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• CDC guidelines for the 2024–25 flu season recommend the flu shot for all individuals ages 6 months and older, with rare exceptions.
• The recommendations include two key updates: a return to trivalent flu vaccines and high dose vaccines for adults receiving organ transplants.
• Infectious disease experts recommend getting both your flu shot and updated COVID-19 shot simultaneously, ideally from late September through October.

The Center for Disease Control and Prevention’s 2024–25 influenza season guidelines recommend the annual flu shot for all individuals ages 6 months and older, with rare exceptions. 

The recommendations highlight two key updates: 

• After more than a decade of quadrivalent formulations, this year’s flu shot is a trivalent vaccine that does not include an Influenza B/Yamagata component. The trivalent vaccine will target three flu strains: two influenza A viruses — H1N1 and H3N2 — and an influenza B/victoria virus. The B/Yamagata lineage has not been detected globally since March 2020, which suggests it may have been eliminated. 
• Flu shots for adult solid organ transplant recipients ages 18–64 on immunosuppressive medications will include HD-IIV3 (trivalent high dose inactivated influenza vaccine) and allV3 (trivalent adjuvanted inactivated influenza vaccine). These high dose vaccines help boost immune response in older adults.

Infectious disease experts say the optimal time to receive both the flu vaccine and updated COVID-19 vaccine is late September and during October. 

This gives both vaccines their best chance to protect during the winter months, according to William Schaffner, MD, professor of preventive medicine and infectious diseases in the Department of Health Policy at Vanderbilt University Medical Center in Nashville.

Healthline spoke with Schaffner to learn more about the upcoming flu season and why it’s important to get vaccinated against respiratory illnesses like influenza and COVID-19.

This interview has been edited and condensed for clarity and brevity.

Why are flu shots trivalent this year?

Schaffner: Flu vaccines in recent years have protected against four different strains of the influenza virus: two influenza A strains and two influenza B strains. We always do that because although there’s a dominant strain, numerous strains are usually circulating. 

This year, the influenza vaccine will protect against three strains because one of the B strains has disappeared from the world and has not been detected in two years, so there’s no need to include it in the vaccine anymore. That’s a good thing.

How bad will the flu season be this year?

Schaffner: We can all hope for a very mild influenza season, but it’s very hazardous to predict the severity of the upcoming flu season. It’s much easier after the flu season to go back and say how severe it was. 

We can look to the Southern Hemisphere — where they have their winter during our summer — but what happens there is not always predictive of what will happen here. 

We have included the strains that were active in the Southern Hemisphere this summer in our flu vaccine, and at the moment, it looks as though we have a very good match between what’s in our flu vaccine and what we anticipate the dominant strains will be.

Can you get your flu shot and COVID shot at the same time? 

Schaffner: Yes, you have to get both shots, whether in the same arm or the other arm, because the flu vaccine won’t protect against COVID-19, and the COVID vaccine will not protect against the flu. 

The recommendations for both vaccines are identical (6 months and older). Both of these vaccines are very important — and that goes for anyone who’s eligible.

Are you concerned about vaccine hesitancy as students return to school?

Schaffner: I’m always concerned about that because familiarity breeds, if not contempt, a certain nonchalance, and so we have come to accept and live with the annual influenza virus outbreaks.

Those of us in infectious diseases and public health take flu very seriously because we know that this nasty family of viruses can take a normal, healthy young person and put them in the emergency room in the hospital. Within 48 hours, every major hospital in the country sees this sort of thing happening every year. 

Yes, most flu in children is mild, and they get over it very easily.  But on occasion, a normal, healthy child can be made morbidly, gravely ill. 

The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) agree 100% with the CDC that children should be vaccinated, and that goes along with adolescents and young and middle-aged adults. 

Why is it important for people to receive the flu vaccine?

Schaffner: Getting vaccinated against the flu is the most comfortable and reassuring thing you can do to protect yourself against severe disease, but you also protect your family and your community.

Older persons, frail persons, people with underlying chronic medical conditions, and people who are immunocompromised are at the greatest risk for severe disease from the flu. 

The flu vaccine is best at preventing severe disease and has some impact on reducing transmission. So if you get the flu vaccine, you will provide some modicum of protection to those around you.

For those who are immune compromised who can’t respond to the vaccine very well because their immune system doesn’t work as well, the best way we can protect them is for everybody else around them to be protected, providing a kind of a cocoon of protection for those who are among the most fragile in our communities. 

Takeaway

The CDC’s recommendations for the 2024–25 flu season include two key updates: a return to trivalent flu shots and high dose vaccines for adults receiving organ transplants.

To protect themselves during the winter months, everyone ages 6 months and older should get their flu and COVID shots, ideally at the same time and before the end of October.

Getting vaccinated against the flu and COVID-19 helps prevent severe illness, even in young, healthy individuals.

• Researchers report that people with coronary artery disease can reduce their risk of heart attack by 44% by quitting smoking.
• The risk for people with this condition increases by 8% for every year they continue to smoke.
• People who only reduce the amount they smoke don’t lower their risk when compared to people who continue to smoke, researchers say.
• Experts advise people both with and without coronary artery disease to stop smoking as soon as possible.

Quitting smoking can significantly reduce the risk of a heart attack for those diagnosed with coronary artery disease, according to a new study.

However, researchers report that simply cutting back on smoking doesn’t appear to do much to lower the risk.

In addition, people who have never smoked still have a lower overall risk of a major cardiovascular event than a person who has quit smoking, even if that person has stopped tobacco use for years.

These findings were presented on August 29 in London at the ESC Congress 2024, the annual meeting of the European
Society of Cardiology.

Although the research has yet to be published in a peer-reviewed journal, experts say it sends an important and strong message.

“This analysis reinforces what has been known from previous smaller studies in years past: there is no safe level of cigarette smoking,” said Richard Wright, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

“The noxious components of smoke immediately lead to a chain of noxious events, and whether one
smokes a quarter-pack or two packs of cigarettes is irrelevant with regards to the increase in cardiac
risk. This enhanced risk also extends to those exposed to second-hand smoke,” Wright told Healthline.

Smoking and heart attack risk

In their study, researchers assessed data from the international CLARIFY registry, a databank that has
been used in past cardiovascular research.

The researchers examined 32,378 people with coronary artery disease. The participants were studied at an average of about six years after their disease diagnosis.

Among the participants at the start of the study:

• 41% had never smoked
• 46% were former smokers
• 12% were current smokers

Among the former smokers who were smoking at the time of their coronary artery disease diagnosis:

• 73% had discontinued smoking within a year of their diagnosis
• 27% quit in subsequent years

Researchers reported that people who quit smoking after their diagnosis saw an overall reduction of 44% in the risk of a major adverse cardiovascular event, regardless of when they stopped tobacco use.

The researchers noted, however, that the risk of a heart attack or other cardiovascular event increased by 8% for each additional year of active smoking.

They pointed out that study participants who reduced the amount they smoked didn’t have a significantly lower risk than participants who continued to use tobacco.

They added that the former smokers “never achieved the cardiovascular risk level of patients who never smoked, even after years of smoking cessation.”

“I like to tell my patients that it is never too soon or too late to stop smoking, though the sooner a patient stops, the better to lower cardiovascular risk,” study author Jules Mesnier, MD, a cardiologist at the Hospital Bichat-Claude Bernard in Paris, in a statement.

“And it is not enough to reduce smoking. Short, clear-cut messages are needed for smokers at every medical intervention highlighting the need to quit,” Mesnier continued.

