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• The U.S. government has two candidate vaccine viruses for H5N1 bird flu that could be used to make vaccines.
• Studies suggest vaccines based on these would offer good protection against the bird flu virus circulating among cattle in the U.S.
• It would take months to produce and ship millions of doses, but experts worry that uptake will still be low.

The H5N1 bird flu circulating in the U.S. remains far more dangerous for birds than for people.

Currently, this strain of the flu that circulated in cows has led to just a single person being affected in the last few months. But the strain of influenza has the potential to mutate, so federal health officials are already thinking ahead toward a potential vaccine.

The country has two candidate vaccine viruses available to manufacturers for the production of a bird flu vaccine, the Centers for Disease Control and Prevention (CDC) said on its website.

How U.S. could make millions of bird flu vaccines within weeks

“These [candidate vaccine viruses] are like seed stock that are kept in reserve in case there is an outbreak of that particular strain,” said David Diemert, MD, a professor of medicine in the School of Medicine and Health Sciences at George Washington University, and director of the GW Vaccine Research Unit.

If bird flu started easily spreading to people, “[the candidate vaccine virus] can be sent to manufacturers to make millions of doses of vaccine,” he said, “using the existing hen egg technology that we normally use for the regular seasonal vaccine.”

A candidate vaccine virus is attenuated, or weakened version of the virus. As a result, it is unlikely to lead to active infections in people who get the vaccine.

This type of weakened virus is able to grow well in hen eggs, which is what most manufacturers use to produce seasonal flu vaccine. 

The candidate vaccine would also have the surface proteins — known as hemagglutinin — of the virus circulating in the community. This enables a vaccine to generate a protective immune response.

Would these bird flu vaccines work?

The U.S. National Pre-Pandemic Influenza Vaccine Stockpile (NPIVS) has four types of H5N1 candidate vaccine viruses, reported STAT News. The bird flu affecting dairy cows is a strain of H5N1.

Only two of these candidate vaccine viruses are a good match for the currently circulating strain of bird flu.

Studies suggest that vaccines based on these two candidate vaccine viruses “will offer good cross-protection against cattle outbreak viruses,” Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, said on a call on May 1.

However, Amesh Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, cautioned that the candidate vaccine viruses are not a “perfect match” for the currently circulating strain of H5N1. This means they may not produce vaccines very effective at preventing disease.

In addition, research done in the mid-2000s found that H5N1 vaccines don’t trigger a strong immune response in people unless it is given in a large enough dose; or if it is given with a compound known as an adjuvant, which boosts the immune response.

Adalja pointed out that the H5N1 vaccines that we have in the stockpile are really not that good at provoking an immune response.

“Even for the viruses they are targeted against,” said Adalja. “In clinical trials, the protective antibody levels that people had were modest.”

One of these existing H5N1 vaccines in the NPIVS is made by CSL Seqirus, which supplies flu vaccine to the U.S. market.

Still, Diemert thinks a bird flu vaccine based on the two candidate vaccine viruses in the NPIVS would be effective and potentially more effective than seasonal influenza vaccines.

This is because a bird flu vaccine would likely only have to target a single virus strain.

In contrast, during seasonal flu season, there may be multiple strains of influenza that spread. Seasonal flu vaccines are developed to target certain strains of influenza every year. The vaccines are developed in the summer and early fall by looking at common strains in the Southern Hemisphere. But during flu season the strains that become more common in North America may not be the strains the vaccine was primed to target.

As a result, seasonal flu vaccines may end up targeting strains of influenza virus that are not the ones in circulation that year.

“That’s one of the reasons that [seasonal flu vaccines] are not 100% effective because they’re not a perfect match,” said Diemert.

Would vaccines need FDA approval?

Before bird flu vaccines could be rolled out, they would need to be approved by the Food and Drug Administration (FDA) but the agency has a process for approving updated seasonal flu vaccines each year.

So this should go fairly smoothly, said Diemert, “especially since the [bird flu] vaccines would be made using the same manufacturing process that they use every year [for seasonal flu vaccines].”

Also, “I’m sure if there was a massive outbreak of this particular strain, then the FDA would speed things up,” he said. “So I don’t see regulatory approval being a rate-limiting step.”

How quickly could the vaccine be rolled out?

