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Medical News Today: How long does a cup of coffee keep you awake?

Caffeine is a familiar drug that stimulates the nervous system. When it enters the body, caffeine raises the heart rate and blood pressure, increasing energy levels and improving the mood.

Caffeine acts quickly, and many people notice the effects within minutes. They last until the body fully metabolizes the drug. This duration depends on several factors.

Each person will feel the effects differently, and some may last longer than others. People who are pregnant or have difficulty sleeping should be careful about timing their caffeine intake and may want to avoid it altogether.

How long does it take to metabolize caffeine?

Caffeine in coffee being poured into cup surrounded by coffee beans.
Caffeine may have a greater effect on people who are sensitive to it.

Caffeine has a half-life of about 5 hours.

Someone who consumes 40 milligrams (mg) of caffeine will have 20 mg remaining in their system after 5 hours.

When do effects peak?

Levels of caffeine peak in the blood within about 15–45 minutes of consumption.

They are then quickly metabolized by the liver.

Most people notice the strongest effects during this time, and many report feeling jittery, needing to urinate, and having sudden bursts of energy. These symptoms tend to go away as the caffeine starts to break down.

Can a person build up a tolerance?

As the body becomes resistant to the drug, people who regularly consume caffeine may barely notice its effects.

However, for someone who is very sensitive to caffeine, effects may persist for hours or until the next day.

How long do effects last?

There is no set time limit. The duration of the drug’s effects depend upon the dosage and on personal factors, including age, body weight, and how sensitive a person is to caffeine.

Foods and drinks that contain caffeine

Caffeine is usually found in beverages, including:

  • coffee and drinks such as espressos, lattes, and cappuccinos
  • black, green, and white tea
  • yerba maté
  • many soft drinks
  • energy drinks

Even decaffeinated coffee contains some caffeine, and people who are very sensitive to caffeine should avoid it.

Caffeine can also be found in foods, such as:

  • chocolate and products containing it, such as hot cocoa
  • coffee or mocha ice creams
  • guarana seeds and beverages
  • some protein and energy bars
  • pre-workout drinks and powders

Caffeine is also a common ingredient in weight loss pills and over-the-counter headache medicines, including Excedrin.

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How much caffeine is in each product?

Cans of energy drinks
Energy drinks have higher levels of caffeine than tea or coffee.

The amount of caffeine in products like coffee and tea varies, but the American Academy of Sleep Medicine has listed the following estimates:

  • 8 ounces (oz) of brewed coffee – 95 mg
  • 1 oz of espresso – 64 mg
  • 8 oz of brewed tea – 47 mg
  • 16-oz average energy drink – 158 mg
  • 12-oz average caffeinated soda – 45 mg
  • 1.55-oz milk chocolate candy bar – 9 mg

Drugs that contain caffeine will display exact amounts on their labels.

Caffeine and breast-feeding

People are usually warned not to consume caffeine while pregnant, as it can pose risks to the mother and child. While these risks diminish after birth, caffeine can affect a baby who is breast-fed.

Small amounts of caffeine can be transferred through breast milk, so anyone who is nursing should limit their caffeine intake before feedings. Most babies older than 3 months can tolerate these relatively small amounts. One study found that regular caffeine consumption by nursing women had little or no consequences on sleep patterns of babies and children aged over 3 months.

However, large amounts of caffeine can make babies fussy and irritable. It can also lead to trouble developing regular sleep patterns and other negative effects.

A doctor can provide specific recommendations, but there should generally be a 1–2-hour gap between caffeine consumption and nursing.

How does caffeine affect sleep?

The overall effects of caffeine can last throughout the day. The drug can linger in the body and may have subtle consequences, even after the noticeable effects have worn off.

Caffeine can lead to sleep of a lesser quality and even disrupt sleep patterns, depending on a person’s sensitivity and how much they have consumed.

Most adults can safely consume 200–300 mg per day, and exceeding this amount can lead to sleep issues.

What to do when too much caffeine disrupts sleep?

If someone suspects that their caffeine intake is causing sleepless nights, they should lower their consumption until they determine the right limit.

It may also help to practice relaxation techniques before bed, such as gentle yoga or breathing exercises.

Caffeine can be a helpful stimulant, but excessive consumption can mask underlying sleep disorders. People who need coffee or tea to wake up every morning may be unwittingly compensating for sleep issues.

Develop a regular sleep schedule by going to bed and waking up at around the same times each day. This can help the body to regulate itself, and reduce the need for stimulants like caffeine.

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Side effects of caffeine

Caffeine may cause diarrhea or an upset stomach.
Caffeine may cause diarrhea or an upset stomach.

People will quickly realize when they have had too much caffeine. Be aware of the following symptoms:

  • nervousness
  • a stomachache
  • diarrhea
  • a rapid or irregular heartbeat
  • an increased rate of breathing
  • insomnia
  • feeling fidgety or restless
  • sweating
  • irritability
  • anxiety attacks

People with kidney or liver problems may find their health gets worse when they have caffeine.

