Month: November 2022

I admit it: I’m not a fan of drug ads. I think the information provided is often confusing and rarely well-balanced. Plus, there are just so many ads. They show up on TV and streaming programs, on social media, on billboards and the sides of busses, on tote bags, and in public bathrooms. Yes, there’s no refuge — even there — from the billions spent on direct-to-consumer ads in the US.

I’ve often wondered how highly-promoted, expensive new drugs stack up against other available treatments. Now a new study in JAMA Network Open considers exactly that.

Many advertised drugs are no better than older drugs

The study assessed 73 of the most heavily advertised drugs in the US between 2015 and 2021. Each drug had been rated by at least one independent health agency. Researchers tallied how many of these drugs received a high therapeutic value rating, indicating that a drug had at least a moderate advantage compared with previously available treatments.

The results? Only about one in four of these heavily advertised drugs had high therapeutic value. During the six years of the study, pharmaceutical companies spent an estimated $15.9 billion promoting drugs on TV that showed no major advantage over less costly drugs!

Why drug ads are not popular

Only the US and New Zealand allow direct-to-consumer medication marketing. The American Medical Association recommended a ban in 2015. While I’ve often written about reasons to be skeptical, let’s focus here on three potential harms to your wallet and your health.

Drug ads may

• raise already astronomical health care costs by increasing requests for unnecessary treatment and promoting much costlier medicines than older or generic drugs.
• create diseases to be treated. Everyday experiences, such as fatigue or occasional dryness in the eyes, may be framed in drug ads as medical conditions warranting immediate treatment. Yet often, such symptoms are minor, temporary experiences. Another example is “low T” (referring to low blood testosterone). While it’s not a recognized illness on its own, ads for it have likely contributed to increased prescriptions for testosterone-containing medicines.
• promote new drugs before enough is known about long-term safety. The pain reliever rofecoxib (Vioxx) is one example. This anti-inflammatory medicine was supposed to be safer than older medicines. It was withdrawn from the market when evidence emerged that it might increase the risk of heart attack and stroke.

Four questions to ask your doctor if you’re curious about a drug ad

Wondering whether you should be taking an advertised drug? Ask your doctor:

• Do I have a condition for which this drug is recommended?
• Is there any reason to expect this drug will be more helpful than what I’m already taking?
• Is this drug more expensive than my current treatment?
• Do my health conditions or the medications I already take make the drug in the ad a poor choice for me?

The bottom line

The AMA recommended banning drug ads nearly a decade ago. But a drug ad ban seems unlikely, given strong lobbying by the pharmaceutical companies and concerns about violating their freedom of speech.

Still, cigarette commercials were banned in 1971, so it’s not an impossible dream. Meanwhile, my advice is to be skeptical about information in drug ads, and rely on more reliable sources of medical information, including your doctor. Consider contacting the Federal Communications Commission if you have complaints about these ads — a step few Americans seem to take. And try this: mute the TV, fast-forward your podcast, and close pop-ups as soon as drug ads appear.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

• Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
• A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
• Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

• Light a candle.
• Get under a heated blanket.
• Frame a photo of a happy time.
• Have breakfast in bed.
• Use pretty table linens.
• Indulge in art (check out various works at museums online).
• Stand still outside to listen to the sounds of nature.
• Curl up in a cozy chair.
• Window-shop in your favorite store.
• Wear a soft sweater that feels good on your skin.
• Use a silk or satin pillowcase on your bed pillow.
• Take a warm bath.
• Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

Here’s a new fact about spring, summer, fall, and sometimes even winter, now that climate change has blurred seasonal boundaries: sizzling heat may be on the way, or currently blanketing your community.

High temperatures stress the body, leading to thousands of heat-related illnesses and deaths every year in the US. Creating a personal heat plan can help you stay safe when the heat index soars.

Caleb Dresser, MD, MPH, is the health care solutions lead for C-CHANGE, the Center for Climate Health and the Global Environment at the Harvard T.H. Chan School of Public Health, and an emergency medicine doctor at Harvard-affiliated Beth Israel Deaconess Medical Center. Below we interview him about who, how, and why heat harms. Then we’ll help you create your personal heat safety plan.