In terms of getting the vaccine to the people who need it the most, “all of the pieces are in place to be able to roll out a vaccine relatively quickly,” said Diemert. 

However, “when you send [the candidate vaccine virus] to the manufacturer, it still takes weeks to months to make all the doses you need,” he said.

This is especially difficult in a “fast-moving situation” such as a pandemic, said Peter Chin-Hong, MD, an infectious disease physician at UCSF Health.

Federal health officials estimate that over 100 million doses could be shipped within three to four months. However, they expect people to need two doses, so this would only cover 50 million people.

Vaccine production could also be affected by the same virus the vaccine would be designed to protect against.

Manufacturers most often use hen eggs to produce flu vaccines, but chickens are also susceptible to the bird flu virus that is affecting cattle.

So, “if you have a global [influenza] pandemic, and you have birds dying too, that may constrain supplies such as chicken eggs,” said Adalja.

As of May 6, over 5 million chickens and other commercial or backyard poultry birds in the United States have been affected by highly pathogenic avian influenza (HPAI). which includes H5N1, reports the U.S. Department of Agriculture. 

The big question is whether enough vaccine doses could be rolled out in time to make a difference.

“With the 2009 H1N1 pandemic, by the time the vaccine came out, the pandemic had already dissipated,” said Chin-Hong.

During that outbreak, tens of millions of Americans were vaccinated, but by the time the vaccine doses were available, the fall wave had subsided.

However, “this is 2024 and things have changed,” said Chin-Hong, referring to the fast development and rollout of the COVID-19 vaccines. “When people put their mind to it, it could be done fast … But the devil is in the details.”

Overall, “it’s going to take some time to actually gear up to be able to vaccinate everybody who’s at risk for flu,” said Adalja. “And as I said, the candidate vaccine virus that is stockpiled is not a perfect match. And even if it were a perfect match, [the H5N1 vaccine] is not a great vaccine to begin with.”

mRNA vaccines and other options

Federal health officials said the government is also pursuing an mRNA bird flu vaccine, based on the same technology as Pfizer’s and Moderna’s COVID-19 vaccines.

Chin-Hong said this type of vaccine could potentially be updated more quickly to match the currently circulating strains of the virus. But these vaccines have their own challenges, he said, such as needing to be stored at extremely cold temperatures.

In addition, given that these vaccines would be a new use of the mRNA vaccine technology, the FDA may require clinical trials which could delay the roll-out to the greater population.

There are other options for dealing with an outbreak of bird flu in people, including antivirals such as Tamiflu, which would be given to people who are already infected.

“Different interventions speak to different people,” said Chin-Hong. “In general, Americans prefer to treat something rather than prevent it, which can be a challenge.”

Vaccine hesitancy may slow uptake

As seen during the COVID-19 pandemic, it’s not just how many vaccine doses you can ship that matters, but also how many people receive the vaccines.

“The problem we may have is that there is more vaccine hesitancy now, so people may not be as willing to get vaccinated,” said Diemert. “I don’t know if that will be different because the [hen egg] flu vaccine technology has been around for decades and there’s a lot of evidence of its safety.”

Chin-Hong pointed to the poor current COVID-19 vaccination rates among American adults as a sign of vaccine fatigue.

Around 22% of all American adults have received the updated COVID-19 vaccine, with a slightly better rate (38%) among older adults, according to the CDC. Both rates are much lower than health officials would like to see.

“That shows how fatigued people are [with vaccination campaigns],” said Chin-Hong. “This [hesitancy] would need to be addressed in the same breath as having a well-oiled plan [for rolling out the vaccines].”

Adalja is concerned not just about vaccine hesitancy, but with growing public opposition to vaccines, in general.

“In 2009 with H1N1, vaccination uptake was subpar because concerns raised by the anti-vaccine community — which were unwarranted concerns — dissuaded people from getting vaccinated,” he said.

But “after COVID-19, the anti-vaccine movement is more powerful than it has been in decades,” he added. “So I think mounting a vaccination campaign in an [future] emergency is going to be very difficult to do in the current political environment.”

Takeaway

There is no sign that the H5N1 bird flu circulating in dairy cow herds is developing the ability to spread easily to people. But federal health officials are planning for the rollout of a bird flu vaccine as a precaution.

