Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

Multivitamins are essentially dietary supplements containing a combination of various vitamins and minerals, often used to bridge nutritional gaps in the diet, treat deficiencies caused by poor nutrition or illness and support overall health.

Designed to provide a broad range of nutrients in one daily dose, they are available in tablets, capsules, gummies or liquids and are widely recommended to adults of all ages and genders.

But which vitamins do women need and when should you be taking them?

Dr Yashica Gudesar, Director & Unit Head of Obstetrics & Gynecology, Max Super Speciality Hospital, Dwarka exclusively tells Healthandme: "A woman’s nutritional needs change at different stages of life, from adolescence to reproductive years, pregnancy, and menopause. While food should always be the primary source of nutrients, certain vitamins may be required as women age or depending on lifestyle, diet, and health conditions."

"There’s honestly no universal vitamin checklist that works for every woman. The needs change with age, lifestyle, stress, whether one is planning a pregnancy, and of course, what the blood reports actually show," Bhakti Samant, Chief Dietician, Kokilaben Dhirubhai Ambani Hospital further told this publication.

Here are the supplements you need to stock your medicine cabinet with:

1. Vitamin D

Vitamin D is a fat-soluble nutrient essential for strong bones, immune function, and calcium absorption, often synthesized when skin is exposed to sunlight or obtained via food and supplements.

Symptoms of Vitamin D deficiency include bone pain, muscle weakness, and depression. Deficiencies are common due to low sun exposure or poor diet, leading to rickets in children and osteomalacia or osteoporosis in adults.

However, this can be avoided by consuming a combination of calcium and Vitamin D supplements. Dr Ginni Kalra, Head Dietician, Aakash Healthcare explained to Healthandme: "One of the frequently deficient nutrients in women is vitamin D. It is very important in calcium absorption, bone density, immune homeostasis and mood balance. In most adult women, the amount needed is 600-800 IU (15-20 mcg) per day although deficient women can take 1000-2000 IU per day under the supervision.

"Calcium is necessary in bone density especially in women post-menopause who experience rapid bone loss owing to the diminishing estrogen. Adult women should take 1,000 mg per day that rises to 1200 mg past 50 years. Calcium supplements are most ideal in separated doses of 500-600 mg each time and preferably following meals. When combined with vitamin D, absorption will enhance much better."

"Calcium becomes especially important after the age of 30, and even more after menopause. It can be taken after meals, often divided into two doses for better absorption," Dr Gudesar added.

Moreover, Samant advised: "Vitamin D is best taken with a meal that has some fat. Calcium (around 1000–1200 mg daily) is better split into two doses and should not be taken with iron."

2. Iron

A vital mineral, iron plays a very crucial role in human functioning by helping create hemoglobin to transport oxygen throughout the body, essential for energy and muscle function. Low iron levels can result in decreased oxygen transport and leading to symptoms like extreme fatigue, weakness, pale skin, cold hands/feet and shortness of breath.

While an iron deficiency is usually caused by poor diet, blood loss due to menstrual periods, ulcers, cancer, or regular use of pain relievers like aspirin or malabsorption issues, it can be remedied through supplements.

Dr Kalra explains: "Iron is also essential especially in menstruating women because they lose blood monthly. It may result in an iron deficiency which causes fatigue, loss of hair, brittle nails, and poor concentration. The acceptable amount of iron that is recommended to be taken by women aged 19 to 50 is approximately 18 mg, but this reduces to 8 mg after menopause.

"Iron supplements are better absorbed on an empty stomach or when taken with vitamin C and not when they are taken with calcium, tea or coffee as they have been found to interfere with absorption. The intake in the morning is usually desirable, but in case of gastrointestinal discomfort, it should be avoided."

3. Vitamin C

Vitamin C is essential for the body because it serves as a powerful antioxidant, supports the immune system, and is crucial for the synthesis of collagen, which is vital for wound healing and the maintenance of healthy skin, bones, and blood vessels.