In some cases, caffeine can make fatigue worse. If someone is exhausted, they may benefit more from napping or practicing a relaxation technique before resuming activity.

Like other drugs, it is possible to become dependent on caffeine, and going without it can lead to symptoms of withdrawal.

Symptoms of caffeine withdrawal

People who stop consuming caffeine often complain of withdrawal. Symptoms include:

  • general fatigue
  • crankiness or irritability
  • muscle pain
  • nausea or an upset stomach
  • a lack of focus
  • headaches or migraines

These symptoms may resolve when a person consumes caffeine again. If a person is determined to stop, withdrawal symptoms often pass within a few days.

When a person who regularly consumed high amounts of caffeine stops suddenly, they may experience more severe withdrawal symptoms.

Rather than quitting abruptly, it may be better to gradually reduce caffeine intake until it can be eliminated without symptoms.


The effects of caffeine typically last for a few hours, unless someone has consumed a high amount or is especially sensitive to the drug.

Caffeine lingers in the body and may disrupt sleep patterns, even after noticeable effects have worn off.

While it is generally considered safe to consume caffeine while breast-feeding, it may be a good idea to cut off consumption 1–2 hours before a feed.

Anyone who regularly has trouble sleeping or waking up should discuss underlying sleep disorders with a doctor.

It may be a good idea to explore natural ways to increase energy levels.

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Medical News Today: What to know about multinodular goiter

A goiter refers to an enlarged thyroid gland. Sometimes, a person can have a goiter that has multiple nodules or bumps on it, which is called a multinodular goiter.

A toxic goiter is one that makes too much thyroid hormone, resulting in a condition called hyperthyroidism.

Most thyroid nodules are harmless, but some can be cancerous. Scientists are still investigating the link between thyroid nodules and cancer. Some experts believe cancer might be more likely to occur within thyroid nodules than once thought.

In this article, we look at the symptoms, causes, and treatments of multinodular goiter, and their relationship with cancer.


Woman holding throat due to difficulty swallowing which is a symptom of multinodular goiter
Hoarseness and difficulty swallowing may be a symptom of a multinodular goiter.

Multinodular goiters do not always cause symptoms. A doctor will often diagnose multinodular goiters while conducting a physical exam or imaging study for another unrelated cause.

Sometimes a multinodular goiter will feel like a single nodule yet consist of several smaller ones.

A person may feel the nodules directly over their thyroid, which is located in the neck just below the Adam’s apple in both men and women.

If a multinodular goiter grows large or presses against nearby structures, a person may notice the following symptoms:

  • hoarseness
  • difficulty swallowing
  • difficulty breathing when lying down

A person with a toxic multinodular goiter may have symptoms of hyperthyroidism. These include, but are not limited to:

  • difficulty tolerating heat
  • fast heart rate, even when at rest
  • irritability
  • nervousness
  • weight loss or inability to gain weight
  • difficulty sleeping

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One cause of multinodular goiter is an iodine deficiency, although this is rare in the United States. Iodine is a mineral present in small amounts in a person’s diet.

The thyroid uses iodine to produce its hormones. Without enough iodine, the thyroid cannot perform its normal functions. For this reason, food manufacturers often add iodine to salt, called iodized salt, to reduce the prevalence of thyroid dysfunction.

Some people have greater risk factors for developing a multinodular goiter. Risk factors include:

  • an iodine deficiency
  • genetic factors that affect thyroid hormone production
  • sex — women are more likely to develop nodules and thyroid disease
  • ageolder women are at higher risk of developing thyroid nodules
  • a family history of multinodular goiter
  • a history of an autoimmune thyroid condition, such as Hashimoto’s thyroiditis or Graves’ disease

If the thyroid gland is not making enough thyroid hormone, the pituitary gland in the brain will release more of the thyroid-stimulating hormone (TSH). The excess TSH can cause the thyroid to enlarge and create a multinodular goiter.

Likewise, an overactive thyroid that is making too much thyroid hormone can cause the thyroid to enlarge and become multinodular.

In some instances, a person may have no known cause for their multinodular goiter.


Doctor examining patients neck to diagnose multinodular goiter
A physical examination may help to diagnose a multinodular goiter.

A doctor will begin to diagnose a multinodular goiter by taking a medical history.

They will ask about a person’s previous health conditions, what medications they are taking, and whether there is a family or personal history of goiter or thyroid-related conditions.

Physical examination

A doctor will examine a person’s neck and look for enlarged neck veins.

They can also feel the size and shape of the thyroid gland and look for anything unusual.

Blood tests

Blood tests can help to diagnose thyroid problems, especially tests for thyroid-stimulating hormone (TSH). If a person’s TSH levels are low, it might mean that they have hyperthyroidism, which means that their thyroid is producing too much thyroid hormone.

If TSH levels are high, a person may have hypothyroidism (low thyroid hormone levels) because the body is trying to ramp up thyroid hormone production.

