Many adults enjoy alcohol or use cannabis products for a variety of reasons. They may use these as ways to relax, but did you know that these substances can raise blood pressure? Here’s what you need to know about how alcohol and cannabis may raise blood pressure in adults.* 

Alcohol is a buzzkill for your liver

Alcohol is processed by the liver, which can handle only so much at a time. Too much alcohol can damage the liver over time. Drinking too much alcohol — beer, wine, or liquor — can raise the force your blood exerts on your arteries. What is “too much”? As with many substances, the poison is in the dose, which means — it depends on how much, your size, gender and age.

“We process alcohol differently as we age,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Men and women handle alcohol differently. Medications also can impact how your body responds to alcohol.” 

Moderate drinking is considered to be two drinks or less in a day for men and one drink or less for women. Binge drinking means four or more drinks for women, or five or more drinks for men during an occasion. Heavy drinking means eight or more drinks for women, or 15 or more drinks for men during a week.

A “drink” is:

• 12 ounces of beer with 5% alcohol
• 8 ounces of malt liquor with 7% alcohol
• 5 ounces of wine with 12% alcohol
• A shot or 1.5 ounces of liquor or distilled spirts (80-proof liquor)
  • 80 proof means the liquor has 40% alcohol.
  • Types of liquor include brandy, gin, rum, tequila vodka, and whiskey.

“Even moderate alcohol consumption can interfere with blood pressure medication,” Dr. Brandon said. 

According to the National Institute on Alcohol Abuse and Alcoholism: 

• Alcohol can alter the metabolism of a medication, speeding or slowing the clearance of the medication from the body and thus lowering or raising the blood levels of the medication.
• A medication can influence the absorption and metabolism of alcohol, potentially resulting in higher blood alcohol concentrations (BACs) and other adverse effects. 
• Alcohol can alter the pharmacological effects of the medication, which can increase or decrease the effect of the medication on the body.

Cannabis is not a chill as you might think (at least for your heart)

Tetrahydrocannabinol (THC) is the primary active compound in cannabis. It’s what gives users a “high.” THC can cause temporary spikes in heart rate and blood pressure. How your body responds to THC depends on several factors, including:

• Dose
• Method — smoking, gummies, edibles
• Overall health, including the presence of chronic conditions
• The presence of other substances, such as medications, alcohol, or tobacco
• Age
• Frequency and duration of use

The side effects of cannabis taken with blood pressure medication include:

• Marijuana’s biggest-known impact is with opioids, sleep medications, muscle relaxants and alcohol, because all affect the central nervous system. Marijuana use combined with these may boost the effects of both.
• Marijuana may increase the risk of bleeding when taken with drugs that increase the risk of bleeding, such as aspirin, blood thinners or other pain relievers, including ibuprofen and naproxen.
• Marijuana may affect blood sugar levels. If you are taking medication or insulin for diabetes, you should be watched closely by a health care provider.  
• Marijuana may cause low blood pressure, which may affect people on high blood pressure medication. 

As cannabis becomes legal in more places, both for recreational use and for medical purposes, people should stay informed about the potential health risks. One small study showed a moderate increase in systolic blood pressure with cannabis use. The general consensus is more research is needed, especially in older adults. 

Blood pressure and substance use

High blood pressure is referred to as a “silent killer,” due to the lack of symptoms. Long-term high blood pressure increases the risk of heart attack, heart disease, stroke and kidney disease.

• High blood pressure is often symptom-free — hence “the silent killer.”
• Long-term high blood pressure  increases risk of heart attack, stroke and kidney disease.
• Alcohol and cannabis can make it harder to manage or detect changes in blood pressure.
• Getting blood pressure checked regularly is key — even if you feel fine.

No judgment, just things to know:

• Your first step should be awareness. Get a baseline blood pressure reading with your health care provider at your annual checkup. Keep track of your blood pressure using an at-home monitor. Check your blood pressure after alcohol consumption or cannabis use. 
• Be honest with your health care provider so they can give you the best care and offer options to keep you safe and healthy. This may help you make smarter choices for your health. 
• Little tweaks can add up, and your doctor can help by adjusting medications or explaining how much to cut back. 

Checking in with your heart

Heart health isn’t about giving up things you enjoy; it’s about understanding how your lifestyle may affect your health. Talk to your doctor honestly about your drinking, even if it’s an uncomfortable topic.

