Medical News Today: Could vitamin D help to keep rheumatoid arthritis at bay?

After studying immune cells taken from the joints of people with rheumatoid arthritis, scientists have found that once the disease sets in, some types of cell lose their sensitivity to vitamin D.
old woman's hands
Researchers explore vitamin D’s role in rheumatoid arthritis.

The team — which comprised researchers from University College London and the University of Birmingham, both in the United Kingdom — reports the new findings in the Journal of Autoimmunity.

Rheumatoid arthritis is an autoimmune disease that arises because the immune system attacks healthy tissue — usually the joints — by mistake, leading to painful inflammation and swelling.

The disease often affects several joints at the same time, such as the knees, hands, and wrists. It inflames the lining of the joint and eventually damages the joint itself. This can lead to long-lasting pain, problems with balance, and deformity.

Estimates suggest that approximately 1 percent of the world’s population has rheumatoid arthritis, including around 1.3 million adults in the United States. It affects women more often than men, raising the question of whether hormonal factors may be involved.

Study examined cells from inflamed joints

In their journal paper, the researchers explain that previous studies have revealed that vitamin D has “potent anti-inflammatory effects,” including the ability to suppress activity in some types of immune system T cell that are known to be active in rheumatoid arthritis.

However, those studies have only used immune cells isolated from blood, and so the impact of vitamin D on immune cells “at the site of active disease is unclear.”

A significant feature of the new study is that it is the first to use immune cells taken from both the blood and from the inflamed joints of people with rheumatoid arthritis.

“Unlike previous studies,” explains senior study author Karim Raza, a professor in the Institution of Inflammation and Ageing at the University of Birmingham, “we isolated different immune cell types from the actual site of disease to determine whether specific subsets of immune cells (specific T cell groups) have equal sensitivity to vitamin D.”

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Immune cells lost sensitivity to vitamin D

For the investigation, the scientists used samples of synovial fluid taken from the joints of 15 people with rheumatoid arthritis aged between 40 and 85. Synovial fluid is a thick, sticky liquid that acts as a lubricant to reduce friction between bones that meet at joints.

They also examined blood samples taken from those with rheumatoid arthritis, and from individuals without rheumatoid arthritis — matched for the same age and gender — who had donated to a blood bank (the controls).

When they tested how immune cells in the different samples reacted to vitamin D, they found that some types of immune cell responded differently.

In particular, they found that some types of T cell taken from inflamed joints were less sensitive to the anti-inflammatory effects of vitamin D than those taken from the blood of the same people.

Corresponding study author Martin Hewison, a professor in the University of Birmingham’s Institute of Metabolism and Systems Research, explains, “This appears to be because immune cells from the joints of rheumatoid arthritis patients are more committed to inflammation, and therefore less likely to change, even though they have all the machinery to respond to vitamin D.”

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Can vitamin D prevent rheumatoid arthritis?

Although the study was limited to investigating cells in the laboratory, the findings would appear to support the idea that maintaining vitamin D levels might help to prevent rheumatoid arthritis and other inflammatory diseases.

However, they would also suggest that simply taking vitamin D supplements is unlikely to help people with rheumatoid arthritis because their immune cells are already desensitized.

“Instead,” notes study co-author Dr. Louisa Jeffery, also from the University of Birmingham, “much higher doses of vitamin D may be needed, or possibly a new treatment that bypasses or corrects the vitamin D insensitivity of immune cells within the joint.”

The researchers now want to take the research further and find out why rheumatoid arthritis causes immune cells to become insensitive to vitamin D, and how this might be prevented. They also want to find out if there are similar effects in other inflammatory conditions.

Our findings were unexpected as we initially thought that cells from the inflamed rheumatoid joint would respond just as well to vitamin D as cells from the blood.”

Prof. Karim Raza

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Medical News Today: What you need to know about PRP

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    Anitua, E., Pino, A., Martinez, N., Orive, G., & Berridi, D. (2017, May). The effect of plasma rich in growth factors on pattern hair loss: A pilot study [Abstract]. Dermatologic Surgery, 43(5), 658-670. Retrieved from

    Braun, H. J., Kim, H. J., Chu, C. R., & Dragoo, J. L., (2014, March 14). The effect of platelet-rich plasma formulations and blood products on human synoviocytes [Abstract]. The American Journal of Sports Medicine, 42(5), 1204–1210. Retrieved from

    Charousset, C., Zaoui, A., Bellaiche, L., & Bouyer, B. (2014, April 1). Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? A prospective study. The American Journal of Sports Medicine, 42(4), 906–911. Retrieved from

    Filardo, G., Di Matteo, B., Di Martino, A., Merli, M. L., Cenacchi, A., Fornasari, P., … Kon, E. (2015, May 7). Platelet-rich plasma intra-articular knee injections show no superiority versus viscosupplementation. The American Journal of Sports Medicine, 43(7), 1575–1582. Retrieved from

    Kang, J. S., Zheng, Z., Choi, M. J., Lee, S. H., Kim, D. Y., & Cho, S. B. (2014, January). The effect of CD34+ cell-containing autologous platelet-rich plasma injection on pattern hair loss: A preliminary study. Journal of the European Academy of Dermatology and Venereology, 28(1), 72–79. Retrieved from

    Patel, S., Dhillon, M. S., Aggarwal, S., Marwaha, N., & Jain, A. (2013, February). Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: A prospective double-blind, randomized trial [Abstract]. The American Journal of Sports Medicine, 41(2), 356–364. Retrieved from

    Gentile, P., Garcovich, S., Bielle, A., Scioli, M. G., Orlandi, A., & Cervelli, V. (2015, November). The effect of platelet-rich plasma in hair regrowth: A randomized placebo-controlled trial. Stem Cells Translational Medicine, 4(11), 1317–1323. Retrieved from

    Platelet-rich plasma (PRP). (2011, September). Retrieved from

    Storrs, C. (2009, December 18). Is platelet-rich plasma an effective healing therapy? Scientific American. Retrieved from

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Medical News Today: Cancer cell growth halted with cold and flu drug

“Feed a cold, starve a fever,” so the saying goes. The results of a new study, however, suggest that “treat a cold, starve cancer cells” might be a more appropriate motto.
illustration of a cancer cell
Researchers suggest that NAC could be used to halt cancer cell growth.

Researchers found that a medication used to ease symptoms of the common cold — called N-Acetylcysteine (NAC) — could also help to prevent the growth of cancer cells by depriving them of proteins that are important for their survival.

Study co-author Prof. Federica Sotgia, of the School of Environment and Life Sciences at the University of Salford in the United Kingdom, and colleagues recently reported their findings in the journal Seminars in Oncology.

Cancer remains one of the biggest health challenges of our time. In the United States, more than 1.6 million new cancer cases were diagnosed last year.

In terms of cancer treatment, we have come a long way over recent years. This is reflected in death rates from the disease, which fell by 13 percent between 2004 and 2013.

Still, cancer continues to the take the lives of more than half a million people in the U.S. every year, highlighting the need for new, more effective therapies.

Prof. Sotgia and colleagues hope that their new research will bring us closer to such treatments, after discovering how NAC could help to halt the spread of cancer cells.

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NAC, oxidative stress, and cancer cells

NAC — sometimes referred to as acetylcysteine — is an over-the-counter medication and dietary supplement commonly used to help alleviate some cold and flu symptoms, such as coughing, wheezing, and thick mucus.

NAC may also be used in the treatment of acetaminophen overdose, cystic fibrosis, and chronic obstructive pulmonary disease.

The medication also has antioxidant properties. This means that it has the ability to reduce cell damage caused by oxidative stress, which is an imbalance between potentially harmful reactive oxygen species and levels of detoxifying molecules.

Prof. Sotgia and team note that previous research has identified high levels of oxidative stress in the stromal cells of tumors, particularly breast cancer tumors. Stromal cells are cells that comprise connective tissue.

The researchers explain that when the stromal cells of tumors are exposed to oxidative stress, they release lactate and other “nutrients” that the cancer cells need to thrive.

With this in mind, the team hypothesized that the antioxidant properties of NAC might help to “starve” cancer cells of these nutrients.

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‘Encouraging results’

To test their theory, the researchers conducted a trial on 12 women who had recently received a diagnosis of stage 0 or stage 1 breast cancer, and who were awaiting surgery for the disease.

For 3 weeks between their breast cancer diagnosis and surgery, each woman received NAC. The medication was administered intravenously at a dose of 150 milligrams per kilogram once weekly. On days when the subjects did not receive NAC intravenously, they received a twice-daily oral dose of 600 milligrams.

Biopsies of each woman’s breast cancer tumor were taken both prior to and during surgery, and the researchers analyzed them for levels of three biomarkers of cancer aggressiveness: MCT4, CAV1, and Ki67.

The study revealed that levels of Ki67 in the tumors had reduced by 25 percent, while levels of MCT4 were reduced by a whopping 80 percent.

These findings indicate that treatment with NAC could be an inexpensive, non-toxic way to stop cancer cell growth and division.

“High levels of stromal MCT4 are extremely worrying,” notes study co-author Prof. Michael Lisanti, also of the School of Environment and Life Sciences at the University of Salford, “as they are linked to aggressive cancer behavior and poor overall survival, so this is very encouraging result.”

Our idea was to repurpose an inexpensive FDA-approved drug, to examine if its antioxidant properties could target the feeding behavior of cancer cells. To be able to inhibit MCT4 protein expression, in a non-toxic way, is huge step forward.”

Prof. Michael Lisanti

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Medical News Today: Cancer: 42 percent of cases down to risk factors you can change

A large new study from the American Cancer Society inventories the risk factors for various types of cancer. Those findings shed much-needed light on the proportion of cancers that could be prevented by making the necessary lifestyle changes.
man breaking cigarette in half
Smoking is the top risk factor for all cancer cases, according to new research.

The new research examined a total of 1,570,975 cancer cases, 587,521 of which resulted in death. During the analysis, 26 cancer types and 17 risk factors were analyzed.

These 17 risk factors are called “modifiable” because people can take active measures to change them. In the new study, such factors included:

  • alcohol intake
  • smoking (both first- and second-hand)
  • excess body weight
  • a low content of fiber in one’s diet
  • the consumption of processed red meat
  • a low intake of fruit and vegetables
  • ultraviolet (UV) radiation
  • low calcium
  • a lack of physical activity

Six infections that have already been linked with cancer were also included among the risk factors.

Dr. Farhad Islami, of the American Cancer Society (ACS), led the research, and the findings were published in the journal CA: A Cancer Journal for Clinicians.

In their analysis, Dr. Islami and his team used not only the prevalence of the risk factors, but also their “associated relative risk” — that is, the probability that said factors actually result in cancer. This information was obtained from “large-scale pooled analyses or meta-analyses.”

Data on the number of cancer cases and cancer-related deaths were gathered from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI).

Study co-author Dr. Otis W. Brawley, ACS chief medical officer, comments on the magnitude of the study, saying, “In 1981, Doll and Peto published what has become a classic paper on the causes of cancer.”

“Since then,” he explains, “volumes of data have been published that have clarified the association between several important risk factors and cancer. In this new report, ACS scientists provide a 21st-century calculation that will guide us in the years ahead.”

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Top risk factors: Smoking, weight, alcohol

The study revealed that 42 percent of all cancers and over 45 percent of all cancer deaths were down to modifiable risk factors. The top three risk factors were smoking, excessive weight, and alcohol use.

Nineteen percent of all cancer cases and almost 29 percent of related deaths were attributable to cigarette smoking. Excess body weight accounted for 7.8 percent of cases and 6.5 percent of deaths, while 5.6 percent of cases and 4 percent of deaths were down to alcohol intake.

UV radiation was attributable to 4.7 percent of cancer cases and 1.5 percent of deaths, and lack of physical activity accounted for 2.9 percent of cancer cases and 2.2 percent of deaths.

Certain major cancers had a high portion of cases attributable to modifiable risk factors. Lung cancer was at the top, with 85.8 percent of cases down to such factors, 81.7 percent of which were attributable to smoking alone.