Follow up thyroid hormone tests to check for levels of hormones called T3 and T4 may be required to understand the complete picture.

Imaging tests

A doctor may also perform thyroid imaging tests. These include a thyroid ultrasound. This test uses sound waves to recreate images of the thyroid, including the size and number of any nodules.


Sometimes, a doctor may recommend taking a biopsy of the thyroid nodules to test for the presence of cancerous cells.

A common biopsy method uses a small needle guided by an ultrasound, known as fine needle aspiration (FNA).

Doctors will probably recommend that anyone who has a nodule larger than 1 centimeter (cm) in size has a biopsy.

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surgeons working in dark operating theatre
A thyroidectomy is rarely necessary.

Not all people with a multinodular goiter will require treatment. It often depends on thyroid function.

If the nodules are not producing thyroid hormone (non-toxic), a doctor will consider its size, symptoms, or growth pattern.

Radioiodine therapy

One treatment for both toxic and non-toxic goiters is radioiodine therapy.

The medication helps reduce the size of thyroid tissue. In the case of toxic goiters, it also shuts down abnormal thyroid hormone production.

The goiter typically shrinks 2 to 6 months after treatment, although it may take up to a year. Studies also have shown that in most cases, normal thyroid function continues or returns to normal after treatment.

Smaller goiters respond better to radioiodine therapy than large ones.

Thyroid medication

If the goiter and its nodules are relatively small in size, a doctor may recommend taking a thyroid hormone medication, such as levothyroxine (Synthroid).

However, research on this topic is not clear. Experts are divided between those who believe thyroid hormone helps this situation and those who do not.


This is the surgical removal of the thyroid gland. With advances in understanding thyroid disease, it is rarely necessary.

If the goiter is compressing nearby blood vessels, affecting a person’s breathing, creating difficulty swallowing, or is causing psychological distress, a doctor may recommend removing the thyroid.

A doctor may also recommend thyroidectomy if a person is not a good candidate for radioiodine therapy. This is especially true if the multinodular goiter is extremely large, as large goiters do not respond as well to radioiodine therapy as smaller ones.

Relation to cancer

Studies have shown that between 10 to 20 percent of people with a multinodular goiter go on to develop thyroid cancer. Research has suggested that the risk of cancer in single and multinodular goiters is similar.

According to the Columbia University Department of Surgery, most people who develop cancer from a multinodular goiter have papillary thyroid cancer, which is the most common type of thyroid cancer.


A person may have a multinodular goiter without knowing about it, as it often creates no symptoms. Other people may have symptoms that impact their daily lives, such as difficulty swallowing or speaking.

Many treatment options are available for both toxic and non-toxic multinodular goiters. If a person suspects they may have a thyroid problem, they should talk to their doctor to find out the best course of action.

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Medical News Today: How do you get rid of itchy eyes?

People generally move less and relax more when they lie in bed at night than they do when they are up and about during the day.

The extra stillness may make a person more aware of their body than they are during an active day.

With this increased awareness, people may begin notice that their eyes are itchy.


Tired older man with itchy eyes rubbing his eye with glasses off.
Eyestrain may cause itchy eyes at night.

Many underlying problems and conditions can cause itchy eyes at night.

These underlying causes include:

  • Eyestrain: Caused from staring at a computer screen for too long or driving long distances.
  • Allergies: Contact with a foreign substance that causes itchy, red eyes, such as makeup, pollen, and dander.
  • Dry eye: A condition where the eye does not get enough lubrication throughout the day.
  • Atopic dermatitis: A type of eczema that causes red, itchy skin as well as dry eyes.
  • Conjunctivitis: A highly contagious infection often referred to as pink eye that causes red, itchy, and burning eyes.
  • Blepharitis: Inflammation of the eyelid caused by the follicle becoming blocked.
  • Meibomian gland dysfunction: When the meibomian glands are blocked and do not produce enough liquid to lubricate the eyes.
  • Some medications: Common culprits that can cause dry eyes include antihistamines and blood pressure medication.

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People with persistent itchy eyes at night should see a doctor to diagnose the cause.

A doctor will likely start by reviewing the person’s medical history and symptoms. The doctor will then probably do a physical exam, which includes checking the person’s eyes and eyelids. If there is any discharge on the person’s eyelids, the doctor may take a sample of the discharge with a swab and send it to a lab for testing.

If a doctor suspects that an allergy is causing the itchy eyes, they may do a patch test. They might also recommend a follow-up visit with an eye doctor.

Home remedies

Humidifier and plants.
Using a humidifier may help to prevent the eyes and skin from becoming dry and itchy.

Some home remedies can help treat and prevent itchy eyes at night including:

  • applying warm and cool compresses
  • keeping the eye area clean
  • using a humidifier
  • avoiding allergens
  • using eye drops
  • following the 20-20-20 rule

The 20-20-20 rule

Spending too long on a computer or doing other activities that may cause eyestrain can make a person’s eyes itchy at night. People with itchy eyes can try to follow the 20-20-20 rule to lessen eyestrain.

