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<ul class="summary-list"><li>Supplements marketed to improve longevity are booming.</li><li>But longevity doctors say, actually, less is more when it comes to flashy supplements.</li></ul>Renew your mitochondria. Rejuvenate your cells. Bring back that youthful muscle strength. Improve your fertility.Over the past several years, a plethora of <a target="_blank" class="" href="https://www.businessinsider.com/nestle-and-loreal-are-betting-on-urolithin-a-longevity-supplement-2024-10">new supplements</a> have emerged on the scene, promising to boost human longevity and preserve youthfulness. Now, longevity doctors are scrambling to get people to slow down."In our clinic, we are de-prescribing," Dr. Andrea Maier, a leading longevity doctor who runs both a private and a public longevity clinic in Singapore, told Business Insider. "We first have to diagnose what's wrong, what somebody needs, and that might differ."Maier, also a professor of medicine and functional aging at the National University of Singapore, is one of several longevity medicine doctors who told BI that they are recommending patients <a target="_blank" class="" href="https://www.businessinsider.com/supplement-expert-doesnt-take-supplements-eats-vegan-2023-11">stop taking many of the supplements</a> they have learned about online."People think that more helps more, and it's not the case," Dr. Evelyne Bischof, who practices longevity medicine in China, Switzerland, and Israel, told BI. "There are interactions, there are side effects."Bischof and other longevity medicine practitioners say the trend toward overdoing it has been supercharged in recent years by more aggressive and flashy online marketing of longevity supplements. Ads on Facebook, books by longevity influencers, along with <a target="_blank" class="" href="https://www.businessinsider.com/equinox-40000-membership-optimize-longevity-health-years-2024-5">gyms</a> and <a target="_blank" class="" href="https://www.businessinsider.com/rich-people-obsessed-longevity-luxury-hotels-iv-drips-mri-scans-2024-10">resorts</a> are touting antiaging fixes.According to a recent <a target="_blank" href="https://www.mckinsey.com/industries/consumer-packaged-goods/our-insights/the-trends-defining-the-1-point-8-trillion-dollar-global-wellness-market-in-2024">McKinsey survey</a>, demand for healthy aging products is soaring; 70% of American consumers across all age groups are spending more in this category than they used to post-pandemic.Doctors like Maier and Bischof say supplements can slowly build up to dangerous health issues, impacting vital organs like the kidneys and the liver or interacting with other drugs and supplements in toxic combinations.Increasingly, they are seeing concerning results from blood, urine, and other tests on patients who take many different products.<h2 id="ac30069c-c621-4f87-835b-6cece95b1fb0">Overdoing supplements can hurt your health</h2><div type="image" title="hand with lots of different supplements in it" height="3449" width="5142" msid="115111811" hostid="261" sizebytes="403768"></div>In the past, patients typically hadn't invested in healthy aging supplements on their own. They would learn about them for the first time from their <a target="_blank" href="https://www.businessinsider.com/what-is-a-longevity-clinic-executive-physical-2024-5">longevity medicine</a> doctor, said Bischof, who serves patients at hospitals in Shanghai and Tel Aviv, as well as in her own VIP concierge longevity medicine business.Things have shifted since the pandemic. In the public clinic where she works in Israel, she estimates that 20% of patients come in with a laundry list of longevity supplements in their regimen, most of them too highly dosed."Five years ago, it was really the opposite," Bischof said. "It was trying to convince a patient to actually take a supplement — besides the vitamins."In her practice, she has seen through clinical testing how supplements can build up in vital organs. One 40-year-old patient who "really overdid" his longevity supplement doses had a biological age four years older than his actual age, as measured by his blood. He also had suboptimal kidney function.He didn't want to quit taking the pills (Bischof did not name the products), but his subsequent blood tests were only looking worse and worse, and his biological age kept creeping up.Eventually, Bischof was able to convince the patient to stop taking his longevity supplements. "And, of course, the <a target="_blank" href="https://www.businessinsider.com/what-is-biological-age-is-reverse-aging-possible-2023-2">biological age</a> reversed," she said.Others have noticed the same trend.Pharmacologist Myriam Merarchi, founder and CEO of the Swiss fertility and biological age testing company Beyond Genomix, sees a lot of "biohackers" wanting to test their telomeres, since telomere health is tightly correlated with aging. The ones with a "suitcase" full of supplements tend to have horrible results."You take 50 pills a day that are interfering with every metabolic pathway of your cells," Merarchi said. "Of course!"<h2 id="df59810c-9839-43c6-9998-cedfc378ce6a">The interactions doctors worry about</h2><div type="image" title="Maier with a dog on the couch" height="1772" width="1181" msid="115111809" hostid="261" sizebytes="156708"></div>Longevity supplements are a booming market. Popular new products touted on TikTok and Instagram include <a target="_blank" href="https://www.businessinsider.com/what-is-nad-longevity-supplement-hollywood-uses-prevent-aging-2024-7">NAD boosters</a> (a popular antiaging supplement among the Hollywood elite), <a target="_blank" href="https://www.businessinsider.com/nestle-and-loreal-are-betting-on-urolithin-a-longevity-supplement-2024-10">urolithin A</a> (ostensibly boosts cellular health, improves muscle strength, and slows aging), and coenzyme Q10 (a popular antioxidant for fertility and aging).Doctors are also seeing a lot of alpha-ketoglutarate (AKG). The compound, being <a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/37217632/">studied clinically</a> as a potential antiaging supplement, is one of the main ingredients in a new $49 "Longevity Mix" sold by tech biohacker Bryan Johnson.Dietician Naras Lapsys, chief clinical officer at Chi Longevity, a private clinic in Singapore, says many people are piling these newer pills on top of older, popular longevity supplements. That could be resveratrol (used for heart health) or spermidine (touted as being good for rejuvenating cells)."If you're taking a longevity supplement, there's no evidence to suggest at all taking one is good and therefore two is even better and three is even better again," Lapsys said. "A good starting point is to strip down to a lesser number and start measuring."Someone who's dehydrated regularly might want to think twice before taking a supplement like NMN, which can <a target="_blank" href="https://www.biorxiv.org/content/10.1101/2024.04.09.588624v1.full.pdf">build up in the kidneys</a> and cause inflammation. CoQ10 can make blood thinners less effective, and resveratrol might <a target="_blank" href="https://www.mskcc.org/cancer-care/integrative-medicine/herbs/resveratrol">help hormonal cancers</a> like breast cancer thrive and proliferate."If you are just taking supplements because a book has told you or an influencer has told you, if we think about levels of evidence, that sits pretty low," Lapsys said. "Test, don't guess."<h2 id="5a439981-0ef7-46e4-98d0-bdda1f648469">Experts recommend a personalized, data-driven approach</h2>All of this is deeply personal. One patient might benefit from getting more calcium, while another could benefit from ditching their B vitamins."I understand that not everybody can get a doctor," Bischof said. "We're trying to say, just educate yourself on what could be the side effect and how — a little bit — to track it."For patients who are excited about longevity supplements, Bischof recommends cycling them, taking one for a few months, and then pausing instead of taking them continuously throughout the year.When you are taking a new kind of longevity supplement, you should keep tabs on how it is affecting your health in specific ways. Is your <a target="_blank" href="https://www.businessinsider.com/vo2-max-explained-what-is-good-how-improve-2024-3">VO2 max</a> improving? Do you have fewer colds during flu season than you used to? These are the kinds of simple check-ins that can help determine if a supplement is doing something for you."Have at least one marker that you can follow, an objective marker, to make sure that it's actually helping you," Bischof said. "Do not take something where you think it might help. You need to have an objective measure that will confirm that it works for you at this dose, at this frequency, at this age, in your current situation."