How smoking affects cardiovascular health

Robert Page, PharmD, professor of clinical pharmacy and physical medicine at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and member of the Drug, Alcohol and Tobacco Use Committee of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health, said the information contained in the new study is powerful. Page was not involved in the study.

“What is quite compelling is that even after quitting smoking, patients did not return to their prior baseline cardiovascular risk status before they began smoking,” he told Healthline. 

“While this study was based on registry data, I want to point out that this is only an association and not direct causation; however, with the amount of robust data on the [cardiovascular] effects of smoking and consistent biological plausibility, these data are quite powerful, especially when educating patients,” Page continued.

Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California, agreed with the strong message of the research. Chen wasn’t involved in the study.

“This study found that quitting smoking, and not just cutting down on smoking, can reduce the risk of a major cardiovascular event by half. This is consistent with our current understanding and recommendations to completely quit smoking rather than cutting down, in order to gain the most health benefits. However, cutting down on smoking can potentially be useful if it puts someone on the path to eventually quit,” Chen told Healthline.

“Our advice is very clear to people with coronary artery disease who smoke: quitting smoking is essential to minimize the risk of a future cardiovascular event, and can potentially be life-saving,” he added.

Jayne Morgan, MD, a cardiologist and vice president of medical affairs at Hello Heart, who is not involved in the study but is attending the ESC conference, said smoking can produce a number of health issues for people with coronary artery disease.

“Smoking damages the endothelial lining of the coronary arteries in an irreversible fashion. This sets a
person up for the development of atherosclerosis. which can then lead to a heart attack and heart
failure,” Morgan told Healthline.

“Additionally, smoking further accelerates the development of atherosclerosis where it is already present, further narrowing the coronary arteries and reducing blood flow and critical oxygen supply to the heart,” she said.

“Moreover, smoking increases levels of certain blood clotting factors further complicating the picture and putting the patient at risk of a cardiovascular event,” Morgan added. 

“And then when you just think about nicotine itself, which causes vasoconstriction or tightening of the coronary arteries further reducing blood flow that may already be reduced by atherosclerosis. Then we must consider that inflammatory response of the body to smoking, including the coronary arteries,” Morgan continued.

Health dangers of smoking

Page said the dangers of smoking extend far beyond people with coronary artery disease.

“Active smoking and secondhand smoke exposure determine over 30% of coronary heart disease deaths,” he explained.

“While the exact mechanisms of cardiovascular damages are not well known, the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function. All of these accelerate early onset ASCVD disease. Thus, I tell patients, ‘Why even start smoking?,’ he added.

Page said he tries to hammer home this message in particular to young adults and teens.

“I have found that teens and young adults believe they are invincible and that ‘this won’t happen to me’ or ‘I just smoke socially.’ These are urban myths and completely false assumptions based on these data,” he said.

Morgan said the health dangers from tobacco use can be particularly acute for women.

“If you are a female, the coronary arteries are generally smaller and these effects of smoking (cardiac events, i.e. heart attacks) may therefore become evident sooner with earlier cardiac events,” she said.

“If you are in perimenopause or menopause (generally 35 to 60 years of age), you may be at particularly high risk. Further, if you have other risk factors that put your body at risk of chronic inflammation, such as obesity and diabetes — even more of a reason to quit smoking,” Morgan noted.

Strategies to quit smoking

Mesnier said measures to promote smoking cessation should include advice, counseling, behavioral interventions, and pharmacological therapy when necessary. Talking with a healthcare professional can be an important step to quit smoking.

Page noted that smokers, as well as medical professionals, must acknowledge how difficult it can be to quit this unhealthy habit.

“It is hard to believe that after more than a half century of research, people continue to smoke, which speaks to the great addiction potential of cigarettes,” he said. “It is important to note that patients have to want to quit, and having them tell you directly a specific quit date is essential.”

Morgan has straightforward advice for people who don’t smoke: “Don’t start. If you have started, there is no better time than now to quit,” she said.

Wright also has some direct advice: “The message is simple. Don’t take up smoking, especially if you are known to have coronary disease,” he said. 

“If you do smoke, quit. Now. You will benefit by next month. In about a decade, that excess risk will evaporate — but only if abstention from cigarette smoke is complete,” Wright concluded.

Takeaway

In a new study, researchers say people with coronary artery disease who stop smoking can lower their risk of heart attack or other major cardiovascular event by 44%, no matter when they quit tobacco use.

However, researchers noted that the risk increases by 8% for every year a person with coronary artery disease continues to stop. They added that people with this condition who reduce the amount they smoke don’t appear to have a lower risk than people who continue to smoke.

Experts say the sooner anyone quits smoking the healthier they will be.

• Real Housewives of Orange County‘s Vicki Gunvalson recently opened up about a health scare she experienced.
• What she initially thought was a stroke turned out to be pneumonia and sepsis.
• Sepsis is a potentially fatal overreaction of the immune system to an infection.
• The businesswoman said she was given a 10% to 20% chance of survival.
• She is now recovering but still dealing with low energy.

Real Housewives of Orange County’s Vicki Gunvalson spoke recently about a health scare that she went through earlier this month.

On an episode of My Friend, My Soulmate, My Podcast, she shakily told host Christian Gray Snow that she had nearly died.

The reality star explained that she was having her boyfriend Michael Smith join her because she had experienced amnesia and couldn’t remember all of the events that had occurred.

“Michael’s going to come in when I get blank,” she said.

Gunvalson then went on to relate how she had gotten her hair done and then went to the office on the day that it happened.

When she arrived at the office, Smith’s daughter Olivia, who worked there, was the first to notice something wasn’t right, she said.

She told the businesswoman that she was “speaking gibberish” and that an email she was typing didn’t make sense.

Luckily for Gunvalson, the client she was meeting with, who happened to be an emergency room doctor, suggested that she might be having a stroke, prompting her boyfriend’s daughter to take her to the hospital.

“And so, really, from that point on, I don’t recall much,” she said, breaking into tears.

She went on to reveal that the hospital “misdiagnosed” her with a sinus infection and released her that night.

Taking over, Smith told Snow that about three weeks earlier, Gunvalson had gotten on antibiotics to treat a sinus infection that was taking longer than usual to go away.

Smith then discussed coming home and finding the star “passed out” in the bathtub, after which he put her in bed to allow her to rest.

When he woke her “about 13-14 hours later,” Smith said she was “so discombobulated” that he was afraid she was having a stroke.

This led to a quick trip to the hospital, where she was diagnosed with pneumonia and sepsis and was given what Gunvalson recalled as a “10% to 20% [chance] of survival.”

After hospitalization and treatment with multiple antibiotics and steroids, Gunvalson is now home. However, she said that she is still low on energy. “I’m having a hard time getting it up. So that’s my biggest thing,” she said. 

What is sepsis?

Dr. Steve R. Fallek, who is a board-certified plastic surgeon and Medical Advisor to the Maskad and Revivv brands, explained that sepsis is a life-threatening condition that occurs when an infection causes widespread inflammation.

“This inflammation can trigger a cascade of changes that damage multiple organ systems, leading them to fail, sometimes resulting in death,” he explained.

Fallek added that any type of infection — whether it’s bacterial, viral, fungal, or parasitic — can potentially lead to sepsis.

If a person is experiencing sepsis, the symptoms can vary, he said, but generally, people will have a combination of the following:

• High fever or very low body temperature
• Rapid heart rate
• Rapid breathing or shortness of breath
• Confusion or disorientation
• Extreme pain or discomfort
• Clammy or sweaty skin

How can sepsis happen?

“Sepsis can happen when an infection that is not properly managed spreads into the bloodstream or throughout the body,” said Fallek.