For every 20 minutes of computer work, people should look away from the screen and look at an object 20 feet away for 20 seconds, which will allow the eyes to relax.

Warm and cool compresses

People can try applying a compress for immediate relief of itchy eyes. Warm compresses over the eyes may help relieve itching due to allergies. If itchy eyes feel warm and swollen, a cold compress on the eyes might help ease the itch.

Keeping the eye area clean

Dirt, chemicals, and makeup can all cause itchy eyes.

Keeping the eyes clean at night can help relieve the itch. Firstly, a person may need to flush the irritant from the eye with cool water to clean the eye area.

Sometimes, gently rinsing the eyes with warm water on a washcloth may be enough.

People who wear makeup should consider removing all their makeup before cleaning the eye.

Using a humidifier

Dry air can make eyes itch because it can cause the eyes to dry out. People with itchy eyes may want to use a humidifier in their bedroom, particularly during the winter or in dry climates.

Discontinue contact lens use

Wearing contact lenses can cause eyes to be itchy even at night. Some people may wear their contact lenses overnight, which may lead to further itching.

Contact lens users who get itchy eyes at night might think about taking their contact lenses out to give their eyes a break until the itching stops.

Also, changing the type of contact lens a person wears may help. A disposable contact lens may help prevent future eye irritation that can lead to itchy eyes at night.

Avoid allergens

People with allergies should take steps to try to avoid any allergens that cause their eyes to itch at night.

Sleeping with the windows closed, for example, can help reduce exposure to pollen and other outdoor allergens that may make eyes itch.

Keeping pets out of the bedroom can help reduce the amount of dander people come into contact with at night. Dusting regularly and changing the sheets can also help limit dust mites.

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Medical treatments

Medication, such as antibiotics and antihistamines, may be prescribed to treat itchy eyes.

Sometimes, over-the-counter (OTC) treatments do not ease itching.

Some people may require medical treatments including the following:

  • oral and topical antibiotics for bacterial infections, such as bacterial conjunctivitis
  • artificial tears to lubricate eyes
  • antihistamines to help control allergic reactions that lead to itchy eyes
  • steroid eye drops for blepharitis and allergies
  • medications that affect the immune system for blepharitis
  • mast cell stabilizers for allergies
  • allergy shots for people with more severe allergies

Avoiding triggers

Preventing itchy eyes at night often starts with figuring out what might be triggering them. Some people may find keeping a journal of potential triggers helpful in figuring out what to avoid.

Avoiding triggers can help prevent or at least reduce the number of instances where the eyes become itchy.

People can take some steps during the day to help prevent eyestrain that can cause itchy eyes.

Some steps include:

  • taking breaks when driving long distances
  • wearing polarized sunglasses when outside or while driving
  • reading in well-lit areas
  • taking breaks when working at a computer or staring at other screens for long periods of time
  • using artificial tears throughout the day
  • wearing contacts or glasses
  • positioning computer screens slightly lower than eye level and about a foot from the face

People may try the following if allergies are the cause:

  • reducing mold in the home through cleaning and using a dehumidifier
  • keeping windows closed at night and during the day
  • removing eye makeup thoroughly before going to bed
  • cleaning up pet hair regularly
  • using bedding that blocks dust mites
  • avoiding touching the eyes before washing hands, especially after being in contact with a trigger, such as pet hair

A person can avoid some diseases, such as pink eye, by avoiding physical contact with a person who has the condition and not sharing products that come in contact with the eyes of other people.

What is the outlook?

Most cases of itchy eyes at night are not serious and are easy to treat. People who experience eyestrain and allergic reactions can often prevent them occurring by avoiding activities or substances that trigger itchy eyes.

When blepharitis causes itchy eyes, treatment focuses on managing the symptoms. Often, blepharitis does not go away completely, but proper treatment and good hygiene can keep symptoms to a minimum.

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Medical News Today: Everything you need to know about thin blood

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Medical News Today: How to identify pitting edema

Edema refers to visible swelling caused by a buildup of fluid within tissues. When an indentation remains after the swollen skin is pressed, this is called pitting edema. The effect may also be noticeable after taking off a tight shoe or stocking.

Anyone can have pitting edema, but because some causes are more dangerous than others, it is often a good idea to consult a doctor.

In this article, we describe who is at risk for pitting edema. We also explore accompanying symptoms, treatments, and prevention techniques.

Symptoms of pitting edema

Pitting edema. Image credit: James Heilman, MD, (2017, February 1).
Pitting edema may cause indentations to remain on the skin after pressure is released.
Image credit: James Heilman, MD, (2017, February 1).

This condition is most common in the lower body, particularly in the legs, ankles, and feet.