“It is important for your health care provider to know if you are using alcohol or cannabis, even if it’s moderate use,” Dr. Brandon said. “There may be potentially harmful interactions that you don’t know about.” 

*Disclaimer: Recreational cannabis use is currently illegal in Kentucky and Indiana.

The post The effects of alcohol and cannabis on your blood pressure appeared first on Norton Healthcare.

You used to bounce back after a weekend of yard work — now your back feels it for days afterward. You started having knee pain when you use the stairs. Or maybe your hands started feeling stiff in the mornings. Any of this sound familiar?

As the years go by, our bodies change, and certain symptoms remind us of the aging process. But how do you know when these body aches and pains are just part of normal aging? When are they signs of something that needs medical attention?

“It’s important to address discomfort early, rather than pushing through pain or limiting your regular movement,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Your primary care provider can suggest early interventions to help you remain active and independent for as long as possible.”

Normal aging aches and pains vs. red flags

As we get older, our bodies inevitably change. After age 55, normal signs of aging can involve some mild stiffness or achiness first thing in the morning, that improves as you move around. After being more active than usual, you might be more susceptible to general muscle soreness that resolves within a couple days. It might take longer to recover from physical exertion, compared with your younger years. Occasional joint stiffness, especially during weather changes, is common as well.

However, you should be aware of the red-flag symptoms when it comes to aches and pains associated with aging:

• Pain that interferes with your regular activities or hobbies you enjoy
• Pain that wakes you up at night
• Visible swelling or redness around joints
• Numbness, tingling or weakness in limbs
• Sharp pain with certain movements
• Pain that steadily worsens over weeks or months
• Discomfort that limits your daily activities or independence
• New symptoms that appear suddenly
• Over-the-counter medications not providing adequate pain relief

Common causes of aging aches and pains

As we age, a variety of factors can cause increased physical discomfort, including:

Arthritis: Over 50% of adults over 65 experience joint pain, with arthritis being one of the most common causes. Osteoarthritis, the wearing down of joint cartilage, is more common in older adults and often affects the knees, hips, hands and/or spine.
Inflammation: Our bodies may develop more chronic inflammation with age, which can contribute to general body aches, muscle pain, joint pain and discomfort.

Past injuries: Old injuries can reemerge as pain points with age. Whether you broke a bone playing high school sports or hurt your neck in a car accident many years ago, the pain may become noticeable again.

Muscle changes: Sarcopenia is the gradual loss of muscle mass in older adults. This can put additional stress on joints and increase the risk for added strain during normal activities.

Underlying conditions: Your primary care provider can help rule out an underlying medical condition. Conditions such as diabetes, osteoporosis, peripheral vascular disease and other health issues also cause pain, stiffness or discomfort in muscles and joints.

How your primary care provider can help

Many adults avoid mentioning new aches and pains during checkups, thinking they’re just part of getting older or fearing they’ll be told to “just live with it.” The reality is that your primary care provider can be one of your greatest advocates in maintaining mobility and comfort as you age.

Your provider can help rule out serious conditions and develop management strategies to address your pain. This may include lifestyle recommendations, medications or referrals to specialists like rheumatologists, orthopedists, physical therapists or pain management specialists.

3 ways to maintain mobility with age

Staying ahead of the aches and pains that come with aging can help preserve your mobility and independence during your older years. Incorporating the following lifestyle habits can help improve your quality of life:

1. Stay active: Regular, gentle movement helps maintain joint function and muscle strength. The Centers for Disease Control and Prevention recommends strength training exercises for older adults twice per week.
2. Maintain a healthy weight: A healthy weight can avoid additional stress on your joints. This includes regular movement, such as walking, and proper nutrition.
3. Have regular checkups: Take notice of symptoms and share details with your provider to help find the best treatment for you. Don’t hesitate to speak up during appointments. Instead of just saying your knee hurts, take note of when it hurts, what makes it better or worse and how it affects your activities.

When it comes to aging, you don’t have to accept persistent pain or misery as an inevitable part of the process. While some bodily changes come with aging, you don’t have to silently endure extreme pain without any medical help. Your provider can help support you on the journey of aging gracefully.

The post Aging aches and pains: Normal or a red flag? appeared first on Norton Healthcare.

The value of primary care for seniors

When dealing with elderly parents, having a plan in place for health care, living arrangements and other considerations before the need arises is a good idea. It’s also important to have an established primary care relationship.

“We can catch issues early and set a baseline for health, such as blood pressure, cholesterol levels and other aspects of health,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Then we can monitor changes over time.”

Primary care providers can help manage medications to avoid harmful drug interactions and can coordinate care services, including respite care or home care.

“We can make a plan for care services, home care or nursing home — whatever the family needs,” Dr. Brandon said. 

It also can be very helpful to have a primary care provider who knows the history and family dynamic of the aging parent.

“It can take time to build a relationship, so sooner rather than later is preferred,” Dr. Brandon said. 

When to offer support for aging parents

Knowing when or how to intervene in an elderly parent’s life isn’t always obvious. Here are some signs it might be time to start the conversation:

• Medication errors: forgetting doses or taking incorrect amounts
• A pattern of missed appointments
• No longer managing chronic conditions effectively
• Changes in sleep or eating patterns
• Notable changes in mobility
• Behavioral changes, including mood swings or withdrawal from typical activities
• Memory lapses beyond normal aging

How to talk to your aging parent about health care

The goal here is to find a situation that works for everyone while maintaining healthy boundaries and open communication. If you’re starting this conversation with the older adults in your life, approach with empathy, patience and an open mind. Frame your talk around maximizing independence for as long as possible, not taking it away. Address concerns — both those of the adult children and the elderly parent — openly and honestly. If it feels appropriate to include siblings, other family members or friends, bring them into the conversation as well. 

Making the most of doctor appointments

It’s a good idea for the elderly parent to take a friend or family member to doctor appointments. Before the appointment, make a list of questions or concerns to take with you, so you don’t forget anything important. 

Norton MyChart lets you see and update medications, review past diagnoses and treatments, and check upcoming appointments. You also can email your care team, and you can set up proxy access for your loved one’s Norton MyChart account. 

Practical next steps

After you’ve had the initial conversations around caring for your aging parent, you can start taking basic next steps, including:

• Making any doctor appointments together, including routine checkups
• Establishing a shared calendar
• Creating a medication system to help with doses and timing
• Considering further or more intensive care services
• Looking at nursing homes or other choices for living situations.
• Considering the need for home health care

Moving forward

As you have these conversations with your loved one about what life might start to look like in the coming years, emphasize that it’s a partnership.

“Even small interventions can make a difference and help build a deeper relationship between adult children and their parents,” Dr. Brandon said.

The post Caring for aging parents can be challenging. Here are some things to know appeared first on Norton Healthcare.

High blood pressure medication and sexual function

“We have a pretty good understanding about the link between high blood pressure and sexual dysfunction in men,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “We understand less about how it affects women.”

High blood pressure does not usually have symptoms. In time, this condition does damage to the lining of the blood vessels throughout the body. As the arteries harden and narrow, blood flow to the entire body is reduced, including the penis. This can lead to a condition called erectile dysfunction, which makes it difficult to get and maintain an erection. High blood pressure also can affect ejaculation. 

For women, it is possible that high blood pressure reduces blood flow to the vagina. Some women may also experience:

• Lowered sex drive or arousal
• Difficulty having an orgasm
• Vaginal dryness

Erectile dysfunction, lowered sex drive, difficulty reaching orgasm and other symptoms of high blood pressure can increase anxiety and relationship issues. 

There are several medications used to treat high blood pressure, and some of them may have sexual side effects. Some high blood pressure medicines can affect sex drive or the quality of sex.

• Water pills can decrease blood flow to the penis, which can make it difficult to get an erection. They also lower levels of zinc, which is needed to make the hormone testosterone. 
• Beta blockers especially older beta blockers such as propranolol, are often linked with sexual issues. 

Some high blood pressure medications may have fewer sexual side effects.

Other common medications and sexual health

Besides blood pressure medication, there are other kinds of drugs that can impact sexual function, including:

• Antidepressants (especially selective serotonin reuptake inhibitors, known as SSRIs) 
• Antihistamines and allergy medications
• Cholesterol-lowering medications
• Diabetes medications
• Hormone therapies
• Parkinson’s disease and seizure medications

Taking control: Practical steps for better sexual health

If you think your medications are causing unwanted side effects, are impacting sexual activity or are affecting your quality of life, it is important to talk to your health care provider. You should always take medications as prescribed, and do not stop or start a medicine without direction from your provider. Consider keeping track of your medication schedule and any effects you notice around sex or intimacy, and share that with your health care provider. 