“This triggers an immune response that, instead of only attacking the infection, also damages healthy tissues and organs,” he said.

Among the conditions that can cause sepsis are pneumonia, urinary tract infections, abdominal infections, and blood infections.

Having a weakened immune system, chronic illnesses, recent surgery, or hospitalization, particularly in intensive care units, can also set the stage for sepsis to occur, according to Fallek.

Dr. John C. Lowe, a physician with Restore Care, described sepsis as being caused by “the hyperactivity of the immune system.”

“The molecules are put in the blood to suppress the infection but in most victims, this leads to too much irritation,” he explained.

When this occurs, people can experience localized blood clotting, increased permeability of the blood vessels, low blood pressure, fluid accumulation in the tissues, and poor blood flow to the brain and organs.

“If the events are not rapidly intervened, they may culminate in dysfunction of more organs, development of septic shock and eventual death,” said Lowe.

What should you do if you suspect you have sepsis?

Lowe said that sepsis is an emergency, which means that every minute counts.

“In case you think you have sepsis or someone else has it, then do not wait and consult the physician,” he said.

Lowe further explained that treatments for sepsis, such as antibiotics and intravenous fluids, are only effective if administered quickly.

“In case there is a persistent rapid heart rate with confusion, breathlessness, or other features of sepsis, do not hesitate—either call out for an ambulance or rush to the hospital,” he advised.

“This is the kind of state where every second can count for life or death,” Lowe concluded.

Takeaway

Real Housewives of Orange County star Vicki Gunvalson recently spoke on My Friend, My Soulmate, My Podcast about a close brush with death that she experienced a few weeks prior.

The reality star, who was being treated for a sinus infection, thought she was having a stroke, but it turned out that she had pneumonia and sepsis.

Sepsis is an overreaction of the immune system to a bad infection. If not treated quickly, it can cause people to go into septic shock and die.

If you are ever experiencing symptoms of sepsis — such as rapid heart rate, confusion, and breathlessness — experts say you shouldn’t hesitate to seek out emergency medical care.

• Weekend warriors — individuals who get most of their physical activity over one or two days in a week — gain similar brain health benefits as those who exercise more regularly.
• According to a new study, weekend warriors had reductions in risk for dementia, stroke, Parkinson’s disease, anxiety, and depression, which is comparable to a more traditional workout schedule.
• The study builds on previous research that has shown weekend warriors also experience significant cardiovascular health benefits.

Weekend warriors reap similar brain health benefits as individuals who exercise more regularly throughout the week.

Researchers have increasingly taken interest in the “weekend warrior” exercise phenomenon: when an individual tends to get the majority of their physical activity in during one or two days of the week. 

Whether due to work or family responsibilities, many people may feel like they have less time for exercise and leisure activity during the week, leaving it for the weekend instead.

But can you really get the same health benefits when cramming weekly exercise into a shorter period of time According to multiple large studies: yes.

While prior studies have focused on outcomes like cardiovascular health and mortality, the latest research, published August 21 in Nature Aging, focused on brain health benefits, including reduced risks for neurological conditions like Parkinson’s disease and mental health conditions like anxiety and depression.

Across a broad spectrum of brain health conditions, weekend warriors showed similar benefits as those with a more traditional exercise schedule when compared to individuals who were inactive.

The findings suggest that from a health perspective, the body may not distinguish between daily exercise or more sporadic activity, as long as weekly physical activity recommendations are met: at least 150 minutes of moderate intensity activity per week.

“It’s really about the volume, not the pattern,” said Shaan Khurshid, MD, MPH, a cardiac electrophysiologist at Massachusetts General Hospital. Khurshid wasn’t affiliated with the study, but has previously published research on weekend warriors and cardiovascular disease outcomes.

“Overall, I think the study was well done. There is a lot of potential to learn more about the ‘weekend warrior’ pattern. So, it was a natural extension to look at brain health in an analogous manner to what we did with cardiovascular health,” Khurshid said.

‘Weekend warriors’ have lower risk of dementia, stroke

The study involved more than 75,000 participants whose health and lifestyle data was available through the UK Biobank. Participants tended to be older, with an average age of 61 years old. The cohort was also well represented by women, making up about 55% of the group.  

While some prior studies on weekend warriors have relied on self-reported data, which tends to be less reliable and objective, researchers used accelerometer (fitness tracker) data to determine participants’ weekly exercise patterns.

Researchers subdivided participants based on these exercise patterns into one of three groups:

• Inactive: Participated in less than the recommended 150 minutes per week of moderate to vigorous physical activity.
• Regularly Active: Participated in 150 minutes or more of moderate to vigorous physical activity per week.
• Weekend Warriors: Participated in 150 minutes or more of moderate to vigorous physical activity per week, with more than half of their activity occurring within 1–2 days.

It’s important to note that although the phrase “weekend warrior” is used, none of the research specifically indicates that physical activity has to occur on weekends. Instead, it simply refers to physical activity concentrated over a few days. Interestingly, this group made up the largest proportion of exercise patterns, accounting for nearly 40% of all participants. 

Researchers divided brain health into neurological and psychological conditions. The neurological grouping included Parkinson’s disease, stroke, and dementia. Psychological conditions included depression, anxiety, and bipolar disorder.

Over more than eight years of follow-up, the weekend warrior group saw comparable reduction in risk to the regularly active group across the entire spectrum of brain health. Bipolar disorder was a notable outlier; no significant association was found between it and physical activity patterns.

Brad Donohue, PhD, a professor of psychology and Creator of The Optimum Performance Program in Sports (TOPPS) at the University of Las Vegas who wasn’t affiliated with the research, told Healthline the findings were exciting.

“The positive relationship between exercise and mental health in scientific studies is becoming increasingly clear. They indicate  that moderate-to-vigorous exercise, regularly or on a weekend warrior schedule improves mental health and physical health,” he said.

After adjusting for health and lifestyle factors, risk reduction levels for specific conditions among weekend warriors were significant across all conditions.

• dementia: 23%
• stroke: 13%
• Parkinson’s disease: 49%
• depression: 26%
• anxiety: 28%

“There are people who might be discouraged from exercise because they think that they have to do it regularly. And this study seems to show that if you can find the time to do one or two days of moderate to vigorous exercise, it’s going to offer very significant health benefits,” Donohue added.

Are there risks associated with being a weekend warrior?

Packing in all your physical activity into a weekend may not always be feasible, but getting as much exercise as you can on a regular basis, even if it’s only for short bouts, can still be helpful.

“This doesn’t change my recommendation that people should try to keep moving as much as they can,” Michael Fredericson, MD, director of PM&R Sports Medicine and co-director of the Longevity Center Stanford Medicine, told Healthline. Fredericson wasn’t affiliated with the research.

“But, on the other hand, for those people who can’t, this is still encouraging that if all you can do is exercise on the weekend you’re still going to get a really significant benefit,” he added.

He pointed out that this and other weekend warrior studies have focused on that 150-minute per week threshold, which is, essentially, the bare minimum that people should be getting. For serious health benefits that actually improve longevity, you’ll likely need to double that amount of physical activity per week.

“Maybe you can meet those basic guidelines, just exercising one or two days a week, but you’re probably not going to be able, nor should you try, to do 300 minutes a week all at once,” he said.

He also cautioned that by concentrating physical activity into a short period of time, you may put yourself at risk of injury.

“There’s a potential downside to achieving very high volumes of activity in a short period of time, especially if you’re not used to that pattern. It always makes sense to listen to your body to ramp up your activity and volume in a way that is sensible,” said Khurshid.