Over 70 percent of liver cancer cases, almost 55 percent of colorectal cancer cases, and nearly 29 percent of breast cancer cases could be attributed to modifiable risk factors.

Additional findings include the fact that UV radiation was linked to 96 percent of skin melanoma cases, and excess body weight to over 60 percent of uterine cancers.

Fifty percent of esophageal cancers were tied to smoking. Cigarettes were also associated with nearly 47 percent of bladder cancer cases. Finally, over 10 percent of colorectal cancers were associated with a low intake of dietary fiber.

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‘Knowing about preventive measures’ is key

“[T]hese findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures,” conclude the authors.

The study authors remind the public of the four key factors that everyone can keep in check: body weight, alcohol consumption, diet, and physical activity.

The combined influence of these four factors made up nearly 14 percent of cancer risk in women and over 22 percent in men.

Dr. Islami and colleagues write:

Our findings emphasize the continued need for widespread implementation of known preventive measures in the country to reduce the morbidity and premature mortality from cancers associated with potentially modifiable risk factors.”

“Increasing access to preventive healthcare and awareness about preventive measures,” the authors conclude, “should be part of any comprehensive strategy for broad and equitable implementation of known interventions to accelerate progress against cancer.”

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Medical News Today: What is precordial catch syndrome?

Precordial catch syndrome is a common cause of chest pain in older children and young adults. Precordial means “in front of the heart,” which is where a person feels the pain. It is also known as Texidor’s twitch.

While it can be painful, it will usually go away on its own, and it leaves no lasting impact.

In this article, we look at the symptoms of precordial catch syndrome, along with why it occurs and what can be done to treat it.


Man in business clothes at desk clutching chest in pain.
Precordial catch syndrome causes pain in the chest, and usually occurs when a person is in a resting position.

Precordial catch syndrome normally occurs when a person is at rest, particularly if they are in a slouched position or if they are bending over.

People report feeling a sharp, stabbing or needle-like pain in the chest when breathing in. A person often feels the pain below the left nipple.

The pain, which has nothing to do with eating, usually only lasts for a short time. This can be between a couple of seconds and 3 minutes. It can happen just once or multiple times throughout the day.

Precordial catch syndrome is often made worse by deep breathing, but there is no tenderness in the area. It does not spread out to other areas of the chest, as pain caused by a heart attack would.

The severity of the pain varies between individuals. Some people experience a dull, annoying pain. Other people experience such intense pain that it can cause momentary vision loss or blurriness.

The pain, which tends to cover an area no bigger than one or two fingertips, completely goes away suddenly.

People with precordial catch syndrome experience no other symptoms or physical changes. They will not experience any paleness, flushing, or wheezing but may feel lightheaded from prolonged shallow breathing. Their pulse rate and rhythm remain normal.

Are there any complications?

Because it can hurt to breathe deeply, people with precordial catch syndrome tend to take shallow breaths, which can lead to light-headedness.

The nature of the pain can sometimes lead to anxiety, as people may think that it is a sign of a more serious cardiac condition, such as a heart attack. This can be made worse by unnecessary, extensive tests or referrals to cardiac specialists.

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Woman with bad slouching posture at desk in front of laptop.
Bad posture, such as slouching, may cause precordial catch syndrome.

There is no obvious trigger for precordial catch syndrome. While the sudden onset of the pain may be scary, it is not caused by a heart attack or lung disease.

Experts think that the pain caused by precordial catch syndrome is caused by nerves getting pinched or irritated in the inner lining of the chest wall.

The symptoms come and go very suddenly, and they may start in the chest wall, ribs, or connective tissue.

Precordial catch syndrome can occur due to a growth spurt, bad posture, or an injury, such as a blow to the chest.

Who is at risk?

Precordial catch syndrome is most common in teenagers and young adults, but children as young as 6 years old can also experience it.

In rare cases, adults can also experience precordial catch syndrome.

Can it be prevented?

Precordial catch syndrome is sometimes caused by a growth spurt, which is not preventable.

Other causes, such as injury to the chest, can be avoided. Bad posture, including slouching, is a contributory factor, so standing or sitting straight may help prevent future episodes.


A doctor will rule out other, more serious causes of chest pain by taking a full medical history, assessing symptoms, and asking about any other health problems.

They will usually carry out a physical examination of the chest, looking for tenderness and listening to the heart and lungs.

Precordial catch syndrome is harmless and very common. In most cases, a doctor will not need to do any tests to diagnose it.

When should I see a doctor?

Someone who thinks they have precordial catch syndrome should seek medical attention if they have any underlying heart conditions, or if they develop other symptoms.

Anyone who experiences changes in the nature or frequency of the pain should visit a healthcare professional.

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Woman taking deep breaths outside, inhaling fresh air.
Improving posture and practising breathing exercises may help to treat precordial catch syndrome symptoms.

The pain associated with precordial catch syndrome will go away on its own, so specific treatment is not usually needed.

Doctors may recommend an over-the-counter anti-inflammatory to help relieve the pain.

Relaxing and taking slow breaths might help, as may changing posture from slouching or being bent over to sitting upright.

Some people have found that taking a deep breath makes precordial catch syndrome go away, but it may do so at the cost of a sharp, brief stab of pain. Most people who experience precordial catch syndrome advise taking shallow breaths until the pain goes away.

People may also benefit from being reassured that the condition is harmless.


Precordial catch syndrome usually affects just children and teenagers, and most will outgrow it by the time they reach their 20s.

It is a harmless condition, and there are no significant side effects as a result of it occurring.

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Medical News Today: Study shows how gut bacteria may trigger MS

Alterations in gut bacteria at a young age could help to trigger and progress multiple sclerosis in people who are genetically predisposed to the autoimmune disease.
blue gut bacteria
Could changes to gut bacteria give rise to MS?

A team of researchers from Rutgers-Robert Wood Johnson Medical School in Piscataway, NJ, came to this conclusion after studying the effect of altered gut bacteria in mice genetically engineered to have a high risk of multiple sclerosis (MS). They report their findings in the journal PNAS.