“We may be able to modify medications, adjust dosage, change prescriptions or recommend other changes you can implement,” Dr. Brandon said. 

It is very important to be as open and honest as possible with your physician. Here are some guidelines for talking about sexual health with your health care provider:

Make a list of side effects and questions you have before your appointment.

Find a way to start the conversation that feels comfortable. Here are some tips for talking to your doctor about this issue. Try saying things like:

• I’m having some concerns about my sexual health.
• I want to ask about a specific health issue.
• I am having issues with sexual desire/low libido/sexual performance.

Once you start the conversation, most providers will pick it up from there. If you sense your provider may be uncomfortable, ask for a referral.

Primary care providers are your ally in sexual wellness

Your provider is a valuable resource and adviser for all your health needs. It may feel uncomfortable, but you deserve to have your questions answered and find help. Sexual health is important for your overall well-being and quality of life.

“We can’t help if we don’t know there is an issue,” Dr. Brandon said.

Beyond medication: Additional Solutions

There are ways to manage sexual side effects of drugs, including antihypertensive medication, mental health medicine and other medications, including: 

• Mechanical aids such as vacuum devices or penile implants may help with erectile dysfunction. There’s also a vacuum device for women. Dilators may help people who experience narrowing of their vagina due to menopause. Devices like vibrators can be helpful to help improve sexual enjoyment and ability to achieve orgasm.
• Sex therapists can help people experiencing sexual issues that can’t be addressed by the primary care physician. Therapists often can do couples counseling.
• Behavioral treatments involve various techniques, such as addressing harmful behaviors or self-stimulation methods. 
• Psychotherapy with a trained counselor can help you address psychological factors that affect sexual function, including trauma from the past, feelings of anxiety, fear, guilt and poor body image. 

The next step

Sexual health is a concern at any age. Prioritize your overall well-being, including intimate relationships. Talk with your primary care provider about any concerns you may have.

The post Medication side effects and your intimate life: A guide for older adults appeared first on Norton Healthcare.

The offices feature roughly 6,000 square feet of space and 14 exam rooms split among Norton Community Medical Associates primary care, a Norton Immediate Care Center and, eventually, a Norton Orthopedic Institute office. The new location also will have laboratory testing and X-ray capability to help providers accurately diagnose a variety of illnesses and injuries.

“Norton Healthcare is committed to expanding access to health care throughout the area,” said Russell F. Cox, president and CEO, Norton Healthcare. “The comprehensive care that will be provided in this new space will make it easier for so many more people to receive the care they need.”

The new space, located at 10798 Dixie Highway, is Norton Healthcare’s southernmost primary care office and immediate care center in Louisville. The building is just off the Gene Snyder Freeway (I-265/KY 841), allowing easy access for those using the city’s highway system, while also supporting population growth in the southwestern part of Louisville. The location also provides access to care for people just outside the city limits, including parts of Meade and Hardin counties.

“It’s very exciting to see the growth in this part of our city,” said Stephanie Harmon, practice manager for the new Norton Community Medical Associates office. “As someone who grew up in the south end of Louisville, I know this is something we’ve needed. To be a part of the team providing that care is extra special.”

The primary care practice will be led by Arilennis Medel Leyva, APRN, family nurse practitioner, who will move from Norton Community Medical Associates – Fairdale. Her diverse, bilingual experience as a clinician enables her to provide comprehensive, patient-centered care. Her philosophy emphasizes empathy, compassion and respect, focusing on individualized patient needs and holistic care.

“Access to primary care is essential for a healthy community,” Leyva said. “I’m excited to bring these services to Valley Station. I believe my experience and expertise can add to the level of care and trust we’ve already built in South Louisville, and I’m excited to care for and form relationships with patients in the area.”

The practice will have self-pay options and quick, easy access to the Norton Healthcare financial services teams for assistance with bill payment.

A Norton Children’s Medical Group pediatrician office will remain open in Fairdale at 189 Outer Loop, with plans to expand. Schedule an appointment by calling (502) 629-1234.

The post Norton Healthcare expanding services in Valley Station appeared first on Norton Healthcare.

Why are so many people lonely?

