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  • From Clinical Trials to Real-World Practice, Experts Examine the Best Options for TNBC

    From Clinical Trials to Real-World Practice, Experts Examine the Best Options for TNBC

    CancerNetwork® recently hosted a first-of-its-kind Tweet Chat with co-hosts Hope S. Rugo, MD, and Paolo Tarantino, MD. Together, they reviewed a patient case of a 52-year-old woman who had been diagnosed with stage IIA triple-negative breast cancer (TNBC) and went into detail regarding treatment options for the metastatic population.

    Rugo, a professor of medicine, and director of Breast Oncology and Clinical Trials Education at the University of California San Francisco Helen Diller Comprehensive Cancer Center; and Tarantino, a Clinical Research Fellow at Dana-Farber Cancer Institute, also examined the use of neoadjuvant therapeutics for early disease and potential adjuvant therapy-sparing regimens.

    During the live Tweet Chat, both experts detailed the impact of antibody-drug conjugates (ADCs) on survival outcomes and the best approach for treating patients following disease recurrence after first-line therapy.

    In the first part of the patient case of a 52-year-old woman with stage IIA TNBC, Rugo mentioned the need for neoadjuvant chemotherapy, “We recommend [neoadjuvant chemotherapy] in this case, following the KN522 regimen. The [addition] of [pembrolizumab increases] pCR and EFS. @SABCS22 Gupta showed better outcomes adding platinum to T/[adjuvant chemotherapy].”

    Tarantino responded with results from the phase 3 KEYNOTE-522 trial (NCT03036488) wherein patients with TNBC received pembrolizumab (Keytruda) plus chemotherapy vs placebo as a neoadjuvant treatment and pembrolizumab vs placebo as adjuvant treatment.1

    Rugo questioned if there is a need to wait a year after starting pembrolizumab for a partial complete response (pCR) to be observed and, if not, whether capecitabine/pembrolizumab is a good alternative treatment option.

    Additionally, she introduced several studies assessing sacituzumab govitecan-nxki (Trodelvy) in patients with TNBC, “OptimICE pCR is an ALLIANCE trial that will randomize [patients] to [pembrolizumab] or not in those with pCR. OptimICE RD and the [phase 3] SASCIA trial [NCT04595565] are evaluating the addition of sacituzumab govitecan in patients with residual disease.”

    In response, Tarantino discussed data from phase 2 GeparNuevo trial (NCT02685059) which added a PD-L1 antibody to taxane chemotherapy.2 In this trial, patients had a high invasive disease-free survival. While OptimICE-pCR is still enrolling patients, he hopes that the results will show the ability to spare adjuvant immunotherapy.

    Next steps of treatment was also a topic of conversation, as the patient experienced recurrence after adjuvant capecitabine and radiation.

    Tarantino responded that chemotherapy and taxane rechallenge is the current standard of care for recurrent TNBC, “[Chemotherapy], with a taxane rechallenge [is] reasonable given [the] long time since completion of [adjuvant taxane].”

    When asked if she agreed with his reasoning behind using taxane in the first-line setting and sacituzumab govitecan in the second-line, Rugo mentioned the phase 3 ASCENT trial (NCT02574455), which had final data read out at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, supported this thought process She mentions that this trial then led to the approval of sacituzumab govitecan in the second-line setting for patients with TNBC.3,4

    Another study that was presented at ASCO and, according to Tarantino, showed impressive results was the phase 3 DESTINY-Breast04 trial (NCT03734029) which analyzed fam-trastuzumab deruxtecan-nkxi (Enhertu) in patients with HER2-low breast cancer.5

    In response to data from the DESTINY-Breast04 trial that Tarantino presented, Rugo said, “Really incredible data from DB04 for HR+ and encouraging in TNBC; just [important] to remember that [there were] only 58 pts so 18 in the control arm. And only 1/3 of TNBC [cases] are HER2 low.”

    Rugo also mentioned the ongoing phase 3 ASCENT-03 trial (NCT05382299) examining sacituzumab govitecan vs physician’s choice therapy in previously untreated metastatic TNBC. There is also the phase 3 ASCENT-04 trial (NCT05382286) assessing sacituzumab govitecan plus pembrolizumab vs physician’s choice plus pembrolizumab previously untreated, locally advanced inoperable or metastatic TNBC. Both of these trials utilized sacituzumab govitecan as second-line treatment.

    Tarantino and Rugo also touched on trials involving ADCs such as the phase 1/2 BEGONIA trial (NCT03742102), assessing durvalumab (Imfinzi), capivasertib, oleclumab, paclitaxel, trastuzumab deruxtecan, and datopotamab deruxtecan for patients with metastatic TNBC.6 To better support the data presented with BEGONIA, Tarantino posted a graphic detailing the change from baseline target lesion size and the change from baseline of the number of target lesions over time.

    When asked how they would treat a patient if progression occurred 3 months after initial treatment with first-line therapy, Rugo responded, “Good question, and tragic situation; in this case, we treat as if we are second line, so [we] would use sacituzumab govitecan first-line. At least that is my approach. @PTarantinoMD?If PD-L1 positive how would you treat?”

