Metabolism plays a big role in our health, it’s not just about helping your digestive system work smoothly, but the way your body breaks down the food and helps nutrients get absorbed into the body that matters. But often due to one reason or the other, your metabolism can slow down, which then causes issues with people. Many people think that the reason they may be gaining weight could be because of their poor metabolism, so how does one go about fixing this issue and how do you even know that the fault lies with your metabolism.

To understand why your metabolism may be slowing down, we must understand what role it exactly plays. Metabolism is the process your body uses to turn food into energy. It's essential for everything from breathing and digestion to keeping you warm. Several things affect how fast your metabolism works, including your genes, health, and lifestyle. A slow metabolism means your body burns fewer calories, which can lead to tiredness, dry skin, weight gain, and cravings.

Why Does Your Metabolism Slow Down?

There can be many reasons why your metabolism may be slowing down. You inherit some of it, and it tends to slow down as you age, often due to changes in your body and less muscle. Men and women have different metabolisms because of body size, makeup, and hormones. What you eat matters too – not enough healthy food or a very low-calorie or high-fat diet can slow it down. A lazy lifestyle, lack of sleep, and stress can also make your metabolism sluggish. Certain health problems like diabetes or an underactive thyroid, and even environmental factors, may also play a role.

Signs You Need To Improve Your Metabolism

While these are some common signs, it is best to visit a healthcare professional and ask for their opinions before you try a solution. There are many underlying reasons as to why you are experiencing slow metabolism, it can also be a side-effect of some medicine. A healthy lifestyle goes a long way, especially for people who already have digestive issues, kidney or even mental health issues like stress and anxiety.

Constant Fatigue

Feeling tired all the time, even without a good reason, could mean your metabolism is slow. A slow metabolism means your body breaks down food into energy slowly, leaving you with low energy levels. You might feel sluggish or get tired easily throughout the day. Changes in what you eat or your body composition (how much fat and muscle you have) can also make you feel more tired.

Dry Skin

Dry skin is common in winter, but if you have it all the time, it could be a sign of a slow metabolism. Thyroid hormones help control your metabolism and also keep your skin hydrated. If your thyroid isn't working right and your metabolism is slow, your skin might get very dry.

Weight Gain

If you're eating healthy and exercising but still gaining weight, a slow metabolism could be the problem. A slow metabolism doesn't turn food into energy quickly, so you burn fewer calories. Extra calories are stored as fat, making it hard to lose weight.

Feeling Cold

Feeling cold even when it's not cold outside can be a sign of a slow metabolism. Your body generates heat through metabolism. If your metabolism is slow, your body temperature might be lower. Some studies show that people with an underactive thyroid or obesity may have lower body temperatures because of a slow metabolism. This can be because of problems with thyroid hormones, which help your body make heat.

Food Cravings

Craving sugary or fatty foods can be a sign of a slow metabolism. Studies show that cravings are related to metabolic health. This is especially true for people who don't eat enough healthy foods, have bad eating habits, or have low muscle mass and high fat mass. Cravings might also mean your body isn't getting enough energy from the food you eat, so it wants more energy.

Mood Swings

Everyone has mood swings sometimes. But if you have them often, it could be from a slow metabolism. Low energy and hormone problems that come with a slow metabolism can make you irritable and frustrated. Some older research also suggests a link between mental health issues and a slow metabolism.

Digestive Problems

Digestion and metabolism are connected. Digestion breaks down food, and metabolism turns it into energy. If your metabolism changes, like slowing down, it can affect your digestion. A slow metabolism can cause constipation, bloating, or diarrhea.

Mrs. Radha Sharma, 78, was brought to the hospital with sudden confusion, irritability, and restlessness. She had no fever, no pain, and no typical urinary complaints. Her family worried it could be dementia or a brain-related issue. However, a simple urine test revealed the real cause— a urinary tract infection (UTI). With timely treatment, fluids, and care, she recovered within a few days. This is a common but often overlooked reality—UTIs in older adults don’t always look like UTIs.

In another case, 72-year-old Mr. Pankaj Verma had repeated UTIs over a year. Each time, antibiotics provided temporary relief, but the infection kept returning. On further testing, doctors found an enlarged prostate that was preventing his bladder from emptying fully. Once this was treated, his infections reduced significantly.

These examples show an important pattern: in the elderly, UTIs are often missed, misunderstood, or keep recurring because the root cause is not addressed.

Why Are UTIs So Common In Older Adults?

As we age, the body goes through changes that make infections like UTIs more likely. In women, menopause leads to a drop in estrogen levels. This weakens the natural lining of the urinary tract, making it easier for bacteria to grow. Women also have a shorter urinary passage, so that bacteria can reach the bladder more easily.

In men, an enlarged prostate is a common issue. It can block the flow of urine, causing some urine to remain in the bladder. This leftover urine becomes a breeding ground for bacteria. Other common reasons include weaker immunity, conditions like diabetes, urinary incontinence, use of catheters, reduced movement, and dependence on caregivers for hygiene.

Symptoms Are Not Always clear

Unlike younger people, elderly individuals may not complain of burning urine or urgency. Instead, the signs can be subtle and confusing, such as:

• Sudden confusion or unusual behavior
• Increased falls
• Weakness or tiredness
• Loss of appetite

These symptoms are often mistaken for ageing or dementia, which can delay treatment.

Men vs Women: What’s the Difference?

UTIs are more common in older women due to hormonal changes and bladder control issues. Many women also experience repeat infections. In men, UTIs are less common but usually more serious. They are often linked to problems like prostate enlargement or urinary blockage, which need proper evaluation. Chronic illnesses play a big role. Diabetes, for example, increases the risk because excess sugar in urine helps bacteria grow. Poor sugar control also weakens the body’s ability to fight infections.

Conditions that affect bladder control, such as stroke or Parkinson’s disease, can also lead to incomplete emptying of the bladder, increasing infection risk.

Diagnosis Needs Careful Attention

Not every bacterium found in urine needs treatment. Many older adults have bacteria in their urine without symptoms—a condition called asymptomatic bacteriuria. Treating this unnecessarily can lead to antibiotic resistance. Doctors usually rely on urine tests, cultures, symptoms, and medical history before deciding on treatment.

Treatment: More Than Just Antibiotics

While antibiotics are important, they are only one part of the solution. Repeated courses without finding the cause often lead to recurring infections.

Treatment should also focus on:

• Drinking enough fluids
• Managing diabetes or other health conditions
• Treating prostate problems in men
• Avoiding unnecessary catheter use
• Reviewing medications that may affect bladder function

Early treatment is crucial. Ignoring symptoms can allow the infection to spread to the kidneys, which can be serious. Recurrent UTIs are common in the elderly. This can happen due to:

• Incomplete treatment
• Underlying problems like prostate enlargement
• Ongoing issues, such as incontinence or catheter use
• Antibiotic resistance

Prevention: Simple But Effective Steps

Preventing UTIs doesn’t always require complex measures. Small daily habits can make a big difference:

• Encourage regular water intake
• Avoid holding urine for long periods
• Maintain proper personal hygiene
• Manage conditions like diabetes well
• Limit catheter use
• Consider probiotics or cranberry products (after medical advice).

Caregivers play a key role in ensuring these habits are followed, especially for elderly individuals who need assistance. Immediate medical attention is needed if there is:

• Fever or chills
• Sudden confusion
• Blood in urine
• Lower back pain

UTIs in the elderly are common but often not straightforward. They may present differently, recur frequently, and require more than just antibiotics. The key is early recognition, identifying the underlying cause, and taking simple preventive steps. With the right care, recurrent UTIs can be reduced—helping older adults live healthier, more comfortable lives.

(By Dr. Sunita Goyal, Senior Consultant – Obstetrician and Gynecologist, Cloudnine Group of Hospitals, Ludhiana)

Systematic Lupus Erythematosus (SLE), also known as Lupus, is a multisystem autoimmune disease in which one's immune system attacks the body. It is most common in women of reproductive age; however, in rare cases, it can present in men and patients of any age.

Lupus Symptoms: More Than Just Joint Pain

Symptoms for SLE can range from unexplained fever for days to months, to oral ulcers, malar rash, photosensitivity (after exposure to sun), hair loss, headache, stroke, seizure, abnormal behavior (psychiatry lupus). A large group of patients experiences joint swelling, pain, and fatigue. If the kidneys are affected in Lupus patients, they can pass blood with their urine.

Their urine output also decreases; their legs swell, and there is swelling around the eyes. Involvement of the heart, brain, and pancreas is also not uncommon. Lupus is one of the causes of multiple unexplained pregnancy losses, especially in the second trimester, but with proper treatment and observation, many patients do well and have an uneventful pregnancy and childbirth.

Common Myths About Lupus

Some very prominent myths about SLE need to be debunked. Many think SLE is contagious and that only women can get it, when in reality, neither is true. Being an autoimmune disease means it cannot spread by contact, and it impacts both men and women, although the incidence rate of SLE is higher for women. Many also believe in the common misconception that it affects only joints, when in reality it is a multisystem disease that can affect the kidneys, heart, brain, skin, and lungs.

There is a common myth that pregnancy is impossible or unsafe for women with Lupus; however, many women with Lupus can conceive and experience safe and healthy full-term pregnancies under the right medical guidance. Kidney biopsy, which is a required test for treating Lupus, is often deemed unsafe, but it is a safe test and is required to decide the stage of the disease and treatment.

Lupus: Warning Signs

Some symptoms that can be a cause of alarm in SLE are rapid rising serum creatinine, new onset seizure or psychosis, sudden onset shortness of breath associated with chest pain, blood in cough with low oxygen saturation, acute confusional state with fever, vision changes, severe abdominal pain, unexplained severe anemia, severe thrombocytopenia (platelet count < 20,000).

Managing Lupus

For accurate diagnosis and treatment, one needs a rheumatologist's consultation. Rheumatologists will decide the plan of treatment to manage symptoms, reduce inflammation, prevent flares of the disease, and minimize organ damage. Lifestyle measures like avoiding Sun exposure, quitting smoking, lowering stress, and engaging in some low-impact physical activities help patients to minimize the disease burden.

There is very little awareness about Lupus in society, and due to varied presentations and symptoms, patients often consult with multiple doctors of different specialties before consulting with rheumatologists. We need to push for more awareness in society about less talked-about ailments like Lupus, which needs efficient intervention and management, as it is a lifelong condition. Talking about it also helps reduce stigma and bust myths around it. Late diagnosis and delay in treatment can cause significant morbidity, disease progression, and mortality. With early diagnosis and optimal treatment.

Holistic care is possible, which goes a long way in helping individuals manage autoimmune conditions like Lupus

(By Dr Niharika Gill, Rheumatologist, Lilavati Hospital and Research Center, Mumbai)

Prostate cancer presents a troubling paradox. It is among the most treatable cancers when detected early, with survival rates exceeding 99% at five years. Yet it continues to be a major cause of cancer-related deaths among men worldwide.

The challenge is not always the aggressiveness of the disease; it is the fact that prostate cancer often develops quietly, with symptoms that are easy to overlook or dismiss.

When Cancer Doesn't Make a Sound?

The prostate is located deep within the pelvis, beneath the bladder and surrounding the urethra. In its early stages, prostate cancer typically causes little to no discomfort. Small tumors rarely affect nearby nerves or tissues, allowing the disease to progress unnoticed.

Even when symptoms do appear, they are often mistaken for natural signs of ageing. Changes such as a weaker urine stream, increased frequency of urination, urgency, or waking up several times at night are commonly associated with benign prostate enlargement. This condition affects many men as they grow older. As a result, warning signs are frequently ignored or attributed to age-related changes rather than investigated further.

Unfortunately, more alarming symptoms, including blood in the urine or semen, persistent bone pain, unexplained weight loss, or difficulty passing urine, often emerge only when the disease has advanced beyond the prostate.

Why Men Delay Seeking Help

Biology is only part of the story. Social and psychological factors play an equally important role in delayed diagnosis.

Many men are conditioned to endure discomfort rather than seek medical attention. Persistent messages around toughness and self-reliance can discourage conversations about health concerns, particularly when symptoms involve urinary or sexual function.

Fear also contributes to postponement. Some men worry about receiving a cancer diagnosis, while others are concerned about potential treatment side effects such as urinary incontinence or erectile dysfunction. For many, avoiding the test feels easier than confronting the possibility of bad news.

A lack of awareness further compounds the problem. Unlike heart health or diabetes, prostate health is rarely discussed openly. Many men are unfamiliar with the prostate gland, its role in the body, or the importance of prostate-specific antigen (PSA) testing.

The Role of Stigma and Social Barriers

Symptoms linked to urinary or sexual health often carry an element of embarrassment, making men less likely to discuss them with friends, family members, or healthcare professionals.

Additionally, many men prioritize work and family responsibilities over their own health. Preventive screening may be viewed as unnecessary, especially when symptoms seem minor or absent. This tendency can delay diagnosis until the disease reaches a more advanced stage.

Health disparities also play a role. Certain populations face higher risks of developing and dying from prostate cancer, yet often experience lower rates of screening and healthcare access, highlighting the need for more targeted awareness efforts.

Challenges Within the Healthcare System

Unlike some other cancers, prostate cancer screening recommendations are not universally standardized. Decisions around PSA testing are often based on age, risk factors, and individual discussions between patients and healthcare providers.

Because symptoms frequently overlap with benign conditions such as urinary tract infections or prostate enlargement, prostate cancer may not always be suspected immediately. Furthermore, many men do not attend regular health check-ups, reducing opportunities for early detection and informed conversations about risk.

Who Should Be Particularly Vigilant?

While all men should be aware of prostate health, certain groups face a higher risk of developing the disease:

• Men over the age of 50
• Individuals with a father, brother, or close relative diagnosed with prostate cancer
• Men carrying inherited genetic mutations such as BRCA2
• Those with obesity, smoking habits, or diets high in processed foods and saturated fats

Breaking the Silence

Improving outcomes starts with changing the conversation around prostate health. Rather than viewing screening as a response to illness, it should be considered part of routine preventive healthcare, similar to monitoring blood pressure, cholesterol, or blood sugar levels. Men should feel comfortable discussing urinary changes, however minor they may seem, with their healthcare providers.

Public awareness campaigns, workplace screening initiatives, and community outreach programs can play a vital role in normalizing conversations around prostate health. Equally important are personal stories from survivors and public figures, which can encourage others to seek timely medical advice.

The Difference Early Detection Makes

When prostate cancer is identified at an early stage, treatment options are often less invasive and highly effective, ranging from active surveillance to curative surgery or radiation therapy. Survival outcomes are excellent.

In contrast, advanced prostate cancer may require long-term hormone therapy, chemotherapy, and ongoing management of symptoms that significantly affect quality of life. The burden extends beyond health, impacting emotional well-being, family life, and financial stability.

A Message Every Man Should Hear

Prostate cancer often develops without obvious warning signs, making awareness and proactive screening essential. The goal is not to create fear, but to empower men to take charge of their health before symptoms become impossible to ignore.

When it comes to prostate cancer, the conversation should begin long before the disease announces itself.