Friday, November 7, 2025

Melatonin May Harm Your Heart, Experts Warn — 5 Ways to Sleep Fast Without It

Melatonin May Harm Your Heart, Experts Warn — 5 Ways to Sleep Fast Without It

Key Findings of the Study

A recent preliminary study has uncovered a potential link between long-term use of melatonin supplements and an increased risk of heart failure, as well as other serious health outcomes. The research, set to be presented at the American Heart Association’s Scientific Sessions 2025, analyzed five years of health data for 130,828 adults with insomnia. Half of these individuals had used melatonin supplements for at least a year, while the other half had not been prescribed it.

The results showed that those using melatonin long-term had a 4.6% chance of developing heart failure over five years, compared to 2.7% in the non-melatonin group. This means that melatonin users had a 90% higher risk of heart failure than those who did not take the supplement. Additionally, they were three and a half times more likely to be hospitalized for heart failure and twice as likely to die from any cause during the same period.

However, the researchers emphasized that their findings show an association, not causation. They noted that people with insomnia may already have underlying health issues that could contribute to both the need for melatonin and the risk of heart problems.

Should You Be Concerned?

Dr. Fady Hannah-Shmouni, MD FRCPC, Medical Director at Eli Health, advised caution but not panic. He explained that the study does not prove that melatonin directly causes these health issues. Instead, he pointed out that insomnia itself can lead to hormonal changes, such as increased cortisol levels, which may affect cardiac health. He also noted that the study's limitations include the lack of information on the severity of insomnia and the possibility that some participants in the non-melatonin group may have taken over-the-counter melatonin.

Despite these uncertainties, Dr. Shmouni stressed the importance of consulting a healthcare provider before starting any new supplement, including melatonin.

Tips for Falling Asleep Without Melatonin

If you're looking for alternatives to melatonin, experts suggest several strategies to improve sleep quality:

  1. Keep Your Sleep Schedule Consistent
    Maintaining a regular sleep and wake time helps regulate your circadian rhythm. This consistency ensures that your body releases the right hormones at the right times, promoting better sleep and alertness during the day.

  2. Practice a Nighttime Routine
    A calming bedtime routine signals to your body that it's time to wind down. Activities like taking a bath with Epsom salts, drinking chamomile tea, or reading can help reduce stress and prepare you for sleep. Avoid screens before bed, or use night mode settings to minimize blue light exposure.

  3. Try Relaxation Exercises
    Techniques such as deep breathing, yoga, progressive muscle relaxation, or meditation can lower cortisol levels and promote mental balance. Guided meditations or visualization exercises can also help ease you into a relaxed state.

  4. Stay Physically Active
    Regular exercise can improve sleep quality by reducing stress and regulating cortisol levels. However, it's best to avoid strenuous workouts close to bedtime, as they may interfere with sleep onset and quality.

  5. Create the Ideal Sleep Environment
    A cool, dark, and quiet bedroom supports better rest. Aim for a temperature between 65 to 70°F (18 to 21°C) and use tools like earplugs, white noise machines, or eye masks to block out disturbances.

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox. Good morning. Yesterday was the submission deadline for Rural Health Transformation applications, and some states have started releasing overviews of their plans. Here’s what we know so far (a special thanks to my colleague Lauren Giella for her reporting on this topic).

At the time of writing on Wednesday, three state governors had publicly unveiled their blueprints: North Dakota Governor Kelly Armstrong, Missouri Governor Mike Kehoe and Mississippi Governor Tate Reeves. Unsurprisingly, telehealth expansion and stronger workforce pipelines were core to their proposals.

But I did find another common thread throughout the states’ plans: They all called for some level of interoperability between health care stakeholders. Missouri aims to create a “unified, regional network” that will connect providers, public health agencies, at-home resources and digital health tools to expand access, according to Kehoe’s news release. Mississippi wants to build a “connected, data-driven network of emergency, clinical and community-based services,” Reeves said. And Armstrong outlined four strategic initiatives for his state, including “connecting technology, data and providers for a stronger North Dakota.”

A few weeks ago, on the heels of the Summit on the Future of Rural Health Care, I wrote about the skepticism that many health care executives expressed when asked about the $50 billion transformation fund. (If you missed it, you can check out that newsletter here.) I’ve come across a few recurring concerns: (1) that the plans will be too broad to effect real change, (2) that they’ll set up costly programs that won’t be sustainable once the cash infusions end and (3) that $50 billion is not nearly enough to offset the $1 trillion in Medicaid and CHIP cuts that hospitals are expecting in the next decade.

We don’t have every state’s plan yet, and the information we do have isn’t very detailed. But so far, those concerns I outlined above appear to be valid—especially when it comes to the sections on “connected networks.”

Health care IT executives know that data exchanges aren’t easy to build. Leaders spoke about this in depth at My healthy of life’s Digital Health Care Forum, chronicling privacy concerns, internal data silos and complex relationships among competitors. And those are concerns from well-funded health systems, which have more solid IT infrastructures than their rural, independent counterparts.

Plus, maintaining a connected network will undoubtedly take resources, and the fund only lasts five years. It is unclear how these projects will sustain themselves over the next few decades.

Fortunately, states won’t be working toward these goals on their own. This week, a coalition of health tech companies launched the Collaborative for Healthy Rural America, specifically designed to advance the Rural Health Transformation projects. The group intends to address access challenges through “shared infrastructure, unified data and modern technology,” and will work up an “AI-enabled interoperable operating platform” to help states carry out their visions, according to the Collaborative’s website and news release.

Founding members include Lumeris (primary care), Teladoc Health (virtual care), Nuna (an app with an AI “coach” for chronic disease patients), Deloitte (for data systems interoperability expertise), and Unite Us (a company that builds networks to coordinate care and improve communications between health care and human services organizations).

Plus, the Collaborative aims to improve access nationwide, not just in awarded states. Perhaps these companies, which are well-resourced and nationally scaled, could give some of the state-wide plans a helpful boost—and keep this entire endeavor from being a bust. We’ll know more when the winners are announced December 31, and as the funds are distributed in early 2026.

What stood out to you from the early Rural Health Transformation Fund proposals? Send me an email at a.kayser@newseek.com and let me know.

In Other News Major health care headlines from the week

My healthy of life will host a live webinar, “Traveler to Teammate: Becoming a Hospital Where Nurses Choose to Stay,” on Wednesday, November 19, at 2 p.m. Eastern.

My colleague Aman Kidwai will host the discussion with Dr. Regina Foley (Chief Nursing Executive and Chief Clinical Transformation and Integration Officer, Hackensack Meridian Health), David Rutherford (Senior Advisor, HR Transformation, OhioHealth) and Dr. Vikas Sinai (President of the Lown Institute). Learn more and register for free here. I hope to see you there!

Athenahealth announced an ambient scribing tool and a clinical copilot named Sage at its annual customer event on Tuesday. The new capabilities will begin user testing in the first half of 2026, at no additional charge to customers.

I spoke with the EHR vendor’s CEO, Bob Segert, about his decision to build these tools internally—and what it might mean for external solutions that currently live atop the platform. Get the scoop here.

Hospitals and health systems across the nation are rebranding. At least six organizations shared new names this week, with many of them symbolizing new visions.

BJC Health System in St. Louis is dropping the “system” from its name and adopting a new tagline (“Because every moment deserves exceptional care”). Franciscan Missionaries of Our Lady Health System in Louisiana will now be known as FMOL Health. CHI Memorial hospitals across Tennessee and Georgia will adopt the name of their parent company, Chicago-based CommonSpirit Health. The national senior living provider CareSouth Health System is rebranding across all its divisions and lines of business, launching an updated website and logo.

Some of the updates apply to recently acquired facilities. For example, Washington Regional Medical Center in Fayetteville, Arkansas, is renaming Physicians’ Specialty Hospital once it assumes operations of the facility on December 1. The new name will include “Washington Regional” ahead of the existing title. And HCA Healthcare has rebranded more than 35 care sites across Charleston, unifying them under the for-profit system’s name, according to The Summerville Journal Scene.

These announcements come as many health systems seek to create a more seamless health care experience for patients—and some look to form competitive brands that can go head-to-head with household names like Amazon and marketing wizards like Hims & Hers.

The government has been closed for more than a month, and anxieties are festering amid lingering policy questions—especially the fate of the Affordable Care Act (ACA) enhanced premium tax credits (APTCs).

On Monday, a pair of House Democrats and a pair of House Republicans released a bipartisan statement of principles, proposing a temporary two-year extension of the APTCs, among other reforms to prevent fraud and “ghost beneficiaries.” It’s not a guarantee, but it is a welcome signal of compromise.

