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.

In my years as an orthopaedic surgeon, I have operated on thousands of joints, ligaments, and bones. And if there is one pattern I have seen repeat itself more consistently than any other, it is this: two patients can undergo the exact same surgery, performed by the same surgeon, using the same technique — and walk away with completely different outcomes. The difference rarely lies in the operating room. It lies in what happens afterwards.

Most patients walk into surgery believing it is the finish line — the hard part, after which everything else is just optional maintenance. Physiotherapy gets treated as something to fit in "if there's time" or "if it still hurts." This is one of the most damaging misconceptions in orthopaedic recovery.

Surgery fixes the structure. It repairs the torn ligament, replaces the worn joint, sets the fractured bone. But it does not, on its own, restore function. That has to be rebuilt — deliberately, gradually, under guidance. And that rebuilding is physiotherapy's job, not the scalpels.

The numbers bear this out. Across orthopaedic procedures, roughly one in five to one in three patients fail to reach their expected functional milestones, and inadequate rehab is consistently among the top reasons why — alongside pre-existing stiffness and delayed rehab starts. A technically flawless surgery, followed by a half-hearted recovery, routinely underperforms a good surgery paired with disciplined rehabilitation.

What's actually happening inside the body

Three things happen to nearly every post-surgical joint, regardless of how well the operation goes. Muscles begin to atrophy almost immediately — the quadriceps around a knee can lose measurable strength within a week of reduced use, and rest alone does not reverse this. Only progressive, graded loading does, which is exactly what physiotherapy provides.

At the same time, as surgical wounds heal, the body lays down scar tissue. Left unmanaged, this tissue binds to surrounding structures, restricts tendon movement, and quietly steals range of motion — tightening further with time rather than loosening on its own. And joints that aren't moved regularly through their range begin to stiffen as the joint capsule tightens around them.

A joint essentially "learns" its new, restricted range unless someone deliberately and safely pushes it beyond that — which is precisely the judgment call a physiotherapist is trained to make.

Also read: Attention Ladies: More Than 5 Cups Of Coffee Linked To Lower Bone Density; Tea May Help

Why the body can't just heal its way back

Healing and recovery are not the same thing. Biological healing — wound closure, bone union, tissue integration — largely happens on its own, on a fixed timeline. But functional recovery — strength, coordination, the confidence to move and bear weight normally — requires the tissue to be used correctly while it heals.

Left alone, the body defaults to protection. It guards the operated area, recruits other muscles to compensate, and avoids the very movements it needs to relearn. Patients typically drift toward one of two extremes: under-loading out of fear, or over-loading out of impatience. Physiotherapy is what calibrates that loading correctly, stage by stage.

There is also a less visible disruption that few patients are aware of — the connection between brain and muscle. Pain, swelling, and immobilisation can cause a structurally intact muscle to simply stop firing efficiently, because the nerve pathways that recruit it have gone quiet from disuse.

Left unaddressed, the body compensates by recruiting other muscles instead — which can look like recovery on the surface while quietly setting up problems in neighbouring joints. This is precisely what targeted neuromuscular re-education in physiotherapy is designed to correct — retraining the brain to activate the right muscle, in the right sequence, again.

Also read: 6-Year-Old Australian Kid Dies From Rarely Seen ‘19th Century Disease’: Why Is Scurvy Still A Risk Today?

When patients stop too soon

The most common reason patients abandon physiotherapy early is what I call the "pain-free equals cured" mentality. Pain typically resolves well before strength, range, and control are fully restored — and once it's gone, patients read that as the finish line. Physiotherapy at that stage feels repetitive and effortful compared to the relief of simply feeling better, so motivation drops exactly when the harder, more important phase of rebuilding begins.

The long-term cost of this is real. In my practice, I regularly see stiffness that never fully resolves, chronic weakness that surfaces years later as instability or a limp, and compensatory strain in neighbouring joints — a hip overworking for an under-rehabbed knee, a shoulder overcompensating for a poorly recovered elbow.

Some of these cases eventually need a second procedure just to release stiffness that consistent physiotherapy could have prevented in the first place. These are not failures of surgery. They are failures of the recovery process that followed it.

The real answer to "I feel fine, do I still need physiotherapy?"

Feeling fine and being fully recovered are not the same thing — and that gap is exactly where physiotherapy does its work. Pain is often the first symptom to disappear and the last thing to reflect what's actually happening inside the joint. Strength deficits, altered movement patterns, and residual stiffness can persist long after pain is gone, only to resurface later as instability, re-injury, or early joint wear.

Stopping physiotherapy because the pain has gone is a bit like stopping antibiotics because the fever broke — the underlying process isn't necessarily finished just because the most obvious symptom has resolved.

Surgery and physiotherapy are not two separate stages of treatment. They are two halves of a single continuous process, and the outcome is determined by both. Surgery repairs the structure. Physiotherapy restores the function. Patients who understand this going in don't just heal better — they move better, for years afterwards.

GLP-1 drugs are set to become the “new statins of the world” and could transform metabolic health, said Wasim Hanif, Professor of Diabetes and Endocrinology at University Hospital Birmingham.

Speaking exclusively to HealthandMe, Prof Hanif discussed their growing use in obesity and diabetes, potential benefits, side effects and when patients should stop treatment.

GLP-1 Drugs Could Save NHS Billions

Even as the NHS is rolling out GLP-1 drugs, including tirzepatide (Mounjaro), for severe obesity, Prof Hanif said their kidney and cardiovascular benefits could also reduce the healthcare burden.

NICE recommendations cover tirzepatide and semaglutide for obesity and type 2 diabetes, with recommendations also expected for obstructive sleep apnea and MASH.

“I think these drugs will have a huge impact. These are going to be the game changers in metabolic health. These are the new statins of the world,” he said.

The only caveat, according to him, "is the cost, especially in the West".

"The cost of these medications is too high, but the hope is that within the next couple of years, once they become generic, they'll be used even more,” the professor told HealthandMe, on the sidelines of an event organized by the BMJ Group in New Delhi.

From GLP-1 To GIP And Glucagon

The Professor explained that the drugs have evolved beyond GLP-1 alone:

• GLP-1: Drugs based on glucagon-like peptide-1
• GLP-1 + GIP: Tirzepatide
• GLP-1 + GIP + glucagon: Retatrutide

US: Obesity And Diabetes Trends Falling

Prof Hanif pointed to growing use in the US and resulting health benefits.

“The total amount that the companies made with the use of these drugs in the United States was 43 billion dollars. Now we are actually seeing, for the first time, the trends of obesity and diabetes coming down,” he said.

He added that cardiovascular benefits are also expected to have a major impact.

‘Weight Losses We Never Imagined’

Prof Hanif said the drugs are producing major clinical improvements.

“For the first time in years I'm seeing my patients with diabetes achieve normal HbA1c once these drugs are used. Secondly, we are seeing weight losses we never imagined we would be able to get,” he said.

He also highlighted improvements in:

• Obstructive sleep apnea
• Cardiovascular health
• Heart failure.

Does Everyone Need A High Dose?

Recent research showed that GLP-1 drugs are showing benefits, even with lower doses. Prof Hanif said dosing depends on the condition and patient.

“For weight loss, yes, you need bigger doses, and that depends upon what your baseline weight is. So if your BMI is 40-45, you probably require a bigger dose, but if your BMI is less, you require a lesser dose,” he explained.

“For diabetes, you don't need the higher doses. With one milligram of semaglutide or five milligrams of tirzepatide, 80% of the patients get the decision,” he said.

“For cardiovascular protection, you don't need big doses. So it really depends upon — it's not that every person will need the topmost dose.”

GLP-1 Side Effects: What Does The Data Show?

Do these drugs have side effects? Prof Hanif said yes — but stressed that side effects occur with every medication. However, he pointed out to increasing "medical misinformation about GLP-1 drugs spreading rapidly through social media and websites in the US, Asia and India".

“Between 2007 and 2025, there were 1900 cases of pancreatitis reported or associated with GLP-1, with 19 deaths in the UK. Now how many patients were using these agents? Millions,” said Prof Hanif, who is also part of the board of the UK’s Medicines and Healthcare products Regulatory Agency (MHRA).

Comparing this with metformin, he added: “During the same period of time or even less, metformin caused 25 deaths.”

Hair Loss, Muscle Loss And Retinopathy

Prof Hanif said side effects associated with GLP-1 drugs do occur, but there are strategies to mitigate them.

“Hair loss is very — it does happen, but it's not that common. Loss of muscle mass happens, but it happens with any kind of weight loss.”

“There are mitigation strategies — how you do it.”

He also highlighted retinopathy, particularly among people with diabetes.

“We know if somebody's having proliferative retinopathy or having laser treatment, you don't use it. There are guidelines on that.”

He also warned against viewing GLP-1 drugs as lifestyle drugs, and buying them online and using them without appropriate medical oversight.

“So these drugs have to be used under medical supervision by people who know how to use these drugs, like any other drugs," Prof Hanif said.

Immunotherapy isn’t always better than chemotherapy. Its benefits depend on the cancer type, stage and biomarkers. Similarly, “superfoods” do not cure cancer, health experts said while addressing comedian Rahul Dua’s claims about cancer treatment.

On a recent podcast, Dua opened up about a family member’s four-year cancer battle and his research into alternative treatments.

Dua said his family member began improving after switching from chemotherapy to immunotherapy. He also claimed that low-cost drug combinations, including ivermectin and fenbendazole, could have potential in cancer treatment and questioned whether pharmaceutical profits influence which treatments receive attention.

But what does science say? HealthandMe spoke to oncologist to fact-check these claims and address common cancer-treatment myths.

Immunotherapy Isn’t Always Better Than Chemotherapy

“Immunotherapy is not universally ‘better’ than chemotherapy. Benefit depends on cancer type, stage, and biomarkers such as PD-L1, MSI-H or TMB,” said Dr Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital.

“In melanoma, mismatch-repair–deficient tumors and selected lung or kidney cancers, immunotherapy often outperforms or usefully combines with chemotherapy. In many other cancers, chemotherapy remains the backbone,” he added.

Patients should not decide their treatment on their own, the expert told HealthandMe.

Accurate diagnosis, staging and molecular testing require a multidisciplinary team. Shared decision-making with an oncologist is essential, as self-directed treatment choices can delay effective care and cause harm.

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

‘Superfoods’ Don’t Cure Cancer

Dua also claimed that certain “superfoods” — including a high-protein, high-fat, low-fibre diet — combined with immunotherapy can cure cancer.

“‘Superfoods’ do not treat cancer. A balanced diet supports strength and treatment tolerance, but no food replaces proven therapy. Miracle-food claims lack rigorous evidence,” Dr Shyam said, stressing that patients should consult their oncologist for individualized, evidence-based care.

The Rs 50 Ivermectin-Fenbendazole Claim

Dua also spoke about a combination of ivermectin and fenbendazole, describing it as a “₹50 cancer treatment” that he believed could be more effective and questioned whether pharmaceutical profits were a factor.

“But since it was a 50 rupee cure. There is no profit for pharma in that. There is no profit for pharma in that. Off the record, there is this medicine combination of Ivermectin and Fenbendazole. Fenbendazole is a dog dewormer. It costs 20 rupees. Ivermectin is a horse dewormer. I am very convinced that as soon as my auntie moved from (4 years of) chemo to immunotherapy. (She) Started becoming better,” Dua shared during the podcast.

According to the American Cancer Society, ivermectin is not approved to treat cancer in people or animals, and no clinical guidelines recommend it as a cancer treatment.

"Ivermectin has not undergone the rigorous clinical trials needed to establish whether it is safe and effective as a cancer treatment in humans. Available research is insufficient to determine whether it could work as an anticancer drug," it says.

While ivermectin may be used at recommended doses to treat certain worm infections, large doses can be dangerous, potentially causing seizures, coma and even death. It may also worsen the side effects of standard cancer treatments such as chemotherapy.

Read More: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

Experts Warn Against ‘Miracle Cure’ Claims

Dua’s claims has drawn sharp criticism from oncologists, public health specialists and medical communicators, who warned that unscientific “miracle cure” claims could mislead patients into delaying evidence-based treatment.

“Don’t fall for this. A ₹50 cancer ‘cure’ that pharma is hiding is clickbait, not care. These people never follow it themselves and feel no responsibility when patients delay real treatment just so a video can go viral. Lives are not content,” Dr Rishabh Jain, Medical Oncologist, AIIMS Delhi, said on X.

Dr Arshiet Dhamnaskar, neurosurgeon at Western India Institute of Neurosciences, also said people not “trained in medical science should refrain from commenting upon it. As even one bit of misinformation can be disastrous.”