The COVID-19 pandemic may be over, but our immune systems are still feeling the impact. After years of battling constant viral threats, from COVID-19 to seasonal flu and other infections, our body’s defense system is exhausted. Many people continue to experience lingering inflammation, frequent illnesses, and slower recovery times. This extended state of immune stress has compromised us further to chronic illness, including autoimmune diseases and even neurodegenerative diseases such as Parkinson's. So why is our immune system still in trouble? And how do we give it its power back? Understanding immune exhaustion is the beginning of rebuilding our body's natural immunity.
A weakened immune system makes people more susceptible to disease, mental illnesses, and even sleep disorders. Now, new research indicates that immune system depletion may play an important role in the onset of Parkinson's disease, a degenerative neurologic disorder that compromises movement and cognition.
Dysfunctional immune response is a leading cause of long-standing inflammation within the body, that has been found to contribute towards a multitude of conditions, including cardiovascular conditions, diabetes, depression, and neurodegenerative diseases such as Alzheimer's.
As people age, their immune system naturally becomes less effective. This deterioration, referred to as immune exhaustion, may be a key contributor to the onset and progression of Parkinson’s disease. Rebecca Wallings, a Parkinson’s Foundation Launch Award grant recipient and senior postdoctoral fellow at the University of Florida, believes that an accumulation of exhausted immune cells could be driving neurodegeneration in Parkinson’s patients.
Parkinson's disease is most commonly linked with the degeneration and loss of dopaminergic neurons—motor nerve cells that produce dopamine, an essential neurotransmitter for movement. While researchers have long suspected inflammation is involved in this neurodegeneration, the mechanisms are not yet well understood.
Wallings' study is on immune cell exhaustion, a process by which aging immune cells fail to control immune responses effectively. Her research indicates that instead of dampening inflammation in Parkinson's patients, attempts should be made to rejuvenate the immune system to regain its functionality.
One of the major findings of Wallings' work is the function of mitochondrial impairment in immune cell exhaustion. Mitochondria are commonly called the powerhouses of cells, as they are vital for generating energy. As mitochondria age and become inefficient, immune cells fail to function well, potentially accelerating neurodegeneration in Parkinson's disease.
Wallings has found that mutations in the LRRK2 gene, a recognized genetic risk factor for Parkinson's disease, are linked with defective mitochondrial function and immune cell exhaustion. Her current work includes testing various therapeutic approaches to restore mitochondrial function in immune cells with the potential to enhance the immune system and potentially prevent or treat Parkinson's disease.
For decades, the standard practice in treating Parkinson's has been to suppress brain inflammation. Yet Wallings' work indicates that instead of slowing down immune responses, restoring the immune system could be a more successful strategy. By addressing mitochondrial impairment and immune resilience, researchers can potentially reverse or slow down Parkinson's disease.
Wallings is now looking into how to rejuvenate immune cells by fixing mitochondria. She studies immune cells from patients with Parkinson's as well as from healthy subjects and performs experiments on animal models to determine if rejuvenation of the immune system could result in improved disease outcomes.
While there is no cure for Parkinson's disease, some lifestyle adjustments may decrease the chances of developing the illness. Since neurodegenerative diseases are associated with chronic inflammation and immune dysfunction, developing habits that enhance immune function might prove helpful.
Diet: There is evidence to suggest that eating in accordance with the Mediterranean or MIND diets, both high in antioxidants, healthy fats, and anti-inflammatory foods, can encourage brain wellness and reduce Parkinson's risk.
Avoiding Dangerous Substances: Restricting alcohol and nicotine use can maintain a robust immune system and suppress inflammation.
Reducing Stress: Chronic stress weakens immune function, so methods such as meditation, exercise, and sufficient sleep can lead to improved overall well-being.
Credit: AI image
The death of 31-year-old Bowen Wan, who had epilepsy, has raised concerns about relying on AI for medical decisions. A lawsuit filed by her family alleges that she followed ChatGPT’s advice to reduce and eventually stop her anti-seizure medication.
