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When something is going wrong in your body, there will be signs. They may be subtle, but they are visible in close observation. If you are a smoker, you may be worried about the smell of smoke emanating from your mouth or clothes. However, there are other signs that tell whether you smoke or not and these signs are difficult to get rid of!
Smoking is the harmful act of inhaling tobacco infused smoke and is a common activity all over the world. According to the Center of Disease Control and Prevention (CDC), over 480,000 deaths happen each year due to smoking or smoke inhalation. The organization explained that smoking causes harm to nearly all organs and quitting lowers the risk of early death and other smoking related diseases.
Like many other substances, there are clear tell-tale signs when someone is smoking. This is especially important for finding lung problems like Chronic obstructive pulmonary disease (COPD), which is a lung disease that makes it hard to breathe, sooner so people can get help.
Action on Smoking and Health (ASH) explains that tobacco smoke has more than 7,000 harmful chemicals like nicotine, carbon monoxide, and various metals like arsenic, cadmium, and lead, quickly reach your lungs and then travel through your blood to all your organs, including your skin. Smoking damages your skin's ability to heal because it increases an enzyme metalloproteinase (MMPs) that breaks down collagen. Collagen is what keeps your skin smooth and elastic. As you lose collagen, your skin sags. Squinting from the smoke and puckering your mouth when smoking also cause wrinkles around your eyes and mouth.
Smoking also reduces blood flow to your skin, which means it gets less oxygen and nutrients. All these things together lead to what doctors call a "smoker's face." Quitting smoking can help prevent or slow down these skin problems."
Here are some visible signs of smoking in people, according to 2013, Lung India
When people smoke, the tar and other chemicals in the smoke stick to their fingers and nails. This repeated contact causes a yellow stain that's hard to wash off. It's a very common sign that someone regularly handles cigarettes or biris.
Especially in older people with white moustaches, smoking causes a yellowing effect. This is most noticeable in the center of the moustache, where the smoke from the nose directly hits the hair. The consistent exposure to smoke colors the hair over time.
Heavy smokers often have a bluish-black tint to their lips. This discoloration happens because the chemicals in tobacco smoke affect the blood flow and the color of the skin on the lips. The constant exposure changes the lip's natural color.
Smoking causes teeth to stain both inside and out. The outside of the teeth turns yellow from the tar, while the inside develops a brownish-black stain. This happens because the smoke seeps into the enamel and discolors the teeth over time.
Smoking makes the skin age faster. This leads to wrinkles like "crow's feet" around the eyes and "cobblestone wrinkles" on the neck. This happens because smoking reduces blood flow, limiting oxygen to the skin, and damages collagen, which keeps skin elastic.
This condition, also known as "Favre–Racouchot syndrome," causes blackheads and wrinkles, especially around the eyes and temples. It is made worse by both sun exposure and heavy smoking. The skin becomes discolored with visible nodules and wrinkles.
A study published in Thorax 2006 found a connection between wrinkles on the face and COPD, a lung disease. It's thought that smoking affects both the skin and lungs through similar processes. If doctors notice signs like "crow's feet" on a smoker's face, they might recommend tests for COPD. This early detection can help people get treatment sooner and improve their lung health.
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In the last few years, biohacker and longevity entrepreneur Bryan Johnson has become famous for maintaining a picture-perfect health in order to defy the norms of aging.
But this week, Johnson shared a shocking health update with his followers. He said that he has been diagnosed with Autoimmune Gastritis (AIG), a chronic autoimmune disease in which the immune system attacks the stomach lining. He said, “My stomach is eating itself.”
Despite years of optimizing his body, Bryan’s Johnson Autoimmune Gastritis diagnosis shocked the internet. While his strict routines, meticulous diet, and million-dollar anti-ageing protocol continue to inspire millions, they also receive equal amounts of skepticism and criticism.
Johnson recently revealed that he had struggled with persistently low iron stores for nearly 11 years, despite taking supplements.
He said that a detailed evaluation confirmed Autoimmune Gastritis, an illness that damages the acid-producing cells of the stomach. The condition can impair absorption of iron and vitamin B12 and may increase the long-term risk of gastric cancer.
He also disclosed that he has autoimmune thyroid disease, suggesting that multiple autoimmune conditions may be interconnected in his case.
Amid his diagnosis, Johnson's journey raises a practical question: Which of his longevity habits are genuinely backed by science and worth adopting, and which remains experimental?
Among all longevity interventions, sleep has the strongest scientific backing. Johnson consistently aims for a regular sleep schedule and treats sleep as a primary health priority. Unlike expensive biohacks, sleeping 7 to 9 hours consistently benefits almost everyone.
Research has linked quality sleep with:
Johnson follows a predominantly plant-based diet rich in vegetables, legumes, nuts, seeds, and healthy fats.
While optimal health is not connected with veganism, evidence supports that diets including vegetables, fruits, whole grains, beans, and nuts are associated with lower risks of heart disease, diabetes, and several cancers.
Johnson combines strength training, cardiovascular exercises, mobility exercises, and walking throughout the day to stay healthy and fit.
Research, too, recommends at least 150 minutes of moderate physical activity per week to enhance longevity.
One of Johnson's greatest takeaways from his blueprint is tracking basic health markers. His long-standing low ferritin eventually prompted further investigation that disclosed his autoimmune gastritis.
It reminds us that routine health check-ups often identify silent diseases before symptoms appear. For most people, daily monitoring should include:
Bryan avoids alcohol and tobacco completely. Research consistently suggests that avoiding smoking and limiting alcohol significantly reduce risks of cancer, liver disease, heart disease, stroke and other chronic lifestyle disorders.
Many of these approaches have not been proven to extend lifespan in humans, and experts caution against assuming that more testing or consuming supplements automatically leads to better health.
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Every year on July 6, we mark World Zoonoses Day. The date marks the day in 1885 when Louis Pasteur gave the first rabies vaccine. It falls right in the middle of our monsoon, which is exactly when zoonotic diseases claim the most lives. So this year, instead of a routine health advisory, let us go through the questions I get asked most often, by patients, by family, and honestly, by fellow doctors too.
A zoonosis is any disease that spreads from animals to humans. The animal could be a rat, a dog, a bat, or even livestock in your backyard. Sometimes the animal itself looks perfectly healthy while carrying the germ that makes us sick. About six out of every ten infectious diseases known to affect humans started in animals at some point. COVID reminded the whole world of this. We have been living with zoonotic threats for years, quietly, every rainy season.
If I had to list the usual suspects, it would be this:
Leptospirosis is the one that rises sharply and predictably every single monsoon. The bacteria live in the kidneys of rats and other rodents and are released into soil and water through their urine. When the rains come, our fields, drains, and waterlogged roads become the perfect place for the infection to spread. Anyone walking barefoot through flood water, working in paddy fields, or wading through stagnant water near their home is at risk.
Scrub typhus rises a little later, once the rain eases and people go back into overgrown fields and gardens to clear vegetation, exposing themselves to the mite larvae hiding there. Our own data from KIMSHEALTH, based on 241 patients over seven years, shows this pattern clearly. Cases start climbing in September, peak in December, and drop off by January.
This means the disease follows the cool, humid weeks right after the monsoon leaves, not the rainy months themselves. Low temperature and high humidity suit the mites best, which is why the weeks just after the monsoon, not the heavy rain itself, are scrub typhus season. Our data also showed a smaller rise between June and August, so the risk is actually spread across two windows around the monsoon, not just one.
This year, our own health department figures have already shown this pattern. Fever clinics across the state have been seeing well over 10,000 patients a day at the peak, with leptospirosis and Shigella infections climbing sharply. Northern districts of Kerala Kannur, Kozhikode, and Malappuram have reported some of the sharper spikes, and rat fever sadly remains the biggest killer among these in most years.
Nipah is not strictly a monsoon disease. It tends to appear when fruit bats are under stress, often during their breeding season or when their natural food is disrupted. Kerala has had confirmed cases in recent years. The good news is that Kerala now has one of the fastest outbreak response systems in the country for Nipah, with quick contact tracing and isolation.
For leptospirosis:
For scrub typhus:
For rabies:
See a doctor without delay if you have a fever along with any of the following:
Leptospirosis in particular can look just like an ordinary viral fever in its first two or three days, and then get worse quickly, leading to kidney failure or bleeding problems. Starting antibiotics early makes a big difference to the outcome. This is not a disease where it is safe to simply wait and watch.
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With less time and more work, chronic fatigue has become a moniker of modern society. However, this not only reduces the quality of life but also constitutes a social issue that affects work efficiency and leads to accidents. On the surface, the cause of fatigue is often attributed to not getting enough rest, but there may be another underlying issue—the lack of proper nutrition.
The world moves at a hectic pace these days. If you feel like you're constantly running on empty, you're not alone. Many people say that they just don't have the energy they need to accomplish all they need to. Sometimes the cause of fatigue is obvious — for example, getting over the flu or falling short on sleep. Sometimes a vitamin deficiency is part of the problem. It might be worth asking your doctor to check a few vitamin levels, such as the three we've listed below.
Anemia occurs when there aren't enough red blood cells to meet the body's need for oxygen, or when these cells don't carry enough of an important protein called hemoglobin. Fatigue is usually the first sign of anemia. A blood test to measure the number of red blood cells and the amount of hemoglobin can tell if you have anemia. The first step in shoring up your body's iron supply is with iron-rich foods (such as red meat, eggs, rice, and beans) or, with your doctor's okay, over-the-counter supplements.
Your body needs sufficient vitamin B12 in order to produce healthy red blood cells. So a deficiency in this vitamin can also cause anemia. The main sources of B12 are meat and dairy products, so many people get enough through diet alone. However, it becomes harder for the body to absorb B12 as you get older, and some illnesses (for example, inflammatory bowel disease) can also impair absorption. Many vegetarians and vegans become deficient in B12 because they don't eat meat or dairy. When B12 deficiency is diet-related, oral supplements and dietary changes to increase B12 intake usually do the trick. Other causes of B12 deficiency are usually treated with regular injections of vitamin B12.
A deficit of this vitamin can sap bone and muscle strength. This vitamin is unique in that your body can produce it when your skin is exposed to sunlight, but there also aren't many natural food sources of it. You can find it in some types of fish (such as tuna and salmon) and in fortified products such as milk, orange juice, and breakfast cereals. Supplements are another way to ensure you're getting enough vitamin D (note that the D3 form is easier to absorb than other forms of vitamin D).
Taking this into account, a research group led by Professor Hiroaki Kanouchi at Osaka Metropolitan University's Graduate School of Human Life and Ecology focused on nutritional status and water-soluble vitamin deficiencies found in unbalanced diets. The team hypothesized that a lack of folate (B9) and vitamin B12 may be related to fatigue, and centered their research around homocysteine (Hcy), a biomarker known to increase when these deficiencies are present.
Blood concentrations of Hcy, folate, and vitamin B12 in approximately 600 healthy Japanese participants were measured. Participants' fatigue and motivation were assessed using the Chalder Fatigue Scale questionnaire and the Visual Analog Scale. The initial results showed that individuals with higher blood Hcy levels had lower levels of vitamin B12 and folate, regardless of sex.
The researchers then examined the relationship between homocysteine levels and fatigue separately for men and women. In their analysis, factors that may influence fatigue, such as age, sleep duration, workload, and dietary habits, were simultaneously accounted for.
The results revealed that higher Hcy levels were associated with greater physical fatigue in men, while higher levels were associated with decreased motivation in women.
(Dr Alex Mathew, Senior Consultant – Internal Medicine, Max Super Speciality Hospital, Patparganj)
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