ul>
 	<li>Hot flashes: Sudden warmth, often over the face, neck, and chest, followed by sweating and chills.</li>
 	<li>Night sweats: Hot flashes during sleep, leading to disrupted rest.</li>
 	<li>Irregular periods: During perimenopause, cycles may become shorter, longer, heavier, or lighter.</li>
 	<li>Mood changes: Increased irritability, anxiety, or risk of <a class="wpil_keyword_link" href="/conditions/depression" title="Depression" data-wpil-keyword-link="linked" data-wpil-monitor-id="975">depression</a>.</li>
 	<li>Vaginal dryness: Reduced lubrication and thinning of vaginal tissues, which can cause discomfort during intercourse.</li>
 	<li>Sleep problems: Insomnia or poor sleep quality, often related to night sweats.</li>
 	<li>Thinning hair and dry skin: Changes in hormone levels can affect skin and hair health.</li>
 	<li>Bladder control issues: Loss of tissue elasticity can lead to incontinence or urgency.</li>
 	<li>Weight gain and slowed metabolism: Hormonal shifts can make weight management more difficult.</li>
 	<li>Osteoporosis: Lower estrogen levels contribute to bone density loss.</li>
 	<li>Cholesterol changes: Menopause may increase LDL (“bad”) cholesterol, raising cardiovascular risk.</li>
</ul>
If any vaginal bleeding occurs after menopause, seek medical attention immediately.
<h2>How is menopause diagnosed?</h2>
Diagnosis is based on menstrual history and symptoms. A woman who has not menstruated for 12 months is considered menopausal, unless menopause was induced surgically or by treatments. Blood tests may include:
<ul>
 	<li>Follicle-stimulating hormone (FSH): Levels rise as ovarian function declines.</li>
 	<li>Estrogen: Levels fall during the transition.</li>
 	<li>Thyroid-stimulating hormone (TSH): Measured if thyroid disorders are suspected.</li>
</ul>
<h2>How is menopause treated?</h2>
Treatment aims to relieve symptoms and reduce long-term risks:
<ul>
 	<li>Hormone replacement therapy (HRT): Effective for hot flashes, night sweats, and osteoporosis prevention; carries some risks and requires individualized assessment.</li>
 	<li>Vaginal estrogen: Administered as a cream, tablet, or ring to alleviate dryness and urinary symptoms.</li>
 	<li>Low-dose antidepressants: Certain SSRIs can reduce hot flashes.</li>
 	<li>Gabapentin: Originally for seizures, can also help with vasomotor symptoms.</li>
 	<li>Clonidine: A blood pressure medication that may ease hot flashes.</li>
 	<li>Osteoporosis treatments: <a class="wpil_keyword_link" href="/medications/calcium" title="Calcium" data-wpil-keyword-link="linked" data-wpil-monitor-id="3015">Calcium</a>, vitamin D, and medications to strengthen bone.</li>
 	<li>Lifestyle changes: Stress reduction (yoga, meditation), healthy diet, regular exercise, <a class="wpil_keyword_link" href="/conditions/smoking-cessation" title="Smoking Cessation" data-wpil-keyword-link="linked" data-wpil-monitor-id="977">smoking cessation</a>, and layered clothing for hot flashes.</li>
</ul>
<h2>What is postmenopause?</h2>
Postmenopause begins 12 months after the final menstrual period. While many symptoms improve, some women continue experiencing hot flashes and other effects for years. Lower estrogen levels increase the risk of osteoporosis and cardiovascular disease.
<h2>How long does menopause typically last?</h2>
Perimenopause can begin up to 10 years before the final period, often in the 40s. Once 12 consecutive months without menstruation have passed, a woman is postmenopausal. Surgical removal of ovaries causes immediate menopause.
<h2>Sources</h2>
<ul>
 	<li>Menopause basics. Office on Women’s Health. Accessed Apr. 11, 2024.</li>
 	<li>Menopausal symptoms: In depth. National Center for Complementary and Integrative Health. Accessed Apr. 11, 2024.</li>
 	<li>Menopause. National Institutes of Health. Accessed Apr. 11, 2024.</li>
 	<li>What is Menopause? National Institute on Aging. Accessed Apr. 11, 2024.</li>
</ul>

Menopause

<h2>What is osteoporosis?</h2>
  <p>Osteoporosis is a disease that weakens bones by causing new bone to be created more slowly than old bone is removed. As a result, bone density and mass decline, making bones brittle and porous. Approximately 54 million Americans are affected. Osteoporosis often develops silently over many years; symptoms may not appear until a fracture occurs. Common fracture sites include the hip, spine, and wrist.</p>

  <h2>What causes osteoporosis?</h2>
  <p>Osteoporosis results from an imbalance between bone formation and bone resorption. Risk factors include:</p>
  <ul>
    <li>Age: Bone mass declines naturally as you get older.</li>
    <li>Hormonal changes: Decreased estrogen at <a class="wpil_keyword_link" href="/conditions/menopause" title="Menopause" data-wpil-keyword-link="linked" data-wpil-monitor-id="964">menopause</a> or low testosterone in men accelerates bone loss.</li>
    <li>Nutritional deficiencies: Inadequate <a class="wpil_keyword_link" href="/medications/calcium" title="Calcium" data-wpil-keyword-link="linked" data-wpil-monitor-id="3012">calcium</a> and vitamin D impairs bone strength.</li>
    <li>Lifestyle factors: Lack of weight-bearing exercise, smoking, and excessive alcohol weaken bone.</li>
    <li>Medical conditions and medications: <a class="wpil_keyword_link" href="/conditions/rheumatoid-arthritis" title="Rheumatoid Arthritis" data-wpil-keyword-link="linked" data-wpil-monitor-id="963">Rheumatoid arthritis</a>, gastrointestinal disorders, prolonged corticosteroid use, certain seizure drugs, and hormone treatments for cancer reduce bone density.</li>
    <li>Genetics: Family history of osteoporosis or fractures increases risk.</li>
    <li>Sex: Women are at higher risk due to smaller bones and lower peak bone mass.</li>
    <li>Other factors: Low body weight, Caucasian or Asian ethnicity, previous fractures.</li>
  </ul>

  <h2>What are the symptoms of osteoporosis?</h2>
  <p>Osteoporosis is often symptomless until a fracture occurs. Signs include:</p>
  <ul>
    <li>Fractures from minor falls or stresses, especially at the hip, spine, or wrist</li>
    <li>Gradual loss of height and a stooped posture due to vertebral compression</li>
    <li>Back pain from vertebral fractures or collapsed vertebrae</li>
    <li>Bones that break more easily than expected, even with mild strain</li>
  </ul>

  <h2>How is osteoporosis diagnosed?</h2>
  <p>Diagnosis relies on bone density assessment and risk evaluation:</p>
  <h3>Bone density testing</h3>
  <ul>
    <li>DEXA (DXA) scan: Low-dose X-ray measures bone mineral density at the hip, spine, or forearm to classify bone mass as normal, osteopenia, or osteoporosis.</li>
  </ul>
  <h3>Other tools and tests</h3>
  <ul>
    <li>FRAX score: Estimates 10-year fracture risk using bone density plus clinical risk factors.</li>
    <li>Heel ultrasound: Screening method that may indicate need for further testing.</li>
    <li>Blood and urine tests: Rule out secondary causes such as thyroid disorders or vitamin D deficiency.</li>
    <li>Medical history and physical exam: Reviews risk factors, prior fractures, height loss, and posture changes.</li>
    <li>Fracture-based diagnosis: A low-trauma fracture in an adult may itself confirm osteoporosis.</li>
  </ul>

  <h2>How is osteoporosis treated?</h2>
  <p>Treatment aims to slow bone loss, increase bone density, prevent fractures, and manage pain:</p>
  <h3>Lifestyle changes</h3>
  <ul>
    <li>Exercise: Regular weight-bearing and strength-training activities improve bone strength and balance.</li>
    <li>Diet: Adequate calcium (dairy, leafy greens, fortified foods) and vitamin D (sunlight, supplements) support bone health.</li>
    <li><a class="wpil_keyword_link" href="/conditions/smoking-cessation" title="Smoking Cessation" data-wpil-keyword-link="linked" data-wpil-monitor-id="965">Smoking cessation</a> and alcohol moderation: Both reduce bone loss.</li>
    <li>Weight management: Maintaining healthy weight eases stress on bones.</li>
  </ul>
  <h3>Supplements</h3>
  <ul>
    <li>Calcium: Ensures sufficient intake when diet alone is inadequate.</li>
    <li>Vitamin D: Enhances calcium absorption; supplementation may be necessary if levels are low.</li>
  </ul>
  <h3>Medications</h3>
  <ul>
    <li>Bisphosphonates: Alendronate, risedronate, ibandronate, zoledronic acid slow bone loss and increase density.</li>
    <li>Denosumab (<a class="wpil_keyword_link" href="/medications/prolia" title="Prolia" data-wpil-keyword-link="linked" data-wpil-monitor-id="3011">Prolia</a>, Xgeva): Monoclonal antibody that reduces bone resorption.</li>
    <li>SERMs (raloxifene): Mimic estrogen’s bone-protective effects in postmenopausal women.</li>
    <li>PTH analogs (teriparatide, abaloparatide): Stimulate new bone formation in high-risk patients.</li>
    <li>Romosozumab: Promotes bone formation and reduces resorption.</li>
  </ul>
  <h3>Surgical and procedural options</h3>
  <ul>
    <li>Vertebroplasty/kyphoplasty: Injecting bone cement to stabilize collapsed vertebrae and relieve pain.</li>
  </ul>
  <h3>Pain management</h3>
  <ul>
    <li>Analgesics and physical therapy for fracture-related pain.</li>
    <li>Back braces to support weakened spinal bones.</li>
  </ul>
  <p>Long-term follow-up with repeat bone density tests is essential to monitor treatment response and adjust therapy.</p>

