Doctors aren’t usually crazy about the numerous supplements that abound in drug stores, except for prenatal vitamins. The problem is, the Food and Drug Administration (FDA) doesn’t bother checking the safety or effectiveness of supplements before they are let loose on the public. So, quality control is not exactly their forte. How come then, doctors are so quick to recommend prenatal vitamins to women who are planning on becoming pregnant – and sometimes, even to those who aren’t?
Only ask your ob/gyn about prenatal vitamins, and you’ll see what I’m talking about. What could be their reason?
Prenatal vitamins are supplements that contain at least 400 micrograms of folic acid which is very important for a healthy pregnancy.
Folic acid is a B vitamin that is vital for DNA production and creation of new cells. Getting adequate folic acid can reduce the risk of neural tube defects – problems associated with the formation of an embryo’s brain and spinal cord. According to the Centre for Disease Control and Prevention (CDC), these defects which occur in the first month of pregnancy, include conditions that affect the brain, skull and spinal cord such as spina bifida and anencephaly.
It’s difficult to say the exact amount of folic acid in a prenatal vitamin since they aren’t regulated by the FDA. However, supplements that contain folic acid usually has about 400 to 800 micrograms per dose, according to the CDC. This includes prenatal vitamins which are just multivitamins with a predominance of nutrients essential for a healthy pregnancy, like folic acid, Fahimeh Sasan, D.O., an assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai, says.There are also supplements which only contain folic acid, and there are those made of a combination of B vitamins including folic acid.
You can also get folic acid in the form of folate. Folate is found in fruits like dark, leafy greens, nuts, beans and eggs. Though getting the recommended dosage from food will hard, unless you eat fortified cereal.
Who are prenatal vitamins meant for?
The CDC recommends a daily intake of 400 micrograms of folic acid for people between the ages of 15 and 45. This could be taken in the form of a prenatal, a supplement containing only folic acid or fortified cereal.
To put it simply- everyone capable of getting pregnant should take folic acid whether or not they plan to get pregnant. This position is also supported by the American College of Obstetricians and Gynecologists (ACOG) who recommend that anyone that can possibly get pregnant take a daily supplement containing folic acid (they didn’t include fortified cereals in their guideline).
Part of the reason for this recommendation is that 45 percent of pregnancies in the US are unplanned. Then again, the neural-tube has little time to properly form – neural tube defects develop just about 21 to 28 days after conception. Since most people are yet to realize they are pregnant by this time, especially is the pregnancy was unplanned, taking folic acid serves as a preventive measure.
Again, folic acid is a water-soluble vitamin which means any leftovers is passed out as you pee, says Dr. Sasan. This means that folic acid isn’t stored in your body to be utilized when the need arises like during pregnancy. More reasons to take prenatals before you conceive instead of waiting until you found out, no matter how early. Though it looks like something straight out of The Handmaid’s Tale, those are the current expert’s recommendations.
For those who have had pregnancies with neural tube defects and are not planning to conceive again, the standard daily intake of 400 micrograms suffices. However, if you are planning to become pregnant, you should speak with your doctor about increasing your dosage. The CDC recommends up to 4,000 micrograms daily to avert a reoccurrence. (the CDC insist you must get this much folic acid under advice from your doctor).
Obviously, folic acid is very important. But what of the other components of the prenatals?
Most prenatals contain a minimum recommended amounts of other vitamins, Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine, says.
Iron is the next in order of importance. Iron is needed for the production of red blood cells, and is even more essential during pregnancy, Dr. Sasan says. Iron aids the healthy growth and development of a fetus. It also helps prevent iron deficiency anemia – a condition caused by insufficient red blood cells, in pregnancy.
Iron is needed to produce sufficient hemoglobin – a protein in red blood cells that transports oxygen throughout your body. During pregnancy, you’re now supplying more oxygen and blood to cater for the growing fetus, and therefore you will need more iron than usual since the extra demand can easily exhaust your iron stores.
