Happiness is influenced by a complex interplay of various chemicals in our brain, particularly four key neurotransmitters, D.O.S.E or Dopamine, Oxytocin, Serotonin, and Endorphins. These chemicals, often referred to as "happiness chemicals," are responsible for creating feelings of joy, motivation, connection, and calm.

However, when there's a deficiency in any of these, it can significantly affect our mood, energy, and overall well-being. Let’s dive into what these four neurotransmitters are, how their deficiency impacts us, and how we can boost their levels naturally.

Dopamine: The Motivation and Reward Chemical

Dopamine is often called the "motivation molecule." It plays a major role in enabling motivation, learning, and the pleasure-reward system in the brain. When we accomplish something — whether it’s finishing a project, completing a workout, or achieving a goal — dopamine gives us that sense of satisfaction and determination to continue.

Deficiency Effects:

When dopamine levels are low, it can lead to procrastination, low self-esteem, lack of focus, and general fatigue. A person might feel anxious, hopeless, or experience mood swings because the brain isn’t getting the reward signals it needs.

Boosting Dopamine:

You can increase dopamine levels by setting and achieving small goals, exercising regularly, eating foods rich in L-Tyrosine (such as almonds, avocados, and eggs), and practicing mindfulness or meditation. Engaging in creative activities like writing or drawing also helps boost dopamine levels.

Oxytocin: The Bonding Chemical

Oxytocin is often referred to as the "love hormone" or "cuddle hormone" because it plays a major role in social bonding and trust. It’s released when we hug, touch, or engage in other forms of physical affection. Oxytocin fosters feelings of connection and emotional intimacy, making it essential for relationships, family bonding, and even team cooperation.

Deficiency Effects:

A lack of oxytocin can lead to feelings of loneliness, stress, anxiety, and difficulties in forming or maintaining relationships. Low oxytocin levels are associated with feelings of isolation and disconnection from others.

Boosting Oxytocin:

You can raise your oxytocin levels through physical touch, socialising, spending quality time with loved ones, and even engaging in activities like massage or listening to soothing music. Acts of kindness, such as helping others or volunteering, also help release oxytocin.

Serotonin: The Mood Stabiliser

Serotonin is responsible for feelings of well-being and contentment. It helps regulate mood, sleep, digestion, and even social behavior. People who have balanced serotonin levels often feel calm, confident, and emotionally stable. Serotonin is crucial in helping people feel valued and significant among their peers.

Deficiency Effects:

Low serotonin levels are linked to depression, low self-esteem, irritability, and mood swings. Individuals may feel overly sensitive to criticism, experience panic attacks, or struggle with social phobias when serotonin is deficient.

Boosting Serotonin:

You can boost serotonin by getting regular exercise, exposing yourself to sunlight, engaging in cold showers or massages, and practicing mindfulness. Simple activities like walking in nature, meditating, or doing yoga are also effective serotonin enhancers.

Endorphins: The Pain Reliever

Endorphins are the body’s natural painkillers. Released in response to stress, pain, or intense physical activity, they help alleviate discomfort and promote a sense of euphoria. Endorphins are what make you feel good after a workout or a hearty laugh, often referred to as the "runner's high."

Deficiency Effects:

Without enough endorphins, people may experience anxiety, depression, chronic pain, and insomnia. A deficiency in endorphins can make daily life feel overwhelming and physically draining.

Boosting Endorphins:

To boost endorphins, engage in laughter, exercise, and stretching activities. Eating spicy foods or dark chocolate can also stimulate endorphin production. Regular massage therapy and meditation are other ways to naturally elevate endorphin levels.

Noncommunicable diseases such as heart disease, cancer, diabetes and chronic respiratory diseases affect billions of people worldwide and cause around 43 million deaths every year, with most deaths occurring in low- and middle-income countries.

These conditions often require lifelong care. From diagnosis and medication to monitoring and follow-up, each stage can carry safety risks, making timely, coordinated and patient-centered care essential.

World Patient Safety Day is observed every year on September 17 to raise awareness about patient safety and accelerate action to reduce avoidable harm in healthcare. Around the world, one in 10 patients experience harm while receiving health care, and approximately half of these incidents are preventable.

In 2026, the campaign focuses on safe care for noncommunicable diseases (NCDs), with the slogan “Safe care for life!”

“World Patient Safety Day is an annual reminder that if it's not safe, it's not care. This year, we're shining a light on safe care for non-communicable diseases. People with heart disease, cancer, diabetes, and chronic respiratory disease need care throughout their lives,” Dr Tedros shared in a post on X.

He noted that every interaction with the health system comes with benefits and risks.

“A delayed diagnosis, the wrong medicine, an unsafe procedure, or poor communication can have deadly consequences. Safe care must be built into every stage of the care journey, from prevention and early diagnosis to treatment, long-term management, and self-care,” the chief added.

Also read: World Patient Safety Day: With 2800% Margin, Costly Hospital Consumables Can Threaten Patient Safety; Here’s How

Why Do Chronic Conditions Raise The Risk Of Harm?

People with chronic diseases often need medicines, tests, consultations and other healthcare services over many years, increasing safety risks, particularly when care is fragmented or healthcare providers are not well coordinated.

Patient safety risks can occur at different stages of care. Common sources include:

• Missed prevention opportunities

• Delayed or incorrect diagnosis

• Medication errors

• Healthcare-associated infections

• Unsafe use of medical devices

• Poor communication and coordination

How Can Patients With Chronic Diseases Stay Safe?

Understanding your diagnosis and treatment can help you take an active role in your care.

• Know your diagnosis, treatment plan and why tests or medicines are needed.

• Use trusted health sources and ask questions when something is unclear.

• Confirm instructions and follow up on test results.

• Speak up if something feels wrong.

• Keep an updated list of your diagnoses, medicines and treatment plan, especially when seeing multiple doctors.

• Attend regular appointments and know the warning signs that need medical attention.

• Plan how you will access essential medicines, tests and follow-up care during disruptions.

Continuity of care is particularly important for people with NCDs. Poorly coordinated referrals, handovers and discharge processes can create safety gaps, especially for those managing multiple conditions or medicines.

Read More: Stem Cell Therapy For Autism: What India’s New Advisory Means For Patients

Safer Care Also Depends On The Health System

Patient safety cannot be addressed by patients alone. Strong policies, coordinated healthcare services and well-supported health workers are essential to reducing avoidable harm.

Fragmented care can put people managing complex chronic conditions at greater risk. Better communication between multidisciplinary teams can help identify problems earlier and reduce gaps in care.

Delayed referrals can also cost valuable time. Well-coordinated referral pathways can help patients receive the right care at the right time.

What Should Healthcare Systems Do?

The WHO called on healthcare facility managers, health leaders and policymakers to strengthen patient safety as part of everyday NCD care. This includes building resilient facilities, strengthening risk management, supporting health workers and establishing reliable systems for continuous care before, during and after emergencies, according to the WHO.

Healthcare systems should also ensure uninterrupted access to essential medicines, diagnostics and medical devices while strengthening referral pathways and communication between healthcare providers.

Investing in preparedness, continuous learning and quality improvement can further help reduce avoidable harm and improve the safety and quality of chronic disease care.

Something as basic as an IV set, syringe, cannula or catheter can make a huge difference in a patient’s essential care and treatment. But a recent FDA survey has raised questions about the affordability of these hospital consumables and whether the lack of transparency in pricing can pose a threat to patient safety.

Maharashtra Food and Drug Administration Commissioner Tukaram Mundhe recently flagged exorbitantly priced hospital consumables and medical devices used in inpatient departments.

The food and drug regulator sought Centre’s intervention to straighten pricing of essential and life-saving medical devices, saying these practices should be ideally “fair, transparent and ethical”.

Maharashtra FDA Chief Tukaram Mundhe Flags Costly Hospital Consumables

The Maharashtra State Price Monitoring Resource Unit, operating under the state FDA, recently conducted the market survey covering medical devices used in inpatient departments, including IV sets, syringes, nebuliser, and oxygen-mask kits, and other consumables.

The survey found that some commonly used medical devices had a gap of up to 2,841% between procurement prices and printed maximum retail prices (MRPs).

For example, an IV infusion set purchased for Rs 11.05 was listed at an MRP of Rs 325. A 10 ml syringe purchased for Rs 6.75 had an MRP of Rs 57.20, while a catheter bought for Rs 29.41 had an MRP of Rs 310.

Maharashtra FDA Commissioner Tukaram Mundhe has sought intervention from the Centre and the National Pharmaceutical Pricing Authority (NPPA), arguing that patients admitted to hospitals are not in the position to bargain over medical products that are essential to their treatment. They may not have the opportunity to compare prices, search for another brand, or simply refuse the product.

In a recent interview, Mundhe said, “A trade margin of 2800 per cent is by any terms not acceptable, either as a consumer or as a hospital or as a regulator.”

Mundhe highlighted this problem in his letter to the Department of Pharmaceuticals, writing, “Because hospitalised patients critically require these non-negotiable surgical consumables during active treatment, they possess zero bargaining power in IPD settings.”

He also described the steep pricing as “completely irrational and unjustified” and argued that the absence of strict statutory price caps for several medical-device categories can leave patients facing large and opaque price differences.

The Centre has now sought a report from the NPPA on the price discrepancies flagged by the Maharashtra FDA.

Also read: Syphilis Among Australian Women Has Risen By 167% In The Last Decade: How It Can Affect Pregnancy & Newborns?

Costly Hospital Consumables May Become A Patient-Safety Issue

World Patient Safety Day is observed on September 17 every year to raise global awareness about the safety of patients and reduce preventable harm in healthcare.

As far as patient safety is concerned, it is not only about whether a device is sterile, functional, or medically appropriate. Affordability and transparency can also influence whether patients are able to access and continue necessary treatment.

A fat hospital bill may cause financial burden, discouraging patients from seeking timely treatment. For families paying out of pocket, unexpected costs can affect decisions about where to seek care, whether to continue treatment or whether to delay non-emergency follow-up.

Mundhe has described the issue directly as a patient-protection concern, saying, “This is not merely a pricing issue; it is a patient-protection issue.”

Also read: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Industry’s Response To The Maharashtra FDA

The procurement price of a device, however, cannot automatically be treated as the final cost of safely delivering it to a patient.

Hospitals may incur costs related to sterile storage, inventory, staff, emergency availability, wastage, expiry, infrastructure, quality checks, and safe disposal.

Industry representatives have therefore argued that pricing frameworks should distinguish between basic commodity consumables and complex medical technologies.

In a statement, the Association of Healthcare Providers of India (AHPI) said, “Price of device or medicine is very small part of overall cost of administering healthcare, which include manpower (doctors, nurses, paramedical, administration etc.) maintaining infection free environment, infrastructure etc.”

They also reacted to Maharashtra FDA’s pricing concerns and said that hospitals play no part in setting up MRPs of these products.

A new social media trend is prompting people to look more closely at their skin, lips, eyes, hair and nails for possible signs of iron deficiency.

The trend, being referred to as “ferritin face,” centers on an appearance that people describe as looking unusually tired — including dull or dry skin, pale conjunctiva, cracked lips, dark circles under the eyes, and brittle hair and nails.

What Is ‘Ferritin Face’?

“Ferritin face” is not a medical term. Ferritin is a protein that stores and releases iron in the body.

Social media users are increasingly sharing photos of changes in their appearance and linking them to low ferritin or iron deficiency. Some are also encouraging others to get their ferritin levels tested.

“Shout out to the person who commented on one of my videos ... ‘you should get your ferritin levels checked because your lips are very pale,’” one woman said in a TikTok video. “It turns out there’s a reason for why I look so tired and crappy all the time.”

Also read: Bryan Johnson's Autoimmune Gastritis Sheds Light On Iron Deficiency In Americans

Can Iron Deficiency Affect Your Appearance?

Although there is no standard medical definition of “ferritin face,” low iron levels can coincide with visible changes in the face and other parts of the body.

“While the catchy name is a social media invention, the idea that depleted iron can affect how someone looks is medically valid,” Anna Komorowski, division chief of hematology and medical oncology at Northwell's Northern Westchester Hospital in Mount Kisco, New York, was quoted as saying to MedPage Today.

“Importantly, these changes typically occur when deficiency has progressed significantly, not from mildly suboptimal levels.”

Why Iron Deficiency Can Be Missed

Iron deficiency is common, affecting nearly a third of adults in the United States. But it can be difficult to recognize because symptoms may be vague and develop gradually. Iron levels are also not routinely checked.

According to research published in JAMA Network Open, about one in four Americans may have inadequate iron intake or absorption. In the study of more than 8,000 Americans, 14 per cent of adults had absolute iron deficiency, reflecting depleted iron stores.

Even after excluding common causes such as anemia, pregnancy, heart failure and chronic kidney disease, 11 per cent remained iron deficient. Another 15 per cent had functional iron deficiency, where iron levels appear normal but the body cannot use the mineral effectively.

“Because some patients may be iron-deficient without being anemic, they may go on for a very long time without being diagnosed,” Imo Akpan, a hematologist at NewYork-Presbyterian and associate professor of medicine at Columbia University Irving Medical Center, was quoted as saying to the Washington Post.

What Are The Common Signs Of Iron Deficiency?

Iron deficiency can cause a range of symptoms, including:

• Constant tiredness
• Weakness
• Pale skin
• Shortness of breath
• Dizziness
• Headaches
• Hair loss
• Difficulty concentrating
• Frequent infections
• Under-eye circles,
• Cracks at the corners of the mouth,
• Brittle or slower-growing nails
• Exercise intolerance,
• Cold hands and feet,
• Brain fog
• Cravings for non-food items such as ice, soap or chalk.

How Is Iron Deficiency Diagnosed?

Iron deficiency can be assessed with blood tests, including a ferritin test, which measures the body's stored iron. Ferritin levels below 30 nanograms per millilitre can indicate iron deficiency.

How Is Iron Deficiency Managed?

Management depends on the underlying cause and the severity of the deficiency. It can include improving dietary iron intake and taking iron supplements when advised by a healthcare professional.

Iron-rich foods include spinach, beans, lentils, nuts and dates. Vitamin C-rich foods, such as oranges and lemons, can also be included in the diet.