Studies, including one from Harvard’s Making Caring Common project, have revealed that while the COVID-19 global pandemic was a contributing factor to the rise of loneliness, about half of American adults surveyed were feeling alone before the pandemic. Some other catalysts for this loneliness epidemic include:

• Reliance on technology as a substitute for interaction: The use of texting, consuming social media, games and media can make it feel like you are part of a community, but it can be very isolating.
• Overwork, busyness and general fatigue: Many people report feeling too busy or too tired to be social.
• No community involvement or strong social network: This could be volunteering, church or other religious involvement, that gets people interacting in person and in real time.
• American society tends to be individualistic: We tend to applaud self-reliance, and resist asking for help.
• Remote work: The pandemic sent a large part of the American workforce home to work during quarantine. Many people have opted to continue this arrangement, which limits in-person interactions.
• Age: This may be surprising, but younger people tend to experience feelings of isolation more frequently than older people. In a Harvard study, people between ages 30 to 44 were the loneliest group — 29% of people in this age range said they were frequently or always lonely. Adults ages 65 and older reported the lowest rate: 10% said they felt lonely.

“There is also still a stigma around mental health issues,” Dr. Brandon said. “People feel embarrassed about their loneliness, or they believe they should be able to ‘snap out of it.’ That creates a cycle of self-isolation.” 

Loneliness and physical health

The Centers for Disease Control and Prevention has noted that social isolation and loneliness can increase a person’s risk for:

• Heart disease and stroke
• Type 2 diabetes
• Depression and anxiety
• Suicidality and self-harm
• Dementia
• Earlier death
• Weakened immune system
• Physical pain

People who feel isolated often need more health care and miss work more often than their counterparts with strong social connection.

What can we do about chronic loneliness?

 The Harvard study revealed some solutions to this public health crisis. If you are experiencing loneliness, you can:

• Reach out to family or friends.
• Work on self-love and practice self-care.
• Learn to be more forgiving of others.
• Find ways to help others.

Researchers from the Making Caring Common project stress the need to foster a culture that cares and serves others and building a sense of community with social infrastructure. Survey respondents mentioned wanting more community events, accessible public spaces and other ways to build meaningful relationships. Also, research on the “Blue Zones” — regions where people live longer and healthier — identified 10 habits for a healthier life, which include ways to get connected, reduce stress and improve overall health.

If you or a loved one is experiencing feelings of loneliness, talk to your primary care provider. There are many resources for people in our community and ways to get involved.

The post More than half of U.S. adults report feeling lonely appeared first on Norton Healthcare.

Most people recover on their own from influenza. Sometimes, the flu and its complications can be deadly. There is a flu vaccination, which can reduce your risk of getting the flu and the severity of flu symptoms. 

You are contagious for a period of time around your illness. Understanding when flu is contagious is important to stop the spread of seasonal flu. 

Understanding the flu virus

Flu is contagious via small droplets from your respiratory system that are expelled when you speak, cough or sneeze. These respiratory droplets can land in someone’s mouth, nose or eyes. In some cases, it spreads when someone touches an infected surface then touches their own nose or eyes. 

Common flu symptoms include:

• Fever, although not everyone with flu has a fever
• Cough
• Chills and sweating
• Muscle aches
• Fatigue
• Sore throat
• Runny nose

Symptoms come on suddenly with flu. Common cold symptoms build more gradually over time.

Contagious period with the flu

Flu takes one to four days to incubate in your system after you come into contact with the virus. You have the potential to spread flu before symptom appear. You are contagious for about three to seven days after symptoms appear. An infected person can spread flu even if they never develop symptoms severe enough to notice they are sick.

“Overall, you can be contagious or were contagious the day before you noticed any symptoms. You still can spread the flu for about a week after you started feeling sick or as long as you have symptoms,” said Rachel N. Alexander, APRN, nurse practitioner with Norton eCare. After symptoms decrease, the virus may continue to shed. Those with a weakened immune system may continue to shed flu virus for longer than an otherwise healthy person. 

The severity of your case of flu, your individual immune response and your flu vaccination status affect how long the flu is contagious. While the flu vaccination is not a guarantee you will not get the flu, it affects the severity of your symptoms and may help control overall flu spread.

Preventing flu spread

• Importance of staying home while contagious
• Proper hygiene practices (hand-washing, covering coughs, disinfecting surfaces)
• Use of masks in public or around vulnerable populations

If you develop symptoms of the flu, stay home and avoid contact with others. Wipe down surfaces in your home with antiviral wipes, wash your hands often and refrain from close contact with others in your home. If you are at higher risk for developing complications for the flu, seek immediate medical attention. 

