President Donald Trump was examined for swelling in his legs and has been diagnosed with chronic venous insufficiency, the White House announced Thursday.

Trump, 79, underwent a “comprehensive examination, including diagnostic vascular studies” with the White House Medical Unit, press secretary Karoline Leavitt said, reading a note from the president’s physician, Capt. Sean Barbabella.

Barbabella’s letter, which was later released by the White House, states that “bilateral lower extremity venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70.”

The examination came after Trump had “noted mild swelling in his lower legs” over recent weeks, Leavitt said.

“Importantly, there was no evidence of deep vein thrombosis (DVT) or arterial disease” and Trump’s lab testing was all “within normal limits,” according to the letter. Trump also underwent an echocardiogram. “No signs of heart failure, renal impairment, or systemic illness were identified,” Barbabella wrote.

Chronic venous insufficiency is a condition in which valves inside certain veins don’t work the way they should, which can allow blood to pool or collect in the veins. About 150,000 people are diagnosed with it each year, and the risk goes up with age. Symptoms can include swelling in the lower legs or ankles, aching or cramping in the legs, varicose veins, pain or skin changes. Treatment may involve medication or, in later stages, medical procedures.

“It’s basically not alarming information, and it’s not surprising,” Dr. Jeremy Faust, an assistant professor of emergency medicine at Harvard Medical School, told CNN.

“This is a pretty normal part of aging, and especially for someone in the overweight to obese category, which is where the president has always been. But the bigger concern … is that symptoms like this do need to be evaluated for more serious conditions, and that is what happened.”

Chronic venous insufficiency can be related to conditions like increased pressure from the heart or sleep apnea, cardiologist Dr. Bernard Ashby told CNN.

“Even though he’s diagnosed with a benign condition, venous insufficiency, by itself doesn’t necessarily mean it’s benign. The question is, what’s causing the venous insufficiency? And so I would want to know whether or not he has any evidence of, again, increased pressures in the heart or increased pressures in the lungs, which can be contributing to that, and if so, what is the primary cause of that?”

Trump’s doctors were “covering all their bases” by screening him for heart failure, increased pressure and other conditions, he said.

Age, obesity and inactivity can all lead to the condition. “If a person is older, a person is overweight, a person is not engaging in regular physical activity or exercise, if a person is sitting or standing for prolonged amounts of time, you can get chronic venous insufficiency,” Dr. Chris Pernell told CNN.

“And while it is not life-threatening, it can be debilitating,” she added.

Leavitt later added that the president was experiencing “no discomfort.”

The press secretary also addressed bruising that has appeared on the back of the president’s hand, which she attributed to his “frequent handshaking,” plus his use of aspirin.

“This is consistent with minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen,” Barbabella’s letter says.

The letter concludes that “President Trump remains in excellent health.”

Trump will become the nation’s oldest president during his second term.

SOURCE : CNN

The post Trump diagnosed with chronic venous insufficiency following leg swelling appeared first on Barbados Today.

The Host

Julie Rovner
KFF Health News

@jrovner

@julierovner.bsky.social

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

The Senate has passed — and sent back to the House — a bill that would allow the Trump administration to claw back some $9 billion in previously approved funding for foreign aid and public broadcasting. But first, senators removed from the bill a request to cut funding for the President’s Emergency Plan for AIDS Relief, President George W. Bush’s international AIDS/HIV program. The House has until Friday to approve the bill, or else the funding remains in place.

Meanwhile, a federal appeals court has ruled that West Virginia can ban the abortion pill mifepristone despite its approval by the Food and Drug Administration. If the ruling is upheld by the Supreme Court, it could allow states to limit access to other FDA-approved drugs.

This week’s panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Shefali Luthra of The 19th, and Sandhya Raman of CQ Roll Call.

Panelists

Joanne Kenen
Johns Hopkins University and Politico

@JoanneKenen

@joannekenen.bsky.social

Read Joanne's bio.

Shefali Luthra
The 19th

@shefali.bsky.social

Read Shefali's stories.

Sandhya Raman
CQ Roll Call

@SandhyaWrites

@SandhyaWrites.bsky.social

Read Sandhya's stories.

Among the takeaways from this week’s episode:

• The Senate approved the Trump administration’s cuts to foreign aid and public broadcasting, a remarkable yielding of congressional spending power to the president. Before the vote, Senate GOP leaders removed President Donald Trump’s request to cut PEPFAR, sparing the funding for that global health effort, which has support from both parties.
• Next Congress will need to pass annual appropriations bills to keep the government funded, but that is expected to be a bigger challenge than the recent spending fights. Appropriations bills need 60 votes to pass in the Senate, meaning Republican leaders will have to make bipartisan compromises. House leaders are already delaying health spending bills until the fall, saying they need more time to work out deals — and those bills tend to attract culture-war issues that make it difficult to negotiate across the aisle.
• The Trump administration is planning to destroy — rather than distribute — food, medical supplies, contraceptives, and other items intended for foreign aid. The plan follows the removal of workers and dismantling of aid infrastructure around the world, but the waste of needed goods the U.S. government has already purchased is expected to further erode global trust.
• And soon after the passage of Trump’s tax and spending law, at least one Republican is proposing to reverse the cuts the party approved to health programs — specifically Medicaid. It’s hardly the first time lawmakers have tried to change course on their own policies, though time will tell whether it’s enough to mitigate any political (or actual) damage from the law.

Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: The New York Times’ “UnitedHealth’s Campaign to Quiet Critics,” by David Enrich.

Joanne Kenen: The New Yorker’s “Can A.I. Find Cures for Untreatable Diseases — Using Drugs We Already Have?” by Dhruv Khullar.

Shefali Luthra: The New York Times’ “Trump Official Accused PEPFAR of Funding Abortions in Russia. It Wasn’t True,” by Apoorva Mandavilli.

Sandhya Raman: The Nation’s “‘We’re Creating Miscarriages With Medicine’: Abortion Lessons from Sweden,” by Cecilia Nowell.

Also mentioned in this week’s podcast:

• The Atlantic’s “The Trump Administration Is About To Incinerate 500 Tons of Emergency Food,” by Hana Kiros.
• KFF Health News’ “Vested Interests. Influence Muscle. At RFK Jr.’s HHS, It’s Not Pharma. It’s Wellness,” by Stephanie Armour.
• The Washington Post’s “A Clinic Blames Its Closing on Trump’s Medicaid Cuts. Patients Don’t Buy It,” by Hannah Knowles.

Click to open the transcript

Transcript: The Senate Saves PEPFAR Funding — For Now

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Julie Rovner: Hello and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, July 17, at 10 a.m. As always, news happens fast and things might have changed by the time you hear this. So, here we go. 

Today we are joined via videoconference by Sandhya Raman of CQ Roll Call. 

Sandhya Raman: Hello, everyone. 

Rovner: Shefali Luthra of The 19th. 

Shefali Luthra: Hello. 

Rovner: And Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine. 

Joanne Kenen: Hi, everybody. 

Rovner: No interview this week, but more than enough news. So we will get right to it. 

We’re going to start on Capitol Hill, where in the very wee hours of Thursday morning, the Senate approved the $9 billion package of rescissions of money already appropriated. It was largely for foreign aid and the Corporation for Public Broadcasting, which oversees NPR and PBS. Now, this bill represents pennies compared to the entire federal budget and even to the total of dollars that are appropriated every year, but it’s still a big deal because it’s basically Congress ceding more of its spending power back to the president. And even this small package was controversial. Before even bringing it to the floor, senators took out the rescission of funds for PEPFAR [the President’s Emergency Plan for AIDS Relief], the bipartisanly popular international AIDS/HIV program begun under President George W. Bush. So now it has to go back to the House, and the clock on this whole process runs out on Friday. Sandhya, what’s likely to happen next? 

Raman: I think that the House has been more amenable. They got this through quicker, but if you look— 

Rovner: By one vote. 

Raman: Yeah. But I think if you look at what else has been happening in the House this week that isn’t in the health sphere, they’ve been having issues getting other things done, because of some pushback from the Freedom Caucus, who’s been kind of stalling the votes and having them to go back. And other things that should have been smoother are taking a lot longer and having a lot more issues. So it’s more difficult to say without seeing how all of that plays out, if those folks are going to make a stink again about something here because some of this money was taken out. It’s a work in progress this week in the House. 

Rovner: Yeah, that’s a very kind way to put it. The House has basically been stalled for the last 24 hours over, as you say, many things, completely unrelated, but there is actually a clock ticking on this. They had 45 days from when the administration sent up this rescission request, and we’re now on Day 43 because Congress is the world’s largest group of high school students that never do anything until the last minute. So Democrats warned that this bill represents yet another dangerous precedent. They reached a bipartisan agreement on this year of spending bills in the spring, and this basically rolls at least some of that back using a straight party-line vote. What does this bode for the rest of Congress’ appropriations work for the fiscal year that starts in just a couple of months? 

Raman: I think that the sense has been that once this goes through, I think a lot of people have just been assuming that it’ll take time but that things will get passed on rescissions. It really puts a damper on the bipartisan appropriations process, and it’s going to make it a lot harder to get people to come to the table. So earlier this week we had the chair of the Appropriations Committee and the chair of the Labor, HHS [Health and Human Services], Education subcommittee in the House say that the health appropriations they were going to do next week for the House are going to get pushed back until September because they’re not ready. And I think that health is also one of the hardest ones to get through. There’s a lot more controversial stuff. It’s setting us up to go, kind of like usual at this point, for another CR [continuing resolution], because it’s going to be a really short timeline before the end of the fiscal year. But if you look at some— 

Rovner: Every year they say they’re going to do the spending bills separately, and every year they don’t. 

Raman: Yeah, and I think if you look at how they’ve been approaching some of the things that have been generally a little bit less controversial and how much pushback and how much more difficulties they’ve been having with that, even this week, I think that it’s going to be much more difficult to get that done. And the rescissions, pulling back on Congress’ power of the purse, is not going to make that any easier. 

Rovner: I think what people don’t appreciate, and I don’t think I appreciated it either until this came up, is that the rescissions process is part of the budget act, which is one of these things that Congress can do on an expedited basis in the Senate with just a straight majority. But the regular appropriations bills, unlike the budget reconciliation bill that we just did, need 60 votes. They can be filibustered. So the only way to get appropriations done is on a bipartisan basis, and yet they’re using this rather partisan process to take back some of the deal that they made. The Democrats keep saying it, and everybody’s like, Oh, process, process. But that actually could be a gigantic roadblock, to stopping everything in its tracks, right? 

Raman: I really think so. And if you look at who are the two Republicans in the Senate that voted against the rescissions, one of them is the Senate Appropriations chair, Susan Collins. And throughout this, one of her main concerns was when we still had the PEPFAR in there. But it just takes back her power as the highest-ranking appropriator in the Senate to do it through this process, especially when she wasn’t in favor of the rescissions package. 

So it’s going to make things, I think, a lot more complicated, and one of her concerns throughout has just been that there wasn’t enough information. She was pulling out examples of rescissions in the past and how it was kind of a different process. They were really briefed on why this was necessary. And it was just different now. So I think what happens with appropriations and how long it’ll take this year is going to be interesting to watch. 

Rovner: And it’s worth remembering that it’s when the appropriations don’t happen that the government shuts down. So, but that doesn’t happen until October. Well, separately we learned that — oh, go ahead, Joanne. 

Kenen: There’s also sort of a whole new wrinkle, is that rescissions is, if you’re a Republican and you don’t like something and you end up, to avoid a government shutdown or whatever reason, you end up having to vote for a bill, you just have the president put out a statement saying, If this goes through, I’m going to cut it afterwards. And then the Republican who doesn’t like it can give a floor speech saying, I’m voting for it because I like this in it and I know that the president’s going to take care of that. It really — appropriations is always messy, but there’s this whole unknown. The constitutional balance of who does what in the American government is shifting. And at the end of the day, the only thing we do know after both the first term and what’s happened so far even more so in the second term, is what [President Donald] Trump wants, Trump tends to get. 

So, Labor-H [the appropriations for Labor, HHS, Education and related agencies], like Sandhya just pointed out, the health bill is one of the hardest because there’s so much culture-war stuff in it. But, although, the Supreme Court has put some of that off the table. But I just don’t know how things play out in the current dynamic, which is unprecedented. 

Rovner: And of course, Labor-HHS also has the Department of Education in it. 

Kenen: The former Department of Education. 

Rovner: To say, which is in the process of being dismantled. So that’s going to make that even more controversial this year. Moving back to the present, separately we learned this week that the administration plans to spend hundreds of thousands of dollars of taxpayer money to destroy stocks of food and contraceptives and other medical devices rather than distribute them through some of the international aid programs that they’re canceling. Now, in the case of an estimated 500 tons of high-energy biscuits bought by USAID [the U.S. Agency for International Development] at the end of the Biden administration, you can almost understand it because they’re literally about to expire next week. According to The Atlantic, which first reported this story, this is only a small part of 60,000 metric tons of food already purchased from U.S. farmers and sitting in warehouses around the world, where the personnel who’d be in charge of distributing them would’ve been fired or transferred or called back to the U.S. 

At the same time, there are apparently also plans to destroy an estimated $12 million worth of HIV prevention supplies and contraceptives originally purchased as part of foreign aid programs rather than turn them over or even sell them to other countries or nonprofits. This feels like maybe the not most efficient use of taxpayer dollars? 

Luthra: I think this is something we’ve talked about before, but it really bears repeating. As a media ecosphere, we’ve sort of moved on from the really rapid dismantling of USAID. And it was not only without precedent. It was incredibly wasteful with the sudden way it was done, all of these things that were already purchased no longer able to be used, leases literally broken. And people had to pay more to break leases for offices set up in other countries, all these sorts of things that really could have already been used because they had been paid for. And instead, the money is simply lost. 

And I think the important thing for us to remember here is not only the immense waste financially to taxpayers but the real trust that has been lost, because these were promises made, things purchased, programs initiated, and when other countries see us pulling back in such a, again, I keep saying wasteful, but truly wasteful manner, it’s just really hard to ever imagine that the U.S. will be a reliable partner moving forward. 

Rovner: Yeah, absolutely. I understand the food thing to some extent because the food’s going to expire, but the medical supplies that could be distributed by somebody else? I’m still sort of searching for why that would make any sense in any universe, but yeah I guess this is the continuation of, We’re going to get rid of this aid and pretend that it never happened. 

Well, meanwhile, it’s only been a couple of weeks, but we’re starting to see the politics of that big Trump tax and spending measure play out. One big question is: Why didn’t Republicans listen to the usually very powerful hospital industry that usually gets its way but did not this time? And relatedly, will those Republicans who voted with Trump but against those powerful hospital interests do an about-face between now and when these Medicaid cuts are supposed to take effect? We’ve already seen Sen. Josh Hawley, the Republican from Missouri who loudly proclaimed his opposition to those Medicaid cuts before he voted for them anyway, introduce legislation to rescind them. So is this the new normal? I think, Joanne, you were sort of alluding to this, that you can now sort of vote for something and then immediately say: Didn’t mean to vote for that. Let’s undo it. 

Kenen: You could even do it before you vote for it, if they play it right. If Congress passes these things, we’re not going to pay attention. We’re already in that moment. But also, when I was working on a Medicaid piece, the magazine piece like four or five months ago, one of the most cynical people I know in Washington told me, he said, Oh, they’ll pass these huge cuts because they need the budget score to get the taxes through, and then they’ll start repealing it. And it seemed so cynical at the time, only he might’ve been right. 

So I don’t think they’re going to cut all of it. Republicans ideologically want a smaller Medicaid program. They want less spending. They want work requirements. You’re not going to see the whole thing go away. Could you see some retroactive tinkering or postponement or something? Yeah, you could. It’s too soon to know. Hospitals are the biggest employer in many, many congressional districts. This is a power— 

Rovner: Most of them. 

Kenen: Most, yeah. I don’t think it’s quite all, but like a lot. It’s the biggest single employer, and Medicaid is a big part of their income. And they still by law have to stabilize people who come in sick, and there’s emergency care and all sorts of other things, right? They do charity care. They do uninsured people. They do all sorts. They still treat people under certain circumstances even when they can’t pay. But right now, the threat of a primary opponent is more powerful than the threat of your local hospital being mad at you and harming health care access in your community. So much in the Republican world revolves around not getting the president mad enough that he threatens to get you beaten in a primary. We’ve seen that time and again already. 

Rovner: Right. And I will also say there’s precedent for this, for passing something and then unpassing it. Joanne and I covered in 19— 

Kenen: But it wasn’t the plan. 

Rovner: Yeah, I know. But remember, back in 1997 when they passed the Balanced Budget Act, every year for the next — was it three or four years? They did what we came to call “give back” bills. 

Kenen: Or punting, right? 

Rovner: Yeah, where they basically undid, they unspooled, some of those cuts, mostly because they’d cut more deeply than they’d intended to. And then we know with the Affordable Care Act, I’ve said this several times, they passed all of these financing mechanisms for it and then one by one repealed them. 

Kenen: And the individual mandate — I mean everything- 

Rovner: And the individual mandate, right. 

Kenen: They kept the dessert and they gave away everything. They undid everything that paid for the dessert, basically. 

Rovner: Right. Right. 

Kenen: And so it was the Cadillac — because people don’t remember anymore — the Cadillac tax, the insurance tax, the device tax. They all were like, One at a time! And they were repealed because lobbying works. 

Rovner: The tanning tax just went. 

Kenen: Right, right. So that dynamic existed, passing something unpopular and then redoing it, but the dynamic now really just comes — basically this is Donald Trump’s town. He has had a remarkable success in not only getting Congress to do what he wants but getting Congress to surrender some of its own powers, which have been around since Congress began. This is the way our government was set up. So there’s a very, very different dynamic, and it’s still unpredictable. None of us thought that the biggest crisis would be the [Jeffrey] Epstein case, right? Which is not a health story, and we don’t have to spend any time on it except to acknowledge— 

Rovner: Please. 

Kenen: —that there’s stuff going on in the background that people who had been extremely loyal to the president are now mad. And we don’t know how long. He’s very good at neutralizing things, too. He’s blaming it on the Democrats. 

But there is a different dynamic. Congress has less power because Congress gave up some of its power. Are they going to want to reassert themselves? There is no sign of it right now, but who knows what happens. I thought they would cut Medicaid. I thought they would do work requirements. I thought they would let the enhanced ACA subsidies expire. But I did not think the cuts would go this deep and this extensive — really transformationally pretty historic cuts. 

Rovner: Shefali, you wanted to say something? 

Kenen: Not pretty historic cuts, very historic cuts. Unprecedented. 

Luthra: I was thinking Joanne made such a good point about how, for all of the talk now about trying to mitigate that backlash, a lot of this is in line ideologically with what Republicans want. They do want a smaller Medicaid program. And I think a really interesting and still open question is whether they are willing and able to actually create policy that does reverse some of these cuts or not, and even if they do, if it’s sufficient to change voters’ perception, because we know that these cuts are very unpopular. Democrats are talking about them a lot. Hospitals are talking about them a lot. And just the failed attempt to repeal the ACA led to the 2018 midterms. And I think there is a real chance that this is the dominant topic when we head into next year’s elections. And it’s hard to say if Josh Hawley putting out a bill can undo that damage, so—. 

Rovner: Well, I’m so glad you mentioned that, because The Washington Post has a really interesting story about a clinic closing in rural Nebraska, with its owners publicly blaming the impending Medicaid cuts. Yet its Trump-supporting patients are just not buying it. Now in 2010, Republicans managed to hang the Affordable Care Act around Democrats’ necks well before the vast majority of the changes took place. Are Democrats going to be able to do that now? There’s a lot of people saying, Oh, well, they’re not going to be able to blame this on the Republicans, because most of it won’t have happened yet. This is really going to be a who-manages-to-push-their-narrative, right? 

Kenen: This really striking thing about that story is that the people who were losing access, they’re not losing their Medicaid yet, but they’re losing access to the only clinic within several — they have to drive hours now to get medical care. And when they were told this was because the Republican Congress and President Trump, they said, Oh no, it can’t be. First of all, a lot of people just don’t pay attention to the news. We know that. And then if you’re paying attention to news that never says anything negative about the president, that blames everything on Joe Biden no matter — if it rains yesterday, it was his fault, right? 

So the sort of gap between — there are certain things that are matters of opinion and interpretation, and there are certain things that are matters of fact, but those facts are not getting through. And we do not know whether the Democrats will be able to get them through, because the resistance, it’s almost magical, right? My clinic closed because of a Republican Medicaid bill? Oh no, it’s hospital greed. They just don’t want to treat us anymore. They just, it doesn’t compute, because it doesn’t fit into what they have been reading and hearing, to the extent that they read and hear. 

Rovner: Sandhya, you want to add something? 

Raman: The one thing that as I’ve been asking around on Capitol Hill about the Hawley bill — and there was one from Sen. Rand Paul, and a House counterpart, from [Rep.] Greg Steube, does sort of the opposite — it wants to move up the timeline for one of the provisions. So one important thing to consider is neither of these bills have had a lot of buy-in from other members of Congress. They’ve been introduced, but the people that I’ve talked to have said, I’m not sure. 

And I think something interesting that Sen. Thom Tillis had said was: If Republicans had a problem with what some of the impacts would be, then why were they denying that there would be an effect on rural health or some of those things to begin with? And I think a lot of it will take some time to judge to see if people will move the needle, but if we’re going to change any of these deadlines through not reconciliation, you need 60 votes in the Senate and you’ll need Democrats on board as well as Republicans. And I think one interesting thing to watch there is that I think some of the Democrats are also looking at this in a political way. If there’s a Republican that has a bill that is trying to tamp down some of the effects of their signature reconciliation law, do they want to help them and sign on to that bill or kind of illustrate the effects of the bill before the midterms or whatever? 

Rovner: A lot more politics to come. 

Raman: Yeah. Yeah. 

Rovner: Meanwhile, over at HHS [the Department of Health and Human Services], there is also plenty of news. Many of the workers who’ve been basically in limbo since April when a judge temporarily halted the Trump administration’s efforts to downsize have now been formally let go after the Supreme Court last week lifted that injunction. What are we hearing about how things are going over at HHS? We’ve talked sort of every week about this sort of continuing chaos. I assume that the hammer falling is not helping. It’s not adding to things settling down. 

Kenen: No. And then Secretary [Robert F.] Kennedy [Jr.] just fired two top aides because — no one knows exactly the full story but it’s — and I certainly do not know the full story. But what I have read is that the personality conflict with his top aide — and that happens in offices, and he’s not the first person in the history of HHS to have people who don’t get along with one another. But it’s just more unsettled stuff in an agency already in flux, because now in addition to all these people being let go in all sorts of programs and programs being rolled back, you also have some leadership chaos at the top. 

Rovner: Well, meanwhile, HHS Secretary Kennedy took office with vows to eliminate the financial influence of Big Pharma, Big Food, and other industries with potential conflicts of interests. But shoutout here to my KFF Health News colleague Stephanie Armour, who has a story this week about how the new vested interests at HHS are the wellness industry. Kennedy and four top advisers, three of whom have been hired into the department, wrote Stephanie, quote, “earned at least $3.2 million in fees and salaries from their work opposing Big Pharma and promoting wellness in 2022 and 2023, according to a KFF Health News review of financial disclosure forms filed with the U.S. Office of Government Ethics and the Department of Health and Human Services; published media reports; and tax forms filed with the IRS. That total doesn’t include revenue from speaking fees, the sale of wellness products, or other income sources for which data is not publicly available.” Have we basically just traded one form of regulatory capture for another form of regulatory capture? 

Kenen: And one isn’t covered by insurance. Some of it is, but there’s a lot of stuff in the, quote, “wellness” industry that providers and so forth, certain services are covered if there’s licensed people and an evidence base for them, but a lot of it isn’t. And these providers charge a lot of money out-of-pocket, too. 

Rovner: And they make a lot of money. This is a totally — unlike Big Pharma, Big Food, and Big Medicine, which is regulated, Big Wellness is largely not regulated. 

Kenen: I think Stephanie — that was a really good piece — and I think Stephanie said it was, what, $6.3 trillion industry? Was that— 

Rovner: Yeah, it’s huge. 

Kenen: Am I remembering that number right? It’s largely unregulated. Many of the products have never gone through any review for safety or efficacy. And insurance doesn’t cover a lot of it. It doesn’t mean it’s all bad. There are certain things that are helpful, but as an industry overall, it leaves something for us to worry about. 

Rovner: Well, in HHS-adjacent breaking news that could turn out to be nothing or something really big, an appeals court in Richmond on Tuesday ruled 2-1 that West Virginia may in fact limit access to the abortion pill, even though it’s approved by the FDA [Food and Drug Administration]. It’s the first time a federal appeals court has basically said that states can effectively override the FDA’s nationwide drug approval authority. And it’s the question that the Supreme Court has already ducked once, in that case out of Texas last year where the justices ruled that the doctors who were suing didn’t have standing, so they didn’t have to get to that question. But, Shefali, this has implications well beyond abortion, right? 

Luthra: Oh, absolutely. We are seeing efforts across the country to restrict access to certain medications that are FDA-approved. Abortion pills are the obvious one, but, of course, we can think about gender-affirming care. We can think about access to all sorts of other therapeutics and even vaccines that are now sort of coming under political fire. And if FDA approval means less than state restrictions, as we are seeing in this case, as we very possibly could see as these kinds of arguments and challenges make their way to the Supreme Court. The case you alluded to earlier with the doctors who didn’t have standing is still alive, just with different plaintiffs now. And so these questions will probably come back. There are just such vast ramifications for any kind of medication that could be politicized, and it’s something that industry at large has been very worried about since this abortion pill became such a big question. And it is something that this decision is not going to alleviate. 

Rovner: Yes. Speaking of Big Pharma, they’re completely freaked out by this possibility because it does have implications for every FDA-approved drug. 

Luthra: And they invest so much money in trying to get products that have FDA approval. There’s a real promise that with this global gold standard, you will be able to keep a drug on the market and really make a lot of money on it. There’s also obviously concerns for birth control, which we aren’t seeing legally restricted in the same way as abortion yet, but it is something that is so deeply subject to politics and culture-war issues that that’s something that we could see coming down the line if trends continue the way they are. 

Rovner: Well, we will watch that space. Moving on. Wednesday was the third anniversary of the federal 988 federal crisis line, which has so far served an estimated 16 million people with mental health crises via call, text, or chat. An estimated 10% of those calls were routed through a special service for LGBTQ+ youth, which is being cut off today by the Trump administration, which accused the program, run by the Trevor Project, as, quote, “radical gender ideology.” Now, LGBTQ+ youth are among those at the highest risk for suicide, which is exactly what the 988 program was created to prevent. Yet there’s been very little coverage of this. I had to actually go searching to find out exactly what happened here. Is this just kind of another day in the Trump administration? 

Raman: I think a lot of it stems back to some of those initial executive orders related to gender ideology and DEI [diversity, equity, and inclusion] and things like that. The Trump administration’s kind of argument is that it shouldn’t be siloed. It should be all general. There shouldn’t be sort of special treatment, even though we do have specialized services for veterans who call in to these services and things. But I— 

Rovner: Although that was only saved when members of Congress complained. 

Raman: Yeah. But I do think that when we have so much happening in this space focused on LGBTQ issues, it’s easier for things to get missed. I think the one thing that I did notice was that California announced yesterday that they were going to step up to do a partnership with the Trevor Project to at least — the LGBTQ youth calling from California to any of those local 988 centers would be reaching people that have been trained a little bit more in cultural competency and dealing with LGBTQ youth. But that’s not going to be all the states and it’s going to take time. Yeah. 

Rovner: Yeah, we’re going to continue to see this cobbled together state by state. It feels like increasingly what services are available to you are going to be very much dependent on where you live. That’s always been true, but it feels like it’s getting more and more and more true. Shefali, I see you nodding. 

Luthra: Something you alluded to that I think bears making explicit is public health interventions are typically targeted toward people who are in greater danger or are at greater risk. That’s not discrimination — that’s public health efficiency. And suggesting that we shouldn’t have resources targeted toward people at higher risk of suicide is counter to what public health experts have been arguing for a very long time. And that’s just something that I think really bears noting and keeping in mind as we see what the impact of this is moving forward. 

Rovner: Yeah, I think that’s a very good point. Thank you. 

Well, speaking of popular things that are going away, a federal judge appointed by President Trump last week struck down the last-minute Biden administration rule from the Consumer Financial Protection Bureau that tried to bar medical debt from appearing on credit reports. This had been hailed as a major step for the 100 million Americans with medical debt, which is not exactly the same as buying a car or a TV that you really can’t afford. People don’t go into medical debt saying, Oh, I think I’m going to go run up a big medical bill that I can’t pay. But this strikes me as yet another way this administration is basically inflicting punishment on its own voters. Yes? 

Kenen: Yes, except we just don’t know. Some red states are so red that you don’t need every voter. We don’t know who actually votes, and we don’t know whether people make these connections, right? What we were talking about before with Medicaid — do they understand that this is something that President Trump not just urged but basically ordered Congress to do? So do people pay attention? How many people even know if their medical debt is or is not on their credit report? They know they have the medical debt, but I’m not sure everybody understands all the implication, particularly if you’re used to being in debt. You may be somebody who’s lost a job or couldn’t pay your mortgage or couldn’t pay your rent. Some of the people who have medical debt have so many other financial — not all — that it’s just part of a debt soup and it’s just one more ingredient. 

So how it plays out and how it’s perceived? It’s part of this unpredictable mix. Trump is openly talking about gerrymandering more, and so it won’t matter what voters do, because they’ll have more Republican seats. That’s just something he’s floating. We don’t know whether it’ll actually happen, but he floated it in public, so— 

Rovner: So much of this is flooding the zone, that people — there’s so much happening that people have no idea who’s responsible for what. There’s always the pollster question: Is your life better or worse than it was last year? Or four years ago, whatever. And I think that when you do so much so fast, it’s pretty hard to affix blame to anybody. 

Raman: And most people aren’t single-issue voters. They’re not going to the polls saying, My medical debt is back on my credit report. There’s so many other things, even if with the last election, health care was not the number one issue for most voters. So it’s difficult to say if it will be the top issue for the next election or the next one after that. 

And I guess just piggybacking that a lot of the times when there’s these big changes, they don’t take effect for a while. So it’s easier to rationalize, Oh, it may have been this person or that person or the senator then, or who was president at a different time, just because of how long it takes to see the effects in your daily life. 

Rovner: Politics is messy. All right, well, this is as much time for the news as we have this week? Now it’s time for our extra-credit segment. That’s where we each recognize a story we read this week we think you should read, too. Don’t worry if you miss it. We’ll put the links in our show notes on your phone or other mobile device. Shefali, why don’t you go first this week? 

Luthra: Sure. My piece is from The New York Times, by Apoorva Mandavilli. The headline is “Trump Official Accused PEPFAR of Funding Abortions in Russia. It Wasn’t True.” And she takes a look at when the head of the OMB [Office of Management and Budget] told the Senate that PEPFAR had spent almost $10 million advising Russian doctors on abortions and gender analysis. And she goes through and says this isn’t true. PEPFAR hasn’t been in Russia. They cannot fund abortions. And she talks with people who were there and can say this simply isn’t true and this is very easy to disprove. And I like this piece because it’s just a reminder that a lot of things are being said about government spending that are not true. And it is a public service to remind readers that they are very easily disproven. 

Rovner: Yeah, and to go ahead and do that. Sandhya. 

Raman: My extra credit is “‘We’re Creating Miscarriages With Medicine’: Abortion Lessons From Sweden,” and it’s from Cecilia Nowell for The Nation, my co-fellow through AHCJ [the Association of Health Care Journalists] this year. Cecilia went to Kiruna, which is an Arctic village in Sweden, to look at how they’re using mifepristone for abortions up to 22 weeks in pregnancy, compared to up to 10 weeks in the U.S. And it’s a really interesting look at how they’re navigating rural access to abortion in very remote areas. Almost all abortions in Sweden are done through medication abortion, and while the majority here are in the 60% versus high 90s. So just interesting how they’re taking their approach there as rural access is limited here. 

Rovner: Really interesting story. Joanne. 

Kenen: This is a piece in The New Yorker by Dhruv Khullar, and it’s “Can A.I. Find Cures for Untreatable Diseases — Using Drugs We Already Have?” And what I found interesting, we’ve been hearing about: Can AI do this? It’s sort of been in the air since AI came around. But what was so interesting about this article is there’s a nonprofit that is actually doing it, and they have this sort of whole sort of hierarchy of why a drug may be promising and why a disease may be a good target. And then the AI look at genetics and diseases, and they have four or five factors they look at. And then there’s this just sort of hierarchy of which are the ones we can make accessible. 

So A, it’s actually happening. B, it has promise. It’s not a panacea, but there’s promise. And C, it’s being done by a nonprofit. It’s not a cocktail for an individual patient. It’s trying to figure out: What are the smartest drugs to be looking at and what can they treat? And they give examples of people who have gone into remission from rare diseases. And also it says there are 18,000 diseases and only 9,000 have treatment. So this is huge, right? Rare diseases may only affect a few people, but there are lots of rare diseases. So cumulatively some of the people they strike are young. So for someone who doesn’t always read about AI, I found this one interesting. 

Rovner: Also, we read somebody’s story about how AI is terrible for this, that, and the other thing. It is very promising for an awful lot of things. 

Kenen: No. Right. 

Rovner: There’s a reason that everybody’s looking at it. 

All right, my extra credit this week is also from The New York Times. It’s called “UnitedHealth’s Campaign to Quiet Critics,” by David Enrich, who’s The Times’ deputy investigations editor and, notably, author of a book on attacks on press freedoms. That’s because the story chronicles how UnitedHealth, the mega health company we have talked about a lot on this show, is taking a cue from President Trump and increasingly taking its critics to court, in part by claiming that critical reporting about the company risks inciting further violence like the Midtown Manhattan murder of United executive Brian Thompson last year. 

I hasten to add, this isn’t a matter of publications making stuff up. United, as we have pointed out, is a subject of myriad civil and criminal investigations into potential Medicare fraud as well as antitrust violations. This is still another chapter unfolding in the big United story. 

OK, that is this week’s show. Thanks as always to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. If you enjoy the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us to review. That helps other people find us, too. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can find me on X, @jrovner, or on Bluesky, @julierovner. Where are you folks hanging these days? Shefali? 

Raman: I’m at Bluesky, @shefali. 

Rovner: Sandhya. 

Raman: I’m at X and at Bluesky, @SandhyaWrites. 

Rovner: Joanne? 

Kenen: I’m mostly at Bluesky, @joannekenen.bsky, and I’ve been posting things more on LinkedIn, and there are more health people hanging out there. 

Rovner: So we are hearing. We will be back in your feed next week. Until then, be healthy. 

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Santo Domingo.- Wellness tourism has become a key growth driver for the hotel industry, with the Global Wellness Institute projecting it will reach US$1.3 trillion by 2025—nearly double the growth of traditional tourism. In this context, the Dominican Republic is positioning itself as a regional leader in healthy and sustainable hospitality, supported by its natural assets, strong medical and tourism infrastructure, and public policies like Decree 787-21, which declares health tourism a national interest.

Hyatt Inclusive Collection is leading this shift with offerings centered on holistic well-being. Its resorts across the country provide yoga and meditation classes, healthy dining options, sound therapy, spa treatments, and fitness programs. Initiatives like the Peloton partnership and the Mind, Body + Sol retreat at Zoëtry Agua Punta Cana highlight a modern approach to travel that prioritizes balance, health, and connection with nature.

With three new resorts—Secrets Playa Esmeralda, Dreams Playa Esmeralda, and Hyatt Vivid Punta Cana—set to open, Hyatt aims to lead a new model of tourism that blends health, sustainability, and innovation. The company plans to explore partnerships with local health experts and providers to expand into more specialized wellness services, positioning the Dominican Republic as a top destination for wellness and health-focused hospitality.

Santo Domingo.- Health authorities in the Dominican Republic have issued a warning about potential adverse reactions linked to the use of Colgate Total 50g Active Prevention Clean Mint toothpaste, which contains stannous fluoride. The alert follows a safety notice from Brazil’s National Health Surveillance Agency after Colgate-Palmolive received six consumer complaints, primarily reported in Brazil.

According to the General Directorate of Medicines, Food, and Health Products (Digemaps), the Dominican Republic has also reported non-serious cases, despite the sale of more than 2.5 million units of the toothpaste locally. Reported symptoms include mouth ulcers, blisters, pain, burning, inflammation of the tonsils and lips, gum irritation, and numbness of the tongue and mouth.

While Digemaps acknowledged the complaints, it clarified that the events reported in the Dominican Republic differ in severity from those in Brazil. The agency also highlighted that stannous fluoride is an effective antimicrobial agent widely used in dental care for its ability to prevent cavities, reduce plaque, alleviate hypersensitivity, and improve gum health.

Health officials continue to monitor the situation and encourage consumers to report any unusual symptoms after using the product.

Pero no se trataba de una enfermedad misteriosa. Como enfermero anestesista, ya jubilado, Sergott sabía que tenía anemia, una deficiencia de glóbulos rojos. En su caso, era consecuencia de una afección hereditaria por la que tenía hemorragias nasales casi a diario y le bajaba la hemoglobina, la proteína de los glóbulos rojos que transporta oxígeno a todo el cuerpo.

Pero al consultar con los médicos sobre su cansancio, Sergott, quien vive en Westminster, Maryland, descubrió que muchos no sabían cómo ayudarlo. Le aconsejaban que tomara suplementos de hierro, que suele ser la primera línea de tratamiento para la anemia.

Sin embargo, como muchas personas mayores, le resultaba difícil tolerar de cuatro a seis pastillas al día.

Algunos pacientes que toman hierro se quejan de estreñimiento intenso o calambres estomacales. Sergott sentía náuseas todo el tiempo. Y las tabletas de hierro no siempre funcionan.

Después de casi 15 años, encontró una solución. Michael Auerbach, hematólogo y oncólogo, y codirector del Center for Cancer and Blood Disorders en Baltimore, sugirió que Sergott recibiera hierro por vía intravenosa y no por la boca.

Ahora, el hombre de 78 años recibe una infusión de una hora cuando sus niveles de hemoglobina y otros marcadores indican que la necesita, generalmente tres veces al año. “Es como llenar el tanque de gasolina”, dijo. Sus síntomas se revierten y “me siento maravillosamente bien”.

La historia de Sergott refleja una afección común que habitualmente se desestima y que no solo puede lesionar la calidad de vida de los adultos mayores, sino también tener graves consecuencias para la salud, como caídas, fracturas y hospitalizaciones.

Los síntomas de la anemia —cansancio, dolor de cabeza, calambres en las piernas, frío, disminución de la capacidad para hacer ejercicio, confusión mental— a menudo se atribuyen al envejecimiento mismo, afirmó William Ershler, hematólogo e investigador. Más aún porque algunas personas con anemia no presentan síntomas.

“La gente dice: ‘Me siento débil, pero todos los de mi edad se sienten débiles’”, explicó Ershler.

Los médicos a menudo no reconocen la anemia, aunque es probable que los niveles de hemoglobina se incluyen en las historias clínicas de sus pacientes: suele ser parte del hemograma completo que se solicita de manera rutinaria durante las consultas médicas.

“Los pacientes vienen a la clínica, se hacen análisis de sangre y no pasa nada”, dijo.

La anemia afecta al 12,5% de las personas mayores de 60 años, según los datos más recientes de la National Health and Nutrition Examination Survey, y la tasa aumenta a partir de esa edad.

Pero esta cifra podría ser una subestimación.

En un estudio publicado en el Journal of the American Geriatrics Society, Ershler y sus colegas examinaron las historias clínicas electrónicas de casi 2.000 pacientes ambulatorios mayores de 65 años de Inova, el gran sistema de salud con sede en el norte de Virginia, del que se jubiló recientemente.

Según los resultados de los análisis de sangre, la prevalencia de anemia fue mucho mayor: aproximadamente uno de cada 5 pacientes presentaba anemia, con niveles de hemoglobina por debajo de lo normal, según la definición de la Organización Mundial de la Salud (OMS).

Sin embargo, solo alrededor de un tercio de esos pacientes tenían la anemia debidamente documentada en sus historias médicas.

La anemia “merece nuestra atención, pero no siempre la recibe”, afirmó George Kuchel, geriatra de la Universidad de Connecticut, quien no se sorprendió por los hallazgos.

Esto se debe en parte a que la anemia tiene muchas causas, algunas más tratables que otras. En quizás un tercio de los casos, se debe a una deficiencia nutricional, generalmente falta de hierro, pero a veces de vitamina B12 o folato (llamado ácido fólico en forma sintética).

Las personas mayores pueden tener menos apetito o dificultades para comprar alimentos y cocinar. Pero la anemia también puede ser consecuencia de la pérdida de sangre por úlceras, pólipos, diabetes y otras causas de hemorragia interna.

La cirugía también puede provocar deficiencia de hierro. Mary Dagold, de 83 años, bibliotecaria jubilada de Pikesville, Maryland, tuvo tres operaciones abdominales en 2019. Estuvo postrada durante semanas y usó una sonda para alimentarse por meses. Incluso después de recuperarse, “la anemia no desapareció”, contó.

Recuerda que se sentía agotada todo el tiempo. “Y sabía que no estaba pensando como siempre”, agregó. “No podía leer ni una novela”. Tanto su médico de cabecera como Auerbach le advirtieron que era poco probable que las tabletas de hierro la ayudaran.

Estas tabletas, de venta libre, son económicas. El hierro intravenoso, que se receta cada vez con más frecuencia, puede costar entre $350 y $2.400 por infusión, dependiendo de la formulación, explicó Auerbach.

Para algunos pacientes una sola dosis es suficiente, mientras que otros necesitarán un tratamiento regular. Medicare lo cubre cuando las tabletas son difíciles de tolerar o ineficaces.

Para Dagold, una infusión intravenosa de hierro de 25 minutos cada unas cinco semanas ha marcado una diferencia sorprendente. “Tarda unos días, y luego te sientes lo suficientemente bien como para retomar tu vida diaria”, dijo. Ha regresado a su clase de aeróbic acuático cuatro días a la semana.

En otros casos, la anemia se debe a afecciones crónicas como enfermedades cardíacas, insuficiencia renal, trastornos de la médula ósea o afecciones inflamatorias del intestino.

“Estas personas no tienen deficiencia de hierro, pero no pueden procesarlo para producir glóbulos rojos”, explicó Kuchel. Dado que los suplementos de hierro no son efectivos, los médicos intentan abordar la anemia tratando las enfermedades subyacentes.

Otra razón para prestar atención: “La pérdida de hierro puede ser el primer presagio de cáncer de colon y de estómago”, enfatizó Kuchel.

Sin embargo, en cerca de un tercio de los pacientes, la presencia de la anemia es inexplicable. “Hemos hecho todo lo posible y no tenemos idea de qué la causa”, dijo.

Aprender más sobre las causas y los tratamientos de la anemia podría prevenir muchos problemas en el futuro. Además de su asociación con caídas y fracturas, “puede aumentar la gravedad de afecciones crónicas: corazón, pulmón, riñón, hígado”, dijo Auerbach.

“Si es realmente grave y la hemoglobina alcanza niveles potencialmente mortales, puede causar un ataque cardíaco o un derrame cerebral”. Sin embargo, entre las incógnitas se encuentra si el tratamiento temprano de la anemia y el restablecimiento de niveles normales de hemoglobina pueden prevenir afecciones posteriores.

Aun así, “se están logrando avances en este campo”, afirmó Ershler, señalando un taller del Instituto Nacional sobre el Envejecimiento sobre anemia inexplicable realizado el año pasado.

La Sociedad Americana de Hematología ha designado un comité para el diagnóstico y tratamiento de la deficiencia de hierro y planea publicar nuevas directrices el próximo año. El Iron Consortium at Oregon Health & Science University convocó un panel internacional sobre el manejo de la deficiencia de hierro y publicó recientemente sus recomendaciones en The Lancet Haematology.

Mientras tanto, muchos pacientes mayores pueden acceder a sus resultados del hemograma completo y a sus niveles de hemoglobina. La OMS define 13 gramos de hemoglobina por decilitro como normal para los hombres y 12 para las mujeres no embarazadas. (Aunque algunos hematólogos argumentan que estos umbrales son demasiado bajos).

Preguntar a los profesionales de salud sobre los niveles de hemoglobina y hierro, o utilizar un portal para pacientes para consultar las cifras ellos mismos, podría ayudarlos a hablar con sus médicos no solo de la fatiga u otros síntomas como consecuencias inevitables del envejecimiento.

Quizás sean signos de anemia, y quizás sea tratable.

“Lo más probable es que te hayas hecho un hemograma completo en los últimos seis meses o un año”, dijo Kuchel. “Si tu hemoglobina está bien, ¡genial!”.

Pero agregó que “si está realmente fuera de los límites normales o ha cambiado en comparación con el año pasado, debes preguntar”.

La sección The New Old Age se produce a través de una alianza con The New York Times.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Guardian Life of The Caribbean Limited has reaffirmed its commitment to improving cancer care and financial access for women across the region, with a focus on prevention, early detection, and inclusive insurance solutions. 

The announcement was made by President at Guardian Life of The Caribbean Limited, Samanta Saugh, last Friday at the Caribbean Association for Oncology and Hematology (CAOH) Conference at Hyatt Regency Trinidad, where Guardian Life participated as a sponsor and strategic partner.

“As a subsidiary as part of the largest indigenous financial services group in the English and Dutch-speaking Caribbean, Guardian Life understands the vital role we play in supporting the wellbeing of our communities,” said Saugh. “We are working to ensure that equity in care includes not only medical treatment but also financial protection and peace of mind.”

Over the past five years, Guardian Life has seen a steady increase in cancer-related claims, particularly among women. 

According to the data:

• Cancer accounts for 47 per cent of all critical illness claims across the company’s portfolio.
• Women file 53 per cent of all claims.
• 68 per cent of female critical illness claims are cancer-related, with breast and ovarian cancers most common.

In response, Guardian Life is taking several meaningful steps to better serve its clients:

• Tailored Insurance Products: Developing inclusive policies with coverage specific to gynaecological cancers and more accessible options for lower-income women.
• Support Beyond the Payout: Bundling financial protection with wellness, care navigation, and mental health support throughout the treatment journey.
• Digital Claims Innovation: Streamlining the claims process through user-friendly technology for faster, more transparent service.
• Healthcare Partnerships: For example, launching a breast cancer screening drive in collaboration with Bayview Urgent Care Facility in Barbados, making preventative care more accessible for policyholders.

Guardian Life continues to work closely with healthcare professionals, NGOs, and policymakers to strengthen the regional ecosystem of care. 

“At Guardian Life, we see the people behind the policies,” said Saugh. 

“We’re here to protect futures—and that means listening, innovating, and acting with compassion.”

The post Guardian Life strengthens commitment to women’s cancer care across the Caribbean appeared first on Barbados Today.

Reducing the risk of Alzheimer’s could be as simple as eating the right food.

A new study by researchers in Boston, Chicago and Washington, D.C., found that eating foods high in choline could lower the risk of developing the common dementia.

Choline is an essential micronutrient found in various foods, including poultry, dairy products (such as milk, yogurt and eggs), cruciferous vegetables like broccoli and Brussels sprouts, beans and some fish, according to the USDA.

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Dietary choline intake has been associated with a lower risk of cognitive function and reduced risk of dementia, the researchers concluded.

In the study, participants averaging 81 years of age who did not have Alzheimer's completed dietary questionnaires and underwent annual neurological exams.

After an eight-year follow-up, researchers determined that consuming about 350 milligrams of choline per day was associated with the lowest risk of clinical Alzheimer’s diagnoses in older adults.

Los Angeles-based registered dietitian nutritionist Ilana Muhlstein has also backed the impact of choline on brain health, citing a 2024 China-based study that found intake improves cognitive function, especially among women.

"This is the study that inspired me to start supplementing choline," she said. "My memory has gotten worse over the years. I first wrote it off as ‘pregnancy brain,’ then ‘mommy brain,’ but eventually realized I should do my best to help it." 

"I already sleep well, exercise regularly, play mahjong and limit my alcohol, so choline was the next obvious tool worth trying." 

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Muhlstein shared that more than 90% of the choline in eggs comes from the yolk. For those who choose to eat egg whites for dietary reasons, taking a choline supplement may be a better option.

Choline intake should be tailored to each person's individual needs, the nutritionist noted, referencing guidance from the Harvard School of Public Health.

"Premenopausal women may have lower requirements for dietary choline, because higher estrogen levels stimulate the creation of choline in the body," the university wrote.

In a separate interview with Fox News Digital, Dr. Daniel Amen, a psychiatrist, brain imaging doctor and founder of Amen Clinics in California, emphasized the importance of eating the right foods for brain health.

"Your brain uses 20% to 30% of the calories you consume," he said. "So, nutrition is critical to help your brain or hurt your brain." 

Walnuts are one of Amen’s favorite brain-healthy food options, as they contain choline as well as omega-3 fatty acids.

He also recommends including wild salmon as a dietary staple, as it's high in omega-3s and healthy protein, as well as organic blueberries and green, leafy vegetables.

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"If you had a salad every day, and you put blueberries and salmon and walnuts on it with a little lemon and olive oil, that would be a perfect brain-boosting lunch," he said.

The doctor also suggested considering certain supplements to foster better brain health, including vitamin D, omega-3 or fish oil, or a daily multi-vitamin.

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"Nearly two-thirds of the American population is low in vitamin D," he said. "And if it's low, it's a universal risk factor for every bad thing related to your brain, but also to your body, including obesity and cancer … Know and optimize your vitamin D level."

Fox News Digital reached out to the study researchers for comment.

The new techniques, described in two recently published research studies, could equip health care workers with powerful new tools for more effectively treating conditions related to opioid exposure, the researchers say.

In a study published in Scientific Reports, the researchers describe a method that can rapidly detect six different opioid compounds from a tiny amount of serum — no more than a finger prick. The second study, published in SLAS Technology, demonstrates a method for detecting opioids in dried blood spots, which are routinely collected from newborns nationwide. The technique could enable a first-of-its-kind quantitative method for assessing opioid exposure in newborns.

The research was led by Ramisa Fariha, a postdoctoral research associate in molecular biology, cell biology and biochemistry at Brown who performed the work while completing her Ph.D. in Brown’s School of Engineering. The work was a collaboration with Carolina Haass-Koffler, an associate professor at Brown’s School of Public Health.

“This project is an example of what happens when translational engineering meets public health,” said Anubhav Tripathi, a professor in Brown’s School of Engineering who oversaw the work. “Dr. Haass-Koffler approached us with a challenge: How can we enable more reliable testing of opioid exposure? Ramisa was able to take up that challenge and develop something quite remarkable in the lab.”

Fariha hopes the work will spur real-world application in opioid treatment.

“This wasn’t about creating another lab tool,” she said. “It was about reimagining what’s possible at the point of care. We were responding to a void that was always there, and we wanted to address it.”

Adults with opioid use disorder

The work began with Haass-Koffler talking with members of the engineering team about the challenges in measuring the presence of opioid substances in people with opioid use disorder. Blood testing for opioids generally requires substantial quantities of blood, which can be difficult to get from frequent opioid users who may have collapsed veins or other conditions. Urine tests, on the other hand, frequently produce inaccurate results.

Working closely with John Murphy, a research engineer at Brown, Fariha developed a fully automated liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay to detect opioid compounds from microsamples including serum or blood spots. They showed that the system is capable of accurately quantifying six different opioids — including buprenorphine, methadone, codeine, hydrocodone, morphine and oxycodone — using a small sample of just 20 microliters (less than a single drop) of serum.

Haass-Koffler then integrated the new diagnostic technique into an ongoing clinical trial. The trial, which assesses the use of oxytocin as a complement to opioid agonist therapy, leveraged the microsampling method to detect opioid use that traditional urine samples had missed. This enhanced detection capability provided critical insights, helping the research team demonstrate that administering oxytocin can be a valuable tool in reducing opioid use among people with opioid use disorder.

Detecting opioids in newborns

After developing a method for detecting opioids from small blood samples in adults, the researchers began thinking of other ways to apply it. Neonatal abstinence syndrome (NAS), in which babies are born with symptoms of opioid withdrawal, seemed like an obvious choice, they said.

Opioid use among expectant mothers is alarmingly high in the U.S — one recent study by the Centers for Disease Control and Prevention found that one in five pregnant women self-reported opioid misuse. Diagnosis of opioid exposure in newborns is currently made by assessing a baby’s symptoms and reviewing a mother’s opioid use history. There is currently no standard blood test for opioids in infants.

“The idea behind this work was to come up with a diagnostic method that’s more quantitative,” Fariha said.

The solution was a device that can extract potential opioid samples from dried blood spots, which are routinely gathered shortly after birth from a small prick on a baby’s heel. The device applies an electric field to a dried blood spot to draw up potential opioid compounds. Once the sample is prepared, it can be sent to a lab for analysis with a mass spectrometer, which are commonly used in neonatal testing.

The research showed that the technique can successfully detect a range of opioid substances including codeine, hydrocodone, morphine, methadone and oxycodone. And the technique is fully automated, making it easy to deploy at the clinical level, the researchers say.

Fariha said she’s hopeful that the technique can not only improve diagnosis of NAS, but also treatment. If clinicians know precisely how much opioid is present, they could potentially make more informed decisions about whether medication is necessary and in what amounts.

“At its core, this work is about more than automation,” Fariha said. “It’s about designing diagnostic tools that are precise, scalable and better aligned with the needs of real-world patients, especially in maternal and infant health.”

The researchers say both studies represent an effort to make diagnostics more useful, accessible and patient-centered.

“Diagnostics shouldn’t be locked inside centralized labs,” Fariha said. “I want to design systems that meet patients where they are — whether that’s a newborn in a NICU or a village clinic halfway around the world. As a Bangladeshi woman, I recognize the need for solutions with global translatability and impact, without requiring major infrastructural support.”

Reference:

Fariha, R., Rothkopf, E., Haass-Koffler, C.L. et al. Opioid quantification via microsampling techniques to assess opioid use in human laboratory studies. Sci Rep 15, 17678 (2025). https://doi.org/10.1038/s41598-025-99130-5