  <h2>Sources</h2>
  <ul>
    <li>National Institute of <a class="wpil_keyword_link" href="/conditions/arthritis" title="Arthritis" data-wpil-keyword-link="linked" data-wpil-monitor-id="1965">Arthritis</a> and Musculoskeletal and Skin Diseases. Osteoporosis. Accessed Apr. 10, 2024.</li>
    <li>International Osteoporosis Foundation. Osteoporosis &amp; Musculoskeletal Disorders. Accessed Apr. 10, 2024.</li>
    <li>Bone Health and Osteoporosis Foundation. What is Osteoporosis? Accessed Apr. 10, 2024.</li>
    <li>National Library of Medicine (U.S.). Osteoporosis. Accessed July 20, 2023.</li>
  </ul>

Osteoporosis

<h2>What is Prostate Cancer?</h2>
  <p>Prostate cancer develops in the prostate gland, a walnut-shaped organ below the bladder that surrounds the urethra. It is the second most common cancer in men after skin cancer and is almost always an adenocarcinoma (arising from glandular cells). Most prostate cancers grow slowly and may not cause symptoms until advanced stages.</p>

  <h2>Risk Factors</h2>
  <ul>
    <li>Age: Risk increases after age 50, with most cases diagnosed over age 65.</li>
    <li>Family history: Having a father or brother with prostate or <a class="wpil_keyword_link" href="/conditions/breast-cancer" title="Breast Cancer" data-wpil-keyword-link="linked" data-wpil-monitor-id="911">breast cancer</a> raises risk.</li>
    <li>Genetic mutations: BRCA1 and BRCA2 gene mutations also contribute.</li>
    <li>Race and ethnicity: African American men have higher incidence and mortality.</li>
    <li>Hormones: Higher levels of testosterone and dihydrotestosterone (DHT) can promote growth.</li>
    <li>Diet and lifestyle: High intake of red meat or high-fat dairy, obesity, and chemical exposures may increase risk.</li>
    <li>Chronic inflammation: Prostatitis and certain infections may play a role.</li>
  </ul>

  <h2>Symptoms</h2>
  <ul>
    <li>Weak or interrupted urine flow, difficulty starting or stopping.</li>
    <li>Frequent urination, especially at night.</li>
    <li>Pain or burning with urination, incomplete bladder emptying.</li>
    <li>Blood in urine or semen.</li>
    <li>Difficulty achieving or maintaining an erection.</li>
    <li>Persistent pelvic or back pain, which may indicate bone spread.</li>
    <li>Unexplained <a class="wpil_keyword_link" href="/conditions/weight-loss" title="Weight Loss" data-wpil-keyword-link="linked" data-wpil-monitor-id="910">weight loss</a> and fatigue in advanced disease.</li>
  </ul>

  <h2>Diagnosis</h2>
  <ol>
    <li>Medical history and digital rectal exam (DRE) to palpate prostate for abnormalities.</li>
    <li>Prostate-specific antigen (PSA) blood test to screen for elevated levels.</li>
    <li>Transrectal ultrasound (TRUS) to image the prostate and guide biopsies.</li>
    <li>Magnetic resonance imaging (MRI) for detailed visualization and biopsy planning.</li>
    <li>Prostate biopsy (core needle) to confirm cancer and determine grade (Gleason score).</li>
    <li>Staging scans (bone scan, CT, PET-CT) if metastatic spread is suspected.</li>
  </ol>

  <h2>Treatment</h2>
  <h3>Active Surveillance</h3>
  <p>Regular monitoring with PSA tests, DREs, and periodic biopsies for low-risk, slow-growing tumors.</p>

  <h3>Surgery</h3>
  <ul>
    <li>Radical prostatectomy: Removal of the prostate and surrounding tissue via open or robotic approaches.</li>
    <li>Orchiectomy: Removal of testes to reduce testosterone production in advanced cases.</li>
  </ul>

  <h3>Radiation Therapy</h3>
  <ul>
    <li>External beam radiation therapy (EBRT) over several weeks.</li>
    <li>Brachytherapy: Radioactive seed implants delivering localized radiation.</li>
  </ul>

  <h3>Hormone Therapy</h3>
  <ul>
    <li>LHRH agonists/antagonists (e.g., leuprolide, relugolix) to lower testosterone.</li>
    <li>Anti-androgens (e.g., abiraterone) to block hormone effects on cancer cells.</li>
  </ul>

  <h3>Chemotherapy</h3>
  <p>Systemic drugs (e.g., docetaxel, mitoxantrone) for advanced or hormone-resistant disease.</p>

  <h3>Targeted &amp; Immune Therapies</h3>
  <ul>
    <li>PARP inhibitors (e.g., olaparib) for tumors with specific genetic mutations.</li>
    <li>Immunotherapy (e.g., sipuleucel-T vaccine, checkpoint inhibitors) to boost anti-cancer immunity.</li>
    <li>Radiopharmaceuticals (e.g., radium-223) for bone-metastatic disease.</li>
  </ul>

  <h3>Ablative Techniques</h3>
  <ul>
    <li>Cryotherapy: Freezing of prostate tissue to destroy cancer cells.</li>
    <li>High-intensity focused ultrasound (HIFU) to thermally ablate tumor areas.</li>
  </ul>

  <h2>Prognosis</h2>
  <p>Early detection through PSA screening and improved treatments yield high survival rates. Prognosis depends on stage, grade (Gleason score), and patient health. Regular follow-up is essential to monitor for recurrence or progression.</p>

  <h2>Sources</h2>
  <ul>
    <li>American Cancer Society. What Is Prostate Cancer? Accessed May 14, 2024.</li>
    <li>Urology Care Foundation. Advanced Prostate Cancer. Accessed May 14, 2024.</li>
    <li>National Comprehensive Cancer Network. Prostate Cancer Guidelines. Accessed May 14, 2024.</li>
    <li>Prostate Cancer Foundation. About Prostate Cancer. Accessed May 14, 2024.</li>
  </ul>


Prostate Cancer

Palliative care is specialized medical care focused on relief from pain and other symptoms of serious illness. Its goal is to improve quality of life for patients, families, and caregivers.
<h2>What is palliative care?</h2>
Palliative care is provided by a team of doctors, nurses, social workers, chaplains, and other specialists. It works alongside curative treatments, and is appropriate at any age and stage of a serious illness.
<h2>Is palliative care the same as hospice care?</h2>
Palliative care is not limited to end-of-life situations. Hospice care is a type of palliative care for those with a prognosis of six months or less and focuses exclusively on comfort rather than cure.
<h2>Who can benefit from palliative care?</h2>
Anyone with a serious or life-threatening illness, including but not limited to:
<ul>
 	<li>Cancer</li>
 	<li><a class="wpil_keyword_link" href="/conditions/heart-failure" title="Heart Failure" data-wpil-keyword-link="linked" data-wpil-monitor-id="949">Heart failure</a></li>
 	<li>Cystic fibrosis</li>
 	<li>ALS (Lou Gehrig’s disease)</li>
 	<li><a href="/conditions/dementia/">Alzheimer’s disease</a></li>
 	<li>Liver or kidney failure</li>
 	<li><a href="/conditions/chronic-obstructive-pulmonary-disease-copd/">COPD</a> and other lung diseases</li>
 	<li>Parkinson’s disease</li>
 	<li><a href="/conditions/stroke/">Stroke</a></li>
 	<li><a href="/conditions/hiv/">HIV/AIDS</a></li>
 	<li><a class="wpil_keyword_link" href="/conditions/multiple-sclerosis" title="Multiple Sclerosis" data-wpil-keyword-link="linked" data-wpil-monitor-id="951">Multiple sclerosis</a></li>
</ul>
<h2>Who makes up the palliative care team?</h2>
A multidisciplinary team may include:
<ul>
 	<li>Physicians</li>
 	<li>Nurses</li>
 	<li>Social workers</li>
 	<li>Mental health counselors</li>
 	<li>Nutritionists</li>
 	<li>Chaplains or spiritual care advisors</li>
</ul>
<h2>What does palliative care include?</h2>
<h3>Symptom management</h3>
Relief from pain, breathlessness, nausea, fatigue, <a class="wpil_keyword_link" href="http://conditions/anxiety" title="anxiety" data-wpil-keyword-link="linked" data-wpil-monitor-id="950">anxiety</a>, depression, sleep problems, and treatment side effects.
<h3>Education and decision support</h3>
Information about illness trajectory, treatment options, advance care planning, and advance directives.
<h3>Emotional and spiritual support</h3>
Counseling, chaplain visits, and help coping with stress, grief, and loss.
<h3>Family and caregiver support</h3>
Respite care planning, counseling, and help navigating financial, legal, and insurance concerns.
<h2>Where can you receive palliative care?</h2>
Settings include home, hospitals, outpatient clinics, assisted living facilities, and nursing homes.
<h2>How can you get palliative care?</h2>
<ol>
 	<li>Discuss palliative care with your healthcare provider.</li>
 	<li>Obtain a referral to a palliative care team.</li>
 	<li>Verify insurance coverage and available services in your area.</li>
 	<li>Begin palliative care alongside ongoing treatments.</li>
</ol>
<h2>Sources</h2>
<ul>
 	<li>Center to Advance Palliative Care. What is palliative care? Accessed May 25, 2024.</li>
 	<li>National Institute of Nursing Research. Palliative care information. Accessed May 25, 2024.</li>
 	<li>Arnold RM, Kutner JS. Palliative care. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024:Chap 3.</li>
 	<li>National Hospice and Palliative Care Organization. Palliative vs. hospice care. Accessed May 25, 2024.</li>
 	<li>World Health Organization. Palliative care overview. Accessed May 25, 2024.</li>
</ul>

Palliative Care

Premarin is a conjugated estrogen therapy used for menopausal symptoms and osteoporosis prevention. Learn about uses, dosage, risks, and alternatives.

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<h2>What is hypothyroidism?</h2>
  <p>Hypothyroidism, also called an underactive thyroid, is a condition in which the thyroid gland does not produce enough thyroid hormones. The thyroid is a small butterfly-shaped gland in your neck that regulates many body functions, including metabolism, body temperature, blood pressure, and heart rate.</p>
  <p>Symptoms may include fatigue, weight gain, sensitivity to cold, dry skin, hair loss, muscle weakness, depression, slowed heart rate, memory problems, and difficulty concentrating. Treatment typically involves taking synthetic thyroid hormone to restore normal hormone levels and relieve symptoms.</p>

  <h2>What causes hypothyroidism?</h2>
  <ul>
    <li>Autoimmune disease (Hashimoto’s thyroiditis), where the immune system attacks the thyroid</li>
    <li>Family history of thyroid disease</li>
    <li>Treatment for hyperthyroidism (radioactive iodine or surgery)</li>
    <li>Thyroid surgery removing part or all of the gland</li>
    <li>Radiation therapy to the head or neck</li>
    <li>Certain medications (amiodarone, lithium, interferon alpha, interleukin-2)</li>
    <li>Iodine imbalance, either deficiency or excess</li>
    <li>Congenital hypothyroidism (born without a functional thyroid)</li>
    <li>Pituitary or hypothalamus disorders affecting TSH release</li>
    <li>Pregnancy-related (postpartum thyroiditis or iodine deficiency)</li>
  </ul>

  <h2>What are the symptoms of hypothyroidism?</h2>
  <p>Symptoms often develop slowly and can include:</p>
  <ul>
    <li>Fatigue or excessive tiredness</li>
    <li>Unexplained weight gain or difficulty losing weight</li>
    <li>Cold intolerance</li>
    <li>Dry, thinning hair</li>
    <li>Dry, rough skin</li>
    <li><a class="wpil_keyword_link" href="/conditions/constipation" title="Constipation" data-wpil-keyword-link="linked" data-wpil-monitor-id="984">Constipation</a></li>
    <li><a class="wpil_keyword_link" href="/conditions/depression" title="Depression" data-wpil-keyword-link="linked" data-wpil-monitor-id="985">Depression</a></li>
    <li>Memory and concentration problems</li>
    <li>Muscle weakness, aches, and stiffness</li>
    <li>Heavy or frequent menstrual periods</li>
    <li>Slowed heart rate</li>
    <li>Enlarged thyroid gland (goiter), causing swallowing or breathing difficulty</li>
  </ul>

  <h2>How is hypothyroidism diagnosed?</h2>
  <p>Diagnosis is made through:</p>
  <ul>
    <li>Clinical evaluation and physical exam, including thyroid palpation</li>
    <li>TSH (thyroid-stimulating hormone) blood test—elevated in primary hypothyroidism</li>
    <li>T4 (thyroxine) blood test—low levels alongside high TSH confirm hypothyroidism</li>
    <li>Free T4 test—measures active hormone levels in the blood</li>
    <li>T3 (triiodothyronine) test—less commonly used for hypothyroidism diagnosis</li>
    <li>Thyroid antibody tests (TPO antibodies) to detect autoimmune thyroiditis</li>
  </ul>

  <h2>How is hypothyroidism treated?</h2>
  <p>Treatment centers on hormone replacement:</p>
  <ul>
    <li>Levothyroxine (synthetic T4) taken daily on an empty stomach</li>
    <li>Dosage tailored by weight, age, hormone levels, and absorption factors</li>
    <li>Regular TSH monitoring to adjust dosage and maintain target levels</li>
    <li>Lifelong therapy, with dosage adjustments for weight changes, health status, or new medications</li>
    <li>Alternative options (Liothyronine, natural desiccated thyroid) for select patients</li>
    <li>Treatment of underlying causes (iodine deficiency, autoimmune disease) as needed</li>
    <li>Routine follow-up to manage symptoms and prevent complications</li>
  </ul>

  <h2>Sources</h2>
  <ul>
    <li>Hypothyroidism. American Thyroid Association. Accessed Apr. 30, 2024.</li>
    <li>Hypothyroidism (Underactive Thyroid). National Institute of Diabetes and Digestive and Kidney Diseases. Accessed Apr. 30, 2024.</li>
    <li>Hypothyroidism. Merck Manual Consumer Version. Accessed Apr. 30, 2024.</li>
    <li>Hypothyroidism. National Library of Medicine. Accessed Apr. 30, 2024.</li>
    <li>Hypothyroidism. Medscape. Accessed Apr. 30, 2024.</li>
  </ul>

Hypothyroidism

ERFA Thyroid dosing: take on an empty stomach 30–60 min before breakfast, same time daily, and separate iron/calcium by 4 hrs for optimal absorption.

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<h2>Bacterial Infections: Causes and Treatments</h2>

  <p>Bacterial infections are illnesses caused by harmful bacteria entering your body and multiplying. Bacteria are single-celled microorganisms that are found everywhere, including soil, water, and your body. While many bacteria are harmless or even beneficial, some can cause infections. You can get a bacterial infection through various ways such as cuts, eating or drinking contaminated food or water, or contact with a sick person.</p>
  <p>Bacterial infections are typically treated with antibiotics. Which one you are prescribed will depend on the type of bacteria causing your infection. It is important that you take the full course of treatment to help get rid of your infection and prevent antibiotic resistance.</p>

  <h2>What are some types of bacterial infections?</h2>
  <ul>
    <li>Salmonella and Campylobacter infections, common types of food poisoning</li>
    <li>Skin infections such as cellulitis and impetigo</li>
    <li>Sinus infections, ear infections, and certain types of bacterial pneumonia</li>
    <li>Lyme disease, carried by ticks</li>
    <li>Bacterial vaginosis, an overgrowth of bacteria in the vagina</li>
    <li>Gonorrhea, chlamydia, and other sexually transmitted infections affecting genitals, rectum, and sometimes mouth</li>
    <li>Strep throat, infection from streptococcus bacteria causing sore throat</li>
    <li>C. diff, an infection in the intestines</li>
    <li>E. coli, a common cause of urinary tract infections (UTIs)</li>
    <li>H. pylori bacteria, causing stomach ulcers or inflammation</li>
    <li>Meningococcal meningitis, infection of the lining of the brain and spinal cord requiring immediate treatment</li>
  </ul>

  <h2>What causes bacterial infections?</h2>
  <p>Bacterial infections occur when harmful bacteria enter the body and multiply, leading to illness and inflammation. Common routes of infection include:</p>
  <h3>Direct Contact</h3>
  <ul>
    <li>Person-to-person: transmitted through skin contact, bodily fluids, or respiratory droplets (e.g., staphylococcal infections, tuberculosis)</li>
    <li>Animal-to-person: transmitted through bites, scratches, or contact with animal waste (e.g., Salmonella, certain E. coli)</li>
  </ul>
  <h3>Contaminated Food and Water</h3>
  <ul>
    <li>Foodborne bacteria: eating contaminated food (e.g., Salmonella, E. coli, Listeria) often from undercooked meat, raw produce, or unpasteurized dairy</li>
    <li>Waterborne bacteria: drinking or contacting contaminated water</li>
  </ul>
  <h3>Environmental Exposure</h3>
  <ul>
    <li>Soil and water: bacteria like Clostridium tetani can enter through wounds in soil</li>
    <li>Surfaces and objects: contact with contaminated items, then touching mucous membranes or broken skin</li>
  </ul>
  <h3>Weakened Immune System</h3>
  <p>Conditions such as HIV/AIDS, cancer treatment, diabetes, or immunosuppressive medications increase susceptibility.</p>
  <h3>Normal Flora Imbalance</h3>
  <p>Disruption of beneficial bacteria (e.g., after antibiotic use or poor hygiene) allows harmful bacteria to overgrow.</p>

  <h2>What are the most common symptoms of bacterial infections?</h2>
  <p>Symptoms vary by infection type and location, but common signs include:</p>
  <ul>
    <li>Fever and chills</li>
    <li>Fatigue and weakness</li>
    <li>Pain, redness, swelling, and warmth at infection site</li>
    <li>Pus or discharge</li>
    <li>Cough, sore throat, and breathing difficulty for respiratory infections</li>
    <li>Nausea, vomiting, diarrhea, and stomach cramps for gastrointestinal infections</li>
    <li>Painful urination, urgency, and cloudy urine for UTIs</li>
    <li>Rashes, blisters, or sores for skin infections</li>
    <li>Headaches, body aches, and swollen lymph nodes</li>
    <li>Chest pain and difficulty breathing in severe infections like pneumonia</li>
  </ul>
  <p>If you experience symptoms of a bacterial infection, seek immediate medical attention for prompt diagnosis and treatment.</p>

