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• About 1.5 million Americans live with rheumatoid arthritis (RA).
• Talisa King is sharing her journey to receiving an RA diagnosis, proper treatment, and finding effective pain relief.
• King helps others navigate RA by volunteering with the Arthritis Foundation.

On April Fool’s Day 2012, then 31-year-old Talisa King hit rock bottom with symptoms she had been experiencing for a few years.

While working the night shift at a youth detention center, she suddenly could not move the entire left side of her body.

“I immediately notified my co-worker who was working with me, and we were able to call medical, and of course, the first thing they thought is that I was having a stroke,” King told Healthline.

However, when she went to the emergency room, doctors determined she was not experiencing a stroke. Because her condition was complicated, she stayed in the hospital for six weeks undergoing various tests that ruled out neurological conditions and rheumatoid arthritis (RA).

“I was released to physical therapy and to do occupational therapy and to go to a series of neurologists who basically diagnosed me with something different every week and flooded my system with medicine because they were treating me for different conditions I didn’t have,” said King.

She finally met with a rheumatologist who diagnosed her with seronegative rheumatoid arthritis, a subtype of RA that is not detected in typical blood tests used to diagnose the condition.

“It can be difficult to determine the type of arthritis by the description of the pain, and many forms of arthritis have similar symptoms,” Dr. Diane Horowitz, director of the Rheumatoid Arthritis Center at Northwell Health, told Healthline.

After a year-and-a-half of having difficulty tying her shoes, cutting her food, and walking on her own, King was relieved to receive an official diagnosis.

She is one of the nearly 1.5 million Americans who live with RA.

How an RA diagnosis led to pain relief

King’s doctor started her on aggressive treatment to control inflammation. However, she still had to go through various forms of treatment, including taking NSAIDs and biologics, before finding one that brought her relief.

“[Keep] in mind that any damage that is done by rheumatoid arthritis is permanent once it becomes any level of erosion, so you have to figure I had lost a year-and-a-half to almost two years of having issues with swelling and erosion on different pieces and parts of my body,” King said.

Managing pain is a constant challenge too.

“One common misunderstanding is that the pain associated with rheumatoid arthritis and other forms of inflammatory arthritis is solely due to joint damage or very active disease,” Dr. M. Elaine Husni, vice chair of the Department of Rheumatic and Immunologic Diseases and director of the Arthritis and Musculoskeletal Center at Cleveland Clinic, told Healthline.

She said that in addition to joint damage, RA pain can come from soft tissue injury around the joint, such as tendinitis or bursitis, or mechanical wear and tear from cartilage loss, known as osteoarthritis (OA).

“You may need additional treatment for soft tissue condition or OA to your RA treatment to best manage pain,” said Husni.

RA pain may also come from central sensitization, where pain can stem from abnormal processing of pain pathways from the brain.

“So there may not be any actual joint damage but still joint pain. This could be chronic pain or fibromyalgia,” Husni said.

To add to the complications of managing RA pain, arthritis pain is variable, fluctuating with disease activity, stress levels, and even weather changes.

“The complexity of pain in RA includes both nociceptive and neuropathic components, making it a multifaceted experience that requires comprehensive management beyond just treating joint inflammation in some cases,” said Husni.

This is also the case for King.

While most people begin experiencing pain at the onset of the RA, she didn’t have pain initially but graduated into pain over time.

“Once the pain kicked in, it was definitely there,” she said.

She journals to keep track of which parts of her body are in pain and also writes down the foods she eats.

“In your mind, you’re having a rough day, but over time, you may realize you feel that way when you eat a lot of gluten,” said King. “Triggers are something to really keep track of.”

The challenges of consistently managing pain while living with RA

Pain from rheumatoid arthritis can be intermittent and can occur at any time.

“This can be very unsettling for people and can add an element of unpredictability to their life,” said Horowitz.

King manages her pain day by day and sometimes hour by hour.

“At this moment, I’m doing okay, but in an hour, I could get up or lay down and be in a different space,” she said.

RA and other forms of inflammatory arthritis are often considered “invisible diseases” because the debilitating pain and fatigue that people experience may not be apparent to others, including healthcare providers.

“When the manifestations of a disease are not overtly apparent, it can be difficult for others to understand the pain a patient may feel,” said Horowitz.

The invisibility can lead to underestimation of the severity of the disease, delays in diagnosis, and inadequate pain management.

“Patients may face skepticism about the legitimacy of their pain, especially when there is a lack of visible joint deformity or radiographic evidence in the early stages of the disease,” Husni said. “Moreover, societal stigma associated with chronic pain conditions can lead to patients feeling dismissed or misunderstood, further complicating their journey to receive appropriate care.”

King has experienced this firsthand and noted that hospitals may treat people with RA like they are drug-seeking, excessively trying to fill medications.

“You have to be diligent and advocate for what you think you need…if you feel like your level [of pain] is higher than what they’re giving you [medication for], let them know what worked for you in the past…but if you are not careful, some doctors will consider it med seeking,” she said.

Standing up for others with RA

When King was first diagnosed with RA, she reached out to the Arthritis Foundation for support and asked for guidance on how to become a resource to others in her community.

“I never want anybody to go through the things I went through when I was initially diagnosed,” said King. “Not having resources in the area, not having peers who I could connect with or people who I could talk to who understood what the condition was, and the ins and outs of it.”

After becoming trained by the Foundation, she became chair of the Buffalo Walk to Cure Arthritis, an event that she started in 2018. She also speaks at the Foundation’s Pathway Conference, leads webinars, and is the facilitator of the African American Connect Group.

She recently took part in a Foundation initiative that invited people living with arthritis to share words or mantras that inspire their lives. (King chose “grace.”) The words were made into bracelets that the Arthritis Foundation will distribute to more than 50 markets in the U.S. and give out free of charge throughout September in cities like Atlanta, New York City, Phoenix, and D.C.

“Whatever I can do to continue to share the message because it’s a form of therapy for me as well, just knowing my story can help somebody else who is having a rough time and doesn’t know how to get started with navigating their condition,” said King.

• CDC guidelines for the 2024–25 flu season recommend the flu shot for all individuals ages 6 months and older, with rare exceptions.
• The recommendations include two key updates: a return to trivalent flu vaccines and high dose vaccines for adults receiving organ transplants.
• Infectious disease experts recommend getting both your flu shot and updated COVID-19 shot simultaneously, ideally from late September through October.

The Center for Disease Control and Prevention’s 2024–25 influenza season guidelines recommend the annual flu shot for all individuals ages 6 months and older, with rare exceptions. 

The recommendations highlight two key updates: 

• After more than a decade of quadrivalent formulations, this year’s flu shot is a trivalent vaccine that does not include an Influenza B/Yamagata component. The trivalent vaccine will target three flu strains: two influenza A viruses — H1N1 and H3N2 — and an influenza B/victoria virus. The B/Yamagata lineage has not been detected globally since March 2020, which suggests it may have been eliminated. 
• Flu shots for adult solid organ transplant recipients ages 18–64 on immunosuppressive medications will include HD-IIV3 (trivalent high dose inactivated influenza vaccine) and allV3 (trivalent adjuvanted inactivated influenza vaccine). These high dose vaccines help boost immune response in older adults.

Infectious disease experts say the optimal time to receive both the flu vaccine and updated COVID-19 vaccine is late September and during October. 

This gives both vaccines their best chance to protect during the winter months, according to William Schaffner, MD, professor of preventive medicine and infectious diseases in the Department of Health Policy at Vanderbilt University Medical Center in Nashville.

Healthline spoke with Schaffner to learn more about the upcoming flu season and why it’s important to get vaccinated against respiratory illnesses like influenza and COVID-19.

This interview has been edited and condensed for clarity and brevity.

Why are flu shots trivalent this year?

Schaffner: Flu vaccines in recent years have protected against four different strains of the influenza virus: two influenza A strains and two influenza B strains. We always do that because although there’s a dominant strain, numerous strains are usually circulating. 

This year, the influenza vaccine will protect against three strains because one of the B strains has disappeared from the world and has not been detected in two years, so there’s no need to include it in the vaccine anymore. That’s a good thing.

How bad will the flu season be this year?

Schaffner: We can all hope for a very mild influenza season, but it’s very hazardous to predict the severity of the upcoming flu season. It’s much easier after the flu season to go back and say how severe it was. 

We can look to the Southern Hemisphere — where they have their winter during our summer — but what happens there is not always predictive of what will happen here. 

We have included the strains that were active in the Southern Hemisphere this summer in our flu vaccine, and at the moment, it looks as though we have a very good match between what’s in our flu vaccine and what we anticipate the dominant strains will be.

Can you get your flu shot and COVID shot at the same time? 

Schaffner: Yes, you have to get both shots, whether in the same arm or the other arm, because the flu vaccine won’t protect against COVID-19, and the COVID vaccine will not protect against the flu. 

The recommendations for both vaccines are identical (6 months and older). Both of these vaccines are very important — and that goes for anyone who’s eligible.

Are you concerned about vaccine hesitancy as students return to school?

Schaffner: I’m always concerned about that because familiarity breeds, if not contempt, a certain nonchalance, and so we have come to accept and live with the annual influenza virus outbreaks.

Those of us in infectious diseases and public health take flu very seriously because we know that this nasty family of viruses can take a normal, healthy young person and put them in the emergency room in the hospital. Within 48 hours, every major hospital in the country sees this sort of thing happening every year. 

Yes, most flu in children is mild, and they get over it very easily.  But on occasion, a normal, healthy child can be made morbidly, gravely ill. 

The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) agree 100% with the CDC that children should be vaccinated, and that goes along with adolescents and young and middle-aged adults. 

Why is it important for people to receive the flu vaccine?

Schaffner: Getting vaccinated against the flu is the most comfortable and reassuring thing you can do to protect yourself against severe disease, but you also protect your family and your community.

Older persons, frail persons, people with underlying chronic medical conditions, and people who are immunocompromised are at the greatest risk for severe disease from the flu. 

The flu vaccine is best at preventing severe disease and has some impact on reducing transmission. So if you get the flu vaccine, you will provide some modicum of protection to those around you.

For those who are immune compromised who can’t respond to the vaccine very well because their immune system doesn’t work as well, the best way we can protect them is for everybody else around them to be protected, providing a kind of a cocoon of protection for those who are among the most fragile in our communities. 

Takeaway

The CDC’s recommendations for the 2024–25 flu season include two key updates: a return to trivalent flu shots and high dose vaccines for adults receiving organ transplants.

To protect themselves during the winter months, everyone ages 6 months and older should get their flu and COVID shots, ideally at the same time and before the end of October.

Getting vaccinated against the flu and COVID-19 helps prevent severe illness, even in young, healthy individuals.

With kids getting back into the classroom, now is a good time for parents to familiarise themselves with some of the common illnesses that could disrupt children’s studies or even cause more serious illness during the colder months. This blog …

With kids getting back into the classroom, now is a good time for parents to familiarise themselves with some of the common illnesses that could disrupt children’s studies or even cause more serious illness during the colder months. This blog …

• Researchers report that people with coronary artery disease can reduce their risk of heart attack by 44% by quitting smoking.
• The risk for people with this condition increases by 8% for every year they continue to smoke.
• People who only reduce the amount they smoke don’t lower their risk when compared to people who continue to smoke, researchers say.
• Experts advise people both with and without coronary artery disease to stop smoking as soon as possible.

Quitting smoking can significantly reduce the risk of a heart attack for those diagnosed with coronary artery disease, according to a new study.

However, researchers report that simply cutting back on smoking doesn’t appear to do much to lower the risk.

In addition, people who have never smoked still have a lower overall risk of a major cardiovascular event than a person who has quit smoking, even if that person has stopped tobacco use for years.

These findings were presented on August 29 in London at the ESC Congress 2024, the annual meeting of the European
Society of Cardiology.

Although the research has yet to be published in a peer-reviewed journal, experts say it sends an important and strong message.

“This analysis reinforces what has been known from previous smaller studies in years past: there is no safe level of cigarette smoking,” said Richard Wright, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

“The noxious components of smoke immediately lead to a chain of noxious events, and whether one
smokes a quarter-pack or two packs of cigarettes is irrelevant with regards to the increase in cardiac
risk. This enhanced risk also extends to those exposed to second-hand smoke,” Wright told Healthline.

Smoking and heart attack risk

In their study, researchers assessed data from the international CLARIFY registry, a databank that has
been used in past cardiovascular research.

The researchers examined 32,378 people with coronary artery disease. The participants were studied at an average of about six years after their disease diagnosis.

Among the participants at the start of the study:

• 41% had never smoked
• 46% were former smokers
• 12% were current smokers

Among the former smokers who were smoking at the time of their coronary artery disease diagnosis:

• 73% had discontinued smoking within a year of their diagnosis
• 27% quit in subsequent years

Researchers reported that people who quit smoking after their diagnosis saw an overall reduction of 44% in the risk of a major adverse cardiovascular event, regardless of when they stopped tobacco use.

The researchers noted, however, that the risk of a heart attack or other cardiovascular event increased by 8% for each additional year of active smoking.

They pointed out that study participants who reduced the amount they smoked didn’t have a significantly lower risk than participants who continued to use tobacco.

They added that the former smokers “never achieved the cardiovascular risk level of patients who never smoked, even after years of smoking cessation.”

“I like to tell my patients that it is never too soon or too late to stop smoking, though the sooner a patient stops, the better to lower cardiovascular risk,” study author Jules Mesnier, MD, a cardiologist at the Hospital Bichat-Claude Bernard in Paris, in a statement.

“And it is not enough to reduce smoking. Short, clear-cut messages are needed for smokers at every medical intervention highlighting the need to quit,” Mesnier continued.

How smoking affects cardiovascular health

Robert Page, PharmD, professor of clinical pharmacy and physical medicine at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and member of the Drug, Alcohol and Tobacco Use Committee of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health, said the information contained in the new study is powerful. Page was not involved in the study.

“What is quite compelling is that even after quitting smoking, patients did not return to their prior baseline cardiovascular risk status before they began smoking,” he told Healthline. 

“While this study was based on registry data, I want to point out that this is only an association and not direct causation; however, with the amount of robust data on the [cardiovascular] effects of smoking and consistent biological plausibility, these data are quite powerful, especially when educating patients,” Page continued.

Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California, agreed with the strong message of the research. Chen wasn’t involved in the study.

“This study found that quitting smoking, and not just cutting down on smoking, can reduce the risk of a major cardiovascular event by half. This is consistent with our current understanding and recommendations to completely quit smoking rather than cutting down, in order to gain the most health benefits. However, cutting down on smoking can potentially be useful if it puts someone on the path to eventually quit,” Chen told Healthline.

“Our advice is very clear to people with coronary artery disease who smoke: quitting smoking is essential to minimize the risk of a future cardiovascular event, and can potentially be life-saving,” he added.

Jayne Morgan, MD, a cardiologist and vice president of medical affairs at Hello Heart, who is not involved in the study but is attending the ESC conference, said smoking can produce a number of health issues for people with coronary artery disease.

“Smoking damages the endothelial lining of the coronary arteries in an irreversible fashion. This sets a
person up for the development of atherosclerosis. which can then lead to a heart attack and heart
failure,” Morgan told Healthline.

“Additionally, smoking further accelerates the development of atherosclerosis where it is already present, further narrowing the coronary arteries and reducing blood flow and critical oxygen supply to the heart,” she said.

“Moreover, smoking increases levels of certain blood clotting factors further complicating the picture and putting the patient at risk of a cardiovascular event,” Morgan added. 

“And then when you just think about nicotine itself, which causes vasoconstriction or tightening of the coronary arteries further reducing blood flow that may already be reduced by atherosclerosis. Then we must consider that inflammatory response of the body to smoking, including the coronary arteries,” Morgan continued.

Health dangers of smoking

Page said the dangers of smoking extend far beyond people with coronary artery disease.

“Active smoking and secondhand smoke exposure determine over 30% of coronary heart disease deaths,” he explained.

“While the exact mechanisms of cardiovascular damages are not well known, the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function. All of these accelerate early onset ASCVD disease. Thus, I tell patients, ‘Why even start smoking?,’ he added.

Page said he tries to hammer home this message in particular to young adults and teens.

“I have found that teens and young adults believe they are invincible and that ‘this won’t happen to me’ or ‘I just smoke socially.’ These are urban myths and completely false assumptions based on these data,” he said.

Morgan said the health dangers from tobacco use can be particularly acute for women.

“If you are a female, the coronary arteries are generally smaller and these effects of smoking (cardiac events, i.e. heart attacks) may therefore become evident sooner with earlier cardiac events,” she said.

“If you are in perimenopause or menopause (generally 35 to 60 years of age), you may be at particularly high risk. Further, if you have other risk factors that put your body at risk of chronic inflammation, such as obesity and diabetes — even more of a reason to quit smoking,” Morgan noted.

Strategies to quit smoking

Mesnier said measures to promote smoking cessation should include advice, counseling, behavioral interventions, and pharmacological therapy when necessary. Talking with a healthcare professional can be an important step to quit smoking.

Page noted that smokers, as well as medical professionals, must acknowledge how difficult it can be to quit this unhealthy habit.

“It is hard to believe that after more than a half century of research, people continue to smoke, which speaks to the great addiction potential of cigarettes,” he said. “It is important to note that patients have to want to quit, and having them tell you directly a specific quit date is essential.”

Morgan has straightforward advice for people who don’t smoke: “Don’t start. If you have started, there is no better time than now to quit,” she said.

Wright also has some direct advice: “The message is simple. Don’t take up smoking, especially if you are known to have coronary disease,” he said. 

“If you do smoke, quit. Now. You will benefit by next month. In about a decade, that excess risk will evaporate — but only if abstention from cigarette smoke is complete,” Wright concluded.

Takeaway

In a new study, researchers say people with coronary artery disease who stop smoking can lower their risk of heart attack or other major cardiovascular event by 44%, no matter when they quit tobacco use.

However, researchers noted that the risk increases by 8% for every year a person with coronary artery disease continues to stop. They added that people with this condition who reduce the amount they smoke don’t appear to have a lower risk than people who continue to smoke.

Experts say the sooner anyone quits smoking the healthier they will be.

• Real Housewives of Orange County‘s Vicki Gunvalson recently opened up about a health scare she experienced.
• What she initially thought was a stroke turned out to be pneumonia and sepsis.
• Sepsis is a potentially fatal overreaction of the immune system to an infection.
• The businesswoman said she was given a 10% to 20% chance of survival.
• She is now recovering but still dealing with low energy.

Real Housewives of Orange County’s Vicki Gunvalson spoke recently about a health scare that she went through earlier this month.

On an episode of My Friend, My Soulmate, My Podcast, she shakily told host Christian Gray Snow that she had nearly died.

The reality star explained that she was having her boyfriend Michael Smith join her because she had experienced amnesia and couldn’t remember all of the events that had occurred.

“Michael’s going to come in when I get blank,” she said.

Gunvalson then went on to relate how she had gotten her hair done and then went to the office on the day that it happened.

When she arrived at the office, Smith’s daughter Olivia, who worked there, was the first to notice something wasn’t right, she said.

She told the businesswoman that she was “speaking gibberish” and that an email she was typing didn’t make sense.

Luckily for Gunvalson, the client she was meeting with, who happened to be an emergency room doctor, suggested that she might be having a stroke, prompting her boyfriend’s daughter to take her to the hospital.

“And so, really, from that point on, I don’t recall much,” she said, breaking into tears.

She went on to reveal that the hospital “misdiagnosed” her with a sinus infection and released her that night.

Taking over, Smith told Snow that about three weeks earlier, Gunvalson had gotten on antibiotics to treat a sinus infection that was taking longer than usual to go away.

Smith then discussed coming home and finding the star “passed out” in the bathtub, after which he put her in bed to allow her to rest.

When he woke her “about 13-14 hours later,” Smith said she was “so discombobulated” that he was afraid she was having a stroke.

This led to a quick trip to the hospital, where she was diagnosed with pneumonia and sepsis and was given what Gunvalson recalled as a “10% to 20% [chance] of survival.”

After hospitalization and treatment with multiple antibiotics and steroids, Gunvalson is now home. However, she said that she is still low on energy. “I’m having a hard time getting it up. So that’s my biggest thing,” she said. 

What is sepsis?

Dr. Steve R. Fallek, who is a board-certified plastic surgeon and Medical Advisor to the Maskad and Revivv brands, explained that sepsis is a life-threatening condition that occurs when an infection causes widespread inflammation.

“This inflammation can trigger a cascade of changes that damage multiple organ systems, leading them to fail, sometimes resulting in death,” he explained.

Fallek added that any type of infection — whether it’s bacterial, viral, fungal, or parasitic — can potentially lead to sepsis.

If a person is experiencing sepsis, the symptoms can vary, he said, but generally, people will have a combination of the following:

• High fever or very low body temperature
• Rapid heart rate
• Rapid breathing or shortness of breath
• Confusion or disorientation
• Extreme pain or discomfort
• Clammy or sweaty skin

How can sepsis happen?

“Sepsis can happen when an infection that is not properly managed spreads into the bloodstream or throughout the body,” said Fallek.

“This triggers an immune response that, instead of only attacking the infection, also damages healthy tissues and organs,” he said.

Among the conditions that can cause sepsis are pneumonia, urinary tract infections, abdominal infections, and blood infections.

Having a weakened immune system, chronic illnesses, recent surgery, or hospitalization, particularly in intensive care units, can also set the stage for sepsis to occur, according to Fallek.

Dr. John C. Lowe, a physician with Restore Care, described sepsis as being caused by “the hyperactivity of the immune system.”

“The molecules are put in the blood to suppress the infection but in most victims, this leads to too much irritation,” he explained.

When this occurs, people can experience localized blood clotting, increased permeability of the blood vessels, low blood pressure, fluid accumulation in the tissues, and poor blood flow to the brain and organs.

“If the events are not rapidly intervened, they may culminate in dysfunction of more organs, development of septic shock and eventual death,” said Lowe.

What should you do if you suspect you have sepsis?

Lowe said that sepsis is an emergency, which means that every minute counts.

“In case you think you have sepsis or someone else has it, then do not wait and consult the physician,” he said.

Lowe further explained that treatments for sepsis, such as antibiotics and intravenous fluids, are only effective if administered quickly.

“In case there is a persistent rapid heart rate with confusion, breathlessness, or other features of sepsis, do not hesitate—either call out for an ambulance or rush to the hospital,” he advised.

“This is the kind of state where every second can count for life or death,” Lowe concluded.

Takeaway

Real Housewives of Orange County star Vicki Gunvalson recently spoke on My Friend, My Soulmate, My Podcast about a close brush with death that she experienced a few weeks prior.

The reality star, who was being treated for a sinus infection, thought she was having a stroke, but it turned out that she had pneumonia and sepsis.

Sepsis is an overreaction of the immune system to a bad infection. If not treated quickly, it can cause people to go into septic shock and die.

If you are ever experiencing symptoms of sepsis — such as rapid heart rate, confusion, and breathlessness — experts say you shouldn’t hesitate to seek out emergency medical care.

• Weekend warriors — individuals who get most of their physical activity over one or two days in a week — gain similar brain health benefits as those who exercise more regularly.
• According to a new study, weekend warriors had reductions in risk for dementia, stroke, Parkinson’s disease, anxiety, and depression, which is comparable to a more traditional workout schedule.
• The study builds on previous research that has shown weekend warriors also experience significant cardiovascular health benefits.

Weekend warriors reap similar brain health benefits as individuals who exercise more regularly throughout the week.

Researchers have increasingly taken interest in the “weekend warrior” exercise phenomenon: when an individual tends to get the majority of their physical activity in during one or two days of the week. 

Whether due to work or family responsibilities, many people may feel like they have less time for exercise and leisure activity during the week, leaving it for the weekend instead.

But can you really get the same health benefits when cramming weekly exercise into a shorter period of time According to multiple large studies: yes.

While prior studies have focused on outcomes like cardiovascular health and mortality, the latest research, published August 21 in Nature Aging, focused on brain health benefits, including reduced risks for neurological conditions like Parkinson’s disease and mental health conditions like anxiety and depression.

Across a broad spectrum of brain health conditions, weekend warriors showed similar benefits as those with a more traditional exercise schedule when compared to individuals who were inactive.

The findings suggest that from a health perspective, the body may not distinguish between daily exercise or more sporadic activity, as long as weekly physical activity recommendations are met: at least 150 minutes of moderate intensity activity per week.

“It’s really about the volume, not the pattern,” said Shaan Khurshid, MD, MPH, a cardiac electrophysiologist at Massachusetts General Hospital. Khurshid wasn’t affiliated with the study, but has previously published research on weekend warriors and cardiovascular disease outcomes.

“Overall, I think the study was well done. There is a lot of potential to learn more about the ‘weekend warrior’ pattern. So, it was a natural extension to look at brain health in an analogous manner to what we did with cardiovascular health,” Khurshid said.

‘Weekend warriors’ have lower risk of dementia, stroke

The study involved more than 75,000 participants whose health and lifestyle data was available through the UK Biobank. Participants tended to be older, with an average age of 61 years old. The cohort was also well represented by women, making up about 55% of the group.  

While some prior studies on weekend warriors have relied on self-reported data, which tends to be less reliable and objective, researchers used accelerometer (fitness tracker) data to determine participants’ weekly exercise patterns.

Researchers subdivided participants based on these exercise patterns into one of three groups:

• Inactive: Participated in less than the recommended 150 minutes per week of moderate to vigorous physical activity.
• Regularly Active: Participated in 150 minutes or more of moderate to vigorous physical activity per week.
• Weekend Warriors: Participated in 150 minutes or more of moderate to vigorous physical activity per week, with more than half of their activity occurring within 1–2 days.

It’s important to note that although the phrase “weekend warrior” is used, none of the research specifically indicates that physical activity has to occur on weekends. Instead, it simply refers to physical activity concentrated over a few days. Interestingly, this group made up the largest proportion of exercise patterns, accounting for nearly 40% of all participants. 

Researchers divided brain health into neurological and psychological conditions. The neurological grouping included Parkinson’s disease, stroke, and dementia. Psychological conditions included depression, anxiety, and bipolar disorder.

Over more than eight years of follow-up, the weekend warrior group saw comparable reduction in risk to the regularly active group across the entire spectrum of brain health. Bipolar disorder was a notable outlier; no significant association was found between it and physical activity patterns.

Brad Donohue, PhD, a professor of psychology and Creator of The Optimum Performance Program in Sports (TOPPS) at the University of Las Vegas who wasn’t affiliated with the research, told Healthline the findings were exciting.

“The positive relationship between exercise and mental health in scientific studies is becoming increasingly clear. They indicate  that moderate-to-vigorous exercise, regularly or on a weekend warrior schedule improves mental health and physical health,” he said.

After adjusting for health and lifestyle factors, risk reduction levels for specific conditions among weekend warriors were significant across all conditions.

• dementia: 23%
• stroke: 13%
• Parkinson’s disease: 49%
• depression: 26%
• anxiety: 28%

“There are people who might be discouraged from exercise because they think that they have to do it regularly. And this study seems to show that if you can find the time to do one or two days of moderate to vigorous exercise, it’s going to offer very significant health benefits,” Donohue added.

Are there risks associated with being a weekend warrior?

Packing in all your physical activity into a weekend may not always be feasible, but getting as much exercise as you can on a regular basis, even if it’s only for short bouts, can still be helpful.

“This doesn’t change my recommendation that people should try to keep moving as much as they can,” Michael Fredericson, MD, director of PM&R Sports Medicine and co-director of the Longevity Center Stanford Medicine, told Healthline. Fredericson wasn’t affiliated with the research.

“But, on the other hand, for those people who can’t, this is still encouraging that if all you can do is exercise on the weekend you’re still going to get a really significant benefit,” he added.

He pointed out that this and other weekend warrior studies have focused on that 150-minute per week threshold, which is, essentially, the bare minimum that people should be getting. For serious health benefits that actually improve longevity, you’ll likely need to double that amount of physical activity per week.

“Maybe you can meet those basic guidelines, just exercising one or two days a week, but you’re probably not going to be able, nor should you try, to do 300 minutes a week all at once,” he said.

He also cautioned that by concentrating physical activity into a short period of time, you may put yourself at risk of injury.

“There’s a potential downside to achieving very high volumes of activity in a short period of time, especially if you’re not used to that pattern. It always makes sense to listen to your body to ramp up your activity and volume in a way that is sensible,” said Khurshid.

Still, Khurshid said the message people should take home about the consistent data on weekend warriors is that they have the freedom to get their activity how and when it works for them.

 “I view that as empowering: we’re able to tell patients, at least on the basis of the data that’s available coming out, that you can structure your exercise the way it makes sense for your lifestyle,” he said.

Takeaway

Research indicates that so-called weekend warriors — people who get the majority of their physical activity over just one or two days per week — get the same brain and cardiovascular benefits as those who exercise during the week.

Weekend warriors experienced significant reduction in risk for both neurological conditions like stroke and Parkinson’s disease, and mental health conditions including depression and anxiety.

Experts say that the findings should empower people who find time to exercise on a schedule that works for them.

• Mosquitoes can carry viruses or parasites that cause a number of diseases in people.
• When a mosquito carrying a virus or parasite bites a person, it can pass on the microbe.
• The most common mosquito-borne diseases in the U.S. are West Nile, malaria, and eastern equine encephalitis.

More than just a summertime annoyance, mosquitoes can also spread disease. When mosquitoes bite and drink blood from a person or animal, they can pick up a virus or parasite. If they bite another person or animal, they can pass on that microbe.

The recent rise in mosquito-borne illnesses across the U.S. has many people concerned about the potential risks to their health and how they can best protect themselves.

“Minimizing excessive mosquito exposure is probably the only thing people can do to protect themselves,” said Marc Siegel, MD, a professor of medicine in the Division of Infectious Diseases at the George Washington School of Medicine and Health Sciences. 

“So avoid the times that mosquitoes tend to feed more, which is dusk to dawn,” he told Healthline.

If you do have to be outside, wear pants and a long-sleeved shirt or jacket, and wear mosquito repellent, he said—especially in wooded or swampy areas.

However, Siegel points out that not every mosquito that bites a person will be carrying a virus or parasite.

Over 200 types of mosquitoes live in the continental United States and U.S. territories, according to the CDC. Yet, only about 12 can spread a virus or parasite that makes people sick.

“Most mosquito bites are not going to result in West Nile virus because the vast majority of mosquitoes are not infected with West Nile virus,” he said.

Climate change, though, has led to the spread of mosquito-borne illnesses to new parts of the world, which will increase people’s exposure to these diseases.

Below are the four most common types of mosquito-borne illnesses, the risks they can pose, and how health experts recommend you can best protect yourself.

West Nile virus

Birds are the natural hosts of West Nile virus. Mosquitoes that become infected by biting and drawing blood from a bird can pass on the virus when they bite a person.

Only about one in five people infected with West Nile virus will have symptoms, which can include fever, headache, body aches, and vomiting. In addition, about one in 150 infected people will develop a serious, sometimes deadly, illness.

West Nile is the most common mosquito-borne disease in the continental United States, according to the CDC. There have been 289 West Nile cases reported to the CDC in the country so far this year. In 2023, there were over 2,566 cases in the country.

This year, cases have occurred in 33 states in the Northeast, South, Midwest, and Southwest.

“There are probably a higher number of total infections, many of which are not diagnosed,” said David Sullivan, MD, a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health.

However, “this is still less than the chance of being hit by lightning,” he told Healthline.

There are no specific medications to treat West Nile virus disease or vaccines that can prevent it.

People of any age can develop severe illness if they are infected with West Nile virus. But those 60 years of age or older are at greater risk for more serious disease.

Dr. Anthony Fauci, once the top US infectious disease expert, recently became infected with West Nile virus. After being hospitalized for a week, Fauci, 83, is recovering at home, reports STAT.

Other people with a greater risk for severe illness include those with cancer, diabetes, high blood pressure, an immunocompromising condition, or other medical conditions.

In an effort to reduce the risk of West Nile virus to the public, the New York City Health Department has been spraying pesticides in parts of the city to control the mosquito population.

Eastern equine encephalitis

Eastern equine encephalitis, or EEE, is a rare but potentially deadly disease caused by a virus passed onto people through the bite of an infected mosquito. Most people infected with the virus don’t develop symptoms.

Those who do become infected may develop symptoms such as fever, chills, body aches, and joint pain. Some people may develop more serious inflammation of the membranes surrounding the brain and spinal cord. About one-third of people who develop severe eastern equine encephalitis die from their illness.

“In worse cases, the virus infects the tissue of the brain, and that’s when we call it encephalitis,” said Siegel. “That is more serious and is much more likely to lead to death or long-term neurological deficits in patients who survive.”

Sullivan said both very young children and older adults are at higher risk of severe illness from eastern equine encephalitis. In contrast, West Nile virus tends to affect older adults more than young children, he said.

Most cases of eastern equine encephalitis occur in eastern or Gulf Coast states. So far this year, four cases have been reported to the CDC, with 38 reported in 2019.

The virus passes between mosquitoes and birds found in freshwater hardwood swamps. Another mosquito species is needed to pass the virus from infected birds to people or horses.

There is no vaccine treatment for eastern equine encephalitis. People with severe symptoms will be given medications and other therapies to manage their symptoms. 

In Oxford, Massachusetts, about 50 miles west of Boston, a man in his 80s was exposed to the virus, health officials announced on Aug. 16.—the first reported human case of eastern equine encephalitis this year in the state.

To minimize further risks to the public, Oxford health officials recommended an outdoor curfew from dusk to dawn, the peak biting time for many mosquitoes. 

Similarly, Plymouth, about 40 miles south of Boston, said all public parks and fields will be closed from dusk to dawn after a recent eastern equine encephalitis infection diagnosed in a horse.

Malaria

Around 247 million malaria cases occurred worldwide in 2021, with around 619,000 malaria deaths. This disease is caused by a parasite that infects a certain kind of mosquito. Malaria cases mainly occur in tropical parts of the world, especially Africa.

Malaria was once common in parts of the United States but was eliminated from the country in the mid-1950s. However, around 2,000 malaria cases are imported into the United States each year by people traveling to other parts of the world.

In 2023, several locally acquired malaria cases occurred in Florida and Texas for the first time since 2003.

Symptoms of malaria, which can include flu-like illness and headache, range from mild illness to severe disease.

Prescription drugs are available to treat and cure malaria. A malaria vaccine is also available in parts of the world where malaria regularly occurs, such as in parts of Africa.

Dengue

Each year, up to 400 million people worldwide are infected with a dengue virus, according to the CDC. Not everyone gets symptoms, which can include aches, eye pain, muscle or joint pain, nausea, vomiting, and rash.

Dengue is most commonly found in tropical and subtropical areas of the world. So far this year, over 4,000 Dengue cases have been reported to the CDC, with cases occurring in most states.

However, most cases reported in the continental United States occurred in travelers infected in other areas. Limited local spread of dengue has been reported in Arizona, California, Florida, Hawaii, and Texas.

There is no specific treatment for dengue, but people may be given medication to relieve pain. In the United States, a dengue vaccine is available for use in children ages 9 through 16 with laboratory confirmation of a previous dengue infection who live in an area where dengue is common.

Takeaway

Over 200 types of mosquitoes live in the continental United States and US territories. Only about 12 can spread a virus or parasite that causes illness in people. When mosquitoes bite and draw blood from an animal or person, they may pick up a disease-causing microbe.

The most common mosquito-borne diseases in the United States are West Nile, malaria, dengue, and eastern equine encephalitis. Some cases occur in returning travelers who were infected in other parts of the world.

West Nile is the most common mosquito-borne disease in the United States, with thousands of reported cases each year. Around 80% of people infected with West Nile virus will have no symptoms. However, some people with symptoms may develop a serious, sometimes deadly, illness.

• New research has found that six herbal supplements that are popular on TikTok may cause liver damage. 
• Researchers at the University of Michigan concluded that supplements, including Ashwagandha, Green Tea Extract, and Garcinia cambogia, may be hepatoxic. 
• However, experts say in most cases, these risks only occur if you’re taking high doses of these supplements. 
• It’s best to do your research before adding any supplement to your health and wellness routine.

Numerous users on social media platforms like TikTok have espoused the benefits of herbal supplements, leading to a surge in their popularity.

However, a new study conducted by researchers at the University of Michigan found that six popular herbal supplements, including green tea extract, turmeric, and ashwagandha, are linked to liver risks.

Furthermore, the researchers estimated that 15.6 million U.S. adults have taken at least one herbal supplement in the last 30 days that might be hepatotoxic or damaging to their liver.

Healthline spoke with experts to help clarify what you need to know about the reported benefits and potential risks to your liver that have been linked with these six popular herbal supplements.

Ashwagandha

“Ashwagandha can help reduce serum cortisol levels, which can lead to people getting better, more restful sleep,” says Pedram Kordrostami, MD, founder and CEO of supplement company Omre. 

“Ashwagandha’s ability to calm the brain is mostly due to the compounds it contains. Considered an adaptogen, ashwagandha is a kind of herb that, when consumed, helps the body deal with stress,” he explains. 

Kordrostami says the benefits will be more pronounced in people who experience insomnia. 

As for the potential risks to your liver?

Kordrostami says it’s rare, but the effects can range from mild to moderate. 

Severe liver injury has been reported by some who have used ashwagandha. In other cases, symptoms arose and then resolved after the supplement was stopped.

He says people need to be wary of commercially available herbal supplements marketed as only containing ashwagandha. 

“These supplements usually are a mixture of multiple different herbs and nutritional products, which are often mislabeled,” he explains. 

Black cohosh

Black cohosh is a plant native to North America that has been traditionally used for various medicinal purposes.

Samael Tejada, a functional medicine expert and founder of Liquivida, says its potential benefits include managing symptoms associated with menopause and hormonal imbalances and reducing hot flashes, night sweats, changes in mood, and sleep disturbances. 

It’s also used to manage menstrual cycles and alleviate PMS symptoms.

“Several case reports have linked black cohosh use to liver damage, including cases of hepatitis and liver failure, necessitating liver transplants,” Tejada notes. 

Risks include jaundice, elevated liver enzymes, and acute hepatitis. 

“The cause is not entirely understood but may involve individual susceptibility, dosage, duration of use, or contamination of supplements. Women with a history of liver disorders should be particularly cautious,” he warns. 

Garcinia cambogia

Garcinia cambogia is a tropical fruit that is commonly used as a weight loss supplement.

Tegada says it contains hydroxycitric acid (HCA), which is believed to help suppress appetite and block an enzyme in the body used to produce fat.

“It’s known for potential weight loss benefits, improved cholesterol levels, reduced appetite, increased stamina, and reduced fatigue, making it popular among athletes,” he explains. 

However, the potential liver risks may outweigh the benefits. 

“Reports of acute liver failure and hepatitis-like symptoms have been associated with Garcinia cambogia, often in individuals who combine it with other weight loss supplements,” Tejada notes. 

“Severe cases can lead to the need for liver transplantation, possibly related to the supplement’s chemical properties or interactions with other supplements.” 

Green tea extract

Green tea extract is derived from the leaves of the Camellia sinensis plant and is rich in antioxidants known as catechins.

Tejada says its high anti-oxidant content helps combat oxidative stress, which is linked to chronic diseases such as cancer, diabetes, and cardiovascular disease.

“It’s believed to improve metabolism and aid in weight loss, improve brain function, including memory loss and focus, reduce cholesterol levels, and may have potential anticancer properties for certain cancers,” he notes. 

As for liver risks, Tejada says risks include liver toxicity, hepatitis, and liver failure, with toxicity believed to be dose-dependent and possibly due to excessive accumulation of catechins in the liver, leading to oxidative damage and inflammation.

Red yeast rice

Red yeast rice is a traditional Chinese medicine made by fermenting rice with a type of yeast called Monascus purpureus.

“It contains compounds known as monacolins, which are similar to statins and may help lower cholesterol levels,” Tejada explains. “It may also improve heart health and lower the risk of cardiovascular disease. Some studies suggest it also has anti-oxidant and anti-inflammatory properties.” 

But there are risks.

“Red yeast rice may cause elevated liver enzymes, liver inflammation, and, in rare cases, acute liver failure,” Tejada notes. “The risk increases with higher doses and prolonged use, especially when combined with other statins or hepatotoxic drugs.” 

Turmeric

Turmeric is a spice commonly used in Indian cuisine and traditional medicine. It contains a compound called curcumin, which has powerful anti-inflammatory and antioxidant properties. 

These properties can help with conditions like arthritis or inflammatory bowel disease.

“Turmeric’s antioxidant properties help neutralize free radicals and reduce oxidative stress,” Tejada explains.  “It also supports digestive health, is believed to enhance cognitive function, and even potentially reduce the risk of certain cancers.” 

However, he says high doses of turmeric supplements have been associated with liver toxicity, leading to elevated liver enzymes and, in rare cases, liver damage. 

Takeaway 

A new study from researchers at the University of Michigan found that six popular herbal supplements that have soared in popularity due to content on TikTok can pose risks to your liver.

The herbal supplements studied included ashwagandha, turmeric, red yeast rice, green tea extract, garcinia cambogia, and black cohosh.

Health experts warn that just because an herbal supplement is popular or “natural” doesn’t mean it’s without risk.

If you are taking supplements, it’s important to ensure you’re taking the correct dose to avoid liver damage.

It’s also a good idea to speak with a healthcare professional before you begin taking any herbal supplement.

• Eli Lilly officials announced a new program that provides consumers with single-dose vials of the weight-loss drug Zepbound at a discount price of 50% or more.
• Consumers who pay for these medications out of pocket must purchase Zepbound through the LillyDirect program. They must also have a valid prescription from their healthcare provider.
• Experts praised the new program for its ability to get weight-loss medications to more people in an affordable manner.

The weight-loss drug Zepbound is about to become significantly less expensive for a select group of people who take the medication.

Officials at Eli Lilly, the manufacturer of the drug, have announced plans to sell Zepbound in 2.5 milligram and 5 mg single-vial doses at a discount of 50% or higher compared to the list price of all GLP-1 medications for obesity.

Here’s the pricing details on the new plan:

• A four-week supply of 2.5mg doses will be $399 ($99.75 per vial).
• The cost for a four-week supply of 5mg doses will be $549 ($137.25 per vial).
• The plan does not include the delivery pens typically used for the weekly injections or syringes needed to extract the medication from the vials.

The discount plan is available only to Eli Lilly’s self-pay customers who purchase pharmaceuticals through the company’s LillyDirect program. These customers pay out of pocket for medications rather than going through an insurance company.

Company officials said the cost savings are similar to those offered to people who are uninsured, but they noted the new program will expand the number of customers who can get Zepbound at a lower cost.

“We are excited to share that the Zepbound single-dose vials are now here, further delivering on our promise to increase supply of Zepbound in the U.S.,” Patrik Jonsson, executive vice president and president of Lilly Cardiometabolic Health and Lilly USA, said in a statement.

“These new vials not only help us meet the high demand for our obesity medicine, but also broaden access for patients seeking a safe and effective treatment option.”

Growing demand for Zepbound, other weight-loss drugs

Company officials said they hope the new plan will help ease shortages of Zepbound supplies and other GLP-1 weight-loss drugs.

Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, agreed that the new program should be helpful since there is still more demand than supply for weight-loss medications.

“Making the medication more affordable will increase the number of people who can access it,” Ali told Healthline.

Other experts also praised the program as a way to help meet the demand for weight-loss drugs.

“People living with obesity have long been denied access to the essential treatment and care needed to manage this serious chronic disease,” said James Zervios, the chief operating officer of the Obesity Action Coalition, in a statement.

“Expanding coverage and affordability of treatments is vital to people living with obesity. We commend Lilly for their leadership in offering an innovative solution that brings us closer to making equitable care a reality. Now, it’s time for policymakers, employers and insurers to work with pharmaceutical companies to ensure no one is left behind in receiving the care they deserve and need,” Zervios continued.

Caroline Apovian, MD, a professor of medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Massachusetts, told Healthline that although the new Eli Lilly Zepbound plan isn’t optimal, it still should make the weight- loss drug more affordable and more accessible.

“I hope other companies will try to lower the price of self-pay drugs for our new obesity medications as well as for type 2 diabetes,” Apovian said.

Zepbound prescription required for discount

Consumers who utilize Eli Lilly’s savings plan must have a valid, on-label prescription for Zepbound from their healthcare provider.

Company officials said this requirement is necessary to ensure that customers are not using the medication for cosmetic weight loss.

They added they hope the easier access to Zepbound will discourage people from using untested, knock-off drugs to treat obesity.

Ali urged companies to stay vigilant about consumers using alternative medications or using the drugs for purposes other than treating obesity and other serious weight management issues.

“The medication still requires a prescription from a legitimate provider. That being said, there will always be people seeking this medication for inappropriate use,” he said.

Novo Nordisk on making medications more affordable

Officials at Novo Nordisk, the manufacturers of the weight loss drugs Ozempic and Wegovy, told Healthline that the key to making these medications more affordable is by expanding consumer coverage through insurance companies and government programs.

“The most effective way for the millions of Americans living with obesity to access affordable medication is by ensuring coverage through government and commercial insurance plans,” a Novo Nordisk spokesperson told Healthline.

“We will not stop advocating for insurance coverage until all Americans have full coverage for obesity medicines and that becomes the standard, not the exception.”

“Novo Nordisk supports additional legitimate options as it creates more safe supply for Americans living with obesity and is a testament to the significant unmet need of addressing obesity as a serious, chronic disease,” the spokesperson added.

What to know about GLP-1 drugs

Zepbound and Mounjaro contain the active ingredient tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. Both are manufactured by Eli Lilly.

Zepbound is approved for use as a weight-loss medication. Mounjaro is approved as a treatment for type 2 diabetes.

Novo Nordisk has two injectable weight-loss medications, both of which include the active ingredient semaglutide, a GLP-1 drug. Ozempic is prescribed to treat type 2 diabetes while Wegovy is used as a weight-loss medication.

Novo Nordisk also manufactures Rybelsus, a daily pill that contains semaglutide that is used to treat type 2 diabetes in adults.

All these medications have performed well in clinical trials.

Last week, researchers reported that in a clinical trial Zepbound and Mounjaro were effective in helping people with obesity or weight management issues maintain weight loss over a 3-year period as well as significantly reducing their chances of progressing from prediabetes to type 2 diabetes.

In May 2023, researchers reported that Wegovy helped reduce obesity in half of teens in a 68-week clinical trial.

In addition, Ozempic has been shown to lower the risk of death from kidney disease as well as reduce the risk of certain cancers.

Some research has indicated that medications containing trizepatide might be more effective for weight loss than those containing semaglutide.

Takeaway

Eli Lilly announced that single-dose vials of the weight-loss drug Zepbound will be sold at a discount price of 50% or more.

Consumers who pay for medications out of pocket without insurance must purchase these products through the LillyDirect program and must also have a valid prescription from their healthcare provider.

Experts say the new program is a step forward for making weight loss drugs more accessible and affordable.