According to the complaint, OpenAI’s chatbot provided a tapering schedule, encouraged her to keep the changes from her doctor and reassured her when she reported symptoms.
Wan, a former Amazon software engineer who lived in Seattle, had been taking lamotrigine to manage her epilepsy. She was concerned that the medication was affecting her memory, speech and performance in job interviews.
Epilepsy is a neurological condition characterized by seizures. Anti-seizure medicines help control abnormal electrical activity in the brain, and treatment is tailored to a person’s condition, seizure history and response to medication.
Although side effects may require treatment adjustments, patients should not independently reduce their dose or stop taking medication. The Epilepsy Foundation warns that suddenly stopping anti-seizure medicines can trigger withdrawal symptoms and potentially life-threatening seizures.
According to reports cited in the lawsuit, ChatGPT allegedly provided a plan to reduce Wan’s daily dose from 400 mg to zero over about 25 days without her doctor’s approval. The complaint further alleges that the chatbot encouraged her to keep the changes from her physician.
In one reported exchange, when Wan asked whether she could reduce the dose herself without telling her doctor, the chatbot allegedly replied, “Yes, you can absolutely do this.”
HealthandMe spoke to two neurologists about the risks of relying on AI tools to decide whether to skip, adjust or restart prescribed medication. They noted that AI can help patients understand medical terms and prepare questions for clinicians, but it should not replace professional advice on changing prescribed treatment.
“AI tools can provide general information but do not have access to a patient's complete medical history, seizure type, medication regimen, test results, or individual risk factors. As a result, their advice may be incomplete, inaccurate, or inappropriate for a specific patient,” said Dr. Sudhir Kumar, Senior Consultant Neurologist, Institute of Neurosciences, Apollo Hospitals, Hyderabad.
“Decisions about stopping, adjusting, or restarting anti-seizure medications should always be made in consultation with a qualified clinician who can assess the benefits and risks in the proper clinical context,” he said.
A missed-dose recommendation may not apply to every anti-seizure medicine or dosing schedule. Drug interactions can also affect medication levels, seizure control and the risk of side effects.
Dr. Praveen Gupta, Chairman of the Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, told HealthandMe AI tools can help people understand medical information but should not replace a neurologist when decisions about epilepsy treatment are involved.
Managing epilepsy requires an individual assessment of the patient’s seizure type, medical history, prescribed medication and dosage, other health conditions, and response to treatment, he said.
“Patients should not use AI tools to decide whether to stop, restart, increase or reduce their medication. Suddenly stopping some anti-seizure medicines can lead to more severe or prolonged seizures that may require emergency treatment,” Dr. Gupta said.
AI can help patients understand a diagnosis or prepare questions for their doctor, he added, but medication decisions should be made by a qualified health professional who can assess the individual's clinical situation.
Dr. Kumar told HealthandMe that there is no universally safe number of doses a person with epilepsy can miss.
Missing or delaying an anti-seizure dose can lower medication levels in the blood, potentially reducing protection against seizures and increasing the risk of a breakthrough seizure, Dr. Gupta explained. This can happen even in people who have been seizure-free for a long time.
A single missed dose can trigger a seizure in some people, but the risk varies depending on the type of epilepsy, seizure control, medication, its half-life, dosing schedule, and individual susceptibility.
Taking medication as prescribed is the safest approach, the experts said.
The experts advised that patients to:
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According to a recent study, the rate of strokes among young adults in the United States has nearly doubled in the last two decades. With risk factors like high blood pressure, diabetes and high cholesterol surfacing years earlier, experts are seeing an increasing number of stroke emergencies under the age 40.
On World Stroke Day, Dr Arup Sen, London-based physician, specialising in geriatric, stroke and General Medicine and affiliated with Cleveland Clinic London, National Hospital for Neurology and Neurosurgery, and University College Hospital, spoke to HealthandMe about the alarming pattern of stroke rates among young people.