    Tarantino noted that if a patient is PD-L1 positive, it is worth it to combine first-line pembrolizumab plus chemotherapy. He referenced the phase 3 KEYNOTE-355 trial (NCT02819518) as an example of when to use this treatment combination.7

    Rugo agreed with Tarantino’s recommended course of action, but questioned if the patient was on single arm pembrolizumab at the time of progression, what should be the standard of care? Tarantino noted this was a hard question but said that he would be inclined to administer treatment as though the patient was in the second line, moving to an ADC.

    He then inquired if the patient had a BRCA mutation, would it change the choice of treatment.

    Rugo responded with results from the phase 3 OlympiAD trial (NCT02000622) that focused on the use of olaparib in patients with a BRCA mutation.

    Survival was also improved in the phase 3 EMBRACA trial (NCT01945775), assessing talazoparib in patients with advanced breast cancer who had a germline BRCA mutation.

    In closing, Rugo said she is interested in seeing outcomes with the use of maintenance PARP inhibitors after response is achieved, specifically those with BRCA mutations. Tarantino responded that PARP maintenance is a very interesting strategy and could even have use in other populations outside of those with BRCA mutations.

    To view the full Tweet Chat, visit, https://bit.ly/3XKj1bk

    References

    1. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382(9):810-821. doi:10.1056/NEJMoa1910549
    2. Loibl S, Schneeweiss A, Huober J, et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022;33(11):1149-1158. doi:10.1016/j.annonc.2022.07.1940
    3. Final data from phase 3 ASCENT study demonstrates Trodelvy extends overall survival over chemotherapy in second-line metastatic TNBC. News release. Gilead. June 6, 2022. Accessed January 27, 2022. https://bit.ly/40aDYh8
    4. FDA grants regular approval to sacituzumab govitecan for triple-negative breast cancer. News release. FDA. April 7, 2021. Accessed January 27, 2023. https://bit.ly/3Hae98x
    5. Modi S, Jacot W, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med. 2022; 387(1):9-20. doi:10.1056/NEJMoa2203690
    6. Loibl S, Schneeweiss A, Huober J, et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022;33(11):1149-1158. doi:10.1016/j.annonc.2022.07.1940
    7. Cortes J, Rugo HS, Cescon DW, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med. 2022;387(3):217-226. doi:10.1056/NEJMoa2202809
  • Doctor Shares Alternative Spike Protein Treatments When Go-to Options Fail

    Doctor Shares Alternative Spike Protein Treatments When Go-to Options Fail

    Over two years into the pandemic and over a year since the COVID-19 vaccinations rolled out, millions of people are still nursing themselves in the aftermaths as they recover from spike protein injuries, whether it be through COVID-19 or vaccinations.

    Many doctors put together recommendations on treating long COVID and vaccine injuries based on clinical observations and published research.

    Ivermectin, low-dose naltrexone, and resveratrol are on the top of the list as the go-to treatments. These treatments have been found to be the most accessible, and generally brings out a positive response. They are classified as the first line treatments by Front Line COVID-19 Critical Care Alliance (FLCCC).

    However, a smaller group of people may not respond to the typical first line treatments or may respond with remaining unresolved conditions.

    That is when doctors bring out treatments considered “second-line.” These treatments are typically more aggressive and targeted, meaning that it could work very well but for a smaller group of people. They can also be more expensive and harder to self-administer.

    Dr. Yusuf Saleeby, integrative medical doctor and the director of Carolina Holistic Medicine shares with The Epoch Times on some of the treatments he would consider second line that he uses in his clinic.

    Spike Protein Injury: A Systemic Disease Requiring Systemic Treatment

    Saleeby, along with other doctors treating spike protein injury including Dr. Paul Marik and Dr. Pierre Kory, both previously interviewed by The Epoch Times, understand spike injury as a syndrome rather than disease since it is precipitated by dysfunctions in many overlapping pathways.

    Dr. Paul Marik was a former professor of medicine and the chief of pulmonary and critical care medicine at Eastern Virginia Medical School. Dr. Pierre Kory was the former chief of the critical care service and medical director of the Trauma and Life Support Center at the University of Wisconsin.

    Therefore, treatments for spike protein-induced disease aims to address the overlapping mechanisms to resolve the system together.

    • Reduced Autophagy: The first thing the spike protein does is that it blocks autophagy. This prevents infected cells from clearing out and dispelling the spike protein, leading to many of the downstream problems. Therefore a major focus of the first line treatment is to reactivate autophagy and clear out the spike protein hidden away in the affected cells.
    • Mitochondrial Dysfunction: In cells, spike protein cause mitochondrial dysfunction by directly affecting the mitochondria or causing stress to its environment.  Mitochondrial dysregulation reduces energy production for the cell and can also result in production of damaging oxidative species, both of which can lead to cell stress, fatigue, and cell death.
    • Reactivated or Persistent Infections: Spike proteins also downregulate immune cells, with studies showing dysregulation in T cells and innate cell responses. A fall in immunity often correlates with opportunistic infections and viral reactivation, with many studies reporting a relapse of latent viruses following vaccination or infection. 
    • Mast Cell Response: Spike proteins can trigger the activation of mast cells. These immune cells play major roles in allergic responses by releasing histamine. Histamine release contribute to inflammation with patients presenting with symptoms of fever, headaches, swelling, and many other debilitating conditions.
    • Blood Clot Formation: Studies found that in the bloodstream, spike protein can bind to blood-clotting proteins such as fibrinogen and form abnormal blood clots. Apart from inflammation, these blood clots can lead to blood vessel blockage and tissue damage, precipitating to stroke and heart attacks.
    • Cancer: Studies found that cells exposed to the spike protein through viral genes or protein exposure would increase in DNA damage markers, indicative of DNA damage. This can lead to dysfunctional, potentially cancerous cells if these cells are not killed by the immune system.
    • Autoimmunity: Spike protein also share many similarities with human proteins and tissues, so antibodies that attack spike protein may also bind to human tissues and proteins, leading to self-attack.