A significant feature of the new study is that it suggests a mechanism through which altered gut bacteria and MS risk genes — acting during young adulthood — may collaborate to trigger the disease. Another is that the researchers engineered a unique mouse model to study MS.

MS is a lifelong autoimmune disease wherein the immune system mistakenly attacks healthy tissue in the central nervous system (CNS), which comprises the brain, spinal cord, and optic nerves.

The immune attacks disrupt the nerve signals between the brain and the body that carry messages and help us to move our limbs and use our senses.

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Clues on causes of MS increasing

There are many different symptoms of MS, depending both on which parts of the CNS come under attack and the extent of the damage.

These include: blurring and loss of vision; poor coordination and balance; tremors; extreme fatigue; numbness; slurred speech; paralysis; and difficulty concentrating and remembering. The symptoms can flare up and subside or they can stay and gradually get worse.

While MS can strike any person any age, most people are diagnosed between the ages of 20 and 50 and it is more common in women than in men.

In the United States, there is currently no formal consistent reporting of MS, but estimates suggest that there could be as many as 1 million people living with MS.

The exact causes of MS are still somewhat of a mystery, although scientists studying animal models of the disease have discovered many clues as to how the immune system and its inflammatory processes attack the myelin sheath and the nerve fibers inside.

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‘Gut dysbiosis’ linked to MS

One area that researchers are homing in on is the role that gut microbes, or gut microbiota, might play in MS.

Alterations in the composition of the gut microbiota — termed “gut dysbiosis” — are often observed in people with MS, but the mechanisms through which they might be contributing to the disease are yet to be described.

To explore the role of gut dysbiosis in MS further, the Rutgers researchers genetically engineered a unique breed of mice so that they had a high risk of developing MS. They did this by inserting human genes known to be linked to MS into the mice.

The team — including Prof. Suhayl Dhib-Jalbut, director of Rutgers-Robert Wood Johnson Center for Multiple Sclerosis — found that if the genetically engineered mice were raised in a germ-free, sterile environment, “they did not develop MS.”

However, when they moved the mice to a normal environment — that is, one that contains many types of bacteria — they found that the animals did develop symptoms that were very similar to human MS.

The mice also developed bowel inflammation, which suggested to the team that something to do with the gut bacteria might have triggered the MS-like disease.

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Age, gut dysbiosis, and risk genes

The team also found that the younger mice were more likely to develop MS than the older mice, suggesting that there was an age-related window of opportunity for the altered gut bacteria and MS risk genes to collaborate and trigger the disease.

During that period in young adulthood of the mice, the researchers observed a reduction in the “development of Foxp3+ Treg cells and expression of E3 ubiquitin ligase genes involved in protection from autoimmune diseases.”

The scientists therefore suggest that a direction for future study could be how to eliminate the harmful strains of bacteria or increase the beneficial strains to slow progression of MS. In their study, they identified some of these.

The team is already in receipt of funding to carry on their investigation in people with MS.

The findings could have therapeutic implications on slowing down MS progression by manipulating gut bacteria.”

Prof. Suhayl Dhib-Jalbut

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Medical News Today: Can you overdose on melatonin?

Melatonin is a popular supplement that many people use to help them fall asleep and stay asleep throughout the night. Melatonin varies in effectiveness from person to person, which may lead to an accidental overdose.

A melatonin overdose can cause unwanted and irritating side effects. It is important for people using melatonin to be mindful of side effects and always begin with the lowest dose possible.

What is melatonin?

Melatonin tablets piled on stone surface.
Melatonin supplements are used to resolve sleep-based problems, such as insomnia or a disrupted sleeping pattern.

Melatonin is a naturally occurring hormone in the body that helps regulate the sleep cycle. It is produced by the pineal gland in the brain.

Melatonin levels increase and decrease throughout the day. Typically, melatonin levels rise through the evening and stay elevated overnight, allowing a person to sleep. In the morning, the levels drop back, allowing a person to wake up.

Melatonin is produced in the body, but a person can also acquire minimal amounts of melatonin from food. Some vegetables and fruit contain small amounts of melatonin, and it is also available as an over-the-counter supplement.

Taking a melatonin supplement may help alleviate insomnia and sleep-related problems. Some people take melatonin supplements while traveling to reduce jet lag.

Shift workers may also take it to help them fall asleep during the day or at irregular hours.

Due to potential side effects, it is essential that anyone starting to take melatonin supplements talk to a doctor first.

Symptoms of a melatonin overdose

The symptoms of a melatonin overdose will vary from person to person. Some people may find that too much melatonin may actually cause them to be more awake, which is the opposite of its intended purpose.

Others find that taking too much melatonin causes them to feel extremely sleepy during unintended times or cause intense dreams or nightmares.

Some additional symptoms of a melatonin overdose may include:

People with high blood pressure or who are taking medications that lower blood pressure should speak to a doctor before using melatonin.

Blood pressure medications may decrease a person’s natural production of melatonin, which may prompt them to take melatonin to help offset the imbalance. However, melatonin can cause changes in blood pressure, including unsafe and unexpected spikes.

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Correct dosage

Pharmacist discussing medicine prescription with customer.
A doctor or pharmacist can advise on the correct melatonin dose to take.

According to, an adult typically begins with a dose of between two-tenths of a milligram (mg) and 5 mg. If this dose is well-tolerated but not effective, the person can slowly increase the dose until they get the desired results.

The same dose may cause unwanted side effects in one individual while not making a noticeable difference in another adult. Age, weight, and overall sensitivity to the supplement affect how much melatonin a person should take.

Melatonin is not recommended for children unless they have a neurodevelopmental disorder that makes it difficult for them to sleep. If a doctor prescribes melatonin for a child, it is important to follow the exact dosage prescribed. Even small amounts of melatonin can cause seizures or other serious side effects.

The United States Food and Drug Administration (FDA) do not regulate melatonin. Supplements may vary in strength between manufacturers, so a person should research consumer reports before choosing a brand of melatonin.