  <h2>How are bacterial infections diagnosed?</h2>
  <p>Diagnosis involves medical history, physical examination, and tests:</p>
  <h3>Medical History and Physical Exam</h3>
  <ul>
    <li>Review of symptoms, exposures, and travel history</li>
    <li>Physical signs such as fever, heart rate, and local inflammation</li>
  </ul>
  <h3>Laboratory Tests</h3>
  <ul>
    <li>Blood tests: complete blood count (CBC) and blood cultures</li>
    <li>Urinalysis and urine cultures</li>
    <li>Sputum culture for respiratory infections</li>
    <li>Stool sample for gastrointestinal pathogens</li>
    <li>Swabs (throat, wound) to identify bacteria</li>
  </ul>
  <h3>Imaging Tests</h3>
  <ul>
    <li>X-rays for lung infections</li>
    <li>Ultrasound, CT, or MRI to locate abscesses and deeper infections</li>
  </ul>

  <h2>How are bacterial infections treated?</h2>
  <p>Treatment depends on the infection type and severity:</p>
  <h3>Antibiotics</h3>
  <ul>
    <li>Selected based on culture and sensitivity results</li>
    <li>Routes: oral, topical, or intravenous</li>
    <li>Complete the full course to prevent resistance, typically 7–14 days</li>
  </ul>
  <h3>Supportive Care</h3>
  <ul>
    <li>Rest and hydration</li>
    <li>Pain relievers like acetaminophen or ibuprofen</li>
  </ul>
  <h3>Drainage and Wound Care</h3>
  <p>Drain abscesses when necessary and maintain proper wound hygiene.</p>
  <h3>Hospitalization</h3>
  <p>Severe infections (sepsis, MRSA, meningitis) require IV antibiotics and supportive care.</p>
  <h3>Follow-Up and Prevention</h3>
  <p>Regular check-ups to ensure resolution and vaccination when available (e.g., pneumococcal, meningococcal).</p>

  <h2>How can you prevent bacterial infections?</h2>
  <p>Prevention strategies include:</p>
  <ul>
    <li>Handwashing with soap and water for at least 20 seconds</li>
    <li>Using alcohol-based hand sanitizer when soap is unavailable</li>
    <li>Proper wound care and covering cuts</li>
    <li>Food safety: washing produce, cooking meats thoroughly, avoiding cross-contamination</li>
    <li>Cleaning and disinfecting surfaces regularly</li>
    <li>Up-to-date vaccinations (pneumococcal, meningococcal, Hib)</li>
    <li>Safe water practices: drinking treated water and avoiding swallowing recreational water</li>
    <li>Responsible antibiotic use: only when prescribed and complete the course</li>
    <li>Safe sex practices to prevent STIs</li>
    <li>Healthy lifestyle: balanced diet, regular exercise, adequate sleep, pest control, and tick precautions</li>
  </ul>

  <h2>Sources</h2>
  <ul>
    <li>Bacterial Infections. National Institute of Allergy and Infectious Diseases. Accessed May 22, 2024.</li>
    <li>Antibiotic Use Questions and Answers. Centers for Disease Control and Prevention (CDC). Accessed May 22, 2024.</li>
    <li>Hygiene and Respiratory Viruses Prevention. Centers for Disease Control and Prevention (CDC). Accessed May 22, 2024.</li>
    <li>Gerba CP. Environmentally Transmitted Pathogens. Environmental Microbiology. 2009:445–84. Accessed May 22, 2024.</li>
    <li>Doron S, Gorbach SL. Bacterial Infections: Overview. International Encyclopedia of Public Health. 2008:273–82. doi: 10.1016/B978-012373960-5.00596-7. Epub 2008 Aug 26. PMCID: PMC7149789. Accessed May 22, 2024.</li>
  </ul>

Bacterial Infections

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<h2>What is anxiety?</h2>
Anxiety is your body’s normal response to stress or perceived threats. It is a natural part of daily life and can serve as an alert to potential dangers and help you prepare for challenges. However, when anxiety becomes excessive, persistent, or overwhelming, it can interfere with your daily activities and quality of life.

<a class="wpil_keyword_link" href="http://conditions/anxiety" title="Anxiety" data-wpil-keyword-link="linked" data-wpil-monitor-id="1043">Anxiety</a> disorders are a group of mental health conditions characterized by excessive and uncontrollable worry, fear, or apprehension. Types include generalized anxiety disorder (GAD), panic disorder, social anxiety disorder (social phobia), specific phobias, and other anxiety-related conditions.
<h2>What are the different types of anxiety?</h2>
<ul>
 	<li>Generalized Anxiety Disorder (GAD): Constant and excessive worry or anxiety that interferes with daily life. Physical symptoms may include restlessness, muscle tension, fatigue, irritability, and difficulty concentrating.</li>
 	<li>Panic Disorder: Recurrent panic attacks—sudden episodes of intense fear or discomfort that peak within minutes. Symptoms can include chest pain, heart palpitations, shortness of breath, dizziness, sweating, trembling, and a sense of impending doom.</li>
 	<li>Social Anxiety Disorder (Social Phobia): Intense fear or anxiety about social situations, worrying about being judged or embarrassed. Physical symptoms may include blushing, sweating, trembling, and nausea; often leads to avoidance of social events.</li>
 	<li>Specific Phobias: Intense, irrational fears of specific objects, animals, situations, or activities, leading to avoidance. Common examples are fear of heights (acrophobia), spiders (arachnophobia), flying (aviophobia), enclosed spaces (claustrophobia), and needles (trypanophobia).</li>
 	<li>Agoraphobia: Fear of being unable to escape or get help, typically involving two or more situations such as using public transportation, being in open or enclosed spaces, standing in line or in a crowd, or being outside the home alone.</li>
 	<li>Separation Anxiety Disorder: Excessive fear or anxiety about separation from people you are close to. Common in children but can occur in adults, sometimes causing nightmares or physical symptoms like headaches or stomachaches.</li>
 	<li>Selective Mutism: Failure to speak in specific social situations despite speaking in other settings. Typically occurs in children around age 5 and is often linked to social anxiety or extreme shyness.</li>
</ul>
<h2>What causes anxiety?</h2>
Anxiety disorders can arise from a combination of factors:
<ul>
 	<li>Genetics: Family history of anxiety disorders increases risk.</li>
 	<li>Brain chemistry imbalances: Neurotransmitters like serotonin, dopamine, and GABA play a role.</li>
 	<li>Environmental factors: Traumatic or stressful life events, chronic stress, or childhood adversity.</li>
 	<li>Personality traits: Perfectionism, low self-esteem, or high sensitivity to stress.</li>
 	<li>Medical conditions: Thyroid disorders, heart disease, respiratory issues, chronic pain, and certain medications or substances (caffeine, alcohol, illicit drugs).</li>
 	<li>Gender: Women are more likely than men to experience certain anxiety disorders.</li>
</ul>
<h2>What are the symptoms of anxiety?</h2>
<ul>
 	<li>Excessive worry about health, finances, work, relationships, and other concerns.</li>
 	<li>Physical symptoms: rapid or irregular heartbeat, chest pain, shortness of breath, trembling, sweating, dizziness, stomach discomfort, muscle tension, headaches, fatigue.</li>
 	<li>Restlessness or irritability.</li>
 	<li>Difficulty concentrating or mind going blank.</li>
 	<li>Insomnia: trouble falling or staying asleep due to racing thoughts or physical discomfort.</li>
 	<li>Avoidance behaviors: avoiding situations that trigger anxiety.</li>
 	<li>Panic attacks: sudden intense fear with physical symptoms and a sense of losing control.</li>
 	<li>Social anxiety: fear of social or performance situations, worry about embarrassment or judgment.</li>
</ul>
<h2>How is anxiety diagnosed?</h2>
<ul>
 	<li>Medical history review: assessment of symptoms, duration, severity, and family history of mental health disorders.</li>
 	<li>Diagnostic criteria: use of DSM-5 criteria by healthcare providers to identify specific anxiety disorders.</li>
 	<li>Clinical interviews: detailed interviews to understand symptom patterns, triggers, and co-occurring conditions.</li>
 	<li>Standardized screening tools: questionnaires like the GAD-7 or HAM-A to quantify symptom severity and track progress.</li>
 	<li>Physical exam and lab tests: to rule out medical conditions (e.g., thyroid tests, blood work).</li>
 	<li>Differential diagnosis: distinguishing anxiety disorders from other mental health conditions such as <a class="wpil_keyword_link" href="/conditions/depression" title="Depression" data-wpil-keyword-link="linked" data-wpil-monitor-id="1042">depression</a>, PTSD, or OCD.</li>
</ul>
<h2>How is anxiety treated?</h2>
Treatment is personalized based on the type and severity of the disorder and may include:
<h3>Psychotherapy</h3>
<ul>
 	<li>Cognitive-Behavioral Therapy (CBT): identifies and changes negative thought patterns and behaviors; includes exposure therapy.</li>
 	<li>Exposure Therapy: gradual, controlled exposure to feared situations to reduce avoidance.</li>
 	<li>Mindfulness-Based Therapies: practices like MBSR and ACT to improve coping and reduce stress.</li>
</ul>
<h3>Medication</h3>
<ul>
 	<li>SSRIs: antidepressants effective for GAD, panic disorder, social anxiety, and OCD.</li>
 	<li>SNRIs: increase serotonin and norepinephrine to alleviate anxiety symptoms.</li>
 	<li>Benzodiazepines: short-term relief for severe symptoms or panic attacks; risk of dependence.</li>
 	<li>Buspirone: anti-anxiety medication for GAD affecting serotonin and dopamine.</li>
 	<li>Beta-blockers: reduce physical symptoms such as rapid heartbeat and trembling.</li>
</ul>
<h3>Lifestyle Modifications</h3>
<ul>
 	<li>Regular exercise: promotes relaxation, improves mood, and reduces stress.</li>
 	<li>Healthy diet: balanced nutrition supports physical and mental health.</li>
 	<li>Stress management techniques: deep breathing, progressive muscle relaxation, meditation, yoga, guided imagery.</li>
 	<li>Limiting caffeine and alcohol: these substances can worsen anxiety and affect sleep.</li>
 	<li>Support groups: peer support provides encouragement and coping strategies.</li>
 	<li>Self-help practices: adequate sleep, routine, hobbies, setting boundaries, and prioritizing relaxation.</li>
</ul>
Work closely with mental health professionals to develop and adjust a personalized treatment plan. Regular follow-up and monitoring are essential for long-term management.
<h2>Sources</h2>
<ul>
 	<li><a href="https://www.nimh.nih.gov/health/topics/anxiety-disorders">Anxiety disorders. National Institute of Mental Health.</a> Accessed Apr. 2, 2024.</li>
 	<li>Anxiety disorders. National Alliance on Mental Illness. Accessed Apr. 2, 2024.</li>
 	<li><a href="https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders#section_9">What are Anxiety Disorders? American Psychiatric Association.</a> Accessed Apr. 2, 2024.</li>
 	<li><a href="https://adaa.org/understanding-anxiety/facts-statistics">Anxiety Disorders. Anxiety and Depression Association of America.</a> Accessed Apr. 2, 2024.</li>
</ul>

Anxiety

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<h2>What is asthma?</h2>
Asthma is a chronic respiratory disease that affects the airways in the lungs. It occurs in people of all ages and often starts during childhood. In asthma the muscles around your airways become tight, causing the bronchial tubes to narrow. You can also have increased mucus production which clogs the airways even more. This can lead to shortness of breath, wheezing, coughing, and chest tightness. If not treated, asthma can be life-threatening. Severe asthma can also lead to the development of <a href="/conditions/chronic-obstructive-pulmonary-disease-copd/">chronic obstructive pulmonary disease (COPD)</a>.

More than 27 million Americans have asthma (about 1 in 12 people), including approximately 4.5 million children under the age of 18. Asthma symptoms can vary in severity and be triggered by allergens (pollen, dust mites, pet dander), respiratory infections, exercise, cold air, air pollution, smoke, and certain medications.

While there is no cure for asthma, it can be managed with medications and lifestyle changes. Treatment typically involves daily controller medications to prevent symptoms, as well as rescue inhalers or nebulizers to deliver medication directly to your lungs during flare-ups. Avoiding known triggers also helps reduce symptoms.
<h2>What causes asthma?</h2>
The exact cause of asthma is not known, but it likely results from a combination of genetic and environmental factors:
<ul>
 	<li>Genetic factors: Family history of asthma or allergic conditions (hay fever, <a class="wpil_keyword_link" href="/conditions/eczema" title="Eczema" data-wpil-keyword-link="linked" data-wpil-monitor-id="1040">eczema</a>) increases risk.</li>
 	<li>Environmental allergens: Pollen, dust mites, mold, pet dander, and cockroach droppings can trigger or worsen asthma.</li>
 	<li>Respiratory infections: Early childhood viral infections can inflame airways and increase reactivity.</li>
 	<li>Occupational/environmental irritants: Secondhand smoke, chemical fumes, poor air quality, and strong odors.</li>
 	<li>Early childhood exposures: Tobacco smoke and pollutants during development increase later asthma risk.</li>
 	<li>Obesity: May contribute via inflammation and altered lung mechanics.</li>
 	<li>Stress: Emotional stress can trigger or worsen symptoms in some individuals.</li>
</ul>
<h2>What are the symptoms of asthma?</h2>
<ul>
 	<li>Shortness of breath: Difficulty breathing, ranging from mild to severe, at rest or during activity.</li>
 	<li>Wheezing: High-pitched whistling sound on exhale (and sometimes inhale).</li>
 	<li>Coughing: Persistent cough, often worse at night or early morning; may be dry or productive.</li>
 	<li>Chest tightness: Sensation of pressure or constriction in the chest.</li>
 	<li>Difficulty sleeping: Symptoms like coughing and wheezing can disrupt sleep.</li>
 	<li>Fatigue: Increased effort to breathe can cause low energy levels.</li>
</ul>
Some people experience asthma in specific contexts:
<ul>
 	<li>Exercise-induced asthma: Triggered by physical activity, especially in cold, dry air.</li>
 	<li>Occupational asthma: Caused by workplace irritants like chemical gases, fumes, or dust.</li>
 	<li>Allergy-induced asthma: Triggered by airborne allergens such as pollen, mold, or pet dander.</li>
</ul>
<h2>How is asthma diagnosed?</h2>
<ul>
 	<li>Medical history: Review of symptoms, triggers, personal and family history of <a class="wpil_keyword_link" href="/conditions/allergies" title="Allergies" data-wpil-keyword-link="linked" data-wpil-monitor-id="1041">allergies</a> or respiratory conditions.</li>
 	<li>Physical exam: Listening to lungs for wheezing and ruling out other causes.</li>
 	<li>Lung function tests (PFTs): Spirometry measures how much and how quickly you can exhale air.</li>
 	<li>Peak flow monitoring: Handheld device tracks exhalation speed over time.</li>
 	<li>Allergy testing: Skin prick or blood tests identify specific allergic triggers.</li>
 	<li>Additional tests: Chest X-ray, CT scan, or evaluation for conditions like GERD or vocal cord dysfunction to exclude other causes.</li>
</ul>
Based on these assessments, your healthcare provider will confirm an asthma diagnosis and develop a management plan.
<h2>How is asthma treated?</h2>
Treatment aims to control symptoms, prevent attacks, and maintain lung function:
<h3>Medications</h3>
<ul>
 	<li>Quick-relief (rescue) medications: Short-acting beta-agonists (e.g., albuterol) relax airway muscles during an attack.</li>
 	<li>Controller medications: Daily inhaled corticosteroids (e.g., fluticasone, budesonide) and long-acting beta-agonists reduce inflammation and prevent symptoms.</li>
 	<li>Leukotriene modifiers: Oral medications (e.g., montelukast) that reduce airway inflammation.</li>
 	<li>Biologic therapies: Injected or infused treatments (e.g., mepolizumab, omalizumab) for severe asthma not controlled by other medications.</li>
 	<li>Oral corticosteroids: Short-term use to quickly reduce inflammation during severe exacerbations.</li>
 	<li>Allergy immunotherapy: Allergy shots to decrease sensitivity to specific triggers over time.</li>
</ul>
<h3>Lifestyle and management strategies</h3>
<ul>
 	<li>Avoiding triggers: Identify and minimize exposure to allergens and irritants.</li>
 	<li>Healthy habits: Maintain a healthy weight, quit smoking, manage stress, and exercise regularly.</li>
 	<li>Asthma action plan: Written plan from your provider outlining daily management and steps for flare-ups.</li>
 	<li>Regular monitoring: Track symptoms, peak flow readings, and medication use; attend follow-up visits.</li>
 	<li>Emergency preparedness: Know when to seek immediate care for severe attacks requiring rescue medications or hospitalization.</li>
</ul>
With proper treatment and self-management, most people with asthma can live active, symptom-free lives.
<h2>Sources</h2>
<ul>
 	<li><a href="https://www.nhlbi.nih.gov/health/asthma">What is Asthma? National Heart, Lung, and Blood Institute.</a> Accessed Apr. 5, 2024.</li>
 	<li>Asthma. Centers for Disease Control and Prevention. Accessed Apr. 5, 2024.</li>
 	<li><a href="https://allergyasthmanetwork.org/what-is-asthma/">What is Asthma? Allergy and Asthma Network.</a> Accessed Apr. 5, 2024.</li>
 	<li><a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/what-is-asthma">What is Asthma? American Lung Association.</a> Accessed Apr. 5, 2024.</li>
 	<li><a href="https://acaai.org/asthma/asthma-101">Asthma 101. American College of Asthma, Allergy and Immunology.</a> Accessed Apr. 5, 2024.</li>
</ul>

Asthma

<h2>What is chronic obstructive pulmonary disease (COPD)?</h2>
    <p>Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow in your lungs. It was the fourth leading cause of death in the United States in 2018 and almost 15.7 million Americans (6.4%) reported that they have been diagnosed with COPD.</p>
    <p>COPD can be caused by long-term exposure to irritants, most commonly cigarette smoke, air pollution, and workplace dust or fumes. COPD is characterized by increasing breathlessness, coughing, wheezing, and chest tightness. It is a progressive disease, meaning it typically worsens over time. There may also be periods when your symptoms suddenly get worse, which is called a flare-up or exacerbation.</p>
    <p>In the United States, the term COPD refers to two main conditions:</p>
    <ul>
        <li>Emphysema: Damage to the walls between many of the air sacs in your lungs. Normally, these sacs stretch when you breathe in and deflate when you breathe out. In emphysema, it becomes harder for your lungs to expel air.</li>
        <li>Chronic bronchitis: Repeated or constant inflammation in the lining of your airways causes thick mucus and phlegm to form, making it harder to breathe.</li>
    </ul>
    <p>There is no cure for COPD. However, treatments can help relieve symptoms, slow disease progression, and increase life expectancy.</p>

    <h2>What causes COPD?</h2>
    <p>Tobacco smoke is the main cause of COPD, accounting for up to 90% of cases. Other risk factors include:</p>
    <ul>
        <li>Environmental exposures such as chemical fumes, dust, secondhand smoke, and industrial pollutants</li>
        <li>A rare genetic condition called alpha-1 antitrypsin deficiency</li>
        <li>Severe or repeated respiratory infections during childhood or adulthood</li>
        <li>Indoor air pollution from biomass fuels used for cooking and heating in poorly ventilated homes</li>
    </ul>
    <p>While multiple factors can contribute, cigarette smoking remains the single most significant risk factor for developing COPD.</p>

    <h2>What are the symptoms of COPD?</h2>
    <p>Symptoms can vary, but common ones include:</p>
    <ul>
        <li>Shortness of breath, especially during activity and, in advanced cases, at rest</li>
        <li>Chronic cough producing mucus that may be clear, white, yellow, or greenish</li>
        <li>Wheezing, a whistling or squeaky sound when breathing</li>
        <li>Chest tightness or pressure</li>
        <li>Fatigue and general tiredness due to decreased oxygen levels</li>
        <li>Frequent respiratory infections such as colds, flu, or pneumonia</li>
        <li>Blue lips or fingertips (cyanosis) when oxygen levels are very low</li>
        <li>Unintended <a class="wpil_keyword_link" href="/conditions/weight-loss" title="Weight Loss" data-wpil-keyword-link="linked" data-wpil-monitor-id="1031">weight loss</a> in severe cases</li>
        <li>Swelling in ankles, feet, or legs due to circulatory effects</li>
    </ul>
    <p>If you experience any of these signs or symptoms, contact your healthcare provider promptly. Do not wait until you need emergency care.</p>

    <h2>How is COPD diagnosed?</h2>
    <p>Diagnosing COPD involves several steps:</p>
    <ul>
        <li>Medical history review, including symptoms, smoking history, and exposure to lung irritants</li>
        <li>Physical exam, listening to your lungs with a stethoscope for wheezing or crackles</li>
        <li>Spirometry, a breathing test measuring how much air you inhale and exhale and how quickly you exhale</li>
        <li>Other lung function tests such as lung volume measurements and diffusion capacity tests</li>
        <li>Imaging tests like chest X-rays or CT scans to rule out other conditions and assess lung damage</li>
        <li>Blood tests to measure oxygen and carbon dioxide levels and to check for alpha-1 antitrypsin deficiency</li>
        <li>Exercise testing in some cases to see how exercise affects your breathing and oxygen levels</li>
    </ul>
    <p>Based on these results, your provider can confirm a COPD diagnosis, assess its severity, and develop a personalized treatment plan.</p>

    <h2>How is COPD treated?</h2>
    <p>Treatment aims to relieve symptoms, improve quality of life, prevent progression, and reduce flare-ups. It typically includes:</p>
    <ul>
        <li><a class="wpil_keyword_link" href="/conditions/smoking-cessation" title="Smoking Cessation" data-wpil-keyword-link="linked" data-wpil-monitor-id="1030">Smoking cessation</a> and avoidance of lung irritants</li>
        <li>Medications:
            <ul>
                <li>Bronchodilators to relax airway muscles (short-acting and long-acting)</li>
                <li>Inhaled corticosteroids to reduce airway inflammation</li>
                <li>Phosphodiesterase-4 inhibitors to decrease lung inflammation</li>
                <li>Antibiotics or antivirals during infection-related exacerbations</li>
            </ul>
        </li>
        <li>Pulmonary rehabilitation combining exercise training, education, and support</li>
        <li>Oxygen therapy for those with low blood oxygen levels</li>
        <li>Vaccinations, including annual flu shots and pneumococcal vaccines</li>
        <li>Lifestyle changes such as balanced diet, regular physical activity, and stress management</li>
        <li>Surgical options in select cases, including lung volume reduction surgery or lung transplantation</li>
    </ul>

    <h2>What are the complications of COPD?</h2>
    <p>People with COPD are more likely to experience:</p>
    <ul>
        <li>Limitations in daily activities such as walking or climbing stairs</li>
        <li>Inability to work or maintain independence</li>
        <li>Memory loss or confusion</li>
        <li>Need for portable oxygen equipment</li>
        <li>Social withdrawal and reduced participation in activities</li>
        <li>Emergency room visits or hospitalizations</li>
        <li>Additional chronic conditions like congestive heart failure, coronary artery disease, diabetes, or <a class="wpil_keyword_link" href="/conditions/asthma" title="Asthma" data-wpil-keyword-link="linked" data-wpil-monitor-id="200">asthma</a></li>
        <li><a class="wpil_keyword_link" href="/conditions/depression" title="Depression" data-wpil-keyword-link="linked" data-wpil-monitor-id="1029">Depression</a> or other mental health challenges</li>
    </ul>

    <h2>Sources</h2>
    <ul>
        <li>COPD-Basics. Centers for Disease Control and Prevention. Accessed Apr. 10, 2024.</li>
        <li>What is COPD? National Heart, Blood, and Lung Institute. Accessed Apr. 10, 2024.</li>
        <li>Chronic obstructive pulmonary disease (COPD). World Health Organization. Accessed Apr. 10, 2024.</li>
        <li>Learn About COPD. American Lung Association. Accessed Apr. 10, 2024.</li>
        <li>Merck Manual. Chronic Obstructive Pulmonary Disease COPD. Accessed Apr. 10, 2024.</li>
    </ul>

Chronic Obstructive Pulmonary Disease (COPD)

<h2>What is chronic bronchitis?</h2>
Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD), along with emphysema. Chronic bronchitis is a long-term inflammation of your bronchial tubes (bronchi), the major airways in the lungs. This lung disease can cause narrowed airways which block air flow in your lungs and cause breathing problems. The most common symptom of chronic bronchitis is a constant, productive cough that lasts for at least three months in two consecutive years.

Chronic bronchitis often develops due to prolonged exposure to irritants that damage the lungs and airways, most commonly tobacco <a href="/conditions/smoking-cessation/">smoke</a>. Other pollutants like dust, chemical fumes, and air pollution can also play a part in the development of chronic bronchitis. The inflammation from these irritants leads to an increase in mucus production, which blocks the airways and prompts coughing.

Managing chronic bronchitis typically involves quitting smoking, using medications to open the airways and reduce inflammation, and sometimes oxygen therapy. Pulmonary rehabilitation programs may also be recommended to help manage your symptoms and improve your quality of life.
<h2>What causes chronic bronchitis?</h2>
The main cause of chronic bronchitis is long-term exposure to irritants that damage your bronchial tubes, which carry air in and out of the air sacs in your lungs. This irritation causes the build-up of mucus. The swelling of your bronchial tube and mucus build-up makes it harder for your lungs to breathe.