Flu complications

Some people are at a higher risk of developing more severe symptoms of the flu. These groups include:

• Adults ages 65 and older
• Children under 5
• Pregnant women
• People with chronic health conditions
• People with weakened immune systems
• People with a body mass index of 40 or higher (Class III obesity)

If you develop these symptoms seek immediate medical attention:

• Difficulty breathing
• Persistent pain or pressure in the chest or abdomen
• Persistent dizziness, confusion or inability to wake up
• Seizures
• Not urinating (peeing)
• Severe muscle pain
• Fever or cough that improves then returns or worsens
• Worsening of chronic medical conditions

When can I resume normal activity after the flu?

Most flu symptoms go away in four to seven days for otherwise healthy adults, but you still may be contagious. You may go back to light exercise when you feel like it, but listen to your body and rest when you need to. The Centers for Disease Control and Prevention advises staying home for at least 24 hours after your fever goes away without the help of ibuprofen (Motril or Advil) or acetaminophen (Tylenol).

A flu vaccination is the best way to prevent spreading seasonal flu. The vaccine has been shown to reduce illness, doctor’s visits, time off work or school due to flu, and lower the risk of serious complications. 

Besides vaccination, everyday steps you can take to prevent seasonal flu spread include:

• Avoid contact with sick people and stay away from others if you are sick.
• Cover your nose and mouth with a tissue if you cough or sneeze, then throw the tissue away. If you cough or sneeze into your hand, wash your hands immediately.
• Wash hands often with soap and water. If those are not available, use an alcohol-based hand sanitizer.
• Avoid touching your mouth, eyes and nose. 
• Clean and disinfect surfaces that may be infected with flu virus.

There are many ways to protect yourself, your loved ones and your community from the flu. Getting a flu shot is the first step.

Read more on the flu

5 things to do if you have a fever

COVID-19 or flu? Each has some similar symptoms, but there are key differences

What’s the best time to get a flu shot?

The post Even when your fever goes away, you still can spread the flu for about 24 hours appeared first on Norton Healthcare.

• Hot flashes
• Night sweats
• Vaginal dryness
• Mood swings
• Sleep disturbances
• Fatigue
• Reduced libido

Menopause is a natural process — all women will go through menopause if they are advanced in age, or if they have experienced premature menopause due to a health condition, surgery or related treatment. The body has slowed or stopped producing hormones such as estrogen, testosterone and progesterone. There is no treatment for menopause; however, the symptoms of menopause can be managed with lifestyle changes and medical interventions. 

One such intervention is the use of hormone replacement therapy (HRT). Hormone therapy’s goal is to replace some of the hormones the body is no longer making enough of, or at all. The hormones replaced may include estrogen and progesterone. 

Hormone replacement therapy for menopause

Various hormones can be used in a variety of clinical treatments, such as for cancer, hormone imbalance or other conditions. HRT is the term usually used for replacing hormones lost or decreasing with menopause or perimenopause. 

There are two main types of HRT:

Estrogen replacement therapy involves taking only the hormone estrogen. It can be given in many forms, including pills; a patch that sticks to your skin; creams, gels, or tablets that go in your vagina; or a spray for the skin on your arm.

Combination therapy mixes estrogen and progesterone. Progesterone is also called progestin and includes natural and synthetic hormones that act like progesterone. People who still have a uterus need progestin. 

Benefits and risks of HRT

HRT prescribing practices have evolved in the last decades as more research has been done. There are risks to any hormone therapy, and there are also benefits that may outweigh those risks. 

Risks include:

The recurrence of cancer in some patients. Systemic estrogen is not recommended for women who have or have had breast cancer. You may be at a higher risk of developing a blood clot or for cardiovascular disease. 

Some factors that affect your risks include:

• How old you are when you start HRT
• The type of HRT prescribed
• Your overall health, including history of cancer
• Delivery method of HRT, such as a patch, vaginal cream or pill
• Whether you have had chemotherapy or radiation treatment
• Certain surgeries such as oophorectomy (removing one or both ovaries)

Benefits of HRT include:

• Easing menopause symptoms, such as hot flashes, bone loss, vaginal dryness and some mental health issues 
• Protecting brain health
• Increased sexual function
• Protecting bone health

What about DHEA?

Dehydroepiandrosterone (DHEA) is a naturally occurring hormone in the body, produced by the adrenal glands. DHEA helps the body make other hormones, such as testosterone and estrogen. DHEA declines with age, and with it, overall levels of the hormones it produces. There has been some investigation into DHEA to manage menopause symptoms, since DHEA is a crucial component in the body’s creation of the hormones HRT aims to replace. Researchers also have wondered if DHEA has antiaging properties.