Longevity doctors are scrambling to get patients to stop taking flashy, expensive supplements

The effects of poisonous gases that leaked from the <keyword id="23933468" type="General" weightage="20" keywordseo="Union-Carbide" source="keywords">Union Carbide</keyword> factory in Madhya Pradesh's Bhopal 40 years ago were seen in the next generations of those who survived the tragedy, a former government forensic doctor has said. At least 3,787 people were killed, and more than five lakh were affected after a toxic gas leaked from the pesticide factory in the city on the intervening nights of December 2 and 3, 1984. Speaking at an event held by organisations of gas tragedy survivors on Saturday, Dr. D. K Satpathy, former head of the forensics department of Bhopal's Gandhi Medical College, said he performed 875 post-mortems on the first day of the disaster and witnessed 18,000 autopsies the next five years. Sathpathy claimed Union Carbide had denied questions about the effects of poisonous gases on unborn children of women survivors and said effects would not cross the placental barrier in the womb in any condition. He said blood samples of pregnant women who died in the tragedy were examined, and it was found that 50% of the poisonous substances found in the mother were also found in the child in her womb. Children born to surviving mothers had the poisonous substances in their system, and this affected the health of the next generation, Sathpathy claimed and questioned why research on this was stopped. Such effects will continue for generations, he said. Satpathy said it was said that MIC gas leaked from the Union Carbide plant, and when it came in contact with water, thousands of gases were formed, and some of these caused cancer, blood pressure, and liver damage. Rachna Dhingra of <keyword id="24137747" type="General" weightage="20" keywordseo="Bhopal-Group-for-Information-and-Action" source="keywords" meta.keywordsubtype="org" meta.entityname="Bhopal Group for Information and Action" meta.hostid="83" meta.entityid="Bhopal Group for Information and Action">Bhopal Group for Information and Action</keyword> said Satpathy, who carried out most autopsies, and other first responders in the 1984 disaster, including the senior doctors in the emergency ward and persons involved in mass burials, narrated their experiences during the event. Rashida Bee, president of the Bhopal Gas Peedit Mahila Stationery Karmchari Sangh, said a poster exhibition covering every aspect of the disaster will be held till December 4 to mark the 40th anniversary of the tragedy. An anniversary rally will be organised, with a focus on global corporate crimes such as <keyword id="20335495" type="General" weightage="20" keywordseo="industrial-pollution" source="keywords">industrial pollution</keyword> and climate change, she said.

Bhopal gas tragedy: Effects of leak seen in next generation of survivors, says ex-forensic doctor

<ul class="summary-list"><li>Dr. Michael Roizen is 78 but claims his biological age is 57.6.</li><li>Roizen, who has written about longevity, takes supplements every day.</li></ul>A doctor who is 78 but claims he has a <a target="_blank" href="https://www.businessinsider.com/doctor-longevity-expert-reverse-biological-age-years-diet-principle-s2024-7">biological age of 57.6</a> shared five of the supplements he takes daily.As life expectancy has grown — the average American is expected to live until <a target="_blank" href="https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240321.htm">77.5</a>, up from 70.8 in 1970 — so has interest in <a target="_blank" class="" href="https://www.businessinsider.com/essential-healthy-habits-for-your-twenties-thirties-longevity-advice-2023-12">staying healthy for longer</a>.Dr. Michael Roizen, an anesthesiologist and the chief wellness officer at Cleveland Clinic whose books include "The Great Age Reboot," told Business Insider how he <a target="_blank" class="" href="https://www.businessinsider.com/busy-doctor-reversed-age-20-years-workout-routine-2024-7">exercises</a> and <a target="_blank" class="" href="https://www.businessinsider.com/doctor-reverse-age-years-foods-eat-weekly-longevity-2024-8">eats to age healthily</a>.Although dietitians advise people to get their <a target="_blank" class="" href="https://www.businessinsider.com/vitamins-dietary-supplements-not-worth-buying-dietitians-2023-7">nutrients from food</a> where possible, he also hopes taking the following five supplements will help boost his longevity.