Down Syndrome

What is Down syndrome?

Down syndrome is a condition in which a person has an extra chromosome or an extra piece of a chromosome. This extra copy changes how a baby's body and brain develop. It can cause both mental and physical challenges during their lifetime. Even though people with Down syndrome might act and look similar, each person has different abilities.

What causes Down syndrome?

Chromosomes are tiny "packages" in your cells that contain your genes. Genes carry information, called DNA, that controls what you look like and how your body works. People with Down syndrome have an extra copy of chromosome 21. In some cases, they may have an extra copy of part of the chromosome. Having an extra copy of a chromosome is called trisomy. So sometimes Down syndrome is also called trisomy 21.

Down syndrome is usually not inherited. It happens by chance, as an error when cells are dividing during early development of the fetus. It is not known for sure why Down syndrome occurs or how many different factors play a role.

One factor that increases the risk of having a baby with Down syndrome is the age of the mother. Women ages 35 and older are more likely to have a baby with Down syndrome.

What are the symptoms of Down syndrome?

The symptoms of Down syndrome are different in each person. And people with Down syndrome may have different problems at different times of their lives. They usually have mild to moderate intellectual disabilities. Their development is often delayed. For example, they may start talking later than other children.

Some of the common physical signs of Down syndrome include:

• A flat face
• Eyes that slant up
• A short neck
• Small hands and feet
• Poor muscle tone
• Loose joints

What other problems does Down syndrome cause?

Many people with Down syndrome have the common physical signs and have healthy lives. But some people with Down syndrome might have one or more birth defects or other health problems. Some of the more common ones include:

• Hearing loss
• Sleep apnea (a disorder that causes you to repeatedly stop breathing during sleep)
• Ear infections
• Eye diseases
• Congenital heart defects (heart defects that are present at birth)
• Digestive problems
• Problems with the upper part of the spine
• Obesity

How is Down syndrome diagnosed?

Health care providers can check for Down syndrome during pregnancy or after a child is born.

There are two basic types of tests that help find Down syndrome during pregnancy:

• Prenatal screening tests can show whether your unborn baby has a higher or lower chance of having Down syndrome. If a screening test shows that your baby could have Down syndrome, you'll need another test to find out for sure.
• Prenatal diagnostic tests can diagnose or rule out Down syndrome by checking the chromosomes in a sample of cells.

These tests have a small risk of causing a miscarriage, so they're often done after a screening test shows that an unborn baby could have Down syndrome.

After a baby is born, the provider may make an initial diagnosis of Down syndrome based on the physical signs of the syndrome. The provider can use a karyotype genetic test to confirm the diagnosis. The test can check for extra chromosomes in a sample of the baby's blood.

What are the treatments for Down syndrome?

There is no single, standard treatment for Down syndrome. Treatments are based on each person's physical and intellectual needs, strengths, and limitations.

Services early in life focus on helping children with Down syndrome develop to their full potential. These services include speech, occupational, and physical therapies. They are typically offered through early intervention programs in each state. Children with Down syndrome may also need extra help or attention in school, although many children are included in regular classes.

Since people with Down syndrome can have birth defects and other health problems, they will need regular medical care. They may need to have certain extra health screenings to check for problems that happen more often in people with Down syndrome.

Centers for Disease Control and Prevention

Health Fraud

Health fraud scams involve selling medicines, supplements, devices, foods, or cosmetics that have not been proven effective. At best, these scams don't work. At worst, they're dangerous. They also waste money and might keep you from getting the treatment you really need.

Some of the possible dangers of scam products are that they could:

• Be contaminated from being made in unclean facilities or without proper quality control
• Contain harmful ingredients that are not listed on the label
• Trigger a harmful interaction with medicines you are taking
• Cause serious, even life-threatening, injuries

Health fraud scams can be found everywhere, promising help for many common health issues, including weight loss, memory loss, sexual performance, and joint pain. They target people with serious conditions such as cancer, diabetes, heart disease, HIV, and Alzheimer's disease.