Risk factors and causes that can increase your risk of chronic bronchitis include:
<ul>
 	<li>Smoking: The most common cause of chronic bronchitis is cigarette smoking. Tobacco smoke irritates the airways, leading to inflammation and increased mucus production.</li>
 	<li>Environmental pollutants: Exposure to air pollution, secondhand smoke, dust, fumes, and toxic gases, especially in industrial work settings, can also contribute to the development of chronic bronchitis.</li>
 	<li>Genetic factors: Although rare, a genetic condition known as alpha-1 antitrypsin deficiency may play a role in the development of chronic bronchitis.</li>
 	<li>Repeated respiratory infections: Frequent respiratory infections that cause acute bronchitis can lead to chronic inflammation of your airways and may lead to chronic bronchitis.</li>
 	<li>Gastroesophageal Reflux (GERD): Repeated episodes of severe heartburn can irritate your throat and make you more likely to develop chronic bronchitis.</li>
 	<li>Age and general health: Older adults and those with weakened immune systems have a higher risk of developing chronic bronchitis.</li>
</ul>
Preventing chronic bronchitis primarily involves avoiding or reducing exposure to these risk factors, especially <a class="wpil_keyword_link" href="/conditions/smoking-cessation" title="Smoking Cessation" data-wpil-keyword-link="linked" data-wpil-monitor-id="1034">smoking cessation</a>.
<h2>What are the symptoms of chronic bronchitis?</h2>
The symptoms of chronic bronchitis can vary between people, but typically include the following:
<ul>
 	<li>Persistent cough: A key symptom of chronic bronchitis is a chronic cough that produces mucus, often called a "smoker's cough." This cough tends to be worse in the mornings and damp weather.</li>
 	<li>Increased mucus production: The inflammation of your airways leads to increased production of mucus, which can be clear, white, yellow, or greenish.</li>
 	<li>Shortness of breath: As the disease progresses, you may find it difficult to breathe, especially during physical activity.</li>
 	<li>Wheezing: A whistling or rattling sound when breathing, especially during exhalation, can occur due to the narrowing of your airways.</li>
 	<li>Chest pain or discomfort: If you have chronic bronchitis, you may experience tightness, pain, or discomfort in your chest.</li>
 	<li>Frequent lung infections: Chronic bronchitis makes it more likely for you to develop lung infections like the common cold or influenza, which can worsen symptoms.</li>
 	<li>Fatigue: Chronic breathing difficulties can lead to fatigue and decreased energy levels.</li>
</ul>
These symptoms can worsen during physical activity and are often triggered by respiratory infections or exposure to additional irritants. Managing symptoms usually involves medications, lifestyle changes such as quitting smoking, and possibly pulmonary rehabilitation.
<h2>How is chronic bronchitis diagnosed?</h2>
Chronic bronchitis is diagnosed primarily through a clinical exam, medical history, and several diagnostic tests. Some common tests include:
<ul>
 	<li><strong>Medical History and Physical Exam:</strong> The doctor will first ask about symptoms, smoking habits, exposure to lung irritants, and family history of respiratory diseases. A physical exam will include listening to your lungs with a stethoscope for signs of wheezing or other abnormal sounds.</li>
 	<li><strong>Pulmonary Function Tests (PFTs):</strong> These tests measure the volume and speed of air that can be inhaled and exhaled, and are key to diagnosing chronic bronchitis. The most common test is spirometry, which checks lung function and can help diagnose chronic bronchitis or rule out other conditions like <a class="wpil_keyword_link" href="/conditions/asthma" title="Asthma" data-wpil-keyword-link="linked" data-wpil-monitor-id="201">asthma</a>.</li>
 	<li><strong>Chest X-ray or CT Scan:</strong> These imaging tests can help to rule out other lung conditions and to view the extent of any lung damage.</li>
 	<li><strong>Sputum Tests:</strong> Analysis of the mucus (sputum) produced when coughing can help detect the presence of infections or other conditions.</li>
 	<li><strong>Blood Tests:</strong> Although not used to directly diagnose chronic bronchitis, blood tests can help evaluate your overall health and detect signs of infection or inflammation.</li>
 	<li><strong>Oximetry or Arterial Blood Gas Test:</strong> These tests measure the oxygen and carbon dioxide levels in your blood and can help see how well your lungs are functioning.</li>
</ul>
The diagnosis of chronic bronchitis is typically considered if you have a persistent cough that produces mucus for at least three months in two consecutive years, particularly when other conditions have been ruled out.
<h2>How is chronic bronchitis treated?</h2>
Treating chronic bronchitis involves a combination of lifestyle changes, medications, and sometimes additional therapies to manage symptoms and prevent complications. This can include any combination of the following:
<ul>
 	<li>Quit Smoking: If you smoke, the most important step is to stop smoking. Quitting smoking can significantly slow the progression of the disease and improve your lung function over time.</li>
 	<li>Medications:
<ul>
 	<li>Bronchodilators: These drugs help relax the muscles around your airways, making it easier to breathe. They are typically administered via inhalers or by a nebulizer.</li>
 	<li>Corticosteroids: Inhaled corticosteroids can help reduce airway inflammation and are often used during flare-ups or when symptoms are persistent.</li>
 	<li>Phosphodiesterase-4 inhibitors: This relatively new type of medication can decrease airway inflammation and relax your airways.</li>
 	<li>Antibiotics: These are used during exacerbations if there is evidence of bacterial infection.</li>
 	<li>Mucolytics: These medications can help thin the mucus in your lungs, making it easier to cough up.</li>
</ul>
</li>
 	<li>Vaccinations: You should receive the influenza vaccine annually and be vaccinated against pneumococcal pneumonia and COVID-19 to help prevent infections that can worsen your condition.</li>
 	<li>Pulmonary Rehabilitation: This is a program that includes exercise, disease management training, nutritional counseling, and psychological counseling and can help you learn to breathe—and function—at the highest level possible.</li>
 	<li>Oxygen Therapy: If you have severe chronic bronchitis and low blood oxygen levels, oxygen therapy can be necessary to help you breathe better.</li>
 	<li>Other Lifestyle Changes: Maintaining a healthy lifestyle, including regular physical activity, a balanced diet, and avoiding air pollutants as much as possible, can also help manage symptoms.</li>
 	<li>Lung Transplant: If you have severe symptoms that have not improved with medications, this may be used as a last resort.</li>
 	<li>Managing Exacerbations: It’s important that you recognize the signs of an exacerbation (such as increased coughing, changes in mucus, or worsening shortness of breath) and seek prompt treatment to prevent further damage.</li>
</ul>
The approach to treatment will vary depending on the severity of your disease and your overall health, so you must work closely with your healthcare provider to develop a treatment plan that meets your specific needs.
<h2>When should you see my healthcare provider?</h2>
Talk to your healthcare provider if you think you have chronic bronchitis. Starting a treatment plan as soon as possible can slow down your disease progression and improve your overall quality of life. See your healthcare provider if you:
<ul>
 	<li>Have a persistent cough that lasts more than 3 weeks or keeps coming back.</li>
 	<li>Have frequent wheezing or shortness of breath.</li>
 	<li>Have a high fever (103° F or 39.4° C) or a fever that lasts more than 5 days.</li>
 	<li>Are coughing up blood.</li>
</ul>
<h2>What is the difference between chronic bronchitis and emphysema?</h2>
Emphysema and chronic bronchitis are two of the most common forms of chronic obstructive pulmonary disease (<a class="wpil_keyword_link" href="/conditions/chronic-obstructive-pulmonary-disease-copd" title="Chronic Obstructive Pulmonary Disease (COPD)" data-wpil-keyword-link="linked" data-wpil-monitor-id="1033">COPD</a>). While both types of COPD can cause similar symptoms, they affect different parts of your lungs. Emphysema gradually destroys the small air sacs at the end of your airways called alveoli and almost exclusively causes shortness of breath. Chronic bronchitis causes swelling and inflammation in your airways, or bronchi, and causes increased mucus production, cough, and fever. If you have COPD, you can have damage to both your airways and alveoli.
<h2>Sources</h2>
<ul>
 	<li>Chronic Bronchitis. American Lung Association. Accessed Apr. 15, 2024.</li>
 	<li>Chronic Bronchitis. National Library of Medicine. Accessed Apr. 15, 2024.</li>
 	<li>Bronchitis. National Institute of Health (NIH). Accessed Apr. 15, 2024.</li>
 	<li>Kim V, Criner GJ. Chronic bronchitis and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013 Feb 1;187(3):228-37. Accessed Apr. 15, 2024.</li>
</ul>

Chronic Bronchitis

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<h2>Fibromyalgia</h2>
Fibromyalgia is a chronic condition characterized by widespread muscle and joint pain, fatigue, sleep disturbances, cognitive difficulties, and mood issues. Although its exact cause is unknown, fibromyalgia involves abnormal processing of pain signals by the central nervous system, leading to heightened sensitivity to pain. Symptoms often follow physical or emotional trauma, infection, or may appear without an identifiable trigger. Women are more commonly affected, and fibromyalgia frequently coexists with conditions such as irritable bowel syndrome, migraines, osteoarthritis, and rheumatoid <a class="wpil_keyword_link" href="/conditions/arthritis" title="Arthritis" data-wpil-keyword-link="linked" data-wpil-monitor-id="919">arthritis</a>.
<h2>Causes and Risk Factors</h2>
<ul>
 	<li>Genetics: Family history increases susceptibility.</li>
 	<li>Abnormal pain processing: Changes in neurotransmitters and pain receptors heighten sensitivity.</li>
 	<li>Infections: Illnesses can trigger or worsen symptoms.</li>
 	<li>Physical or emotional trauma: Accidents, surgery, or severe stress may precipitate onset.</li>
 	<li>Coexisting conditions: <a href="/conditions/irritable-bowel-syndrome-ibs/" data-wpil-monitor-id="105">Irritable bowel syndrome</a>, migraines, arthritis, lupus, and chronic fatigue syndrome.</li>
 	<li>Hormonal imbalances: Fluctuations may play a role.</li>
</ul>
<h2>Symptoms</h2>
<ul>
 	<li>Widespread pain: A constant dull ache lasting at least three months, on both sides of the body.</li>
 	<li>Fatigue: Persistent tiredness not relieved by rest.</li>
 	<li>Cognitive difficulties (“fibro fog”): Problems with concentration, memory, and focus.</li>
 	<li>Sleep disturbances: Nonrestorative sleep, frequent awakenings, sleep disorders.</li>
 	<li>Emotional issues: Anxiety and <a class="wpil_keyword_link" href="/conditions/depression" title="Depression" data-wpil-keyword-link="linked" data-wpil-monitor-id="920">depression</a> may both result from and exacerbate symptoms.</li>
 	<li>Other signs: Headaches or <a class="wpil_keyword_link" href="/conditions/migraines" title="Migraines" data-wpil-keyword-link="linked" data-wpil-monitor-id="1963">migraines</a>, abdominal pain, dry eyes/mouth, numbness/tingling, temperature sensitivity, morning stiffness.</li>
</ul>
<h2>Diagnosis</h2>
<ul>
 	<li>Medical history and symptom review: Detailed discussion of pain, fatigue, sleep, and cognitive complaints.</li>
 	<li>Physical exam: Assessment of tender points (or use of the Widespread Pain Index and Symptom Severity score).</li>
 	<li>Duration: Symptoms present for at least three months.</li>
 	<li>Exclusion of other conditions: Blood tests and imaging to rule out rheumatoid arthritis, <a class="wpil_keyword_link" href="/conditions/lupus" title="Lupus" data-wpil-keyword-link="linked" data-wpil-monitor-id="921">lupus</a>, thyroid disorders, and other causes.</li>
</ul>
<h2>Treatment</h2>
<h3>Medications</h3>
<ul>
 	<li>Pain relievers: <a title="Is acetaminophen Tylenol?" href="/blog/is-acetaminophen-tylenol/" data-wpil-monitor-id="106">Acetaminophen or nonsteroidal anti-inflammatory drugs</a> for mild pain.</li>
 	<li>Antidepressants: Duloxetine and milnacipran improve pain and fatigue.</li>
 	<li>Anti-seizure drugs: Gabapentin and pregabalin reduce certain types of pain.</li>
</ul>
<h3>Lifestyle and Home Remedies</h3>
<ul>
 	<li>Regular exercise: Low-impact activities such as walking, yoga, or tai chi.</li>
 	<li>Stress management: Meditation, deep breathing, and relaxation techniques.</li>
 	<li>Sleep hygiene: Consistent bedtime routine and restful environment.</li>
 	<li>Balanced diet: Nutrient-rich foods to support overall health.</li>
</ul>
<h3>Therapies</h3>
<ul>
 	<li>Physical therapy: Exercises to increase strength, flexibility, and reduce pain.</li>
 	<li>Occupational therapy: Strategies to perform daily tasks with less stress on the body.</li>
 	<li>Cognitive behavioral therapy: Techniques to cope with pain and stress.</li>
</ul>
<h3>Complementary Treatments</h3>
<ul>
 	<li>Acupuncture</li>
 	<li>Massage therapy</li>
 	<li>Chiropractic care</li>
</ul>
<h2>Sources</h2>
<ul>
 	<li><a href="https://www.niams.nih.gov/health-topics/fibromyalgia">National Institute of Arthritis and Musculoskeletal and Skin Diseases</a></li>
 	<li>Centers for Disease Control and Prevention</li>
 	<li><a href="https://www.nccih.nih.gov/health/fibromyalgia">National Center for Complementary and Integrative Health</a></li>
 	<li>Goldenberg DL. Clinical manifestations and diagnosis of fibromyalgia in adults.</li>
 	<li><a href="https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia">American College of Rheumatology</a></li>
 	<li><a href="https://medlineplus.gov/fibromyalgia.html">National Library of Medicine</a></li>
</ul>

Fibromyalgia

<h2>What is depression?</h2>
Depression (also called major depressive disorder, major depression, and clinical depression) is a common and serious mental health condition that affects your feelings, thoughts, and behaviors.