The federal government has two candidate vaccine viruses stockpiled. These are weakened so they cannot infect people or cause illness, but they grow well in hen eggs, which is how flu vaccine are most often made.

The candidate vaccine viruses are not a “perfect match” for the bird flu virus currently circulating, but they should offer good protection, say health officials. However, experts are concerned that vaccine fatigue will deter uptake.

• Healthy, older men with higher concentrations of testosterone were more likely to develop atrial fibrillation, according to a new study.
• The findings follow a landmark 2023 trial that found that men using testosterone-replacement therapy had a higher incidence of atrial fibrillation.
• Maintaining testosterone in a healthy, normal range appears to mitigate atrial fibrillation risk.

Higher natural testosterone levels are associated with an increased risk of atrial fibrillation (AFib).

The findings, published April 29 in The Lancet, substantiate prior research that identified a higher incidence of AFib among men who used testosterone-replacement therapy (TRT). In 2023, researchers published a landmark study, known as the TRAVERSE trial, that found that men with pre-existing or high risk of cardiovascular disease using TRT were not at increased risk of death from cardiovascular disease. However, it did find that men prescribed TRT did have slightly higher rates of AFib. 

Using that research as a jumping-off point, the authors of The Lancet study wanted to investigate whether they could identify an association between testosterone and AFib in men who were not prescribed TRT, using only natural testosterone levels.

“Amongst 4,570 initially healthy older aged men aged 70 years or older, those with testosterone concentrations at the higher end of the clinical normal range had nearly double the risk of developing AFib compared to men in the middle of the range,” Cammie Tran, MPH, a researcher at the Monash University School of Public Health in Australia, and First Author of the study, told Healthline.

The risk factors for AFib

Tran and her team utilized data from the ASPREE clinical trial, a long-term study that looks at the effects of aspirin on health in older adults for their study. They included 4,570 males with an average age of 74 years old with no history of cardiovascular disease (including AFib). Participants had their circulating testosterone concentrations measured at baseline. During an average 3-5 year follow-up period, researchers observed that 286 participants, or around 6%, developed AF.

They found that men who developed AFib had higher baseline testosterone levels compared to those that did not. The average testosterone concentration for the men who developed AFib was 17 nmol/L compared to 15.7 nmol/L. They also tended to be current or former tobacco smokers and had a higher baseline BMI. However, the association between testosterone and AFib persisted after controlling for these factors.

“Male sex has been recognized as a risk factor for AFib for a long time, but it’s been hard to determine whether that was due to the effect of testosterone directly, or just other risk factors that are more common in men. This study found that higher testosterone levels conferred a higher risk for [AFib] even when other clinical risk factors like age, BMI, smoking, and alcohol use were accounted for. This suggests a direct role for testosterone,” M. Ben Shoemaker, MD, the Director of Vanderbilt University’s Atrial Fibrillation Precision Medicine Program, told Healthline. Shoemaker wasn’t affiliated with the research.

The ideal testosterone level

Another important finding of the study was that the association between testosterone concentrations and AFib was not linear. That means what they found isn’t as simple as: higher testosterone equals a higher risk of atrial fibrillation. 

Men in the high-normal of testosterone concentration did have higher risk of AFib, but so did men below the normal range. 

“This study suggests that testosterone levels need to be ‘just right,’” said Shoemaker.

Prior related studies have come to similar conclusions.

A 2017 study published in the Journal of the American Heart Association found that men with low testosterone had a higher incidence of AFib compared to men within a normal range. But, when their testosterone levels were normalized through TRT, the prevalence of AFib dropped.

“Men with higher testosterone concentrations had a higher risk of atrial fibrillation, but there was no reduction of risk in men with lower testosterone. Our results would suggest that being within the mid-range of the clinical normal range would be best for lower risk of [AFib],” said Tran.

Testosterone and TRT: what to know

Despite the findings, the mechanism for why testosterone outside of normal ranges is associated with AFib is still not known.

“Originally, the focus was on testosterone’s role in regulating gene expression- a process that slowly increases the risk of [AFib] over time. Now, it’s recognized that testosterone can directly bind to receptors in the heart that regulate its electrical activity, and those changes promote AFib,” said Shoemaker.

Maintaining testosterone in a healthy range is therefore important due to AFib risk, but overall health as well. 

Low testosterone, also called low T and testosterone deficiency, is defined as a concentration of less than 300 ng/dl, according to the American Urology Association. Testosterone production and circulating concentration typically decrease with age.

Signs and symptoms of low T include:

• Low sex drive
• Erectile dysfunction
• Decreased muscle mass
• Increased body fat
• Low energy
• Smaller testicle and penis size

For individuals with low T, a doctor may prescribe TRT, or testosterone replacement therapy, to increase the circulating concentration of testosterone.

TRT is also frequently used off-label for various non-medical issues like gaining muscle mass, losing weight, and boosting sexual performance. It is also popularly believed to have “anti-aging” properties. However, the use of TRT for these purposes may be illegal and without scientific merit.

Risks of high testosterone from TRT include:

• Acne
• High blood pressure
• Difficulty urinating
• Shrinking of testicles
• Fluid retention

“Recreational or off-label use of testosterone needs to be strongly discouraged. There are risks of harm, including heart-related complications in androgen abusers. Testosterone should only be prescribed to men with medical conditions necessitating this treatment, with appropriate medical supervision and monitoring,” said Tran.

The bottom line

In healthy older men, abnormal testosterone levels were associated with a greater risk of developing AFib, according to a new study.

The findings follow the findings of the 2023 TRAVERSE trial that identified men using testosterone-replacement therapy as having higher incidence of AFib, but not other cardiovascular disease risks.

Experts say that maintaining testosterone concentrations in a normal range — neither too high nor too low — is optimal to minimize AFib risk.

• A new review has found that ancient grains like oats and brown rice can improve type 2 diabetes.
• More research is needed to better understand the association between these grains and diabetes.
• Aside from incorporating more ancient grains in your diet, experts recommend portion control and eating more heart-healthy fats and lean protein.

A new meta-analysis found that ancient grains (oats, brown rice, and millet) can improve health outcomes in people with type 2 diabetes.

The findings were published in the journal Nutrition, Metabolism and Cardiovascular Diseases this week.

The review included 29 randomized controlled trials and 13 were meta-analyzed. 

Results showed for those with type 2 diabetes, oat consumption could improve cholesterol levels. However, further research is needed to learn more about the relationship between ancient grains and diabetes.

How ancient grains can improve heart health

Oats, brown rice, millet, and all other “ancient grains” are considered whole grains. Whole grains include not only starch, but also fiber, vitamins, minerals, and healthy fats. 

“When we consume starch, it’s quickly digested into sugars and then absorbed into our bloodstream,” said Dr. Nate Wood, physician at the Yale School of Medicine and culinary school graduate. “This can cause a blood sugar spike. Over time, we know that these blood sugar spikes can lower our body’s sensitivity to insulin, which is the problem in type 2 diabetes.”

However the healthy fats and especially the fiber contained in whole grains like oats, brown rice, and millet work to slow the speed with which the sugar from the grain is absorbed into our bloodstream, reducing glucose spikes. 

Reducing the number of glucose spikes in the blood can help preserve our body’s insulin sensitivity, which helps reduce the risk of developing diabetes. This is one big reason that eating whole grains is linked to lower rates of type 2 diabetes, Wood explained.

How fiber helps your heart

Oats, brown rice and millet are also good dietary sources of soluble fiber.  

“Soluble fiber has been found in studies to have a positive impact on T2D [type 2 diabetes] and blood lipids [cholesterol and triglycerides,]” said Nancy M. Ryan, MS, RD, inpatient diabetes coordinator at Greenwich Hospital. “Soluble fiber absorbs water in the intestinal tract and the gel that forms can slow gastric emptying. This may decrease the after-meal rise in blood glucose in T2D.”  

Soluble fiber also binds with bile salts in the intestinal tract, reducing absorption of these salts back into the body and reducing the amount of bile salts available to the liver to manufacture cholesterol, Ryan explained.

Additionally, soluble fiber also supports a healthy microbiome, the beneficial bacteria in the intestinal tract.  

“These bacteria have a positive impact on the immune system and anti-inflammatory effects,” Ryan stated.

Dr. Marie-Pierre St-Onge, associate professor of nutritional medicine at Columbia University Vagelos College of Physicians and Surgeons explained, “These grains are typically whole grains, which means that they have not been stripped of their bran and therefore provide more fiber than refined counterparts. Higher fiber intakes produce more stable blood glucose patterns with less pronounced spikes upon consumption.”

More study needed

While the research found positive benefits of the grains for overall health, the different studies examined different types of grains and over a variety of time periods. As a result, experts said more studies will be needed to verify the findings.

The authors note that most of the studies indicated a positive impact on measures of blood sugar management and lipid profiles.

However, the small number of studies for each of the grains limited the ability to come to a definitive conclusion that ancient grains improve blood sugar management and blood lipid control in individuals with type 2 diabetes.

Reducing type 2 diabetes symptoms with dietary and lifestyle changes

Experts say to help manage type 2 diabetes staying on track with diet is key, especially by monitoring the intake of simple carbohydrates. These carbohydrates can break down quickly leading to blood sugar spikes.

“Reducing overall sugar intakes not only from refined grain products (bakery products, sweets, desserts) but also from beverages, is a longstanding recommendation to reduce blood sugar swings in patients with [diabetes,]” St-Onge stated.

“But, aside from diet, patients should also consider other lifestyle behaviors that are important for health, including obtaining sufficient sleep and exercise.”

In managing type 2 diabetes, Ryan explained it is important to consider three treatment goals to monitor: blood sugar, blood lipids, and blood pressure.  Dietary modifications should take these three goals into account.  

The American Diabetes Association does not promote one specific diet or way of eating.  

“The emphasis is on supporting an eating pattern and food choices that support these three goals, including a variety of nutrient-rich foods, incorporating preferred foods and foods with cultural meaning/value,” said Ryan.

There are many strategies to achieve these goals.

“The first step is knowing which foods contain carbohydrates as that is the nutrient that will raise blood glucose the most after eating.  With that knowledge, portion management can be very helpful,” Ryan stated. 

Additionally, including heart-healthy fat (such as nuts, nut butters, avocado, olive oil) and/or lean protein (such as chicken, turkey, fish, lower fat cheese) at meals and snacks blunts the after-meal rise in blood glucose, Ryan explained.  Slowing down our eating pace also reduces the after-meal rise in blood glucose.  

Also, the order in which we eat the foods on our plate can make a difference.  

“If we eat vegetables (cooked vegetables and/or salad) first, then our protein (chicken, turkey, fish, lean meat) and finally our starch (potato, rice, pasta), slows down the rise in blood glucose after eating,” said Ryan.

If the person with diabetes is not meeting their personal management goals, meeting with a registered dietitian/nutritionist can be very helpful. Collaboratively, a plan can be developed to support diabetes goal attainment. The contact information for a registered dietitian/nutritionist near you can be found on the website for the Academy of Nutrition and Dietetics.

Takeaway

A new review showed ancient grains can improve cholesterol levels in people with type 2 diabetes.

Aside from incorporating more ancient grains in your diet, experts recommend portion control, and eating more heart-healthy fats and lean protein.

• A small study has found that combining time-restricted eating and high intensity exercise may improve cardiometabolic health and contribute to weight loss.
• Participants who combined this diet and exercise approach achieved the most noticeable body composition changes.
• Experts say this is because time-restricted eating can create a calorie deficit, and exercise can lead to an increase in lean muscle mass.

A new study has found that time-restricted eating and high intensity exercise can work together to improve health and help people achieve fat loss. 

Time-restricted eating, also known as intermittent fasting, involves limiting the hours for eating to a specific number of hours each day. 

The research published in the PLOS ONE Journal found that, when combined, time-restricted eating and high intensity exercise could contribute to weight loss and improve markers of cardiometabolic health, including cholesterol, blood glucose, and lipid levels. 

How the study was conducted

64 women with obesity were assigned to one of three groups: time-restricted eating (diet only), high intensity functional training (exercise only), or time-restricted eating plus high intensity functional training (diet + exercise).

Participants ate only between 8:00 am and 4:00 pm, and those in the functional training groups worked out three days per week with an instructor.

After 12 weeks, all three groups had achieved significant weight loss and body composition improvements. Favorable changes were also found in lipid and glucose levels.

Participants in the diet+exercise group achieved more noticeable body composition changes and cardiometabolic parameters compared to the other two groups. 

The authors said, “Combining time-restricted eating with High-Intensity Functional Training is a promising strategy to improve body composition and cardiometabolic health.”

However, they note that this is a small study and more research is needed. 

The benefits of time-restricted eating and high intensity exercise 

Registered dietitian Emma Shafqat, who was not involved in the research, says she isn’t surprised by the findings of this study, even though time-restricted eating doesn’t seem to restrict your total calorie intake – which is necessary for weight loss to occur. 

She said that studies have found that people often spontaneously reduce their energy intake when following an intermittent fasting plan, inducing a mild (1%–4%) body weight loss over periods of time lasting from 1 week to 3 months.

Likewise, celebrity personal trainer Michael Baah says the combo of time-restricted eating and high intensity experience tend to work well together.

“When we limit the time we eat and do intense workouts, our bodies get better at using energy and processing sugar, and it’s like they become more efficient at staying healthy,” he explains.

Intense exercise has added benefits when it comes to fat loss. “Time-restricted eating helps us burn fat, and intense exercise helps us build muscle,” Baah surmises. 

This is good news for anyone wanting to sustain their weight loss in the long term as lean muscle mass increases your body’s metabolic rate, meaning you burn more calories. 

As well as triggering weight loss, the combination of time-restricted eating and high intensity exercise can also lead to improvements in cardiometabolic health. 

“Cardiometabolic disease describes a range of conditions starting with insulin resistance, progressing to the metabolic syndrome, prediabetes, and finally to more severe conditions including cardiovascular disease and type 2 diabetes,” Shafqat explains. 

She notes that time-restricted eating improves cardiometabolic health in lots of ways, for example, improving glucose tolerance, reducing blood pressure, and enhancing gut function. 

Risks and challenges of time-restricted eating to consider

However, time-restricted eating won’t be the right weight loss tool for everyone. 

“The only way to lose fat is to be in a calorie deficit. For some people, time-restricted eating is simply a tool that allows them to achieve that goal,” says Baah. “If they restrict their time eating window, it [often] reduces their overall calories for the day, which puts them in a calorie deficit.” 

While this works for some, it may not fit with your lifestyle or may feel too restrictive. Time-restricted eating is not the only way to lose fat. However, if you are planning to follow a time-restricted eating plan, Shafqat says ensuring you feel adequately fuelled and satiated is key. 

“I recommend starting your day with a breakfast that is high in fiber, protein, and some fruit, for example, full-fat yogurt with seeds and fruit or porridge with added seeds and fruit,” she says. “I’d also recommend eating a good balanced meal before 4 pm, which includes fiber-rich carbohydrates, protein, and plenty of vegetables to help prevent hunger before bedtime.” 

Shafqat says planning is key when it comes to time-restricted eating. 

“In this study, there appears to be an 8-hour schedule in which participants can eat, so if you’re following this schedule. I recommend scheduling your meal and snack times and preparing your food in advance.” 

How to get started with high intensity exercise for beginners

However you plan to lose weight, factoring exercise into your schedule is a good idea. If high intensity exercise sounds intimidating, don’t worry, says Baah.

“Start with simple exercises and focus on using good form,” he advises. 

Ideally, you should aim for a mix of strength and cardio exercises. Some exercises Baah recommends include skipping or jumping jacks, bent-over rows, weighted crunches, and dumbbell reverse lunges. 

The term ‘high intensity’ can conjure up images of grueling workouts, but Baah says it’s important to give your body time to rest and recover. Take a rest period of about 60 seconds between each set and plan rest days into your schedule. 

The key to making progress, according to Baah, is to ensure you lift heavier weights over time. 

Takeaway 

Combining time-restricted eating and high intensity exercise appears to contribute to fat loss and improve other health markers related to cardiometabolic health.

However, if you have a goal of losing weight, a calorie deficit is the most important factor, and if you find time-restricted eating too restrictive, you should consider something else.

• A study has found that psilocybin appears to have antidepressant properties.
• Experts say it activates serotonin receptors.
• It might also work by increasing the brain’s neuroplasticity.
• Side effects are minimal, and it is regarded as non-addictive.

“Magic mushrooms” are often used by people seeking their hallucinogenic effects.

However, psilocybin, a compound found in magic mushrooms, might also have applications in treating depression, according to a study published on May 1, 2024, in BMJ.

This is significant since an estimated 5% of adults around the world are affected by this common mood disorder.

The authors of the study note that it appears to reduce symptoms after only one or two doses.

Additionally, there are minimal side effects and it is regarded as non-addictive.

Studying whether psilocybin relieves depression

To learn more about how well psilocybin works for depression, the researchers searched various databases for randomized controlled trials comparing the drug with controls, such as microdoses of psychedelics, niacin or a placebo.

The review also included any studies in which psychotherapy was used in both the experimental and control groups. This allowed them to distinguish between the effects of psychotherapy and psilocybin.

Altogether, they were able to gather seven trials, including 436 participants with depression. A little over half were women, while most (90%) were white.

After analyzing changes in depression scores, they found that psilocybin had a large effect size, meaning that it had a strong positive effect on depression symptoms when compared with the control groups.

The team of scientists also found that factors like having depression secondary to another health condition, being assessed using a self-reported scale, being older, and having previously used psychedelics were associated with larger improvements in scores.

Psilocybin’s potential as a treatment for depression

Padam Bhatia, MD, FAPA, Chief Executive Officer at Elevate Psychiatry in Miami, Florida, commented on the research saying that the large effect size was the most “impressive” part of the study.

“While most studies answer a single question (“Did the medication work or not?”), effect size goes a step further and looks at how well the medication worked,” he said.  

“For this study, the effect size was huge, much greater than any oral antidepressant that has ever been studied.”

However, he did point out that while the results are promising, the individual studies were small and had significantly different methods and results.

Bhatia said that more studies would need to be done to reach a conclusive answer.

Before it becomes an accepted treatment for depression, there would also need to be a change in the legal landscape of the country to allow its medicinal use.

According to Psychedelic Alpha, while several cities throughout the U.S. have decriminalized the personal use of psilocybin, only two states, Oregon and Colorado, have decriminalized psilocybin in general and have legalized psilocybin use at licensed service centers.

However, several other states have active legislation or working groups to study its use.

Why psilocybin might be effective for depression

Alex Dimitriu, MD, who is double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, explained that researchers are still learning why psilocybin might have an antidepressant effect.

He said one possible mechanism “is increased neuroplasticity, allowing the brain to make new connections, known as synaptogenesis.”

Dimitriu went on to explain that neuroplasticity might allow a patient to develop new ways of looking at old problems. It might also allow them to make connections to life events and behaviors that previously did not exist.

“Put more briefly,” he said, “the effects are likely biological as well as psychological and rooted in improvement in the function of the serotonin system, as well as higher-level changes in thought patterns.”

Risks associated with psilocybin treatment

Bhatia noted that while research is growing on the potential mental health benefits of the therapeutic use of psilocybin, magic mushrooms should still be used with caution since being in an altered state of mind can be challenging

“An extreme version of these side effects, sometimes called a ‘bad trip,’ can be associated with confusion, disorganized thinking, and severe panic,” said Bhatia.

“Although this is temporary, it is certainly disturbing to the individual and can lead to physical aggression or [in rare cases] seeking emergency treatment.”

Dimitriu agreed with Bhatia, noting that while there are minimal physiological risks with psychedelic use, the “power and intensity of these substances and experiences cannot be underestimated.”

He noted that while some experiences “can be very positive and uplifting,” others can be scary or temporarily destabilizing.

Dimitriu advised that you should seek out guidance and support before, during, and after using psilocybin for the best outcome.

Using an analogy, he added, “You would never willingly fly an airplane alone for the first time,” noting that you should not attempt to treat yourself as it could be “catastrophic.”

“Of particular concern is people with any history of psychosis, bipolar disorder, and possibly panic attacks,” he concluded.

Takeaway

A new study published in BMJ has found that psilocybin, the active compound in magic mushrooms, could have applications as an antidepressant.

In a meta-analysis of seven studies, they found it had a strong positive effect on depression symptoms.

It might exert its antidepressant effect by increasing serotonin receptor sensitivity or by increasing brain neuroplasticity.

However, while the findings of the meta-analysis are promising, the selected studies were small, and more research is needed to determine whether psilocybin is an effective antidepressant.

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