While there is a link between low DHEA levels and symptoms of menopause, there is not enough evidence to support the use of DHEA as a frontline treatment of menopause symptoms. A 2022 meta-analysis of data in the The Journal of Clinical Endocrinology & Metabolism concluded that there are no consistent benefits of taking DHEA. According to the analysis, there may be some minor increases in quality of life or overall mood, but no impact on anxiety, sexual function, brain function or overall well-being in women. The researchers concluded that long-term use of DHEA may increase unwanted side effects in women such as acne and male-patterned hair growth.

More research is needed about the impact of DHEA on aging, menopause symptoms and other conditions. Always talk to your health care provider before taking any new medication or supplement. DHEA can interact negatively with drugs our supplements you are already taking, so it’s best to talk to a doctor before adding something new.

Is HRT right for me?

Your family physician or OB/GYN is the first place to start asking this question. Your health care provider will go over an appropriate course of treatment tailored to you.

The post Hormone replacement therapy is different from over-the-counter supplementation appeared first on Norton Healthcare.

How do I know if I have hypothyroidism?

“Thyroid problems in general can be difficult to diagnose, because the symptoms can be so mild they are unnoticeable, and because they mimic other conditions,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. Some common symptoms include:

• Often feeling cold 
• Fatigue or muscle weakness
• Constipation
• Dry skin.
• Weight gain
• High cholesterol
• Depression

Thyroid issues and heart function

Thyroid hormones affect almost every organ system in the body, from your bones to your central nervous system. With hypothyroidism, you can experience:

• Bradycardia, or a low heart rate  
• Cardiomyopathy: enlargement of the heart  
• Dizziness

When should I see a doctor?

It can be difficult to link some of the above symptoms to a thyroid issue. Your health care provider may run some blood tests to check your hormone levels.

“Make sure your primary care provider has all your health information, including symptoms and family history,” Dr. Brandon said. 

Thyroid tests

Thyroid function can be determined with a blood test. Thyroxine (T3) and triiodothyronine (T4) are the hormones the thyroid makes. Blood tests can show if you have an underactive thyroid (hypothyroidism). 

Thyroid stimulating hormone (TSH) is a hormone made in the pituitary gland that tells the thyroid how much T4 and T3 to make.

A high TSH level may mean you have hypothyroidism, or an underactive thyroid. This means that your thyroid isn’t making enough hormone. As a result, the pituitary system keeps making and releasing TSH into your blood.

If the TSH test results are not normal, your doctor may perform least one other test to help find the cause of the issue.

T4 test

A high blood level of T4 may mean you have hyperthyroidism. A low level of T4 may mean you have hypothyroidism.

In some cases, very high or low T4 levels may not mean you have thyroid problems. If you are pregnant or are taking oral contraceptives, your thyroid hormone levels will be higher. Severe illness or the use of corticosteroids (medicines to treat asthma, arthritis, skin conditions, and other health issues) can lower T4 levels. 

T3 testing

With hyperthyroidism, your T4 level may be normal, but you may have a T3 test to confirm the diagnosis. Sometimes T4 is normal but T3 is high, so measuring both T4 and T3 levels can be useful in diagnosing thyroid issues.

Thyroid antibody test

Measuring levels of thyroid antibodies may help diagnose an autoimmune thyroid disorder like Hashimoto disease, the most common cause of hypothyroidism. Thyroid antibodies are made when your immune system attacks the thyroid gland. 

Other tests may include imaging, such as a thyroid scan, which uses radioactive iodine to help the doctor see your thyroid clearly. This test can show thyroid nodules, which are small, often harmless lumps on the gland. It can also detect inflammation, an enlarged thyroid and other abnormalities.

Testing also can show signs of thyroiditis, or an inflammation of the gland. There are several types of thyroiditis, but the most common is Hashimoto disease. 

Treating hypothyroidism

An underactive thyroid gland affects your whole body. There is no cure for thyroid disorders, so the symptoms are treated as needed. Treatment for hypothyroidism symptoms usually includes taking a levothyroxine pill (Levo-T, Synthroid) every day. It boosts thyroid hormone production, keeps hormones in a healthy range and relieves symptoms of hypothyroidism. Most patients feel better one to two weeks after starting treatment.