Still, Khurshid said the message people should take home about the consistent data on weekend warriors is that they have the freedom to get their activity how and when it works for them.

 “I view that as empowering: we’re able to tell patients, at least on the basis of the data that’s available coming out, that you can structure your exercise the way it makes sense for your lifestyle,” he said.

Takeaway

Research indicates that so-called weekend warriors — people who get the majority of their physical activity over just one or two days per week — get the same brain and cardiovascular benefits as those who exercise during the week.

Weekend warriors experienced significant reduction in risk for both neurological conditions like stroke and Parkinson’s disease, and mental health conditions including depression and anxiety.

Experts say that the findings should empower people who find time to exercise on a schedule that works for them.

• Mosquitoes can carry viruses or parasites that cause a number of diseases in people.
• When a mosquito carrying a virus or parasite bites a person, it can pass on the microbe.
• The most common mosquito-borne diseases in the U.S. are West Nile, malaria, and eastern equine encephalitis.

More than just a summertime annoyance, mosquitoes can also spread disease. When mosquitoes bite and drink blood from a person or animal, they can pick up a virus or parasite. If they bite another person or animal, they can pass on that microbe.

The recent rise in mosquito-borne illnesses across the U.S. has many people concerned about the potential risks to their health and how they can best protect themselves.

“Minimizing excessive mosquito exposure is probably the only thing people can do to protect themselves,” said Marc Siegel, MD, a professor of medicine in the Division of Infectious Diseases at the George Washington School of Medicine and Health Sciences. 

“So avoid the times that mosquitoes tend to feed more, which is dusk to dawn,” he told Healthline.

If you do have to be outside, wear pants and a long-sleeved shirt or jacket, and wear mosquito repellent, he said—especially in wooded or swampy areas.

However, Siegel points out that not every mosquito that bites a person will be carrying a virus or parasite.

Over 200 types of mosquitoes live in the continental United States and U.S. territories, according to the CDC. Yet, only about 12 can spread a virus or parasite that makes people sick.

“Most mosquito bites are not going to result in West Nile virus because the vast majority of mosquitoes are not infected with West Nile virus,” he said.

Climate change, though, has led to the spread of mosquito-borne illnesses to new parts of the world, which will increase people’s exposure to these diseases.

Below are the four most common types of mosquito-borne illnesses, the risks they can pose, and how health experts recommend you can best protect yourself.

West Nile virus

Birds are the natural hosts of West Nile virus. Mosquitoes that become infected by biting and drawing blood from a bird can pass on the virus when they bite a person.

Only about one in five people infected with West Nile virus will have symptoms, which can include fever, headache, body aches, and vomiting. In addition, about one in 150 infected people will develop a serious, sometimes deadly, illness.

West Nile is the most common mosquito-borne disease in the continental United States, according to the CDC. There have been 289 West Nile cases reported to the CDC in the country so far this year. In 2023, there were over 2,566 cases in the country.

This year, cases have occurred in 33 states in the Northeast, South, Midwest, and Southwest.

“There are probably a higher number of total infections, many of which are not diagnosed,” said David Sullivan, MD, a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health.

However, “this is still less than the chance of being hit by lightning,” he told Healthline.

There are no specific medications to treat West Nile virus disease or vaccines that can prevent it.

People of any age can develop severe illness if they are infected with West Nile virus. But those 60 years of age or older are at greater risk for more serious disease.

Dr. Anthony Fauci, once the top US infectious disease expert, recently became infected with West Nile virus. After being hospitalized for a week, Fauci, 83, is recovering at home, reports STAT.

Other people with a greater risk for severe illness include those with cancer, diabetes, high blood pressure, an immunocompromising condition, or other medical conditions.

In an effort to reduce the risk of West Nile virus to the public, the New York City Health Department has been spraying pesticides in parts of the city to control the mosquito population.

Eastern equine encephalitis

Eastern equine encephalitis, or EEE, is a rare but potentially deadly disease caused by a virus passed onto people through the bite of an infected mosquito. Most people infected with the virus don’t develop symptoms.

Those who do become infected may develop symptoms such as fever, chills, body aches, and joint pain. Some people may develop more serious inflammation of the membranes surrounding the brain and spinal cord. About one-third of people who develop severe eastern equine encephalitis die from their illness.

“In worse cases, the virus infects the tissue of the brain, and that’s when we call it encephalitis,” said Siegel. “That is more serious and is much more likely to lead to death or long-term neurological deficits in patients who survive.”

Sullivan said both very young children and older adults are at higher risk of severe illness from eastern equine encephalitis. In contrast, West Nile virus tends to affect older adults more than young children, he said.

Most cases of eastern equine encephalitis occur in eastern or Gulf Coast states. So far this year, four cases have been reported to the CDC, with 38 reported in 2019.

The virus passes between mosquitoes and birds found in freshwater hardwood swamps. Another mosquito species is needed to pass the virus from infected birds to people or horses.

There is no vaccine treatment for eastern equine encephalitis. People with severe symptoms will be given medications and other therapies to manage their symptoms. 

In Oxford, Massachusetts, about 50 miles west of Boston, a man in his 80s was exposed to the virus, health officials announced on Aug. 16.—the first reported human case of eastern equine encephalitis this year in the state.

To minimize further risks to the public, Oxford health officials recommended an outdoor curfew from dusk to dawn, the peak biting time for many mosquitoes. 

Similarly, Plymouth, about 40 miles south of Boston, said all public parks and fields will be closed from dusk to dawn after a recent eastern equine encephalitis infection diagnosed in a horse.

Malaria

Around 247 million malaria cases occurred worldwide in 2021, with around 619,000 malaria deaths. This disease is caused by a parasite that infects a certain kind of mosquito. Malaria cases mainly occur in tropical parts of the world, especially Africa.

Malaria was once common in parts of the United States but was eliminated from the country in the mid-1950s. However, around 2,000 malaria cases are imported into the United States each year by people traveling to other parts of the world.

In 2023, several locally acquired malaria cases occurred in Florida and Texas for the first time since 2003.

Symptoms of malaria, which can include flu-like illness and headache, range from mild illness to severe disease.

Prescription drugs are available to treat and cure malaria. A malaria vaccine is also available in parts of the world where malaria regularly occurs, such as in parts of Africa.

Dengue

Each year, up to 400 million people worldwide are infected with a dengue virus, according to the CDC. Not everyone gets symptoms, which can include aches, eye pain, muscle or joint pain, nausea, vomiting, and rash.

Dengue is most commonly found in tropical and subtropical areas of the world. So far this year, over 4,000 Dengue cases have been reported to the CDC, with cases occurring in most states.

However, most cases reported in the continental United States occurred in travelers infected in other areas. Limited local spread of dengue has been reported in Arizona, California, Florida, Hawaii, and Texas.

There is no specific treatment for dengue, but people may be given medication to relieve pain. In the United States, a dengue vaccine is available for use in children ages 9 through 16 with laboratory confirmation of a previous dengue infection who live in an area where dengue is common.

Takeaway

Over 200 types of mosquitoes live in the continental United States and US territories. Only about 12 can spread a virus or parasite that causes illness in people. When mosquitoes bite and draw blood from an animal or person, they may pick up a disease-causing microbe.

The most common mosquito-borne diseases in the United States are West Nile, malaria, dengue, and eastern equine encephalitis. Some cases occur in returning travelers who were infected in other parts of the world.

West Nile is the most common mosquito-borne disease in the United States, with thousands of reported cases each year. Around 80% of people infected with West Nile virus will have no symptoms. However, some people with symptoms may develop a serious, sometimes deadly, illness.

• New research has found that six herbal supplements that are popular on TikTok may cause liver damage. 
• Researchers at the University of Michigan concluded that supplements, including Ashwagandha, Green Tea Extract, and Garcinia cambogia, may be hepatoxic. 
• However, experts say in most cases, these risks only occur if you’re taking high doses of these supplements. 
• It’s best to do your research before adding any supplement to your health and wellness routine.

Numerous users on social media platforms like TikTok have espoused the benefits of herbal supplements, leading to a surge in their popularity.

However, a new study conducted by researchers at the University of Michigan found that six popular herbal supplements, including green tea extract, turmeric, and ashwagandha, are linked to liver risks.

Furthermore, the researchers estimated that 15.6 million U.S. adults have taken at least one herbal supplement in the last 30 days that might be hepatotoxic or damaging to their liver.

Healthline spoke with experts to help clarify what you need to know about the reported benefits and potential risks to your liver that have been linked with these six popular herbal supplements.

Ashwagandha

“Ashwagandha can help reduce serum cortisol levels, which can lead to people getting better, more restful sleep,” says Pedram Kordrostami, MD, founder and CEO of supplement company Omre. 

“Ashwagandha’s ability to calm the brain is mostly due to the compounds it contains. Considered an adaptogen, ashwagandha is a kind of herb that, when consumed, helps the body deal with stress,” he explains. 

Kordrostami says the benefits will be more pronounced in people who experience insomnia. 

As for the potential risks to your liver?

Kordrostami says it’s rare, but the effects can range from mild to moderate. 

Severe liver injury has been reported by some who have used ashwagandha. In other cases, symptoms arose and then resolved after the supplement was stopped.

He says people need to be wary of commercially available herbal supplements marketed as only containing ashwagandha. 

“These supplements usually are a mixture of multiple different herbs and nutritional products, which are often mislabeled,” he explains. 

Black cohosh

Black cohosh is a plant native to North America that has been traditionally used for various medicinal purposes.

Samael Tejada, a functional medicine expert and founder of Liquivida, says its potential benefits include managing symptoms associated with menopause and hormonal imbalances and reducing hot flashes, night sweats, changes in mood, and sleep disturbances. 

It’s also used to manage menstrual cycles and alleviate PMS symptoms.

“Several case reports have linked black cohosh use to liver damage, including cases of hepatitis and liver failure, necessitating liver transplants,” Tejada notes. 

Risks include jaundice, elevated liver enzymes, and acute hepatitis. 

“The cause is not entirely understood but may involve individual susceptibility, dosage, duration of use, or contamination of supplements. Women with a history of liver disorders should be particularly cautious,” he warns. 

Garcinia cambogia

Garcinia cambogia is a tropical fruit that is commonly used as a weight loss supplement.

Tegada says it contains hydroxycitric acid (HCA), which is believed to help suppress appetite and block an enzyme in the body used to produce fat.

“It’s known for potential weight loss benefits, improved cholesterol levels, reduced appetite, increased stamina, and reduced fatigue, making it popular among athletes,” he explains. 

However, the potential liver risks may outweigh the benefits. 

“Reports of acute liver failure and hepatitis-like symptoms have been associated with Garcinia cambogia, often in individuals who combine it with other weight loss supplements,” Tejada notes. 

“Severe cases can lead to the need for liver transplantation, possibly related to the supplement’s chemical properties or interactions with other supplements.” 

Green tea extract

Green tea extract is derived from the leaves of the Camellia sinensis plant and is rich in antioxidants known as catechins.

Tejada says its high anti-oxidant content helps combat oxidative stress, which is linked to chronic diseases such as cancer, diabetes, and cardiovascular disease.

“It’s believed to improve metabolism and aid in weight loss, improve brain function, including memory loss and focus, reduce cholesterol levels, and may have potential anticancer properties for certain cancers,” he notes. 

As for liver risks, Tejada says risks include liver toxicity, hepatitis, and liver failure, with toxicity believed to be dose-dependent and possibly due to excessive accumulation of catechins in the liver, leading to oxidative damage and inflammation.

Red yeast rice

Red yeast rice is a traditional Chinese medicine made by fermenting rice with a type of yeast called Monascus purpureus.

“It contains compounds known as monacolins, which are similar to statins and may help lower cholesterol levels,” Tejada explains. “It may also improve heart health and lower the risk of cardiovascular disease. Some studies suggest it also has anti-oxidant and anti-inflammatory properties.” 

But there are risks.

“Red yeast rice may cause elevated liver enzymes, liver inflammation, and, in rare cases, acute liver failure,” Tejada notes. “The risk increases with higher doses and prolonged use, especially when combined with other statins or hepatotoxic drugs.” 

Turmeric

Turmeric is a spice commonly used in Indian cuisine and traditional medicine. It contains a compound called curcumin, which has powerful anti-inflammatory and antioxidant properties. 

These properties can help with conditions like arthritis or inflammatory bowel disease.

“Turmeric’s antioxidant properties help neutralize free radicals and reduce oxidative stress,” Tejada explains.  “It also supports digestive health, is believed to enhance cognitive function, and even potentially reduce the risk of certain cancers.” 

However, he says high doses of turmeric supplements have been associated with liver toxicity, leading to elevated liver enzymes and, in rare cases, liver damage. 

Takeaway 

A new study from researchers at the University of Michigan found that six popular herbal supplements that have soared in popularity due to content on TikTok can pose risks to your liver.

The herbal supplements studied included ashwagandha, turmeric, red yeast rice, green tea extract, garcinia cambogia, and black cohosh.

Health experts warn that just because an herbal supplement is popular or “natural” doesn’t mean it’s without risk.

If you are taking supplements, it’s important to ensure you’re taking the correct dose to avoid liver damage.

It’s also a good idea to speak with a healthcare professional before you begin taking any herbal supplement.

• Eli Lilly officials announced a new program that provides consumers with single-dose vials of the weight-loss drug Zepbound at a discount price of 50% or more.
• Consumers who pay for these medications out of pocket must purchase Zepbound through the LillyDirect program. They must also have a valid prescription from their healthcare provider.
• Experts praised the new program for its ability to get weight-loss medications to more people in an affordable manner.

The weight-loss drug Zepbound is about to become significantly less expensive for a select group of people who take the medication.

Officials at Eli Lilly, the manufacturer of the drug, have announced plans to sell Zepbound in 2.5 milligram and 5 mg single-vial doses at a discount of 50% or higher compared to the list price of all GLP-1 medications for obesity.

Here’s the pricing details on the new plan:

• A four-week supply of 2.5mg doses will be $399 ($99.75 per vial).
• The cost for a four-week supply of 5mg doses will be $549 ($137.25 per vial).
• The plan does not include the delivery pens typically used for the weekly injections or syringes needed to extract the medication from the vials.

The discount plan is available only to Eli Lilly’s self-pay customers who purchase pharmaceuticals through the company’s LillyDirect program. These customers pay out of pocket for medications rather than going through an insurance company.

Company officials said the cost savings are similar to those offered to people who are uninsured, but they noted the new program will expand the number of customers who can get Zepbound at a lower cost.

“We are excited to share that the Zepbound single-dose vials are now here, further delivering on our promise to increase supply of Zepbound in the U.S.,” Patrik Jonsson, executive vice president and president of Lilly Cardiometabolic Health and Lilly USA, said in a statement.

“These new vials not only help us meet the high demand for our obesity medicine, but also broaden access for patients seeking a safe and effective treatment option.”

Growing demand for Zepbound, other weight-loss drugs

Company officials said they hope the new plan will help ease shortages of Zepbound supplies and other GLP-1 weight-loss drugs.

Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, agreed that the new program should be helpful since there is still more demand than supply for weight-loss medications.

“Making the medication more affordable will increase the number of people who can access it,” Ali told Healthline.

Other experts also praised the program as a way to help meet the demand for weight-loss drugs.

“People living with obesity have long been denied access to the essential treatment and care needed to manage this serious chronic disease,” said James Zervios, the chief operating officer of the Obesity Action Coalition, in a statement.

“Expanding coverage and affordability of treatments is vital to people living with obesity. We commend Lilly for their leadership in offering an innovative solution that brings us closer to making equitable care a reality. Now, it’s time for policymakers, employers and insurers to work with pharmaceutical companies to ensure no one is left behind in receiving the care they deserve and need,” Zervios continued.

Caroline Apovian, MD, a professor of medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Massachusetts, told Healthline that although the new Eli Lilly Zepbound plan isn’t optimal, it still should make the weight- loss drug more affordable and more accessible.

“I hope other companies will try to lower the price of self-pay drugs for our new obesity medications as well as for type 2 diabetes,” Apovian said.

Zepbound prescription required for discount

Consumers who utilize Eli Lilly’s savings plan must have a valid, on-label prescription for Zepbound from their healthcare provider.

Company officials said this requirement is necessary to ensure that customers are not using the medication for cosmetic weight loss.

They added they hope the easier access to Zepbound will discourage people from using untested, knock-off drugs to treat obesity.

Ali urged companies to stay vigilant about consumers using alternative medications or using the drugs for purposes other than treating obesity and other serious weight management issues.

“The medication still requires a prescription from a legitimate provider. That being said, there will always be people seeking this medication for inappropriate use,” he said.

Novo Nordisk on making medications more affordable

Officials at Novo Nordisk, the manufacturers of the weight loss drugs Ozempic and Wegovy, told Healthline that the key to making these medications more affordable is by expanding consumer coverage through insurance companies and government programs.

“The most effective way for the millions of Americans living with obesity to access affordable medication is by ensuring coverage through government and commercial insurance plans,” a Novo Nordisk spokesperson told Healthline.

“We will not stop advocating for insurance coverage until all Americans have full coverage for obesity medicines and that becomes the standard, not the exception.”

“Novo Nordisk supports additional legitimate options as it creates more safe supply for Americans living with obesity and is a testament to the significant unmet need of addressing obesity as a serious, chronic disease,” the spokesperson added.

What to know about GLP-1 drugs

Zepbound and Mounjaro contain the active ingredient tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. Both are manufactured by Eli Lilly.

Zepbound is approved for use as a weight-loss medication. Mounjaro is approved as a treatment for type 2 diabetes.

Novo Nordisk has two injectable weight-loss medications, both of which include the active ingredient semaglutide, a GLP-1 drug. Ozempic is prescribed to treat type 2 diabetes while Wegovy is used as a weight-loss medication.

Novo Nordisk also manufactures Rybelsus, a daily pill that contains semaglutide that is used to treat type 2 diabetes in adults.

All these medications have performed well in clinical trials.

Last week, researchers reported that in a clinical trial Zepbound and Mounjaro were effective in helping people with obesity or weight management issues maintain weight loss over a 3-year period as well as significantly reducing their chances of progressing from prediabetes to type 2 diabetes.

In May 2023, researchers reported that Wegovy helped reduce obesity in half of teens in a 68-week clinical trial.

In addition, Ozempic has been shown to lower the risk of death from kidney disease as well as reduce the risk of certain cancers.

Some research has indicated that medications containing trizepatide might be more effective for weight loss than those containing semaglutide.

Takeaway

Eli Lilly announced that single-dose vials of the weight-loss drug Zepbound will be sold at a discount price of 50% or more.

Consumers who pay for medications out of pocket without insurance must purchase these products through the LillyDirect program and must also have a valid prescription from their healthcare provider.

Experts say the new program is a step forward for making weight loss drugs more accessible and affordable.

• A study in overweight individuals concludes that misaligned body clocks are associated with raised metabolic risk factors.
• The findings show these metabolic changes vary between males and females.
• Realigning the body clock with sufficient sleep could help reduce the negative health implications of overweight and obesity, researchers say.

Circadian rhythms are 24-hour cycles that the body goes through each day — an internal “body clock.” These cycles include fluctuations in levels of hormones and neurotransmitters and drive the daily sleep-wake cycle.

A recent study from researchers at Oregon Health & Science University (OHSU) shows that people with overweight or obesity whose circadian rhythms are poorly aligned may experience negative metabolic effects.

The findings, published August 20 in The Journal of Clinical Endocrinology & Metabolism, suggest these negative effects vary significantly between males and females.

Readjusting the body clock could potentially reduce some of the risks associated with overweight and obesity, researchers say, although more evidence is needed to determine these effects.

How does overweight or obesity affect sleep?

Scientists have known for many years that getting enough good quality sleep is essential for good health. However, many people in our modern society are getting fewer hours of shuteye than ever.

Research has also shown a close relationship between inadequate sleep and weight gain.

For instance, the authors of a review on the subject concluded that short sleep duration was significantly associated with the risk of developing obesity in the future, but that long sleep duration was not. Research also suggests that circadian misalignment may be linked to increased energy intake and obesity risk.

Jacob Teitelbaum, MD, a board-certified internist and expert in chronic fatigue syndrome, fibromyalgia, sleep, and pain, explained why circadian rhythms are so important. 

“The circadian rhythm is the critical ‘orchestra conductor’ for your body,” he told Healthline. “It regulates the proper timing of your hormonal and immune systems, and numerous other functions.” Teitelbaum was not involved in this study.

Studies have shown that circadian misalignment — which could mean feeling awake while the internal body clock is promoting sleep or eating when the body should be sleeping — is associated with less energy expenditure during the day.

In other words, people in this misaligned state burn fewer calories. Not sleeping enough is also linked to consuming more calories throughout the following day.

The relationship is complex, though, and researchers are still trying to understand precisely how body clock misalignment and insufficient sleep impact metabolic health.

What’s the relationship between circadian rhythm and obesity?

In the latest study, the scientists recruited 15 females and 15 males, all with overweight. They measured their body composition and took blood samples.

They also assessed their dim-light melatonin onset (DLMO). Melatonin is an important hormone that helps maintain circadian rhythms. As the day draws to a close and light levels fall, the brain produces melatonin. As levels increase, the individual becomes increasingly sleepy.

DLMO measures when melatonin release begins in dimly-lit conditions. Because melatonin release is a sign that the body clock is preparing an individual for sleep, scientists use DLMO as a marker of circadian rhythm phase.

By measuring the time difference between melatonin beginning to rise and the participant going to sleep, the researchers gauged the level of circadian rhythm misalignment.

Study co-author Brooke Shafer, PhD, a postdoctoral researcher with the Sleep, Health, & Chronobiology Laboratory at OHSU Portland Campus School of Nursing explained why this is important: 

“Your body has a time that it starts to signal the brain to fall asleep, and if we try to sleep really close to that time, we may have trouble sleeping or have a lower quality sleep,” Shafer told Healthline.

Following the week-long study, the researchers identified sex-specific effects of body clock misalignment.

Misaligned males had:

• higher levels of abdominal fat
• higher levels of blood fat (triglycerides)
• a greater risk of metabolic syndrome

Misaligned females had:

• a higher percentage of overall body fat. 
• higher blood sugar levels.
• a higher resting heart rate.

Shafer shared that she was surprised by the sex differences. “These findings really emphasize that there is no one-size-fits-all approach to maintaining healthy behaviors,” she said.

In particular, she explained, “the sex-specific differences in how sleep habits affected glucose and triglyceride levels were quite notable.”

This is important because individuals who have high levels of blood fat or blood sugar have an increased risk of heart disease.

These findings suggest that “circadian disruption may not only promote a trajectory of weight gain but could also contribute to negative health consequences in a sex-dependent manner in those already with overweight/obesity,” the study authors wrote.

The researchers hope that optimizing circadian alignment could help reduce the risk of poorer health outcomes, particularly in people with overweight or obesity.  

Shafer said the team will continue to study the impact of circadian rhythm misalignment.

“Our next steps are to look at sex-specific differences in health markers for individuals who are vulnerable to extreme sleep disturbances, such as those who work during nighttime hours,” she said.

How to realign circadian rhythm

The current study is small-scale, so scientists need to carry out more work to confirm the results. However, a number of studies have shown that a misaligned body clock is linked to negative health outcomes.

The good news is that most people can readjust their body clock with good sleep habits. 

This could mean that an individual with overweight might be able to reduce their risk of metabolic diseases by working to realign their circadian rhythms. However, trying to maintain a healthy weight should still be the primary goal.

Chelsea Perry, PhD, owner of Sleep Solutions in Westborough, MA, not involved in the study, and member of the American Academy of Sleep Medicine, suggested the following tips to for getting your internal body clock back on track:

• Maintain a consistent sleep schedule, even on weekends.
• Get exposure to natural light, especially in the morning. 
• Limit screen time and bright lights in the evening. This helps signal to your body that it is time to wind down. 
• Gradually adjust your bedtime and wake time by 15–30 minutes each day to help ease your body back into its natural rhythm.

Cherilyn Davis, MD, a board-certified pediatrician with Elliston Pediatrics, likewise not involved in the study, offered additional tips to optimize sleep:

• Avoid things that may disrupt sleep, like drinking caffeinated drinks before bedtime. 
• Make your sleeping space comfortable, cool, and dark. 
• Avoid napping or exercising late in the day, as this may make you less tired at night and disrupt circadian rhythm.

Takeaway

A new study concludes that people with overweight and have a misaligned body clock may be at a greater risk of metabolic disease. Conversely, the authors hope that realigning circadian rhythms might help reduce these risks.

• About 2% of people in the United States have an unruptured brain aneurysm.
• Most aneurysms don’t show any signs or symptoms.
• Peggi Wegener shares her story of experiencing an aneurysm.

It was a typical Saturday afternoon in January for 65-year-old Peggi Wegener as she enjoyed one of her favorite pastimes, crocheting. However, the day took a turn when she suddenly experienced a “popping” sensation in her head.

“[When] I looked up, I had double vision and remember thinking, Wow, that’s really weird,” she told Healthline.

At first, she thought it might be related to the one contact she wore to enhance her distance vision, but she quickly began to worry that she might be experiencing a stroke. After she found her way to the bathroom, she examined her face looking for signs of stroke.

“[The feeling] didn’t last a long time, but it lasted long enough for me to end up sitting down on top of the toilet and just kind of sitting there thinking, What is happening? What is going on? It cleared, and so again, I kind of sat there thinking, Do I feel okay? Does anything hurt?”

Because the sensation passed, Wegener moved on with her day. The next morning, she woke up with a headache but went to church as usual. Her headache continued to get worse, and when she got home, she felt queasy. She decided to call her brother, a retired primary care physician.

“[Whenever I call him], he usually does the typical ‘Ahuh, ahuh. Just go to your primary care doctor tomorrow’ like no big deal…This time, I tell him, and he says, ‘You need to go to the emergency room right now,’” said Wegener.

How an aneurysm diagnosis ignited self-advocacy

By the time Wegener arrived at the ER, her headache had intensified. She stayed overnight and underwent several tests, including an MRI, which discovered an aneurysm.

“The word aneurysm is scary to me. I don’t know much about it, but my colleague’s 20-something son [suddenly died] of an aneurysm that ruptured,” she said.

Unlike Wegener’s case, the majority of aneurysms often show no symptoms and are discovered by accident when medical workups for unrelated causes are performed, said Dimitri Laurent, MD, an endovascular neurosurgeon at Norton Neuroscience Institute.

However, he said subarachnoid hemorrhage (a bleed into the space around the brain) may be the first presentation of a brain aneurysm.

Signs of subarachnoid hemorrhage include:

• severe headache
• neck stiffness
• seizure
• loss of consciousness

“When aneurysms grow to a large size, they may cause compression on the surrounding brain and cranial nerves. Symptoms are dependent on the aneurysm location and the critical structures that are affected. This can result in double vision, restricted eye movements, gait instability, difficulty with speech or swallowing,” Laurent told Healthline.

Similar to Wegener, many people describe feeling a “pop” at the onset of the headache due to the subarachnoid hemorrhage, said Patrick Youssef, MD, a neurosurgeon at The Ohio State University Wexner Medical Center.

“This can then be followed by nausea, vomiting, double vision, or loss of consciousness,” he told Healthline. “The headache can persist long after the aneurysm is treated and the patient is stabilized.”

After learning about her aneurysm, Wegener was discharged from the hospital and told to follow up with a cardiologist, stroke clinic, and endovascular surgeon, who had a 5-week waiting time.

With some help from her brother, she advocated to get into the endovascular surgeon sooner.

The support of her adult children also inspired her to push for proper treatment.

“All I have is a word that is scary, and I have my child staying with me, and so…every night I would go to bed saying, ‘Please do not let me die and my child have to find me,’” she said.

Treatment, recovery, and finding hope

A week after seeing the endovascular surgeon, Wegener underwent surgery in February 2024 with a Medtronic Pipeline device that is a neurovascular stent designed to divert blood flow away from the aneurysm through a minimally invasive procedure. The device was paired with endovascular coils, which are also designed to prevent blood flow into the aneurysm.

“The basic process of aneurysm treatment involves elimination of the aneurysm from the normal arterial flow. Essentially, if blood cannot enter the aneurysm, then the aneurysm cannot rupture and bleed,” said Youssef.

In addition to flow diversion and flow disruption treatment options like Wegener underwent, he said there are a variety of methods to treat aneurysms, including open surgical procedures such as clipping or bypass and sacrifice of the diseased blood vessel.

“This would involve a craniotomy and surgical procedure. The advantage to open surgical procedures is if there is a space occupying hemorrhage, this can be evacuated at the same time to relieve pressure from the brain,” said Youssef.

He noted that endovascular treatment options are less invasive and can be performed with a needle puncture in the femoral or radial artery.

“These procedures include coiling of the aneurysm by placing platinum coils inside the aneurysm to fill it. This can be balloon or stent-assisted as needed based on the vascular anatomy,” Youssef said.

When Wegener woke up from her surgery, she was surprised she didn’t experience much pain.

“Normally, you wake up from surgery, and you’re real clear that you had surgery, and the only thing was I had a headache,” she said.

She was also elated when her doctor told her she didn’t have any limitations and could resume life as usual.

“I’m like, OK, I had this thing in my brain that could potentially kill me, but I can now do anything I want?” she said. “[It] is amazing and I did go back doing anything I wanted.”

After surgery, she took a blood thinner for three months, followed up with her doctor, and will continue to receive screenings going forward.

“[This] is sounding like an ongoing thing, but at the end of the day, I’m gonna live my life like I’m not gonna sit around and wait to die,” said Wegener.

Living life with gratitude and resilience

About 1 in 50 people in the United States have an unruptured brain aneurysm.

“With an estimated 2% of the population having a brain aneurysm, most of whom are unaware, this means that someone you know probably has a brain aneurysm,” said Laurent.

While aneurysms are often termed “ticking time bombs” as if they are a disaster waiting to happen, he said the majority of brain aneurysms do not rupture. 

“The goal is to identify those aneurysms at high risk of rupture and treat them before such an event occurs,” he said.

Ways to reduce the risk of an aneurysm are to avoid activities and lifestyle choices that could damage your blood vessels, such as smoking and illicit drug use, atherosclerosis (plaque buildup on the walls of blood vessels), having uncontrolled high blood pressure, and being overweight or obese. However, some people may have a family history of brain aneurysms or may have been born with a weakness in the walls of the blood vessels, which puts them at risk for aneurysm.

Before Wegener’s experience, the only thing she knew about aneurysms was that people died from them.

“[To] know that it can be found and can be repaired and you can resume your life, it’s just remarkable…to be able to take a little of the fear out of hearing the word,” she said.

Recovering fully from her aneurysm reinforced a gratitude for life she learned five years earlier after being diagnosed with early stage breast cancer.

“I mean, I’m not saying I didn’t have a meltdown when I was diagnosed with breast cancer, a meltdown when they told me about this aneurysm, but it was being able to right myself and say, ‘OK, hang on, all you know is you have this named something; you don’t know what your future holds, so stay right here, one day at a time, and live it as well as you can,’” she said.

• In a new clinical trial, the GLP-1 drug tirzepatide was effective in helping people maintain weight loss over a 3-year period.
• Researchers reported the resulting weight loss also lowered participants’ risk of progressing from prediabetes to type 2 diabetes.
• Experts agree these medications are effective, but encourage a long-term commitment to weight loss through a healthy diet and regular exercise.

A new clinical trial presents more evidence showing the GLP-1 drug tirzepatide can help people lose weight over a long period of time as well as reduce their risk of developing type 2 diabetes.

Officials at Eli Lilly made that announcement while unveiling the latest results of their 3-year SURMOUNT 1 clinical trial.

Company officials reported that people in the study who received weekly injections of tirzepatide, which is sold under the brand names Mounjaro and Zepbound, reduced the risk of progression from prediabetes to type 2 diabetes by 94% when compared to study participants who were given a placebo.

They also said that tirzepatide treatments led to sustained weight loss during the 3-year period. They noted that study participants who stopped receiving tirzepatide after 176 weeks began to regain weight. These participants also had signs of progression to type 2 diabetes during a 17-week follow-up period.

The company plans to submit the clinical trial results to a medical journal and present the findings at the Obesity Week 2024 conference sessions in November.

“These data reinforce the potential clinical benefits of long-term therapy for people living with obesityand prediabetes,” said Jeff Emmick, MD, senior vice president of product development at Eli Lilly, in a
statement.

Tirzepatide led to long-term weight loss, lowered diabetes risk

In the clinical trial, researchers studied 1,032 adults who had prediabetes as well as obesity or other weight management issues.

The study was a multi-center, randomized, double-blind, parallel, placebo-controlled trial. Participants were put on a reduced-calorie diet and asked to follow a regular physical activity routine.

Participants who received trizepatide were given weekly injections of 5 milligrams (mg), 10mg, or 15mg. The other participants received a placebo. Results from the clinical trial results showed:

• Participants who received tirzepatide for the 176-week period had an overall reduction in risk of
  progression to type 2 diabetes of 94%.
• Those who were given the 15mg dose experienced a nearly 23% decrease in body weight compared to
  about 2% for people who were given a placebo.
• People who received the 10mg dose had an average weight loss of nearly 20%.
• Those on the 5mg dose experienced an average weight loss of about 15%.

Researchers reported that during the 17-week off-treatment follow-up period, the participants who stopped taking tirzepatide began to regain weight and saw their risk reduction to type 2 diabetes fall to 88% compared to the placebo group.

Weight management is a long-term commitment

Experts said the post-treatment data in Eli Lilly’s trial reinforces the notion that weight loss is a long-term commitment.

“The study showed that weight regain is common after stopping these medications,” said Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California. Ali is not affiliated with the study.

“Many doctors are starting to think of obesity as a long-term chronic condition such as diabetes or hypertension; therefore, long term treatment may be required to maintain the weight loss,” Ali told Healthline.

Robert Gabbay, MD, PhD, the chief scientific and medical officer at the American Diabetes Association, agreed with the need for long-term commitment. Gabbay is likewise not affiliated with the study.

“These medications, like most all medications, tend to only be effective when being used. Therefore, it’s not surprising that there is weight regain with cessation of therapy.  We have seen this in other studies with this class of drug,” Gabbay told Healthline.

“Overall, as the full results become available and published, this becomes another consideration for high-risk individuals with prediabetes to help bend the curve on the number of people developing diabetes,” he added.

Health risks of obesity

The Centers for Disease Control and Prevention (CDC) estimates that about 40% of U.S. adults have obesity.

Experts say the weight gain that results from obesity can cost a wide array of health issues, including:

• type 2 diabetes
• high blood pressure
• high cholesterol
• heart disease
• fatty liver disease
• certain cancers
• stroke

In addition, the CDC estimates that obesity accounts for more than $170 million in annual medical expenditures.

GLP-1 drugs successfully aid weight loss

The first GLP-1 drug that received approval from the Food and Drug Administration (FDA) was exenatide. It was given the greenlight in 2005 as a treatment for type 2 diabetes.

The first GLP-1 drug that was approved specifically for weight loss was Saxenda (liraglutide) in 2014.

Wegovy, a semaglutide drug, received FDA approval for weight loss in 2021. Since then, other GLP-1 drugs, including Ozempic as well as the medications containing tirzepatide, have been spotlighted for their ability to suppress appetite and help people lose weight.

In the past two years, there are have been numerous studies lauding the weight-loss benefits of GLP-1 drugs. In addition, researchers have reported that GLP-1 drugs can help:

• reduce the risk of some cancers
• reduce the risk of a heart attack
• curb addictive behaviors such as smoking and alcoholism
• reduce rheumatoid arthritis flare-ups

“The trial results will likely increase the number of people seeking these medications,” Ali said. “Surgical weight loss still has the best long-term results for those who qualify. These medications are currently the most effective alternative to surgery.”

What to know before taking weight-loss drugs

There are side effects to taking weight loss medications. The researchers noted that some participants in the SURMOUNT 1 trial developed gastrointestinal-related symptoms that were mild to moderate in severity.

Specific side effects of GLP-1 drugs may include:

• nausea and vomiting
• diarrhea
• constipation
• abdominal pain
• indigestion

The researchers also pointed out that Zepbound may cause tumors in the thyroid and potentially result in thyroid cancer.

They noted that people should consult with their healthcare provider before taking medications such as Zepbound. They added the people who take medications such as insulin to treat diabetes should monitor their blood sugar levels while taking Zepbound.

They also said that the effectiveness of birth control pills could be diminished while taking Zepbound.

“I advise patients starting these medications to use them as a tool to help change to a healthier diet and lifestyle,” Ali said. “Also, depending on the degree of obesity, the patient may require long-term treatment for
sustained results.”

Takeaway

The latest results from GLP-1 drugmaker Eli Lilly’s clinical trial show that tirzepatide helped people maintain weight loss after 3 years. This resulting weight loss also helped significantly lower participants’ risk of developing type 2 diabetes.

Experts agree GLP-1 medications are effective, and encourage people need to make a long-term commitment to weight loss by following a healthy diet and exercising regularly.