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Why Am I So Tired? 10 Possible Causes of Fatigue
When it's time to see a doctor about your exhaustion -- and what to try first.

Do you feel tired all the time? Lots of people do. It's a sign of our overbooked times.

You may wonder if you're doing too much. But surprise! The most likely answer is just the opposite: You're not doing enough.

3 Changes to Make Now

There are three key lifestyle changes that can make a big difference in your energy level -- starting now:

1. What you eat. Reaching for caffeine and sugar can backfire, leaving you more fatigued as your blood sugar levels fluctuate wildly. Instead, go for a balanced, healthy diet replete with fruits, vegetables, and lean protein. "Most people feel like they're less tired if they eat a healthy diet," says J. Fred Ralston Jr., MD, past president of the American College of Physicians. "Eating healthy also means you'll carry less weight, and obesity is a big contributor to fatigue.

2. How much you sleep. You saw this one coming, right? Many people don't get enough sleep. If you're one of them, avoid caffeine and alcohol in the hours just before bedtime, turn off the TV before bed, and keep your bedroom quiet and restful.

3. How much you exercise. This is the biggie, Ralston says. His favorite prescription for plain old tiredness is regular, vigorous exercise. Finish at least three hours before bedtime, so you have time to wind down.

If you think that exercise would just make you more tired, there's good news: Exercise breeds energy. Almost all the studies that have looked at this question have found the same thing: Sedentary people who start exercising feel much less fatigue than those who stay idle. It's one of those surprising truths: move more and you'll get more energy.

Ralston recommends getting 40 minutes of exercise at least four days a week, to get you going.

Do that, and a month from now, you should notice some improvement. Keep with it for three to six months more, and you should feel much better.

If you follow your exercise prescription for at least a month -- and you're also making enough time for sleep -- and you're still feeling lousy, look into other causes, Ralston advises.

Could It Be Something Else?

The most common reasons for feeling so tired all the time are those we've just discussed. Don't start thinking that you've got a medical condition until you've tried those strategies and really given them a chance.

If you still feel exhausted, you'll need to check with your health care provider to look into it. Chronic tiredness is linked to many different medical conditions, such as:

Anemia. "This is a very common cause of fatigue and very easy to check with a simple blood test," says Sandra Fryhofer, MD, an Emory University clinical associate professor of medicine. "It's particularly a problem for women, especially those who are having heavy menstrual periods." You can remedy anemia with an iron-rich diet, heavy in meats and dark, leafy greens, or supplements if you have a chronic iron deficiency.

Deficiencies in key nutrients, such as potassium. Again, this is easily checked with blood testing.

Thyroid problems. Over- and under-active thyroids both can cause fatigue, Fryhofer says. A blood test for your level of thyroid-stimulating hormone can help evaluate your thyroid function.

Diabetes. People who have uncontrolled diabetes "just plain don't feel good," Fryhofer says. "If you feel draggy and you're also having blurred vision or lots of urination, you should get that checked with a blood test."

Depression. If your feelings of exhaustion are accompanied by sadness and loss of appetite, and you just can't find any pleasure in things you once enjoyed, you may be depressed. Don't keep that to yourself. Your doctor, or a therapist, can start you on the path back to feeling better.

9. Sleep problems. If you never feel rested, and nothing seems to fix that, you might look into visiting a sleep lab, especially if you snore. Snoring can be part of obstructive sleep apnea, in which people briefly stop breathing several times a night. There are treatments for that.

10. Undiagnosed heart disease. Tiredness can be a sign of heart trouble, particularly in women, Ralston says. "If you have trouble with exercise you used to do easily, or if you start feeling worse when you exercise, this could be a red flag for heart trouble. If you have any doubts, see your doctor."

But again, start with the basics: your sleep, your diet, and your activity level. Sometimes the simplest fixes are all it takes.


Muscle Spasms, Cramps, and Charley Horse

You could be out for a run or drifting off to sleep when it happens: The muscles of your calf or foot suddenly become hard, tight, and extremely painful. You are having a muscle cramp.

Sometimes called charley horses -- particularly when they are in the calf muscles - - cramps are caused by muscle spasms, involuntary contractions of one or more muscles. In addition to the foot and calf muscles, other muscles prone to spasms include the front and back of the thigh, the hands, arms, abdomen, and muscles along the rib cage.

Almost everyone experiences muscle cramps, which come without warning. What causes them, and what can you do to relieve them?

Possible Causes of Muscle Cramps

Muscle cramps can have many possible causes. They include:
Poor blood circulation in the legs
Overexertion of the calf muscles while exercising
Insufficient stretching before exercise
Exercising in the heat
Muscle fatigue
Dehydration
Magnesium and/or potassium deficiency
Calcium deficiency in pregnant women
Malfunctioning nerves, which could be caused by a problem such as a spinal cord injury or pinched nerve in the neck or back

Muscle cramps can also occur as a side effect of some drugs. Medications that can cause muscle cramps include:
Lasix (furosemide), Microzide (hydrochlorothiazide), and other diuretics ("water pills") used to remove fluid from the body Aricept (donepezil), used to treat Alzheimer's disease Prostigmine (neostigmine), used for myasthenia gravis Procardia (nifedipine), a treatment for angina and high blood pressure Evista (raloxifene), an osteoporosis treatment Brethine (terbutaline), Proventil and Ventolin (albuterol), asthma medications Tasmar (tolcapone), a medication used to treat Parkinson's disease Statin medications for cholesterol such as Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), or Zocor (simvastatin).

Treatment of a Muscle Spasm

When muscle cramps occur, there are several things you can do to help ease them, such as massaging, stretching, or icing the muscle, warming the muscle, or taking a bath with Epsom salt.

For a charley horse in the calf or a cramp in the back of the thigh (hamstring), try putting your weight on the affected leg and bending your knee slightly, or sit or lie down with your leg out straight and pull the top of your foot toward your head. For a cramp in the front of the thigh (quadriceps), hold onto a chair to steady yourself and pull your foot back toward your buttock.

To help reduce the risk of cramps in the future, try the following:
Eat more foods high in vitamins and calcium.
Stay well hydrated.
Stretch properly before exercise.

In most cases, self-care measures are sufficient for dealing with muscle cramps, which typically go away within minutes. But if you experience them frequently or for no apparent reason, you should speak to your doctor. They could signal a medical problem that requires treatment.


Lessons in self-care for healthy holiday season

Everyone experiences symptoms of depression or anxiety at some point. Whether it be the holidays, job or family stress, loss, or a huge life change, most of us have struggled at one time or another.

For the mentally ill, struggling can be a fact of life. Finding the right balance of medication and treatment can be a daunting task, and more may be required than meds and therapy. Learning self-care can ease these symptoms and prevent unpleasant episodes from happening.

Taking time and doing things to manage your mental health is not selfish. It can be one of the most important things you do for yourself. Here are some ideas to help keep you mentally healthy or help you manage your or a loved ones mental illness during the holidays:

1. Taking medications: Whether they are for high blood pressure or bipolar disorder, taking your medications at the same time every day is important. Build medications into your daily schedule so you are less likely to forget.

2. Healthy diet: Eating too much or not enough can contribute to not feeling well and can even affect your mood. Always eat three meals a day. Eat even when your schedule is busy. Your body needs protein to heal itself and depriving it can have adverse effects. Research the right diet for your diagnosis.

3. Limit stimulants: Caffeine can amplify negative symptoms and make you feel worse than you really do. This makes it difficult to judge how well youre really doing.

4. Self-awareness: Know when you are upset, stressed, ill, resentful, etc. Be in touch with your own emotions and know what to do about how you feel.

5. Know your triggers: Be aware of things that trigger symptoms. Do what is necessary to avoid them or be prepared to deal with symptoms if you cant avoid them. Be aware of what soothes you and what doesnt.

6. Journaling: Keeping a journal can help keep you aware of how you feel and can help release pent-up emotions. It can also help track symptoms and their severity. This can give you a place to look back and see how you felt before significant events.

7. Keep appointments with your doctor: Keeping appointments keeps your wellness on your mind. It can also help detect when you are headed in a negative direction. Be honest about any symptoms you are experiencing.

8. Information, information: Educate yourself about your diagnosis. The more you know, the better you will be able to take care of yourself and ward off setbacks.

9. Sleep: The right amount of sleep can go a long way toward wellness. Too little or too much sleep can worsen symptoms and contribute to depression. Adjust your sleep schedule to whatever makes you feel your best.

10. Privacy: Everyone has a need for privacy. When you need time alone, ask that others respect that and dont allow others to intrude on it. (This is different from avoiding people; know the difference, whether you need privacy or are hiding and avoiding something.) Your mental health is important; dont allow others to intrude on it.

11. Be honest with yourself: Dont allow yourself to slip back into denial. Dont fall into just this once scenarios. If you know something isnt good for you, dont do it.

12. Place your own needs first when necessary: It is not selfish. Your needs are just as important as anyone elses.

13. Say no when necessary: Piling too many things on your schedule can stress you out and can lead to setbacks. Understand your recovery/wellness is very important. Sometimes taking care of yourself means disappointing others. Its OK to say no. It doesnt mean youre being selfish. It just means you need to do something else right now. Your wellness is more important than pleasing everyone else.

14. Healthy self-esteem: Self- esteem means loving yourself unconditionally. Remember you are worthy of love just because youre breathing. Having a mental illness or struggling does not make you unlovable. Love yourself no matter what.

15. Learn how to self-soothe: Create activities that help make you feel better when you are upset. Dont always depend on others to calm you down. Talk when necessary, but have other ways to calm yourself that you can do by yourself.

16. Ask for help when you need it: You dont have to carry every burden alone. Ask for help instead of doing everything yourself. Dont settle for no as an answer. Keep looking until you find the help you need.

17. Know your limits: Recognize when youre pushing yourself too hard. If something starts to stress you out or begins to trigger you, stop or walk away if you can. Book me time into your schedule.

18. De-brief: Talk to someone about a particularly stressful event or how your day went. Get in touch with how it made you feel. Journal about it.

19. Avoid harsh language with yourself: Listen to the messages you send yourself. Dont call yourself names or be demeaning with yourself. Everything doesnt have to be perfect. Stop yourself in the middle of a negative message and reframe the way you say it in a positive manner.

20. Change your surroundings: Surround yourself with things that calm you. Have a space that is just for you. It can be an entire room or a favorite chair.

21. Pace yourself: Realize that recovery is a slow process. It takes a whole lot of knowledge to get where you need to be. It takes time to learn all that you/your loved one will need to know. Dont rush it. There will be setbacks. Dont punish yourself for them. Pushing too hard can cause stress and trigger setbacks.

22. Surround yourself with positivity: Get rid of negative relationships. Surround yourself with people who get and encourage you.

23. Think outside the box: Dont try to fit yourself or your loved one into the way things should be or used to be. Doing so will keep you grieving for something you cannot have. Accept that you, your loved one or the circumstances are different and learn to work within them.

24. Organize: Plan ahead. Lay out your clothes the night before. Finish tasks completely. Dont surround yourself with unfinished tasks. Doing so will affect your state of mind.

25. De-clutter your surroundings: Sleeping in a messy room can affect your sleep as well as give you a messy place for private time. Small things can affect wellness the same as large ones.

26. Pick your battles: Ask yourself Is this really important? If it isnt then let it go.

27. De-stress: Find activities that demand all your attention. Break your tunnel-vision about an issue.

28. Mindfulness: Concentrate on a particular item to clear your mind of troubling thoughts. Become aware of only that item. What does it look like? What kind of texture does it have? Are there any imperfections? How does it feel? Become aware of your impressions of the item.

29. Play: Add an activity that is fun for you, even child-like. Watch cartoons, color in a coloring book, work a puzzle, dance, sing, play a video game, tell yourself a funny story, play with a stuffed animal. Legos work well. Its hard not to have a smile on your face when youre building a Lego house.

For more information on mental illness and wellness go to www.nami.org.


Should Blood Pressure Be Taken in Both Arms?
Differences in Blood Pressure Between Arms May Signal Blood Vessel Problems

Differences in blood pressure readings taken from the left and right arms may be a sign of heart and blood vessel disease and death risk, according to a new review of recent research.

Researchers found that a difference of 15 points or more in the readings between the left and right arms raised the risk of peripheral vascular disease, a narrowing or blockage of the arteries, by two-and-a-half times.

That same 15 point-difference in systolic readings (the top number in a blood pressure reading) also increased the risk of cerebrovascular disease by 60%. Cerebrovascular disease is associated with thinking problems, such as dementia, and an increased risk of stroke.

Researchers say the results suggest that doctors should routinely compare blood pressure readings from both arms to prevent unnecessary deaths.

Although the practice of taking blood pressure from both arms as a part of heart disease screening has been adopted in Europe, and some guidelines in the U.S. recommend it, American Heart Association spokesman Richard Stein, MD, says its not routinely done in the U.S.


Aspirin and Your Heart

Aspirin can help prevent a second heart attack or second stroke. And it may even help some people prevent heart attacks and strokes from happening in the first place. But it's important to talk with your doctor before you start taking aspirin regularly.

If you have a headache, toothache or other everyday pain, aspirin can be a good, occasional friend. If youve had a heart attack or a common type of stroke, aspirin may become a trusted, constant companionmaybe even a lifesaver.

Thats because aspirin can do more than control minor aches and pains. Taken correctly, it may also protect the heart and blood vessels.

Who aspirin can help

Researchers have found that aspirin helps prevent a second heart attack, a second stroke and serious recurrent angina, according to the American Heart Association (AHA). As a result, people with a history of these conditions may be advised to take aspirin regularly.

According to the U.S. Food and Drug Administration (FDA), aspirin can also be used after coronary bypass surgery or angioplasty to help prevent complications.

If youve had a stroke caused by a blood clot, a heart attack, bypass surgeryanything involving coronary arteries, you need to take a [low-dose] aspirin, says Gerald Fletcher, MD, spokesman for the AHA.

However, while the science is clear about the value of aspirin in preventing second heart attacks and strokes, more research needs to be done on aspirin's role for people who haven't had a cardiovascular event.

Still, some studies also indicate that aspirin may help people at high risk avoid their first stroke or heart attack. This may include people with high cholesterol, high blood pressure, or a family history of heart attack or stroke, Dr. Fletcher says.

How aspirin works

Aspirin is an antiplatelet drug, meaning it works on platelets, disk-shaped cells in the blood that clump together to help form blood clots.

Blood clots, of course, are essential to repairing cuts. But clots can also cause problems.

For example, when blood vessels are damaged by smoking, cholesterol or high blood pressure, a substance called plaque can build up. When plaque breaks free, platelets respond. That can lead to the formation of a blood clot inside the vessel.

A clot can prevent blood from flowing to the heart muscle, causing a heart attack. If a clot blocks blood flow to the brain, it causes a stroke.

But an antiplatelet drug such as aspirin can help keep blood vessels clear by limiting platelets clumping ability.

The right dose

When aspirin is taken to prevent blood vessel problems, the dosage is usually 81 milligrams a day. By comparison, pills for occasional pain relief contain 325 milligrams of aspirin.

Eighty-one milligrams will usually do it, Dr. Fletcher says. Some people think twice that dosage is better, but its fairly routine to take a [low-dose] aspirin.

Such a small dose of such a common medicine may lead some people to think they can start taking daily low-dose aspirin on their own. But experts say otherwise.

Its important to talk to your doctor first, Dr. Fletcher says, because even well-known medications like aspirin can cause problems for some people.

According to the FDA, the same antiplatelet properties that help aspirin prevent heart attacks and strokes can also lead to unwanted side effects such as stomach bleeding, kidney failure and bleeding in the brain.

In addition, aspirin may cause problems when taken with other medications, including blood thinners.

Before taking a daily aspirin, tell your doctor about all the prescription and over-the-counter medications and supplements youre taking.

Despite its potential risks, aspirin is an important treatment for many people, especially those hoping to prevent a second cardiovascular event.

This is a very simple medication, available over the counter and with very few side effects, Dr. Fletcher says.

Just check with your doctor before using it, he says.


Use of These Meds Tied to Higher Odds for Dementia

Class of drugs interferes with a key brain chemical, but study can't prove cause- and-effect

WebMD News from HealthDay

MONDAY, Jan. 26, 2015 (HealthDay News) -- Long-term and/or high-dose use of a class of medications used for hay fever, depression and other ills has been linked in a new study to a higher risk of dementia.

The drugs -- called anticholinergics -- include nonprescription diphenhydramine (Benadryl) and tricyclic antidepressants like doxepin (Sinequan). This class of medications also includes older antihistamines like chlorpheniramine (Chlor- Trimeton) and "antimuscarinic" drugs for bladder control, such as oxybutynin (Ditropan).

However, the study could only point to an association between long-term or high- dose use of these drugs and a higher risk of dementia, it could not prove cause-and- effect.

Also, the relationship "did not occur at the lowest dosage range but did occur at higher dosages used long- term," said one expert, Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City. He was not involved in the new study.

Manevitz also stressed that consumers "should not abruptly stop any current medication treatment but rather should first consult with their physician."

The new study was led by Shelly Gray of the Group Health Research Institute- University of Washington. Her team explained that the anticholinergic class of medications work by blocking a neurochemical called acetylcholine, in both the brain and body.

Manevitz noted that people "suffering from Alzheimer's disease typically show a marked shortage of acetylcholine."

The new study tracked outcomes for more than 3,500 seniors who were followed for more than seven years. Gray's group found that people who took at least 10 milligrams per day of Sinequan, 4 mg per day of Benadryl, or 5 mg per day of Ditropan for more than three years were at greater risk for developing dementia.

Manevitz noted that occasional use of these medications did not seem to be tied to a rise in dementia risk. "The risk of dementia was due to a cumulative total of exposure, not to an acute short course of treatment," he said.

And, Gray said in an institute news release, "Older adults should be aware that many medications -- including some available without a prescription, such as over- the-counter sleep aids -- have strong anticholinergic effects. And they should tell their health care providers about all their over-the- counter [drug] use," she added.

However, "no one should stop taking any therapy without consulting their health care provider," said Gray, director of the geriatric pharmacy program at the University of Washington's School of Pharmacy.

Instead, "health care providers should regularly review their older patients' drug regimens -- including over-the-counter medications -- to look for chances to use fewer anticholinergic medications at lower doses," she advised.

The study, published Jan. 26 in JAMA Internal Medicine, is the first to link higher use of anticholinergic medications to increased risk of dementia, the researchers said. It is also the first to suggest that the dementia risk associated with these drugs may not be reversible even years after people stop taking them.

Manevitz called the new study "well designed," and said the reversibility issue is a troubling one.

"The general view has been that mild cognitive impairment is reversible in discontinuation of anticholinergic medication therapy," he said, but this study seems to find otherwise.

According to Manevitz, "we need to educate patients and their families about over-the- counter medicines and alternative therapies. Also, elderly people in nursing homes tend to have a long list of medicines that need to be reviewed periodically for need to continue, interactions and redundancy."

He believes doctors should think about substitutes for anticholinergics when possible, prescribe the lowest dose possible, and stop the medication as soon as is medically advisable.

Gray offered similar advice. "If providers need to prescribe a medication with anticholinergic effects because it is the best therapy for their patient, they should use the lowest effective dose, monitor the therapy regularly to ensure it's working, and stop the therapy if it's ineffective," she suggested.

She said that substitutes are available for some anticholinergic drugs, including a selective serotonin re-uptake inhibitor (SSRI) antidepressant like citalopram (Celexa) or fluoxitene (Prozac) for depression, or a second- generation antihistamine such as loratadine (Claritin) for allergy relief.


Mental Health Center
Food Addiction

The idea that a person can be addicted to food has recently gotten more support from science.

Experiments in animals and humans show that, for some people, the same reward and pleasure centers of the brain that are triggered by addictive drugs like cocaine and heroin are also activated by food, especially highly palatable foods. Highly palatable foods are foods rich in:
Sugar
Fat
Salt
Like addictive drugs, highly palatable foods trigger feel- good brain chemicals such as dopamine. Once people experience pleasure associated with increased dopamine transmission in the brain's reward pathway from eating certain foods, they quickly feel the need to eat again.

The reward signals from highly palatable foods may override other signals of fullness and satisfaction. As a result, people keep eating, even when they're not hungry.

People who show signs of food addiction may also develop a tolerance to food. They eat more and more, only to find that food satisfies them less and less.

Scientists believe that food addiction may play an important role in obesity. But normal-weight people may also struggle with food addiction. Their bodies may simply be genetically programmed to better handle the extra calories they take in. Or they may increase their physical activity to compensate for overeating.

People who are addicted to food will continue to eat despite negative consequences, such as weight gain or damaged relationships. And like people who are addicted to drugs or gambling, people who are addicted to food will have trouble stopping their behavior, even if they want to or have tried many times to cut back.

Signs of Food Addiction

Researchers at Yale University's Rudd Center for Food Science & Policy have developed a questionnaire to identify people with food addictions.

Here's a sample of questions that can help determine if you have a food addiction. Do these actions apply to you? Do you:
End up eating more than planned when you start eating certain foods Keep eating certain foods even if you're no longer hungry Eat to the point of feeling ill Worry about not eating certain types of foods or worry about cutting down on certain types of foods When certain foods aren't available, go out of your way to obtain them

The questionnaire also asks about the impact of your relationship with food on your personal life. Do these situations apply to you: You eat certain foods so often or in such large amounts that you start eating food instead of working, spending time with the family, or doing recreational activities.
You avoid professional or social situations where certain foods are available because of fear of overeating. You have problems functioning effectively at your job or school because of food and eating.

The questionnaire asks about withdrawal symptoms. For example, when you cut down on certain foods (excluding caffeinated beverages), do you have symptoms such as:
Anxiety
Agitation
Other physical symptoms

The questionnaire also tries to gauge the impact of food decisions on your emotions. Do these situations apply to you?
Eating food causes problems such as depression, anxiety, self-loathing, or guilt. You need to eat more and more food to reduce negative emotions or increase pleasure. Eating the same amount of food doesn't reduce negative emotions or increase pleasure the way it used to.

Science is still working to understand and find treatments for food addiction.

Some argue that recovery from food addiction may be more complicated than recovery from other kinds of addictions. Alcoholics, for example, can ultimately abstain from drinking alcohol. But people who are addicted to food still need to eat.

A nutritionist, psychologist, or doctor who is educated about food addiction may be able to help you break the cycle of compulsive eating.

There are also a growing number of programs that help people who are addicted to food. Some, like Food Addicts in Recovery Anonymous, are based on the 12-step program that has helped many people addicted to alcohol, drugs, or gambling.

Others, like Food Addicts Anonymous, use the principles of the 12-step program along with strict diets that require people to abstain from problem ingredients, like sugar, refined flour, and wheat.


What Is Restless Legs Syndrome?

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that affects the legs and causes an urge to move them. Because it usually interferes with sleep, it also is considered a sleep disorder.

Symptoms of Restless Legs Syndrome

People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The sensations are difficult to describe: they are an uncomfortable, "itchy," "pins and needles," or "creepy crawly" feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting. The sensations can lead to sleep deprivation and stress.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night and less severe in the morning. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair a person's quality of life.

Who Gets Restless Legs Syndrome?

Restless legs syndrome may affect up to 10% of the U.S. population. It affects both sexes but is more common in women and may begin at any age, even in young children. Most people who are affected severely are middle-aged or older.

RLS is often unrecognized or misdiagnosed. In many people it is not diagnosed until 10 to 20 years after symptoms begin. Once correctly diagnosed, RLS can often be treated successfully.

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless leg syndrome; however, they suspect that genes play a role. About half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinsons disease, kidney failure, diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from restless legs symptoms.

Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing antihistamines may worsen symptoms.

Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Diagnosis of Restless Legs Syndrome

There is no medical test to diagnose restless legs syndrome; however, doctors may use blood tests and other exams to rule out other conditions. The diagnosis of restless legs syndrome is based on a patients symptoms and answers to questions concerning family history of similar symptoms, medication use, the presence of other symptoms or medical conditions, or problems with daytime sleepiness.

Treatment for Restless Legs Syndrome

Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS- associated condition also provides relief of symptoms.

Other non-drug restless legs treatments may include:
Leg massages
Hot baths or heating pads or ice packs applied to the legs Good sleep habits

Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:
Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Pramipexole (Mirapex), rotigotine (Neupro), and ropinirole (Requip) are FDA approved for treatment of moderate to severe RLS. Others, such as levodopa (Larodopa, Dopar) and pergolide (Permax) may also be prescribed. Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain. Anticonvulsants, or antiseizure drugs, such as carbamazepine (Tegretol) and gabapentin (Neurontin, Horizant).

Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.


Are You Making Your Cold Worse?

A lot of what we believe about the common cold is myth. No, you won't get a cold because you went outside with a wet head or slept in a drafty room. But here's what is true. When you're sick, some common mistakes can make your cold symptoms worse -- or prevent you from getting better.

If you're feeling crummy and stuffed up, here are 7 things that could make your cold worse.

1.Pretending you're not sick. This never works. You can't ignore a cold. When you get sick, you need to take care of yourself. Your body needs extra energy when it's fighting an infection. If you try to push through a cold, especially if you have a fever, you'll exhaust yourself. That could make your cold worse.

2.Not sleeping enough. Getting enough sleep is key for a healthy immune system. One study found that sleeping less than 7 hours a night almost triples your risk of getting a cold in the first place. If your cold symptoms keep you up at night, try to go to bed earlier or take naps during the day. You need extra rest, however you get it.

3.Getting stressed. It turns out that stress -- particularly chronic stress - - can make colds worse. It can also make you more likely to get a cold. Over time, high levels of stress hormones can stop your immune system from working normally. The result? More sick days and a cold that lingers. So take it easy when you're sick. You'll lower your stress levels and recover faster.

4.Drinking too little. You need to drink a lot of fluid when you're sick. Why? Fluids will help thin your mucus, making your sinuses drain better. Just about any fluid will help. Water, juice, hot tea, and soup are all good. Contrary to what you've heard, even milk is OK -- the notion that it causes mucus build-up is a myth.

5.Drinking too much (alcohol.) Too much alcohol can leave you dehydrated and worsen cold symptoms such as congestion. It can also suppress your immune system and -- potentially -- interact with cold medications you're taking. Until you're feeling better, it's best to lay off the booze.

6.Overusing decongestant sprays. Be careful with decongestant sprays. They may work well at first. But if you use them for more than three days, your stuffy nose will get worse when you stop.

7.Smoking. Smokers get more colds than nonsmokers. They also get worse colds that last longer. Smoking damages cells in the lungs, making it harder for you to fight off a cold. If you're sick with a cold, don't smoke -- and don't let anyone around you smoke either.


Is Your Vacuum Cleaner Making Allergies Worse?

You vacuum to clean your house and get rid of dust, dirt, and pet dander that trigger your allergies. Sometimes, though, vacuuming might make your allergies worse.

Every time you walk across rugs or carpet, you stir up those allergens and send them into the air. When you vacuum, you could be doing the same thing.

One study found that some vacuum cleaners throw fine dust and germs back into the air, where they can trigger allergies and spread infections.

But dont stop vacuuming forever! Most good vacuums suck up more dust, dirt, and allergens than they spit out.

The vacuums that seem to cause the most problems are older, cheaper models. Newer ones that cost more generally do a better job of containing allergens. If your vacuum cleaner is aging and dirty, its time for a new one.

Some experts say you should get a vacuum cleaner with a high-efficiency HEPA filter. Others say the best vacuums are central units. With these, the motor and filter are outside your house, so dust and dirt are filtered away. One drawback is the cost -- central vacuums are more expensive because you have the installation cost.

Other ways to keep the air clean in your home: Wash throw rugs every week in hot water to kill dust mites and other allergens. Use a microfiber or electrostatic cloth for dusting. They don't stir up dust or allergens. Replace carpeting, if you can, with tile or hardwood floors.


More Women than Men Have a Stroke

Approximately 55,000 more women than men have a stroke each year. Women are twice as likely to die from stroke than breast cancer annually. African Americans have almost twice the risk of first-ever stroke.

Two million brain cells die every minute during stroke, increasing risk of permanent brain damage, disability or death.

Recognizing symptoms and acting FAST to get medical attention can save a life and limit disabilities.

Memorize these signs of stroke:

 F = FACE Ask the person to smile. Does one side of the face droop?

 A = ARMS Ask the person to raise both arms. Does one arm drift downward?

 S = SPEECH Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?

 T = TIME If you observe any of these signs (independently or together), call 9-1-1immediately.


15 Cancer Symptoms Women Ignore

Women tend to be more vigilant than men about getting recommended health checkups and cancer screenings, according to studies and experts.

They're generally more willing, as well, to get potentially worrisome symptoms checked out, says Mary Daly, MD, oncologist and head of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia.

But not always. Younger women, for instance, tend to ignore symptoms that could point to cancer. "They have this notion that cancer is a problem of older people," Daly tells WebMD. And they're often right, but plenty of young people get cancer, too.

Of course, some women are as skilled as men are at switching to denial mode. "There are people who deliberately ignore their cancer symptoms," says Hannah Linden, MD, a medical oncologist. She is a joint associate member of the Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington School of Medicine, Seattle. It's usually denial, but not always, she says. "For some, there is a cultural belief that cancer is incurable, so why go there."

Talking about worrisome symptoms shouldn't make people overreact, says Ranit Mishori, MD, an assistant professor of family medicine at the Georgetown University School of Medicine in Washington, D.C. "I don't want to give people the impression they should look for every little thing," she says.

With that healthy balance between denial and hypochondria in mind, WebMD asked experts to talk about the symptoms that may not immediately make a woman worry about cancer, but that should be checked out. Read on for 15 possible cancer symptoms women often ignore.

What Is Your Cancer Risk? Take the WebMD Cancer Health Check

No. 1: Unexplained Weight Loss

Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.

"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.

Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.

No. 2: Bloating

Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.

If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.

No. 3: Breast Changes

Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.

Likewise, if the look of a nipple changes, or if you notice discharge (and arent breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.

If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.

No. 4: Between-Period Bleeding or Other Unusual Bleeding

'Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.

Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."

"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three- quarters who get it have some abnormal bleeding as an early sign."

Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.

No. 5: Skin Changes

Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.

If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.

No. 6: Difficulty Swallowing

If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.

But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.

Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.

No. 7: Blood in the Wrong Place

If you notice blood in your urine or your stool, dont assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."

Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.

Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.

Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.

No. 8: Gnawing Abdominal Pain and Depression

Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.

No. 9: Indigestion

Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.

It could be an early clue to cancer of the esophagus, stomach, or throat.

Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.

No. 10: Mouth Changes

Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.

Ask your dentist or doctor to take a look and decide what should be done next.

No. 11: Pain

As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.

Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.

No. 12: Changes in the Lymph Nodes

If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.

"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.If there are none, your doctor will typically order a biopsy.

No. 13: Fever

If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.

Other cancer symptoms can include jaundice, or a change in the color of your stool.

Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.

No. 14: Fatigue

Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.

No. 15: Persistent Cough

Coughs are expected with colds, the flu, allergies, and sometimes are a side effect of medications. But a very prolonged cough -- defined as lasting more than three or four weeks -- should not be ignored, Mishori says.

You would expect your doctor to take a careful history, examine your throat, check out your lung functioning and perhaps order X-rays, especially if you are a smoker.


100 Things to Make Your Home Safer

Safety doesn't take a lot of time, but it does take thought and planning. Not sure how to Commit a Minute to Safety? Pick one, 10 or 100 of the things below and get started today. You'll see that sometimes it just takes a minute to avoid what could be a lifetime of regret.

1.Test each smoke alarm in your home

2.Replace the batteries in each smoke alarm

3.Count how many smoke alarms you have in your house. If you do not have one on every level and near sleeping areas, purchase additional smoke alarms

4.Designate an outside meeting place for your family (for example: the mailbox) in case of a fire or emergency

5.Blow out candles before leaving the room or going to sleep

6.Use a sturdy candle holder or hurricane lamp

7.Turn down your hot water heater to 120 degrees or less to prevent burns

8.Roll up your sleeves before you start cooking

9.Have oven mitts nearby when cooking

10.Turn pot handles toward the back of the stove

11.Store all matches and lighters out of reach of children

12.Put hot food and drinks near the center of the table only

13.Put down your hot drink when carrying your baby

14.Test hot water with an elbow before allowing a child to touch

15.Post your fire escape plan on your refrigerator

16.Put water on cigarette butts before throwing them away

17.Unplug small appliances such as hair dryers and toasters after using them

18.Use flameless candles

19.Move anything that can burn, such as dish towels, at least three feet away from the stove

20.Practice Stop, Drop and Roll with your kids

21.Schedule an appointment to have your furnace cleaned and inspected

22.Look for the UL Mark when you buy appliances

23.Tell kids to stay away from the stove/oven

24.Turn space heaters off before going to bed

25.Remove any gasoline from your home

26.Put non-slip strips in your tub and shower

27.Install night lights in the hallway

28.Put a flashlight in each bedroom

29.Wipe up spills as soon as they happen to prevent slips and falls

30.Use a sturdy Christmas tree stand

31.Water your Christmas tree every day

32.Keep your Christmas tree at least three feet away from any heat source

33.Inspect your Christmas lights for signs of damage

34.Flip over large buckets so water cannot accumulate and become a drowning danger

35.Store cleaners and other poisons away from food

36.Post the Poison Control hotline number (1-800-222- 1222) next to your phone

37.If you have young children, use cabinet locks on cabinets that have poisons such as antifreeze, cleaners, detergents, etc.

38.Keep medicine in its original containers

39.Purchase a carbon monoxide detector for your home

40.Test your carbon monoxide (CO) alarm

41.Put your infant to sleep on his/her back

42.Remove any soft bedding, stuffed animals and pillows from your infant's crib

43.Cut your toddler's food into small bites

44.Use safety straps on high chairs and changing tables

45.Check www.recalls.gov to see if any items in your home (including cribs) have been recalled

46.Move cribs away from windows

47.Use safety covers on unused electrical outlets

48.Test small toys for choking hazards - if it fits in a toilet paper roll, it's too small

49.Remove all plastic bags from the nursery

50.Pick up any small items, such as coins or buttons, that can be choking hazards for infants and toddlers

51.Write down emergency contact information for your family and make sure everyone has these numbers

52.If young children live in or visit your home, move furniture away from windows so they don't climb up to look out and accidentally fall

53.Tie window cords out of a child's reach

54.Check your child's bath water temperature (use your wrist or elbow) to make sure it is not too hot

55.Remove drawstrings from your baby's clothing

56.Keep the toilet lid shut to prevent little fingers from getting slammed by a falling lid

57.If you have toddlers, install a toilet seat lock

58.If you have young children, install door knob covers on bathroom doors

59.Use a fireplace screen

60.Put toys away after playing

61.Don't refer to medicine or vitamins as candy

62.Put on safety glasses before any DIY project

63.Put tools away after your DIY project is complete

64.Post emergency numbers near your phone

65.Pick up one new thing for your family's emergency preparedness kit

66.Use a ladder, not a chair, when climbing to reach something

67.Use plastic instead of glass near the pool

68.Cover any spa or hot tub when it is not in use

69.Purchase a first aid kit

70.Drain the bath tub immediately after bathing

71.Remove clutter from the stairs

72.Use the handrail when you are walking up or down the stairs

73.If the power goes out, use flashlights instead of candles

74.Ask smokers to smoke outside

75.Wear proper shoes when climbing a ladder

76.Check your home for too many plugs in one socket and fix the problem

77.Install baby gates at the top and bottom of stairs if you have young children

78.Never leave food cooking unattended

79.Make sure pools or spas are properly fenced to keep out small children

80.Teach kids to tell you when they see matches or lighters

81.Turn out the lights when you leave the room

82.Unplug appliances that aren't in use (especially in the kitchen)

83.Take your hair dryer off of the bathroom counter and store it safely

84.Check your electronics for the UL Mark

85.Identify two exits from every room with your kids in case of fire

86.Check your holiday decorations - keep breakable decorations out of reach of young children

87.Replace an old light bulb with a new energy-efficient option

88.Check the walls for loose paint chips and re-paint with low-VOC or VOC-free paint

89.Check all the outlets in your home for overloaded sockets or extension cords 90.Remove any extension cords that are pulled under rugs or tacked up

91.Place fire extinguishers in key areas of your home

92.Place an escape ladder in an upstairs room that might not have an easy exit

93.Remove any painted furniture that is pre-1978 to avoid possible lead exposure

94.Lock medications safely in a cabinet

95.Consider low-flow toilets

96.Check that all major appliances are grounded and test your GFCIs

97.Clean the lint trap and hose on your dryer

98.Check your swing set for sharp edges or dangerous S- hooks

99.Take a tour of your home from your childs perspective looking for hazards

100.Hold a family fire drill


Understanding And Coping With Painkiller Addiction

Once some people start taking painkillers to alleviate feelings of pain or discomfort, it can be hard for them to stop. Unfortunately, that feeling of dependency can become an addiction, which can cause serious harm and consequences to a persons life and health. Overcoming the addiction is difficult and is a process that many struggle with or dont feel they can attempt. However, breaking the habit is possible with the right treatment.

What Causes Painkiller Addiction?

Becoming addicted to pain medication is serious because the addiction cannot be broken without going through a severe withdrawal. This withdrawal can be terrible for some people because their brain has become dependent on the drug. The following is the physical process of addiction as outlined by Spine-Health.com:

1.Nerve cells start to function abnormally due to the brains increased production of receptors for the painkiller.

2.Endorphins, which are the bodys natural painkillers, stop being produced because the body is now receiving the drugs instead.

3.Because the nerve cells have ceased to function correctly, the brain is now dependent on the painkillers instead.

Aside from the physical aspect, other factors contribute to the addiction of painkillers as well. Genetics may play a part in the addiction along with lifestyle. If a person is raised in an environment where drug usage is acceptable or surrounds themselves with people who encourage drug use, then an addiction could very well develop in that person.

Symptoms Of Painkiller Addiction

When people become addicted to painkillers, they may deny it or try to hide it from others. However, a close examination of their actions will probably give them away. These are the symptoms of an addiction to painkillers:

Using the drug more than needed: If the person is taking an unusually high dose of the drug, or is taking it daily or even several times a day, this is the first sign that he or she is addicted.

Keeping a well-stocked supply: People with addictions will be sure to have an ample supply of the drug on hand.

Spending excessive amounts of money on the drug: Some people with addictions will even go so far as to spend money they dont have on the drug. They may forego other necessary expenses or even steal just so they can afford to feed their addiction.

Failed attempts at quitting: If the person cannot stop using the drug or feels that the drug is needed in order to deal with lifes problems, then that person is definitely addicted.

Treatment Options

Going through a withdrawal can be extremely uncomfortable, and even painful, especially for those who have been addicted to painkillers for a long time. Many people quit detox or dont even start for fear of the unsettling experience of withdrawal symptoms, which include intense cravings, twitching, tremors, vomiting, and severe aches and pains once off the painkillers. The ideal detox process should be:

Done as briefly as possible

Done through a safe method with as few symptoms as possible

Completed with the encouragement and understanding of supportive friends and family

Because detox is a serious and somewhat complicated process, those suffering form painkiller addiction should not attempt to detox on their own. Its best to complete a medically- assisted treatment to ensure the most ease and success throughout the process.

One of the most common methods of detox is known as Rapid Opiate Detoxification or ROD. This method entails going under anesthesia so as not to endure the symptoms of withdrawal. High doses of naltrexone are administered to shorten the withdrawal symptoms and when the patient wakes up, his or her body is free of the drug and did not have to experience any unpleasant symptoms.

Another method is called Accelerated Opiate Neuro- regulation or AON, which is a type of rapid detox. In this process, the patient is also administered anesthesia and basically sleeps off the symptoms of withdrawal. But in this case, the patient will feel slightly ill the next day and may experience nausea, vomiting, diarrhea and have little to no energy. However, the patient should feel better after a few days.

Addiction Prevention

Painkiller addiction is not actually as common as you may think it is. And just because you need to use painkillers doesnt mean that you have an addiction to them or at risk of becoming addicted to them. But if you are taking painkillers and are worried about dependency, follow these tips:

Know the side effects of the medication youre taking and how it can affect you and your health.

Take the proper dosage. If the medication isnt working for you, consult with your doctor.

Check in often with your doctor anyway to make sure the medication is working properly and that youre on the right track to recovery.

Follow the directions closely. Take no more than whats been prescribed for you and never take someone elses medication.

Having an addiction to painkillers can have a serious impact on your physical, mental and even social health. Getting treatment may seem like a tough, scary process but with the right method, recovery can be easier than you think.