Your health care provider usually will test you every year to check thyroid function. 

You’ll likely start to feel better one or two weeks after you begin treatment. Treatment with levothyroxine likely will be lifelong. Because the dosage you need may change, your health care provider may check your TSH level every year.

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Type 1 diabetes is also called juvenile diabetes or insulin-dependent diabetes. It can develop at any time, but typically this condition presents before age 40 and usually in children or adolescents. In people with Type 1 diabetes, the pancreas makes little to no insulin. Insulin is a hormone that helps the body use sugar (glucose).

“When your body can’t produce insulin, sugar builds up in the blood,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Over time, this does damage to your organs, tissues and blood vessels.”

RELATED ARTICLE: Can diabetes be misdiagnosed? Here’s what patients should know.

Type 1 diabetes symptoms

Excessive thirst is a common symptom of diabetes. Here are some other typical signs:

• Increased thirst (the medical term is polydipsia) even with increased water intake
• Excessive urination
• Feeling very hungry
• Weight loss without trying
• Feeling irritable or having other mood changes
• Feeling tired and weak
• Having blurry vision

Causes of Type 1 diabetes

Researchers do not know the exact cause of diabetes. In many cases, the body’s own immune system — which normally fights harmful bacteria and viruses — destroys the insulin-producing (islet) cells in the pancreas.

“We know genetics and environmental factors play a role,” Dr. Brandon said. 

Why does Type 1 diabetes cause increased thirst?

If your blood sugar level is high and there is not enough insulin to reduce the amount of sugar in the blood, the kidneys will work harder to filter and absorb the sugar. In order to flush sugar out of the body, the kidneys pull fluid from your tissue. You then will pass the sugar through your urine.

“That’s why we see symptoms such as dry mouth, excessive thirst and frequent urination associated with diabetes,” Dr. Brandon said.

Complications of Type 1 diabetes

Left untreated, Type 1 diabetes can cause:

• Heart disease or blood vessel disease. This includes coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.
• Nerve damage (neuropathy). Too much sugar in the blood (hyperglycemia) can damage the walls of the tiny blood vessels (capillaries) that feed the nerves. This often happens in the legs, since the heart has to work hard to pump the blood to the extremities. Poorly controlled blood sugar can cause you to lose all sense of feeling in certain parts of your body. 
• Kidney damage (nephropathy). Millions of tiny blood vessels in the kidneys keep waste from entering the blood. Diabetes can damage these blood vessels. Over time, this can lead to kidney failure or end-stage kidney disease that can’t be reversed. Advanced kidney disease is treated by filtering the blood with a machine (dialysis) or with a kidney transplant.
• Eye damage (diabetic retinopathy). Diabetes can damage any of the body’s blood vessels, including those of the retina (part of the eye that senses light). Left untreated, this may cause blindness. 
• Foot damage. Nerve damage and poor blood flow in the feet increases the risk of complications. You gradually can lose feeling in the feet, so you don’t notice cuts and blisters. These can become serious infections. Very severe infections may result in removal of toes, feet, or parts of the leg (amputation).

Diabetes also can be an issue for pregnant people. If the person has a high blood sugar level, it can be dangerous for both parent and baby. Uncontrolled high blood sugar can increase the risk of miscarriage, stillbirth and birth defects. 

How is diabetes diagnosed?

A simple blood test can tell your primary care provider if you have diabetes. This test is called an A1C test. It measures the average amount of glucose in your blood over about the past three months. A1C results fall into normal, prediabetic, and diabetic ranges. 

• Normal A1C level is below 5.7%.
• Prediabetes is between 5.7% to 6.4%.
• A level of 6.5% or more indicates diabetes.

Seeing your provider every year for a general checkup that includes bloodwork will help your health care team establish a baseline for you and ensure you get your A1C level tested. Drastic changes in your A1C from year to year can be a sign that you are headed toward prediabetes or diabetes. 

“If you have some of these symptoms that get worse over time — excessive thirst, dry mouth, excessive urination or unexplained weight loss — see your general physician for bloodwork,” Dr. Brandon said. “Or if you have a parent or sibling with any type of diabetes, remember that is a risk factor. It is easier to treat diabetes the sooner it’s caught.”

Routine bloodwork to determine your diabetes status typically is covered by most insurance plans. You can make an appointment online via Norton MyChart. Blood test results usually are returned from the lab in a few days.

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