Depending on your age, you’ll require 15 to 18 milligrams of iron daily which goes up to 27 milligrams when you’re pregnant. To get sufficient iron as recommended by ACOG, eat iron-rich foods like lean red meat, poultry, fish, dried beans and peas, fortified cereals and prune juice. To get the best out of them, try and eat them with vitamin C rich foods such as citrus and tomatoes because they make it easier for the body to absorb iron. If you feel you’re still not getting enough, the ACOG says that you can supplement with a prenatal vitamin to make sure you have sufficient supply of iron while pregnant.
According to the Mayo Clinic, Calcium is another mineral which is found in some prenatals. Calcium helps to maintain bone strength for pregnant women and their fetuses. The National Institutes of Health recommends that pregnant women should get either 1,300 milligrams of calcium daily (if they’re 14-18) or 1,000 milligrams (if they’re 19 or over). This is also the same amount people who are not pregnant people should be getting. Calcium can be easily obtained through food like milk, yogurt, cheese, kale, and broccoli and that makes many prenatals contain low amounts of calcium. This can be a low as 150 to 300 milligrams or none at all.
Prenatal vitamins may also contain some vitamin D to aid calcium absorption. Vitamin D might be difficult to get normally and depends on your diet and exposure to the sun. Since vitamin D assists the body get enough calcium, it is vital for maintaining bone strength in women and their fetuses. Everyone, whether pregnant or not, need at least 15 micrograms of vitamin D daily which might be obtained without the use of supplements.
In addition, the ACOG suggests that vitamin B6 which is found in many prenatals, could relieve symptoms of the notorious morning sickness. “We don’t know the exact mechanism of action, but it seems that vitamin B6 helps reduce nausea and vomiting in pregnancy,” says Dr. Minkin. The recommended amount for pregnant women is 1.9 milligrams daily and 1.2 to 1.3 milligrams for everyone else.
Since there are potential risks involved in taking supplements you do not need, always consult your doctor if you’re thinking of getting prenatals when you’re not pregnant.
The fact that reputable bodies like the CDC recommend prenatals doesn’t mean you can thoughtlessly include them in your daily regimen. Even nutrients have what is called a tolerable upper intake level which is the maximum amount you can safely ingest daily without risk of dangerous side effects, according to the CDC. You can easily pass this upper limit for various nutrients when taking a prenatal if your diet already contains large amounts of the minerals or if you’re taking another vitamin.
For instance, calcium is stored in your bones and teeth and has a tolerable upper intake level of 2,000 to 3,000 milligrams depending on age, in people who are not pregnant and are over a year old. The national institute of health has observed that people are more likely to take too much calcium from supplements. Excess calcium in your body can cause constipation and increase your risk of developing painful kidney stones. Calcium supplements can also interfere with some medicines like drugs to prevent bone density loss and antibiotics.
Iron also. The National Institute of Health notes that iron is stored in your hemoglobin, liver, spleen, bone marrow, and muscle tissue. The tolerable upper intake level is 45 milligrams in people aged 14 and over who are not pregnant. Anything higher can cause nausea and constipation. Iron also interferes with drugs for treating hypothyroidism and Parkinson’s disease.
The same thing also applies to fat-soluble vitamins, such as A, D, and E, which can be present in some prenatals. These fat-soluble vitamins are stored in the fatty tissues of the body and could cause different symptoms depending on the vitamin concerned.
According to the Mayo Clinic, ingesting more than 10,000 micrograms a day of vitamin A can cause headaches, diarrhea, liver damage, and bone thinning. In the same way, high levels of vitamin D from supplementation (the tolerable upper intake level is 100 micrograms for anyone 9 and over) might lead to weight loss, frequent peeing, and even heart arrhythmias.
These vitamins can also interfere with various medications in various ways. Therefore, prenatals are not to be tossed back indiscriminately like some tic tac. Consult your doctor before commencing therapy with any supplement.
Prenatal and other supplements are to be used strictly under Doctors advice whether you are pregnant or not.
If there’s any possibility you could get pregnant soon, you should take some form of folic acid as adviced by experts. However, if pregnancy is not in your agenda, the decision is entirely up to you. Either way, make sure you consult your healthcare provider, Dr. Minkin says. If you’re at a loss on how to get the right prenatal, or you need confirmation that you have the right prenatal, seeking advice from your healthcare provider is the way to go. Thomas Vanek Womens Jersey
Why Do the Corners of My Mouth Crack—and How Do I Fix It?
It took me a while to realize that I had angular cheilitis. Because it was winter and I didn’t fancy lip balm, I had initially assumed it to be a nasty case of chapped lips. But despite all my attempts to get rid of it, the cracks at the corner of my mouth stayed put.
I went about my business on my college campus with self-conscious resignation till I finally went to a dermatologist.
One look and he instantly diagnosed it as angular cheilitis (sounds like key-litis).
Angular cheilitis is an inflammation of the area around the mouth corners which causes them to become red, swollen and cracked. Apart from its unsightly appearance, it is also painful.
Fortunately, once diagnosed and properly treated, the cracks disappeared in a few days. But before going to see the dermatologist, living with the condition was terrible. Not having any idea of what caused the cracks, what they were, and if they would ever clear were a steady source of worry and low self-esteem. Knowing what causes angular cheilitis and more critically, how to make it go away, makes the condition less fearful.
Unlike chapped lips – which is usually due to a lack of moisture, angular cheilitis is a fungal infection.
Your mouth is an ecosystem of sorts where many species of bacteria, viruses, and fungi (including Candida albicans, a fungus) thrive. Candida Albicans often exists harmlessly in your mouth and other parts of the body, but can sometimes grow out of control and causes candidiasis – an infection also known as yeast infection.
But how exactly does this fungus cause angular cheilitis? Oddly, saliva that comes into contact with the corners of your mouth can dry them out, leading to fissures and cracks, Ted Lain, M.D., chief medical officer of Sanova Dermatology, says. When you try to sooth the irritating dryness by licking your lips, you introduce yeast into the open wounds. “It’s just a breeding ground for yeast to grow,” Dr. Lain says.
Some factors make you more likely to have Angular cheilitis.
A lot of factors determine the possibility of coming down with angular cheilitis. One of them is down syndrome. This could be due to muscular hypotonia, a condition characterized by low muscle tone. It makes people with down syndrome to leave their mouth open, and their tongues hang out, irritating the corners of their mouth.
Xerostomia or dry mouth also increases your chances of developing angular cheilitis. Xerostomia is usually caused by dehydration, health conditions that lead to dehydration (like diabetes), drugs that irritate the skin, or side effects of treatments like chemotherapy.
Xerostomia is associated with the autoimmune condition Sjogren’s syndrome. Lupus, Crohn’s disease, and Ulcerative Colitis are some of the other autoimmune disorders which can cause changes in the immune system leading to a higher possibility of angular cheilitis.
Inadequate nutrition is also a culprit. Studies have linked iron deficiency which causes anemia to angular cheilitis. The possible reason is that iron deficiency can lower your immunity. Deficiencies in some B vitamins and zinc have also been linked to angular cheilitis, probably due to their immune-strengthening role.
These risk factors indicate that older people are more susceptible to suffer from angular cheilitis. For instance, ageing makes people more likely to suffer from dry mouth. Their immune system is also easily compromised, making it tough for them fight off infections, says Dr. Lain. The additional risk lies in age-related changes around their mouths, says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. “When older individuals lose the structural support around the mouth, the corners tend to turn downward, and you develop folds in those corners, where saliva tends to pool,” Dr. Zeichner says.
As it is, angular cheilitis can still afflict anyone at any age; there are other random risk factors to be considered. It can happen to some people due to changes in the weather which causes dry skin and lips, according to Dr. Lain. Mine started as winter set in and I resumed going to bed wearing my nightly retainers, which is another common contributing cause. “Any kind of appliance you have in your mouth—braces, retainers, or anything else that change the anatomy of your mouth—can affect what happens to your saliva while you sleep,” Dr. Lain says.
Angular cheilitis is easy to treat.
