Before you start shopping for or taking supplements, it’s important to know that not all supplements are created equally. This is because supplements are not as closely regulated by the U.S. Food & Drug Administration (FDA) as prescription medicines and conventional foods are. “Supplements may carry harmful risks such as inaccurate dosing information and contaminated ingredients,” says Wendy Kaplan, MS, RDN, a dietitian in Long Island, New York.
That’s why smart supplement shopping is so important. “If you’re not sure about the safety of an ingredient, the first thing you should do is talk to your doctor or pharmacist,” notes John Travis, a senior research scientist at NSF International, a global public health and safety organization. “Also look for an independent certification mark on the label before you start using the product; this is especially important if you’re already taking a prescription medication.” Examples of such certifications include ones from NSF International and the United States Pharmacopeial Convention.
11 things your itchy skin can reveal about your health
11 things your itchy skin can reveal about your health
An intense itch all over the body often occurs in people with late stage kidney disease or who suffer from chronic renal failure. In fact, one study showed that 42 percent of dialysis patients suffered from moderate to extreme renal itch. “Some people describe it as a nuisance,” says Anthony M. Rossi, MD, assistant attending at Memorial Sloan Kettering Cancer Center and New York Presbyterian Hospital. “[The itch] is so intense that people wake up in the middle of the night scratching.” Science has yet to uncover why kidney disease causes itchiness, but doctors suspect it has to do with the build up of toxins in your body when your kidneys are unable to remove the waste from your bloodstream. Aside from treating the disease, a doctor may prescribe medications like gabapentin, an anti-seizure medicine that’s been FDA-approved for off-label use to quell renal itch. Here are 9 more little body changes that could signal much bigger health problems.
Itching all over could also be a silent sign of liver disease. Where incessant itchiness shows up late-stage in kidney disease, it can be an early symptom of liver disease. “If your liver is not functioning properly to detoxify the body, byproducts like bile acids back up,” says Dr. Kathleen Cook Suozzi, MD, assistant professor in the Department of Dermatology at Yale School of Medicine. “The primary goal is to treat the underlying liver disease and prescribe medications that can eliminate the bile acids.” Doctors will typically prescribe medications that can inhibit your body’s uptake of bile acids or help reduce the amount of bile acid returning to the liver. Don't miss these 9 signs your liver is in big trouble.
A chronically itchy upper middle of the back (without a rash) can be a hallmark of neuropathic itch, a symptom of nerve malfunction. Before providing treatment, doctors will first rule out spinal cord disease as a cause. Research has shown that spinal disease, whether due to age or injury, can apply pressure on the nerve and pinch it, which results in an itchy sensation on the skin. Neuropathic itches can occur on one side of the body or both, but it's a big red flag if scratching brings no relief. “People with eczema get a good sensation from scratching,” says Dr. Rossi. “But [nerve itch] doesn’t improve with scratching. The itch intensifies most of the time.” Some people say it feels like insects are crawling on them. Once spinal cord disease or other health conditions have been ruled out, neuropathic itches can be treated with capsaicin cream, which is derived from hot peppers, to burn out the nerves that are firing irregularly on the skin. Make sure you know what muscle spasms can reveal about your health.
Extremely itchy bumps or blisters on knees, elbows, buttocks, and/or hairline are signs of dermatitis herpetiformis (DH), a skin manifestation of celiac disease. “When a person with celiac disease consumes gluten, the mucosal immune system in the intestine responds by producing a type of antibody called immunoglobulin A (IgA),” John Zone, MD, Celiac Disease Foundation medical advisory board member told celiac.org. These IgA antibodies travel to and bind with the skin cells to trigger an itchy response. The prescription Dapsone can provide short-term itch relief for the skin, but the intestinal damage is serious and patients have to adopt a strict gluten-free diet for life. If they continue to eat gluten, celiac patients can develop malnutrition, anemia, bone loss, ulcerative colitis, and even cancer. Here are 11 celiac signs you need to pay attention to.
“The other thing that you want to rule out are blood disorders,” says Dr. Suozzi. “Anywhere from five to 30 percent of lymphomas such as Hodgkin’s and non-Hodgkin’s can present with itch.” Itchiness with or without a rash can be the first symptom of Hodgkin’s disease—likely caused by cytokines, cell signal molecules that trigger inflammation in response to infection. If your doctor suspects lymphoma, she may order a chest X-ray to eliminate the possibility. If you're diagnosed with the disease, the itching will cease soon after starting chemotherapy or radiation therapy.
“Thyroid disease, whether it’s overactive or underactive can cause weird sensations in the skin,” says Cameron Rokhsar, MD, associate clinical professor of dermatology at Mount Sinai Hospital and dermatologist and cosmetic surgeon at New York Cosmetic, Skin & Laser Surgery Center. “No one knows the association but it may be that the changes in the sweat glands can cause skin dryness.” Itchy, dry skin is more common in people who have hypothyroid, because skin tissue contains thyroid hormone receptors that are seeing diminished cellular activity in the absence of thyroid hormone.
Allergies are one of the most common chronic health conditions in the world. In fact, many skin allergies are classified under the umbrella term contact dermatitis, the itchy rash on your skin that you get when you come into contact with an allergen. Poison ivy, nickel, or compounds found in personal care items like baby wipes and makeup are just a few of the allergens that can cause contact dermatitis. Your dermatologist may stick patches on your skin with different compounds that are correlated to the most common allergens to pinpoint the root cause of your allergies. “It’s like a treasure hunt when we’re trying to look into all the products that people use,” says Dr. Suozzi. A strong topical steroid is prescribed for relief. Don't miss these 8 signs your skin products are secretly damaging your face.
If you’ve finally hit menopause, you may have noticed a sudden change in your appearance—including dry skin. The loss of estrogen, an essential building block for collagen production, leads to thinner, itchier skin due to a diminished supply of natural oils that keep your skin’s moisture intact. Maintain your fountain of youth with Aloe Vera gel or calamine lotion, which help hold water in your skin’s outermost layer to alleviate drying and itching.
Paget’s disease of the nipple is an incredibly rare form of breast cancer where cancer cells collect in or around the nipple. According to the National Cancer Institute, Paget’s disease of the nipple accounts for less than 5 percent of all breast cancer cases in the United States. The first sign is scaly, red, itchy patches around the nipple and areola. “Sometimes it's misdiagnosed as eczema of the nipple,” says Dr. Suozzi. “But when it's breast cancer-associated it's unilateral.” Itchy skin isn't the only sign of disease; here are the 10 subtle signs of disease that your feet can show.
The American Pregnancy Association states that 1 in 150 women will develop pruritic urticarial papules and plaques (PUPP), an outbreak of itchy red rashes commonly seen on the abdomen, though they can also appear on your legs and arms. Most women can’t do much about the itch because the rash typically doesn’t develop until late into the third trimester when most medications are off limits. “It’s not proven but some people say [PUPP] can happen with multiple gestations like twins,” says Dr. Rossi. “And some people think it’s because the skin gets stretched out.” Fortunately, it’s harmless and goes away after pregnancy.
If after lightly scratching your skin, your fingernails leave thin, raised red welts on your skin that take 15 to 30 minutes to disappear, you may suspect dermatographia. Although the cause of this condition is unclear, the Mayo Clinic says it could be triggered by stress, infections, allergens, or medications like penicillin. “It’s an extreme skin condition, where your skin is sensitive to touch and releases too much histamine,” says Dr. Rokhsar. Areas of touch and clothing are the most susceptible to dermatographic flare-ups. It’s easy to diagnose but often goes undiagnosed because it’s not severe or bothersome enough for people to make an appointment with their dermatologist. If the itch becomes severe, your doctor can prescribe an antihistamine to relieve the inflammation. If this becomes a regular occurrence, ask your doctor if you might have histamine intolerance or even mast cell activation syndrome—both are conditions where the body fails to process histamine properly.
Other resources exist to help you shop smartly. CVS Pharmacy recently launched a “tested to be trusted” program for the supplements it sells; the program requires that all supplements sold at the store have undergone third-party testing to verify the accuracy of ingredients and also to confirm that products are free from certain additives and ingredients. And ConsumerLab.com runs reviews of the top-rated supplements in many supplement categories. Here are additional reasons to chat with your doctor before you start taking supplements.
Your doctor may recommend a blood test
Self-diagnosing isn’t necessarily the best strategy. While if you’re pregnant, it may be a no-brainer that you need a prenatal vitamin, not everyone needs to supplement with vitamins such as vitamin D or vitamin B12. “A supplement, just from the word itself, is meant to supplement or augment any vitamin or mineral you might be lacking or not having enough of,” says Robert Segal, MD, founder of Medical Offices of Manhattan in New York City. “Your doctor can recommend a blood test to find out which (if any) vitamins or minerals you may have deficiencies of.”
You want to get the intel on supplement benefits
“Ongoing research shows some supplements can have striking health benefits,” says William Li, MD, author of Eat to Beat Disease. “For example, a supplement formulation called AREDS may reduce the risk of vision loss from a condition called age-related macular degeneration. Fish oil supplements containing omega-3 fatty acids can lower risk factors for heart disease, and supplements containing prebiotics and probiotics are looking like they may be future game-changers for health as we begin to understand how our gut microbiome defends us against chronic diseases.” Discuss your specific health concerns and family history with your doctor. Then find out the probiotics brands nutritionists trust the most.
Supplements may have unproven claims
“Some dietary supplements make claims that are either not well substantiated or have no data to back up the specific claim,” says Marilyn Schorin, PhD, RDN, a dietitian in Louisville, Kentucky. “Some claims are very vague—such as helping brain health or boosting immunity—so your perceived benefit may vary substantially from the studies used to support the claim. Your doctor or health professional can help to sort the benefit from bluster.” Registered dietitians tend to be especially schooled in supplement knowledge, and you can find one in your area using the “find an expert” tool at EatRight.org. These are the anti-aging supplements doctors trust the most.
Your doctor may want to chat about family history
“It is not a good idea to just add supplements without discussing with your doctor and knowing what you need,” says Melissa Altman-Traub, MS, RDN, a dietitian in Jamison, Pennsylvania. “For example, if a person feels tired and decides to take an iron supplement to treat that, she may not know if she has a hereditary condition that causes her to absorb more iron and accumulate it. The excess iron could cause organ damage, and the original cause of the fatigue would go untreated.” Learn the nutrients even nutritionists don’t get enough of.
Certain supplement ingredients may be dangerous
“Many supplements have complicated names, and some potentially dangerous ingredients are listed under names that make them seem like safer, natural products,” says Travis. “For example, harmful compounds such as DMAA, DMBA, and DEPEA have been deceptively labeled as botanical extracts like geranium oil and dendrobium extract.” DMAA, for example, is an amphetamine that can cause health problems as serious as a heart attack, according to the FDA. See the vitamin brands doctors trust most.
Supplements may contain fillers that don’t agree with you
It’s common to look at a supplement but not the filler ingredients it contains. These ingredients may be problematic for certain people. For instance, they may contain inactive ingredients that pose a risk to someone with celiac disease. “It’s important for people to remember that not all supplements are created equally, and there can be added fillers, sugars, or other ingredients in supplements in addition to what you think you are taking,” says Nicole Avena, PhD, assistant professor of neuroscience at Mount Sinai School of Medicine, in New York City. “This is why it is important to review the ingredients list of any products you plan to take with your doctor to ensure that all are safe and won’t interact with anything in your personal medical history.”
You may end up taking in toxic levels
It may sound like a great idea to take a supplement such as vitamin A. But your body stores the fat-soluble vitamins A, D, E, and K—and you can easily overdo it. “Certain supplements may contain excessive amounts of vitamins and minerals, and if taken every day they can accumulate into toxic levels,” says Allie Hosmer, MS, RDN, a dietitian in Washington, D.C. Minerals can also accumulate in your body. “You could be feeling nauseous due to excess iron intake,” adds Segal.