Medications that interact with melatonin

Melatonin can have a direct effect on a person’s sleep cycle. A person should avoid taking melatonin alongside products containing caffeine or alcohol, as both of these can affect a person’s ability to fall asleep.

Anyone who is taking other medications should discuss possible side effects with their prescribing doctor. Prescription and over-the-counter drugs can interact with melatonin supplements.

Some medications, such as birth control, can cause the body to produce more melatonin. Taking a supplement may cause levels of melatonin to increase too much, producing unwanted side effects.

Immune suppressors and some blood thinners may also react with melatonin. For example, melatonin may intensify the effects of some blood thinners, causing a risk of excessive bleeding.

When to see a doctor

Woman clutching her chest because of heart pain.
Sudden, unexplained pain in the chest may require immediate medical attention.

A person should speak to a doctor if they are considering taking melatonin for trouble sleeping. A doctor can recommend the correct dose and tell a person whether their medication is likely to cause unsafe side effects.

People should also report any unwanted side effects from melatonin to a doctor as soon as possible.

A person using melatonin should contact poison control, 911, or their local emergency number if they experience any of the following side effects:

  • extremely high blood pressure
  • shortness of breath
  • sudden chest pain

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Treating an overdose

Treatment for a melatonin overdose will depend on the severity of the symptoms. In an emergency situation, a doctor will focus on stabilizing the person’s condition. A person experiencing chest pain or trouble breathing may require additional medical interventions.

In most cases, the best treatment is to reduce or eliminate melatonin use. There is no research indicating that it is unsafe to stop using melatonin suddenly.

If a person has to stop using melatonin because of side effects, a doctor or sleep specialist may be able to recommend other methods to help the person fall asleep.


Some people may find melatonin far more effective to help them fall and stay asleep throughout the night than others. Some people may not tolerate even small doses of melatonin and others may not experience any benefits from taking melatonin.

For some people struggling with insomnia or having trouble sleeping, a sleep specialist may be able to give additional suggestions. A sleep specialist may recommend cutting out caffeine or reducing alcohol consumption.

It is not likely that an adult taking melatonin will experience a medical emergency. On the other hand, children are far more likely to experience severe medical issues when they take melatonin supplements.

All people should start with the smallest dose of melatonin possible to avoid potential overdose, and consult a doctor before they begin.

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Medical News Today: How to cope with social anxiety over Thanksgiving

Thanksgiving meal
What can you do to cope with social anxiety at Thanksgiving?
Social anxiety isn’t just nervousness; it can have a heavy impact on lifestyle, social relationships, and self-esteem. Thanksgiving is nearly here, and the thought of being surrounded by dozens of relatives may make you uneasy. So what are some things that you can do to keep anxiety at bay?

The National Institute of Mental Health (NIMH) report that 6.8 percent of all adults in the United States experience social anxiety — also known as “social phobia” — each year. Of these, 29.9 percent of cases are classed as “severe.”

Social anxiety is defined as an “intense, persistent fear of being […] judged by others,” and standing out from the crowd. People who live with this disorder may struggle with school, work, and various other social situations such as parties, weddings, and other family celebrations, as they are constantly — and painfully — self-aware, scared of doing or saying the wrong thing.

In social anxiety, words and gestures are blown out of proportion, and individuals fear that the smallest thing that they’ve said or done may severely impact the way that others see them. This fear can become debilitating and put people with this type of anxiety off from attending events that others take great pleasure in.

With Thanksgiving drawing ever nearer, households across the U.S. are getting ready to celebrate love and gratitude with family members and friends. But how can you let these warm feelings shine, and how can you enjoy the event, if being around people makes you so anxious?

Below, we look at some methods that may help you to keep social anxiety manageable, so you can begin to relax a little and enjoy yourself this Thanksgiving.

1. Prepare in advance

If you already know that you’ll have to be around a large group of people — including relatives who you haven’t seen in months or years, or new girlfriends and boyfriends you’ve never even met — then it’s probably a good idea to do a little mental and practical preparation.

For instance, you may want to engage in something relaxing and enjoyable beforehand, such as meditation or breathing exercises. Many studies suggest that meditation and mindfulness techniques are effective in reducing stress and worry.

A useful breathing exercise for anxiety is to take a breath in, slowly, maybe counting to five, and feel the air fill your belly. Then, release the breath just as slowly, feeling first your belly and then your chest deplete completely. Repeat this a few times, until the tension in your body eases a little, and you feel more relaxed.

You may want to prepare a list of potential conversation topics in advance. If you get people talking about themselves — their children, pets, jobs, projects, and so forth — then you’ll be placing them in the limelight, and you won’t have to worry about your own performance.

Research has suggested that people with social anxiety tend to focus too much on the impression that they might leave on someone else. Switching the focus to other people — what they’ve been doing, what kind of things they enjoy, or what they plan to do come next weekend — can help to disperse some of that heavy self-consciousness.

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2. Make sure you a have a ‘job’ to do

Speaking of focusing on someone else, psychologist Anita Sanz — who had to cope with social anxiety for many years herself — explains that “giving herself a job to do” in a social setting has often helped her to alleviate anxiety.

In an interview, she explains that a sense of purpose allows her to forget that she’s worried about how others might perceive her.

I have found that the best way to manage social anxiety is to give myself a ‘job’ to do. I substitute purpose for confidence and meaning for fear. I don’t focus on how others are perceiving me or evaluating me when I am trying to accomplish something important or meaningful.”

Anita Sanz

setting the table
It may help if you give yourself a concrete ‘job’ to do, such as helping the host with the meal arrangements.

So, once you get to the Thanksgiving dinner party, make sure you have a practical job to do: set the table, check on the turkey, do some dishes, or decorate the dessert. This will keep you occupied and may allow you to avoid the hustle and bustle of the event.

As a bonus, studies have shown that performing an altruistic deed to help someone else boosts happiness and decreases stress levels.

Research reported by Medical News Today earlier this year, for instance, found that being generous and performing selfless acts activates the ventral striatum, which is a region of the brain linked with happiness and the reward cycle.