Interview edited for clarity

Who is especially vulnerable during hot weather?

High temperatures can affect anyone. But some people — children, outdoor workers, people who are pregnant or have health problems or disabilities, and older people — are more likely to experience harm when temperatures rise. For example:

• Young children, especially babies, have less physical capacity to deal with very high temperatures.
• People working outdoors may not have access to shade and could be performing physically intensive labor. They need adequate hydration, adequate breaks, and access to a cool space during break time, as OSHA guidelines spell out.
• People with chronic medical conditions, such as kidney disease or heart disease, may have difficulty adapting physiologically to hot weather, or may be more susceptible to its health impacts.
• And some people living with disabilities or certain neurological conditions may have difficulty with thermoregulation — that is, controlling the temperature of their bodies — or may not be able to take actions that keep them safe, such as taking off layers or moving to a cool area.

Which weather patterns create dangerous levels of heat?

Dangerous heat is the result of both high temperatures and high humidity, which interfere with our ability to cool off by sweating. In dry areas, extremely hot temperatures can be dangerous on their own.

Danger zones vary across the United States and around the world. But hospital use and deaths rise once we get above threshold temperatures. The threshold varies in different places depending on whether bodies, cultures, and architecture are adapted to heat.

For example, here in New England, where some people (particularly those of limited means) may not have access to air conditioning, we see increases in healthcare use and deaths at a lower temperature than in the American South, where people and organizations may be more used to dealing with hot weather.

When does hot weather become dangerous to our health?

Risk goes up the longer hot weather sticks around.

One hot day can put some people at risk. A stretch of several hot days in a row during a heat wave is particularly dangerous because it can overwhelm people’s ability to adapt. Eventually people run out of physiological reserves, leading to greater health harms and greater need for medical care.

Surprisingly, spring and early summer are particularly dangerous times because people and organizations aren’t as prepared for hot weather.

How to create your personal heat safety plan

Five key points to help you create a personal heat plan are below. Americares offers further information through heat tip sheets developed with the Harvard C-CHANGE team that are tailored to people in different health circumstances.

Planning is important because intense heat is occurring more often: a Climate Central analysis found 21 additional risky heat days, on average, for 232 out of 249 locations between 1970 and 2022.

• Stay ahead of hot weather. Check apps, websites, TV, or radio for updates on weather today and in coming days. If local weather alerts are available by phone or text, sign up.
• Have a cooling plan. When temperatures soar, you need to spend as much time as possible in cool spaces. Plan options if your home is likely to be too hot and unsafe to stay in. You may be able to stay with a neighbor or family member who has air conditioning until a heat wave passes. Many cities and towns have neighborhood splash pads for children, and open cooling centers or air-conditioned libraries, public buildings, or community centers to everyone — sometimes even overnight. Spending time in air-conditioned businesses or malls, or in a shady green space like a park, may help too.
• Sip plenty of fluids. Water is the best choice. Skip sugary drinks and avoid caffeine or alcohol.
• Use fans correctly. Fans help if surrounding air is relatively cool. If air temperatures are very high, it’s important to dampen your clothes or skin to help keep your body from overheating, and move to a cooler location, if possible.
• Know your personal risks and the signs of heat-related illness. If you have health problems or disabilities, or take certain medicines such as diuretics, talk to your doctor about the best ways for you to cope with heat. It’s also essential to know the signs of heat-related illnesses, which range from heat rash and sunburn to heat cramps, heat exhaustion, and heat stroke. This chart from the Centers for Disease Control and Prevention describes the signs to look for and what you can do, particularly when heat becomes an emergency.

About the Author

Francesca Coltrera, Editor, Harvard Health Blog

Francesca Coltrera is editor of the Harvard Health Blog, and a senior content writer and editor for Harvard Health Publishing. She is an award-winning medical writer and co-author of Living Through Breast Cancer and The Breast … See Full Bio View all posts by Francesca Coltrera

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD