We are always told to never mix work and friendships in social settings. While it is normal to make friendships at work, you should always keep a professional distance to make sure things do not go sour and start affecting your work. This also means that you do not divulge private information or have private conversations with your colleagues as you may never know how this could be brought up and affect you. This is an unsaid rule in corporate culture that if you are sick or you are coming down with a serious issue, you should never bring it up and keep it to yourself. While this may seem unusual to new workers, it is a very common knowledge for people who have been in the industry for a long time. A new study showed that this is much more common than many people believe!

A new poll shows that a lot of U.S. workers with long-term health problems keep it a secret from their bosses. This affects their health and their jobs. It's a big problem that employers could help fix, which would be good for everyone. This isn't just about people having a sniffle. We're talking about serious conditions like heart disease, diabetes, and asthma that require ongoing management and can significantly impact a person's life, both inside and outside of work. The fact that so many people feel they need to hide these conditions shows a larger issue of stigma and lack of support in the workplace.

How Does Health Become A Hidden Burden?

Most U.S. workers which were over half of the people, have some kind of long-term health problem. But a lot of them, about 6 out of 10, don't tell their boss. They might be afraid their boss will treat them differently or think they can't do their job. Keeping secrets like this can make it hard to get the help you need at work. It can also make your health problems worse because you're stressed about hiding them. It's a tough situation, and it shows that many workplaces aren't as supportive as they could be.

The poll also found that more than a third of people with health problems have had to miss doctor's appointments because of work. This means they're putting their jobs ahead of their health, which isn't good. It's hard to balance work and health, especially when you have a long-term illness. People need understanding bosses who will let them take time off for important medical stuff. Missing appointments can make health problems worse, and it can also make people feel more stressed and anxious.

Does It Impact Their Career And Well-Being?

Almost half of the workers with health problems said they couldn't even take breaks during the day to take care of themselves. They also said they felt like they'd been passed over for promotions because of their health. And some people even got bad reviews at work because of their health problems. This can make people feel really bad about themselves and their jobs. It can also make their health problems worse because they're so stressed. It's not fair, and it's something that needs to change.

It's not just people with health problems who have a hard time. Lots of people are also taking care of someone at home who is sick. Almost half of these caregivers have to help their sick family member during work hours. And many of them have trouble taking time off to care for their loved ones. Some people even have to work fewer hours, which means less money. This shows how much pressure people are under, trying to juggle work and family and health.

Insulin resistance is a condition in which the body cannot effectively use insulin. Shockingly, this condition is now being linked to first-trimester miscarriages, especially in women with PCOS, with lab markers such as HbA1c and fasting insulin offering early clues. Therefore, it is essential for women to take charge of their health and maintain their blood sugar levels within the recommended range, as per Dr Sushruta Mokadam, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharadi, Pune. The expert went on to talk about other aspects of the same, detailing just how first trimester miscarriages could be a consequence of ignoring high blood sugar or insulin resistance.

Why are miscarriages in the first trimester rising?

Currently, there is a surge in cases of miscarriages during the first trimester, which is raising concern among experts. This may be due to undiagnosed insulin resistance. Yes, that’s right—miscarriage is not only caused by infections, hormonal imbalance, or blood clotting disorders, but also by insulin resistance. Many women fail to pay attention to insulin resistance, which affects how the body processes sugar and plays a major role in causing hormonal imbalance. Women with Polycystic Ovary Syndrome (PCOS) are at a higher risk, as metabolic dysfunction can lead to miscarriage. Many women are experiencing repeated early pregnancy loss but are not screened for insulin resistance, leading to missed opportunities for early intervention.

How are miscarriages and insulin resistance linked?

Miscarriage and insulin resistance link: Insulin resistance occurs when the body’s cells do not respond properly to insulin, leading to higher blood sugar and insulin levels. This imbalance can impact ovulation and egg quality and interfere with the implantation of the embryo. In early pregnancy, it may affect placental development, increasing the risk of miscarriage in the first trimester. In women with PCOS, insulin resistance is commonly present, even in those who are not overweight.

The impact of insulin resistance on reproductive health

High insulin levels can lead to increased androgen (male hormone) production, further affecting reproductive health. This hormonal imbalance can make it difficult for a pregnancy to be sustained, especially in the early weeks, which may result in miscarriage. Lab tests such as HbA1c (which reflects average blood sugar levels over time) and fasting insulin levels can help identify at-risk women. Even subtle elevations in these markers, including those within the upper-normal range, can indicate underlying metabolic dysfunction that may increase the chances of miscarriage.

What to do?

Pregnant women should opt for regular screening, manage blood sugar levels, eat a balanced diet, and exercise daily before planning pregnancy. Even during pregnancy, they should stay in touch with an expert who can guide them throughout the process.

The relationship between chronic stress and liver health is a complex physiological loop driven largely by cortisol, the body’s primary stress hormone. While the liver is often viewed as a detox organ, it is highly responsive to hormonal signals, especially during prolonged stress. But at a time when competition is at its all-time peak in every aspect of life, be it work or school, it is a no-brainer that stress levels are peaking across age groups. That being said, Dr. Tushar Madake, Consultant, Department of Transplant Hepatology at Ruby Hall Clinic, Pune, spoke about the impact of high cortisol on the liver.

What is cortisol?

When stress becomes chronic, the adrenal glands continuously release cortisol. The liver, rich in glucocorticoid receptors, responds by shifting into a survival mode. In short-term situations, this helps by releasing glucose into the bloodstream for quick energy. However, when stress persists without physical activity, this constant signal disrupts normal metabolism.

The impact of high cortisol levels

One major effect is increased glucose production, where the liver generates sugar from non-carbohydrate sources. Over time, this leads to consistently high blood sugar and forces the pancreas to produce more insulin, eventually contributing to insulin resistance. At the same time, cortisol promotes the release of fatty acids into the bloodstream. The liver absorbs these fats but struggles to process and export them efficiently, leading to elevated triglycerides and unhealthy cholesterol levels.

How does stress affect the liver?

Stress also drives fat storage in the abdominal region and within the liver itself. This can result in fatty liver disease, even in individuals without poor dietary habits. As fat accumulates, inflammation follows. Liver immune cells release inflammatory substances, creating oxidative stress that damages liver cells. Additionally, when the liver is overloaded with managing excess glucose and fat, its ability to detoxify the body declines. Hormone balance, toxin clearance, and medication metabolism are all affected.

Stress can also impair bile flow, which is essential for fat digestion and toxin removal. Reduced bile movement further worsens internal imbalance. Ultimately, chronic stress keeps the liver in a constant state of overdrive, leading to long-term metabolic strain, inflammation, and gradual liver dysfunction.

Fatty liver disease, as a term, has been used for several years to describe a state of excess fat accumulation in the liver. However, the perception is changing—once known as non-alcoholic fatty liver disease (NAFLD), the condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The new term, according to leading diabetologist Dr V Mohan, offers more clarity because fatty liver is often associated with alcohol intake. However, even people who do not drink alcohol can develop this condition, and it has a metabolic angle to it. Despite the new name, the concern around fatty liver disease remains the same—can it be reversed?

Can MASLD be reversed?

In an interview with Health and Me, Dr Tushar Madake, consultant in the Department of Transplant Hepatology at Ruby Hall Clinic in Pune, spoke about the new name for fatty liver disease and why the metabolic angle is important.

Fatty liver disease may have a new name, but the concern around it has not changed. The current medical nomenclature identifies this as steatotic liver disease (SLD), with the previously identified NAFLD referred to as metabolic dysfunction–associated steatotic liver disease (MASLD). This classification places emphasis on the true source of the disease—metabolic health—and not necessarily alcohol intake.

Symptoms and diagnosis of MASLD

One of the reasons why fatty liver disease is challenging to diagnose is the fact that it does not exhibit noticeable symptoms in its early stages. The organ functions without issues, and individuals might not suspect a problem. Unlike common assumptions, this condition affects people who are not necessarily overweight or who consume alcohol.

Some of the early symptoms include constant fatigue, an increase in abdominal fat storage, and a feeling of heaviness in the upper right quadrant of the abdomen. Changes in the skin, such as discolouration around the neck and armpits and skin tag development, can also be among the symptoms of the condition. Individually, these signs do not necessarily indicate any cause for concern. However, when present together with metabolic issues such as type 2 diabetes, obesity, high levels of cholesterol, and high blood pressure, they might signify liver impairment in the early stages.

Therefore, early diagnosis and monitoring are crucial. If you have these risk factors or experience these symptoms, it is recommended that you undergo tests for liver dysfunction and ultrasonography. In some cases, you may also need to undergo a scan, for instance, a FibroScan, for early detection of liver fibrosis.

Reversing MASLD is possible

Dr V Mohan, one of India’s leading diabetologists, said, “The encouraging news is that early-stage fatty liver is not a permanent condition. With consistent lifestyle changes, reversal is possible. Weight loss, regular physical activity, reduced intake of refined carbohydrates and fats, and higher protein consumption can all contribute to improved liver health.”