<h2 id="99f3ab81-4149-46c5-bd6d-14ffc8d269f1">Multivitamins</h2>Roizen takes half a <a target="_blank" href="https://www.businessinsider.com/multivitamins-for-memory-older-adults-benefit-2023-10">multivitamin</a> twice a day. Although his approach hasn't been proven in clinical trials, he believes it will keep vitamin levels in the blood as stable as possible, as most of a water-soluble multivitamin is peed out.Roizen said evidence suggests multivitamins could lower the risk of dementia and cancer. Indeed, a 2022 <a target="_blank" href="https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12767">study</a> by researchers at Columbia University and Brigham and Women's Hospital found that taking a multivitamin daily for three years appeared to improve older adults' cognition and memory, although it was unclear why.In participants with cardiovascular disease, a risk factor for <a target="_blank" class="" href="https://www.businessinsider.com/detecting-and-preventing-cognitive-decline-with-ai-2023-11">cognitive decline</a>, the authors said the micronutrients may have treated deficiencies linked to the condition.However, the jury is still out on multivitamins. A 2022 review of studies by the US Preventive Services Task Force found no evidence that they prevent cardiovascular disease or cancer. In June, a study on 390,124 US adults by researchers at the National Cancer Institute found no evidence that they boosted longevity.<div type="image" title="A man pouring a multivitamin into his hand." height="1412" width="2122" msid="112967517" hostid="261" sizebytes="57886"></div><h2 id="6198cae1-62ff-40a5-8a3d-761c911d840b">'Baby' aspirin</h2>Roizen takes a low dose of <a target="_blank" href="https://www.businessinsider.com/drugs-like-aspirin-linked-higher-heart-attack-risk-hot-weather-2022-8">aspirin</a> (usually 81 milligrams), sometimes known as "baby aspirin," twice a day in the hope it will <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/conditions-symptoms/how-to-prevent-heart-attack">prevent heart attacks</a> and strokes. Taking aspirin regularly long-term carries risks because it can thin the blood so that the body can't form clots when bleeding.But Roizen believes it is safe for him to take as "someone over the age of 50 with a low risk of bleeding."However, the US Preventive Services Task Force <a target="_blank" class="" href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication#fullrecommendationstart">does not recommend</a> adults over 60 take preventive aspirin.<h2 id="42c3882b-4221-4d9e-92e6-769f703f605c">CoQ10</h2><a target="_blank" href="https://www.businessinsider.com/guides/health/coq10-benefits">CoQ10</a> is a substance found in cells that helps convert food into energy. As an antioxidant, it has been linked to a reduction in the effects of aging on the skin and on a cellular level in humans and rodents. It's also thought to prevent problems associated with free radicals, which are DNA-damaging particles that move around the body.Roizen said he takes the supplement alongside statins to <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/treatments/high-cholesterol">reduce his cholesterol levels</a>, because statins decrease CoQ10 levels in the body.However, a small 2022 study involving 37 participants published in Antioxidants found that the supplement didn't the amount of CoQ10 in their muscles, where pain can occur in people who take statins.And, according to the National Center for Complementary and Integrative Health, there isn't strong evidence that CoQ10 improves <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/conditions-symptoms/high-blood-pressure">blood pressure</a> and heart failure despite some claims.<h2 id="f341eece-a3d3-4325-bbeb-0de5dbc4176c">ASU</h2>ASU stands for avocado-soybean unsaponifiables, which are vegetable extracts leftover from soap-making.Roizen takes it to decrease the pain of osteoarthritis. There some evidence to suggest that ASU could treat osteoarthritis because of its anti-inflammatory properties. However, researchers say more long-term studies in humans are needed.<h2 id="ce728601-ade0-432a-85bc-b6e6c37404b0">Ergothioneine</h2><a target="_blank" href="https://www.businessinsider.com/list-foods-to-increase-life-span-like-a-tech-billionaire-2023-4">Ergothioneine</a> is present in most foods, but mushrooms are particularly rich in it. Roizen doesn't take an ergothioneine supplement but regards the substance as a supplement to his diet.Instead of taking a pill, he gets it from mushrooms. Five days a week, he has an "MLT" — a mushroom, lettuce, and tomato sandwich — for lunch.Eating plenty of ergothioneine as part of a healthy diet was linked to a lower risk of coronary artery disease in a 2020 study by researchers from Lund University, Sweden.Meanwhile, studies on cells suggest that ergothioneine can help prevent DNA damage from UV exposure, according to a 2022 review of studies published in the journal Antioxidants &amp; Redox Signaling.

5 supplements a doctor who says he's reversed his age by 20 years takes every day

<ul class="summary-list"><li>Dr. Sarah Oreck balances her roles as a reproductive psychiatrist, mother of three, and CEO.</li><li>Oreck cofounded Mavida Health after experiencing postpartum anxiety and pregnancy loss.</li></ul>This as-told-to essay is based on a conversation with <a target="_blank" href="https://www.instagram.com/sarahoreckmd/?hl=en">Dr. Sarah Oreck</a>, a reproductive psychiatrist in Los Angeles and cofounder of <a target="_blank" href="https://www.mavidahealth.com/">Mavida Health</a>. The following has been edited for length and clarity.I'm a reproductive psychiatrist and a married mother of three young children.After starting my career on the East Coast, I moved to LA in 2018, took a new position, and started creating video content on psychiatric topics, serving as an on-camera expert with MedCircle, Inc.I began a private practice, providing personalized psychiatric care and psychotherapy, focusing on women's mental health and perinatal mental health. I also now have a digital mental health platform.My husband, a venture capital CEO and entrepreneur, and I share family responsibilities.<h2 id="707c1258-a45a-4d1b-95e9-9e67ec349457">I started my company because I could've used it myself</h2>After experiencing pregnancy, <a target="_blank" href="https://www.businessinsider.com/i-went-back-to-work-4-weeks-after-giving-birth-2024-10">postpartum anxiety</a>, and <a target="_blank" href="https://www.businessinsider.com/stillbirth-what-i-wish-i-knew-before-lost-pregnancy-2021-12">late-term pregnancy loss</a>, I realized the care I needed wasn't available to me, which fueled my mission of providing those on the path to parenthood the resources they need for their mental health.I met Emma Sugerman, who had also experienced a pregnancy loss, and we created <a target="_blank" href="https://www.mavidahealth.com/">Mavida Health</a> in April 2023. Now, as the cofounder and CEO, I'm caring for patients and working to raise awareness of relevant mental health issues.<a target="_blank" href="https://www.businessinsider.com/working-mom-solo-travel-mom-guilt-2024-4">Mom guilt</a> initially prevented me from starting the company. I felt a strong internal conflict about dedicating time and energy to a new venture when I believed I should focus solely on my first child.After the birth of my second son, I experienced a shift in perspective. It became clear that pursuing this project was not about neglecting my role as a parent but about fulfilling a deeper purpose that aligned with my professional and personal values.While I have considered focusing solely on family, I find fulfillment and purpose in my work. I know continuing to work is key to my happiness, and even though it's challenging, it makes me a better mother and partner.<h2 id="d56eb56b-2167-45dd-a2f2-a7ad1d8f73a0">Here's what a weekday looks like for me</h2><h3 id="fbc13bad-d8f3-47b0-853b-4589f431fe62">5:30 a.m. - 6 a.m.:</h3>This time is precious — I try to meditate each morning for at least 10 minutes, do a quick workout every other day, and make myself matcha every morning.<h3 id="b0e8bad0-de34-4c5d-8b68-5610d3db0e88">6 a.m. - 8 a.m.:</h3>The kids (four, almost three, and four months old) wake up around 6 a.m. My husband keeps East Coast hours, so by 6 a.m., he's busy in his home office.My mom, who moved in with us during the pandemic because I worried about her safety and living alone, is extremely helpful. Our nanny also arrives around this time, helping wrangle our two toddlers and baby while I try to get ready and help them prepare for the day.Once our second child was born, we decided a nanny would be helpful for our family. Parenting is not an individual sport.<h3 id="6b867e7c-a20d-4cdc-a5ef-4289073c7792">8 a.m. - 8:30 a.m.:</h3>After breakfast, either my mother or I drop off the toddlers at school. The newborn stays home with our nanny.<h3 id="ec7d99c7-37a8-4e10-abb8-3d9e2713dd3f">9 a.m. - 12 p.m.:</h3>My husband and I work from home every weekday. My workday begins with meetings. I oversee all our providers, offering close supervision and support on their cases. I also focus on product updates and refining the member experience.<h3 id="8df79240-54c5-4433-9ad8-72ab4a0cee7e">12 p.m. - 1 p.m.:</h3>Lunchtime is a brief break from work, where I try to relax and spend time with my baby. It's my time to recharge and recenter.<h3 id="d203c4b3-e441-464b-beb7-cc815bcec4ea">1 p.m. - 5 p.m.:</h3>The afternoon is filled with more provider consultations, clinical research, creating social media content, or meetings. My husband picks the kids up from school.<h3 id="27b042ac-beb5-4820-96c5-4e222c78bf8f">5 p.m. - 7 p.m.:</h3>Dinner time is family time — I block my work calendar to be fully present during these hours. We eat together, talk about our day, and unwind.Our nanny leaves around this time, and my mom rests in her room. The evening usually involves playing with the toddlers and caring for the baby, but by this point, I'm pretty exhausted.I try to remind myself that these years will go by quickly. This is sometimes when I yearn for the days to be longer so I could spend more hours with the kiddos. Guilt tends to creep in, and I wish I had more to give.<h3 id="1cf989b4-869d-48f6-b2ec-cfd2a9975940">7 p.m. - 7:30 p.m.:</h3>Our baby goes down first, and then my husband and I put the toddlers to bed, usually with bedtime stories or some quiet time.<h3 id="25d878b7-7961-4f54-aaf0-2b8c87def575">8 p.m. - 10 p.m.:</h3>I might spend this time with my partner, catch up on a book, or relax. This is also when I sometimes lose track of good <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/sleep-hygiene">sleep hygiene</a> and end up scrolling through Instagram or watching reality TV. On an ideal night, I would prefer to do another 10-minute meditation, and I try when I can, but it's hard.There have been some very tough times, especially when our third child was born, but we also know it's the best time of our lives.<h2 id="6f990ed4-9b65-42ee-8dea-f89135fd0f0d">Communication and planning are essential</h2>My husband and I use shared calendars to keep track of our schedules, which helps us stay coordinated and avoid conflicts. We have occasional epic fails, like forgetting to leave on time to pick up our kids from school or camp.I know my husband doesn't feel guilty. I think it's partially because he's a man, but he also feels very comfortable with all of our different caretakers and that part of the work he does outside our home benefits our family and children.<h2 id="5806e438-54f7-4875-894f-f3a888237ca9">I'm not afraid to ask for help and set boundaries</h2>I don't hesitate to delegate tasks and ask for help. I couldn't have three children if I didn't have other adults in my home helping me mother my children as well as mothering me.I also have boundaries between work and family time. We have a rule not to check work emails while with our children. We've also created family traditions, like weekend outings, to make special memories together.<h2 id="18f4897c-e0e6-4f64-add4-ebde0d3c45d3">Making time for myself is important</h2>I try to meditate daily, journal when I remember to, and stick to an exercise routine that works for me, but I accept that things won't be perfect.There are days when everything feels chaotic, my house doesn't look Instagram-ready, and the balance feels off. Learning to let go of perfectionism and find joy in the moment has been key.My cofounder and my husband are my two critical partners. We each hold the other accountable. It's a sign of incredible strength to share honestly and respect your needs, reconciling them with those who depend on you.Want to share your work-life balance story? Email Lauryn Haas at lhaas@businessinsider.com.

I'm a doctor, CEO, and mother of 3. I set aside time to be fully present with my family every day, but I wish I had more to give.

Doctors in India are grappling to diagnose and treat unexplained and persistent symptoms of <keyword id="9814327" type="General" weightage="100" keywordseo="long-covid" source="Orion">long Covid</keyword> patients due to limited guidelines, whereas researchers have flagged inadequate studies on the condition. With the <keyword id="19896311" type="General" weightage="20" keywordseo="world-health-organization" source="keywords">World Health Organization</keyword> declaring an end to <keyword id="19896627" type="General" weightage="20" keywordseo="covid" source="keywords">Covid</keyword> as a global <keyword id="416511" type="General" weightage="20" keywordseo="health-emergency" source="Orion">health emergency</keyword> in May last year, focused efforts are underway around the world to estimate the burden of long Covid among the population. The condition refers to the set of lingering symptoms affecting varied body parts and persisting well beyond the acute Covid infection period, including cough, muscle and joint pain, fatigue, brain fog and difficulty in focusing. The viral disease is caused by the SARS-CoV-2 virus. While studies have suggested that about a third of those moderately or severely infected are likely to suffer from long Covid, region-wise though, incidence could vary. A study by researchers, including those from <keyword id="19988007" type="General" weightage="20" keywordseo="harvard-medical-school" source="keywords">Harvard Medical School</keyword>, US, estimated that 31 % of the once-infected people in North America, 44% in Europe, and 51% in Asia, have long Covid, which is "challenging the healthcare system, but there are limited guidelines for its treatment". It was published in the International Journal of Infectious Diseases in September. In India, however, studies on long Covid are few and far between. One such study by Maulana Azad Medical College in New Delhi, conducted from May 2022 to March 2023 on 553 patients who had recovered from Covid, found that about 45% had lingering symptoms, persistent fatigue and dry cough being the most common. "There is limited exploratory research on the long Covid syndrome with scarce data on long-term outcomes," the authors wrote in the study published in the journal Cureus in May this year. Understanding the long-term effects of the virus is important for developing management strategies, optimising healthcare delivery, and providing support to recovered Covid patients