It is normal for you to feel sad about or grieve over difficult life events, such as losing your job, the loss of a loved one, or a divorce. However, depression is different because it happens nearly every day for at least two weeks and involves symptoms beyond sadness alone. Symptoms of depression can include:
<ul>
 	<li>Persistent sadness, anxiety, or feeling "empty"</li>
 	<li>Feelings of hopelessness or pessimism</li>
 	<li>Irritability</li>
 	<li>Feelings of guilt, worthlessness, or helplessness</li>
 	<li>Loss of interest or pleasure in hobbies and activities</li>
 	<li>Lack of energy or fatigue</li>
 	<li>Difficulty concentrating, remembering, or making decisions</li>
 	<li>Difficulty sleeping, early-morning awakening, or oversleeping</li>
 	<li><a href="/conditions/weight-loss/">Weight gain or loss</a></li>
 	<li>Thoughts of self-harm or suicide attempts</li>
</ul>
Depression typically requires long-term treatment that includes medications and psychotherapy. Most people with depression can be effectively treated and live a happy, healthy life.
<h2>What are the different types of depression?</h2>
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies them as follows:
<ul>
 	<li>Major depressive disorder (MDD): depressed mood for at least two weeks, plus symptoms like sleep problems, appetite changes, and loss of interest in daily activities.</li>
 	<li>Persistent depressive disorder (PDD): depression lasting at least two years, with symptoms that are less severe than MDD.</li>
 	<li>Disruptive mood dysregulation disorder (DMDD): long-term, severe irritability and frequent anger outbursts in children or adolescents, starting before age 10.</li>
 	<li>Premenstrual dysphoric disorder (PMDD): premenstrual symptoms with severe depression, irritability, or anxiety, improving within days after the period starts.</li>
 	<li>Seasonal affective disorder (SAD): depression related to certain seasons, typically fall and winter.</li>
 	<li>Postpartum and perinatal depression: occurs during pregnancy or within four weeks of childbirth due to hormonal changes.</li>
 	<li>Depression co-occurring with other mental illnesses or medical conditions, such as OCD, anxiety disorders, substance use disorders, and eating disorders.</li>
</ul>
<h2>Who gets depression?</h2>
Depression results from a combination of genetic, biological, environmental, and psychological factors. Common risk factors include:
<ul>
 	<li>Genetics: family history of depression</li>
 	<li>Brain chemistry and neurotransmitter imbalances</li>
 	<li>Hormonal changes (thyroid issues, <a class="wpil_keyword_link" href="/conditions/menopause" title="Menopause" data-wpil-keyword-link="linked" data-wpil-monitor-id="1016">menopause</a>, childbirth)</li>
 	<li>Life events (loss, relationship issues, financial stress)</li>
 	<li>Early childhood trauma (abuse or neglect)</li>
 	<li>Medical conditions (chronic illness, insomnia, chronic pain, <a class="wpil_keyword_link" href="/conditions/attention-deficit-hyperactivity-disorder-adhd" title="Attention Deficit Hyperactivity Disorder (ADHD)" data-wpil-keyword-link="linked" data-wpil-monitor-id="1015">ADHD</a>, diabetes, cancer, heart disease, Parkinson’s)</li>
 	<li>Personality traits (low self-esteem, high stress sensitivity, pessimism)</li>
</ul>
Understanding these factors is important for effective treatment and prevention.
<h2>What are the symptoms of depression?</h2>
Depression affects emotions, cognition, physical health, and behavior. Common symptoms include:
<h3>Emotional Symptoms</h3>
<ul>
 	<li>Persistent sadness, anxiety, or emptiness</li>
 	<li>Hopelessness, pessimism, or despair</li>
 	<li>Irritability or frustration</li>
 	<li>Guilt, worthlessness, or helplessness</li>
 	<li>Loss of interest or pleasure in usual activities</li>
</ul>
<h3>Cognitive Symptoms</h3>
<ul>
 	<li>Trouble concentrating, remembering details, or making decisions</li>
 	<li>Slowed thinking, speaking, or movements</li>
 	<li>Frequent thoughts of death, suicidal ideation, or suicide attempts</li>
</ul>
<h3>Physical Symptoms</h3>
<ul>
 	<li>Fatigue or lack of energy</li>
 	<li>Changes in appetite (increased or decreased)</li>
 	<li>Sleep disturbances (insomnia or hypersomnia)</li>
 	<li>Unexplained aches and pains (headaches, back pain)</li>
</ul>
<h3>Behavioral Symptoms</h3>
<ul>
 	<li>Avoidance of social interaction</li>
 	<li>Neglect of responsibilities and personal care</li>
 	<li>Decreased performance at work or school</li>
 	<li>Restlessness or slowed movements</li>
</ul>
These symptoms usually last at least two weeks and represent a change from previous functioning. If you or someone you know experiences these symptoms, seek professional help.
<h2>How is depression diagnosed?</h2>
Diagnosis is made by a healthcare professional through evaluation of symptoms, medical and family history, and mental health assessment. This may include:
<ul>
 	<li>Medical history and interview about symptom duration and impact</li>
 	<li>Physical exam and lab tests to rule out other medical conditions</li>
 	<li>Psychological evaluation using questionnaires or self-assessment tools</li>
 	<li>Application of DSM-5 criteria requiring at least five key symptoms nearly every day for two weeks</li>
 	<li>Exclusion of other mental health disorders like <a class="wpil_keyword_link" href="/conditions/bipolar-disorder" title="Bipolar Disorder" data-wpil-keyword-link="linked" data-wpil-monitor-id="1014">bipolar disorder</a> or anxiety disorders</li>
</ul>
<h2>How is depression treated?</h2>
Treatment typically involves a combination of medications, psychotherapy, lifestyle changes, and supportive therapies:
<h3>Medications</h3>
<ul>
 	<li>SSRIs: Prozac (fluoxetine), <a href="/medications/zoloft/">Zoloft</a> (sertraline), Lexapro (escitalopram), Paxil (paroxetine), <a href="/medications/viibryd/">Viibryd</a> (vilazodone)</li>
 	<li>SNRIs: Cymbalta (duloxetine), <a href="/medications/effexor-xr/">Effexor XR</a> (venlafaxine), <a href="/medications/pristiq/">Pristiq</a> (desvenlafaxine), Fetzima (levomilnacipran)</li>
 	<li>TCAs: Tofranil (imipramine), Pamelor (nortriptyline), <a href="/medications/elavil/">Elavil</a> (amitriptyline), Norpramin (desipramine)</li>
 	<li>Atypical antidepressants: <a href="/medications/wellbutrin-xl/">Wellbutrin XL</a> (bupropion), Remeron (mirtazapine), Trintellix (vortioxetine)</li>
 	<li>Other medications: mood stabilizers, antipsychotics, anxiety medications as adjuncts</li>
</ul>
<h3>Psychotherapy</h3>
<ul>
 	<li>Cognitive Behavioral Therapy (CBT) to change negative thought patterns</li>
 	<li>Interpersonal Therapy (IPT) to address relationship issues and life changes</li>
</ul>
<h3>Lifestyle Changes and Home Remedies</h3>
<ul>
 	<li>Regular exercise to boost mood and health</li>
 	<li>Balanced nutrition for energy and well-being</li>
 	<li>Consistent sleep schedule to improve sleep quality</li>
 	<li>Stress management techniques like meditation and yoga</li>
 	<li>Avoiding alcohol and recreational drugs</li>
</ul>
<h3>Brain Stimulation Therapies</h3>
<ul>
 	<li>Electroconvulsive Therapy (ECT) for severe, treatment-resistant depression</li>
 	<li>Transcranial Magnetic Stimulation (TMS) for depression unresponsive to medications</li>
</ul>
<h3>Supportive Care</h3>
<ul>
 	<li>Support groups for emotional support and coping strategies</li>
 	<li>Education about depression for patients and families</li>
</ul>
<h2>Sources</h2>
<ul>
 	<li>Depressive Disorder (Depression) Fact Sheet. World Health Organization. Accessed May 13, 2024.</li>
 	<li>Depression. National Institute of Mental Health. Accessed May 13, 2024.</li>
 	<li>Depression. National Alliance on Mental Illness. Accessed May 13, 2024.</li>
 	<li>What Is Depression? American Psychiatric Association. Accessed May 13, 2024.</li>
 	<li>Mental Health Conditions: Depression and Anxiety. Centers for Disease Control and Prevention. Accessed May 13, 2024.</li>
 	<li>Depression. Merck Manual. Accessed May 13, 2024.</li>
</ul>

Depression

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