Swelling caused by edema will usually make the skin feel tight, heavy, or sore. Other symptoms depend on the cause, but they can include:

  • tingling or burning sensations around the swelling
  • pain and aching in the swollen areas
  • skin that feels puffy or stiff
  • skin that is warm or hot to the touch
  • numbness
  • bloating
  • water retention
  • cramps
  • unexplained coughing
  • fatigue or decreased daily energy
  • chest pain
  • shortness of breath and difficulty breathing

People who experience chest pain, shortness of breath, or swelling in only one limb should seek immediate medical attention.

Pitting vs. non-pitting edema

Edema occurs when fluid that accumulates in tissues leads to swelling. When pressure is applied to a swollen area, it may leave a pit, in the skin.

In non-pitting edema, the skin will return to its swollen shape once the pressure has been removed.

Causes of pitting edema

A variety of factors can lead to pitting edema, including:

  • flying
  • poor circulation
  • obesity
  • pregnancy
  • dehydration
  • low levels of protein
  • trauma or injuries

Alternatively, any of the following conditions may be responsible:

Pitting edema may also be a side effect of medications such as:

  • steroids
  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • medications that supplement estrogen
  • medications for high blood pressure
  • thiazolidinediones, a class of drugs used to treat type 2 diabetes

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Risk factors

sedentary lifestyle shown by woman lying on couch.
A sedentary lifestyle may increase the risk of pitting edema.

Pitting edema can affect anyone, though certain factors can increase a person’s risk.

These include:

  • a sedentary lifestyle
  • living in a warm climate
  • a diet overly rich in sodium
  • obesity
  • multiple pregnancies
  • a history of lymph node surgery
  • thyroid conditions
  • lung diseases, such as emphysema
  • heart disease

When to see a doctor

In most cases, a doctor should determine the cause of pitting edema and, if necessary, refer a person to a specialist.

Some accompanying symptoms require urgent care. Anyone experiencing shortness of breath, difficulty breathing, chest pain, or swelling in a single limb should seek immediate medical attention.

When leg pain and swelling persist after a person has been sitting for several hours, this may indicate deep vein thrombosis. This occurs when a blood clot develops deep in the leg. Anyone who suspects this should seek urgent medical care.

Pitting edema during pregnancy

Pregnancy can cause pitting edema, and it usually resolves as the pregnancy ends.

However, it is a good idea to discuss every new symptom with a doctor, who can test to rule out serious conditions linked with edema, such as very high blood pressure or preeclampsia.

Diagnosis and grading

Pitting edema is often diagnosed with a physical exam. The doctor may apply pressure to the swollen skin for about 15 seconds to check for lasting indentation.

Because some associated conditions are more dangerous than others, it is important to find the underlying cause of the edema. This may require thorough testing. The edema will usually resolve once the cause has been treated.

To properly identify the underlying cause, a doctor may take a detailed medical history and ask about medications. They may then refer the person to a doctor who specializes in issues concerning the veins or circulatory system.

Tests that can aid in a diagnosis of pitting edema include:

  • a physical exam
  • imaging tests, such as X-rays, which can show fluid retention and problems in the lungs
  • blood tests
  • urine tests
  • an echocardiogram, which is an ultrasound scan of the heart

Pitting edema is classified based on the depth and duration of the indentation. The following scale is used to rate the severity:

Grade 1: The pressure applied by the doctor leaves an indentation of 0–2 millimeters (mm) that rebounds immediately. This is the least severe type of pitting edema.

Grade 2: The pressure leaves an indentation of 3–4 mm that rebounds in fewer than 15 seconds.

Grade 3: The pressure leaves an indentation of 5–6 mm that takes up to 30 seconds to rebound.

Grade 4: The pressure leaves an indentation of 8 mm or deeper. It takes more than 20 seconds to rebound.

Understanding the severity of edema can help a doctor to identify the underlying cause and best course of treatment.

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Doctor prescribing treatement.
The treatment plan for pitting edema will depend upon the cause.

This involves addressing the underlying cause of the edema. A range of treatments correspond with the range of causes, but common methods include:

  • elevating the swollen limbs above the level of the heart
  • wearing compression stockings to encourage circulation
  • undergoing vascular surgery
  • increasing blood protein levels
  • taking diuretics to flush out excess fluid


When the underlying cause has been successfully treated, edema is unlikely to recur.

Some adjustments to lifestyle and diet can reduce the likelihood of developing edema, particularly if a person has a high risk.

These changes may include staying active, avoiding sitting or standing for long periods, and doing gentle exercises to reduce swelling.


Pitting edema is a common symptom. It is usually not a cause for concern in itself, but many underlying conditions require treatment, sometimes urgently.

Edema should not cause any long-term complications. After working with a doctor, many people find lasting relief from the symptom.

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Medical News Today: What causes teeth to turn black?

Black teeth can be a sign of an underlying decay or cavities that should be addressed as soon as possible. However, black teeth may also be the result of staining. Different foods and drinks can leave behind a bit of pigment, causing the teeth to turn black.

Teeth owe their color to the high amount of calcium found in the outer layer of the teeth, known as the enamel.