in the community, they said. Dr Rajesh Sagar, Professor of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, said, "Looking at the current state of long Covid studies in India, it is too premature to say that we understand the condition well enough to know how to diagnose or treat it." Animesh Samanta, assistant professor at School of Natural Sciences in <keyword id="19897094" type="General" weightage="20" keywordseo="shiv-nadar-university" source="keywords">Shiv Nadar University</keyword>, Greater Noida, said, "While studies in India highlight the growing recognition of neurological complications in long Covid patients, more focused research on neuroinflammation is needed." Doctors, too, have reported a rise in patients complaining of symptoms that they did not have pre-Covid. "People who never had <keyword id="6465125" type="General" weightage="20" keywordseo="asthma" source="Orion">asthma</keyword> in the past, post-Covid, with every viral infection, they get a long cough, shortness of breath and wheezing, which require the use of <keyword id="31257" type="General" weightage="20" keywordseo="inhalers" source="Orion">inhalers</keyword> or nebuliser," senior consultant Dr Neetu Jain, who runs a post-Covid care clinic at Pushpawati Singhania Hospital and Research Institute, New Delhi, said. Dr Arun Garg, chairman, Neurology and Neurosciences, Medanta-The Medicity, Gurugram, said he was noticing a spike in stroke cases among young patients not suffering from known risk factors such as diabetes, hypertension and obesity. "Similarly, we are seeing more cases of encephalopathy (swelling of the brain) without reason and having a confused state of mind following one or two days of fever. Their MRI scans show no changes. These patients have increased significantly after Covid," he said. In the absence of medical guidelines to diagnose long Covid, doctors are having to resort to broad, non-specific tests and questionnaires to gauge a patient's 'quality of life'. Studies have shown that the fatigue experienced in long Covid is similar to that in cancer patients, with a quality of life similar to patients of Parkinson's disease. "We really do not have any test to diagnose long Covid, even though it is definitely a clinical diagnosis. We diagnose long Covid for people who had at least moderate to severe infection, following which they could never regain the quality of life pre-Covid. Checking for inflammatory markers like C-reactive proteins (CRP) can support the diagnosis," Dr Jain said. "Other than routine blood tests that measure inflammation, we do antibody tests to look for direct markers. In many of these patients, we are finding rare antibodies which are very new to us and were not there pre-Covid," Dr Garg said. Inflammation persisting despite recovery from acute Covid infection is thought to lie at the heart of long Covid. However, tests to measure this specific immune response are lacking, even as researchers have been working in this direction worldwide. One such effort comes from Shiv Nadar University, where a team led by Samanta has developed a fluorescent probe capable of detecting inflammation in brain cells that can arise due to Covid infection. The probe measures nitric oxide levels in brain cells, especially in human microglia cells, where increased NO levels are linked to the SARS-CoV-2 infection. Microglia are immune cells in the brain that fight disease and help maintain brain health. Lysosomes within microglia, which help clear foreign disease-causing agents like the SARS-CoV-2 virus, produce nitric oxide as part of an immune response to infection. The probe detects nitric oxide produced in lysosomes in response to infection and thereby allows for a measurement of inflammation levels. This examination method can provide "qualitative information on infection status", said Samanta, corresponding author on the study published in the journal Analytical Chemistry in American Chemical Society. He explained that patients with pre-existing conditions such as Alzheimer's disease, Parkinson's disease or multiple sclerosis (an autoimmune disorder) could exhibit prolonged neuroinflammation and loss of brain cells following Covid infection. While the probe has shown efficacy in cell cultures, animal studies would need to be done, before testing it in humans, Samanta said. Looking at the World Health Organization International Clinical Trials Registry Platform, the study by Harvard Medical School had found that 587 clinical studies were conducted on long Covid, of which about 53% (312) were testing potential treatments. Most of these were found to be conducted in the US (58), followed by India (55) and Spain (20). The trials looked at interventions including physical exercise, psychotherapy, and pharmacological ones such as paxlovid and fluvoxamine. However, "to date, only 11 of these 312 studies have published their results that were not confirmative," the researchers wrote. The team called for studies to look into sleep disorders which were rarely included in the registered clinical studies. Further, interventions targeting the biological processes responsible for long Covid are needed but currently lacking, they said.