    The first line of treatments particularly focus on promoting autophagy to clear out the spike protein, the second line of treatment are more directed at reducing its toxicity by resolving the different pathways.

    Methylene Blue

    Methylene blue (MB) has been recommended by many doctors as a priority second line treatment due to its antiviral, anti-inflammatory, and antioxidizing properties.

    “It’s kind of an interesting compound,” said Saleeby. MB started its life as an industrial dye for textiles, it was later used to stain cells under the microscope, and scientists noticed that parasites would die when stained with MB.

    Methylene blue (MB) started its life as an industrial dye for textiles, but studies found it has anti-viral properties. (Juan Gaertner/Shutterstock)
     Methylene blue (MB) started its life as an industrial dye for textiles, but studies found it has anti-viral properties. (Juan Gaertner/Shutterstock)

    “So they found heavy anti-parasitic properties.” said Saleeby.

    MB has been used to treat malaria, urinary tract infections, and is the most well known for its use in methemoglobinemia, a condition where the red blood cells cannot carry oxygen due to the loss of an electron on its iron group.

    Scientist also discovered its anti-viral properties on different viruses, particularly when used in conjunction with light therapy. Methylene blue has antiviral properties against SARS-CoV-2, Ebola, herpes simplex virus, Zika viruses, and many more.

    Though recommended as a second line treatment for spike protein-induced diseases, MB actually carries first line spike injury treatment functions.

    First line treatment focuses on clearing out spike proteins, and MB is also able to help spike-infected cells remove spike protein by degradation and recycling of cellular and mitochondrial materials. These two processes are also known as autophagy and mitophagy respectively.

    MB can also bind to spike proteins, prevent their entry, and neutralize spike toxicity. Most importantly, it has specific roles in restoring mitochondrial function, improving the health and energy of the cells.

    MB is an antioxidant and prevents damage by neutralizing reactive oxygen species. Mitochondria are also the greatest producer of these oxygen species, particularly when they’re stressed. MB therefore can neutralize the damaging oxidants they produced, preventing further damage and stress.

    MB can also donate its own electrons to mitochondria’s metabolic pathway to promote energy production.

    MB is therefore highly useful for restoring mitochondrial dysfunction and cellular health. Since it improves cellular function, it is also neuroprotective, with studies suggesting that it may reduce cognitive decline.

    It is recommended to alleviate neurological symptoms related to brain fog, fatigue, memory, and cognition, which are common spike injury symptoms.

    Additionally, MB’s function as an antioxidant also enables it to contribute to anti-aging.

    A laboratory study on human skin cells showed that the cells exposed to MB increased in proliferation and also had delayed senescence. Another in vitro study found that MB reduced DNA damage in human cells when they were exposed to ultraviolet light and therefore reduced cell death.

    The product is highly accessible, however people wanting to take MB should take care that they are using pharmaceutical grade MB rather than industrial or research grade.

    “You can get the dye at the industrial level that they use as a dye which could be contaminated with heavy metals and a lot of other junk,” said Saleeby, “Then there’s research grade, to be used in vitro and things for research.”

    The safest grade are those that meet the standard of the United States Pharmacopeial (USP) Convention.

    “There are a couple of places you can get [purchase] that or you can have it compounded at a compounding pharmacy, [the pharmacist can] just write a prescription for say, a 30 ml bottle of 1 percent methylene blue solution and that will be for human consumption or veterinary consumption.” said Saleeby.

    Methylene blue is not recommended for pregnant and breastfeeding women and people with G6PD deficiency. For people taking selective serotonin reuptake inhibitors (SSRI), methylene blue can interact with SSRIs, potentially leading to serotonin syndrome—a critical condition.

    People with kidney or liver problems should check with their primary care physicians. Herx reaction—short term detoxification response—may occur in people with Lyme disease or fungal diseases.

    Oxytocin

    Colloquially known as the love hormone, oxytocin is often associated with happiness, love, and emotional bonding.

    However, oxytocin does not only affect the brain but also has receptors in heart, kidney, uterus, breast, and the testes, and therefore plays much bigger roles than contributing to happiness.

    The FLCCC protocol currently recommends (pdf) oxytocin nasal sprays for spike-injured people with brain fog, tinnitus, and a loss of smell.

    Saleeby found that oxytocin was very effective for people with neuropsychiatric problems such as depression and anxiety. It also helped to improve emotional relationships.