Just remember - if it sounds too good to be true, it's probably a scam. Some red flags to watch for are product claims that:

• Have personal testimonials by "real" people or "doctors" played by actors claiming amazing results.
• Say that the product can treat or cure a wide range of unrelated diseases. No one product can treat or cure many different illnesses.
• Mention conspiracy theories like "This is the cure our government and Big Pharma don't want you to know about."
• Include phrases such as:
  • Ancient remedy
  • Miracle cure
  • No-risk money back guarantee
  • Natural cure
  • Quick fix
  • Secret ingredient
  • Scientific breakthrough
• Use scientific-sounding terms that don't make sense for the products, such as "molecule multiplicity."
• Refer to prestigious prizes, for example "Nobel Prize winning technology."

Before taking an unproven or little-known product, talk to your health care provider, especially if you are taking any prescription medicines.

Food and Drug Administration

Health Risks of an Inactive Lifestyle

What is an inactive lifestyle?

Being a couch potato. Not exercising. A sedentary or inactive lifestyle. These all mean the same thing: a lifestyle with a lot of sitting and lying down, with very little or no exercise.

People are spending more time doing sedentary activities. During our leisure time, we are often sitting while using a computer or other device, watching TV, or playing video games. Many of our jobs have become more sedentary, with long days sitting at a desk or while commuting. And the way most of us get around involves sitting - in cars, on buses, and on trains.

How does an inactive lifestyle affect your body?

When you have an inactive lifestyle:

• You burn fewer calories. This makes you more likely to gain weight
• You may lose muscle strength and endurance, because you are not using your muscles as much
• Your bones may get weaker and lose some mineral content
• Your metabolism may be affected, and your body may have more trouble breaking down fats and sugars
• Your immune system may not work as well
• You may have poorer blood circulation
• Your body may have more inflammation
• You may develop a hormonal imbalance

What are the health risks of an inactive lifestyle?

Having an inactive lifestyle can increase your risk of developing chronic (long-term) diseases. This is sometimes referred to as "sitting disease". By not getting regular exercise, you raise your risk of:

• Obesity
• Heart diseases, including coronary artery disease and heart attack
• High blood pressure
• High cholesterol
• Stroke
• Metabolic syndrome
• Type 2 diabetes
• Certain cancers, including colon, breast, and uterine cancers
• Osteoporosis and falls
• Increased feelings of depression and anxiety

Having a sedentary lifestyle can also raise your risk of premature death. And the more sedentary you are, the higher your health risks are.

How can I get started with exercise?

If you have been inactive, you may need to start slowly. Your health care provider can help you choose the best type or amount of activity for you based on your fitness level and health. You can keep adding more exercise gradually. The more you can do, the better. But try not to feel overwhelmed and do what you can. Getting some exercise is always better than getting none. Eventually, your goal can be to get the recommended amount of exercise for your age and health.

There are many ways to get exercise; it is important to find the types that are best for you. You can also try to add activity to your life in smaller ways, such as at home and at work.

How can I be more active around the house?

There are some ways you can be active around your house:

• Housework, gardening, and yard work are all physical work. To increase the intensity, you could try doing them at a more vigorous pace.
• Keep moving while you watch TV. Lift hand weights, do some gentle yoga stretches, or pedal an exercise bike.
• Work out at home with a workout video (on your TV or on the internet).
• Go for a walk in your neighborhood. It can be more fun if you walk your dog, walk your kids to school, or walk with a friend.
• Stand up when talking on the phone.
• Get some exercise equipment for your home. Treadmills and elliptical trainers are great, but not everyone has the money or space for one. Less expensive equipment such as yoga balls, exercise mats, stretch bands, and hand weights can help you get a workout at home too.

How can I be more active at work?

Most of us sit when we are working, often in front of a computer. It can be challenging to fit physical activity into your busy workday, but here are some tips to help you get moving:

• Get up from your chair and move around at least once an hour
• Park at the back of the parking lot
• Stand when you are talking on the phone or during a video conference
• Find out whether your company can get you a stand-up or treadmill desk
• Take the stairs instead of the elevator
• Use your break or part of your lunchtime to walk around the building
• Stand up and walk to a colleague's office instead of sending an email
• Have "walking" or standing meetings with co-workers instead of sitting in a conference room

The good news is that it's never too late to change your exercise habits. You can start slowly and find ways to fit more physical activity into your life. Regular exercise has many benefits and may help prevent or control many diseases.