It also enhances the absorption of iron from plant-based foods and protects cells from damage caused by free radicals, potentially reducing the risk of chronic diseases like cancer and heart conditions.

While, foods such as oranges, lemons, red and green peppers, kiwifruit, broccoli, strawberries, and Brussels sprouts can provide help maintain Vitamin C levels, supplements can help boost absorption and maximize benefits.

Dr Kalra notes: "Vitamin C helps to maintain the immunity, collagen synthesis, and iron uptake. It should be taken in 75 mg daily by adult women. It is soluble in water and can be consumed together with breakfast."

Additionally, she also recommends intaking: "Vitamin E and vitamin A also help the skin, vision, and antioxidant defense, but overconsumption is not advisable because it may be toxic."

4. Omega 3

Omega-3 fatty acids are polyunsaturated fats known for their crucial role in brain function and overall mental health. Fish oil is particularly rich in EPA and DHA, which are vital components of cell membranes and have strong anti-inflammatory effects in the body.

These omega-3s play a critical role in human development, and they are primarily found in fatty fish and fish oil. Some popular sources of Omega-3 include:

• Salmon
• Cod Liver Oil
• Algae Oil
• Oysters
• Nuts and seeds, such as flaxseeds, chia seeds, and walnuts
• Plant oils, such as flaxseed oil, soybean oil, and canola oil
• Fortified foods, such as eggs, yogurt, juices, milk, etc.

But as many people do not consume enough fish, supplementation is often recommended to ensure adequate intake of these essential fatty acids.

Dr Kalra suggests: "Though not vitamins, omega-3 fatty acids are worth mentioning because of the cardiovascular, hormonal, and anti-inflammatory effects. About 250–500 mg of combined EPA and DHA a day may be helpful and is most often administered after meals."

5. Vitamin B12

Symptoms of a Vitamin B12 deficiency often appear slowly. You may not notice them at first, or may blame them on stress, lack of sleep or a busy schedule. However, if the deficiency continues for long, it could lead to serious health problems.

Dr Gudesar recommends: "Vitamin B12 supports nerve health and energy levels. Vegetarian women are more prone to deficiency. It is typically taken in the morning."

"Vitamin B12 is needed to promote nerve well-being, red blood cell building, and energy conversion. The chances of deficiency are increased in vegetarian women because B12 is mostly found in foods of animal origin. The suggested daily dose is 2.4 mcg, but the dosage can be raised in deficiency. It is preferable in the morning as it could increase alertness," Dr Kalra explained.

However, Dr Kalra also advises: "There should be individualization of supplement timing and dosage. Decisions should be based on routine blood tests, dietary assessment, age, lifestyle, and existing medical conditions.

"Excessive supplementation is detrimental, in particular, fat-soluble vitamins. The only safe and effective approach is nutritional adequacy by means of whole foods, and supplements are the supportive therapy only in cases where deficiencies are observed."

The digital revolution has transformed childhood. From online classes to gaming and entertainment, headphones and earphones have become constant companions for children. While technology has brought convenience and learning opportunities, it has also introduced a silent threat, damage to children’s hearing.

In my clinical practice as an ENT surgeon, I am witnessing an alarming increase in young patients presenting with symptoms such as ear discomfort, ringing in the ears (tinnitus), and reduced hearing ability. These issues, once uncommon in children, are now becoming increasingly frequent due to excessive and unsafe use of personal audio devices.

Understanding the Risk

What makes the situation more concerning is that children often do not recognize the early warning signs. By the time symptoms become noticeable, significant damage may have already occurred.

The 60/60 Rule: A Simple Preventive Measure

• Listen at no more than 60% of the maximum volume

• Limit usage to 60 minutes at a time, followed by a break

This simple guideline can significantly reduce the risk of hearing damage and should be strictly followed by children and adolescents.

Warning Signs Parents Must Watch For

• Frequently increasing the volume of devices

• Complaints of ringing, buzzing, or ear pain

• Difficulty in hearing conversations

• Speaking unusually loudly

If any of these symptoms are noticed, it is important to consult an ENT specialist promptly.

Promoting Safe Listening Habits

1. Limit Earphone Use: Encourage children to use speakers whenever possible instead of earphones.

2. Choose Safer Devices: Over-the-ear headphones are generally safer than in-ear earbuds as they reduce direct sound impact.

3. Ensure Quiet Environments: Avoid using headphones in noisy surroundings, as children tend to increase volume to compensate.

4. Take Regular Breaks: Continuous listening should be avoided. Short breaks help the ears recover.

5. Avoid Night-time Use: Using headphones before sleep can harm both hearing and sleep quality.

A Shared Responsibility

Routine hearing check-ups should also be encouraged, especially for children who frequently use headphones for study or entertainment.

The digital age is here to stay, and technology will continue to play a central role in children’s lives. However, safeguarding their health must remain a priority. Hearing is a precious sense that, once lost, cannot be restored.

By adopting simple precautions, spreading awareness, and encouraging responsible use of technology, we can ensure that our children enjoy the benefits of the digital world, without compromising their hearing health.

In a recent post, Dr Sudhir Kumar shared the case of a five-year-old Rishi, a seemingly healthy boy, who suddenly started showing symptoms of deafness and even vision loss. However, the problem wasn’t as surface level as it seemed, as the boy’s brain health was the root cause.

Dr Sudhir Kumar, a Bangalore-based neurologist, shared the rare neurological case of Landau-Kleffner syndrome, he encountered in a five-year-old on the social media platform X.

What is Landau-Kleffner Syndrome?

According to John Hopkins Medicine, Landau-Kleffner Syndrome is a rare nervous system disorder that can cause the loss of ability to understand and use language.

They explain that it can happen to a child who has been developing normally and can also cause seizures. It can happen over time or even suddenly.

But what causes it and is it treatable? The condition is treatable with speech therapy and medication; however, not much is known regarding what causes it.

Researchers say it could be caused by mutation in the genes or the immune system attacking its own tissues like an autoimmune disorder.

Can A Child Stop Hearing Out Of The Blue?

While the first 3 years of Rishi’s life was on track with the development of an average child, things quickly changed.

He stopped looking up when his name was called and acted as if he couldn't hear at all. His parents took him to ear specialists, but the tests showed his ears were perfectly healthy. Over the next year, Rishi stopped speaking entirely and was eventually labeled as "deaf and mute."

Dr Sudhir explained that the timeline of his symptoms didn't match typical deafness. Most children who can't hear are born that way; they don't usually start talking and then suddenly stop.

This suggested that Rishi hadn't lost his hearing, he had lost his ability to understand sound. To solve the mystery, the doctor ordered a sleep EEG to monitor Rishi’s brain waves overnight.

What Are The Symptoms Of Landau-Kleffner Syndrome?

The symptoms of Landau-Kleffner Syndrome can be confusing because they often look like hearing loss or autism. Based on Rishi’s experience, the main signs include:

• Word deafness, which means that the child might hear a sound (like a bell) but cannot understand spoken words.

• Loss of speech is one of the main symptoms of this condition. As the child stops understanding language, they eventually stop speaking the words they once knew.

• Behavioral changes like the children may become frustrated or seem unaware of their surroundings.

• Hidden seizures could also be a symptom. While some children have physical seizures, many (like Rishi) only have abnormal brain activity during sleep.

Is Landau-Kleffner Syndrome Treatable?

The most important takeaway for Rishi’s family was that LKS is treatable. Because it is caused by abnormal electrical activity, doctors can use anti-seizure medications to "calm" the brain. Once Rishi started his treatment, the results were life-changing.

After three months, he began responding to his name again. Within six months, he was talking, playing, and laughing just like any other child. The "silence" in his home was finally gone.

Rishi’s story is a reminder that when a child suddenly loses language skills, every second counts. If LKS is caught early, the brain has a much better chance of recovering and rewiring itself.

If left untreated for too long, the loss of speech could become permanent. By understanding that the problem was in the brain and not the ears, Rishi’s doctors were able to give him his future back.