    “With the lockdown, you had a lot of social distancing and people forgot how to socially interact with each other and that’s problematic,” said Saleeby, “this is actually helpful in rebounding as a bonding, reestablishing humans and social connections.”

    He also prescribes it for people with reproductive problems such as erectile dysfunction in males and anorgasmia in females. He also uses oxytocin as a last resort treatment to improve bone health when common treatments such as calcium, vitamin D, and vitamin K2 all fail.

    “It’s probably one of the most ignored hormones out there,” said Saleeby.

    Saleeby found that oxytocin was very effective for people with neuropsychiatric problems such as depression and anxiety. (Martina Sappe/Shutterstock)
     Saleeby found that oxytocin was very effective for people with neuropsychiatric problems such as depression and anxiety. (Martina Sappe/Shutterstock)

    Oxytocin is rarely prescribed, since it needs to be refrigerated to prevent degradation, regardless of whether it is in powder or solution, making it less practical for daily use. Oxytocin nasal sprays found in supermarkets and online stalls are thus likely not effective, Saleeby cautioned.

    Yet the multifaceted roles oxytocin plays can often make up for its logistic annoyances.

    Oxytocin can inhibit mast cell action, promote mitochondrial function, and also increase immune function.

    It can reduce inflammation by lowering cortisol, the stress hormone. Cortisol causes inflammation, and inhibits digestion, reproduction, and growth. In prolonged states of stress, the immune system may also be inhibited, leading the person to become more susceptible to infections.

    Oxytocin could reverse this action.

    Studies in animals showed that the hormone also has anti-aging properties. Studies in rats showed that increasing oxytocin by increasing social interaction increased the length of telomeres. Since telomeres shorten as we age, this extension is suggestive of anti-aging properties.

    Despite these benefits, “a lot of [oxytocin’s mechanism of action] is poorly understood. We just know that it works, especially with behavioral things like bonding,” said Saleeby.

    Epoch Times Photo
     There are many herbs and roots that contain very healthy compounds that can help us deal with stress, injury and even mood. (Shutterstock)

    Adaptogens

    Saleeby also recommends nutraceuticals such as vitamins and adaptogens as both first and second line treatments for spike protein injuries.

    Adaptogen are herbs that can work as medicine; this includes curcumin, certain types of mushrooms, and various plants.

    An adaptogen Saleeby often recommends for COVID-related conditions is Andrographis paniculata; both research and his own clinical observations have found the herb to be effective for preventing COVID-19, treating COVID-19, and also for spike injuries.

    The main bioactive component of A. paniculata is andrographolide, which is known for its broad anti-viral and anti-inflammatory effects. Studies have shown it can work against common cold and fever as well as more threatening viruses including influenza virus, SARS-CoV-2, dengue virus, and HIV.

    A laboratory study showed that andrographolide can bind to spike protein as well as the other proteins of the COVID virus, to prevent viral entry and spike toxicity. Another laboratory study on human lung cells showed that A. paniculata and andrographolide could prevent and fight off COVID-19 infections.

    “Government in Thailand, early on in the pandemic … actually condoned [A. paniculata], recommended it to the people of their nations to use it with zinc, with vitamin C, with vitamin D to help with COVID,” said Saleeby.

    Nutraceuticals

    Many nutraceuticals such as magnesium, vitamin D, vitamin C, and omega-3 oils are also recommended as second line treatments by doctors to improve individuals’ immune function and reduce inflammation.

    Magnesium, vitamin D, vitamin C, and omega-3 are linked with anticoagulant effects and may prevent the formation of blood clots. These nutraceuticals also strengthen immunity and reduce inflammation.

    Studies have shown that magnesium, vitamin D, and vitamin C play important roles in inhibiting mast cell activation, thereby reducing debilitating conditions of inflammation.

    Omega-3 fatty acids have cardiac protective properties; studies show that it reduces the risk of heart arrhythmia and all-cause mortality in people with underlying coronary disease. It is therefore recommended for patients with cardiac problems including myocarditis.

    Both vitamin D and omega-3 are also recommended for hair loss following vaccination.

    Saleeby advised that for magnesium, patients must seek out organic magnesium such as magnesium citrate, magnesium glycinate, magnesium taurate, magnesium threonate, and magnesium malate. The body has a very difficult time breaking down inorganic magnesium such as magnesium oxide, and therefore little magnesium is actually being absorbed.

    For all vitamin nutraceuticals, Saleeby recommended getting pharmaceutical grade supplements rather than easily accessible ones from the supermarkets or pharmacies.

    “I would stick with pharmaceutical grade vitamins in general, 90 percent of the stuff you get over the counter is pretty much garbage,” said Saleeby. “Ninety percent of the fish oil that you get over the counter is what’s leftover from making the pharmaceutical grade.”

    “You can’t go wrong if you use one of these high end pharmaceutical grade companies.”

    Marina Zhang

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    Marina Zhang is based in New York and covers health and science. Contact her at [email protected].

  • Health benefits, best options, risks, and more

    Health benefits, best options, risks, and more

    Espresso that contains cannabidiol (CBD) may possibly give some added benefits, but study is inconclusive. Some people report dealing with more vitality and fewer jitters than with a standard cup of espresso.

    The purported advantages appear from caffeine, CBD, and the anti-oxidants and other chemicals in coffee.