Pulse Check Executive perspectives on key industry issues

Financial sustainability is a top concern for health system CEOs and CFOs. That’s why I sat down with Ann Jordan, president and CEO of the HFMA, for this week’s Pulse Check.

The HFMA (or the Healthcare Financial Management Association) is in a unique position. It’s a non-lobbying organization and expands beyond the traditional definition of a professional association because it speaks to a number of players rather than to a single trade, like nursing or cardiology. In other words, it occupies a “horizontal lane of an industry that is becoming increasingly dynamic and destabilized,” as Jordan put it.

Currently, the HFMA is focused on equipping members with insights to advance their organizations’ financial management and applying that acumen to guide strategy in the broader health care industry, Jordan said. To advance that goal, the HFMA recently launched the business initiative Vitalic Health, which focuses on convening stakeholders to discuss industrywide solutions. In mid-August, they launched a “Vitals Tracker” to rapidly assess the health of the health care system—and declared that it is in “serious condition.”

Here’s what Jordan told me about the new tool and the work to stabilize health systems’ finances.

Editor’s Note: Responses have been edited for length and clarity.

What are the main barriers to financial sustainability for hospitals and health systems right now, and how are you working to address them?

Point number one is understanding what we should look at in terms of financial sustainability and from what perspective. When your practice [is] horizontal [like the HFMA’s], should it be from the perspective of sustaining a business, a stakeholder group or the overall “greater system,” if you want to call it that, to advance health care generally to our communities?

When you talk about sustainability, one, naturally, is making sure that there is financial sustainability so that service can be delivered right, at the end of the day. If health systems and hospitals cannot stay open, health care is not going to be delivered. So that’s primal, that’s basic.

But this longer-term play in terms of financial sustainability and outcomes, there really has not been a meaningful and objective conversation on what that means, and that’s a little scary, given the fact we have a $5 trillion industry pushing upward to 20 percent [of the nation’s] GDP. So, part of this initiative underlying Vitalic Health and the tracker was, for the first time, to start identifying those measures and sub-measures, how they have interconnectivity and [whether they are] getting better or worse. It’s strange that that has not been done before at the macro level.

For me, in terms of what are we thinking about [when it comes to] how we become financially sustainable, we’re trying to educate and understand [that] ourselves, and we want the whole industry to help us.

Tell me a little bit more about the Vitals Tracker. As you were building this out, what did you find that is pertinent to call out?

When we began this initiative of Vitalic Health, we didn’t want to tell people what we were doing and why, because then they would bring bias to the table. So there was a whole working task force for about a year behind the scenes that looked into the components and elements of financial sustainability from the top lines in health care. That was done generatively, and that was purposeful. [We] gathered up a big vat of knowledge to begin with, starting with the question, do you believe the system is financially sustainable? Over 95 percent of that big group said “no.” And you can’t get experts to agree with that percentage on anything, right?

Then [we started] breaking down all the components: First of all, what matters from a macro-economic standpoint? Our intuition is to go mezzo, to go [are] organizations surviving? That’s not what this [tracker focuses on]. This is really looking at that dynamic part of the industry, year over year. Are we getting better or worse?

Of all these different factors that we’re hearing, there are two main buckets. One is the cost, the financial element, so we wrestled it as expenditures and affordability. The other is the outcome, which we’re calling functional longevity, and that takes into account not only the wellbeing of the population, but the social determinants of health that are interconnected with those outcomes. Think of it as your hardcore financial components and what’s going into it, and then the outcome side of them, breaking down all the measures and sub-measures that are seen as the most critical indicators, year over year.

The beauty of this tracker is we didn’t have to invent sub-measures on our own and collect data. There are enough first-class institutions that have been collecting this for a very, very, very long time. But how do we create a storytelling and a measurement device that can not only look backwards to allow us to learn, but proactively be turned forward to see how potential policy could impact us in the future?

You mentioned that 95 percent of experts said the health care system is not financially sustainable. But how many believe that it can become sustainable? Is there optimism there?

This is where you begin to have different views. If you go back to innovative disruption models—incumbents versus disruptors, builders versus fixers—we’re at that epicenter right now, and I think it’s going to be a combination.

So, do we think we can get there? We don’t have a choice. There’s too much on the line when you’re talking about health care. To serve our communities, we have to figure out a way to do it, and there are a lot of brilliant people out there looking at this.

But what needs to happen is a concerted effort so [that], at the end of the day, it’s not a few that survive; there is that interconnectivity across all stakeholders to go forward together. Right now, you see a lot of trends going around the country where different groups are incubating together, right? They’re forming these different initiatives, where stakeholders, maybe 10 or so, are coming together to look at how our model can be successful. Well, that’s going to just lead to bigger silos across the country.

How do we make sure there is that ongoing concern, so that overall, we’re delivering health care in a way that is available to all Americans? I believe there is optimism that it can become sustainable. I believe there are very divergent theories right now in terms of the incumbents versus the disruptors, on what that looks like.

From your perspective, what does a path to financial sustainability require? How do we get the entire health system on the same page?

We’re calling it solve-based convening. There needs to be a purposeful effort to bring together stakeholders that are aligned in purpose, [that] put down [their] own self-interest and bias. Look at the opportunity or the problem before you, and come together and solve it, because there’s so much of that collaboration that can occur, starting with payers and providers.

I think everyone can admit there’s a lot of administrative waste that’s driving up cost in health care. There are ways to solve that. An army of the willing, if you want to call it that, can do this in a safe, unbiased place.

Now, going back to HFMA, we’re non-money, we are apolitical, and we play in that horizontal plane, and that’s why we do feel it’s upon us to step forward at this time, to be one of those few organizations that can set a table and bring everyone to it. I truly believe, too, when your mission is leading the financial management of health care and the data is showing that your system is financially unsustainable…what obligation do we have to step up right now? That is the soul-searching that we had to do, and it’s critical for all the players in health care to do right now.

The other comment that I’ll say is, if we are the leaders of health care financial management [and] we don’t [take action], if not us, who? Eventually someone is going to have to lead this. We can either be active leaders and participants, or we can let someone else come that might have bias or different interests than our own.

What’s one thing that you would recommend all hospital and health system CFOs do to improve their organizations’ financial sustainability?

I want to thank them for their perseverance and resilience. They have been going through [a lot, from] the pandemic to this current environment of drastic change. Whether it be from AI and technology or the [Trump] administration, the role of the CFO in the United States health care realm has changed so much. And, man, are they stepping up to the task.

Number one, I want to recognize that [at a] higher level, they have become the ultimate risk managers, and to understand the consequences to the community of not making this work. That’s a lot of pressure. I want to give credit to those financial professionals leading us through all this change.

But in terms of what we need to be mindful of for sustainability, when you’re in a financial realm, it comes down to your payment model. All these different changes that are going on, we’re going to assess that a lot of it comes down to their payer mix, and a lot of it comes down to understanding risk pools.

So, as we’re going through all of this, be mindful [that] despite the fact we have all these things going on from supply chain, or going on from accelerating labor costs, the core comes down to that payment model—and that’s going to have to change, too.

The complexity of the CFO…think about it. They’re getting hit from all these macro-factors, [including rising] litigation costs. But to serve the patient, you gotta have that payment model intact.

It’s a very hard role right now. I definitely don’t have all the answers, but I think through the convening that we’re seeing, particularly of CFOs across the country, we’re trying very hard to figure it out.

C-Suite Shuffles Where health care leaders are coming and going

Dr. David Kirk has joined Regard as chief medical officer. He comes to the technology company—which specializes in proactive documentation solutions that review EHR data to recommend diagnoses—from WakeMed Health & Hospitals in Raleigh, North Carolina. He most recently served as the system’s chief clinical integration officer and executive medical director of critical care medicine and eICU.

AdventHealth named Todd Goodman its new CFO, just months after David Banks took the reins as president and CEO. Goodman has worked at the Altamonte Springs, Florida-based health system since 1991. He was promoted to CFO after serving as its executive vice president of finance. Read more at My healthy of life.

In Montgomery, Alabama, Jackson Hospital is assembling a power team to guide it through ongoing Chapter 11 bankruptcy proceedings— including a few former executives from the for-profit health system giant, HCA Healthcare. The 344-bed hospital appointed John Quinlivan as CEO. He spent nearly two decades at HCA Healthcare, overseeing hospitals in Florida and Georgia, and is charged with leading a restructuring to “avoid hospital closure,” according to a press release from Jackson Hospital.