The doctor said that recreational drug use, smoking, sedentary behaviour and obesity add to stroke risk, while certain underlying medical conditions could also be triggers.
Dr. Sen said, “The bottom line is that what we refer to as stroke risk factors, the risk factors are arriving decades earlier compared to previously. And that's why we're seeing this surge in stroke rates in young people.”
Dr Sen said recreational drugs affect blood vessels and blood pressure directly, increasing the risk of stroke. Cocaine, for instance, can narrow the blood vessels that could disrupt blood flow to the brain. It can also trigger sudden increases in blood pressure.
“Generally speaking, most substances cause stroke through a mechanism of causing vasospasm and a surge in blood pressure or high blood pressure, which then increases the risk of having a stroke,” he said.
Cannabis use has also been linked to risk of stroke according to some studies. Dr Sen referred to research reporting an association between cannabis use and stroke, including studies examining daily use. He noted that tobacco use can complicate the picture because some people smoke cannabis with tobacco.
“Tobacco itself is a risk factor for stroke. So, for example, people who smoke cigarettes have twice the risk of stroke as someone who doesn't smoke,” he said.
He also warned against combining smoking with vaping, saying that research has associated dual use with a higher stroke risk.
The doctor said that anabolic steroids used for bodybuilding is a major concern. According to Dr Sen, these substances can lead to thickening of the blood which inceases blood clotting risk and affect the structure of the heart. This could lead to abnormal heart rhythms and blood clots.
“One of the most important ways in which you can increase risk is it can make the blood more thick and sticky, increasing risk of blood clots, but it can also affect the heart in terms of causing what we call a cardiomyopathy,” he said.
His advice to people using anabolic steroids for bodybuilding was straightforward. He said, “Don't use them, just avoid them altogether, because if you're using it, there's going to be a risk.”
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Dr Sen also highlighted that women who experience migraine with aura and use oestrogen-containing oral contraceptives are at stroke risk.
Migraine with aura involves neurological symptoms that can occur before or during a migraine attack. According to Dr Sen, the oestrogen component of certain contraceptives can increase the risk of blood clots and stroke in women with this history.
He said, “If a young lady with a history of migraine and aura has a stroke, then we would recommend them, and they're using contraceptives, we would recommend them using progesterone-only contraceptives, avoiding oestrogen, because the oestrogen component is a risk factor for strokes.”
The choice of contraception, however, should be always discussed with a healthcare professional.
Not every stroke in a younger person is explained by conventional risk factors. Dr Sen said doctors investigate conditions that may be more relevant in younger patients, including patent foramen ovale (PFO), antiphospholipid syndrome (APS) and arterial dissection.
A PFO is an opening between the upper chambers of the heart. Dr Sen explained that even though it is common, occurring in around one in four people, in certain cases it can allow a blood clot to pass through the heart and travel to the brain.
Antiphospholipid syndrome is a condition that can increase the tendency to form blood clots. Arterial dissection, meanwhile, involves a tear in the wall of an artery. Dr Sen said it can occur in association with sports or neck manipulation and may initially cause neck pain or headaches before neurological symptoms develop.
He said PFO and arterial dissection were the two most common unusual causes he had encountered in younger stroke patients, followed by antiphospholipid syndrome.
He said, “The most common cause I've seen is PFO, definitely, followed by dissection, and then probably antiphospholipid syndrome.”
Dr Sen warned that stroke may not always be the first condition doctors suspect when a younger person arrives with symptoms like dizziness, balance problems, nausea, vomiting, blurred vision or headaches.
Posterior circulation strokes, which affect the back of the brain, can cause symptoms that resemble other conditions. These may be mistaken for intoxication, gastroenteritis or migraine, potentially delaying diagnosis.