    Quite a few latest scientific tests counsel that espresso, caffeine, or a mix offer you health benefits, specifically with average intake. Research into the purported gains of CBD is ongoing and inconclusive.

    Read on to discover about CBD coffee, its potential advantages, hazards, and more.

    Is CBD authorized?The 2018 Farm Monthly bill eliminated hemp from the lawful definition of marijuana in the Managed Substances Act. This manufactured some hemp-derived CBD items with less than .3 {fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} THC federally lawful. Nonetheless, CBD goods containing extra than .3 p.c THC nonetheless drop beneath the lawful definition of cannabis, building them federally unlawful but lawful beneath some point out guidelines. Be sure to verify state laws, primarily when touring. Also, keep in intellect that the Food and drug administration has not permitted nonprescription CBD products and solutions, and some products and solutions may possibly be inaccurately labeled.

    Hashish has quite a few unique chemical compounds. Cannabidiol (CBD) is a non-psychoactive compound in hashish, which usually means that in contrast to tetrahydrocannabinol (THC), it will not make a individual truly feel significant.

    CBD currently has Food and drug administration approval for use as an antiseizure medicine to address three certain conditions, but it has no other documented professional medical use. Having said that, ongoing study is examining other prospective benefits, these kinds of as anxiousness relief and dealing with arthritis.

    CBD espresso manufacturers assert that their product or service delivers the benefits of CBD, as nicely as the rewards of espresso. Research significantly indicates that average caffeine intake could supply some health and fitness added benefits and that substances in coffee could have health positive aspects.

    It is important to be aware that the Food and drug administration does not control CBD as a treatment in nutritional supplements, meals, and beverages, including coffee. There is no promise that introducing CBD to espresso offers any precise rewards.

    Study extra about CBD in MNT’s focused hub below.

    The Food and drug administration does not regulate most CBD items, which includes dietary supplements these kinds of as CBD in espresso. For this rationale, there is no ensure that these products are protected, helpful, or include the portions of CBD they claim to.

    On top of that, the Fda continues to specific considerations about unregulated CBD products and solutions.

    No scientific evidence specifies the best CBD espresso or how to discover the correct espresso. Even so, the subsequent guidelines may assistance a human being make a secure final decision:

    • Select a firm with a fantastic track record.
    • Only acquire espresso that lists all components and precise quantities of caffeine, CBD, and other components.
    • Commence with a little amount, and pay close focus to how a individual feels following consuming the coffee.

    Discover what CBD to invest in in our shopper’s guideline below.

    CBD products, which includes CBD coffee, do not consist of sizeable quantities of THC. They may well include extremely little quantities of THC as a byproduct.

    In the United States, CBD items need to contain less than .3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} THC to be sold legally. This signifies that CBD will not get a individual significant, but it could theoretically lead to a human being to are unsuccessful a quite sensitive drug check.

    Find out the variances in between CBD and THC right here.

    Anecdotal stories include things like a vast array of advantages from CBD coffee, such as:

    • more electricity
    • a reduction in the adverse results of espresso, these kinds of as sensation jittery
    • body weight reduction
    • improved sleep
    • minimized stress

    Currently, scientific analysis supporting the use of CBD stems from the tested gains of coffee, not CBD. There is no the latest, effectively-managed investigate on the positive aspects of combining the two.

    Learn whether caffeine is terrible for you here.

    Wellbeing rewards of espresso

    Researchers have debated the health advantages of espresso for a long time, but the assistance has changed, and not all experiments concur on the well being benefits or challenges of coffee.

    Coffee consists of anti-oxidants that may perhaps lower irritation and mitigate oxidative stress in the entire body. On top of that, the caffeine in coffee might present several overall health benefits, these kinds of as improvements in cardiovascular wellness.

    Around the shorter phrase, caffeine may well increase mood, electrical power, and concentration.

    Investigation suggests that espresso drinkers have lower costs of sort 2 diabetes, particular types of coronary heart illness, and particular forms of cancer. When this is promising, investigate has not but established that espresso causes these benefits. Some other shared elements amongst coffee drinkers, this kind of as staying physically lively, could possibly clarify the phenomenon.

    Discover more about whether or not coffee is excellent for you in this article.

    Wellness positive aspects of CBD

    Several ongoing scientific trials are investigating CBD for use in managing anxiety, Alzheimer’s, Parkinson’s, and other diseases.

    In accordance to a 2022 analyze, CBD can minimize soreness, improve snooze, and control mood disturbance in persons with musculoskeletal suffering. Nevertheless, the authors note that clinical proof is lacking, and gurus have not recognized distinct dosage suggestions.

    However, this study is each ongoing and inconclusive.

    A 2018 systematic critique appeared at the potential rewards of CBD for noncancer long-term pain and found evidence supporting a tiny reward. This indicates CBD may support to lower long-term soreness.

    Nevertheless, there is no evidence that CBD coffee provides related rewards. As research continues, researchers could uncover proof to aid anecdotal statements of CBD’s benefits.

    Learn far more about CBD for cancer right here.

    The Food and drug administration implies 400 milligrams (mg) of caffeine for each day, or about 4–5 cups of espresso, is ordinarily a safe and sound degree of usage.