Over time, additional elements left behind by foods and drinks can start to make teeth yellow or gray. If the teeth turn black, however, a person should visit a dentist as soon as possible.

What causes black teeth?

Teeth turn black from either extrinsic or intrinsic causes.

Extrinsic causes

Woman with black teeth <br>Image credit: Calvin Smith, 2009</br>
Black teeth may be caused by tartar buildup and stains.
Image credit: Calvin Smith, 2009

Extrinsic causes of the teeth turning black come from the outside of the tooth.

These can include:

  • damage to the enamel
  • stains
  • tartar buildup

Some direct causes of staining include:

  • frequently eating or drinking a dark food product, such as coffee
  • taking certain medications, such as liquid iron supplements
  • using certain mouth rinses and toothpastes
  • using tobacco
  • having crowns and fillings made with silver sulfide

Intrinsic causes

The tooth may appear black when damaged from the inside. The most common culprits of black teeth in these cases are decay or cavities. For example, a pulp infection or dead tooth may turn a tooth black.

The damage starts on the inside and works its way to the surface. The black color of the tooth may first appear in spots and eventually cover the entire tooth if left untreated.

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It is not normal for a tooth to quickly change from a whitish hue to black. A person will typically notice some other signs before the tooth starts to turn black.

In some cases, a spot may appear brown or gray. Over time, the brown spots can turn black.

Other times, the teeth may develop small dots that appear black. These small dots often appear near the gumline, which is a common occurrence in children who have black teeth.

When tartar is the cause, a person will probably notice black coloration on the outside of the molars or the inside of the front teeth. Tartar will continue to build up the stain unless it is removed. In these cases, holes may appear as the enamel erodes away.

What stains can be avoided?

Coffee and cola may lead to black teeth
Coffee and cola may lead to black teeth.

People concerned about developing black teeth should avoid putting certain things in their mouth.

They should also be sure to practice proper dental hygiene after eating.

Also, they may want to avoid or reduce their use of some of the following:

  • coffee
  • cola
  • black tea
  • red wines
  • tobacco products

Good dental hygiene can often protect against the potential extrinsic causes of black teeth.

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Treatment and prevention

Treating black teeth at home is not usually possible. Several home whitening kits are available that may help with mild discoloration, but black teeth typically require professional treatment.

A dentist will examine the teeth to diagnose the underlying cause and will then determine the right treatment.

What if tartar is the cause?

A dentist will need to remove the buildup when tartar is the cause. This is typically done by scraping the tartar off the teeth. The dentist may need to use ultrasonic instruments that use vibration to break up the tartar and make it easier to remove.

What if decay is the cause?

In cases of decay, it is unlikely that a dentist will be able to improve the black teeth through a simple cleaning. They will instead need to remove the decayed portion of the tooth.

If the decay is in one part of the tooth, the dentist might be able to remove the affected portion and close the hole with a filling. If the decay has reached the second layer of the tooth, however, the dentist will remove all the decay and place a crown over the top of the tooth.

Sometimes, the tooth may be too severely damaged to recover with a crown or filling. The dentist may need to remove the entire tooth instead.

Prevention tips

People can often avoid black teeth with proper dental hygiene. The American Dental Association (ADA) recommend:

  • brushing twice a day with a fluoride toothpaste
  • cleaning or flossing between the teeth at least once a day
  • scheduling regular dental visits
  • avoiding sugary foods


A dentist is the best resource to determine if black teeth are caused by staining, tartar buildup, or decay. A person will need professional help to treat the black teeth, no matter what the cause.

Practicing proper dental hygiene can help prevent black teeth. Once removed, and with proper care, a person may never have black teeth again.

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Medical News Today: What causes a piercing rejection to occur?

Body piercing is not without risk. Sometimes a piercing may be rejected, which can cause discomfort and scarring. Spotting a piercing rejection early can reduce scarring and damage to the skin.

Whenever the skin is broken, there is a risk of infection, scarring, allergies, or other skin problems.

In this article, we look at the causes and symptoms of piercing rejection, and how to stop it from happening.

What causes piercing rejection?

Anti-eyebrow piercing. Image credit: Ralf Roletschek, (2008, August 11).
The body may try to reject a piercing because it is a foreign object.
Image credit: Ralf Roletschek, (2008, August 11).

Sometimes, the body’s immune response sees the jewelry as a foreign object and rejects it.

Piercing rejection can cause discomfort and scarring.

The following can help reduce the risk of piercing rejection:

  • choosing a qualified and experienced piercer
  • using proper jewelry
  • practicing proper piercing aftercare

Anyone who has piercings should keep a careful eye on them while they heal. Catching a piercing rejection early can reduce scarring or damage to the skin.

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Symptoms of piercing rejection

A piercing rejection usually happens gradually. Symptoms tend to appear several days or weeks before the body finally pushes the jewelry out of the skin in a process called migration.

