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Healthwatch
What Is Prostatitis And How Is It Treated?
~3.5 mins read
Prostatitis can cause painful or uncomfortable symptoms, but various types of treatment can help.
Prostatitis, or inflammation of the prostate, is more common than you might think — it accounts for roughly two million doctor visits every year. The troubling symptoms include burning or painful urination, an urgent need to go (especially at night), painful ejaculations, and also pain in the lower back and perineum (the space between the scrotum and anus).
Prostatitis overview
There are four general categories of prostatitis:
Acute bacterial prostatitis comes on suddenly and is often caused by infections with bacteria such as Escherichia coli that normally live in the colon. Men can suffer muscle aches, fever, and blood in semen or urine, as well as urogenital symptoms. Acute inflammation can cause the prostate to swell and block urinary outflow from the bladder. A complete blockage is a medical emergency that requires immediate treatment. Depending on symptom severity, hospitalization may be necessary.
Chronic bacterial prostatitis results from milder infections that sometimes linger for months. It occurs more often in older men and the symptoms typically wax and wane in severity, sometimes becoming barely noticeable.
Chronic nonbacterial prostatitis, also called chronic pelvic pain syndrome (CPPS), is the most common type. CPPS can be triggered by stress, urinary tract infections, or physical trauma causing inflammation or nerve damage in the genitourinary area. In some men, the cause is never identified. CPPS can affect the entire pelvic floor, meaning all the muscles, nerves, and tissues that support organs involved in bowel, bladder, and sexual functioning.
Asymptomatic inflammatory prostatitis is diagnosed when doctors detect white blood cells in prostate tissues or secretions in men being evaluated for other conditions. It generally requires no treatment.
Both acute and chronic bacterial prostatitis can cause blood levels of prostate-specific antigen (PSA) to spike. This can be alarming, since high PSA is also indicative of prostate cancer. But if a man has prostatitis, then that condition — and not prostate cancer — may very well be the reason for the rise in PSA.
Prostatitis treatments
Fortunately, research advances are leading to some encouraging developments for men suffering from this condition.
Antibiotics called fluoroquinolones are effective treatments for acute and chronic bacterial prostatitis. A four-to six-week course of the drugs typically does the trick. However, bacterial resistance to fluoroquinolones is a growing problem. An older drug called fosfomycin can help if other drugs stop working. PSA levels will decline with treatment, although that process may take three to six months.
CPPS is treated in other ways. Since it is not caused by a bacterial infection, CPPS will not respond to antibiotics. Medical treatments include nonsteroidal anti-inflammatory drugs such as ibuprofen, alpha blockers including tamsulosin (Flomax) that loosen tight muscles in the prostate and bladder neck, and drugs called PDEF inhibitors such as tadalafil (Cialis) that improve blood flow to the prostate.
Specialized types of physical therapy can provide some relief. One method called trigger point therapy, for instance, targets tender areas in muscles that tighten up and spasm. With another method called myofascial release, physical therapists can reduce tension in the connective tissues surrounding muscles and organs. Men should avoid Kegel exercises, however, which can tighten the pelvic floor and cause worsening symptoms.
Acupuncture has shown promise in clinical trials. One study published in 2023 showed significant improvements in CPPS symptoms lasting up to six months after the acupuncture treatments were finished. Mounting evidence suggest that CPPS should be treated with holistic strategies that also consider psychological factors.
Men with CPPS often suffer from depression, anxiety, and other mental health issues that can exacerbate pain perception. Techniques such as mindfulness and cognitive behavioral therapy for CPPS can help CPPS sufferers develop effective coping strategies.
Comment
"An accurate diagnosis is important given differences in how each of the four categories of prostatitis is treated," said Dr. Boris Gershman, a urologist at Beth Israel Deaconess Medical Center and assistant professor of surgery at Harvard Medical School. PSA should also be retested after treating bacterial forms of prostatitis, Dr. Gershman added, to ensure that the levels go back to normal. If the PSA stays elevated after antibiotic treatment, or if abnormal levels are detected in men with nonbacterial prostatitis, then the PSA "should be evaluated in accordance with standard diagnostic approaches," Dr. Gershman said.
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Healthwatch
What Can Magnesium Do For You And How Much Do You Need?
~5.7 mins read
This forgotten mineral is having a moment.
cardiovascular disease, including high blood pressure or coronary artery disease
insomnia
migraines
anxiety
diabetes and diabetic neuropathy
muscle soreness after exercise
constipation.
malnutrition (or simply choosing a diet that’s low in magnesium)
gastrointestinal conditions (such as Crohn’s disease) that cause vomiting, diarrhea, or poor absorption of magnesium
kidney disease, some types of which cause excess loss of magnesium in the urine
medications like diuretics or certain types of chemotherapy
alcohol use disorder, because alcohol can boost the loss of magnesium in the urine.
magnesium citrate, which is often taken as a laxative for gut health
magnesium glycinate, which is commonly promoted for improved sleep and reduced anxiety
magnesium oxide, which tends to be taken for constipation or indigestion.
In the world of nutrients, minerals, vitamins, and supplements, magnesium seems to be having a moment. Perhaps it’s long overdue: in many ways, magnesium has been overlooked, underappreciated, or even forgotten. That may be ending.
But why is magnesium getting so much attention lately? Are claims about its benefits true? Are you getting enough magnesium, or should you join the rising number of people who take magnesium supplements every day? If you have these questions, this post is for you.
What is magnesium?
Magnesium is a mineral the human body needs to function properly. It’s especially important for a healthy cardiovascular system, nerves, muscles, and bones. It helps regulate the body’s calcium and blood sugar levels, and it’s vital for the body’s production of protein. And that’s just the short list: more than 300 chemical reactions in the body rely, at least in part, on magnesium.
Are you getting enough magnesium?
Most of us don’t need to fret over how much magnesium we’re getting. The recommended daily amount of magnesium — 320 milligrams (mg) a day for women and 420 mg a day for men — isn’t difficult to take in through a healthy diet.
But getting extra magnesium is important for people with magnesium deficiency, and those who have complications of pregnancy known as preeclampsia and eclampsia.
More limited evidence suggests that extra magnesium could also be helpful for people with:
There are even studies suggesting that magnesium supplements might help with brain health and smoking cessation.
Many studies of the potential benefits of magnesium are quite small, and some have inconsistent results. Despite the shaky evidence for many claims, this large and expanding list of proposed health benefits is one reason magnesium supplements have been increasingly popular in recent years.
Is there a test to check magnesium levels?
A blood test can measure whether you’re getting enough magnesium. The normal range for blood magnesium is 1.7 to 2.2 milligrams per deciliter (mg/dL).
In general, the body does a great job of regulating the blood levels of magnesium. If levels rise, the kidney dumps excess magnesium into the urine; if levels fall, the kidneys hold onto more magnesium, bones release the mineral into the circulation, and the intestinal absorption of magnesium from the diet increases.
What are the symptoms of low magnesium?
The symptoms of too little magnesium (hypomagnesemia) include nausea, fatigue, and reduced appetite. Of course, these symptoms can be due to many other conditions, such as a stomach bug or medication side effects.
When severe, low magnesium may cause numbness in the arms and legs, muscle cramps, and an abnormal heart rhythm.
Some common causes of magnesium deficiency are:
Studies also suggest that magnesium deficiency is common among adults over age 70. The reasons include low intake of magnesium, poor absorption in the digestive tract, use of certain medicines, and kidney disease.
What are the symptoms of too much magnesium?
The symptoms of too much magnesium (hypermagnesemia) include nausea, headache, muscle weakness, and trouble breathing.
Hypermagnesemia is quite rare. Most people with higher-than-normal blood levels of magnesium have kidney failure. Others may be taking too much magnesium in supplements or taking certain medicines (such as magnesium-containing laxatives).
Which foods are good sources of magnesium?
Magnesium-rich foods like green, leafy vegetables (such as spinach), beans, nuts, and whole grains will help you get there. Pumpkin seeds, soy milk, bananas, and dark chocolate (in moderation!) are also good sources.
Eating one serving of spinach, an ounce of almonds, and a banana provides 190 mg of magnesium. That’s nearly 60% of the daily recommendation for women and 45% for men. Fortunately, magnesium is found in many healthy foods, so a good diet (such as the Mediterranean diet) will usually provide all the magnesium that you need.
Should you take a magnesium supplement?
Unless you have a diagnosed or suspected magnesium deficiency, or a condition with clear evidence of benefit such as preeclampsia or Crohn’s disease, there’s no compelling reason to routinely take a magnesium supplement.
For some conditions, such as insomnia or migraine headaches, a magnesium supplement may be worth a try. But it’s a good idea to run this by your doctor first. All supplements come with a risk of side effects. In the case of magnesium, this includes nausea and diarrhea. Magnesium supplements can also interact with other medicines and supplements you’re taking.
Which type of magnesium is best?
Magnesium found in foods is usually the best choice. When needed, magnesium supplements are available in several different forms, including:
All of these can provide extra magnesium. So the choice mostly comes down the reason you’re taking it, whether you experience side effects, cost, and personal preference.
Daily supplements of less than 350 mg usually are considered safe. But when people have certain health conditions such as kidney disease, it can be tricky to get the right amount of magnesium, and monitoring blood levels is important.