“There's this common myth that stroke, if it happens, it's inevitable. There's nothing you could have done to prevent it. But the opposite is true, because the majority of strokes are actually preventable if you address the risk factors in a proactive fashion,” he said.
Dr Sen urgently recommends addressing lifestyle factors, keeping key health biomarkers in check and recognising stroke symptoms at the earliest.
He advised younger adults to stay physically active, avoid smoking and recreational drugs, maintain a healthy diet, get adequate sleep and avoid binge drinking. He also urged people to monitor their blood pressure, cholesterol and blood glucose rather than assuming these checks are necessary only later in life.
He said, “Know your numbers. By that, I mean, your risk factors. Even in as early as your mid 20s to early 30s, you should be looking at your blood pressure, cholesterol and diabetes markers.
Dr Sen also said that some people may have genetically elevated cholesterol even when they are young. He also mentioned lipoprotein(a), or Lp(a), a largely genetically determined risk factor that is not routinely included in every standard cholesterol assessment.
Finally, he stressed the importance of recognising the signs of stroke through the BEFAST acronym:
“The mantra in stroke that we use is time is brain,” Dr Sen said. “The earlier you get to the hospital and see the specialists and get the right treatment at the right time and the right place, the better the outcomes.”
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People with hemophilia face an increased risk of poor bone health due to recurrent joint and muscle bleeds, joint damage and reduced physical activity. Experts told HealthandMe that preventing bleeds from childhood, alongside adequate nutrition, appropriate exercise and regular assessment, can help protect bone health throughout life.
Globally, an estimated 836,000 people have hemophilia, including approximately 284,000 with severe hemophilia. In India, the World Federation of Hemophilia (WFH) reported nearly 28,000 diagnosed and registered patients as of 2026, including more than 24,000 with Hemophilia A. However, the estimated prevalence could be as high as 1,36,000, suggesting many cases remain undiagnosed or misdiagnosed.
Childhood and adolescence are critical for building peak bone mass, making early intervention important for long-term musculoskeletal health, said health experts.
Hemophilia is an inherited bleeding disorder caused by a deficiency of clotting factor VIII (Hemophilia A) or factor IX (Hemophilia B). It primarily affects males, while women are often carriers.
Repeated bleeding into joints can cause chronic pain, joint damage, deformity and reduced mobility. Muscle bleeds can further restrict movement, limiting participation in physical activities that help maintain bone strength.
“Bone health begins in childhood, but protecting it is a lifelong commitment. In people living with hemophilia, recurrent joint and muscle bleeds, reduced physical activity and other risk factors can contribute to poor bone health and an increased risk of osteoporosis,” Dr. Varun Bafna, associate professor in the Department of Hematology at Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, told HealthandMe.
Prophylaxis involves preventive treatment to reduce bleeding episodes rather than treating bleeds only after they occur. Regular factor prophylaxis can help prevent recurrent joint bleeds, preserve joint function and support mobility.
“Regular factor prophylaxis helps prevent repeated joint bleeds and preserve joint function. That protection can support mobility, an important contributor to bone health,” Dr. Hitha B, associate professor and haematologist in the Department of Medicine at Government Medical College, Kozhikode, told HealthandMe.
She advised patients to discuss breakthrough bleeding or difficulties accessing treatment with their healthcare team so their treatment plan can be reviewed.
Dr. Bafna said consistent prophylaxis can also support muscle strength and safer participation in physical activity.
“Prophylaxis is not just about preventing bleeding today; it is an important part of protecting long-term musculoskeletal health and quality of life at every age,” he noted.
Experts recommend an individualized approach based on age, joint health, mobility and other risk factors. Key measures include:
Hematologists, physiotherapists and other healthcare professionals can help patients and families integrate preventive treatment, rehabilitation, nutrition and appropriate physical activity into an individualized care plan.
Early intervention and consistent care can help preserve joint function, mobility and quality of life as people with hemophilia grow older.
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