You must take precautions before surgery
Having surgery in the near future? Disclosing your supplement regimen to your doctors and surgical team is of the utmost importance. This is because certain supplements may increase your risk of bleeding during surgery. This list includes gingko biloba, milk thistle, and turmeric, according to the Stanford University School of Medicine. Your doctor will likely tell you to stop taking such supplements a certain amount of time before surgery.
Supplements and meds may interact badly
“Because dietary supplements are mainly sold over the counter, it is very easy to start and stop dietary supplementation without your doctor’s knowledge,” says Sophia O. Tolliver, MD, MPH, family medicine physician at The Ohio State University Wexner Medical Center, in Columbus, Ohio. “Depending on the complexity of your health history, you could be at risk for medication interactions with unknown dietary supplementation.” Case in point: If you’re taking the blood thinner Warfarin, your doctor may advise against taking vitamin A, vitamin E, or garlic supplements. These can thin the blood—and when coupled with Warfarin, may make bleeding more likely, notes Dr. Li.
Interactions may make you feel icky
Even if you’re taking a short-term medication, such as an antibiotic, let your doctor know about your supplement routine. Here’s an example: “Combining magnesium and an anti-hypertensive medication could potentially have added effects, making a patient lightheaded, dizzy, or even faint,” says Lauren Tessier, ND, a naturopathic physician in Waterbury, Vermont. See the supplement or medication combos you should never mix.
Supplements may make meds less effective
“St. John’s Wort is often hailed for it’s used for depression,” says Joan Salge Blake, EdD, RDN, a nutrition professor at Boston University and host of the health and wellness podcast SpotOn! “Unfortunately, this supplement can weaken the effects of many medicines, including crucially important ones such as birth control pills.” Many, many other potential interactions exist—for instance, vitamin K1 can counteract Warfarin, notes Adam Splaver, MD, a cardiologist in Hollywood, Florida. So always give your doctor a full list of every single medicine and supplement you take, even if you take them infrequently.
You could land in the emergency room
More than 23,000 emergency room visits per year are linked with negative effects from supplements, per a study in the New England Journal of Medicine. If you tell your doctor everything you’re taking, she could advise you to stop a supplement that’s dangerous, pronto. “Having a discussion with your doctor about dietary supplements will help to flush out the potential risks and benefits of dietary supplements,” says Tolliver. Find out medication mistakes that could make you sick.
Genetics play a big part in health conditions, so looking at your mom’s health can give you a clue what’s to come. This is especially true of complications that affect women more than men, like osteoporosis, a weakening of the bones. According to the CDC, osteoporosis affects 25 percent of women over 65, but only six percent of men—and recent research has found genetic variants predisposing some people to the disease. “There is strong evidence for an increased risk of osteoporosis if your mother had it,” says Todd Sontag, DO, a family medicine specialist with Orlando Health Physician Associates. “Many times this has to do with an inherited body structure of having lower body weight—less than 58kg [128 pounds] in adults or a BMI of less than 22.” Another risk factor is simply having a parental history (mom or dad) of hip fracture, he says. To mitigate these affects, make sure you’re getting enough calcium and vitamin D, and are living a healthy lifestyle. Here are the signs you’re not as healthy as you think.
Wonder if you’re going to get wrinkles or skin damage? Take a look at your mom’s face. Research has shown that male and female skin ages differently due to different hormones. “Your mother’s ability to break down collagen and the age when it started breaking down—the age when she got wrinkles—are passed down to you, as well as the pattern of collagen breakdown: Did she get wrinkles around her eyes first, or deeper lines around her mouth?” says dermatologist Purvisha Patel, MD, creator of Visha Skin Care. “Looking at pictures of her as she ages helps you understand how to combat your aging process.” Daily sunscreen and an anti-aging serum with retinol, vitamin C, ferulic acid, and vitamin E work to fight these genetic effects, she says. In addition, your skin type, passed down from your mother and your father, can affect your chances of sun damage and skin cancer. Those with fairer skin are most at risk. This is what dermatologists wish you knew about preventing wrinkles.