It’s safest to check with your doctor if you’re wondering whether to start taking a magnesium supplement, or unsure which one or how much to take.
The bottom line
Most people are fine without paying too much attention to their magnesium status. If you have concerns about whether you’re getting enough magnesium and whether you should take a supplement, ask your doctor about it. But don’t be surprised if you get some familiar advice: Choose a healthy, well-balanced diet. Your body will take care of the rest.
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Healthwatch
Flowers, Chocolates, Organ Donation Are You In?
~6.1 mins read
Gifts of life are fitting on Valentine's Day and any other day of the year.
bone, cartilage, and tendons
corneas
face and hands (though uncommon, they are among the newest additions to this list)
kidneys
liver
lungs
heart and heart valves
stomach and intestine
nerves
pancreas
skin
arteries and veins.
birth tissue, such as the placenta, umbilical cord, and amniotic fluid, which can be used to help heal skin wounds or ulcers and prevent infection
blood cells, serum, or bone marrow
a kidney
part of a lung
part of the intestine, liver, or pancreas.
doctors won't work as hard to save your life if you're known to be an organ donor — or worse, doctors will harvest organs before death
their religion forbids organ donation
you cannot have an open-casket funeral if you donate your organs.
Blood, platelets, or plasma: If you're donating blood or blood products, there is little or no risk involved.
Bone marrow: Donating bone marrow requires a minor surgical procedure. If general anesthesia is used, there is a chance of a reaction to the anesthesia. Bone marrow is removed through needles inserted into the back of the pelvis bones on each side. Back or hip pain is common, but can be controlled with pain relievers. The body quickly replaces the bone marrow removed, so no long-term problems are expected.
Stem cells: Stem cells are found in bone marrow or umbilical cord blood. They also appear in small numbers in our blood and can be donated through a process similar to blood donation. This takes about seven or eight hours. Filgrastim, a medication that increases stem cell production, is given for a number of days beforehand. It can cause side effects such as flulike symptoms, bone pain, and fatigue, but these tend to resolve soon after the procedure.
Kidney, lung, or liver: Surgery to donate a kidney or a portion of a lung or liver comes with a risk of complications, reactions to anesthesia, and significant recovery time. It's no small matter to give a kidney, or part of a lung or liver.
Chocolates and flowers are great gifts for Valentine's Day. But what if the gifts we give then or throughout the year could be truly life-changing? A gift that could save a life or free someone from dialysis?
You can do this. For people in need of an organ, tissue, or blood donation, a donor can give them a gift that exceeds the value of anything that you can buy. Fittingly, Valentine's Day is also known as National Donor Day, a time for blood drives and sign-ups for organ and tissue donation. Have you ever wondered what can be donated? Had reservations about donating after death or concerns about risks for live donors? Read on.
The enormous impact of organ, tissue, or cell donation
Imagine you have kidney failure requiring dialysis 12 or more hours each week just to stay alive. Even with this, you know you're still likely to die a premature death. Or, if your liver is failing, you may experience severe nausea, itching, and confusion; death may only be a matter of weeks or months away. For those with cancer in need of a bone marrow transplant, or someone who's lost their vision due to corneal disease, finding a donor may be their only good option.
Organ or tissue donation can turn these problems around, giving recipients a chance at a long life, a better quality of life, or both. And yet, the number of people who need organ donation far exceeds compatible donors. While national surveys have found about 90% of Americans support organ donation, only 40% have signed up. More than 103,000 women, men, and children are awaiting an organ transplant in the US. About 6,200 die each year, still waiting.
What can you donate?
The list of ways to help has grown dramatically. Some organs, tissues, or cells can be donated while you're alive; other donations are only possible after death. A single donor can help more than 80 people!
After death, people can donate:
Live donations may include:
To learn more about different types of organ donations, visit Donate Life America.
Becoming a donor after death: Questions and misconceptions
Common misconceptions about becoming an organ donor limit the number of people who are willing to sign up. For example, many people mistakenly believe that
None of these is true, and none should discourage you from becoming an organ donor. Legitimate medical professionals always keep the patient's interests front and center. Care would never be jeopardized due to a person's choices around organ donation. Most major religions allow and support organ donation. If organ donation occurs after death, the clothed body will show no outward signs of organ donation, so an open-casket funeral is an option for organ donors.
Live donors: Blood, bone marrow, and organs
Have you ever donated blood? Congratulations, you're a live donor! The risk for live donors varies depending on the intended donation, such as:
The vast number of live organ donations occur without complications, and donors typically feel quite positive about the experience.
Who can donate?
Almost anyone can donate blood cells –– including stem cells –– or be a bone marrow, tissue, or organ donor. Exceptions include anyone with active cancer, widespread infection, or organs that aren't healthy.
