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Do Supplements And Herbs Cure Depression?

Introduction

As predicted earlier by the World Health Organization (WHO), major depressive disorders now account for a major illness in the world<a href="#accordion">[1]</a>, especially since the emergence of <a href="https://www.merisehat.pk/disease/covid-19">COVID-19</a>. As the pandemic rapidly swept across the globe, it induced a considerable degree of fear, worry and concern in populations at large. Additionally, social isolation and loneliness worsened mental health worldwide.&nbsp; 
&nbsp;

Major depressive disorder is a major contributor to the incidences of suicide and ischemic heart disease. Moreover, it is the second leading cause of years lived with disability (YLDs) worldwide<a href="#accordion">[2]</a>. <a href="https://www.merisehat.pk/disease/depression">Depression</a> not only affects day-to-day activities but also decreases the quality of life and well-being of people. The mood disorder can present with mild to potentially debilitating and life-threatening symptoms.&nbsp;

&nbsp;

Over the years, the increase in the prevalence of psychiatric disorders, depression, anxiety, and insomnia has led to a search for more effective treatments. For this reason, people look to manage depression with more natural remedies. Hence, treatment (often self-treatment) with supplements and herbs continues to gain popularity. But natural does not always mean safe or effective.&nbsp; 
&nbsp;

Herbal formulas are commonly prescribed for the treatment of mental illnesses. More people are now turning to herbal medications because of the various side effects, high prices, and increased relapse rates associated with prescription medications. Over the past decade, several studies have been conducted on the mechanism of action of supplements and herbal medications for treating depression, anxiety, and insomnia.&nbsp;

&nbsp;

<h4>"Did you know that heart rate variability can detect stress levels? Head on over to our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>and check your heart rate variability today!" </h4>

Understanding the role of natural remedies  in treating depression

Below are some supplements and herbs that are most widely used for the treatment of depression:&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Omega-3 fatty acids&nbsp;</h5>
	</li>
</ul>

Omega-3 fatty acids are essential fats that help with treating depression. A randomized control trial conducted on pregnant women in 2020 concluded that omega-3 fatty acids significantly improve symptoms of depression and postpartum depression<a href="#accordion">[3]</a>. Supplements containing the two omega-3 fatty acids eicosatetraenoic acid (ECA) and docosahexaenoic acid (DHA) are most effective. Omega-3 supplements containing 60% or more eicosapentaenoic acid (EPA) show an overall positive effect on treating depressing symptoms<a href="#accordion">[4]</a>. While there is a lack of research to support the argument, the supplement is a well-tolerated and considered healthy addition to your diet that may help treat the mood disorder.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>NAC (N-acetylcysteine)&nbsp;</h5>
	</li>
</ul>

NAC is a precursor of glutathione, an important antioxidant in your body. It is essential for protecting cells against oxidative damage and regulating inflammation<a href="#accordion">[5]</a>. Studies have shown that people with depression are more likely to have higher levels of inflammatory markers. Thus, taking NAC may reduce inflammation and relieve the symptoms of depression. Doses of 2 to 2.4 grams in a day are thought to help treat mental health conditions. 
&nbsp;

<ul>
	<li>
	<h5>Vitamin D&nbsp;</h5>
	</li>
</ul>

Vitamin D is an essential nutrient for the body. However, many people, especially in Pakistan don&rsquo;t have sufficient vitamin D. Studies have further shown that people with depression are deficient in vitamin D. Similarly, people with vitamin D deficiency have more severe depressive symptoms<a href="#accordion">[6]</a>. Vitamin D helps curb depression by reducing inflammation and regulating mood. A randomized control study highlighted that vitamin D supplements are beneficial for people with clinical depression<a href="#accordion">[7]</a>. Another study found that 300,000 IU of adjunctive vitamin D significantly improved the severity of illness and overall quality of life in people with clinical depression<a href="#accordion">[8]</a>. 
&nbsp;

<ul>
	<li>
	<h5>B vitamins&nbsp;</h5>
	</li>
</ul>

B vitamins play an essential role in the regulation of mood. These vitamins include folate, B12 and B6, and are needed to produce serotonin or the &ldquo;happy hormone&rdquo;. Studies have shown that a deficiency in vitamin B12 and folate increases the risk of depression. Whereas, supplementing vitamin B12 may help reduce depressive symptoms. According to a study published in 2020, low vitamin B12 levels are associated with a high risk of developing depression<a href="#accordion">[9]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Zinc&nbsp;</h5>
	</li>
</ul>

Zinc is an essential mineral for brain health and a deficiency in the mineral may increase the risk of depression and the severity of symptoms. Studies have further shown that zinc when used alongside antidepressant medications may reduce depressive symptoms.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Magnesium&nbsp;</h5>
	</li>
</ul>

Magnesium is an important mineral that may help with the symptoms of depression. A randomised study concluded that 248 mg of magnesium per day for 6 weeks can significantly reduce the symptoms of depression<a href="#accordion">[10]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Creatine&nbsp;</h5>
	</li>
</ul>

Creatine is an organic compound that is essential for maintaining brain energy, which has shown to be involved in the development of depression. Some studies have shown that supplementing creatine can help with the symptoms of clinical depression.&nbsp; 
&nbsp;

<ul>
	<li>Rhodiola Rosea&nbsp;</li>
</ul>

Rhodiola Rosea is a popular herb that has several health benefits when taken in the form of a supplement. In addition to helping the body cope with stressful situations, the herb is known to reduce symptoms of depression. The herb when used in combination with saffron can significantly reduce depression and anxiety symptoms of mild to moderate depression<a href="#accordion">[11].</a>&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Saffron&nbsp;</h5>
	</li>
</ul>

Saffron is a spice that is commonly used in Asian foods. The spice is packed with antioxidants that have been shown to improve the symptoms of depression. While the exact mechanism behind it is unknown, studies have shown that saffron increases levels of the &ldquo;happy hormone&rdquo; in the brain 
.

<ul>
	<li>
	<h5>Ginseng&nbsp;</h5>
	</li>
</ul>

The ginseng plant has been used by the Chinese for thousands of years to help reduce the effects of stress, and improve mental clarity and energy. Derived from the plant, ginseng supplements have properties that help with low energy and motivation levels in people with depression. However, currently, there are not many studies to support the benefits of ginseng for depression&nbsp;&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Chamomile&nbsp;</h5>
	</li>
</ul>

Studies have shown that chamomile is useful in the management of depression and anxiety. The herb provides significant relief from depressive symptoms. However, there is a need for further studies to support the benefits of chamomile to treat depressive symptoms.&nbsp;

&nbsp;

Key Points

<ul>
	<li>While herbal and natural supplements may work for some people, they are not a substitute for conventional treatments. Especially, for people who also struggle with thoughts of self-harm or suicide.&nbsp;</li>
	<li>Depression is a treatable illness, and you may try different herbs and supplements, but they may have potential side effects.&nbsp;</li>
	<li>These herbs and supplements can also interact with other drugs, reducing their potency.&nbsp;</li>
	<li>If you struggle with depression or have thoughts of suicide or self-harm, seek professional help immediately.&nbsp;</li>
</ul>

&nbsp;

[1].Depressive disorder (depression). World Health Organization. Accessed May 18, 2023

[2].Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J., Vos, T. and Whiteford, H.A., 2013. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS medicine, 10(11), p.e1001547.

[3].Zhang, M.M., Zou, Y., Li, S.M., Wang, L., Sun, Y.H., Shi, L., Lu, L., Bao, Y.P. and Li, S.X., 2020. The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials. Translational psychiatry, 10(1), pp.1-9.

[4].Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramanieapillai, M., Fan, B., Lu, C. and McIntyre, R.S., 2019. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Translational psychiatry, 9(1), pp.1-9.

[5].Šalamon, Š., Kramar, B., Marolt, T.P., Poljšak, B. and Milisav, I., 2019. Medical and dietary uses of N-acetylcysteine. Antioxidants, 8(5), p.111.

[6].Menon, V., Kar, S.K., Suthar, N. and Nebhinani, N., 2020. Vitamin D and depression: a critical appraisal of the evidence and future directions. Indian journal of psychological medicine, 42(1), pp.11-21.

[7].Vellekkatt, F. and Menon, V., 2019. Efficacy of vitamin D supplementation in major depression: A meta-analysis of randomized controlled trials. Journal of postgraduate medicine, 65(2), p.74.

[8].Vellekkatt, F., Menon, V., Rajappa, M. and Sahoo, J., 2020. Effect of adjunctive single dose parenteral vitamin D supplementation in major depressive disorder with concurrent vitamin D deficiency: a double-blind randomized placebo-controlled trial. Journal of Psychiatric Research, 129, pp.250-256.

[9].Sangle, P., Sandhu, O., Aftab, Z., Anthony, A.T. and Khan, S., 2020. Vitamin B12 supplementation: preventing onset and improving prognosis of depression. Cureus, 12(10).

[10].Tarleton, E.K., Littenberg, B., MacLean, C.D., Kennedy, A.G. and Daley, C., 2017. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PloS one, 12(6), p.e0180067.

[11].Bangratz, M., Abdellah, S.A., Berlin, A., Blondeau, C., Guilbot, A., Dubourdeaux, M. and Lemoine, P., 2018. A preliminary assessment of a combination of rhodiola and saffron in the management of mild–moderate depression. Neuropsychiatric disease and treatment, 14, p.1821.

Staff Writer

Madeeha Syed

What Is Cupping And Do You Need It?

Overview

Have you noticed those small, circular marks that celebrities flaunt these days? In malls, on red carpets, they&rsquo;re everywhere. What is it? Is it a cause for concern?&nbsp;

Well, they are a result of cupping therapy.&nbsp;

Cupping is a form of complementary therapy. It is believed that the suction it creates would enhance your body&#39;s energy flow and promote healing. 
&nbsp;

Cupping Treatment

Historical text referring to cupping therapy dates back to 1550 B.C. It has been a part of many ancient healing systems &ndash; Chinese, Tibetan, Korean, and Unani. Even the &ldquo;father of medicine&rdquo;, Hippocrates, wrote and compiled extensively on cupping procedures.&nbsp;

Nowadays, traditional Chinese medicine practitioners are known for using cupping therapy as a form of treatment. 
&nbsp;

The Chinese word for life force is Qi. Proponents of cupping believe the therapy is helpful in regulating the flow of Qi in the body. A lot of people also believe it balances out the negative and positive energy flow within the body. This balance is necessary to fight pathogens (illness causing microorganisms), increase blood flow, and <a href="https://merisehat.pk/article/natural-remedies-for-pain">reduce the level of pain</a>. 
&nbsp;

The process of cupping improves blood flow to the area where the cups are applied. This eases muscular tension, which, in turn, promotes cell repair and enhances general blood flow.&nbsp;

Additionally, cupping might support the development of new blood vessels and connective tissues.

Cups are frequently placed on the back, chest, abdomen, or legs. The most common site is back, though. For facial cupping, as the name suggests, the cups are placed on the face. 
&nbsp;

People use cupping as a supplementary type of treatment for a variety of symptoms and ailments:

<ul>
	<li>Neck and back pain</li>
	<li>Lowering cholesterol levels</li>
	<li>Knee and joint pains</li>
	<li>Improving immune system performance</li>
	<li>Chronic headaches 
	&nbsp;</li>
</ul>

The question here is how exactly cupping helps in treating these conditions? It is still unclear how sucking and drawing of blood under the skin could be this beneficial.&nbsp;

One study describes cupping as a complementary treatment and draws attention to how it deals with any disease-causing factors by simply restoring the body&rsquo;s energy flow and eventually improving blood circulation.

Actually, the cup is first heated with the herbs, alcohol, and paper placed within it. The heated cup is then placed on the skin upside down. The air inside the heated cup cools down. This creates a vacuum that pulls the skin and muscles up into the cup. As a result, changes in blood pressure causes the skin to turn red. 
&nbsp;

Unfortunately, despite the fact so much research has been carried out on cupping, no one seems to have come up with solid evidence to prove whether it actually works.&nbsp;

Back in 2015, an evaluation of the evidence discovered that cupping might help relieve chronic neck or back discomfort to some extent. Unfortunately, the quality of the research was insufficient to make definite conclusions.&nbsp;

In 2017, according to a study, cupping could increase the blood flow and stretch the underlying tissue.

Despite many competing theories, however, the effectiveness of cupping remains dubious. 
&nbsp;

Bottom Line

Cupping might be a useful supplemental treatment for a number of symptoms and illnesses, according to a growing body of research. However, more credible research is required to confirm the benefits of cupping.

Namwer Rao

Beat The Heat: What Happens When Heat, Sweat And Skin Collide

The summer months can be a fun time for outdoor activities and spending time with friends. But if you&rsquo;re prone to chafing or rashes, they may not be so enjoyable.&nbsp; 
&nbsp;

effect of heat on skin

Chafing and rashes are a common problem, especially during the summer months. The main cause of these annoying conditions is sweat. When your skin gets wet and rubs against itself or another surface, it can become inflamed and tender to the touch.

When you put on clothes that are too tight or made with synthetic materials like lycra, they can act like a glue trap for sweat, which contributes to chafing and rashes by trapping moisture between your skin and clothing. Sweat can also irritate sensitive skin as it evaporates off of your body &mdash; this is why you should always wear breathable fabrics such as cotton when exercising outdoors or in an air-conditioned room on hot days. 
&nbsp;

Sweat is the main cause of chafing, but it&rsquo;s not the only one. Friction is also a major factor in causing irritation and soreness that can make you unable to enjoy your day-to-day activities. 
&nbsp;

There&rsquo;s a rash for every occasion:

<ul>
	<li>Boob Rash: It&rsquo;s the bane of many a lady&rsquo;s existence, especially during sweaty summers and strenuous workouts. The friction of your bra rubbing against your skin causes irritation, which leads to red bumps and rashes.</li>
	<li>Thigh Chafing: Similar to boob rash but on your legs instead of chest, thigh chafing is caused by the constant rubbing of clothing against bare skin as you walk or run around all day long &mdash; especially if you&rsquo;re wearing shorts or skirts!</li>
	<li>Nipple Chafing: This is one particular type of nipple rash that can happen during pregnancy or breastfeeding when there&rsquo;s excess fluid flowing through those delicate glands in addition to sweat from exercise! 
	&nbsp;</li>
</ul>

Sweat itself doesn&rsquo;t cause chafing, but it can make things worse. If your skin is already sensitive to friction or susceptible to rashes and blisters, then sweat will make it even more sensitive.

&nbsp;

When you&rsquo;re trying to keep cool in the summer heat, it&rsquo;s easy to over-hydrate and end up with a gush of liquid dripping down your back as you walk around. When that happens, you might start thinking that all this sweat must be causing me some discomfort &mdash; but in reality, we just need a little bit more salt!

&nbsp;

These rashes could cause serious health problems if left untreated

Cuts and scrapes can lead to infections. Chafing can lead to blisters, and, in turn, those blisters can become infected.

Infections in the skin can cause damage that leaves you vulnerable to infection by other germs and even viruses like <a href="https://merisehat.pk/disease/hepatitis-b-113">Hepatitis B</a> and C or <a href="https://merisehat.pk/disease/hiv-61">HIV</a>, which can be fatal if left untreated.

To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw.

A rash is an uncomfortable, and sometimes painful, skin condition that can occur due to a variety of reasons. The most common cause of rashes is sweat and friction. To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw. 
&nbsp;

Avoiding Sweat And Friction: Using a lubricant between two surfaces that rub together without causing much wear (skin against fabric) will help prevent chafing and blisters caused by sweating under heavy loads or tight-fitting clothing like cycling jerseys or hiking shorts. Silicone-based lubricants work well because they stay slick longer than water-based lubricants; however, they&rsquo;re not as safe for use around water because silicone doesn&rsquo;t absorb into fabrics so it can be slippery when wet!

Keeping Skin Dry: You should apply sunscreen before you go outside since sun exposure makes you more susceptible to getting burned &mdash; especially if there isn&rsquo;t any breeze to cool down your body temperature during long runs outdoors (or even short ones). 
A good rule of thumb is that if it&rsquo;s hot outside but feels less humid than usual then put on sunscreen anyway just in case because humid conditions make it harder for sweat from evaporating off our bodies which means we need more frequent hydration breaks during long workouts outside in summer heat waves! 
Don&rsquo;t forget about protecting yourself against UV rays too because even though clouds may block direct sunlight from reaching us directly down here on earth&rsquo;s surface &mdash; they don&rsquo;t block UV rays which come through holes in them called &ldquo;glare points.&rdquo; These glares points are responsible for generating many different kinds of reflections including glare reflection off surfaces such as pavements when walking along city streets. 
&nbsp;

The first rule of treating any skin condition is not to try to rub it off. The rubbing can make it worse, and you may introduce bacteria into the area, which could cause inflammation and infection. The best thing to do is keep the area dry by using talcum powder or a non-oily moisturizer with a high water-content like Vaseline or Petroleum Jelly. 
&nbsp;

<h4>&quot;Most rashes will clear up within a few days after you adopt prevention techniques that keep your skin dry and limit friction&quot; 
&nbsp;</h4>

If you&rsquo;re at risk of developing a rash, it&rsquo;s best to take the following precautions:

<ul>
	<li>Use a towel to dry off immediately after swimming or sweating.</li>
	<li>Apply a moisturizer with an SPF of at least 30 every morning and reapply in the afternoon if you plan on being outside for longer than an hour.</li>
	<li>If you are wearing clothes that rub against your skin, use an anti-chafing product such as zinc oxide paste until your rash clears up and then switch to a heavier formula like dimethicone which will protect against future rashes. You may also want to try tea tree oil or aloe vera gel if those options appeal more strongly than using medication prescribed by a healthcare professional. 
	&nbsp;</li>
</ul>

The best way to prevent chafing while running is to take steps before your run. You can start with a good exfoliating shower and apply some body lotion or cream to dry areas. Then, wear the right clothes. Make sure they fit you well and aren&rsquo;t too tight or too loose where it counts &mdash; the thighs and crotch area are particularly susceptible to chafing.

Lastly, you should use products like Vaseline on dry spots before you hit the road. These products will help protect against rubbing and chafing during exercise so that when it&rsquo;s time for your next long run, all of those miles won&#39;t be spent dealing with embarrassing rashes instead of crossing finish lines! However, this is not just limited to the girlies who are active. Even when you are going on with your daily life, you can always incorporate these hacks to make summers more comfortable for you. 
&nbsp;

We know that dealing with these rashes can be frustrating. We want you to know that there is hope, though! They are all preventable, and it&rsquo;s not just about following the rules of hygiene either. You need to keep your skin dry and limit friction by wearing loose clothing and changing out of sweaty clothes as soon as possible after an activity ends. If you find yourself with a rash or chafing, don&rsquo;t try rubbing it off&mdash;that will only make things worse! Instead let your body heal naturally by keeping the affected area clean and dry until the symptoms subside on their own.

Umna Salah

How To Heal From Grief?

Grief is a natural reaction to any kind of loss. It&rsquo;s something we all experience, but the way it manifests itself varies from person to person. Some people are able to move on quickly, while others find it harder to heal. In this article I&rsquo;ll explain how the stages of grief work and give some tips on how you can help yourself or a loved one through their grieving process. 
&nbsp;

Tips to Heal From Grief

Denial is a defense mechanism. It&rsquo;s a way to protect yourself from the pain of loss, or at least postpone facing it. You may have heard of denial as something that happens during the grieving process, but this isn&rsquo;t quite accurate. Denial doesn&rsquo;t necessarily kick in once someone has died; it can also be an immediate coping mechanism for people who aren&rsquo;t yet ready to admit their loved one is gone.

Denial helps shield you from the <a href="https://merisehat.pk/article/natural-remedies-for-pain">pain</a> of grief by avoiding reality and hiding from feelings you&rsquo;d rather not experience (such as anger and sadness). 
&nbsp;

Anger is a natural and healthy reaction to loss. Anger can help you express your feelings, release negative emotions and show others that you are upset or hurt by what happened.

However, while it is normal to feel angry after the loss of someone or something close to you, there are some things that should be avoided when expressing anger:

Don&rsquo;t direct your anger at anyone else. You may have some pent-up frustrations with people associated with the loss (e.g., family members or friends), but directing your rage toward them will only make things worse for everyone involved.&nbsp;

Directing your anger inward instead by staying home from work or school can also be harmful because it could prevent you from accomplishing goals (such as getting back into college).&nbsp;

It&rsquo;s best not to let anger boil over into lashing out at others unnecessarily; instead, find other outlets for releasing negative emotion such as yoga classes or therapy sessions with a counsellor who specialises in grief counselling. 
&nbsp;

When you are bargaining, you are essentially trying to make the best of an intolerable situation. You may start thinking that there is something you could have done differently or something that will help save your loved one&rsquo;s life. You might even try to bargain with God or a higher power in order to get them back again.

For example, you might think, &ldquo;If only I had spent more time with my husband before he died!&rdquo;, &ldquo;If only I hadn&rsquo;t taken so long buying groceries!&rdquo; or &ldquo;If only I had remembered to call him earlier!&rdquo;&nbsp;

While these thoughts and feelings aren&rsquo;t necessarily accurate (the reality is that death or breakups happens when they happen), they can still be helpful if they allow you some peace of mind and perspective during this difficult time of grieving. 
&nbsp;

Bargaining can also manifest itself as guilt &mdash; for instance, if someone close dies from an illness but another person survives the same illness, there may be some sense that it should&rsquo;ve been the other way around, even though there&rsquo;s no real reason for this feeling beyond just being human (and overthinking things).&nbsp;

If this sounds like how you&rsquo;re feeling right now &mdash; like maybe there was something else r someone else who could&rsquo;ve helped prevent their death (for example) &mdash; it might be helpful for friends and family members who care about your well-being (or just want their own questions answered) not dismiss these thoughts or feelings outright by saying things like, &ldquo;It wasn&rsquo;t your fault&rdquo; or &ldquo;Of course everything would have been different if only...&rdquo;&nbsp;

Instead, they could take those questions seriously while acknowledging how hard they must be on whoever lost their loved ones without belittling them at all &mdash; because sometimes just recognising how painful it must feel helps us move forward without letting ourselves stay stuck in grief forever.&rdquo; 
&nbsp;

The final stage of grief is sadness and acceptance. The loss of someone leaves you feeling helpless. There will be times when you are too distracted by the world and work to think about it but at times, it is common to have a depressive episode and completely lose your pace or focus.&nbsp;

People who are unable to cope and accept tend to go into depression at this stage and numb themselves towards the outside world. The only way to avoid suffering from this illness is to deal with your loss and come to terms with it mentally. This requires your maximum input as your experience life without the person, the need for acceptance and doing things differently now. The only way is the way forward.&nbsp; 
&nbsp;

The stages of grief are not a checklist, nor are they rules to follow. They aren&rsquo;t even in the same order for everyone.

The five stages &mdash; denial, anger, bargaining, sadness and acceptance &mdash; are merely a general guide to help you understand what your loved one might be experiencing during their time of grieving. However, everyone grieves differently and no two people will go through all five stages at the same time or in the same way. It&rsquo;s important to remember that every person needs different kinds of support during times like these: some may need lots of love and affection as they work through their feelings; others will want space from others so they can take care of themselves first before reaching out for support later on. 
&nbsp;

The most important thing that needs to be acknowledged is that there is no shortcut to coping with grief. You cannot skip the stages. However, you can make it easy for yourself to handle your grief and speed up the process. Following are the steps that are age-old practices employed by people to help them cope:

<ul>
	<li>There are people around you who care about you, lean on them. Share your feelings with your friends and family. Hangout with them more to keep yourself distracted.</li>
	<li>Be acceptable for whatever support you are getting. Not many people know what to say or how to act around someone grieving, appreciate their efforts. They are doing it because they care.</li>
	<li>Religion has been a very strong catalyst for people struggling with grief. If you believe in one, resort to your faith. Praying can be very relaxing for the mind.</li>
	<li>A support group or therapy. Both allows you to talk about your experience, how it has affected you without getting a biased answer from the other side.&nbsp; 
	&nbsp;</li>
</ul>

Grief is a normal part of life and it can be hard to deal with. But remember, there are ways to cope with your feelings and move on from them. If you&rsquo;re struggling with grief or have lost someone close to you, remember that you&rsquo;re not alone. Reach out for help if needed, but don&rsquo;t forget that it may take time before things feel better again!

Iqra Mazhar

Is Keto Diet Safe For People With Diabetes?

In recent years, there has been a significant surge of interest in exploring different weight loss regimes, specifically following high-protein diets. One such high-protein diet is the <a href="https://www.merisehat.pk/article/what-is-the-ketogenic-diet">ketogenic diet</a>, or simply the keto diet, which is a diet rich in proteins and fats. Initially, the ketogenic diet was primarily proposed to reduce the frequency of epileptic seizures in children, but it has since gained popularity for weight loss. While there is evidence of short-term results with the keto diet, the verdict on its long-term benefits is still inconclusive. However, unlike other low-carb diets that center around protein, the ketogenic diet focuses mainly on fat.

&nbsp;

Understanding The Advantages Of Keto Diet In Diabetes

In 2008, researchers conducted a 24-week study to determine the effects of a low-carbohydrate diet on people with diabetes type 2 and obesity. The study concluded that people who followed the ketogenic diet saw a significant improvement in the glycemic index compared to those following a low-glycemic diet<a href="#accordion">[1]</a>. Patients following a ketogenic diet also saw a significant reduction in the use of medication. Another study conducted in 2013 reported that participants on a ketogenic diet showed improvements in their blood sugar levels and were also able to taper off insulin requirements compared to other diets<a href="#accordion">[2]</a>. Similarly, the ketogenic diet outperformed a low-fat diabetes diet, and the participants showed better weight loss and control of HbA1c in another study<a href="#accordion">[3]</a>.&nbsp;

Although it may seem unlikely that a high-fat diet focuses on weight loss, the ketogenic diet is different and can potentially change the way your body stores and uses energy. The ketogenic diet is high in fat and low in carbs. Instead of sugar, your body converts fat into energy in the keto diet. As mentioned earlier, the diet was initially considered for the treatment of epilepsy in the 1920s, but the effects were later also studied for type 2 diabetes<a href="#accordion">[4]</a>. The ketogenic diet improves blood sugar levels and reduces the need for insulin. However, as with any other diet, there are risks associated with the keto diet as well. Thus, it is important to discuss the possibility of starting the keto diet with your doctor before making any drastic changes to your current diet plan.&nbsp;

&nbsp;

Diabetes is of 2 types: diabetes type 1 and diabetes type 2.&nbsp;

<ul>
	<li>In type 1 diabetes, the body is incapable of producing insulin, and the patient has to rely on medication for life. This condition is less common and is typically diagnosed during childhood.&nbsp;</li>
	<li>In diabetes type 2, which has a more common presentation of the two, the body either does not produce enough insulin to meet the body&rsquo;s needs, or the insulin produced does not work effectively in lowering blood glucose levels.&nbsp;</li>
	<li>Pre-diabetic people have higher than normal blood sugar levels&nbsp;and are at a higher risk of developing diabetes type 2 if they do not take precautionary lifestyle and dietary measures.&nbsp;</li>
	<li>Gestational diabetes is described as diabetes that develops when you are pregnant. This type of diabetes generally resolves after giving birth. Though, it places you at a higher risk of developing type 2 diabetes.&nbsp;</li>
</ul>

&nbsp;

<h4>"Good diabetes control can increase your heart rate variability. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> and get your reading now!"</h4><h4> </h4>

Unlike other low-carb diets, the keto diet aims to force your body to use a different type of fuel. And instead of relying on sugar that comes from carbohydrates, for example, fruits, vegetables, legumes, and grains, the diet relies on ketone bodies. This is a type of fuel that the liver produces using stored fat. While burning fat sounds like an ideal way to lose weight, getting the liver to make ketone bodies is a tricky process.&nbsp;

<ul>
	<li>The diet requires that you restrict your intake of carbohydrates to 20 to 25 grams per day.&nbsp;</li>
	<li>Typically, reaching the state of ketosis takes a few days.&nbsp;</li>
	<li>If your diet is too high in protein, it can also interfere with ketosis.&nbsp;</li>
</ul>

In many cases, people with type 2 diabetes are overweight and a high-fat diet may seem unhelpful. The goal of a ketogenic diet is to train the body into using fat instead of carbohydrates or glucose. On the ketogenic diet, most of the energy comes from fat and only a small amount comes from carbohydrates. However, there are some ground rules. A diet high in fats doesn&rsquo;t mean that you should load up on saturated fats. It is recommended that your diet is rich in heart-healthy fats to maintain overall health. Some healthy foods that you can eat on a ketogenic diet include:&nbsp;

<ul>
	<li>Eggs&nbsp;</li>
	<li>Fish&nbsp;</li>
	<li>Cottage cheese&nbsp;</li>
	<li>Avocado&nbsp;</li>
	<li>Olives&nbsp;</li>
	<li>Nuts&nbsp;</li>
	<li>Seeds</li>
	<li>Olive oil&nbsp;</li>
	<li>Nut butter&nbsp;</li>
</ul>

&nbsp;

Foods To Be Eaten In Moderation

<ul>
	<li>Berries -&nbsp;1 cup or less</li>
	<li>Plain, Greek yogurt -&nbsp;1 cup or less</li>
	<li>Cottage cheese -&nbsp;1/2 cup or less</li>
	<li>Nuts and peanuts -&nbsp;1&ndash;2 ounces&nbsp;or 30&ndash;60 grams</li>
	<li>Flaxseeds or chia seeds -&nbsp;2 tablespoons</li>
	<li>Dark chocolate (at least 85% cocoa) -&nbsp;30 grams or less</li>
</ul>

&nbsp;

Foods To Avoid

<ul>
	<li>Bread&nbsp;</li>
	<li>Pasta&nbsp;</li>
	<li>Cereal&nbsp;</li>
	<li>Corn and other grains&nbsp;</li>
	<li>Potatoes, sweet potatoes</li>
	<li>Milk&nbsp;</li>
	<li>Fruits excluding berries&nbsp;</li>
	<li>Juices, sodas, and sweetened teas</li>
	<li>Desserts, candies, ice cream, and other baked goods</li>
</ul>

&nbsp;

When you eat carbs, your body&rsquo;s digestive system breaks down the carbohydrates and turns them into sugars that enter your bloodstream. The more sugar there is in your bloodstream, the more insulin your body needs to break down the sugar for energy. Insulin signals the cells to use the sugar for energy and energy storage. Moreover, the pancreas releases glucagon when the cells of your body begin to use the blood sugar. The two hormones, insulin, and glucagon work together to ensure that you have enough energy. If you have diabetes, then this means that your body is not using the insulin properly or cannot make or is not making enough insulin.

Hence, for people with diabetes type 2, it is recommended to control carbohydrate intake because it turns to sugar, and having it in large quantities can cause spikes in blood sugar levels. However, the ketogenic diet has the potential to decrease the levels of blood glucose. Your doctor will determine the number of carbs you should have based on your needs, current BMI, etc. Studies have shown that some people experience reduced blood sugar by switching to a diet high in fat.

Diabetes affects about 10 percent of the American population. Whereas in Pakistan, 17.1% of the population is estimated to be living with diabetes. This makes a total of 19 million adults in Pakistan who are at risk of the life-threatening complications of diabetes making it a pertinent public health issue<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Other than the standard keto diet, there are 3 other variations of the diet: the cyclical ketogenic diet, the targeted ketogenic diet, and the very low-carb diet.&nbsp;

<ul>
	<li>On the cyclical ketogenic diet, you can eat 100 to 150 grams of clean carbs once or twice a week.</li>
	<li>With the targeted ketogenic diet, you can follow the same rules as a regular keto diet but the time you eat carbs is fixed. It is suggested to consume carbs before or after a workout.&nbsp;</li>
	<li>The very low-carb diet, as the name suggests, allows you to eat very small quantities of carbs, high fat, and moderate protein. However, compared to the standard keto diet that allows only 50 grams of carbs a day, this diet allows you to eat 100 to 150 grams of carbs daily. However, this may not help you reach a state of ketosis.&nbsp;</li>
</ul>

&nbsp;

Conclusion

After reading this article, you may be wondering how a diet that focuses on fat makes it good for you. Especially, considering the fact that many people with diabetes also have obesity. While this question is completely reasonable, the keto diet is about redefining our understanding of fat. For years, people have focused on low-fat foods, milk, and yogurt thinking that fats are the root cause of all our health concerns, including obesity. However, the situation is more complex.&nbsp;

A recent study indicates that focusing on reducing total fats leads to harmful habits such as increased consumption of refined carbohydrates and added sugars. Moreover, it also leads to avoiding nutrient-dense foods, such as nuts, seeds, vegetable oils, and avocados. We all need fat to keep ourselves healthy and only recently researchers have started shifting from anti-fat foods to encouraging high-fat foods. In simpler words, fat is an important source of energy. It helps our bodies absorb essential vitamins and minerals, helps our muscles move, and enables blood to clot. Thus, science shows that a diet high in fat can be healthy, whereas eating low-fat diets can actually be harmful in the long run because of overconsumption of carbs and processed foods.&nbsp;

&nbsp;

<ul>
	<li>It is important that you speak with your doctor before you start a keto diet. Speaking with your doctor is a rule that should be followed before starting any diet.&nbsp;</li>
	<li>A keto diet can be helpful for diabetics who want to lose weight and lessen the need for medications. However, for others, it might even make diabetes worse. The diet isn&rsquo;t a magic weight loss pill, and there is currently limited information on the long-term effects of a keto diet.&nbsp;</li>
	<li>Moreover, be cautious when transitioning from the keto diet to adding carbs back to your diet. Sudden high consumption of carbs can cause your blood sugar levels to spike, and cause you to gain weight.</li>
</ul>

&nbsp;

[1] Westman, E.C., Yancy, W.S., Mavropoulos, J.C., Marquart, M. and McDuffie, J.R., 2008. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & metabolism, 5(1), pp.1-9.

[2] Paoli, A., Rubini, A., Volek, J.S. and Grimaldi, K.A., 2013. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition, 67(8), pp.789-796.

[3] Saslow, L.R., Mason, A.E., Kim, S., Goldman, V., Ploutz-Snyder, R., Bayandorian, H., Daubenmier, J., Hecht, F.M. and Moskowitz, J.T., 2017. An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: a randomized controlled trial. Journal of medical Internet research, 19(2), p.e5806.

[4] Meira, I.A., Romão, T.T., do Prado, H.P., Krüger, L.T., Pires, M.E.P. and da Conceição, P.O., 2019. Ketogenic diet and epilepsy: What we know so far, Front. Neurosci-Switz.(13), 5.

[5] Akhtar, S., Nasir, J.A., Abbas, T. and Sarwar, A., 2019. Diabetes in Pakistan: a systematic review and meta-analysis. Pakistan journal of medical sciences, 35(4), p.1173.Akhtar, S., Nasir, J.A., Abbas, T. and Sarwar, A., 2019. Diabetes in Pakistan: a systematic review and meta-analysis. Pakistan journal of medical sciences, 35(4), p.1173.

Ismail Munir

How Do I Boost My Iron Levels?

Iron is an essential mineral that your body uses to make hemoglobin. Iron is also an essential mineral for growth and development. There are two types of iron in food: animal-derived and plant-derived. While there is enough iron available in our food sources, it can also be taken as a supplement.

Understanding Ways To Treat Iron Deficiency Anemia

Studies have shown that the average amount of iron is 8.7 milligrams per day for men and 14.8 milligrams per day for women. The requirement for iron in vegetarians and vegans is 1.8 times more than in people who eat meat.&nbsp;

&nbsp;

You need iron to function properly. A lack of iron in your diet will lead to iron deficiency. Iron plays an important role in different bodily functions; it is an essential nutrient needed to form hemoglobin and carry oxygen in your blood to organs and tissues. This is important for optimal heart health, immune function, and respiratory functions.

&nbsp;

<a href="https://www.merisehat.pk/disease/anemia">Anemia</a> occurs when the body does not have enough red blood cells to carry oxygen to the body&rsquo;s organs and tissues. There are different types of anemia, but iron-deficiency anemia is the most common type of anemia in developing countries. According to the World Health Organization, 1.62 billion people are estimated to be affected by anemia worldwide.&nbsp;

&nbsp;

Low levels of iron can further lead to iron deficiency anemia. The symptoms of anemia include:&nbsp;

<ul>
	<li>Fatigue&nbsp;</li>
	<li>Weakness&nbsp;</li>
	<li>Pale and yellow skin&nbsp;</li>
	<li>Shortness of breath&nbsp;</li>
	<li>Lightheadedness&nbsp;</li>
	<li>Chest pain&nbsp;</li>
	<li>Cold hands and feet&nbsp;</li>
	<li>Headaches&nbsp;</li>
</ul>

&nbsp;

There are some types of anemia that are inherited and cannot be prevented, for example, sickle cell anemia, hemolytic anemia, and aplastic anemia.&nbsp;

However, anemia caused because of iron deficiency, vitamin B12, and vitamin B9 deficiency, can be prevented by eating well. This includes eating foods that provide enough iron and vitamins, in addition to vitamin C food sources, because it helps with the absorption of iron. Studies have also shown that drinking enough water helps keep hemoglobin levels up.

Moreover, daily iron supplementation may increase hemoglobin levels, and decrease the risk of anemia in infants, school-aged children, and pregnant and non-pregnant women. Foods fortified with iron and improving overall diet also have benefits in reducing the risk of developing iron-deficiency anemia.

There are some types of anemia that are short-term and mild. However, others can affect you throughout your life. There are several ways to manage anemia, including:

<ul>
	<li><a href="https://www.merisehat.pk/article/anemia-best-meals-for-boosting-iron">A healthy, well-balanced diet</a></li>
	<li>Stay hydrated</li>
	<li>Regular exercise</li>
	<li>Avoid&nbsp;exposure to chemicals that trigger anemia</li>
	<li>Visiting the dentist regularly because anemia increases the risk of tooth decay and gum disease</li>
	<li>Keep track of your symptoms and talk to your doctor about any changing symptoms</li>
</ul>

&nbsp;

If you have anemia, it is important to make good food choices. For example, avoid junk foods because it means adding calories to your diet without getting any essential nutrients. In addition, some foods impair the absorption of iron. Therefore, it is important to make the right food choices.

Here are some foods you should avoid:&nbsp;

<ul>
	<li>Coffee, tea, and other tannin-containing products, such as some spices</li>
	<li>Egg whites</li>
	<li>Fiber, but not all of it because some iron supplements may cause constipation</li>
	<li>Soy protein</li>
	<li>You should not be taking calcium with iron supplements because it impairs its absorption</li>
</ul>

&nbsp;

Here are some foods you should eat:

<ul>
	<li>Whether you eat meat or not, you should generally eat iron-rich foods, such as lentils, spinach, and pistachios.&nbsp;</li>
	<li>You can also get protein from different kinds of meat, like lean beef and turkey. There are some iron-fortified foods also available for vegans and vegetarians.&nbsp;</li>
	<li>It is also important to incorporate citrus fruits, berries, and other vitamin C-containing foods such as peppers and tomatoes in your diet to improve iron consumption.</li>
</ul>

&nbsp;

Consult with a healthcare provider to help with your iron intake, and do what works best for you.&nbsp;

&nbsp;

The Power Of Stepping Forward

There&rsquo;s a widely held perception that <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">effective exercises</a> are meant to exhaust you and be physically difficult. When looking to build an exercise regime, most of us are quick to add high-intensity activities like weightlifting and running. Rarely, if ever, does one consider beginning with the simplest and easily accessible activity: walking.&nbsp;

While it may not necessarily outweigh the benefits of a high-intensity strength circuit, walking comes with a host of benefits for both the body and mind. If one is completely new to exercising, or even returning after a long hiatus, walking is a more sustainable place to start. There is no learning curve because it is the one movement that&rsquo;s been inherent to our lives since infancy. It also allows you to start with a gentle pace and build up as your body allows. Whether you start with a moderate pace for ten minutes a day or walk at a faster pace for an hour, you will still be able to reap the many benefits of this activity. 
&nbsp;

Benefits of walking

Walking has been shown to improve blood circulation in the body and lower one&rsquo;s resting heart rate, while lowering blood pressure and cholesterol. A six-year study found that moderately paced walking showed similar reductions in the risk of high blood pressure and cholesterol when compared to vigorous running. A study of post-menopausal woman also showed that walking just one to two miles a day can lower blood pressure by 11 points in 24 weeks. 
&nbsp;

&nbsp;Research shows that walking contributes towards preventing a range of diseases. Improvement in cardiovascular health leads to a decrease in risk of heart disease. In one study, women who walked 30 minutes a day showed a 20 percent decrease in the possibility of having a stroke. Those who walked at a faster, above average pace showed a 40 percent decrease.

In another study, women who walked seven or more hours a week were shown to be 14 percent less likely to get breast cancer as compared to women who walked less than three hours. Even women with other risk factors, such as being on supplemental hormones, were less likely to get the disease.&nbsp;

With its benefits to overall health, regular walking has been shown to reduce risk of early death by upto 39 percent as compared to a sedentary lifestyle. 
&nbsp;

&nbsp;Walking has also been shown to reduce risks of developing Type 2 diabetes, as it helps to balance blood sugar levels. A meta-analysis of 300,000 showed that walking regular decreases the likelihood of Type 2 diabetes by 30 percent. Walking at a brisk pace, of more than 20 minutes to a mile, is even more effective, reducing risk by 41 percent. Meanwhile, a smaller study, of 201 people with Type 2 diabetes showed that every additional 2,600 steps in daily activity was associated with a 0.2 percent decrease in blood sugar level. 
&nbsp;

&nbsp;A joint is the point where two or more bones are joined, such as our knees and elbows. The health of our joints greatly impacts our overall mobility and is essential for living comfortably and pain free. Walking has been shown to improve joint health while reducing chances of osteoarthritis. It lubricates the joints, which protects our bones from friction, and strengthens the muscles that support them. Research has shown that people who walk regularly experienced a 40 percent reduction in knee pain as opposed to those who didn&rsquo;t. 
&nbsp;

&nbsp;Walking has been proven to boost our immune system&rsquo;s ability to protect us against illness. A study tracked 1,000 adults during flu season. Those who walked at a moderate pace for 30 to 45 minutes a day faced 43 percent less sick days and suffered from fewer respiratory infections overall. Even if they did get sick, their symptoms were not as severe or long-lasting when compared to adults with sedentary lifestyles. 
&nbsp;

&nbsp;Like other forms of exercise, walking causes our body to release endorphins. These are neurotransmitters which elevate our mood and alleviate pain. There is ample evidence to support the positive relationship between walking and mental health. One study showed that the more steps people took in a day, the better their mood was. Just 12 minutes of walking resulted in more self-confidence and a better mood in the subjects of another study.

Walking in nature helps us ruminate less over negative experiences, which in turn decreases negative emotions and risk of depression. A study of post-menopausal women showed that walking three times a week for 40 minutes provided relief from symptoms of depression. With all the research to support walking, it&rsquo;s no surprise that psychologists agree a 10-minute walk can be as effective as a 45-minute vigorous workout when it comes to relieving depression. 
&nbsp;

&nbsp;For creative professionals, walking can be a valuable tool in facilitating idea generation. One study compared people trying to think of new ideas while they were walking with those who were sitting. Participants who were walking did better, especially if they were walking outdoors. Research has also shown that walking improves creative output by more than 60 percent. Science shows that engaging in activities that allow our mind to wander creates a mental state that is conducive to coming up with ideas. If we are able to let go of our thoughts while walking, we can go to a place where ideas flow freely to us.

Although simple, walking has incredible and wide-ranging benefits for your body and mental health and should definitely be incorporated as a part of your lifestyle.&nbsp;

Ayesha Binte Rashid

Can't Go To Sleep? Here’s Why And How To Fix It

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

How An Over-Prescription Of Antibiotics Affects Your Immune System

The ground-breaking discovery of the first antibiotic penicillin changed the fate of medical science forever. The diseases people were losing their lives over were now only a minor setback. Back then, however, we could not have imagined that our very own invention could turn on us.&nbsp; 
&nbsp;

Effect of Antibiotics

There are many kinds of microbes (bacteria, fungi, viruses etc.) that attack the human body and can be eradicated by using antimicrobial agents. Antibiotics are antimicrobial agents prescribed for bacterial infections, the most common ones being Urinary Tract Infections (UTIs), strep throat, <a href="https://merisehat.pk/disease/pneumonia">pneumonia</a>, tuberculosis, cholera etc.

Antibiotics can be naturally occurring (made by other microorganisms) such as penicilin or synthetic such as sulfonamides. Much of the progress medical science has made, surgeries for instance, can be traced back to our ability to control infections and their deleterious impact. Infections went from being the top three causes of mortality back in the 1900s to being something we now take for granted.&nbsp; 
&nbsp;

Many doctors, especially in the third-world countries, don&rsquo;t think twice before writing you a quick prescription of metronidazole, a common antibiotic given for many ordinary infections, mostly for an ailment as little as an upset stomach.&nbsp;

Some stats report that around 47 million doctors worldwide prescribe antibiotics for absolutely no reason.&nbsp;

On the other hand, these maladies are so common and the drugs so easily available and effective that some people don&rsquo;t even bother going to the doctor for an opinion and will end up taking the antibiotic prescribed by the internet at home. This casual consumption of antibiotics has led to the development of antibiotic resistance.&nbsp;

The use of antibiotics doesn&rsquo;t extend to just medical illnesses, but they are also used in agriculture and livestock. 
&nbsp;

This is when the bacteria evolve to resist the impact of antibiotics. Once that happens, patients then need stronger antibiotics and eventually even those stop working.&nbsp;

There are several reasons behind this, some of which are:&nbsp;

<ul>
	<li>The over-prescription of antibiotics. This includes both misuse and overuse of the drugs.&nbsp;</li>
	<li>Patients not completing their antibiotic course as soon as get some see relief in their symptoms.&nbsp;</li>
	<li>Excessive usage in livestock and farming.&nbsp;</li>
	<li>Lack of infection control in hospitals.&nbsp;</li>
	<li>Poor hygiene and sanitation efforts.</li>
</ul>

No wonder then that antibiotic resistance has been called &ldquo;the greatest public health challenge of our time&rdquo; by several healthcare regulatory bodies such as WHO and the CDC.&nbsp; 
&nbsp;

A study published in the Lancet way back in 2013 claimed that we were already, &ldquo;at the dawn of a post-antibiotic era&rdquo;. This is a threat to food security as well. We are at a point where common diseases such as tuberculosis and salmonella etc. are harder to treat than before. This has also added burden to the healthcare system given that we now have longer hospital stays, higher costs of treatment and increased mortality.&nbsp; 
&nbsp;

Think of our immune system as the security guards of our body. It not only destroys any foreign body or pathogen that might harm us but also memorises these invaders and will recognise and destroy them if they detect them. The function of antibiotics is to provide support to our immune system.&nbsp;

Antibiotics enter the body and coordinate with our immune system in order to control infections. What ends up happening many times, however, is that they will indiscriminately kill any bacteria they see since they can&rsquo;t distinguish between healthy and harmful bacteria. This way even helpful microbes in our body are eliminated that actually can help us fight some of the more harmful infections such as fungal infections.&nbsp; 
&nbsp;

These antibiotics also destroy the healthy gut microbes that help in running the machinery of our digestion smoothly. Once lost, our digestive system suffers immensely, our metabolism is ruined and even our mental health eventually suffers. There are also immune cells present in our gut that can&rsquo;t function normally anymore. This effect on our gut microbiome due to antibiotic consumption can also be irreversible.&nbsp;

Studies conducted in mice have shown that antibiotics were able to completely alter the natural biochemistry of their cells. Instead of helping the cells kill these bacteria, they were making the cells protect them.&nbsp; 
&nbsp;

One study found that the immune cells of these mice suffered at the hands of the antibiotics to an extent where they couldn&rsquo;t perform their normal function of killing the pathogens &mdash; which can be anything from bacteria to virus or fungi and protozoans.&nbsp;

This goes on to show that antibiotic drugs have the ability to adjust immune responses by directly acting on the cells of our immune system and overhauling the metabolic microenvironment of our body. In the absence of an appropriate protective response, all kinds of invaders can wreak havoc on the body, even the ones that would be least harmful under normal conditions.&nbsp;&nbsp; 
&nbsp;

The impact of the over-prescription of antibiotics is all kinds of new, more powerful diseases become an insurmountable issue for mankind to resolve. We have all been exposed to overuse of antibiotics in some way shape or form.

If you do end up with symptoms where the cause could be viral or bacterial and you aren&rsquo;t sure about it, schedule an appointment with your doctor and go through the necessary tests to confirm the cause. If and when prescribed antibiotics, make sure you complete the full course. Don&rsquo;t stop midway just because your symptoms have been alleviated. Maintaining better hygiene, vaccinating when needed and not demanding that your doctor prescribe you an antibiotic are some other measures you can take to protect your immune system.&nbsp;

Add probiotics to your food. These are foods such as curd, cheese, kombucha, cocoa, bananas, lentils, nuts, whole grains, beans, broccoli, peas, and berries are all great options to help restore gut bacteria.&nbsp;

Dr. Safia Mehmood

Your Body After Giving Birth

Post-pregnancy or postpartum is a crucial period. It&rsquo;s also known as the fourth trimester. This is when your body is <a href="https://merisehat.pk/disease/chronic-fatigue-syndrome">recovering from the fatigue</a> of pregnancy.

During pregnancy, the body goes through a lot of changes to accommodate your baby. The body eventually goes back to normal, but this can take a while.&nbsp;

Continue reading to find out more about some common changes that take place in your body, after you give birth. 
&nbsp;

Post-pregnancy or postpartum

During pregnancy, hair growth gets better and the texture of hair gets thicker. This is all thanks to the hormones that are active during that phase. However, post-delivery, this phase settles down and enters into a resting phase for about one to five months. Normal hair growth pattern usually returns six to 15 months after delivery. 
&nbsp;

Shoe surprise is pretty common after pregnancy. It is not just the midsection that gets affected. After a baby is born, your shoe size changes permanently. That is because during pregnancy women gain an average of 25-35 pounds which puts extra pressure on the feet. This pressure flattens out the arch in your feet which is the reason for extra inches in your feet. 
&nbsp;

Belly bulge is common after pregnancy. A lot of women expect that the belly will return to its normal size after birth. The upper portion of the uterus is at the level of your navel. Post-pregnancy belly returns to its normal size in about six to eight weeks. A good diet and exercise are the key to toning down your belly. Workouts focused on the core can show quick results. 
&nbsp;

A common expectation of most women is that the breast size will go up after giving birth and breastfeeding. Once you stop breastfeeding, however, the size goes back to what it was. In fact, in some cases, it goes a cup down. The main reason for the size to increase is that fat tissue in the breast is replaced by functional tissue. Once a woman stops breastfeeding, functional tissue depletes as it is no longer needed. 
&nbsp;

The first six months of the post-partum period are the recovery period. No matter how easy or smooth your pregnancy is, your body has gone through a lot of stress and trauma. It needs time to recuperate. Remember that every mom goes through a different experience and symptoms; hence, the recovery rate also changes.

Most of the symptoms, like sore nipples, backache, pain in the thigh area, etc., continue for more than a week. Other symptoms, like leaky breasts, can linger on for months.

In vaginal delivery, recovery timelines vary depending upon the kind of delivery. The soreness and perennial pain go away in three weeks. However, in the case of vaginal tear or episiotomy (incision made on the vagina to ease the delivery process), recovery can take up to six weeks.

If you have been delivered through c-section, it will take around three to four days in the hospital to recover. In about four to six weeks you can recover completely. 
&nbsp;

For the first 24 hours after birth, ice your perineum region. Sit in warm baths for 20 minutes to ease pain and avoid long periods of standing or sitting.

Ease pain and aches by taking hot showers and massages.

Do your Kegel exercises, to strengthen your pelvic muscles.

Keep up with your doctor appointments. It will help you stay on track. Your doctor can also notify you about your emotional well-being and help you with your new journey.

Ask your doctor regarding your workout plan. They can guide you about how and when can you exercise. It is a good idea to start by walking into your house and then gradually into the neighbourhood. Walking helps in recovery by improving blood circulation and toning muscles. 
&nbsp;

Your diet after pregnancy shouldn&rsquo;t be very different from what you eat during pregnancy. Avoid processed foods. Focus on eating whole grains, high fibre foods, Omega-3 fatty acid-rich food, nuts, and fish.&nbsp;

<ul>
	<li>Lean Meat: Milk, cheese, and yogurt are all crucial components of a breastfeeding mother&#39;s diet. Your infant receives calcium from breastmilk for the formation of bones. Consume foods high in calcium to replenish the calcium your body has lost. Include three cups of dairy in your diet each day.</li>
	<li>Pulses: These are a good source of protein and fibre. You can cook them with different seasonings to make them tasty and easy to eat. Pulses also prevent fat from accumulating in the body.</li>
	<li>Vegetables:&nbsp;These are low-calorie healthy food. They are rich in antioxidants and aid in losing weight. Spinach and broccoli are good sources of Vitamin A which is healthy for you and your baby.</li>
</ul>

Once the baby is born, you can resume most of the food you avoided during pregnancy. Include nutrient-rich foods like legumes, proteins, fibre, citrus fruits, and vegetables. Don&rsquo;t forget to keep yourself hydrated. You may consult a dietician and your doctor in designing your diet plan.

<a href="https://www.merisehat.pk/disease/irritable-bowel-syndrome-62">Irritable Bowel Syndrome (IBS)</a> is defined as a type of gastrointestinal condition that causes problems in the digestive system. IBS affects 10 to 15 percent of the world&rsquo;s population. However, the symptoms are different for every person. While IBS is not a life-threatening condition, it can have a significant impact on one&rsquo;s well-being by affecting one&rsquo;s quality of life. The situation worsens when a person suffers from anxiety and IBS.

&nbsp;

Understanding Link Between Anxiety And IBS

Anxiety disorders is an umbrella term used for general anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder. A shared symptom of these disorders is excessive worry or anxiety.&nbsp; Physical symptoms of anxiety disorders include fast heart rate, sweating and fatigue. This may interfere with one&rsquo;s ability to get through normal everyday activities.&nbsp;

&nbsp;

IBS is a disorder of the digestive tract that causes abnormal bowel movements. Unlike Crohn&rsquo;s disease or ulcerative colitis, the physical structure of the digestive tract is unaffected, i.e. IBS is not a functional disorder. Common symptoms of IBS include diarrhea, constipation, and abdominal pain. Anxiety disorders affect more than a third of all U.S. adults while IBS affects 7% to 21% of the U.S. population. However, there is no reliable data for how many people experience both anxiety disorder and IBS. Some studies have shown that anxiety disorders are more common in people with IBS. According to a study assessing the prevalence of anxiety disorders and IBS, 44% of people with IBS had an anxiety disorder, compared to 8% of people without IBS.&nbsp;

&nbsp;

According to scientists, the mind and gut are intertwined. This is what scientists refer to as the gut-brain axis, which is a two-way signaling system between the gut and the brain. In response to our thoughts, feelings, and environment, our bodies release chemicals that affect different processes in our bodies. However, in the case of anxiety and IBS, whenever you feel anxious, your body releases stress-related chemicals in the gut causing inflammation leading to abnormal bowel movements, abdominal pain, and a change in gut bacteria.

Additionally, a poorly functioning gut has also been linked with mental health problems. Scientists explain that this is because our brain depends on the chemicals and hormones made by the bacteria in the gut for e.g. 90% of the serotonin (which is an important chemical that controls our mood and keeps anxiety levels low) is produced in our gut. Mental health problems are associated with increased and decreased production of serotonin.&nbsp;

&nbsp;

Unfortunately, the causative factors of IBS have yet to be elucidated. However, there is reason to believe that it may depend on a person&rsquo;s mental health. Anxiety and other health conditions may trigger IBS.&nbsp;

Certain other risk factors may increase one&rsquo;s risk of IBS, including:&nbsp;

<ul>
	<li>Having a family history of IBS&nbsp;</li>
	<li>Females are at a higher risk of developing IBS than males</li>
	<li>Being younger than 50 years of age</li>
	<li>History of severe gut infections&nbsp;</li>
	<li>Chronic psychological stress either caused by traumatic life events or alcohol addiction&nbsp;</li>
	<li>Smoking&nbsp;</li>
	<li>Certain medications that cause changes in the gut bacteria</li>
</ul>

&nbsp;

Studies have shown that keeping stress under control can help prevent or ease the symptoms of IBS. This is because the gut has a brain of its own, known as the enteric nervous system which is why you get butterflies in your stomach when you are nervous. Also, this &ldquo;second brain&rdquo; of yours also controls how food is digested. This second brain is in constant communication with your brain via the gut-brain axis. Thus, this connection can help manage your IBS. You can try and get rid of the tension by incorporating simple things in your daily routine, for example, going shopping, listening to music, reading, or talking to a friend. Other ways to alleviate stress and anxiety include:

&nbsp;

<ul>
	<li>
	<h5>Exercise&nbsp;</h5>
	</li>
</ul>

Exercising, for example, walking, swimming, running or other such physical activities can help you cope with anxiety and depression. Exercise also helps with normal bowel contractions.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Mind-Body Exercise, Mindfulness, And Meditation&nbsp;</h5>
	</li>
</ul>

Meditation can help trigger your body&rsquo;s relaxation response. You can either sign up for meditation, breathing or yoga classes offered online or in person. They will help you manage stress by targeting the gut-mind connection and changing the way you think.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Relaxation Exercises&nbsp;</h5>
	</li>
</ul>

Relaxation techniques, such as deep breathing, can help you feel calmer. The purpose of relaxation techniques is to learn about visualization and to imagine a peaceful scene. These techniques will also help you get enough sleep and eat well. You can also consider joining a self-help group for people with IBS or other digestive disorders. Members of the group will know what it is like to deal with IBS and may also be able to offer more meaningful support that you may not be able to get from even your closest friends.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Diet And Lifestyle Changes&nbsp;</h5>
	</li>
</ul>

The food we eat has a huge impact on our overall health. Your stomach and intestines are some of the first organs that feel the effect of the food you are eating. For treating IBS, you must start with your diet. There are specific foods that can trigger the symptoms of IBS. However, these triggers differ for everyone. Maintain a food/bowel movement journal wherein you can write about how different foods affect your bowel movements. This journal could also be helpful for discussing treatment options with your doctor. Research shows that avoiding certain foods can help prevent symptoms of IBS:&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Gas-Producing Foods</h5>
	</li>
</ul>

People with IBS are more sensitive to foods that make a person gassy for example, beans, bananas, and brussel sprouts. These foods may trigger discomfort after eating them.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Dairy&nbsp;</h5>
	</li>
</ul>

Even if lactose is not an issue for you, you may be sensitive to other milk proteins due to your IBS.&nbsp; Try using dairy-free alternatives, such as soy or oat milk to ease bloating and other stomach issues.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Foods High In FODMAPs</h5>
	</li>
</ul>

Foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short carbohydrates, such as fructose and sorbitol that appear in many fruits, vegetables, honey, and wheat. Studies have shown that these FODMAPs can linger in our guts, absorb water, and ferment, which can then cause irregular bowel movements. If you struggle with constipation, then it is recommended you stay well hydrated and eat 4-5 small meals regularly rather than eating 3 large meals a day. A diet high in fiber and soluble fiber, such as psyllium may also be helpful. Similarly, alcohol, tobacco, and caffeine aggravate symptoms of both IBS and anxiety, so reduce their consumption.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Cognitive Behavioral Therapy&nbsp;</h5>
	</li>
</ul>

Studies have shown that cognitive behavioral therapy is an effective treatment for IBS. However, before starting with CBT, practitioners need to rule out alternative diagnoses. The most important medical conditions to rule out include inflammatory bowel disease, Crohn&rsquo;s disease, and celiac disease. Baseline blood and stool tests are generally enough to rule out these conditions. The next step is to educate the patient about the gut-brain link and how stress can directly impact gut health.

The CBT practitioner will first help train the patient in relaxation techniques including deep belly breathing. Once the patients are able to use the relaxation techniques CBT is introduced. The focus of CBT is to educate the patient that the beliefs that affect our emotions negatively can be baseless. For example, if a person is embarrassed to go to the bathroom in a public place, it can be helpful to send them to a movie theater and have them sit at the back of the theater to count the number of people who get up to use the bathroom and return. The patient will be able to see two things: the frequency of people getting up to use the bathroom and the lack of reaction towards this behavior by the surrounding people. This will help the patient understand that it is not a big deal to get up and use the bathroom.&nbsp;

Similarly, CBT exposure therapy focuses on patients overcoming their fear of doing things that they have been avoiding. For example, if a person is afraid of long car trips, make them sit in a parked car for thirty minutes. Once this gets boring, drive them around the area. Once this gets easy, drive them a mile away from home and back. If the patient worries about not being able to &ldquo;hold it&rdquo;, experiment with them to &ldquo;hold it&rdquo; for 30 seconds, then a minute, and then 5 minutes. This will prove that they can hold it and worry is unnecessary.

&nbsp;

<ul>
	<li>
	<h5>Medications&nbsp;</h5>
	</li>
</ul>

If diet and lifestyle changes are not enough to curb the problem of anxiety and IBS, many medications will help relieve symptoms.

<ul>
	<li>Metamucil, or soluble fibers available over the counter, for constipation relief.</li>
	<li>Miralax helps pull water into the intestines and encourages bowel movements.</li>
	<li>Medications approved by the FDA for IBS-related constipation, Amtizia, Linzess, and Zelnorm.&nbsp;</li>
	<li>Antidepressants, including tricyclic antidepressants and selective serotonin reuptake inhibitors.</li>
	<li>Imodium is a popular over-the-counter medication that slows down gut and bowel movements and treats IBS-related diarrhea.&nbsp;</li>
	<li>Antispasmodics relax the muscles of the digestive system and relieve IBS-related abdominal pain.&nbsp;</li>
</ul>

&nbsp;

<ul>
	<li>Although there is no clear answer as to how anxiety affects your IBS or vice versa, both conditions are triggered by many different factors.</li>
	<li>If you have IBS, then there are many treatment options (medications, cognitive behavior therapy, etc.) and lifestyle changes that have been shown to help relieve symptoms and stress.&nbsp;</li>
	<li>You can discuss these treatment options with a healthcare provider and implement whatever works best for you.</li>
</ul>

&nbsp;

[1] Banerjee, A., Sarkhel, S., Sarkar, R. and Dhali, G.K., 2017. Anxiety and depression in irritable bowel syndrome. Indian journal of psychological medicine, 39(6), pp.741-745.

[2] Locke, G.R., Olden, K., Peterson, W., Quigley, E., Schoenfeld, P., Schuster, M. and Talley, N., 2002. Systematic review on the management of irritable bowel syndrome in North America. Am J Gastroenterol, 97, pp.S7-26.

[3] Camilleri, M., 2018, December. Management options for irritable bowel syndrome. In Mayo Clinic Proceedings (Vol. 93, No. 12, pp. 1858-1872). Elsevier.