    There is no recognized harmless usage amount of CBD. Its use in nutritional supplements, coffee, and other products is primarily unregulated. As a result, the main dangers and aspect results of CBD coffee come from the simple fact that the Fda does not control this item.

    For case in point, if a brand name of CBD coffee does not comprise the mentioned quantity of CBD, a human being will not know how a lot they are consuming.

    Some opportunity side effects include things like:

    • sleepiness
    • confusion
    • liver wellness issues
    • suicidal ideas, specifically in persons with despair or a history of suicidal thoughts
    • allergic reactions
    • interactions with other medication

    Whilst there are no absolute contraindications to using it, coffee is not risk-free for everybody. Caffeine can worsen some situations, which includes:

    Study about CBD tea listed here.

    CBD coffee is generally risk-free to check out, but the effects fluctuate from individual to individual. Folks interested in hoping this item should initial converse with a certified healthcare expert, primarily if they have preexisting health and fitness ailments or frequently get medicine.

    Like all organic items, CBD can have identical results to other medications, so it is crucial to check for facet consequences and drug interactions.

  • People suffering from migraine have multiple treatment options, says neurologist

    People suffering from migraine have multiple treatment options, says neurologist

    By Danielle Wilhour for The Coversation

    Migraine head aches at the moment have an impact on a lot more than one particular billion individuals throughout the globe and are the next-leading induce of incapacity globally.

    Just about one particular-quarter of US homes have at the very least just one member who suffers from migraines. An approximated 85.6 million workdays are missing as a result of migraine complications every 12 months.

    However many who suffer with migraine dismiss their pain as simply a undesirable headache.

    Relatively than searching for professional medical treatment, the condition generally goes undiagnosed, even when other incapacitating indications manifest alongside the pain, such as light and seem sensitivity, nausea, vomiting and dizziness.

    Researchers have found that genetics and environmental factors participate in a purpose in the problem of migraine.

    They transpire when variations in your brainstem activate the trigeminal nerve, which is a significant nerve in the suffering pathway.

    This cues your entire body to launch inflammatory substances such as CGRP, small for calcitonin gene-related peptide. This molecule, and some others, can cause blood vessels to swell, creating agony and swelling.

    Also read | French health authority urges wider monkeypox vaccination

    For some, medicine has its restrictions

    A migraine can be debilitating. People who are dealing with a person are typically curled up in a darkish space accompanied by only their discomfort.

    Attacks can final for days lifetime is set on keep. The sensitivity to mild and sound, coupled with the unpredictability of the illness, causes many to forego work, college, social gatherings and time with household.

    Various prescription drugs are obtainable for equally the prevention and therapy of migraine. But for quite a few people, typical therapy has its restrictions.

    Some folks with migraine have a inadequate tolerance for certain prescription drugs. Several simply cannot afford to pay for the higher price of the medications or endure the facet effects. Other people are expecting or breastfeeding and just can’t just take the medications.

    Nevertheless, as a board-certified neurologist who specialises in headache medication, I’m constantly amazed at how open up-minded and enthusiastic individuals turn out to be when I examine different alternatives.

    These methods, collectively, are referred to as complementary and alternative drugs. It may be shocking that a usually qualified Western physician like me would advocate factors like yoga, acupuncture or meditation for people today with migraine. Yet in my observe, I value these nontraditional treatments.

    Investigate exhibits that option therapies are involved with improved sleep, experience improved emotionally and an increased perception of management.

    Some sufferers can avoid prescription medications altogether with one or much more complementary remedies. For many others, the nontraditional solutions can be utilised alongside with prescription medication.

    These options can be utilized just one at a time or in combination, depending on how severe the headache and the lead to powering it.

    If neck stress is a contributor to the agony, then actual physical treatment or therapeutic massage might be most effective.

    If pressure is a cause, probably meditation would be an ideal area to begin. It is value talking to your supplier to investigate which alternatives may perhaps get the job done finest for you.

    Also browse | In periods of stroke, BEFAST however 61{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} men and women really don’t know about this, says study

    Mindfulness, meditation and much more

    Due to the fact tension is a big set off for migraines, just one of the most powerful choice therapies is mindfulness meditation, which is the act of concentrating your attention on the existing instant in a nonjudgmental way of thinking.

    Research display that mindfulness meditation can cut down headache frequency and soreness severity.

    One more helpful tool is biofeedback, which enables a person to see their vital indications in serious time and then discover how to stabilize them.

    For case in point, if you are pressured, you might detect muscle mass tightness, perspiration and a rapidly coronary heart fee.

    With biofeedback, these improvements look on a keep an eye on, and a therapist teaches you routines to help deal with them. There is robust proof that biofeedback can reduce the frequency and severity of migraine complications and lessen headache-similar disability.

    Yoga derives from classic Indian philosophy and brings together actual physical postures, meditation and respiratory workouts with a intention of uniting the brain, entire body and spirit.

    Training yoga regularly can be beneficial in reducing anxiety and treating migraine.

    Also study | Sleep deprivation a major but mostly neglected trouble

    Manipulation-centered treatment

    Bodily remedy uses manual approaches this sort of as myofascial and trigger-place release, passive stretching and cervical traction, which is a gentle pulling on the head by a skilled hand or with a healthcare unit.