If you’re aware of what psychologists wish you knew about depression, you might already know that depression is diagnosed twice as often in women as in men, possibly as a result of hormonal fluctuations and women’s response to trauma and stress. “Another important aspect in gender studies shows that women have a more chronic course of depression than do men,” says psychologist Deborah Serani, PsyD, award-winning author of Living With Depression. “This means that females experience depression more often and for a longer duration of time than males.” Plus, it’s genetically linked, with Harvard Medical School experts noting that certain genetic mutations associated with depression occur only in women. So if your mother had depression, you should be on the lookout for symptoms, and get treatment if needed. “This is why knowing your family medical history is so important to become proactive about your own personal health,” Dr. Serani says. Here are the signs you’re healthy from every type of doctor.
Women are more likely to have the eye condition glaucoma, and are also more likely to be visually impaired or blind from it, says the American Academy of Ophthalmology (AAO). Thanks to menopause, women are also more likely to have dry eye syndrome, which frequently occurs with glaucoma. Plus, glaucoma runs in families—so if your mom (or dad) has it, be sure to let your eye doctor know, and get screened for it regularly. “You are at higher risk for developing glaucoma and [another eye condition] macular degeneration if your mother had it,” says Dr. Sontag. “Just like everything else, there are other lifestyle factors that contribute as well.” The AAO says to also avoid smoking to reduce your risk. Here’s how to improve your eyesight—without eating carrots!
There are multiple reasons you might have a migraine, and your mother is just one of them. According to the Mayo Clinic, women are three times more likely than men to have migraines, likely because of hormonal fluctuations. The National Headache Foundation notes that 70 to 80 percent of migraine sufferers have a relative who gets the debilitating attacks as well. “One of the main risk factors for migraines is family history of migraines,” Dr. Sontag says. “So yes, if your mother has migraines, you are more likely to develop them as well.” Emerging research is identifying how and why genetics play a role, with one large international study suggesting it may have to do with how the blood vessels function in the brain. But until we know more, if your mother suffers from migraines, you can try to reduce your risk by limiting other risk factors, like getting regular exercise and sleep, managing stress, and avoiding caffeine and any individual food triggers.
Nearly two-thirds of those with Alzheimer’s are women, according to the Alzheimer’s Association. The exact reasons why are yet unknown, but seem to go beyond the simple fact that women live longer than men. Researchers have also found genetic links for Alzheimer’s. “There are genetic alleles that have been identified that increase risk of developing Alzheimer’s disease,” Dr. Sontag says. “A maternal history does increase the risk.” The National Institute on Aging reports that if your mother or father has a genetic mutation for early-onset Alzheimer’s (which appears from your thirties to mid-sixties), there’s a 50/50 chance you will inherit it—and if you do, there is a strong possibility of developing the disease. If your mother had Alzheimer’s or other dementia, you can reduce your risk by exercising, eating a heart-healthy diet, maintaining social ties, and staying mentally active. These are the early signs of Alzheimer’s disease every adult should know.
Weight, body shape and fitness level
As with many other aspects of health, the condition of your body is partly genetic, partly environmental. So if your mother has a certain body type or weight, you may be more likely to have the same one—but that could be the result of learned behaviors, too. “While there is some solid research to support a maternal’s body shape and weight and its influence on her children, this is definitely not the only contributing factor,” Dr. Sontag says. “Many times, the lifestyle of the mother is what is learned and passed down to her kids, which includes the way she eats and exercises.” So if you grow up eating the same way as you mother, it’s not surprising if you develop a similar body. Likewise, the fitness level you can achieve is part hereditary, part lifestyle. “Genetics do play a strong role in our muscle make-up,” Dr. Sontag says. “No matter how much certain people train, they will never be as fast as Usain Bolt or Michael Phelps.” Still, if your mom is overweight, you can help avoid the same fate by eating healthy and exercising, with the goal of being the healthiest you can for your individual body.