3. Try to turn anxiety into excitement

When you feel the wave of panic coming on, try to imagine that you’re excited instead. You can make this a general statement, repeating “I’m excited” to yourself, like a mantra. Or, you can make it specific, fooling your mind that you’re hyped about a coming event or situation. For instance, you can anticipate your upcoming hike, or an online shopping spree.

This way, you may be able to trick your brain into thinking that your anxiety is actually a feeling of intense anticipation felt in the lead-up to a good thing. In scientific terms, this technique is called “reappraisal.”

Prof. Alison Wood Brooks, from the Harvard Business School in Boston, MA — who published a paper on this topic — explains that it may be easier to transition from anxiety to excitement than from anxiety to a state of calmness. That is because anxiety and excitement are more similar to each other, and closer in intensity.

“The way we verbalize and think about our feelings,” explains Prof. Brooks, “helps to construct the way we actually feel. Saying ‘I am excited’ represents a simple, minimal intervention that can be used quickly and easily to prime an opportunity mindset and improve performance.”

A more recent study published in the Journal of Consulting and Clinical Psychology also suggests that reappraising your emotions can be helpful, at least in the short-term, in tackling situations that cause anxiety.

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4. Be in the moment, be curious

As mentioned above, being mindful and being “in the moment” can be helpful in reducing anxiety, which brings us to the next tip: try to be curious.

According to Todd Kashdan — a professor of psychology at George Mason University in Fairfax, VA — curiosity is often key to turning anxiety into excitement, and daring to try out things that normally make you nervous.

In an article he published in the Journal of Anxiety Disorders, Prof. Kashdan and colleagues note that, “Socially anxious people who experience high levels of curiosity, or appraise certain events as having a high possibility to satisfy curiosity, may be more likely to engage in approach behavior amidst conflicting avoidance motivations.”

In the context of a Thanksgiving meal, you could achieve this by purposefully paying attention to the food — how it tastes, how it smells, and what the texture is like — as well as by listening to other guests’ conversations and being open to noticing small or surprising details in your surroundings.

Another study, which was published in the journal Neuron, found that curiosity engages with our brain’s reward circuitry: when we’re curious about something, we get pleasure by investigating it further, as the brain releases dopamine, the so-called feel good hormone.

5. Remember, you’re in charge

At the end of the day, however, it’s vital to take everything in your stride. If you start feeling tired due to the effort of socializing and being around so many people, then remember that you can always make a retreat and go home.

The Anxiety and Depression Association of America advise “stepping back” and “taking a time-out” if your emotions become too intense. Just doing your best is enough, and it’s important to be able to recognize when you’d best spend some quality time on your own.

If you’re worried that your family won’t be too happy about you leaving the party early, also remember that simply acknowledging that you now need some space is nothing to be frowned upon. Admitting tiredness, for instance, won’t do any harm and will clearly indicate that it’s time you took your leave.

We hope the tips outlined in this article will help you to make the most of this Thanksgiving, as well as other social events in the upcoming holiday season. Social anxiety may be a part of your life right now, but it shouldn’t stand in the way of your happiness and enjoyment.

For more information on the best avenues for the treatment of social anxiety and how to overcome it in the long-term, please see the dedicated pages on the NIMH website.

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Medical News Today: The 10 best blogs for ADHD

man using a smartphone next to his laptop
ADHD blogs are dedicated to supporting individuals with ADHD and their friends and family.
Blogs that specialize in ADHD can provide educational information, advice, and support for those with the disorder and their friends and family, and tips on day-to-day living with ADHD. We have selected the best blogs for the disorder.

ADHD (attention deficit hyperactivity disorder) is a condition that includes a combination of persistent behavioral symptoms, such as attention difficulties, hyperactivity, and impulsiveness.

ADHD affects around 11 percent of children aged between 4 and 17 years in the United States and often continues into adulthood.

Children with ADHD may struggle with poor performance at school, low self-esteem, and have trouble with relationships. Adults with ADHD may have problems with organization and prioritizing, time management, and multitasking. They may also experience difficulties with focusing, frustration, mood swings, and coping with stress.

Although there is no cure for ADHD, treatments can help to reduce symptoms and improve functioning. Treatments often include education, training, psychological counseling, and medications.

ADHD blogs can provide strategies, recommendations, and suggestions for coping with daily tasks from both experts and those with the disorder, wirth the aim of empowering their readers.

Here are Medical News Today’s top 10 blogs for ADHD.

ADHD Kids Rock

ADHD Kids Rock logo

Jeff Rasmussen has just graduated from high school and is the creator of the website ADHD Kids Rock. Jeff was diagnosed with ADHD in Grade 7 and says that his biggest dream is to change the world for children, who, like him, “are punished daily for having ADHD.”

Jeff had many bad experiences at school as a result of his ADHD. Before he started taking medication, his teachers would take away his recess, gym classes, and suspend him from school. Through the ADHD Kids Rock blog, Jeff shares his experiences, strategies, and stories for kids, parents, teachers, and others about living with ADHD.

Recent posts on the blog include how summer camp is not all fun and games for kids with ADHD, how to avoid fights when faced with an angry bully who is out to prove a point, and why video games can be more helpful than you think for those with ADHD.

Visit the ADHD Kids Rock blog.

The ADHD Homestead

The ADHD Homestead logo

Jaclyn Paul is a stay-at-home mom and writer for the blog The ADHD Homestead. Jaclyn and her husband share a home, a preschooler, and a diagnosis of ADHD.

Jaclyn says, “It’s possible to calm the chaos!” Despite having ADHD, Jaclyn has created a satisfying life and a peaceful home for her and her family. Jaclyn achieved this by treating her ADHD, learning about her brain, and figuring out what works best to keep her home, relationships, and schedule under control.

Through her blog, The ADHD Homestead, Jaclyn shows others how to live happily with ADHD. Featured posts include how to handle kin-keeping when you are a woman with ADHD, how to make sure you catch all the important details when you read, and using music and songs to help with poor memory.

Visit The ADHD Homestead blog.

A Splintered Mind

A Splintered Mind logo

Douglas Cootey is the man behind A Splintered Mind blog. He has been blogging about mental health on the site since 2005. Douglas began blogging to primarily overcome the stigma of his ADHD and depression and talk about his conditions more openly without feeling shame.

Douglas also aims to reach out to others who are experiencing similar issues, to not only share how ADHD and depression affect him but also to learn how it affects others by reading their comments and emails.

A Splintered Mind gives an honest and sometimes humorous account of life with ADHD. Posts include a trip to the doctor’s office on the wrong day and how to prevent that from happening next time, tips to slay ADHD tardiness, and how to overcome an overwhelming sense of underachievement.

Visit A Splintered Mind blog.

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Raised on Ritalin

Raised on Ritalin logo

Raised on Ritalin is the blog of Tyler Page. Tyler was diagnosed with ADHD when he was 8 years old and says that it was just before his 9th birthday that he started medication and “became a hard drug user.”

Now in his 40s, Tyler is an artist who is based in Minneapolis. With the use of written posts and cartoon drawings, the Raised on Ritalin blog explores ADHD, treatments for the condition, and details of how ADHD has affected his life and the lives of his family. He has even released a graphic novel on his personal ADHD story.

Comic book posts on the blog include how cycling has helped with ADHD, how making comics clicked with the way Tyler’s brain works, and how Tyler’s ADHD education and research has changed the way he approaches his life.

Visit Raised on Ritalin blog.

ADHD Roller Coaster

ADHD Roller Coaster logo

Gina Pera is an “accidental adult ADHD expert” and writer of the blog ADHD Roller Coaster. Gina entered into the field of ADHD by chance after reading a book about the brain at the library, which changed her life, her husband’s life, and the lives of others.

In the book, Gina read about a condition called adult ADHD, which struck a chord with her and suddenly gave her a clue as to why her and her then-fiancée, a molecular biologist, constantly drove each other crazy. Gina’s husband was diagnosed with ADHD many years into their relationship, and she began to think that perhaps other couples could be in the same boat.

Gina has spent 17 years on a mission to reduce suffering and elevate the conversation around adult ADHD. Her latest blog posts include six ADHD management tools and strategies, the high cost of using fear-based management for ADHD, and whether ADHD can affect sense of smell.

Visit ADHD Roller Coaster blog.

Totally ADD

Totally ADD logo

Totally ADD is dedicated to supporting adults with ADHD and individuals affected by ADHD, such as family, employers, and healthcare professionals. Totally ADD’s mission is to liberate those with ADHD from fear, shame, and stigma so that they can create a life that they love.

The Totally ADD team is made up of individuals with ADD or people who are affected by it. They offer knowledge, social interaction, and a healthy dose of humor in their posts. The information on the site is reliable and presented in a way that is both memorable and fun.

Articles on the blog include strengths that are common to people with ADHD, whether ADD adults experience low self-esteem, and how to find out if you have ADHD.

Visit the Totally ADD blog.

An ADD Woman

An ADD Woman logo

Brenda Nicholson is the creator of An ADD Woman. Around 30 years ago, Brenda realized that her son had ADHD and has been passionate about helping others to figure out how to live their best life with ADHD ever since. Brenda was diagnosed with ADHD at the age of 42, and her two daughters also have ADHD.

Brenda is an ADD coach and has been working with many women and young adults with ADHD since the year 2000. Brenda says that she is living proof that it is possible to live a full life with ADHD and that starts with understanding your ADHD and taking good care of yourself.

An ADD Woman includes ADHD-related posts such as whether women with ADHD are confident, how to be organized and get stuff done, and the things you can manage to get done around the house in 5 minutes or less.

Visit An ADD Woman blog.

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ImpactADHD logo

ImpactADHD is a space for parents of children with ADHD to receive vital support, coaching, and solutions. ImpactADHD point out that while many parents put everyone else before themselves, empowering yourself is the best possible way to empower your children.

ImpactADHD provide coaching to help parents remove obstacles and work toward success and satisfaction. They teach how to set realistic, attainable goals and how to communicate more effectively to reach a happier path of parenting.

The blog is categorized into overcoming school challenges, organizing life and family, maintaining healthy relationships, and managing emotions and impulses. Posts include how to help your child concentrate, some simple tricks to manage the morning madness, and how to create a relationship of trust with your child.

Visit the ImpactADHD blog.

ADD Consults

ADD Consults logo

Terry Matlen is a psychotherapist, ADHD coach specializing in ADHD in women, and is the founder of ADD Consults. Terry has ADHD, as does one of her two children.

Terry is passionate about raising awareness of the unique challenges that women with ADHD face and the issues they experience when their children are also diagnosed with ADHD. She is a nationally recognized speaker on the topic of ADHD and a Senior Certified Coach.

Blog posts on ADD Consults cover a range of ADHD topics, such as steps to take to make your relationship less destructive, tips on how to stay connected and become a better listener, and strategies to help families affected by ADHD improve relationships, self-esteem, and life in general.

Visit the ADD Consults blog.

Untapped Brilliance

Untapped Brilliance logo

Jacqueline Sinfield is an ADHD coach for adults and educates adults with ADHD how to manage their ADHD naturally through her site Untapped Brilliance.

Jacqueline always dreamed of being a nurse and pursued a career path practicing nursing until she realized her real passion was in speaking with patients and their families. She proceeded to take a career shift in psychology and coaching.

The Untapped Brilliance blog covers subjects such as ideas of what to include on your ADHD “don’t do” list, ways to eliminate afternoon crashes for those with ADHD, and facts about ADHD and shame.

Visit the Untapped Brilliance blog.

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Medical News Today: How to get rid of a bruise: Home remedies

Bruising is a normal response to an injury. Tiny blood vessels beneath the skin can be damaged by even a small impact, leaving behind blood trapped beneath the skin.

This trapped blood is eventually reabsorbed by the body as the injury heals. In the meantime, it can leave a gray, bluish, or purple patch that is tender to the touch.

Bruises can be difficult to treat, as most of the damage is beneath the surface of the skin. However, some home remedies may be able to speed up healing, minimize their appearance, and prevent them from happening in the first place.

The following home remedies are safe for minor bruising and may help get rid of bruises faster.

1. Arnica montana

Bruise on person's arm.
Bruises usually fade by themselves, but there are ways to speed up recovery.

Arnica montana, or arnica, is an herb widely used for pain and bruising. This is because it contains compounds that are known to have an anti-inflammatory effect that can be absorbed through the skin.

Some research has found that arnica may be an effective remedy for bruising.

  • One study found that people who took oral arnica after a rhinoplasty (nose job) had improved appearance of post-surgery bruising.
  • Another study found that applying a 20 percent arnica ointment to the skin sped up healing time when compared with a placebo.

People should look for oral arnica, arnica gel, or arnica ointment that contains at least 20 percent arnica. It can be applied as directed on the product package.

If using oral arnica, it is usually best to let the pill dissolve under the tongue. An arnica mouth spray should also be used to coat the underside of the tongue.

A person should stop using the product if irritation or a rash develops.

2. Bromelain

Bromelain is a mixture of enzymes found in the pineapple plant. These enzymes may have anti-inflammatory properties and help reduce bruising and swelling when applied to the skin.

A study in the Journal of Oral and Maxillofacial Surgery found that oral bromelain improved pain and swelling after tooth extractions when compared to a painkiller and a placebo.

A person can apply a cream or gel containing bromelain two to three times a day or as otherwise directed.

Oral bromelain supplements can cause unwanted side effects, including digestive problems and increased heart rate. People who are allergic to pineapple should not use bromelain.

Bromelain supplements are sometimes recommended after surgery to help minimize bruising, but a person should only take bromelain by mouth if directed by a doctor.

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3. Quercetin

Person applying cream or ointment to bruised skin.
Some skin creams used to heal bruises contain quercetin.

Similar to bromelain, quercetin is a flavonoid derived from certain fruits. It may have natural anti-inflammatory powers that can help heal bruises.

Some skin creams and gels intended to help with bruising contain quercetin, usually in combination with bromelain, vitamin K, or other ingredients. Creams or gels containing quercetin can be used as directed on the package, typically twice a day.

Taking quercetin by mouth has not been proven to be safe. It can also interact with many medications. Avoid taking oral quercetin supplements unless directed by a healthcare professional.

4. Vitamin K cream

The body needs vitamin K to help the blood clot when necessary. But a pill may not be the best solution, especially for those taking blood thinners or other medications. Topical vitamin K, however, shows some promise as a remedy for bruises and is generally safe for most people to use.

A study in the Journal of Drugs in Dermatology found that people who applied a vitamin K gel after having a cosmetic procedure had less bruising than those who used a placebo.

Many different vitamin K products are available over-the-counter. A person should look for one that lists vitamin K near the beginning of its ingredients, and apply it as often as directed.

5. R.I.C.E.

R.I.C.E. stands for rest, ice, compression, and elevation. Many people who have had surgery or have sprains or strains employ this tactic to aid recovery, but it has benefits for bruising as well.

These actions aim to temporarily reduce blood flow to the injured area, which can help prevent some swelling and bruising.

Elevating and resting the area, as well as applying ice for up to 20 minutes per hour and using a light compression bandage, can help decrease the blood flow and inflammation that contribute to bruising.

Following R.I.C.E. as soon as possible after an injury and throughout the healing process can also decrease pain.

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6. A bruise-healing diet

Pineapple being cut up.
Pineapple contains bromelain, which has anti-inflammatory properties that may encourage bruise healing.

A person’s diet can have an impact on all areas of health, including how their injuries and bruises heal. Certain foods can strengthen the body’s blood vessels, which may minimize bruising.

Other foods can help keep the body’s skin and tissues strong and pliable. Eating a healthful, balanced diet that includes the following foods may help prevent or heal bruises:

  • Pineapple. Eating fresh pineapple gives the body a natural dose of bromelain, which may help the bruise heal faster.
  • Fruits with natural quercetin. Foods with high amounts of quercetin include apples, citrus fruits, red onion, dark-colored berries and cherries, and leafy green vegetables.
  • Citrus fruits. One study found that citrus flavonoids significantly improved bruising in seniors who had senile purpura, or ongoing bruising. Citrus fruits include oranges, tangerines, and lemons.
  • Foods with vitamin K. A diet that includes vitamin K will prevent deficiency and may help a person bruise less. Good sources include kale, spinach, broccoli, Brussels sprouts, lettuce, soybeans, strawberries, and blueberries.
  • Lean protein. Fish, poultry, tofu, and lean meat provide protein to help strengthen capillaries. Avoid sources of protein with high amounts of saturated fat and cholesterol, such as hamburger or fried meats.
  • Zinc-rich foods. Zinc helps the body heal wounds and tissues. Good sources of zinc include crab, lobster, spinach, pumpkin seeds, and legumes.

7. Essential oils

Frankincense essential oil may help with pain relief and relaxation. It works well when a few drops are added to a Vitamin K or arnica product.

A person can create a soothing cold compress for injuries with a cool washcloth and a few drops of rosemary and lavender essential oils applied to the cloth.

It is important to dilute oils with a carrier oil or a lotion before putting directly on the skin unless directed otherwise. Using essential oils without diluting them can cause skin irritation.

When to see a doctor

Although bruises happen to everyone, some bruising may be a red flag for an underlying medical problem or nutritional deficiency. Symptoms to see a doctor about include:

  • bruises that appear without an obvious injury
  • frequent bruising
  • bruising very easily
  • bruises that suddenly appear after taking a new medication or supplement
  • bruises in strange places, such as the back or abdomen

Women tend to bruise more than men, and older people bruise more than younger people.

Antibiotics, blood thinners, and asthma medications also cause increased bruising in some people. However, a person should not stop taking a medication without first speaking with their doctor.


There is no magic trick to prevent or erase bruises. The good news is, most bruises are harmless, and there are home remedies to reduce their appearance and help them heal faster.

Most topical products are safe to try but do not take oral supplements for bruising without talking to a healthcare professional first.

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