What about age? By itself, your age does not disqualify you from organ donation. In 2023, two out of five people donating organs were over 50. People in their 90s have donated organs upon their deaths and saved the lives of others.
However, bone marrow transplants may fail more often when the donor is older, so bone marrow donations by people over age 55 or 60 are usually avoided.
Finding a good match: Immune compatibility
For many transplants, the best results occur when there is immune compatibility between the donor and recipient. Compatibility is based largely on HLA typing, which analyzes genetically-determined proteins on the surface of most cells. These proteins help the immune system identify which cells qualify as foreign or self. Foreign cells trigger an immune attack; cells identified as self should not.
HLA typing can be done by a blood test or cheek swab. Close relatives tend to have the best HLA matches, but complete strangers may be a good match as well.
Fewer donors among people with certain HLA types make finding a match more challenging. Already existing health disparities, such as higher rates of kidney disease among Black Americans and communities of color, are worsened by lower numbers of donors from these communities, an inequity partly driven by a lack of trust in the medical system.
The bottom line
You can make an enormous impact by becoming a donor during your life or after death. In the US, you must opt in to be a donor after death. (Research suggests the opt-out approach many other countries use could significantly increase rates of organ donation in this country.)
I'm hopeful that organ donation in the US and throughout the world will increase over time. While you can still go with chocolates for Valentine's Day, maybe this year you can also go bigger and become a donor.
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Healthwatch
A Low-tech School Vacation: Keeping Kids Busy And Happy Without Screens
~3.5 mins read
Nine ways to encourage children to connect, create, and play off-screen.
School vacation coming up? Wondering how to spend that time? Given how tiring holidays can be — especially for parents who are working — it's understandable why children are often allowed to spend hours with the TV, tablet, or video games. After all, happy, quiet kids make for happy parents who can finally get stuff done — or relax.
Except kids are spending way too much time in front of screens. According to the American Academy of Child and Adolescent Psychiatry, kids ages 8 to 12 are spending four to six hours a day watching or using screens — and tweens and teens are spending nine hours.
Given how enticing devices and social media can be, those numbers can easily go higher during unscheduled times like weekends and school vacation. That's why it's good to be proactive and come up with other activities. Below are some ideas for parents and caregivers to try. These are mostly good for kids through elementary school, but tweens and teens may enjoy some of them too.
Spending time off the screen
Go outside. This sounds obvious, but spending time outdoors is something kids do less than they used to — and it can be really fun. If you have a yard, go out into it and play hide-and-seek or build a fort from snow or anything else that's around. If you don't have a yard, go to a local park or just go for a walk. A scavenger hunt up and down the block or game of I Spy may be a good enticement.
Go to the library. Do this early on in vacation, so that your child has lots of books, puzzles, and games to pass the time. Check out as many as they allow and you can carry. Ask if a Library of Things is available at a branch near you: crafts, tools, musical instruments, birding kits, telescopes — even metal detectors may be checked out for free.
Build a fort in the living room. Use blankets or sheets over chairs; if you have a small tent, set it up. Bring in pillows, sleeping bags, and flashlights; let the kids sleep in it at night. Let it stay up all vacation.
Build a city in the living room. Use blocks, Legos, boxes (or anything else), and add roads, cars, people, animals, trains, and other toys. Let it stay up all vacation, and make it bigger every day.
Getting creative off the screen
Get creative. Go to the craft store and stock up on inexpensive supplies. Buy things like poster board, huge pieces of paper (you could use those for your city, too, to make parks, roads, and parking lots), paints, and markers. You can make a paper mural, a comic book, a story, posters, or whatever catches your child's imagination. If you know how to knit or sew, think about teaching your child or making a simple project together. Play music while you create.
Read out loud. There are so many books that are fun to read aloud. When my children were younger, we read the Harry Potter series out loud, as well as the Chronicles of Narnia and books by E.B. White and Roald Dahl. Act out the voices. Have some fun.
Have a puppet show. If you don't have puppets, you can make some with socks — or you can hold up dolls or action figures and do the talking for them. You can make a makeshift stage by cutting out the back of a box and taping cloth (like a pillowcase) to fall over the front.
Get out the games. There are so many that work across the ages, like checkers, chess, Uno, Connect 4, Sorry, Twister, Clue, Scrabble, or Monopoly. We forget how much fun these can be.
Bake. You don't have to get fancy — it's fine to use mixes or pre-made cookie dough. There's nothing better than baked goods straight from the oven, and adding frosting and decorations makes it even more fun. Turn on music and dance while things bake.
While parents or caregivers need to be involved with some of these activities (like the ones involving the oven, or reading out loud), kids can do many of them independently once you have it started. Which, really, is what children need: time to use their imagination and just play.
But you just may find that once you have things started, you'll want to play, too.
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