Doctors struggle to treat long Covid patients in India; researchers point to inadequate studies

<ul class="summary-list"><li>Walking pneumonia infections rose nationwide as kids returned to school this fall.</li><li>The infection can be tricky to diagnose, and testing is expensive.</li></ul>A common infection known as "walking pneumonia" has been on an uptick across the US in recent months, especially among kids and teens.The respiratory illness caused by mycoplasma pneumoniae bacteria is often called walking pneumonia because it tends to be milder than other lung infections. Patients may feel run down, with a cough and a slight fever, but are often still well enough to continue their daily life."It can be a little incognito, it can sneak up on people," Dr. Elizabeth Schlaudecker, medical director of infectious diseases at Cincinnati Children's Hospital, told Business Insider.The illness can be tough to identify and expensive to test for, and it can linger for several weeks, making it a frustrating sickness for families. Plus, treatment isn't necessarily one-size-fits-all.Here's what to know about how to spot it and treat it.<h2 id="c3f3c068-3915-4781-ba32-003daf8df1ce">Look out for a persistent cough, fever, and fatigue</h2><div type="image" title="kids going to school" height="1147" width="1600" msid="114857745" hostid="261" sizebytes="163892"></div>The tell-tale signs of walking pneumonia are not obvious. Illnesses caused by mycoplasma pneumoniae tend to be milder than infections caused by the more common bacterial pneumonia, streptococcus pneumoniae.ER doctor Russell Migita at Seattle Children's Hospital says it's hard to know exactly how many of the patients he sees have walking pneumonia cases, versus strep pneumonia or viral pneumonia. Often, doctors use a stethoscope to listen for a characteristic, localized "crackling" noise in patients with walking pneumonia, but not every patient has that.Testing for the bacteria that causes walking pneumonia is also expensive, relatively new, imperfect, and may not be covered by insurance, Migita said, so it's hard for experts to know exactly how bad this fall outbreak really is, compared to years past.The latest CDC data on the tests that are being done suggests more toddlers are getting walking pneumonia this year than was thought to be typical; the illness used to be viewed as more common in school-age kids. There have also been outbreaks among young adults living in dorms, where the bacteria has plenty of time to incubate and spread.Schlaudecker is part of the CDC surveillance network testing patients for mycoplasma bacteria across the country. She said test results indicate a surge in infections peaked in late August and early September as kids headed back to school, and started trading germs again. "Hopefully it's starting to slowly decline, but we're definitely still seeing it," she said.People who've recently <a target="_blank" class="" href="https://www.yalemedicine.org/news/walking-pneumonia">had the flu</a> are also at increased risk for developing walking pneumonia.<h2 id="bd4d6715-82de-4c8c-8927-c9f2b650d92c">Amoxicillin may not be your doctor's first choice</h2><div type="image" title="amoxicillin tablets" height="2167" width="3250" msid="114857752" hostid="261" sizebytes="441756"></div><a target="_blank" href="https://link.springer.com/article/10.1007/s12519-024-00831-0">New studies</a> suggest there isn't always a clear winner when it comes to the best treatment for walking pneumonia.Even though macrolide antibiotics, like azithromycin, are the <a target="_blank" href="https://www.cdc.gov/mmwr/volumes/73/wr/mm7307a3.htm">recommended treatment</a> and should perform better than penicillin-based antibiotics like amoxicillin on this bacteria, there isn't great data on which medication actually helps shorten and improve the course of this infectious disease best.In practice, Migita says doctors often use a mix of their own experience, local disease trends, and a particular patient's history and preferences to get a sense of what might work. In some cases, patients will get better without medication, but for bacterial pneumonia, an antibiotic can help. Doctors assess the situation on a case-by-case basis, similar to how they would treat an ear infection."Empiric treatment is what we do in most cases for most pediatric infections because it's hard to say for sure what's causing it," he said. "If you're not getting better on your first antibiotic in two to three days, then get seen again."Doctors say even though walking pneumonia doesn't tend to be as severe as other seasonal illnesses kids pass around like the flu, COVID, or RSV, it can still be a burdensome one for families, because it tends to last for a long time. In rare cases, walking pneumonia can prompt brain swelling, kidney issues, and difficulty breathing, and people with lung issues, and weakened immune systems may be especially at risk of hospitalization with walking pneumonia.Earlier this year, Schlaudecker's 15-year-old daughter had a persistent cough that continued for a week after what her mom thought was just a cold. They went to see her pediatrician, who listened to the girl's chest with a stethoscope.Without any testing, the daughter was diagnosed with walking pneumonia, and prescribed a Z-Pak (azithromycin). Within 24 hours of beginning her medication, the teenager felt great again."She was like, 'Wow, this is so cool that we figured out what it was and got on the right drug," Schlaudecker said. "It was a good medical success story."

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