The hospital also selected a new three-person board of trustees to help carry out the restructuring plan. That team includes Charles Evans (former president of HCA Healthcare’s Eastern Group), Jeff Crudele (former CFO of Allegheny Health Network) and Gary Murphey (a former CEO, CFO and chief restructuring officer at financially distressed companies in various industries, and the current managing director of Resurgence Financial Services). Click here for the full scoop from My healthy of life Senior Reporter Lauren Giella.

Executive Edge How health care execs are managing their own health

We’re heading into that end-of-year push, and many leaders are feeling the pressure to finish out 2025 strong and set expectations for 2026. But 10 tumultuous months behind us, it’s not uncommon to feel a little bit burnt out—and to feel like that holiday break can’t come soon enough.

This week, I asked Ellen Sexton, executive vice president and chief growth officer at Blue Shield of California, how she prioritizes herself while juggling the demands of health care leadership—especially as part of a team that serves 6 million members in the nation’s most populous state. Here’s what she told me.

Editor’s Note: Responses have been edited for length and clarity.

“Working in the health care industry means that every day, we are working for our members. Over the years, I’ve learned I have to take care of my own health and stay grounded to keep showing up fully for my team, my family and the members, partners and communities we serve. For me, that grounding comes from doing what I love, what brings me joy and by giving back to the community.

“In addition to making sure I schedule regular checkups (including dental and vision appointments) and follow preventive care recommendations, I find that how I spend my free time also impacts my overall health. After all, what we find joy in doing impacts our mood, our overall outlook on life and how we feel each day. I spend my free time listening to podcasts, reading (I highly recommend Poor Charlie’s Almanack, a collection of speeches and lessons encouraging lifelong learning), attending music festivals, walking my dog, Sugar, and doing anything that gives me an opportunity to get away from my desk and have fun.

“I also find that laughing with my family (I’m a proud hockey mom to a teenage son), friends and colleagues plays a big role in how I feel. I also strongly believe in giving back, and for me, that is expressed through service. It’s how I reconnect to the reason I chose this field in the first place: to support the whole person, including body, mind and spirit. That same belief guides my professional work, seeing our members as individuals with stories, families, and dreams.

“Giving back doesn’t always have to mean large-scale volunteerism. Sometimes it’s mentoring a colleague, checking in on a team member, or offering encouragement to a peer after a tough meeting. These seemingly small gestures create a ripple effect—lifting others while restoring my own sense of balance and purpose.

“Whether I’m volunteering with the Salvation Army, preparing for a Milwaukee Public Library Foundation Board of Directors meeting, or contributing to the Wisconsin School of Business External Advisory Board, these experiences remind me of the ‘why’ behind my work and the broader impact we can make when we lead with empathy.

“Through the years, I’ve learned that service is sustaining. It recharges my energy, deepens my empathy and reminds me that leading with heart is the best strategy for longevity, and thus, professional wellbeing.”

CEO Circle Insights from health care thought leaders around the world

Before you go, check out this profile of Dr. Bhana Chandrakamol, the director overseeing eight hospitals for the BPK Hospital Group in Thailand, and a member of My healthy of life’s CEO Circle. His interview traces his path from the “aha” moment that sparked his career in medicine, to the top of an innovative health system.

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox.

Related Articles Sutter Health Study Finds Ambient AI Can Ease Physicians Burnout Cigna Group Appoints New Chief Medical Officer States Submit Plans for Rural Health Transformation Funding Start your unlimited My healthy of lifetrial

Top Cat Food for Urinary Health Support

Top Cat Food for Urinary Health Support

Understanding Urinary Health in Cats

Urinary problems are among the most common health issues affecting cats, and they can range from minor and uncomfortable to life-threatening. In conjunction with your veterinarian’s guidance, the right cat food for urinary health is essential. Diet plays a vital role in supporting urinary tract health by helping cats maintain a proper pH balance.

Cats can be masters of hiding their pain and discomfort, so pet parents must pay close attention to signs and symptoms of urinary issues. Symptoms include, but are not limited to, frequent urination, bloody urine, and even urination outside the litter box after the problem has lingered. Without treatment, urinary blockages may turn into medical emergencies within hours.

Whether it’s urinary crystals, stones, blockages, or a urinary tract infection, your veterinarian should correctly diagnose the issue and provide treatment. In this guide, we’ll explore urinary cat food in both traditional and prescription formulas. Whether your cat has long-standing urinary problems or you are proactively managing things, understanding available options will help you make the best choice for your feline best friend.

Cat Food for Urinary Health: What Is It?

Cat food for urinary health is more than a fancy label; it’s designed to reduce issues that cause urinary problems in cats. Mineral balance, for example, is the foundation of urinary support. You’ve probably heard of the essential elements magnesium, calcium, and phosphorus. However, high levels of them may contribute to stone and crystal formation in your cat’s urinary tract and bladder. This is where problems begin.

Moisture and hydration are the most essential factors in urinary health, and for most cats, that means proper water intake. It’s always a good idea to monitor how much water your cat drinks, but as busy pet parents, that may not always be possible. Wet foods, which generally contain 75-to-80 percent water, help dilute urine and flush the bladder. Some cat food formulas slightly increase sodium to encourage drinking, but this should be closely monitored in cats with kidney or heart conditions.

Urinary diets may also help keep your cat’s urine on the acidic side, which is about 6.0 to 6.5 on the pH scale (your veterinarian can monitor this, and you can do so with specific urine strips at home). A pH reading in this range may help dissolve struvite crystals and prevent their formation. The right pH balance comes from the right ingredients, such as cranberry support, herbal ingredients, and natural acidifiers like DL-methionine.

Pro Tip:

Food is not a cure-all or complete preventative for urinary health in cats, which is why your veterinarian should closely monitor your cat.

Vetstreet’s Top Healthy Cat Food Choices for Mineral Balance

Best Overall for Urinary Health:

Tiki Cat Solutions & Mineral Balance Adult Chicken Recipe

Buy at PetSmart

Key Urinary Health Features Formulated for mineral balance support, the guaranteed analysis of Tiki Cat Solutions & Mineral Balance Adult Chicken Recipe reveals a maximum magnesium level of 0.15 percent and a maximum phosphorus of 1.4 percent, both of which may help reduce crystal formation.

The high level of 34 percent crude protein helps support overall adult cat health in this grain-free recipe. Scientifically balanced with vitamins A and E, it also contains omega fatty acids to support overall feline health.

Pros The low maximum magnesium content of 0.15 percent, compared to other standard dry foods, is ideal for urinary health. The formula is grain-free and high in protein, ideal for cat moms and dads who prefer a premium cat food. The kibble formula is easy for pet parents and great for cats who enjoy dry food. Deboned chicken is packed with essential nutrients cats need. Reviewed and recommended by Tiki Cat veterinary nutritionists. Rich in omega-3s and 6s.

Cons Dry food tends to have lower moisture than canned or wet varieties, but a topper can be added for more moisture. Some of the formula’s ingredients may have a higher carb content (such as chickpeas and peas), which may be a consideration for felines with metabolic risks. The guaranteed analysis of 1.4 percent phosphorus max is moderate; check with your veterinarian to see if this percentage is acceptable. (All cats are different).

Why It Made the List We chose this formula because it boasts a strong combination of features designed for urinary health in cats. While not a prescription food, this is a higher-quality dry food with controlled minerals in a grain-free formula.

Best Wet / High-Moisture Option:

Tiki Cat Luau Succulent Chicken in Chicken Consomme

Buy at PetSmart

Key Urinary Health Features Tiki Cat’s Succulent Chicken Recipe in Chicken Consomme contains non-GMO ingredients, is grain-and-potato-free, and has 70-to-80 percent moisture to support hydration and help dilute urine, which may reduce the formation of crystals. The lower mineral levels of 0.10 percent magnesium and 1.04 percent phosphorus are ideal.

Pros The wet formula may benefit cats with urinary issues, as this helps with hydration. The shredded chicken in broth is likely to appeal to even the most finicky cat. Grain-free and potato-free formula means minimal filler ingredients. Chicken is free of hormones and antibiotics.

Cons This is not a prescription formula. Even with more moisture than dry food, cats must still drink water if they also eat dry food. Some cats may not care for the flavor if they just don’t like chicken.

Why It Made the List The Tiki Cat’s Succulent Chicken Recipe in Chicken Consomme is species appropriate, has a controlled mineral foundation, and is high in moisture. We like that it does not require a prescription and that its ingredients are transparent. Many reviews indicate cats devoured the food and really enjoyed the taste, too, which is a bonus.

Best Dry Option:

Purina ONE +Plus Urinary Tract Health Formula

Buy at PetSmart

Key Urinary Health Features With real chicken as the first ingredient, every ingredient in the bag has a purpose. The Purina ONE +Plus Urinary Tract Health Formula is low in magnesium and may help reduce urinary pH. We like that it contains four antioxidant sources to support a strong immune system.

Pros Two important urinary health factors with lower magnesium and urine pH control. Combines urinary support and overall adult cat needs, like proper protein and immune/antioxidant support. Real chicken is ideal for most cats that enjoy it as a protein source. Veterinarian-recommended in an easy-to-serve kibble format.

Cons Like most dry foods, it has a lower moisture content than wet foods, so additional hydration is necessary. Exact mineral thresholds are not fully revealed (i.e., magnesium, phosphorus, calcium, and sodium). Contains corn protein meal, which may not appeal to some cat parents.

Why It Made the List The Purina ONE +Plus Urinary Tract Health Formula provides urinary support for cats without a hefty price tag or prescription. This is one of the few readily available dry foods for cats with urinary issues that promotes a healthy pH level while keeping magnesium levels in mind. Purina is a name that most pet parents know and trust, thanks to their extensive research in the pet food market.

Best for Picky Eaters:

BLUE Buffalo True Solutions Urinary Care Chicken Recipe

Buy at PetSmart

Key Urinary Health Features Formulated by veterinarians and animal nutritionists, BLUE Buffalo’s True Solutions Urinary Care canned food focuses on maintaining recommended urine pH levels and a controlled magnesium level in cats. The high moisture content of up to 78 percent helps promote hydration, which may help prevent urinary crystals.

Pros The wet texture is more ideal for urinary health than kibble aloe. Picky eaters may love the natural ingredients of real chicken, free of by-products. Contains no corn, soy, or wheat. No artificial flavors or preservatives.

Cons This is not a prescription diet, which may be required for some cats. There is no guarantee a finicky cat will consume this or any other food. Not highly available online, other than sources noted.

Why It Made the List This formula stands out by combining clinical urinary support with clean, natural ingredients, which is rare in the non-prescription world. The wet format promotes hydration while maintaining healthy urinary pH and mineral balance, but what sets it apart is its appeal to health-conscious pet parents seeking holistic options without sacrificing functional benefits for finicky cats.

Best Vet-Formulated / Premium Option:

Hill’s Prescription Diet c/d Multicare Stress Urinary Care

Buy at PetSmart

Key Urinary Health Features This veterinary diet requires a prescription and is clinically tested and formulated by Hill’s nutritionists and veterinarians to reduce recurrence of urinary signs by up to 89 percent. It is specifically designed to help dissolve struvite stones in as little as 7 days, though the average is 27 days. It may help promote a urinary environment in your cat’s bladder, reducing the risk of calcium oxalate or struvite crystals. The controlled levels of key minerals are ideal, too.

Pros Potassium citrate may help acidify urine and reduce crystal formation. Designed for lifelong feeding to cats suffering from urinary health concerns. Requires a veterinary prescription because it is a therapeutic strength diet. The 89 percent reduction in recurrence according to Hill’s is a strong point. Easy-to-serve kibble formula.

Cons Some pet parents may balk at the need for a prescription. A bit pricier due to its ingredients and veterinarian-recommended formula. It may not solve all urinary issues, including blockages and stone removal. Some cats may not find it palatable.

Why It Made the List This formula earns the Best Vet-Formulated or Premium Option designation for its combination of clinical research, veterinary endorsement, and proven results in managing urinary conditions. Further, Hill’s c/d Multicare represents the gold standard for cats with diagnosed or recurrent urinary issues, offering precise mineral control and urinary-specific ingredients backed by extensive clinical testing from a leading veterinary nutrition brand.

Best Budget-Friendly Option:

IAMS ProActive Health Urinary Tract Health Adult Dry Cat Food

Buy at PetSmart

Key Urinary Health Features Formulated to reduce urinary pH and promote feline urinary tract health, the IAMS Proactive Health Urinary Tract Health chicken formula is well-priced. It features DL-methionine for urinary acidification support and has chicken as the first ingredient.

Pros Widely available at most retailers and online. High-quality chicken protein from a trusted brand. Convenient dry format makes feeding easier. More affordably priced than others. Contains essential ingredients like calcium and potassium.

Cons It has a lower moisture content than wet food, which isn’t ideal for cats who don’t drink much water. Contains grains such as corn and rice. Does not explicitly disclose the specific mineral levels in each bag.

Why It Made the List This IAMS formula earns its place as the Best Budget-Friendly Option because it makes urinary support achievable for cat parents. It bridges the gap between everyday kibble and costly prescription diets by providing meaningful urinary-tract nutrition and gentle pH balance without the hefty price tag or veterinary authorization.

How We Selected & Evaluated Foods

We used the following criteria when selecting and evaluating each cat food for urinary health on our list: - Mineral content and balance - Ingredient transparency and quality - Moisture content and hydration support - Veterinary involvement or nutritionist input - Real-world feedback and reviews from pet parents - Price point - Accessibility - Need for a prescription or not - Palatability, even for finicky cats

Buyer’s Guide: What to Look For in a Cat Food for Urinary Health

Before you start your cat on a new food, for urinary health or otherwise, it’s always a good idea to speak with your veterinarian or veterinary nutritionist. Here are some other key points to look for: - Low Magnesium Levels - Balanced Urinary pH - Ample Hydration Support - Seek High-Quality Animal Proteins - Smart Sodium & Filler Choices - Transparent Formulas & Reliable Brands - Taste & Feeding Compliance

Pro Tip:

If your cat eats when you are away, consider using an in-home camera to monitor the behavior and the amount eaten.

Consider Prescription Diet

For cats diagnosed with stones, blockages, chronic urinary issues, or recurring infections, non-prescription diets may not be enough. Veterinary-prescribed formulas provide the precise mineral and pH control needed for accurate therapeutic results.

Feeding Tips & Best Practices

Be aware of these time-tested tips and best practices when switching or feeding your cat a diet for urinary health: - Gradual Diet Transition - Encourage More Water Consumption - Monitor the Litter Box

Pro Tip:

Take photos or video of your cat’s litterbox to show your veterinarian.

Caution & When to Consult a Veterinarian

Never second-guess things if your cat seems off, and keep in mind that a diet is not a cure-all for cats with urinary issues. For example, some stones need surgery, infections require antibiotics, and blockages demand emergency treatment.

If your cat strains to urinate, produces little or no urine, cries or is very vocal in the litter box, urinates outside of it, or you see blood, contact your veterinarian immediately. Male cats are especially at risk of life-threatening blockages within 24 to 48 hours.

Final Thoughts On Cat Food For Urinary Health

The right food plays a vital role in your cat’s urinary wellness in helping balance pH, regulate minerals, and support hydration to keep the urinary tract functioning smoothly. It may also reduce the risk of crystals, prevent recurrences, and keep your cat comfortable long term.

However, the best urinary health diet is the one your cat will actually eat every day. Consider their taste preferences, texture likes, health status, and your budget. Cats with a history of urinary issues have different needs than those without, so match the food to your cat’s individual situation. No two cats are alike.

Before switching diets, especially for cats with past or current urinary problems, consult your veterinarian. They can help identify the cause, recommend the right formula, and ensure the diet truly supports your cat’s health and comfort. Here’s to happy, healthy cats everywhere.

Thursday, November 6, 2025

Legislature Advances 'Medical Aid in Dying' Bill for Governor's Review

Legislature Advances 'Medical Aid in Dying' Bill for Governor's Review

The Debate Over Medical Aid in Dying

CHICAGO, Ill. – A new bill has been passed by the Illinois legislature that could allow terminally ill adults to access life-ending medication prescribed by a physician. This legislation, known as Senate Bill 1950, is currently awaiting the governor’s signature and, if signed, would take effect after nine months. The measure has sparked a heated debate between advocates and opponents, with supporters emphasizing compassion and autonomy while critics raise concerns about potential risks and ethical implications.

How the Bill Was Passed

The bill was approved by the Senate with a vote of 30-27 on Oct. 31, following its passage in the House with a 63-42 vote in May. It now only needs the governor's approval to become law. Advocates believe this will provide terminally ill individuals with a sense of control over their final days, while opponents express worries about the impact on vulnerable populations and religious values.

Support from Advocates

Suzy Flack, an advocate from Chicago, has been a strong supporter of the bill. She pushed for it in memory of her son Andrew, who died of cancer in 2022. Andrew chose to live in California, where medical aid in dying options were available, and he experienced a peaceful death. Flack believes that the bill will bring comfort to others in similar situations.

"Inevitably, losing a child is the hardest thing that anyone could go through," Flack said. "I am just comforted every day by the way his death was so peaceful. He had some control over things."

What the Bill Includes

Senate Bill 1950 outlines specific requirements for eligibility. Patients must be Illinois residents aged 18 or older with a terminal illness that is expected to result in death within six months. Two physicians must confirm the diagnosis. A diagnosis of major depressive disorder alone does not qualify patients for the medication.

Patients must make both oral and written requests for aid in dying. Physicians are required to evaluate the patient’s mental capacity and assess for any signs of coercion or undue influence. They must also inform patients of alternative hospice care and pain management options before prescribing the medication.

Those who qualify must be able to self-administer the medication, and they retain the right to withdraw their request at any time or choose not to ingest the medication.

Death certificates for those who use the medication will list the cause of death as the underlying terminal disease, not suicide.

Safeguards and Concerns

Bill sponsor Linda Holmes, D-Aurora, emphasized that there are over 20 safeguards in place to prevent abuse or coercion. She cited Oregon’s 28-year history of medical aid in dying, noting that no substantiated cases of coercion or abuse have occurred there.

However, critics like Jil Tracy, R-Quincy, expressed concerns about the six-month prognosis window. She argued that medical advancements can sometimes extend a patient’s life beyond the initial diagnosis. Holmes responded that doctors typically overestimate patients’ prognoses and that most patients who qualify do not end up taking the medication.

Tracy also raised concerns about the potential for potent drugs to fall into the wrong hands, particularly among young people struggling with mental health issues.

Impact on Physicians and Culture

Sen. Steve McClure, R-Springfield, drew parallels between veterinarians and physicians, suggesting that providing end-of-life care could create a mental health crisis among medical professionals. The American Medical Association has long opposed physician-assisted aid in dying, calling it incompatible with the physician’s role as a healer.

The bill does not require physicians to prescribe the medication and protects them from legal consequences for either prescribing or refusing to do so.

"Nobody who doesn’t want to be involved is going to have to be involved," McCurdy said.

Opposing Views

Sen. Chris Balkema, R-Channahon, called the bill a "slippery slope" and warned against introducing a "culture of death" in Illinois. He pointed to other states that have expanded medical aid in dying options over time.

Advocates argue that the bill is not about promoting death but about giving agency to those who are already dying. Suzy Flack emphasized that the term "assisted suicide" is misleading and insulting to those who seek to live.

Compassion, Not Suicide

Sen. Laura Fine, D-Glenview, described the issue as one of choice and compassion. She stressed that the bill is not about suicide but about allowing terminally ill individuals to make decisions about their own lives.

Flack hopes Gov. JB Pritzker will sign the bill to provide agency to people like her son. At a recent news conference, Pritzker said he was reviewing the legislation and acknowledged the pain of those facing terminal illnesses.

"I know how terrible it is that someone who’s in the last six months of their life could be experiencing terrible pain and anguish," Pritzker said.

HIV Crosses Borders, Trump's Plan Leaves U.S. at Risk, Expert Says

HIV Crosses Borders, Trump's Plan Leaves U.S. at Risk, Expert Says

The Importance of Global Health in Protecting American Interests

In a world that is increasingly interconnected, the health of people in other countries directly impacts the safety and well-being of Americans. Diseases such as HIV do not respect national borders, and the spread of untreated HIV in one region can pose a risk to U.S. citizens. This reality underscores the importance of global health initiatives in safeguarding public health both domestically and internationally.

Changes in U.S. Policy Under Trump's Administration

The Trump administration introduced several changes to U.S. global health policy that have raised concerns among experts and public health advocates. One significant shift was the America First Global Health Strategy, announced by the U.S. Department of State in September 2025. This strategy aimed to make "America safer, stronger, and more prosperous" by encouraging other governments to take responsibility for their citizens' health while promoting U.S. commercial and faith-based interests.

The plan included a commitment to purchase and distribute lenacapavir, a breakthrough HIV preventive drug, for up to 2 million people—primarily pregnant and breastfeeding women—in 10 countries heavily affected by HIV. However, this initiative has been criticized for not addressing the needs of the most vulnerable populations who require access to HIV care.

Disruption of PEPFAR and Its Consequences

One of the most significant impacts of the Trump administration's policies was the disruption of the President's Emergency Plan for AIDS Relief (PEPFAR), one of the most effective foreign assistance programs in U.S. history. Since its inception in 2003 under President George W. Bush, PEPFAR has saved an estimated 26 million lives and played a crucial role in reducing HIV deaths by 70% since 2004.

However, on January 20, 2025, President Donald Trump signed an executive order that paused funding for all foreign aid programs, including PEPFAR. This decision led to the shutdown of PEPFAR-supported clinics, halted medical shipments, and resulted in mass layoffs of the global HIV workforce. The dissolution of USAID further undermined PEPFAR's ability to function effectively.

The consequences of these actions have been severe. It is projected that the disruption will cause 4.1 million additional deaths and 7.5 million new HIV infections by 2030. These numbers highlight the devastating impact of cutting critical health programs.

Limitations of the New HIV Prevention Strategy

The Trump administration's new global HIV prevention strategy focuses primarily on preventing mother-to-child transmission of HIV. While this is an important goal, it overlooks the needs of other vulnerable populations, such as sex workers, people who use injectable drugs, men who have sex with men, transgender individuals, prisoners, and their sexual partners. These groups account for 55% of new HIV infections globally and face significant barriers to accessing care due to stigma, discrimination, and legal challenges.

Legal pushback allowed limited parts of PEPFAR to restart, but access to HIV medication was restricted to only pregnant and breastfeeding women. This exclusion leaves many at-risk individuals without the necessary support and treatment.

The Role of Community-Led Initiatives

Community-led initiatives have historically played a vital role in addressing HIV. Peer-to-peer support networks have been instrumental in connecting vulnerable populations with essential services. However, the Trump administration's strategy shifts focus away from these community-driven efforts, favoring government health care workers instead.

This approach raises concerns about the quality of care provided to marginalized communities. Many individuals living with or vulnerable to HIV distrust government-run facilities due to past experiences of discrimination, mistreatment, and lack of confidentiality. Research shows that fear of repercussions, such as arrest, violence, or loss of employment, further deters people from seeking care.

Faith-Based Organizations and Their Impact

The new strategy also reallocates funds to faith-based organizations, citing their potential reach through religious leaders. However, some of these organizations have been associated with anti-LGBTQ+ stances and discriminatory practices. For example, conservative evangelical groups have supported punitive laws against homosexuality in countries like Uganda, where HIV remains a major public health challenge.

These organizations often fail to provide the inclusive and non-judgmental care that vulnerable populations need. As a result, many at-risk individuals avoid seeking help due to fear of stigma and discrimination.

A Unique Approach to HIV

Effectively addressing HIV requires more than just medical treatment; it demands a comprehensive approach that considers the social, psychological, and structural factors affecting vulnerable populations. Unlike other diseases, HIV disproportionately affects adults and adolescents, requiring interventions focused on sexual health and harm reduction.

The Trump administration's strategy consolidates efforts across four diseases—malaria, polio, tuberculosis, and HIV—without accounting for the unique needs of each population. This one-size-fits-all approach may not be effective in addressing the specific challenges faced by those at risk of HIV.

A Healthy World Benefits Everyone

While the countries that benefited from PEPFAR may seem far from U.S. soil, their health issues are closely tied to American interests. In an interconnected world, global health crises can have far-reaching economic and societal consequences. The initial HIV crisis and the COVID-19 pandemic serve as reminders of the importance of global health security.

Ensuring that people worldwide receive appropriate HIV treatment and care supports U.S. national security, diplomatic, and economic interests. A healthy global population fosters economic stability and strengthens international partnerships. Ultimately, a healthy world contributes to a more prosperous, peaceful, and stable world for everyone.

Wednesday, November 5, 2025

Millions Miss Colon Cancer Screening, New Studies Reveal Solutions

Millions Miss Colon Cancer Screening, New Studies Reveal Solutions

Understanding Colorectal Cancer Screening Preferences

Tens of millions of middle-aged and older Americans have not received their recommended checks for early signs of potential colon cancer, either through the "gold standard" of colonoscopy or a non-invasive test. Two recent studies published in Current Medical Research and Opinion examine two aspects of the screening process: the preferences of patients and physicians for all currently available colorectal cancer screening options, and the impact of a 2023 federal policy change that eliminated out-of-pocket costs for those who get an abnormal result on a home-based stool test and then need a colonoscopy.

The preference study shows that 75% of adults eligible for screening would prefer a non-colonoscopy option based on a sample of their stool or blood as their initial test. Respondents received information about the nature, accuracy, and frequency of all currently available options. However, only 5% of physicians chose non-colonoscopy screening as their preferred option for their patients after receiving similar information.

The Role of Policy Changes in Colonoscopy Follow-Up

The other study shows that follow-up colonoscopies after abnormal home stool tests rose 41% after the policy that removed patient cost sharing took effect, even though the total number of colonoscopies didn't rise. Pre-cancerous polyps can be seen and removed during a colonoscopy, making the colorectal cancer screening process a key tool to prevent cancer.

Both studies were led by A. Mark Fendrick M.D., a University of Michigan Medical School professor with a decades-long interest in the prevention and early detection of colorectal cancer. He emphasized the importance of understanding why eligible individuals are not receiving this potentially life-saving preventive service.

"We hope these findings will increase the number of those undergoing screening and follow-up tests when necessary, ultimately leading to an increase in the number of pre-malignant polyps—that may progress to cancer—removed and more cancer cases detected at an early stage, when this cancer is more effectively and less expensively treated."

Fendrick, who leads the U-M Center for Value Based Insurance Design, has been a longtime advocate for reducing patients' out-of-pocket costs for care that delivers a high level of health benefit for an individual. This includes costs related to screening for multiple types of cancer, including follow-up tests needed to confirm or rule out a cancer diagnosis after an initial screening test.

Patient and Physician Preferences for Screening

To see which type of colon cancer screening tests would be preferred by individuals in the target group for screening, and by physicians, Fendrick and his colleagues conducted a predicted choice probability study. They did an online survey of 1,249 adults between the ages of 45 and 75 who have no individual or family history of colorectal cancer, and 400 physicians divided equally between primary care doctors and gastroenterologists.

They asked both groups to choose a preferred screening option for themselves or their patients, from among colonoscopy, several types of stool-based testing, and blood-based testing. Each respondent received information about the nature of each test, how often it needs to be repeated for ongoing screening, how often it gives a true positive result when a person does have cancer (sensitivity), and how often it gives a true negative result when a person doesn't have cancer (specificity).

The physicians also received information about each test's ability to detect non-cancerous growths in the colon, called adenomas or polyps. Insurance coverage or cost to the patient were not addressed.

In all, 39% of the screening-age individuals chose multi-target stool DNA tests (mt-sDNA, the product made by Exact Sciences), 25% chose colonoscopy; 21% chose the blood test, and 15% chose a stool test called a fecal immunochemical test or FIT, which looks for microscopic signs of blood that could be related to cancer.

Among people who had had a colonoscopy in the past, colonoscopy and mt-sDNA were preferred by nearly equal percentages (34% and 32%, respectively). Among those who had never had any screening test for colorectal cancer, or had had a test other than colonoscopy, mt-sDNA preference was far higher than all other options.

Among physicians, 95% chose colonoscopy and just over 4% chose mt-sDNA for their patients; less than 1% chose either of the other two tests. There was no difference between primary care and gastroenterology practitioners.

"Understanding patient preferences is critical to encouraging screening, and in this survey we show that most consumers choose noninvasive testing even if it means more frequency and less accuracy than the 'gold standard' of colonoscopy," Fendrick said. "But it is extremely important that we clearly convey at the time of screening to those who choose non-invasive tests that a colonoscopy must be performed after an abnormal result, which up to 10% will receive depending on the modality chosen."

That could involve having patients formally "commit" to follow-up colonoscopy if needed when they choose a home-based test. It could also include help with navigating logistical issues that accompany colonoscopy, such as scheduling, bowel preparation, and the need for a driver to accompany the patient. Fendrick is working with others at U-M Health to increase follow-up testing among patients at U-M primary care clinics.

The Impact of Cost Reduction Policies

The idea of seeing colorectal cancer screening as a process, rather than a single test, formed the basis for federal policies that took effect in January 2023. The policies required private insurance companies and Medicare to make follow-up colonoscopies available without cost to patients who had an abnormal result on a stool-based screening test, including co-pays, co-insurance and deductibles.

In their new paper, Fendrick and colleagues examined national insurance claims data for 10.8 million colonoscopies performed in 2022 and the first 11 months of 2023. They were able to see which ones involved patients who had had an abnormal result in the last six months on a non-invasive stool test that looks for blood or DNA.

The number of these follow-up colonoscopies saw a relative increase of 41% from 2022 to 2023, even though the total number of colonoscopies performed each month didn't change appreciably. The absolute increase was 1.5%, because the percentage of all colonoscopies that were coded as follow-ups to abnormal stool tests went from 3.6% to just over 5% of all colonoscopies.

Given the relatively fixed supply of colonoscopy appointments in the U.S., this suggests that increased noninvasive testing could lead to a shift in use of colonoscopies, rather than an increase in procedures performed. This is desirable, says Fendrick, because patients are already facing delays in colonoscopy scheduling thanks to a guideline change in 2021 that made 20 million Americans between the ages of 45 and 49 eligible for no-cost screening, as well as ongoing catch-up for patients who delayed screening during the height of the COVID-19 pandemic.

At the same time, clinicians and health systems are interested in maximizing the efficient use of colonoscopy teams and facilities but not overwhelming them, said Fendrick.

More information: A. Mark Fendrick et al, Patient and physician preferences among colorectal cancer screening tests: updated predictions from a discrete choice experiment, Current Medical Research and Opinion (2025). DOI: 10.1080/03007995.2025.2576596 Mallik Greene et al, Completing the colorectal cancer screening process: impact of eliminating cost-sharing for follow-up colonoscopy, Current Medical Research and Opinion (2025). DOI: 10.1080/03007995.2025.2577763

Alcohol and Prostate Cancer: Key Facts You Should Know

Alcohol and Prostate Cancer: Key Facts You Should Know

Alcohol and Prostate Cancer: Key Facts You Should Know

Alcohol and Prorogen Cancer Risk

Alcohol is a common part of many people's social lives, whether it's a glass of wine with dinner or a beer while watching the football game. However, if you're paying close attention to your prostate health, you might wonder whether drinking alcohol could increase your risk of prostate cancer. Or if you're getting treatment for prostate cancer, you may be asking if it's okay to drink.

Studies on alcohol and prostate cancer don't all agree, which can make it tricky to know what's safe. Here's what experts say so far.

The Connection Between Alcohol Use and Prostate Cancer Risk

The connection between alcohol use and the risk of prostate cancer is not clear, and scientists agree that more research is needed. But studies do show a pattern, especially when it comes to heavy drinking.

Current research indicates that alcohol consumption, especially heavy or long-term intake, is associated with an increased risk of aggressive forms of prostate cancer, says David Taub, MD, a board-certified urologist and the director of urologic oncology at Baptist Health South Florida in Boca Raton. The risk seems to be even higher for those who begin heavy drinking at a younger age.

Heavy drinking for men means five or more drinks on any day, or a total of 15 or more drinks per week. For reference, a standard drink is about 12 ounces (oz) of beer, 5 oz of wine, or 1 oz of liquor like vodka or whiskey. Having more than about 30 grams (g) of alcohol daily (roughly two or more standard drinks) may increase the risk of both getting prostate cancer and dying from it, says Brian Helfand, MD, a board-certified urologist at Endeavor Health in Glenview, Illinois.

In general, the more alcohol you drink, the higher your risk tends to be. Even low to moderate drinking (about one to two drinks per day) has been linked to a slightly increased risk of prostate cancer compared with not drinking, although this varies by the type of alcohol. Beer and liquor seem to drive most of this link, says Dr. Taub, while wine doesn't show the same connection.

That said, not all studies agree. Some even suggest that drinking moderate amounts of red wine may be linked with a slightly lower risk of the more-serious, fast-growing types of prostate cancer.

How Alcohol May Affect Prostate Cancer Risk

When your body metabolizes alcohol, the alcohol breaks down into acetaldehyde. This is a known carcinogen, meaning a substance that can increase the risk of cancer. Alcohol and acetaldehyde can damage the genetic material in cells, increase inflammation in your body, and interfere with hormones, all of which can create conditions where cancer is more likely to develop, says Taub.

The evidence linking alcohol to prostate cancer continues to grow, according to the American Cancer Society and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Both groups recommend limiting alcohol consumption to reduce cancer risk.

The research results don't all line up, but there's enough evidence to suggest that drinking in moderation or limiting alcohol intake is a reasonable way to help protect yourself, says Dr. Helfand.

Drinking Alcohol During Prostate Cancer Treatment

One question you might have if you've been diagnosed with prostate cancer is whether alcohol can interfere with treatment. Here's how alcohol can affect prostate cancer treatment and recovery.

Surgery

Drinking alcohol, especially with heavy or regular use, can increase the risk of complications after prostate cancer surgery, says Taub.

He says that people who drink alcohol before surgery face higher rates of:

  • Infections
  • Wound-healing problems
  • Breathing troubles
  • Long hospital stays

They also have a higher risk of death after the surgery, he says. The risk of death is even greater for older adults, who often have other health conditions. But stopping alcohol use for at least a few weeks before surgery, ideally four to eight weeks, can greatly reduce these complications, says Taub.

Drinking alcohol can also worsen urinary symptoms like urgency, frequency, and stress incontinence, says Helfand. These symptoms are already common if you have prostate cancer or an enlarged prostate. Many men report that stress incontinence gets noticeably worse after having two or more drinks during the recovery period after surgery, he says.

Chemotherapy

Alcohol consumption during chemotherapy for prostate cancer may worsen certain side effects, says Taub. It can also affect how your body processes chemotherapy medications, potentially making them less effective or more toxic.

Alcohol and its by-products can stress your liver, heart, and nervous system, which may make chemo-related fatigue or nausea worse, says Taub. It can also change how your liver breaks down chemotherapy medications, changing how well they work and increasing the risk of side effects. A small research study found that 38 percent of people who drank while getting chemo for various cancers experienced complications.

Radiation Therapy

When it comes to radiation therapy for prostate cancer, alcohol use may make the treatment less effective. Alcohol promotes inflammation and weakens your immune system, both of which can interfere with healing and radiation's ability to target cancer cells. Alcohol use during radiation therapy is also linked to poorer treatment outcomes and a higher risk of the cancer returning.

Targeted Therapy and Immunotherapy

Little research has been done on alcohol consumption during targeted therapy and immunotherapy. But there appears to be similar effects seen with other treatments, such as weakening of the immune system. More research is needed on this topic to fully understand how these effects might happen, but it's safest to limit alcohol during these treatments as well.

Taub emphasizes that people getting cancer treatment who drink alcohol face increased risks of the cancer coming back, developing new cancers, and dying from the disease. Both experts agree that limiting or avoiding alcohol before, during, and after prostate cancer treatment can help your body heal better and may improve treatment success.

Alcohol and PSA Levels

If you're getting tests to track your prostate-specific antigen (PSA) levels, be aware that alcohol may affect your test results. PSA is a protein made by your prostate gland. A high PSA level could be a sign of prostate cancer or other health conditions.

Alcohol intake can modestly lower PSA levels and may interfere with the accuracy of PSA testing, says Taub. This means prostate cancer may be harder to detect in people who drink moderate to large amounts of alcohol. And the more alcohol a person drinks each week, the more their PSA levels tend to drop.

Lower PSA levels in drinkers may reduce the sensitivity of PSA-based prostate cancer screening, potentially delaying diagnosis or underestimating risk, says Taub. Because current guidelines don't list alcohol as a factor that may affect PSA interpretation, it's important to mention your drinking habits to your healthcare provider when discussing PSA results.

How Much Alcohol Is Safe?

There's no truly safe amount of alcohol when it comes to health. Alcohol is a toxin, says Helfand. Our bodies can handle small amounts, he says, but repeated exposure can cause problems.

Helfand recommends drinking in moderation or completely avoiding alcohol for most people. Men at higher risk of prostate cancer, such as those with a family history of prostate cancer or genetic mutations like BRCA2, should be especially careful and consider abstaining from alcohol altogether, he says.

If you do choose to drink, current guidelines suggest keeping it to no more than two alcoholic beverages per day for men. Drinking more than that is linked to a higher cancer risk, says Taub. Cancer survivors should stay within these limits or avoid alcohol to support their long-term health, according to organizations like the National Comprehensive Cancer Network (NCCN).

While some studies suggest that red wine may be less harmful when it comes to prostate cancer risk compared with beer and liquor, the findings are inconsistent. Experts agree that the safest choice for anyone concerned about their risk of prostate cancer or for anyone getting prostate cancer treatment is to avoid alcohol or limit intake. The less alcohol, the better for individuals with or at risk for prostate cancer, says Taub.

Replacing alcohol with nonalcoholic drinks is one way to support your health and lower your cancer risk. In addition to mocktails or nonalcoholic beer, other options include flavored or sparkling water, kombucha, and juices, to name a few. If you're thinking about cutting back on alcohol or you need help quitting, ask your healthcare provider to guide you to resources and support.

If you or someone you know is struggling with substance use, reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) for resources near you.

The Takeaway

There's a link between heavy or long-term drinking and a higher risk of aggressive prostate cancer, though more research is needed.

Alcohol can interfere with prostate cancer treatment and recovery, making surgery, chemotherapy, radiation, or targeted therapy less effective, with potentially worse side effects.

Drinking may also lower PSA levels, which can make prostate cancer harder to detect. Be sure to tell your healthcare provider about your drinking habits when reviewing test results.

The safest choice for prostate health is to avoid alcohol or limit it to no more than two drinks per day, especially if you're at higher risk or you're currently getting prostate cancer treatment.

Melatonin and Heart Failure: What Sleep Experts Advise Now

Melatonin and Heart Failure: What Sleep Experts Advise Now

Understanding the Link Between Melatonin and Heart Failure

Recent research has sparked concern over the potential link between long-term melatonin use and heart failure. While the findings are significant, they do not necessarily mean that taking melatonin will directly lead to heart issues. Instead, they highlight the need for further investigation into the relationship between this popular sleep supplement and cardiovascular health.

Melatonin is a hormone naturally produced by the brain in response to darkness, helping regulate the body's internal clock and promoting sleep. It is also available as a supplement, often used to address insomnia or adjust sleep schedules. Over the past few years, its use has surged in the U.S., with studies showing a fivefold increase in usage between 1999 and 2018.

What Did the Study Find?

A study conducted on nearly 131,000 adults with insomnia found that those who took melatonin for at least 12 months had about a 90% higher risk of developing heart failure over five years compared to those who didn’t take the supplement. The overall numbers were still relatively low, with 4.6% of melatonin users developing heart failure versus 2.7% of non-users. Additionally, individuals with two or more prescriptions filled at least 90 days apart had an 82% higher risk of heart failure.

The study also revealed that people taking melatonin were nearly 3.5 times more likely to be hospitalized for heart failure and almost twice as likely to die from any cause during the five-year period.

Why Is This Confusing?

Despite these findings, experts caution against jumping to conclusions. Dr. Ekenedilichukwu Nnadi, the study’s lead author, emphasized that the research only shows an association, not causation. “We can’t say for sure whether melatonin itself is causing harm,” he said.

Dr. Christopher Winter, a sleep specialist, pointed out that people who use melatonin—such as shift workers or international travelers—are already at a higher risk for heart issues. Poor sleep quality, which often leads to melatonin use, is also linked to an increased risk of cardiovascular disease. “Taking melatonin could be a marker for people with worse sleep quality and more disturbances,” he explained.

Dr. Cheng-Han Chen added that conditions like sleep apnea, which often mimic insomnia, are major cardiovascular risk factors. Meanwhile, some studies have shown that melatonin may even have a positive effect on heart failure patients, adding to the confusion.

What Should You Do?

While more research is needed, doctors recommend reevaluating regular melatonin use. The American Academy of Sleep Medicine (AASM) states there isn’t enough evidence to support its use for chronic insomnia. Instead, it suggests using melatonin for short-term issues like jet lag or shift work.

Dr. Nnadi advises using the lowest effective dose for the shortest time possible and under medical guidance. An effective dose can be as low as 0.5 milligrams, though many supplements come in 5 or 10 milligram doses.

If you’re struggling with sleep regularly, improving sleep habits is often the most effective approach. This includes maintaining a consistent sleep schedule, avoiding screens before bed, limiting caffeine and alcohol, and creating a calming bedtime routine. Cognitive behavioral therapy for insomnia is also highly effective and often better than medication in the long run.

Final Thoughts

If you’ve tried these strategies and still struggle with sleep, it’s important to consult a healthcare provider. There may be an underlying issue contributing to your sleep problems, and proper diagnosis is key to finding the right solution.

In the meantime, consider the broader implications of your sleep patterns and lifestyle choices. Addressing the root causes of poor sleep may be more beneficial than relying solely on supplements like melatonin.

Tuesday, November 4, 2025

From Toilets to TB: The Activist Journey of Candice Andisiwe Sehoma

From Toilets to TB: The Activist Journey of Candice Andisiwe Sehoma

From Toilets to TB: The Activist Journey of Candice Andisiwe Sehoma

A Young Advocate Fighting for Access to Essential Medicines

Candice Andisiwe Sehoma's journey from the streets of Alexandra to becoming a key figure in the fight for affordable medicines is one of resilience, determination, and deep personal conviction. Growing up in a community marked by inadequate healthcare and poor sanitation, Sehoma learned early on about the disparities that define South Africa’s health landscape.

Her childhood was shaped by the challenges of living in a single-room home on what she still calls "London Road." She witnessed firsthand the impact of limited access to quality healthcare, which would later become the driving force behind her career. The loss of her younger sibling due to preventable health issues left a lasting impression on her, fueling her desire to make a difference.

Sehoma’s early efforts to improve her community began with a simple yet impactful idea: building flushing toilets. Inspired by a visit to her grandmother in the Eastern Cape, she recognized the need for better sanitation in her neighborhood. With support from residents and local experts, she organized a community effort to construct two flushing toilets in 2012. This project not only improved hygiene but also instilled a sense of ownership and pride among the residents.

This success led to the formation of Building Blocks, an organization she co-founded with friends to replicate this model in other communities. Over time, the group built 22 flushing toilets, helping to address one of the most basic yet critical aspects of public health.

From Toilets to Global Health Advocacy

After matriculating, Sehoma pursued higher education in psychology and development studies while continuing her work with Building Blocks. Her experiences in community organizing and grassroots activism laid the foundation for her future role in global health advocacy.

In 2017, she joined Doctors Without Borders (MSF), where she has since focused on ensuring access to essential medicines for people living with infectious and non-communicable diseases. Her work at MSF Access, a unit dedicated to addressing medicine affordability and availability, has brought her into the heart of some of the most pressing health equity issues.

One of her most significant contributions came in the fight over bedaquiline, a drug used to treat multidrug-resistant tuberculosis (MDR-TB). When pharmaceutical company Johnson & Johnson attempted to extend its patent on the drug through secondary patents, Sehoma took action. She partnered with TB survivor and advocate Phumeza Tisile to challenge the patent in India, leading to a successful outcome that allowed generic production once the primary patent expired. As a result, J&Johnson reduced the price of the drug by more than half in many countries, including South Africa.

The Fight for Affordable Diabetes Medicines

Today, Sehoma serves as a regional adviser for MSF Access, focusing on Southern and East Africa. Her current work centers on diabetes, a growing public health concern in South Africa and beyond. She highlights the irony that while the HIV/AIDS movement once mobilized large-scale protests for affordable antiretroviral drugs, the same urgency is not always applied to chronic conditions like diabetes.

In November 2024, Sehoma led a protest outside Novo Nordisk’s Johannesburg office, demanding action after the company discontinued the production of insulin pens. This decision had a direct impact on patients who rely on these devices for daily management of their condition. The shortage exposed gaps in the health system and raised questions about the profit-driven priorities of pharmaceutical companies.

Sehoma emphasized the importance of collaboration between activists, governments, and international organizations. While past conflicts between groups like the Treatment Action Campaign (TAC) and MSF were common, today there is greater alignment in the shared goal of improving access to lifesaving medicines.

A Legacy of Community Empowerment

Despite her global influence, Sehoma remains deeply connected to her roots in Alexandra. During our meeting at River Park Cafe, she reflected on the progress made in her community, including the four flush toilets built in 2013. Even though the surrounding area still faces challenges, the toilets stood as a testament to the power of collective action.

Her story is a reminder that change begins at the grassroots level. Whether it’s building toilets or fighting for affordable medicines, Sehoma’s work underscores the belief that healthcare should not be a luxury, but a fundamental right.





Time to Innovate, Not Panic: South Africa's HIV Strategy Without Donor Aid

Time to Innovate, Not Panic: South Africa's HIV Strategy Without Donor Aid

Time to Innovate, Not Panic: South Africa's HIV Strategy Without Donor Aid

The Shift in South Africa’s HIV Response: Adapting to a New Reality

South Africa has made remarkable progress in its fight against HIV, with the country now home to the world's largest HIV treatment programme. However, this achievement would not have been possible without significant donor support over the years. As international funding begins to decline, the country faces a critical juncture in how it manages its HIV response.

The golden age of health development assistance is coming to an end. This shift presents both challenges and opportunities for South Africa to rethink its approach to HIV care. By integrating HIV management into primary healthcare, the country can better address the growing burden of noncommunicable diseases (NCDs) while maintaining effective HIV services.

A Changing Landscape of Funding

Earlier this month, South Africa received R2-billion in bridging funds from the United States' President's Emergency Plan for AIDS Relief (Pepfar). This funding is intended to ensure uninterrupted HIV service delivery until the end of March next year. However, this amount represents only a quarter of South Africa's FY2024/5 Pepfar grant and is part of a broader phase-out plan by the U.S. government.

This reduction in aid has had a ripple effect across the global donor landscape. For instance, the Global Fund for HIV, TB, and Malaria, which previously contributed roughly a third of the yearly amount from Pepfar, will now provide about R2.3-billion less over the next three years due to reduced contributions from wealthy governments.

Over the past 25 years, international funding has played a crucial role in the roll-out of South Africa’s HIV programme. It has supported essential research, including large national surveys that tracked the picture of HIV in the country. These efforts were particularly vital during the height of Aids denialism.

The Impact of Declining Donor Support

Despite the progress made, the loss of donor funding poses a serious threat to South Africa’s HIV response. If Pepfar funding stops without being replaced by government money, projections suggest between 150,000 and 296,000 additional new HIV infections and between 56,000 and 65,000 HIV-linked deaths could occur by 2028. Additionally, many health workers employed by Pepfar-funded NGOs may lose their jobs.

The reality is that the golden age of health development assistance is over. But can there be opportunity in adversity?

Rethinking Business as Usual

National statistics show a significant drop in HIV-related deaths, from 169,076 in 2010 to 77,639 in 2025. While this represents a 54% decrease, it still falls short of the UNAids target of reducing deaths to 10% of 2010 levels by 2030.

Moreover, life expectancy has climbed from around 57 to 67 years in the last decade, and about a fifth of the population is older than 50. Deaths from NCDs now far exceed those from infectious diseases, with the crossover occurring around 2009 when access to ARVs was expanded.

This changing health landscape necessitates a rethinking of how South Africa responds to HIV within the context of declining donor funding.

Do More with Less

An immediate reaction might be to protect and increase funding for the HIV programme. This could involve increasing the health budget and channeling extra money to HIV projects. However, this approach has downsides, such as continuing inefficient services and missing the chance to review what works and what doesn't.

Instead, South Africa could use the current situation to take seriously that HIV is a chronic disease and integrate its management into primary healthcare. For example, research shows that people over 50 on ARVs are up to four times more likely to have another chronic condition like high blood pressure or diabetes.

A More Integrated Approach

What could a more integrated approach to HIV services look like? One solution could be to make HIV services part of routine health checks for pregnant women, vaccinations for children, or sexual and reproductive health advice. This can help end mother-to-child transmission and lower infections among teenage girls.

Adapting services to specific client groups, as done in differentiated care for HIV, is also key. Patients with well-controlled conditions could receive several months' worth of medicine at once, improving efficiency and adherence.

Using data from these systems can help flag when people are not taking their medication consistently. Artificial intelligence can turn this data into meaningful insights, making programmes run more efficiently and empowering patients to take charge of their care.

The Most Bang for Limited Bucks

However, caution is needed to ensure that people receiving HIV prevention or treatment are not left worse off. Overworked staff, longer waiting times, and a drop in quality of care are risks if integration is not carefully managed. Stigma and distrust could also increase, especially for key populations.

Donors often fund standalone programmes and require solid data to report on their impact. Integrating HIV services into primary care could compromise this data, making donors reluctant to continue funding. However, this challenge can be overcome by directing donor funding to government institutions rather than NGOs, as seen in Zambia.

In conclusion, rethinking how to handle dwindling international aid could benefit not only South Africa’s HIV response but also programmes dealing with the surging burden of NCDs. This approach can help make healthcare more accessible and equitable for all.