Signs that a piercing is migrating and possibly being rejected include:

  • more of the jewelry becoming visible on the outside of the piercing
  • the piercing remaining sore, red, irritated, or dry after the first few days
  • the jewelry becoming visible under the skin
  • the piercing hole appearing to be getting larger
  • the jewelry looking like it is hanging differently
  • the jewelry moving more freely than it should

Which piercings are more likely to be rejected?

Piercing rejection scar on nape piercing.
Surface piercings, such as nape piercings, are at risk of rejection, which can lead to scarring.

Any piercing has the potential to be rejected. Rejection depends on the person’s immune system and how well the piercing heals. But, the body tends to reject some types of piercings more often than others.

Surface piercings are the most common types of piercing to be rejected by the body. Surface piercings travel along an area of skin, rather than going directly through a body part. The jewelry punctures only a small amount of the skin’s surface.

Examples of surface piercings include eyebrows, neck, hip, and wrist.

Surface piercings may be prone to rejection just because it is easier for the body to push the jewelry out of a small amount of skin.

Non-surface piercings include the earlobe, ear cartilage, lip, or tongue. These types of piercings go all the way through the body tissue — in one side and out the other.

Non-surface piercings may be rejected less often because there is more tissue to hold them in place, making it more difficult for the body to push them out.

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How to prevent piercing rejection

Sometimes, a piercing rejection occurs without an apparent cause. However, the following steps may make a piercing rejection less likely to happen.

Choose the right piercer

It is essential to select a piercer who is familiar with the body’s anatomy, the healing process, and where best to place a piercing. Before getting a piercing, talk to the piercer about:

  • The type of piercing. Ask about the specific kind of piercing desired and their experience with it. Their expertise with specific piercing locations. Ask to see photos of piercings they have done in the past. These should show a variety of piercings that look well-suited to individual body types.
  • Their sterilization and safety measures. The Association of Professional Piercers state that every piercer should use an autoclave for sterilizing equipment. Good hygiene can help lower the risk of infection and trouble with healing, both of which can lead to piercing rejection.
  • Other sanitary and health measures. Ask about single-use needles, gloves, and the cleaning of hands and rooms between each customer.

Also, consider reading online reviews or talking to previous customers. Choosing an experienced, skilled, and hygienic piercer is crucial.

Choose the right jewelry

A qualified piercer should recommend a size and type of jewelry best suited to the indivdual’s body and the location of the piercing.

Using a thicker piece of jewelry might reduce the risk of rejection.

Using materials such as niobium and titanium offer the lowest risk of irritation and allergies. This can also help speed up the healing process and prevent complications. Research the specific piercing beforehand and the best jewelry size and material for it.

Follow aftercare instructions

Keeping a piercing clean is vital for healing and preventing infection. Do not use harsh cleansers such as peroxide, antibacterial soaps, or alcohol, as they can irritate the skin and delay healing.

Ideally, clean the area with a sterile saline solution or a product recommended by a professional piercer.

Take care not to bump piercings, especially while they heal. An injury to the area could cause irritation, rejection, or migration. Ask the piercer about what precautions to take to protect the piercing during contact sports.

How to stop the process of rejection

Ear piercing bar
Having a professional remove jewelry when it seems to be moving towards the surface may prevent rejection.

If the piercing appears to be migrating toward the surface, take the following steps:

  • Remove the jewelry and contact the piercer. Keeping the jewelry in increases the chances of scarring. A large scar can prevent a person having a new piercing in the same location after it heals.
  • Ask the piercer about using a different piece of jewelry. Thicker-gauge jewelry or a different shape or material may help the piercing heal and settle into place better.
  • Do not try to treat the rejection at home with bandages or coverings. This may slow healing and has not been shown to help keep piercings in place.

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Most people who experience a piercing rejection will recover without any lasting health issues. However, there may be scarring, which can range from mild to severe.

Scarring can make it difficult or impossible to get a new piercing in the same location. It may also be a cosmetic concern. People who are prone to raised or keloid scars are generally advised to avoid piercings.

Antibiotics may be needed if an infection occurs. Anyone who suspects a piercing infection should discuss it with a doctor.

Signs of infection include the following at the piercing location:

  • redness
  • hot to the touch
  • swelling
  • discharge

With proper antibiotic treatment, most piercing infections heal without long-term problems.

After a piercing rejection, people should think about what may have caused it. Did they follow proper aftercare instructions? Did the piercer use appropriate equipment, technique, and jewelry?

If the piercing was done correctly and the person looked after it properly, the rejection may just be bad luck. A person can sometimes have one rejection then have no problems with future piercings. People should consider the risk of another piercing rejection before getting pierced again.

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Medical News Today: Can sneezing during pregnancy affect the baby?

Although many people do worry more than usual while pregnant, sneezing during pregnancy should not cause any anxiety. Sneezing can occur more frequently during pregnancy but does not usually mean anything is wrong with baby or mother.