Home Care Services

Home care is care that allows a person with special needs to stay in their home. It might be for people who are getting older (aging in place). It could also be for people who are chronically ill, recovering from surgery, orhave a disability. Home care services include:

• Personal care, such as help with bathing, washing your hair, or getting dressed
• Household chores, such as cleaning, yard work, and laundry
• Cooking for you in your home or delivering meals to you
• Money management, such as help filling out forms and making sure that your bills are paid on time
• Health care, such as having a home health aide come to your home or getting care from your provider through telehealth

You can get almost any type of help you want in your home. You have to pay for many of them. But some types of care and community services are free or donated. Sometimes government programs or your health insurance will help cover the cost of certain home care services.

NIH: National Institute on Aging

Hyperthyroidism

What is hyperthyroidism?

Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.

Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.

What causes hyperthyroidism?

Hyperthyroidism has several causes. They include:

• Graves' disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. This is the most common cause.
• Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancer). But they may become overactive and make too much thyroid hormone. Thyroid nodules are more common in older adults.
• Thyroiditis, inflammation of the thyroid. It causes stored thyroid hormone to leak out of your thyroid gland.
• Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Taking too much of them can cause your thyroid to make too much thyroid hormone.
• Too much thyroid medicine. This can happen if people who take thyroid hormone medicine for hypothyroidism (underactive thyroid) take too much of it.

Who is at risk for hyperthyroidism?

You are at higher risk for hyperthyroidism if you:

• Are a woman
• Are older than age 60
• Have been pregnant or had a baby within the past 6 months
• Have had thyroid surgery or a thyroid problem, such as goiter
• Have a family history of thyroid disease
• Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
• Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
• Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements

What are the symptoms of hyperthyroidism?

The symptoms of hyperthyroidism can vary from person to person and may include:

• Nervousness or irritability
• Fatigue
• Muscle weakness
• Trouble tolerating heat
• Trouble sleeping
• Tremor, usually in your hands
• Rapid and irregular heartbeat
• Frequent bowel movements or diarrhea
• Weight loss
• Mood swings
• Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.

Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes this can be mistaken for depression or dementia.

What other problems can hyperthyroidism cause?

If hyperthyroidism isn't treated, it can cause some serious health problems, including:

• An irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart problems
• An eye disease called Graves' ophthalmopathy. It can cause double vision, light sensitivity, and eye pain. In rare cases, it can lead to vision loss.
• Thinning bones and osteoporosis
• Fertility problems in women
• Complications in pregnancy, such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage

How is hyperthyroidism diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, including asking about symptoms
• A physical exam
• Thyroid tests, such as
  • TSH, T3, T4, and thyroid antibody blood tests
  • Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.

What are the treatments for hyperthyroidism?

The treatments for hyperthyroidism include medicines, radioiodine therapy, and thyroid surgery:

• Medicines for hyperthyroidism include
  • Antithyroid medicines, which cause your thyroid to make less thyroid hormone. You probably need to take the medicines for 1 to 2 years. In some cases, you might need to take the medicines for several years. This is the simplest treatment, but it is often not a permanent cure.
  • Beta blocker medicines, which can reduce symptoms such as tremors, rapid heartbeat, and nervousness. They work quickly and can help you feel better until other treatments take effect.
• Radioiodine therapy is a common and effective treatment for hyperthyroidism. It involves taking radioactive iodine by mouth as a capsule or liquid. This slowly destroys the cells of the thyroid gland that produce thyroid hormone. It does not affect other body tissues. Almost everyone who has radioactive iodine treatment later develops hypothyroidism. This is because the thyroid hormone-producing cells have been destroyed. But hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism.
• Surgery to remove part or most of the thyroid gland is done in rare cases. It might be an option for people with large goiters or pregnant women who cannot take antithyroid medicines. If you have all of your thyroid removed, you will need to take thyroid medicines for the rest of your life. Some people who have part of their thyroid removed also need to take medicines.

If you have hyperthyroidism, it's important not to get too much iodine. Talk to your health care provider about which foods, supplements, and medicines you need to avoid.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases