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Medscape
7 days ago
- Health
- Medscape
Fast Five Quiz: Sjögren Disease Differential Diagnoses
Learn more about oral dryness in Sjögren disease. Dry eye, or xerophthalmia, is another other classic symptom of Sjögren disease. Similarly, several factors can also cause dry eye, which must be ruled out for accurate diagnosis. For example, data indicate that androgen can significantly influence the lacrimal gland/tear production and overall optical health. Hypoandrogenemia is a known cause of dry eye along with Vitamin A deficiency; hyperandrogenemia is another known cause of dry eye, especially in females and those with polycystic ovary syndrome. Hypercalcemia, anemia, and Vitamin B deficiency are usually associated with dry mouth, rather than dry eye. Elevated CRP does not appear to be specifically associated with dry eye, and levels are usually normal in Sjogren disease. Learn more about dry eye in Sjögren disease. According to the most recent ACR classification guidelines, dry eyes and/or mouth must persist for more than 3 months after controlling for differential diagnoses. Their criteria suggest Sjögren disease can be confirmed by a classification score of at least 4 points from factors such as histology of the labial salivary gland (up to 3 points), detection of SS-A/Ro antibodies (3 points), pathological Schirmer test (1 point), whole saliva flow rate ≤ 0.1ml/min (1 point), and abnormal ocular staining score (1 point). Although various diseases can cause chronic dry eye, external factors such as drug use and environmental factors can be excluded upon resolution when the patient is removed from exposure. Learn more about classification criteria for Sjögren disease. Experts note that Sjogren disease is typically diagnosed based on 'the patient's subjective sicca symptoms if these cannot be explained by other differential diagnoses, after excluding certain diseases and using the objective classification criteria.' Graft versus host disease, along with amyloidosis, sarcoidosis, HIV, HCV, and history of head and neck radiation therapy, is specifically recommended by the ACR classification system to be excluded when diagnosing Sjögren disease. Further, pre‐existing lymphoma is no longer part of this exclusion criteria. Although fatigue is common in both Sjogren disease and fibromyalgia, presentation of subjective sicca usually prompts the differential diagnosis for Sjögren disease in the ACR classification. Chronic pancreatitis and rheumatic fever are also not typically associated with sicca symptoms. Learn more about differential diagnosis for Sjögren disease. Contrast is a rare but often overlooked cause of salivary gland enlargement, another characteristic Sjogren disease symptom. It is most often associated with iodine contrast media, leading to its nickname of 'Iodide mumps.' Other potential causes of salivary gland enlargement include several types of infections and inflammatory conditions, neoplasms, and immunosuppression. Though parotid enlargement can occur with gadolinium use, the association is not as frequent as iodine. Barium and microbubble use have not been consistently shown to directly cause parotid enlargement. Learn more about parotid gland enlargement in Sjögren disease. Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication. Lead image: Peakstock/Science Source
The Hindu
18-07-2025
- Health
- The Hindu
Is social media telling you what to eat? Here's how to access accurate nutritional information
Do you start your mornings with detox water, flaxseeds, chia seeds, eat collagen for skin during the day and add a dose of magnesium for good sleep? If your answer is yes, you are not alone. The global health and wellness market stood at $1.4 trillion in 2024 according to a report by McKinsey, the multinational consulting firm. The report highlighted that people are prioritising wellness more than ever and are looking for science-backed products. How is wellness and nutrition a central narrative of our conversations these days? Clinical nutritionist Amita Gadre explained: 'Today, the ultimate status symbol is health and vitality. A glowing skin, a high-energy lifestyle, and a fit physique are the new aspirations. And social media is the perfect stage for this display.' However, in an information-filled world, people are struggling to understand nutrition science, an area of study that is already a complex subject. A recent peer-reviewed study conducted on Indian students highlighted how 'social media impacts an individual's eating patterns by acting as a stimulus for immediate consumption of food, cravings and trying trends.' Another study from South Africa also found that social media is used to 'access and implement nutrition information while showing the inability of participants to assess whether nutrition information on social media is evidence-based and correct.' A simple Google search tells us what to eat or drink and how much, for our weight concerns, skin concerns or even conditions such as diabetes. However, this information is not always accurate, as it is sometimes not backed by strong scientific evidence, may promote conflicting views and could even distort scientific findings to promote one particular food item or product. 'While social media has raised awareness, it has simultaneously created a 'Wild West' of information that has deeply complicated the public's understanding of nutrition,' said Ms. Gadre. So what is the science behind nutrition and food? Eating five oranges will not give you glowing skin overnight Vikrant Ghanekar, scientific officer, Biology Cell at Homi Bhabha Centre for Science Education explained that the small intestine has an extensive supply of blood vessels to facilitate the uptake of nutrients. He added that 'excess vitamins, minerals may not give immediate benefits because water-soluble vitamins (Vitamin B and Vitamin C) are lost through body fluids [urine] and excessive oil-soluble vitamins can be harmful for metabolism. Regular supply through fruits and leafy vegetables is enough to maintain a balance,' he said. Ms. Gadre explained how eating one food may not immediately impact our health. 'Take Vitamin C as an example (from oranges). It is water-soluble, so it is absorbed in the small intestine and carried in the blood. Your body takes only what it needs. The rest is excreted in urine. No amount of oranges can force your skin to glow instantly. Glow comes from a combination of hydration, healthy fats, protein and antioxidants, not just one vitamin. Also, absorption depends on gut health, the presence of other nutrients, and overall balance.' 'So yes, eat your oranges. But also eat your dal, rice, ghee, sabzi, nuts - glow comes from nourishment, not gimmicks.' Food as a cure What many struggle to understand or often misunderstand, is whether food can cure diseases or medical conditions. Krish Ashok, author of the book Masala Lab explained 'good food provides ingredients for the body's immune system to function at its best (genetically determined) capacity. But beyond that, food cannot act like medicine.' It is the same with seeds, spices and water. According to Ms. Gadre, kitchen ingredients such as carom seeds or fennel seeds (ajwain, dalchini, jeera, saunf) are great in culinary doses and have traditional digestive benefits. When asked if they could help lose weight, she said, 'To expect them to cure obesity or diabetes is taking it too far. Superfoods don't undo overeating or inactivity. Weight loss and metabolic health require exercise, stress and sleep management and calorie balance.' Commenting on daily water requirements, she said, 'Hydration is vital, but that 8-glass rule is generic. Overhydration can lead to electrolyte imbalance. A good rule of thumb: drink when you're thirsty, sip more in hot weather or after workouts, and observe your urine color - pale yellow is ideal. Water doesn't flush toxins.' The internet's latest obsession A simple keyword search - 'how to lose weight' unwraps a whole lot. Search results lead to multiple videos explaining how to lose weight with the help of 'natural ozempic'. These videos say that a concoction of vegetables such as cucumber, celery, and bitter gourd constitute 'Nature's Ozempic' and claim that this can lower blood sugar and melt fat. Ozempic is an antidiabetic and anti-obesity medicine which is prescribed under medical supervision for weight management. There are multiple videos promoting juices of certain vegetables and drinking these on empty stomach for weight loss. Ms. Gadre, commenting on this trend, explained: 'There is no clinical evidence supporting these drinks for sustainable weight loss. Moreover, Ozempic is a prescription GLP-1 drug used for type 2 diabetes under strict medical supervision. You can't DIY that with karela [bitter gourd].' She further warned that 'Overconsumption of raw vegetable juices can cause bloating, nutrient imbalances, risk of kidney stones and even blood sugar dips if not combined with meals.' Hazards of social media-related nutritional information While social media promotes certain foods, it also creates fear around a few food products. This makes understanding what to eat and what not more complex. Both sugar and carbohydrates have earned a bad reputation on social media. And while too much of either can be detrimental, many take extreme measures to curb it from their diets. The Mayo Clinic prescribes: 'people need at least 130 grams of carbohydrates every day to meet the body's energy needs.' A Johns Hopkins blog post on sugar explains, 'Our bodies run on sugar. Removing natural sources of sugar and other carbohydrates from your diet — fruits, dairy products and grains — is not a healthy choice'. Diets that cut out all carbohydrates and sugars, such as the ketogenic diet, can be harmful to your health, it says. Ms. Gadre added: 'Social media thrives on black-and-white thinking. Nutrition science is all about context, dose, and individuality. Is sugar 'bad'? It depends. A spoonful in your chai is vastly different from drinking a litre of soda. The diet that worked for a 22-year-old actor in Bollywood is unlikely to be the right fit for a 45-year-old working mother in Delhi. Genetics, gut microbiome, lifestyle, stress levels, and cultural background all determine what works for you.' The nuances of nutrition science When it comes to a nuanced understanding of nutrition science, randomised controlled trials are the gold standard to understand how and why certain foods get easily absorbed by the body. But a lot of claims are based on observations and observational studies, and therefore can or cannot be applied to everyone. A study by the American Diabetes Association explores what makes nutrition research so difficult to conduct and interpret. It states: 'observational studies have been used to track dietary intake in large numbers of participants and can be used to track such data over many years. Observational studies are not carefully controlled like clinical trials, so their results may be less reliable.' So how do younavigate nutritional misinformation? Here are some tips that may help: Follow verified accounts and check the credibility of the person posting the video. Do not follow anything online blindly. Always verify - cross check, read and use multiple sources. Beware of fad diets, easy solutions and seemingly magical remedies. If in doubt, or if you have an existing medical condition, always consult your doctor before starting or stopping anything (Nabeela Khan is is a Delhi-based health and science journalist. nabeelainayati@
Time of India
27-06-2025
- Health
- Time of India
Vitamin B12 Deficiency: Feeling exhausted all the time? Cardiologist talks about why vitamin B12 is essential
Do you feel tired all the time? Persistent fatigue is not normal. Feeling exhausted, even after a restful night, signals an underlying issue. Fatigue is one of the signs of vitamin B12 deficiency. Tired of too many ads? go ad free now This nutrient is responsible for some of the important functions in the body, including DNA synthesis, energy production, and central nervous system function. Despite its importance, about 47% of the Indian population has a vitamin B12 deficiency, according to a 2019 . Dr. Alok Chopra, a renowned cardiologist and functional medicine expert, emphasizes the vital role of vitamin B12, its dietary sources, and the risks associated with deficiency, especially in vegetarians. What is vitamin B12 Vitamin B12 is a water-soluble nutrient crucial for several bodily functions. 'It is essential for metabolism, digestion, and overall health,' the cardiologist stresses. It is naturally present in certain foods, and available as a dietary supplement and a prescription medication. What are the sources of vitamin B12 Vitamin B12 is naturally present in foods like fish, poultry, eggs, and milk. However, it absent in most plant-based foods unless fortified. 'Vegetarians always have a problem with not having enough B12,' the doctor . Plant-based foods generally do not contain B12, but fortified foods like nutritional yeast and certain cereals can serve as reliable sources. He suggested that vegetarians can take supplements or B12-fortified products to meet daily requirements. What are the functions of vitamin B12 Vitamin B12 is responsible for several important in the body. This nutrient plays a pivotal role in the production of healthy red blood cells and prevents megaloblastic anemia. Tired of too many ads? go ad free now It also helps in the replication and maintenance of DNA in the cells. Vitamin B12 also maintains the health of nerve cells and supports the proper functioning of the nervous system. It also has a crucial role in converting carbohydrates into glucose. Vitamin B12 is also vital for brain health. It boosts memory, focus, and overall cognitive health, and also reduces the risk of neurodegenerative diseases. This nutrient has a significant role in heart health. Vitamin B12 helps regulate homocysteine levels in the blood, thereby reducing the risk of cardiovascular disease. It also helps in mood regulation, bone health, skin, hair, and nail health, and boosts the immune system. 5 superfoods packed with both Vitamin B and Vitamin C What are the signs of vitamin B12 deficiency Despite its crucial role in the body, vitamin B12 deficiency is very common. Some of the signs of vitamin B12 deficiency include: Fatigue Pale or yellow skin Headaches Depressive symptoms Gastrointestinal issues Difficulty focusing Glossitis and mouth ulcers Weight loss Feeling unwell 'Deficiency can be cured by adequate nutrition, intramuscular injections or even oral B12 therapy,' the cardiologist said. The doctor also cautioned about the negative effects of excessive intake of vitamin B12. 'Overuse can cause diarrhea, itching, rashes, headache, dizziness, nausea, and heart failure. Patients with optic neuropathy, polycythemia, gout, iron, folate deficiency, and when there are low potassium levels, you must consult a doctor.' Do not take with certain other nutrients The doctor suggests not combining vitamin B12 supplements with vitamin D. 'Vitamin B12 and D should not be taken together as vitamin D is fat soluble and is absorbed better with food, and B12 is water soluble and taken on an empty stomach. Same for vitamin C,' he adds.
7NEWS
20-05-2025
- Health
- 7NEWS
Best Australian-made serum for hydrating skin this winter: Dr Naomi Let It B
If your skin is already starting to feel the effects of winter, or you've noticed an increase in flakes and patches, consider it your sign to up your hydration. To battle the colder weather, hundreds of shoppers across the globe are seeking the help of an Aussie-made serum to rehydrate, plump and glow. Meet one of Dr Naomi's best-sellers, the Let It B serum ($129), a silky soft formula jam packed with niacinamide, panthenol and triple hyaluronic acid. Deemed as a 'must-have' as the temperature drops, it's a multi-level Vitamin B formula to soothe, nourish and restore the skin barrier. Perfect for all skin types (particuarly those with extreme dryness), it's lightweight and easy to apply, and can be added in your daily routine. Shoppers who have got their hands on the game-changing formula have described it as 'absolute heaven on the skin.' 'I have tried so many B vitamin, hyaluronic acid based serums over the years and this is by far my favourite,' one shopper commented. 'It absorbs quickly into the skin, hydrates without breaking me out and doesn't pill under other skincare and makeup. I will always repurchase this!' Perfect for applying first-thing in the morning before SPF or as the last step before a night cream in your evening routine, the Let It B serum acts as a soothing layer that dry skin will lap up. Founded by renowned Cosmetic Doctor Dr. Naomi, Dr Naomi Skincare has become one of the country's best-selling brands and a must-have for shoppers across the globe. Take one look at social media and you'll be indundated with product reviews and reviews with shoppers praising the formulas and the 'filter-like' finishes and 'real results.' As a certified cosmetic Doctor with years of experience, Dr. Naomi formulates each product to address real skincare concerns (including dryness and dehydration) with clinically proven ingredients. ' Skincare should be effective, but it doesn't have to be boring,' Dr. Naomi tells Best Picks. 'I wanted to create a line that combines the fun of beauty with the science of dermatology,' she explains.
Daily Mirror
16-05-2025
- Health
- Daily Mirror
Get glowy skin and reduce puffiness by adding these fruits to your diet
Adding these ingredients to your skincare routine can help you achieve clearer, youthful skin, but many of these can actually be found in these favourite foods, as found by our skincare expert Maintaining healthy skin is not easy. Sometimes, no matter how many products you use, they don't always guarantee the best results. As we age, many of us are looking for alternatives to keep our skin as rejuvenated as possible. An abundant source of skin-boosting nutrients and essential vitamins are fruits and vegetables. For example, Vitamin C is known to be great for reducing acne marks and skin brightening, whereas Vitamin B is good for improving the overall skin appearance. Maintaining a healthy skin can be challenging, but using products with the right nutrients can make a significant difference. Vitamins C and B found in watermelon and dates are best for hydration, inflammation and signs of ageing. A balanced skincare routine with these essentials can help rejuvenate the skin. Dr Anatalia Moore, an NHS GP and skin specialist, told The Mirror:"Your food literally provides the building blocks to maintain a healthy body, mind and skin. For my patients, understanding how their food and lifestyle choices directly influence the processes of inflammation, repair and cellular aging is integral to achieving a skincare and anti aging routine that will last." Saima Rashid, an Advanced Clinical Pharmacist and founder of The SRX Formula, told The Mirror: "Skin health often mirrors what's happening inside the body, and the right fruit can make a noticeable difference." A healthy skin barrier is essential for overall health, as it provides a barrier to protect the body from bacteria and other environmental hazards. A regular skincare routine helps regenerate skin cell production to keep the skin healthy and young. By incorporating these four essentials, you can rest assured to have a glowy, youthful look in no time! These are the four foods to add into your skincare routine, all packed with skin-boosting vitamins, most importantly, promising to deliver amazing results. Watermelon Watermelon can help with pore refinement and keeping skin clear. Its natural properties help tighten the pores and tone the skin, which is beneficial for those with oily or acne-prone skin. Additionally, its exfoliating enzymes can unclog pores and help prevent future breakouts. Dr Anatalia Moore said: "It is not just immensely hydrating, but also contains antioxidants such as Vitamin C and beta-carotene which help reduce the aging effects of UV and free-radicals found in pollution on collagen and elastin; our key structural proteins in the skin." Lemon balm Lemon balm is a popular herb, known to have a nice scent and light citrus taste. It's sold in the form of teas, oils, extracts and capsules. It's often used in skincare as it has bothy anti-inflammatory and antioxidant properties, which can help with skin conditions such as acne. Lemon balm can also soothe irritated skin, as well as protect the skin from stress and environmental damage. In addition, Women's Health Magazine reported that many have suggested that it also helps with stress, insomnia, alertness and PMS symptoms, some believing that it also helps reduce weight. Potato peels During the Covid-19 lockdown, an at-home acne remedy went viral. It consisted of using the potato peels and rubbing it on your face. Some believe that the azelaic acid and starch in potatoes can help lighten acne scars, blemishes and dark spots. Potatoes also contain salicylic acid and vitamin C, which are important for treating acne and improving skin health. It also helps reduce dark circles and puffiness, lightening and soothing the skin. Saima Rashid told The Mirror: "Potato peels might not be the first thing that comes to mind when thinking about skincare, but they're packed with nutrients like vitamin C, potassium, and zinc. " "These all play a role in fading acne scars and calming irritated skin," Saima explained. "The natural enzymes in the peel are also said to encourage cell turnover, which can help the skin heal and renew itself more effectively, especially when used topically." Dates Dates contain antioxidants that can help protect the skin. They are rich in antioxidants and other nutrients that can benefit skin complexion. Have you ever woken up with a puffy face after a big hearty meal? According to Amala Earth, a daily intake of dry dates can strengthen the skin, as well as reduce inflammation, and protect against cell damage. Dr Anatalia Moore explained: "They contain a lot of antioxidants such as flavonoids, carotenoids and phenolic acids. By maintaining collagen and elastin, antioxidants help keep skin plumps, smooth and elastic." "By maintaining this process it allows day-to-day damage to be repaired, slowing down signs of ageing including lines, accumulation of dead skin on the surface that can lead to the appearance of more visible pores and balance of pigmentation," she added.