Heart disease and diabetes
Women may believe they don’t have to worry about heart disease, but just like men they need to understand their genetic heart disease factors. Given genetic similarities in weight and body shape, you and your mother might also have a similar risk of heart disease, the number one killer of women, as well as type-2 diabetes. A recent study presented at the American Society of Human Genetics found that maternally inherited gene variants of how women store fat can affect their risk of type-2 diabetes. “There is strong evidence that if your mother has heart disease, type-2 diabetes, or strokes, that you are at a higher risk to develop them,” Dr. Sontag says. “The younger the age that the mother developed it tends to correlate with a higher risk in the children.” But again, there are lifestyle factors to consider. “If your mother had a heart attack at 50, but weighed 300 pounds, never exercised, and smoked, the risk may be completely related to her lifestyle,” he says. “You can’t have soda every day and ice cream every night and then use your family history as an excuse when you develop diabetes.” Still, if your mother (or father) had early heart disease, Dr. Sontag recommends a checkup with a cardiologist. These are the physical and emotional ways heart disease is different for women.
Pregnancy and fertility
If you’re looking to see what your pregnancy experience will be like, ask your mother about carrying you. “Gestational diabetes is more common in women who are risk for adult onset diabetes, which does run in families, so if you have a strong family history of diabetes, you are at increased risk for gestational diabetes,” says Pamela Berens, MD, an OBGYN with McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital. In addition, “preeclampsia is more common in women who have had high blood pressure, and high blood pressure may be inherited.” A Norwegian study showed severe morning sickness, or hyperemesis gravidarum, may be inherited as well. As for issues getting pregnant, most causes of infertility and miscarriage are not genetic—but some may be. “There appears to be an increased risk of endometriosis in first-degree relatives of women with endometriosis,” Dr. Berens says. “Rarely, some women with recurrent miscarriages can have an inherited chromosome issue that makes miscarriage more common, and genetic testing can be done.” For some other infertility conditions, such as PCOS, it’s not clear yet whether genetics are at play.
You should also ask your mom if she suffered from postpartum depression after pregnancy. Like other aspects of mental health, it may be passed from mother to daughter. “Studiesshow that postpartum depression is genetically linked,” Dr. Serani says. “Your risk for PPD increases if your mother, or another family member—sister, aunt—has experienced it.” One small study from Johns Hopkins found specific chemical alterations in two genes that, when they occur during pregnancy, can predict whether a woman will develop postpartum depression with 85 percent accuracy. The researchers hope this will eventually lead to a blood test that can give pregnant women a better indication of their risk—but for now, knowing your family history is important. “Ask your mother about her postpartum experiences,” Dr. Serani says. “This can informally clue you in to whether or not depression is a risk factor for you.” Here are seven dangerous postpartum depression myths.
Breast and ovarian cancers
Awareness on the genetic link of breast and ovarian cancers may be due in part to Angelina Jolie, whose mother died from breast cancer. After discovering she carried the BRCA1 gene, the actress underwent a preventive mastectomy, reducing her breast cancer risk from 87 percent to under 5. “The gene mutations that are most commonly associated with hereditary breast and ovarian cancer are the BRCA1 and 2 gene mutations,” Dr. Berens says. “If you have a suspicious family history—for example, if you have multiple family members with breast or ovarian cancer, if the breast cancer happened at an early age, or if the same family member had both cancers—it is more suspicious that you could have a genetic tendency.” Talk to your doctor about your individual risk if you mom or other female relatives had one of these cancers, and consider seeing a genetic counselor for genetic testing.
Studies have shown that the age at which your mother went through menopause will be partly responsible for when you do. In addition, if your mother went through menopause early, you should let your doctor know. “Premature ovarian insufficiency, before 40, can be caused by a number of conditions, and some of these conditions can be inherited—for instance women who are fragile X carriers,” Dr. Berens says. Fragile X is a gene mutation linked to the X chromosome, and it can trigger anxiety, hyperactivity, and intellectual disability. As for menopause symptoms such as hot flashes and night sweats, Dr. Berens says scientists are trying to clarify if there’s a genetic link. The first study of its kind in humans, from UCLA, might have found a related gene variant, but more research is needed. Next, check out what your sweat says about your health.