Most dermatologists and oral medicine specialists can diagnose angular cheilitis instantly. “The appearance is pretty characteristic,” says Dr. Zeichner. It is treated with a topical corticosteroid to reduce inflammation and an antifungal cream to eliminate fungal overgrowth, A. Ross Kerr, D.D.S., an oral medicine specialist and clinical professor in the Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, and New York University College of Dentistry, says.
If you notice cracks appearing at the corners of your mouth and you are unable to see a dermatologist, Dr. Zeichner recommends using a 1-percent hydrocortisone cream together with an over-the-counter antifungal, such as the type used to treat athlete’s foot. The antifungal cream can be used alone to clear the infection, unlike a topical corticosteroid which could further aggravate the condition. “A corticosteroid decreases the immune system where you apply it, so it makes any infection get worse,” says Dr. Lain.
If you have a mild case of angular cheilitis, this DIY treatment may be enough for you. “If you’re trying a home remedy and it’s not getting any better after a week or two, make sure to visit a dermatologist to get some extra help,” says Dr. Zeichner.
Angular cheilitis can be prevented. Most times.
Luckily, I haven’t had angular cheilitis in years, but writing this article resurrected my old fears. If you had had angular cheilitis before, fret not: there are hacks which could help reduce your chances of suffering the cracks again. At night, apply a lotion that contains petroleum jelly around your lips. “[This] can help provide a seal over the skin to prevent saliva from disrupting the outer layer,” says Dr. Zeichner.
Ensure you stay hydrated at all times, especially during winter, to counter dryness. Also, make good oral hygiene practices a daily habit to keep the ecosystem in your mouth under control, Dr. Kerr says.
Try to control any urge to lick your lips. “We tend to lick our lips and the angles of our mouths much more frequently to combat dryness, but the more you do that, the worse it gets,” says Dr. Kerr.
Lastly, if you are in the habit of consuming excess sugar and the corners of your mouth are always inflamed, try eliminating sugar in your diet because the candida yeast thrives on it, Dr. Kerr explains.
If you take these precautions and the cracks still constantly reoccur, see your doctor to find out the cause. “You could be predisposed to developing candidiasis because your immune system isn’t functioning the way it normally should,” says Dr. Kerr. Getting treatment for any underlying health issue may keep you from suffering another outbreak of angular cheilitis.
Effectively Treating Yeast Infections During Pregnancy
Is it ok to use over the counter medication for yeast infections?
We look at the best ways to treat yeast infection and these answers from Yvonne Butler, M.D will guide us.
You can easily treat yeast infections with different kinds of antifungal vaginal creams found in stores even during pregnancy. But it is wise to confirm from your health care provider that you actually have the symptoms from a yeast infection before seeking treatment options.
Yeast infections are more likely to occur during pregnancy due to all the hormonal changes and pH balance of the vagina. The symptoms usually manifest in the form of itching and discharge of a thick white substance.
Medication such as Miconazole (Monistat) and Clotrimazole (Gyne-Lotrimin) can be found in your typical drug stores. These medications can be used at any time during your pregnancy and pose no risk or side effects of your pregnancy. It is best to stick to a 7-day formula. Home remedies are heavily discouraged.
Certain medications that are commonly prescribed such as fluconazole are also discouraged especially during the first three months. If you see a doctor for treatment of yeast infection and you happen to be pregnant, make sure to make this known to avoid prescription of that particular med.
Camila Cabello and Her Journey with Obsessive Compulsive Disorder
It often takes time to finally accept any diagnosis that pertains to mental health. Camila Cabello reveals in her interview with the Cosmopolitan UK how she has journeyed to a place in her life when she can finally distance herself from her obsessive-compulsive disorder and better deal with it.
“OCD is weird. I laugh about it now,” Cabello said in the interview, as reported by E! Online. “Everybody has different ways of handling stress. And, for me, if I get really stressed thinking about something, I’ll start to have the same thought over and over again, and no matter how many times I get to the resolution, I feel like something bad is about to happen if I don’t keep thinking about it.”
In another interview with Billboard in 2016, she revealed that she went through times of constant anxiety in her life and it was a very bad place for her. She described her heart beating furiously throughout the day and she would need to take up to two hour naps to calm down.
It got so bad one time that she had to leave in the middle of a Fifth Harmony concert that year. She later indicated that it was due to her excess anxiety during her set. Her story is different now after her diagnosis and she understands how her body works. “I didn’t know what it was and when I found out, and [learned] how to step back from it, it made me feel so much better,” she says in her Cosmo U.K. cover story. “I feel so much more in control of it now. To the point where I’m just like, ‘Aha! OK, this is just my OCD.’ I’ll ask my mom a question for the fourth time, and she’ll be like, ‘That’s OCD. You’ve got to let it go.'”
Contrary to popular belief, OCD does not always equate to having detailed complex cleaning rituals or counting. It is basically a compulsion to do things repeatedly and cleaning happens to be one of those things. This compulsion becomes a problem when it starts to interfere with your day to day life. It can also be fear and anxiety in certain situations.
The first step to dealing with any problem is actually identifying he problem.
Managing Stress: Identifying Your Triggers
Know your triggers and you’ve solved half the problem.
Life comes at you fast sometimes and there is a flurry of things to get done. This all leads to stress. Identifying the kinds of stress is the first step of managing them.
Stress is your response to the challenges of this world. Stressors are those things that contribute to your stress in your environment. Your body deals with these stressors uniquely depending on the nature- short term or cute stress and long-term or chronic stress.
Short Term Stress
This is also known as acute stress and as the name implies, this is stress that is abrupt and your body is going to respond immediately to this stress in a fight, flight or freeze manner. This can be very telling on the body. Some instances of this stress can be found in job interviews, being stopped by the police etc.
A single occurrence of this kind of stress typically doesn’t do any damage but when it is severe it can lead to mental problems such as post-traumatic stress disorder. It can also manifest physically in terms of headaches, stomach aches, and even a heart attack.
Long Term Stress
This is also known as chronic stress. While mid acute stress can be helpful to you in small doses as it helps motivate you into action, long-term stress is always bad news. Stress becomes chronic when stressors are consistent and persistent and this can lead to a variety of health problems such as headaches and insomnia. While the effects of chronic stress are not easily noticeable, they tend to do the most damage over a prolonged period of time.
Identify your Stressors
The first step to managing stress is knowing what causes them. Strategies to handle stress can then be fashioned out in a manner that best suits you. You can do this by writing down every scenario, circumstance, and obstacle that triggers your stress response. You will find that some of your stressors are external while others are internal.
These are stressors that come from your environment and affect you as a result. Some examples are:
Major Life Changes: Change is constant in life but some changes are major and can have a huge effect on us. Examples are getting married, pregnancy and death of a loved one or a divorce. You will notice that the changes can be both positive and negative.
Environment: Everything in your surroundings can add to your stress levels. Noises, Intense lights, dull lights and even smells can trigger a stress response.
Random events: when things happen without your knowledge, you are denied the opportunity to plan and set up to accommodate these events and it can lead to stress. Think about uninvited guests, unexpected news etc.
Jobs: This is perhaps one of the leading causes of stress. Having to deal with all the intricacies of work can really take its toll on your body on a daily basis.
Social: interacting with people can be stressful in itself especially when they are strangers. Think about social events or dates.
You can deal with external stress mainly by committing to a better lifestyle such as eating healthy, being physically active and getting enough rest. You should also be open to asking for help when things get crazy, manage your time more effectively and try to laugh more.
Some stress is within and has nothing to do with the environment around us. Those voices that pop up in your head and tell you all sorts are the main culprits here. It can manifest in the form of fears. Fear of facing a crowd or a fear of heights. It can also be rooted in your beliefs and this extends into your attitude and expectations. Usually, you don’t even realize how much these things affect you.
The bright side here is that you have total control over your mind and how your thoughts affect you. The danger is that these internal fears and beliefs have been a part of you for so long that it will take a lot of work to rid your mind of them. Try to imbibe a positive attitude, embrace relaxation techniques and talk to people who can help.
Identifying the problem is the crucial first step to dealing with the issues and consequently better managing your stress.
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