Some causes of sneezing during pregnancy include:

What are the causes of sneezing during pregnancy?

People can sneeze for many reasons while they are pregnant:

Pregnancy rhinitis

Pregnant woman sitting on bed sneezing and blowing her nose.
Pregnancy rhinitis is a common condition that causes nasal congestion.

Pregnancy causes many changes in the body.

These changes can lead to pregnancy rhinitis, a condition that affects 39 percent of women at some point during their pregnancy.

Pregnancy rhinitis often causes extra nasal congestion.

This congestion can last for 6 weeks or longer during pregnancy and can cause many symptoms, including increased sneezing.

During pregnancy, blood flow to the mucous membranes increases. The nose is full of mucous membranes. The extra blood flow causes the nasal passages to swell, which leads to extra watery discharge and congestion.

Both the additional discharge and congestion can lead to increased sneezing.


Pregnant people have weaker immune systems and are more likely to get a cold, flu, or another bug. These illnesses may last longer and be more severe than in someone who is not pregnant.

When a person is not pregnant, their body typically reacts to germs quickly. During pregnancy, the body’s immune system responds more slowly and gently, because it does not want to mistake the baby for something harmful.

Colds are usually harmless during pregnancy, but the flu or any other illness that causes a fever can be dangerous for both mother and baby. Expectant mothers who are sneezing and think they may have the flu or another illness that causes a fever should call a doctor promptly.


People who have allergies that cause sneezing and other upper respiratory symptoms when they are not pregnant, will likely still have allergy symptoms while pregnant. Seasonal allergies, such as hay fever and pollen allergies, as well as indoor allergies can all trigger sneezing.

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Pregnant woman with pain in belly.
Sneezing during pregnancy may cause pain around the belly.

Sneezing during pregnancy does not pose a risk to mother or baby most of the time.

Sneezing can, however, be a symptom of an illness or a more significant problem that may affect the baby.

When sneezing indicates a more severe problem, there may be risks. For example, if someone gets the flu, risks might include miscarriage, low birth weight, and premature birth.

People who are pregnant may also find that sneezing causes pain around the belly. While this radiating pain does cause discomfort, it is not dangerous. This phenomenon is known as round ligament pain and occurs as the ligaments stretch and loosen during pregnancy.

How is it managed?

Many medicines that are safe to take while not pregnant are not recommended during pregnancy.

The American Pregnancy Association recommend that pregnant people limit the amount of over-the-counter (OTC) medications they take during pregnancy. This means that many common cold medications that would reduce sneezing are off limits.

Home remedies

Ways to manage sneezing during pregnancy without using medication include:

  • saline nasal sprays
  • neti pots
  • using a humidifier
  • avoiding known allergens
  • using an air purifier
  • treating asthma as directed by a doctor
  • exercising regularly
  • eating a diet rich in vitamins

People should also talk to their doctor about the best ways to avoid getting ill during pregnancy. Most doctors recommend people have a flu shot to prevent the flu while they are pregnant.

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When to see a doctor

Pregnant patient looking at clipboard with doctor.
A doctor should be consulted if sneezing is accompanied by other symptoms, such as a fever.

People should see their doctor immediately if they suspect that the sneezing is a symptom of a more significant problem, such as the flu or asthma.

A pregnant woman should also seek immediate medical attention if she has any of the following symptoms or concerns along with sneezing:

  • a fever of 102°F or higher
  • trouble breathing
  • chest pain
  • coughing up yellow or green mucus
  • blowing colored mucus from the nose
  • wheezing
  • loss of appetite
  • inability to sleep
  • a severe headache


There are a lot of misconceptions about sneezing during pregnancy. We answer some of the common questions about pregnancy and sneezing below:

Does sneezing affect the baby?

Sneezing during pregnancy will typically not harm the baby.

The baby is well-protected in the uterus, and even a hard sneeze will not affect the baby.

The only time that sneezing may be problematic for the baby is if the sneezing is the symptom of an underlying illness or problem. In these instances, it is the underlying illness that may affect the baby, not the sneezing itself.

Does sneezing while pregnant influence the baby’s sex?

Despite lots of stories, tales, and myths highlighting ways to influence the sex of the baby, sneezing cannot determine or change the sex of the baby.

A baby’s sex is determined at conception by a chromosome from the male’s sperm.

If the man’s sperm has an X chromosome, the baby will be a female; if it has a Y chromosome, the baby will be a male.

Can a pregnant woman sneeze out her baby?

No. A baby will not be born because a pregnant woman sneezes.

While some people may joke about fast childbirth, even those who deliver their babies quickly still go through the labor process. During labor, contractions help guide the baby out of the uterus through the open cervix.

People will still have to push and go through labor or cesarean delivery for a baby to be born.


Sneezing during pregnancy is a frequent occurrence for many.

Most of the time sneezing during pregnancy is harmless. However, if the sneezing is accompanied by other symptoms that might indicate a more significant problem, then it is essential to visit a doctor as soon as possible.

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