    Scientific studies show that actual physical remedy with medication was remarkable in decreasing migraine frequency, ache depth and soreness notion around medications by yourself.

    By decreasing worry stages and advertising relaxation, therapeutic massage can minimize migraine frequency and enhance rest. It might also minimize pressure in the days next the therapeutic massage, which provides further defense from migraine assaults.

    Some individuals are helped by acupuncture, a type of standard Chinese medicine.

    In this practice, high-quality needles are placed in unique spots on the pores and skin to boost therapeutic.

    A significant 2016 meta-assessment paper discovered acupuncture lowered the length and frequency of migraines no matter of how typically they happen. Acupuncture added benefits are sustained right after 20 weeks of procedure.

    What’s also fascinating is that acupuncture can improve the metabolic exercise in the thalamus, the location of the brain critical to agony perception. This transform correlated with a lower in the headache depth score subsequent acupuncture therapy.

    Also go through | Battling with submit-Covid syndrome?

    Natural vitamins, health supplements and nutraceuticals

    Organic dietary supplements and nutraceuticals, which are meals-derived products and solutions that may possibly have therapeutic benefit, can also be employed to avert migraine.

    And there is evidence to suggest vitamins work moderately well as opposed to standard prescription medicine. They also have much less aspect consequences. Below are some examples:

    — Magnesium is believed to assist regulate the blood vessels and electrical exercise in the mind. A analyze located that patients specified 600 milligrams of magnesium citrate everyday for 12 weeks experienced a 40 per cent reduce in migraine. Aspect results incorporated diarrhea in nearly 20 for each cent of clients.

    — Vitamin B2, or riboflavin, is also thought of practical in migraine prevention.

    When dosed at 400 milligrams daily for 12 weeks, scientists observed it decreased migraine frequency by 50 {fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} in a lot more than 50 {fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of individuals.

    — A further useful supplement is Coenzyme Q10, which is included in mobile strength creation.

    Soon after three months, about 50 {fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of those getting 100 milligrams of Coenzyme Q10 a few occasions a working day experienced half the range of migraine assaults.

    — A prospective natural resolution is feverfew or Tanacetum parthenium, a daisylike perennial plant known to have anti-migraine properties. Taken 3 times day-to-day, feverfew minimized migraine frequency by 40 per cent.

    Also study | The job of food and diet in recovery

    Gadgets can be valuable

    The Food and Drug Administration has authorised quite a few neuro-stimulation devices for migraine therapy. These devices do the job by neutralising the ache alerts despatched from the brain.

    Just one is the Nerivio device, which is worn on the upper arm and sends alerts to the brainstem soreness centre in the course of an assault. Two-thirds of people report discomfort reduction after two hours, and side outcomes are unusual.

    One more device that demonstrates assure is the Cefaly. It provides a moderate electrical recent to the trigeminal nerve on the brow, which can lessen the frequency and depth of migraine assaults.

    Soon after 1 hour of therapy, patients seasoned a approximately 60 per cent reduction in soreness depth, and the relief lasted up to 24 hrs. Aspect results are unusual and contain sleepiness or skin irritation.

    These choice therapies support handle the individual as a complete. In just my exercise, many achievement stories come to brain: the college student who once experienced chronic migraine but now has unusual occurrences soon after a routine of nutritional vitamins the expecting lady who prevented medication through acupuncture and actual physical therapy or the individual, previously on a lot of prescription medications, who employs a neuro-stimulation system for migraine alternatively of incorporating another prescription.

    Granted, option ways are not essentially wonder therapies, but their likely to minimize discomfort and struggling is notable. As a physician, it is really gratifying to see some of my clients reply to these treatment plans.

    (The writer is an Assistant Professor of Neurology at the College of Colorado Anschutz Health-related Campus)

  • Replace your high cholesterol items with these 5 healthy options | Health

    Replace your high cholesterol items with these 5 healthy options | Health

    Replacing your large cholesterol snacks with balanced food stuff solutions will come with a myriad of rewards considering the fact that by changing our cholesterol-laden diet with fibre and nutrient-dense choices, we can unquestionably realize a nutritious existence free from disorders and ailments. Foodstuff which are high in soluble fibre not only enable in lowering the absorption of cholesterol in the overall body but also assist the process of flushing this greasy substance out of the process.

    An perfect listing of healthy selections ought to incorporate foodstuff superior in soluble fibre, fruits and veggies, plant-based protein and full-grain objects. Though there is a variety of options that can conveniently healthy the bill, we list down 5 products that can effortlessly swap significant cholesterol snack possibilities you have come to be habitual of:

    1) Apple with Nuts

    Summary: Zero-cooking, fast recipe with loads of good fat and fibre

    Do not have time to cook anything? Fret not and just keep it basic with an apple and a blend of almonds, walnuts and raisins. This electrical power-packed snack alternative has hundreds of soluble fibre with an extra dose of healthier fats, Omega 3 and anti-oxidants. It will also maintain you comprehensive till meal and is a best recipe for retaining your recurring starvation pangs at bay. Alternatively, you can choose to go for a protein, multigrain bar but make confident that it does have large protein information rather of sugar or synthetic sweetener.

    Execs and downsides: Superior in carbs and superior fat however, the fibre articles is not so superior.

    2) Popped Potato Chips (50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} a lot less unwanted fat)

    Summary: An great snacking companion for well being-mindful and exercise freaks

    Consuming balanced doesn’t signify that you have to allow go of your appreciate for wafers. The trick below is to opt for much healthier possibilities these as popped chips instead than going for the fried kinds. Popped chips have up to 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} considerably less fat than the common ones and make for an outstanding option when it comes to taking pleasure in snacking in a fully guilt-free manner. More, you can select from distinct flavours or variants and allow your flavor buds enjoy the treats without having pinching your conscience.

    Professionals and cons: Guilt-free of charge snacks with drastically significantly less unwanted fat and no draw back

    3) Broccoli Salad

    Summary: A powerhouse of nutritional vitamins and minerals with an additional boost of fibre

    Introducing a healthful dose of eco-friendly leafy greens is vital to major a balanced daily life. The veggies block the absorption of cholesterol and also help the process to flush out the toxins from the body. For a swift snack possibility, Broccoli Salad is just what the physicians counsel. You can customise the salad by introducing some more veggies (spinach, kale, and so forth.) and top it up with chopped onion, sliced tomatoes, boiled corns and a spoon of mint sauce. Sounds yummy, isn’t going to it? Additional, you can have this salad with some saucy gourmet dip which can choose its taste to a different level completely.

    Pros and negatives: Packed with antioxidants but the flavor may possibly not go down effectively with everyone

    4) Vegan Milk Smoothie

    Summary: A delectable and filling way to quench the starvation pangs

    Any list of healthier foods are not able to be entire without the need of a smoothie. Just toss some sliced banana, berries, nuts and 50 percent cup vegan milk into a blender and get your best 4 pm snack all set in a jiffy. The significant antioxidant character of berries retains the cholesterol down even though the banana will incorporate a increase of vitality to the smoothie. Vegan milk, on the other hand, will also source the considerably-needed dose of protein to full the macro and micronutrient profile of this very healthful and filling snacking alternative. You can pair this smoothie with some chocolate cigars for that added kick of sweetness and indulgence.

    Pros and negatives: Delicious in flavor but substantial in carbs and energy

    5) Roasted Lotus Seeds

    Summary: An Indian superfood with a myriad of positive aspects

    An great resource of calcium and powerhouse of vitamins, lotus seeds are counted between the superfoods boasting a assortment of well being rewards. The snack alternative is rather filling also and keeps you sated for a very long period of time of time. For quick preparation, just roast 100 gm of lotus seeds in a pinch of Desi Ghee (not oil) and swap off the flame once the seeds get started turning a minor brownish. Sprinkle some salt and add some crushed curry or mint leaves to carry excess flavour and flavor to the recipe. You can incredibly nicely complement these with some Controlled calorie cookies to double the pleasure and pleasure of indulging much healthier ways.

    Professionals and downsides: Exceptional dietary profile but the cost is a small on a better facet

  • UK faces hay fever medicine shortage as Dr Hilary Jones shares alternative options

    UK faces hay fever medicine shortage as Dr Hilary Jones shares alternative options

    Hay fever sufferers have been warned of a potential shortage of medication – just as the Met Office forecasts high pollen levels in Wales in the coming days. Supply issues mean that some drug manufacturers are experiencing shortages and it could spell trouble for people with hay fever.

    The NHS is also experiencing shortages of blood pressure pills and anti-depressants as drug manufacturers continue to experience supply issues. And experts warn there is a “real risk” of further shortages in the coming months.

    As a result of the hay fever medicine shortage, millions of people could be forced to spend a lot of their time indoors this summer. For many, antihistamines are the only thing that helps to ease the symptoms of hay fever, but if there is no medicine available what else can you do?

    READ MORE: Woman wakes up to find neighbour has hung washing out in her garden

    Tv doctor Hillary Jones has shared some of his top alternatives to help manage hay fever symptoms, as he says sufferers shouldn’t be “extraordinarily worried” by the short supply, as reported by the MEN. During Lorraine Kelly’s morning ITV show, Dr Hilary voiced his opinions on the shortages, saying Brexit “hasn’t helped” and explained: “There is a shortage of some medicines but certainly not all.

    “We’ve got 90 products that treat hay fever, which you purchase over the counter at chemists, and there’s four in short supply.” The TV doctor shared some of his own hacks for dealing with hay fever, starting with advice to “listen to Laura Tobin with the weather forecast and the pollen forecast” adding: “She will tell you when the bad days are on their way – Friday is going to be a bad day because we’ve got higher temperatures.”

    Do you know any hay fever remedies? Share them in the comments below

    He went on to say: “Avoid going out in the early morning and early evening, which is when the pollen tends to rise into the sky and then fall to the ground later on as the air cools. Think about wrap-around sunglasses, thinking about pollen filters in your car, think about Vaseline in the nostrils.

    “Think about having a shower when you come in from a walk outside. To get rid of pollen in your hair and shampoo your hair as well”. He also recommended pet owners shampoo their pets, particularly dogs, after a walk as they can carry pollen on their coats and can also develop symptoms of hay fever.

    See the weather forecast in your area below: