Then it happened. A driver behind him surged forward, flashing headlights and shouting from a rolled down window. Something inside John, something he didn’t recognize as fully himself, rose like a flash-flood. He stepped out of the car. Words flew, harsh and hot. A minor shove. A misstep. A fall.

And suddenly someone was hurt. The police came. The reports were written. And John, sitting alone in a small, echoing cell, realized that sometimes a life doesn’t crumble in a long, slow descent—it collapses in thirty seconds of unguarded anger.

It wasn’t planned. It wasn’t wanted. It simply…happened. Like an anaphylactic reaction, sudden, overwhelming, and profoundly destructive.

Medicine offers a remarkable parallel. Some of the body’s most violent reactions appear to erupt without warning, yet they are often the culmination of processes that have been unfolding quietly for years.

Johanna had no reason to fear a peaceful Sunday picnic, until a single bite of a cookie made with a trace of hazelnut awakened an old immune memory buried deep within her body. Within minutes her lips tingled, her skin flushed, and her throat tightened as her immune system, mistaking the harmless nut for a mortal enemy, unleashed a tidal wave of histamine that constricted her airway and dropped her blood pressure. Panic blurred the moment, but a friend quickly injected epinephrine, the medicine racing through her bloodstream like a calming command that opened her airways and steadied her pulse. The episode seemed instantaneous, but in truth the reaction was years in the making. Before that picnic, Johanna’s immune system had already encountered the allergen, misidentified it as dangerous, and stored that mistake in its memory. The cookie did not cause the reaction out of nowhere. It merely awakened a response that had been waiting silently beneath the surface.

In medicine, anaphylaxis is the body’s form of a lightning strike; a rapid, life-threatening allergic reaction. It is a serious, potentially fatal medical emergency that is rapid in onset and requires immediate medical attention regardless of the availability of on-site treatments while not under medical care.

Within minutes, a simple trigger like a peanut, a bee sting, or even a medication can send the immune system into chaos. The body panics. The airways narrow. Blood pressure collapses. The entire system reacts disproportionately to a threat that, under normal circumstances, would be harmless, like Johanna above gasping for breath after eating a cookie, or a hiker stung by a bee feeling her throat close, or a patient given an antibiotic erupting in hives, dizzy, and pale.

When a severe allergic reaction occurs, every second matters. The first and most important treatment is epinephrine, a medication usually injected into the thigh. It acts quickly, interrupting the body’s dangerous overreaction before it becomes fatal. The airways relax, blood pressure rises, and circulation begins to stabilize. Additional doses or intravenous fluids may sometimes be required, but the principle remains the same: the faster the reaction is interrupted, the greater the chance of recovery. Doctors may also administer intravenous fluids to support blood flow, while the patient is laid flat with the legs slightly elevated to help restore circulation to the heart and brain.  

Other medications, such as antihistamines and steroids, may help relieve symptoms, but they are not substitutes for epinephrine. Individuals who have previously experienced anaphylaxis are strongly advised to carry an epinephrine auto-injector (commonly known as an EpiPen) and wear medical identification. Even when symptoms improve after treatment, emergency medical evaluation remains essential, as the reaction can recur unexpectedly.  

Fortunately, anaphylaxis is relatively rare. Although estimates vary, it affects only a small percentage of the population, and with prompt recognition and treatment, survival rates are exceptionally high. It tends to occur more in young people and in women. Nearly everyone who receives timely hospital care recovers.  

What actually causes anaphylaxis?

Before someone ever has an anaphylactic reaction, their immune system must first “learn” to recognize an allergen (such as peanuts, bee venom, or certain medications). During this first exposure, sensitization (immune memory formation) takes place, and the immune system mistakenly identifies the allergen as a threat. Then, it produces IgE antibodies that attach to mast cells and basophils. These IgE-coated cells “wait” for the next exposure.

Anaphylaxis happens during the next exposure (which might be years later). When exposed, the allergen binds to the IgE antibodies and mast cells release massive amounts of histamine and other mediators. This causes anaphylaxis in the form of hives, swelling, low blood pressure, airway tightening, etc.

Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. In rare cases, anaphylaxis may be delayed for hours. Signs and symptoms include:

• Skin reactions, including hives and itching and flushed or pale skin

• Low blood pressure (hypotension)

• Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing

• A weak and rapid pulse

• Nausea, vomiting or diarrhea

• Dizziness or fainting

Genetics can predispose someone to allergies (e.g., family history of atopy), but anaphylaxis itself is not genetically predetermined. It still requires exposure, sensitization and IgE antibody production.

Lessons from anaphylaxis

Just as the immune system can overreact to a small trigger, the heart can overreact to a small frustration. Anger can arrive suddenly without invitation, without calculation. A word misunderstood, a gesture interpreted as disrespect or a horn honked impatiently.

And instantly, the soul releases its own internal “mediators” such as adrenaline, cortisol, and tunnel vision. Then, judgment collapses, empathy becomes constricted, and perspective disappears.

What anaphylaxis is to the body, anger is to the spirit. Both are reactions far greater than the triggers that provoke them. Anger may appear to erupt in an instant, but like anaphylaxis, it is built slowly. Years of unprocessed stress, patterns of reaction learned in childhood, ego sensitivities left unexamined, and emotional habits repeated until they become automatic all lie beneath the surface. A single insult may ignite the explosion, but the invisible fuel has been accumulating quietly for years. Just as immune memory primes the body for anaphylaxis, emotional memory primes the mind for anger.

Even prophets teach us that anger is human, but mastery of anger is divine guidance.

Prophet Muhammad (peace be upon him) understood the physiology of emotion long before modern neuroscience. He taught: “When one of you becomes angry while standing, let him sit. If the anger does not leave him, let him lie down” (Sunan Abu Dawud 4782). And in another teaching, he advised ablution (wudu), saying anger is “from fire” and water extinguishes it. These are not merely symbolic instructions—they are antidotes. Sitting eases the body’s tension, lying down disarms the fight-or-flight response, and washing with water cools the face, slows the heartbeat, and interrupts the physiological surge of anger before it gains control.   

These are emotional epinephrine, quick, simple, and deeply effective. They not only calm the immediate reaction, but they also slowly re-educate the emotional-memory system, changing the default response. Prophet Muhammad (peace be upon him) was teaching the spiritual equivalent of resetting immune memory, reducing oversensitivity and interrupting automatic reactions.

In the Battle of Uhud, when the archers disobeyed the Prophet’s explicit command and abandoned their posts, the consequences were severe. The Muslim army suffered painful losses. Yet the Prophet (peace be upon him) did not publicly shame those responsible, did not single them out by name, and did not allow anger to fracture the unity of the community. Even his Companions refrained from identifying them.

His calmness repaired what disobedience had damaged. His mercy became more memorable than the mistake itself. His positive approach was confirmed in the Qur’an: “So by mercy from God, [O Muhammad], you were lenient with them. And if you had been rude [in speech] and harsh in heart, they would have disbanded from about you. So, pardon them and ask forgiveness for them and consult them in the matter. And when you have decided, then rely upon God. Indeed, God loves those who rely [upon Him]” (Al Imran 3:159).

Jesus (peace be upon him) reminds us that spiritual maturity is not the absence of passion but the discipline of response: “Blessed are the peacemakers, for they shall be called children of God.”—Matthew 5:9.

James is quoted in the New Testament as follows: “Be slow to anger, for human anger does not produce the righteousness of God.”—James 1:19–20.

Moses (peace be upon him) struggled with a fiery temperament. When he struck the Egyptian man, he regretted it deeply (Qur’an 28:15–16). When he saw his people worshipping the calf, he reacted strongly—but afterward prayed for them (Qur’an 7:150).

Fethullah Gülen reminds us to shape our hearts into sanctuaries, each with a humble chair reserved for every soul God sends our way. He uses the metaphor of the heart as a sanctuary to call for emotional restraint and moral readiness in the face of others. By reserving a “humble chair” for every person we encounter, Gülen emphasizes unconditional hospitality rather than judgment or dominance. This image challenges the reflexive nature of anger, encouraging a pause between stimulus and response. In this way, it suggests that compassion can regulate emotional reactions much like balance in the immune system prevents anaphylactic overreaction.

Just as the immune system can be trained away from overreaction, the soul can be trained away from explosive anger. Both require memory to be re-written, habits to be relearned, and the inner terrain to be cultivated patiently.

To prevent anaphylaxis, we avoid triggers, strengthen resilience, and carry epinephrine. Similarly, we can prevent destructive anger, if we can cultivate the following in our spiritual journey:

With mindfulness, we can notice irritation before it grows. With self-awareness, we can know the history behind reactions. Practicing patience through remembrance (dhikr), meditation, and stillness can strengthen our resilience. Reducing chronic stressors can help us build healthy boundaries. Having generous, merciful assumptions about others reduces anger.

There is a Turkish proverb that “Sharp vinegar harms its own container.” Anger is vinegar. Before it burns others, it corrodes the heart that holds it.

Anaphylaxis teaches us how the body collapses when overwhelmed. Anger teaches us how relationships, reputations, and inner peace can collapse in a fleeting moment of emotional shock.

Let us learn to love people, to be gentle with their faults, and to show mercy, not because they are perfect, but because mercy is the epinephrine of the soul.

References

1. https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.

2. Shaker MC, et al. Anaphylaxis — A 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology. 2020; doi:10.1016/j.jaci.2020.01.017.

3. Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S, Geller M, Gonzalez-Estrada A, Greenberger PA, Sanchez Borges M, Senna G, Sheikh A, Tanno LK, Thong BY, Turner PJ, Worm M. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020 Oct 30;13(10):100472. doi: 10.1016/j.waojou.2020.100472. PMID: 33204386; PMCID: PMC7607509.

4. https://en.wikipedia.org/wiki/Anaphylaxis

An electronic cigarette (e-cigarette) is a device that heats liquid nicotine and flavorings so they can be inhaled. The use of e-cigarettes is often called “vaping,” because many people believe it produces a vapor. E-cigarettes create an aerosol composed of tiny particles, which is different from a true vapor.

E-cigarettes are known by many different names. This includes e-cigs, vapes, vape pens, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vaporizers, and tank systems. E-cigarettes are also sometimes known by their brand names.

Vaping works by heating liquid inside a small device, which turns it into an aerosol that is then inhaled into the lungs. Unlike smoking, which burns tobacco, vaping heats liquid to release particles suspended in air. The aerosol contains nicotine, flavorings, and other chemicals. When inhaled from the mouthpiece, these particles travel down the throat and into the lungs.

E-cigarettes are available in many shapes and sizes. They can look like cigarettes, cigars, pipes, pens, and USB flash drives. Most types of e-cigarettes have:

• A cartridge, tank or pod that holds liquid (can be refillable).
• A heating element for turning the liquid into breathable particles (aerosol, commonly called “vapor”).
• A battery to power the heating element.
• A power or control button (some are activated by sensors when you inhale).
• A mouthpiece to breathe in the aerosol.

E-cigarettes don’t have tobacco, but many of them have nicotine, which comes from tobacco. E-cigarettes heat liquid to make an aerosol; cigarettes burn tobacco, which creates smoke. Because of this, the U.S. Food and Drug Administration (FDA) classifies them as “tobacco products.”

Electronic cigarettes (e-cigarettes) were developed as a smoking cessation tool and a safer alternative to traditional cigarettes for people unable or unwilling to quit nicotine. The intention was to help people who smoke to reduce nicotine intake without exposure to the harmful tar and toxins in tobacco smoke, thus, reducing smoking-related diseases and deaths. However, 21 years since Chinese pharmacist Hon Lik, first introduced the modern e-cigarettes in 2003, to help himself quit smoking cigarettes, this did not work. He is now a dual user, both smoking and vaping. We must question whether they have achieved their intended objectives or if they have inadvertently become a Trojan horse in public health, presenting unforeseen risks and challenges.

Patterns of use

Some groups of adults use e-cigarettes at a higher percentage than others. For example:

• More men than women report current e-cigarette use.
• A higher percentage of young adults (18–24 years old) use e-cigarettes compared to older adults, usage declines with age.
• Use is higher among adults with less education, lower incomes, or without health insurance.
• Adults who identify as lesbian, gay, or bisexual report higher rates of use compared to heterosexual adults.
• Adults experiencing serious psychological distress are more likely to use e-cigarettes.

In 2024, e-cigarettes were the most used tobacco product among middle and high school students in the United States:

1. 63 million (5.9%) students currently used e-cigarettes. This includes:
   3. 410,000 (3.5%) middle school students.
   4. 21 million (7.8%) high school students.
2. Among students who had ever used e-cigarettes, 43.6% reported current use.
3. Among students who currently used e-cigarettes:
   38. 4% used an e-cigarette on at least 20 of the last 30 days.
   39. 3% used an e-cigarette every day.
4. 6% used flavored e-cigarettes. Vapes come in a variety of youth-friendly flavors, including fruit, candy, mint, and menthol.
5. Among students who currently used e-cigarettes; 55.6% used disposable e-cigarettes, 15.6% used prefilled or refillable pods or cartridges, and 7.0% used tanks or mod systems.

Most middle and high school students who vape both want to quit and have attempted to do so. In 2020, 63.9% of students who were current e-cigarette users reported wanting to quit, and 67.4% reported that they had tried to quit within the past year.

Why youth vape

Most tobacco use, including vaping, starts and is established during adolescence. There are many factors associated with youth tobacco product use. These include:

1. Tobacco advertising that targets youth: In 2021, 7 out of 10 U.S. middle and high school students reported exposure to e-cigarette marketing. Most students reported seeing e-cigarette advertisements or promotions in retail settings. Students also reported seeing advertisements on the internet, television, streaming services, movies, or in print media. In addition, about three out of four students (74%) who used social media reported seeing e-cigarette–related posts or content.
2. Product accessibility: Some e-cigarettes cost less than regular cigarettes, which may also contribute to youth vaping.
3. Availability of flavored products: A study from 2013–2015 showed that most youth who use e-cigarettes first start with a flavored variety. Availability of flavored vapes is among the top 10 reasons youth report ever trying an e-cigarette. In 2024, nearly 9 out of 10 middle and high school students who currently used e-cigarettes reported using a flavored product, with the most commonly used flavors being fruit, candy, and mint.
4. d) Social influences: The most common reason U.S. middle and high school students give for trying an e-cigarette is that a friend used them. Youth also report vaping because they are curious about e-cigarettes or because a family member used them.

Youth often obtain the e-cigarettes from others. Among U.S. middle and high school students who used e-cigarettes in 2021:

• 3% got them from a friend.
• 1% bought the products themselves.
• 7% had someone else buy the products for them.
• 7% had someone offer the products to them.

Dual use of e-cigarettes: Many young people who vape also use other tobacco products, including cigarettes and cigars. This is called dual use. In 2024:

• Among U.S. students who currently use a tobacco product, more than one-third report using more than one type of product, including 6%of high school students and 38.9% of middle school students.

Cannabis content of e-cigarettes: E-cigarettes can also be used to deliver other substances, including cannabis. In 2016, nearly one out of three (30.6%) of U.S. middle and high school students who had ever used an e-cigarette reported using marijuana in the device.

Health risks of E-cigarettes

The term “vapor” might sound harmless. But the aerosol that comes out of an e-cigarette is not water vapor, and it can be harmful. The aerosol from an e-cigarette can contain nicotine and other substances that are addictive.

1. Nicotine content: The e-liquid in most e-cigarettes has nicotine, the same addictive chemical in regular cigarettes, cigars, hookah, and other tobacco products. But nicotine levels are not the same in all types of e-cigarettes. Sometimes, product labels do not list the true nicotine content. There are some e-cigarette brands that have been found to contain nicotine even though they claim to be nicotine-free.

Young people can start showing signs of nicotine addiction quickly, sometimes before the start of regular or daily use. Because the adolescent brain is still developing, it is uniquely susceptible to nicotine.

The nicotine content of e-cigarettes has increased over time. Many e-cigarettes contain nicotine salts. These allow people to consume high levels of nicotine without experiencing the harshness of freebase nicotine.

High-nicotine products dominate US e-cigarette unit sales. In March 2022, products with a nicotine strength of 5% or more made up 81% of total e-cigarette unit sales. In recent years, the price of high-nicotine products decreased or stayed the same while the price of low-nicotine products increased.

2. Cancer risk: E-cigarettes contain chemicals that can cause cancer (carcinogens), like acetaldehyde and formaldehyde but their long term effect on cancer development is not yet clear.
3. Heart and lung disease: E-cigarettes contain chemicals known to cause lung disease, such as acrolein, diacetyl and diethylene glycol. A Johns Hopkins Medicine-led analysis of medical information gathered on a diverse group of almost 250,000 people over four years has significantly clarified the link between the “exclusive” use of e-cigarettes and chronic obstructive pulmonary disease, as well as high blood pressure in a sub-group of adults 30 to 70 years of age.

E-cigarettes and other similar products have been linked to lung problems. Using them can increase your risk of breathing problems. This includes worsening asthma symptoms, more frequent bronchitis, and lung infections.

The nicotine in e-cigarettes also increases heart rate, raises blood pressure, and might irritate blood vessels.

4. Vitamin E acetate, linked to lung injury caused by vaping (EVALI): An outbreak of EVALI in late 2019 and early 2020 put thousands of people in the hospital. At least 68 people died. Since then, EVALI cases have been declining, but people who vape can still get EVALI. Among people hospitalized with severe EVALI, most were younger than 35 and used THC-containing vapes from informal sources, such as online sellers or family and friends. However, EVALI can occur in anyone who uses either nicotine or THC-containing vapes.

Symptoms of EVALI included:

• Cough, trouble breathing, or chest pain
• Nausea, vomiting, or diarrhea
• Fatigue, fever, or weight loss

Some people had to be hospitalized, and some died from their illness. Some of these lung injuries were linked to products that were changed, including products that had vitamin E acetate. But there were also many EVALI cases that did not involve added vitamin E.

The number of EVALI cases has since dropped, but there are still people being diagnosed with EVALI. More studies are being done to look for other possible causes.

5. Heavy metals: E-cigarettes may contain heavy metals like nickel, tin, lead and cadmium which have been shown to have adverse health effects.
6. Tiny particles: E-cigarettes may contain tiny (ultrafine) particles that can get deep into your lungs passing the filtration system of the lungs.
7. Seizures: There have been reports of people having seizures after vaping. This has been reported most often in young people. These seizures are thought to be caused by nicotine, but more studies are being done.
8. Dental problems: Studies are also starting to show a link between e-cigarette use and damage to teeth and other oral tissues. This includes cavities in the teeth and irritation of gums and other membranes in the mouth.
9. Secondhand aerosol: E-cigarettes expose people to secondhand aerosol or vapor that can contain harmful chemicals. Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. Secondhand aerosol can expose others to nicotine and possibly to other harmful chemicals.
10. Explosions: There have been reports of e-cigarettes exploding and causing serious injuries. The explosions are thought to be caused by faulty batteries or because the batteries were not handled as they should be.

Can e-cigarettes help people quit?

E-cigarettes are not approved by the FDA and European Medicines Agency as smoking cessation devices due to limited data on safety and effectiveness. This is because there is not enough research to show that they help people to stop using tobacco.

Recent research indicates that people who use both cigarettes and e-cigarettes have a higher risk of getting lung cancer than people who only use cigarettes. People should not use both products at the same time and are strongly encouraged to completely stop using all tobacco products.

Globally, regulation varies:

• 88 countries have no minimum purchase age.
• 74 countries lack regulations entirely.
• E-cigarettes are banned in about 35 countries.
• Others regulate them as consumer, pharmaceutical, or tobacco products.

Marketing frequently targets youth, with over 16,000 flavors, cartoon packaging, and sleek designs resembling toys or tech gadgets. Alarmingly, in many countries, e-cigarette use among adolescents exceeds adult use. Even brief exposure to vaping content on social media increases the likelihood of trying these products.

One of the greatest public health risks is that vaping could “re-normalize” smoking after decades of successful tobacco control. Smoking remains the leading preventable cause of death, killing more than 480,000 people annually in the United States alone.

Conclusion

Taken together, these findings show that no tobacco products, including e-cigarettes, are safe. Most e-cigarettes contain nicotine, a highly addictive substance that poses serious health risks, particularly for youth, pregnant women, and developing fetuses. In addition to nicotine, e-cigarette aerosol can contain harmful and potentially harmful substances, including cancer-causing chemicals and ultrafine particles that can be inhaled deep into the lungs. For these reasons, e-cigarettes should not be used by youth, young adults, or individuals who are pregnant. Moreover, e-cigarettes pose potential health risks not only to those who vape but also to others exposed to secondhand emissions, while placing an added burden on public health systems and government healthcare budgets. Compounding these concerns, the short- and long-term health effects of e-cigarette use remain unclear, and much is still unknown about their full impact on human health. Until more is understood, this evidence underscores the importance of prevention, education, and informed decision-making.

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2. Centers for Disease Control and Prevention. (n.d.). E-cigarettes. Retrieved October 9, 2025, from https://www.cdc.gov/tobacco/e-cigarettes/
3. American Cancer Society. (n.d.). E-cigarettes and vaping. Retrieved October 9, 2025, from https://www.cancer.org/cancer/risk-prevention/tobacco/e-cigarettes-vaping.html
4. Wikipedia contributors. (n.d.). Health effects of electronic cigarettes. In Wikipedia. Retrieved October 9, 2025, from https://en.wikipedia.org/wiki/Health_effects_of_electronic_cigarettes
5. Farsalinos, K. E., & Polosa, R. (2014). Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: A systematic review. Therapeutic Advances in Drug Safety, 5(2), 67–86. https://doi.org/10.1177/2042098614524430
6. Hajek, P., Etter, J. F., Benowitz, N., Eissenberg, T., & McRobbie, H. (2014). Electronic cigarettes: Review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 109(11), 1801–1810. https://doi.org/10.1111/add.12659
7. World Health Organization. (n.d.). Tobacco: E-cigarettes. Retrieved October 9, 2025, from https://www.who.int/news-room/questions-and-answers/item/tobacco-e-cigarettes
8. Rhode Island Department of Health. (n.d.). E-cigarettes: Know the health risks. Retrieved October 9, 2025, from https://health.ri.gov/tobacco/e-cigarettes-know-health-risks
9. American Heart Association. (n.d.). Is vaping safer than smoking?. Retrieved October 9, 2025, from https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/is-vaping-safer-than-smoking
10. The Lancet Regional Health – Europe. (2024). [Article on e-cigarettes]. The Lancet Regional Health – Europe, 40, https://doi.org/10.1016/j.lanepe.2024.100265
11. Gentzke, A. S., Wang, T. W., Cornelius, M., et al. (2022). Tobacco product use and associated factors among middle and high school students—National Youth Tobacco Survey, United States, 2021. MMWR Surveillance Summaries, 71(5), 1–29. https://doi.org/10.15585/mmwr.ss7105a1

In our world today, food surrounds us in a way no past generation could have imagined. Markets are always stocked, restaurants and takeout keep our plates full at any hour, and kitchens rarely sit empty. With just a few clicks, we can sample flavors from around the globe. And if hunger ever does come, it usually doesn’t linger for long. 

At the same time, we live under a constant wave of health advice: eat more of this, avoid that, count calories, cut sugar, embrace fats. Each new headline seems to promise the secret to living longer, thinking more clearly, or having more energy. We jump from one diet to the next, hoping for lasting change. 

But beneath all this noise is a truth people have known for centuries. It’s written in scripture, seen in how living things function, and now confirmed deep within the workings of our own bodies. As modern science continues to explore how we work at the smallest levels, it often uncovers insights that match wisdom already taught long ago. 

The careful manager in the cell

Hidden inside almost every cell is a small sensor called mTORC1. It acts like a careful manager, always checking if food is available. When we eat—especially meals rich in proteins and sugars—this sensor knows. It sends a clear message: “It’s time to build.” Our bodies start making new proteins, storing energy, and growing stronger. Without this, we couldn’t heal from daily wear or keep ourselves sturdy over time.

Research has shown that mTORC1 is a key piece in how our bodies decide when to grow and how to balance resources, connecting what we eat directly to how we age and how diseases develop (Liu and Sabatini, 2020) (Valvezan and Manning, 2019).

The routine cleaning in the cell

But there’s also another critical part of this system. When mTORC1 is active, it slows down the cell’s built-in cleaning process, called autophagy. During autophagy, cells remove and recycle damaged or old parts, making room for fresh, healthy components. It’s like doing routine cleaning and repairs in a home so problems don’t build up. Without it, small issues add up, and things start breaking down.

Recent reviews have shown how essential this process is, with disruptions in autophagy linked to conditions such as obesity, diabetes, heart disease, and problems with brain health (Klionsky et al., 2021).

The natural order was created in such a way that these two states—building up and clearing out—alternate, each serving a purpose in sustaining life and health. When food is plentiful, our bodies focus on growth. When food becomes scarce, even for short periods, mTORC1 quiets, and cells switch from building to essential repair. This built-in cycle helps maintain health over the long term.

In modern life, however, this balance is easily lost. Food is not only always available, but also often designed to be extremely appealing. Many meals are made with combinations of salt, sugar, and fats that encourage us to keep eating long after hunger is gone. This means mTORC1 stays switched on far more often than intended. Our bodies remain in growth mode every day, with little opportunity to slow down and do the necessary cleaning inside.

At first, this might not seem like a big problem. But over months and years, it quietly adds up. Waste builds up in our cells. Tissues lose some of their strength. The natural systems that once kept everything balanced start to slow down, weighed down by what should have been cleared away long ago. As a result, even though people today often live longer than past generations, illnesses tied to this imbalance—like obesity, type 2 diabetes, heart disease, and liver issues—have become extremely common.

This is only made worse by the kinds of foods many people now eat. Large studies confirm that diets high in ultra-processed, heavily flavored foods are directly linked to more obesity, metabolic problems, and heart disease (Lane et al., 2024). It’s one of the most surprising problems of our time: we suffer not because we lack food, but because we have too much, too often, with too few breaks.

Ancient wisdom prescribes fasting

Remarkably, ancient wisdom long urged moderation and fasting, echoing what science now confirms.

“Eat and drink, but do not be excessive. Surely, He does not love those who waste.” (Qur’an 7:31)

This advice is not just about polite behavior or humility. It protects the very patterns our bodies rely on for health. By holding back from always eating, we give our bodies the chance to slow down and do the internal work that keeps us strong.

The Qur’an also links fasting to building awareness and self-restraint:

“O you who believe, fasting is prescribed for you as it was prescribed for those before you, so that you may become mindful.” (Qur’an 2:183)

Fasting is a tradition shared by many faiths, from Islam to Christianity and Judaism. It is more than simply going without food. It opens up space—both physically inside the body, and mentally inside the heart.

Today, researchers are learning exactly why this matters. Periods of fasting, or even simply having time between meals, allow mTORC1 to quiet down. This lets autophagy rise, so cells can clear out waste and fix what is worn. Major reviews in respected journals show that fasting helps switch the body from growth into repair, improving metabolism, reducing inflammation, and even extending healthy years of life (de Cabo and Mattson, 2019).

A clearer mind

People who fast often notice more than just physical changes. Many describe a clearer mind, a deeper gratitude for simple foods, and a sense of being lighter—not only in their bodies, but also in their outlook. In this way, fasting becomes like pressing a reset button, not only for the body, but for the heart and mind too.

What’s even more striking is how these practices help the brain. New studies show that fasting and careful eating patterns support memory, focus, and emotional resilience (Kapogiannis et al., 2024, Longo and Mattson, 2014). It seems the same systems that clean and repair our cells also clear away some of the mental clutter that weighs on our thoughts.

Eat thoughtfully

This does not mean we need harsh or extreme fasting to find balance. Even small habits can help. Waiting until we feel genuine hunger. Choosing simpler foods that truly nourish instead of just excite. Eating slowly enough to notice when we feel satisfied rather than full. Allowing some time between meals so the body can quietly repair itself. These small steps help keep the natural cycles of building and cleaning moving, supporting health that many today have quietly lost.

Beyond biology, moderation shapes our character. It builds contentment—the ability to enjoy what we already have instead of always chasing more. It teaches patience, showing us how to sit with small discomforts calmly. It grows compassion. By sometimes feeling hunger ourselves, we better understand those who face it daily. Our hearts soften, and we become more grateful for the blessings we have.

This way, eating thoughtfully becomes more than just a health choice. It becomes a way to remember God and show thanks for what He provides. With each meal approached with care, we give thanks not only in our words, but also through how we live.

Many of the health struggles common today can be traced back to ignoring these built-in patterns. When we eat constantly, our bodies stay in growth mode, never taking the needed time to clean and restore. When we always want more, we lose the simple joy that comes from recognizing what is already enough.

It is quietly powerful that as science learns more about metabolism and how cells work, it keeps returning to truths faith traditions have long taught. Careful studies repeatedly show that cycles of eating balanced with gentle hunger protect us, keeping our bodies strong, our minds clearer, and our lives more stable. These modern findings do not replace old truths—they help us see them more clearly and value them even more.

“Eat and drink, but do not be excessive.”
“Fast, so that you may become mindful.”

These verses bring together both our physical needs and our spiritual growth. They invite us to live according to the way God created us, thriving through a pattern that balances growth with careful renewal.

For each of us, this is a calm invitation. It does not call for harsh denial, but for wise care. It might mean waiting for true hunger before eating, savoring each bite, or stopping once we are satisfied. It might mean picking foods that leave us feeling healthy rather than heavy. Or simply leaving a little space between meals so our bodies can quietly do the work they were designed to do.

Most of all, it invites us to reflect. To recognize that tiny switches like mTORC1 respond constantly to how we eat, shaping our health, thoughts, and even moods. And to remember that long before we discovered these details, we were given guidance that leads us kindly toward this balance.

In the end, lasting health and deeper gratitude may not come from every new diet or headline. They may be found instead by returning to timeless guidance — eating with care, respecting gentle hunger, and remembering with each meal the One who created us so perfectly to thrive in this balance.

References

• De Cabo, R. & Mattson, M. P. 2019. Effects of Intermittent Fasting on Health, Aging, and Disease. N Engl J Med, 381, 2541-2551.
• Kapogiannis, D., Manolopoulos, A., Mullins, R., Avgerinos, K., Delgado-Peraza, F., Mustapic, M., Nogueras-Ortiz, C., Yao, P. J., Pucha, K. A., Brooks, J., Chen, Q., Haas, S. S., Ge, R., Hartnell, L. M., Cookson, M. R., Egan, J. M., Frangou, S. & Mattson, M. P. 2024. Brain responses to intermittent fasting and the healthy living diet in older adults. Cell Metab, 36, 1668-1678 e5.
• Klionsky, D. J., Petroni, G., Amaravadi, R. K., Baehrecke, E. H., Ballabio, A., Boya, P., Bravo-San Pedro, J. M., Cadwell, K., Cecconi, F., Choi, A. M. K., Choi, M. E., Chu, C. T., Codogno, P., Colombo, M. I., Cuervo, A. M., Deretic, V., Dikic, I., Elazar, Z., Eskelinen, E. L., Fimia, G. M., Gewirtz, D. A., Green, D. R., Hansen, M., Jaattela, M., Johansen, T., Juhasz, G., Karantza, V., Kraft, C., Kroemer, G., Ktistakis, N. T., Kumar, S., Lopez-Otin, C., Macleod, K. F., Madeo, F., Martinez, J., Melendez, A., Mizushima, N., Munz, C., Penninger, J. M., Perera, R. M., Piacentini, M., Reggiori, F., Rubinsztein, D. C., Ryan, K. M., Sadoshima, J., Santambrogio, L., Scorrano, L., Simon, H. U., Simon, A. K., Simonsen, A., Stolz, A., Tavernarakis, N., Tooze, S. A., Yoshimori, T., Yuan, J., Yue, Z., Zhong, Q., Galluzzi, L. & Pietrocola, F. 2021. Autophagy in major human diseases. Embo J, 40,
• Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., Mcguinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’neil, A., Segasby, T. & Marx, W. 2024. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ, 384,
• Liu, G. Y. & Sabatini, D. M. 2020. mTOR at the nexus of nutrition, growth, ageing and disease. Nat Rev Mol Cell Biol, 21, 183-203.
• Longo, V. D. & Mattson, M. P. 2014. Fasting: molecular mechanisms and clinical applications. Cell Metab, 19, 181-92.
• Valvezan, A. J. & Manning, B. D. 2019. Molecular logic of mTORC1 signalling as a metabolic rheostat. Nat Metab, 1, 321-333.

It has been over half a year since Covid-19 swept across the world and forced many countries into quarantine. Hopes of a quick resolution of the disease in many countries have since been, unfortunately, proven to be wrong, and it is evident that the virus is here to stay for a while [1]. The virus is so difficult to deal with considering it can be transferred from person to person even if the carrier does not outwardly display symptoms. Even animals, ranging from mice to tigers, can contract and transmit it to humans [2, 3], and we cannot quarantine or force them to wear facemasks. The virus will eventually hit each person; it is just a matter of time. The virus may additionally arrive in multiple waves, as it is possible to be reinfected [4]. COVID-19 will most likely have a lifespan of a few years, much like other major virus outbreaks of the past such as the swine flu in Hong Kong or Spanish flu. It will probably come and go like a common flu in never ending waves. So, each of us need to be ready until a successful vaccine is developed, and the wisest action for each person to be ready would be to boost our immune systems and practice effective social distancing and sanitation measures, while we deal with this virus for however long it may last.

Vaccines are critical for stunting the development and spread of viruses; however, they can be costly, time-intensive to develop, and not always perfect. It is worth exploring alternative methods to help protect our bodies from these pathological invaders while vaccines are being researched. As it so happens, the best method of prevention to date for HIV infections is not a vaccine, but is instead a tradition that is as old as thousands of years: male circumcision [5]. To give a comparison, the current widely popular and heavily promoted influenza vaccine is considered “50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)” [6]. On the other hand, according to an article published in the prestigious medical journal, The Lancet, circumcision is up to 88% effective in preventing heterosexual transmission of HIV [7]. Male circumcision does not have any medicinal side effects, and the only risks that are involved are those related to any minor surgery – bleeding and infection.

In the 1980s, when I first heard of HIV, I remember reading articles which claimed, quite arrogantly, that vaccines and cures for the condition would be found within two or three years [8]. Forty years later, and after spending many billions of dollars on research, we are still nowhere near an HIV vaccine. At best, we found treatments which helped keep the HIV virus at bay [9]. To date, only two people have been fully cured with a method far too expensive to be applied to the general public [10]. In the meantime, at least 30 million people have died with more than half a million in the year 2019 alone [11]. While vaccines are critical for helping to eradicate viruses, putting all of our eggs into that basket alone can be a risky public health strategy due to how difficult and time consuming they are to discover, verify, and distribute. It is impossible to know for sure how long it will take to develop a vaccine for the coronavirus. In the meantime, communities should heavily consider following the instructions of their local health officials which often include social distancing, limited size gatherings, and frequent hand washing as these methods are already proven to help reduce the spread of the virus.

Development, and even the rushed development of a vaccine, is always a very tedious and dangerous process. The science behind them is exceptionally complex, and imperfect results can have disastrous consequences upon thousands of people. This is further complicated by the fact that phase 2 and phase 3 trials can have quite diverging results [12]. In the USA, AstraZeneca’s COVID-19 vaccine trials were stopped after trial participants fell ill [13]. Third phase trials, which encompass thousands of people [14], still can give little indication of the long-term side effects to any vaccine. Besides, even though there is human life at risk, the vaccine has already become an instrument for many political and economic disputes and conspiracy theories. Some governments claim they have already developed a vaccine, while others find them unreliable, or try to lure a foreign company to work for themselves [15]. In August of this year Russia rushed registration of an unproven Coronavirus vaccine and named it, in Cold-War-like fashion, the “Sputnik V” [16]. The announcement was made by none other than Vladimir Putin himself. It was offered to the USA, but was rejected due to safety concerns stemming from a belief that the drug was not adequately researched and developed [17]. In the meantime, Russia announced the development of a second vaccine [18]. Surely enough, it was dismissed and downplayed by the West as unproven and unreliable. On the other hand, a vaccine developed by a Chinese company Sinovac proved to be the most successful in its phase 3 trials in Brazil [19]. Sao Paulo Governor João Doria purchased 47 million shots of the vaccine. However, the transaction was stopped, arguably for political reasons, by the Brazilian President Jair Bolsonaro [20]. Bolsonaro’s comments when rejecting the purchase of the Sinovac vaccine on the basis that “the Brazilian people will not be anyone’s guinea pig” are not totally without merit. Recalls of “proven and tested” vaccines have happened in the past [21].

It is important for all people to continue exploring methods to develop their immune systems and prevent the spread of the virus while we wait for a vaccine. In an article I had previously published, I discussed the benefits of fasting, vitamin C, and Wim Hof breathing methods to help protect the body from disease [22]. All of these methods are well known and quite benign with respect to side effects, however they are unable to cure Covid-19 or prevent its spread. Additionally, the Center for Disease Control (CDC) has heavily stressed practices included social distancing and the wearing of non-ventilated face masks. Our hope is that going above and beyond to protect ourselves and our neighbors will give scientists the time that they need.

One way of giving that time to scientists is fasting. Fasting, like circumcision, is a tradition that is thousands of years old. In recent studies, a three-day water fast has been shown to reset the immune system of elderly people to the level of a twenty-year old’s [23]. At this current level of emergency in the world it would be very easy to find thousands of willing volunteers to trial monthly three-day water fasts and/or to take extra doses of vitamin C, not as a cure, but as a shield against COVID-19. This kind of study would not pose much risk and would definitely be very cost-effective. We could dive straight into the third phase of trials, for any side effects of fasting are already well known. And finally, if proven effective, its uptake by the population at large would be basically cost free and readily available across the whole world.

Our world has been enduring a difficult and challenging period for the better half of a year now. Time has given us the ability to learn more about the virus, how it disrupts our bodies, and how it spreads. This knowledge has, in turn, allowed us to research it and develop effective social guidelines for limiting its spread. Still, there is much work to be done. Hysteria and haste are not conducive to producing a vaccine that is thorough, effective, and efficient. It should be the responsibility of every able-bodied citizen to do what they can to learn more about how they can protect themselves from the virus and thus prevent it from spreading even more while we wait for a vaccine.

1. https://www.wuky.org/post/beshear-next-few-weeks-will-be-critical#stream/0
2. https://www.washingtonpost.com/science/2020/09/03/coronavirus-deer-mice-spread/
3. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326402/
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)03421-2/fulltext?_eventId=login
6. https://www.aafp.org/news/health-of-the-public/20200226interimfluve.html
7. Halperin, D. T., & Bailey, R. C. (1999). Male circumcision and HIV infection: 10 years and counting. The Lancet, 354(9192), 1813-5. doi:http://dx.doi.org/10.1016/S0140-6736(99)03421-2
8. https://www.immunology.org/publications/bsi-reports/60-years-immunology-past-present-and-future/the-hunt-for-hiv-vaccine
9. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html
10. https://www.medicalnewstoday.com/articles/2nd-person-cured-of-hiv-thanks-to-stem-cell-transplant
11. https://www.unaids.org/en/resources/fact-sheet
12. https://www.fda.gov/media/102332/download
13. https://www.usatoday.com/story/news/health/2020/09/09/covid-vaccine-astrazeneca-trial-hold-what-does-mean/5757590002/
14. cancer.org/treatment/treatments-and-side-effects/clinical-trials/what-you-need-to-know/phases-of-clinical-trials.html
15. 15 https://www.nytimes.com/2020/03/15/world/europe/cornonavirus-vaccine-us-germany.html
16. https://www.theverge.com/2020/8/11/21363135/russia-coronavirus-vaccine-unproven-registration
17. https://www.techtimes.com/articles/251792/20200814/covid-19-us-says-no-to-russias-vaccine-sputnik-v-saying-theyll-never-use-it-on-monkeys-let-alone-people-vietnam-and-philippines-say-otherwise.htm
18. https://abcnews.go.com/Health/wireStory/russia-approves-2nd-virus-vaccine-early-trials-73614460
19. https://fortune.com/2020/10/20/covid-vaccine-china-brazil-testing-ground-safest-most-promising-sinovac/
20. https://apnews.com/article/virus-outbreak-brazil-state-governments-health-sao-paulo-b7b5b620ba54f402dbf803e26fe6b842
21. https://www.cdc.gov/vaccinesafety/concerns/recalls.html
22. https://medium.com/@arasweb/surviving-the-pandemic-370b47120d8d
23. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/

“Free radicals” are a special type of atom that have been linked to many age-related diseases. They form as a result of a process called Oxidative Stress, which takes place when an oxygen molecule splits into single atoms with unpaired electrons. The nature of electrons is such that they like to be in pairs and as a result will “freely” and “radically” search throughout the body for another electron to pair with. They could almost be considered romantic if they were not so dangerous!

Their main danger comes from the damage that they cause to cells or cell membrane, proteins, and DNA. Cellular damage occurs when free radicals travel through cells and disrupt the structures of other molecules. The gradual accumulation of them, and the increased damage that builds as more and more of them collect, is what helps cause many of the aforementioned aging diseases. Our body is under constant assault from oxidative stress, and cells may function poorly or die if it occurs too frequently and without proper bodily maintenance.

Free radicals are a waste byproduct that form as a result of various chemical reactions that take place during our bodies’ normal metabolic processes. They are then “dumped,” and their eventual buildup will often harm our bodies much like how factory waste harms the environment However, they are not entirely useless; it is impossible for our bodies to turn air and food into chemical energy without a chain reaction of free radicals. Free radicals are also a critical part of the immune system, as they additionally move through our veins and can confront foreign invaders [1].

What are free radicals?

Understanding free radicals necessitates an elementary knowledge of chemistry.

Electrons orbit around atoms in levels called shells. Each shell is filled by a fixed number of electrons, and when the first shell is full then electrons will start to fill the next shell.

If there is an atom whose outer shell is not full then it may bond with another atom by using the electrons to fill its outer shell. These types of atoms are known as free radicals.

Atoms that have a full outer shell become stable, however free radicals are unstable. They are “desperate” to acquire the full number of electrons that are necessary to fill all of their shells and will therefore react quickly with other substances.

Take the example of oxygen molecules. If they split into single atoms that have unpaired electrons then they too will become unstable free radicals that seek other atoms or molecules to bond to. If this procedure continually occurs, then it will begin a process called oxidative stress.

Smoking, UV rays, air pollution, fast food, pesticides, ionizing radiation, drugs, and inflammation have all been linked to the formation of free radicals. We must be diligent when it comes to understanding how these influences can affect our bodily health, and then fight back with natural antioxidants.

Free radicals are heavily linked to aging

One of the effects of oxidative stress is that it can damage our body’s cells and thus promote many of the diseases and symptoms related to aging, such as wrinkles and gray hair. They will take electrons from other atoms in order to become more stable, a process that may cause diseases or signs of aging [2].              

In 1956, the “Free Radical Theory of Aging” was outlined as a way to understand how exactly our bodies age over time. Everybody ages, and as we age our body loses its ability to fight the effects of free radicals. Over time our bodies produce more free radicals and more oxidative stress, which increases the rate at which cells are damaged and thus can bring about degenerative processes.

Many age-related diseases such as muscular degeneration, certain cancers, atherosclerosis, cardiovascular disease, emphysema, Alzheimer’s disease, Parkinson’s disease, ulcers and all inflammatory diseases such as arthritis and lupus, and many others are linked to free radicals. Free radicals can be found in the food we eat such as fried foods, the medicines we take, the air we breathe, and the water we drink. Free radicals are also found in alcohol, tobacco smoke, pesticides, and air pollutants.

Several studies and theories have been linked to oxidative stress and the buildup of free radicals including: [3]

• Genetic degenerative diseases, such as Huntington’s disease or Parkinson’s
• Age-related changes in appearance, such as loss of skin elasticity, wrinkles, graying hair, hair loss, and changes in hair texture
• Cataracts and age-related vision decline
• Diabetes
• Cancer, which is associated with chromosomal effects and oncogene activation due to the reaction of free radicals [2]
• Central nervous system diseases, such as Alzheimer’s and various forms of dementia
• Cardiovascular diseases due to clogged arteries
• Autoimmune and inflammatory disorders, such as rheumatoid arthritis and cancer

The free radical theory of aging is comparatively new; however, several studies boost its credibility. Researchers focused on cell’s mitochondria, the “powerhouse” that process nutrients to power the entire cell. Experiments on rats, for example, showed a noteworthy increase in free radicals as the rats aged. These alterations coincided with age-related declines in their health. These experiments also showed that free radicals produced in the mitochondria harm the substances that the cells need in order to work properly. This damage causes mutations that produce more free radicals, thus accelerating the process of damage to the cell. This helps explain aging since aging quickens over time. The gradual, but increasingly rapid buildup of free radicals, offers one explanation for why even healthy bodies age and depreciate over time [2].

Antioxidants can stave off free radicals

Antioxidants, molecules that prevent other molecules from oxidizing and thus undergoing oxidative stress, can help to avert the harmful effects of free radicals. They can also decrease or even nullify the effects of free radicals, as they can provide an electron to free radicals and thereby reduce their reactivity. The uniqueness of antioxidants is that they can donate an electron without becoming reactive free radicals themselves.

There is no single antioxidant that can combat the effects of every free radical. Free radicals have different effects in different areas of the body, and every antioxidant performs differently due to its chemical properties. Antioxidants such as vitamins C and E, beta-carotene, glutathione, and plant estrogens called phytoestrogens all scavenge the body and help remove free radicals. Honey can also function similar to antioxidants by removing free radicals. Additionally, selenium, a trace metal that is required for proper function of one of the body’s antioxidant enzyme systems, is sometimes included in this category. The body cannot manufacture these micronutrients so they must be supplied in the diet.

Foods that are rich in antioxidants include citrus fruits such as oranges and limes, berries, and many other fruits that are rich in vitamin C. Carrots are known for their high beta-carotene content, while the soy in soybeans, and some meat substitutes, are high in phytoestrogens. Apricots, spinach, mangoes, pumpkins, broccoli, and eggplants are all also helpful, along with a plethora of other fruits and vegetables [4].

More research needed

A 2010 study on antioxidant supplementation for the prevention of prostate cancer found no benefits. Furthermore, a 2012 study found that antioxidants did not lower the risk of lung cancer. On the other hand, the study found that people who were already at a heightened risk of cancer, such as smokers, actually had a slightly elevated risk of cancer due to antioxidants.

Some investigators have found that supplementation with antioxidants is injurious when people take more than the recommended daily allowance (RDA). A recent analysis found that high doses of beta-carotene, or vitamin E, appreciably increased the risk of dying. One study found that long-term use of beta-carotene could reasonably reduce the risk of age-related mental problems [4]. But perhaps one of the most important discoveries is that antioxidants are unable to “cure” the effects of free radicals completely [5].  

Additionally, we do not yet fully understand why free radicals form in the first place. They may result as an early sign of cells fighting diseases, or that free radical formation is simply a natural expectation that comes with aging. It is not possible to understand them completely without more conclusive research, which should be encouraged considering the significant impacts that free radicals can have upon our bodies.

References

1. https://www.rice.edu/~jenky/sports/antiox.html
2. https://www.medicalnewstoday.com/articles/318652#How-do-free-radicals-damage-the-body
3. http://www.mytruehealth.info/mytruehealth_antioxidants_freeradicals.html
4. https://www.medicalnewstoday.com/articles/318652#Antioxidants-and-free-radicals
5. https://www.medicalnewstoday.com/articles/318652#What-we-do-not-know

Most of us have taken, or at least interacted with, medicine at some point or another in our lives. This can range from more “simple” over-the-counter drugs to more complex medicines specifically designed for exact illnesses. Considering the Covid-19 era we are going through and as search for a vaccine is at the highest possible speed, it is important to have at least a general idea on how medicines are developed for our use. This article aims to explore how a complicated mix of chemical compounds in a laboratory end up as pills on a shelf in your local pharmacy. We will also explore a brief history of pharmacology, where drugs get their names, how drugs come into fruition, the various affects that drugs can have on our bodies, along with the discrepancies that exist between them in regard to when, how, and why they should be taken.

Pharmacology is the study of the interactions that occur between a living organism and the chemicals that affect normal or abnormal biochemical functions. It includes the study of how a drugs can affect our biological systems, such as individual organs or an entire part of the body, and how the body overall responds to the drug. The discipline encompasses the sources, chemical properties, biological effects and, therapeutic uses of drugs. Substances with medicinal properties are considered pharmaceuticals, whereas drugs given for therapeutic purposes are usually called medications. Drug therapy, which is also called pharmacotherapy, is the use of drugs to prevent, diagnose, and treat signs, symptoms, and disease processes. When prevention or cure is not a reasonable goal, relief of symptoms can greatly improve quality of life and the ability to function properly on a day-to-day basis. Developing an understanding of this craft can allow us to better appreciate how molecules interact to form the drugs and medicines that can change our lives, and perhaps even allow us to contemplate their complex creation and existence.

In its most simplistic definition, a medication is a substance that is ingested or placed onto the body in order to cure a disease or condition (antibiotics are given to cure an infection), treat a medical condition (anti-depressants are given to treat depression), relieve symptoms of an illness (pain relievers are given to reduce pain), given to prevent diseases (flu vaccine helps to prevent the person from complications of having the flu).

Source of drugs

Historically, drugs were mainly derived from plants, animals, and minerals. Morphine, insulin, and iron are all commonly used examples of their respective sources. Belief in the curative powers of plants and certain substances rested exclusively upon traditional knowledge. But empirical information was not subjected to critical examination. Until the end of the 19th century, medicines were made by natural organic or inorganic products including mostly dried or fresh plants and their parts. These compounds might contain substances that possess healing properties or reactions that exert a toxic effect. It is important to remember that many fruits, vegetables, and plants still possess great power despite not having a “modern” origin.

Most drugs used nowadays are synthetic chemical compounds manufactured in laboratories which are synthesized by altering the chemical structure of an existing drug. The first drug of a particular group of drugs are called prototypes. For example, morphine is the prototype of opioid analgesics, and penicillin is the prototype of antibacterial drugs. Drug classifications and prototypes are defined and most new drugs can be assigned to a group. We must be hopeful and continue to search far and wide for cures for all  diseases, whether they be organic or synthetic, since our world is full of an infinite amount of possibilities and discoveries.

Drug names

The systematic naming of pharmaceutical drugs is called “drug nomenclature.” Drugs primarily have three types of names: chemical names, generic names, and trade names. The chemical names are the scientific names that often sound complex and are based upon the molecular structure of a drug. During development, the company will apply for regulatory approval of the drug by the relevant national regulatory agency, such as the U.S. Food and Drug Administration (FDA), and will be granted a generic name for it. Generic names usually indicate, via their stems, what drug class the drug belongs to. For example, oseltamivir is an antiviral drug because its name ends in the -vir suffix.

After development, testing, and regulatory acceptance of a drug, the pharmaceutical company gives the drug a trade name, which is a standard term in the pharmaceutical industry for a brand name or trademark name. Many drugs have multiple trade names which can reflect separate marketing strategies in different countries, manufactured by different companies, or both.

Drug investigation

A new drug investigation is the beginning of the journey of a chemical compound to a drug that will be used in clinics. The testing process of a chemical compound begins with animal studies to determine potential beneficial uses and also potential toxic side effects of the candidate compound.  The results from these animal studies are reviewed, and if the results are satisfactory, the compound then undergoes clinical trials in humans that people can voluntarily sign up for. Most clinical trials use a randomized, controlled experimental design that involves selection of subjects according to established criteria, random assignment of subjects to experimental groups, and administration of the test drug to one group and a control substance to another group.

Patent protection

New drugs that are developed by pharmaceutical companies will be covered under patent protection. This means that only the pharmaceutical company that holds the patent is allowed to manufacture, market, and eventually profit from the drug. This is seen as a return on the company’s investment that it took to develop the drug, which may require years of work and millions of dollars, along with an incentive for developing other drugs. Other pharmaceutical companies cannot manufacture and market the drug during the patent period.

Usually, the drug patent is awarded for around twenty years in the United States, however the number of years varies across countries and drugs. Pharmaceutical companies apply for a patent long before the clinical trial period even begins. The effective patent period after the drug has finally received approval is often around seven to twelve years. After the patented period expires the drug can be manufactured and sold by other companies. The drug is referred to as a generic drug at this point, and they are required to be therapeutically equivalent and much less expensive than trade name drugs.

Pharmacoeconomics

Pharmacoeconomics involves all of the costs that are accrued due to drug therapy and experimentation including those related to purchasing supplies, dispensing the drug, storing it, administrative fees, laboratory and other tests that are used to monitor patient responses, and losses from expiration. The length of a patient’s illness or hospitalization is also considered. While the most important factor is the health of the patient the costs for treatment are increasingly being considered as a major factor when choosing medications, and research projects that compare costs have greatly increased in recent years. The goal is to make it easier for patients to choose the most cost-effective drugs that combine high quality treatment at an affordable price. For drugs or regimens of similar efficacy and toxicity, there is considerable pressure upon doctors and pharmacies to prescribe less costly drugs for shorter duration.

Prescription and non-prescription drugs

In many countries, consumers have two legal routes of access to therapeutic drugs. One route involves a prescription or order from a licensed health care provider, such as a physician, dentist, or nurse practitioner. The other route is by over-the-counter (OTC) purchase of drugs that do not require a prescription. Both of these routes are regulated by various drug laws that change from country to country. Acquiring and using prescription drugs for non-therapeutic purposes, by persons who are not authorized to have the drugs or for whom they are not prescribed, is illegal.

The rejection of drugs in modern society

Nowadays, there are some people who deny various kinds of treatments because of their religious beliefs. This category of people is only a minority, as the majority of religions advocate for people to be healthy and to take care of their health as much as they can. In almost all belief traditions, the human body is believed to be a trust, and in case of any disease, the most appropriate and fastest treatment methods should be used. Even substances that are not normally permitted are allowed by scholars to be used if the person’s safety is concerned. For believers, the most important goal in life is to worship God, and for this to be possible the body must be healthy.

One day, people asked Prophet Muhammad, peace be upon him:

“Should we make use of medical treatment?”

He replied: “Make use of medical treatment, for God has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.”

People are encouraged to seek out those remedies and to use them with skill and kindness. Let us also remember that Jesus, peace be upon him, too, was very active in his ministry of healing. He showed by God’s permission miracles like curing the blind and the deaf, and bringing the dead back to life. Thus, religions do not refuse treatment with any available methods, and they even strongly encourage treatment and prevention of diseases.

Religions are also well known to treat stress, which wreaks havoc on the mind and body. It is still not known exactly how stress harms our health, but researchers have found that chronic psychological stress is associated with body’s losing its ability to regulate the inflammatory response. It has been shown that the effects of psychological stress on the body’s ability to regulate inflammation can promote the development and progression of disease. We know that religions and beliefs give people hope and significantly decrease the stress.

Human beings are the most precious creation, and health is necessary for us to achieve the purpose of our existence. Using scientific medicine together with faith and religion can help people to protect their health. Being the science of drugs and by investigating new drug therapies, pharmacology helps us exactly with that.

History of Pharmacology

Claudius Galen (129–200 A.D.) was the first person who attempted to consider the theoretical background of pharmacology.

Ali al-Tabari (838 A.D.) Medieval Islamic physicians used natural substances such as Papaver somniferum Linnaeus, poppy, and Cannabis sativa Linnaeus, hemp as a source of medicinal drugs. Although poppy had medicinal benefits, Ali al-Tabari explained that the extract of poppy leaves was lethal, and the extracts and opium should be considered poisons (4).

Theophrastus von Hohenheim (1493–1541), also known as “Paracelsus”, began to question doctrines from antiquity. He prescribed chemically defined substances with such success that professional enemies had him prosecuted as a poisoner. Against such accusations, he defended himself with the thesis that has become an axiom of pharmacology:

“If you want to explain any poison properly, what then isn‘t a poison? All things are poison, nothing is without poison; the dose alone causes a thing not to be poison.”

Johann Jakob Wepfer (1620–1695) was the first to use animal experimentation for pharmacological or toxicological actions.

Rudolf Buchheim (1820–1879) founded the first institute of pharmacology at the University of Dorpat (Tartu, Estonia) in 1847, which firstly made pharmacology as an independent scientific discipline. In addition to a description of effects, he strove to explain the chemical properties of drugs.

Oswald Schmiedeberg (1838–1921), together with his many disciples, helped to establish the high  reputation of pharmacology. He partnered with pathologist Bernhard Naunyn (1839–1925) to found the first journal of pharmacology, which has since been published without interruption.

After 1920, the pharmacological industry had their own pharmacology laboratories outside established university institutes. After 1960, departments of clinical pharmacology were set up at many universities and in industry.

References

1. Clinical Drug Therapy: Rationales for Nursing Practice – Seventh 7th Edition, Lippincott Williams &Wilkins.
2. Basic&Clinical Pharmacology, 12^th Edition, McGrawHill Lange.
3. Modern Pharmacology with Clinical Applications, Sixth Edition, Charles R. Craig and Robert E. Stitzel, Lippincott Williams &Wilkins.

Gastro-esophageal reflux disease (GERD) is among the most common chronic diseases in the Western world, affecting up to 30% of the general population in Europe and the US. It is a condition which develops when the acidic contents of the stomach flow backwards into the esophagus and cause what’s known as heartburn. While most patients respond well to the standard therapy of proton pump inhibitors which block acid-secreting cells in the stomach, we are still trying to understand the molecular reasons why 30-40% of reflux patients do not respond adequately to acid-suppressant therapy. Not only does GERD have a significant negative impact on health-related quality of life, but the over-subscription of ineffective drugs causes a significant economic burden on healthcare.

Heartburn is the most noticeable and troublesome symptom of GERD. From what we currently understand about the pathophysiology of the disease, we know that the reflux of acid evokes different types of pain, but the basic mechanisms and pathways by which this pain is generated is incompletely understood. The junction between the esophagus and stomach is structurally and functionally designed in a way to ensure that any acid secreted in the gastrointestinal tract flows towards the stomach, and not up onto the lining of the esophagus. This function is served by the muscle structure sitting at this junction, called the lower esophageal sphincter (LES), which ensures that the ingested food following a meal does not reflux. However, there are several factors which can make the LES’s job more difficult. One of the most obvious factors includes the excessive consumption of food, particularly during the later hours of the day. There is convincing evidence that 90% of reflux episodes occur post-prandially, due to minor elevations of intragastric pressure which causes the LES to relax and therefore allow the reflux of acid. In more advanced cases of reflux disease, acid pockets form at the gastroesophageal junction where unbuffered acid collects into a reservoir. When the LES fails in this setting, there is reflux of a higher volume of acid.

Focusing on the microscopic structure of the esophagus and stomach, we can see a minute yet essential difference between the linings of these two gastrointestinal organs. The esophagus has a stratified squamous epithelial lining, which acts as a tight protective barrier against food but is readily damaged when exposed to a chemical environment. On the other hand, the stomach is lined by tall columnar epithelium, which is designed to withstand very low pH and high levels of proteolytic activity. Our gastrointestinal tract (and the human body in its entirety) is perfectly designed to carry out the specific role of transporting food from the oral cavity from the esophagus to the stomach, where it is digested for our nourishment. It is oftentimes our greediness and overindulgence which disrupt the perfect order of our anatomy at a molecular level, resulting in the macroscopic changes we see at endoscopy and the symptomatic discomfort we feel from the painful circumstances of reflux. 

The stomach is our center of nourishment. Given that every food particle has the purpose of nourishing the cells of our body, why do we so commonly make the mistake of eating excessively, nocturnally, and quickly? Fatty foods influence the relaxation of the lower esophageal sphincter, along with alcohol, coffee, and acidic drinks. Large meals and rapid food intake distend the stomach, increase intragastric pressure and facilitating the reflux of acid from the stomach. Given these, it is plain to see that, in most cases, simple lifestyle changes can prevent the development of such chronic and discomforting diseases. The following verse in the Holy Qur’an offers a short but very effective prescription: “Eat and drink, but do not be wasteful” (7:31).

The philosopher and physician Ibn Sina (Avicenna) summarized the science of medicine as follows: “Eat little when you eat, and after eating do not eat again for a certain period of time; health lies in digestion. There is nothing heavier for the body to tolerate than putting food after food in the stomach.” Frugality in eating is also echoed in the teachings of Prophet Muhammad, peace be upon him, who famously said “There is no vessel which the son of Adam can fill more evil than his stomach, for it is sufficient for him to take a few mouthfuls in order to straighten his back; but if he must, then fill one-third with food, one-third with drink, and one-third with air” (Tirmidhi).

The lifestyle factors that are strongly associated with GERD are obesity and smoking. In the 30-40% of GERD patients who do not respond to acid-suppressant therapy, simple lifestyle changes such as cutting out acidic drinks and eating more slowly, and not after 7 pm have been effective alternative treatments. While our understanding of molecular pain mechanisms of the esophagus need further improvement, the simple act of making minor changes in our eating habits can ensure that the anatomy and function of our gastrointestinal tract remains optimal.

Every organ in the human body has vital functions. The kidneys play fundamental roles in maintaining human health.

One of the most important functions of the kidneys is producing urine. This function is performed by nephrons, the morphological unit in our kidneys. A nephron is simply made up of the glomerulus, where urine is filtered from blood, and tiny tubes where the filtered fluid passes through and is finally turned into urine (these tubes are proximal tubule, loops of henle, distal tubule, and collector channels).

There are approximately one million nephrons in the two kidneys of an adult. Each nephron is designed to produce urine by itself. Kidneys cannot renew nephrons. The number of nephrons, therefore, decreases gradually because of kidney damage, disease, or aging. After the age of 40, the number of nephrons generally decreases ten percent every ten years, and as a result, an 80-year-old has 40% fewer nephrons than 40 years ago. This loss is not life-threatening because adaptive changes in the remaining nephrons enable them to dispose of water, electrolytes, and metabolic waste in proper amounts.

The functions of the kidneys can be stated as follows:

• Discharging metabolic waste from the body, i.e cleaning our blood. The most significant of types of waste are urea, creatine, and uric acid. The kidneys are the path to eliminating medicine and hormones from the body. Many antibiotics and hormones, or their metabolic end-products, are discharged through the kidneys.
• Maintaining the body’s water-electrolyte balance. The kidneys are charged with balancing the amounts or concentrations of water and substances conducting electricity, such as dissolved sodium, calcium, chlorine, and potassium. If there is too much water or salt, it is discharged through urine. If the amount of water or salt has decreased, then the kidneys keep them in the body by preventing their discharge through urine and hence maintain the balance.
• Establishing an acid-base balance. It is vital to balance the acid or base level of the blood and other bodily fluids. The pH of blood is maintained at 7.4. If is too low, there is an excess of acid. A great excess of acid (acidosis) can cause sudden death. If it too high – called alkalosis – it leads to many disorders.
• Regulating the osmolarity of bodily fluids. The solid substances in blood (Na, K, glucose, amino acids, protein, etc.) must have a certain density. We can talk about the collective, rather than individual, density of the solid substances. One mole of solid particle in a liter of water (6,02 x 10²³) produces an osmotic pressure of 1 osmole. All bodily fluids (intracellular fluids, extracellular fluids, and blood) have an osmolarity of 300 milliosmoles. The discharge of solid particles and water are performed by the kidneys according to this delicate balance.
• Regulating blood pressure. The kidneys perform critical functions in balancing blood pressure by increasing the amount of urine when blood pressure increases or by decreasing the amount of urine when blood pressure decreases. The amount of urine is normal during normal blood pressure. If blood pressure decreases by half, the amount of urine becomes zero. If blood pressure doubles, the amount of pressure increases eightfold.
• Secreting hormones. The kidneys act like an endocrine gland in the secretion of several hormones. One of the most important of these hormones is erythropoietin, used in the production of blood cells in bone marrow. The kidneys also play a significant role in the production of vitamin D, which has recently been considered to be a hormone rather than a vitamin. Renin is also secreted from the kidneys when blood pressure drops.
• Glyconeogenesis: This function is primarily performed by the liver. Yet we know that this process is carried out by kidneys as well. Glyconeogenesis is the production of sugar (glucose) from the glycerol of non-sugar substances and all amino acids.

What should we pay attention to if we want to protect our kidneys?

• Proteins. They are probably the most valuable nutrients. Meat, milk, and eggs are rich in proteins, but grains like wheat and legumes contain proteins, too. Amino acids obtained from proteins are used as building blocks of the body. In this regard, proteins are essential for nutrition. When they are taken in excess amounts, however, proteins are converted into other substances (sugar and fats) or spent for energy production. Meanwhile, ammonia and then urea are produced in the liver. The urea produced in the liver is discharged by the kidneys through urine. Excess urea is considered a burden for the kidneys, so it is a risk for our kidneys to consume too much protein (particularly red meat). If there is a case or probability of renal failure, protein intake should be reduced.
• Salt. Kidneys can easily get rid of water, yet it takes some effort to discharge salt. Kidneys especially suffer when they are left without water. If kidneys cannot discharge enough salt, blood pressure rises. Therefore, if a person has a risk of heart or kidney failure or have high blood pressure, you should cut down on salt. It is crucial for anyone overweight to stop consuming salt. Foods without salt (such as minced meat and potatoes) decrease the appetite and stop a person from eating too much. Besides, meals without salt partly reduce the absorption of food in the intestines. A low-salt diet is good not only for the heart and blood pressure but also for kidneys. Yet people whose kidneys work perfectly, especially children and teenagers, run no risk when they consume salty food. It is also known that excess salt contributes to the formation of kidney stones.
• Water. It is vital for kidneys. Water helps kidneys clean the blood. It is not possible without water to cleanse blood of salt, other waste materials, and drugs. You should therefore be careful about drinking sufficient water. The daily requirement varies from person to person. Drinking 4-8 glasses, or 1.5–2 liters, of water will usually meet the body’s daily requirement. Drinks such as tea and coffee cannot be substituted for water because they increase water discharge. The minimum amount of water required for cleaning an adult body in a desert environment is half a liter. Though rare, it can also be a burden or problem for the kidneys if a person drinks too much Solid substances such as sodium, potassium, and calcium can be lost in excess as a result of overdrinking water, just like dirt is washed away by a flood.
• Acidic foods and drinks. One of the most important functions of the kidneys is to get rid of the acids produced through metabolic activities in the body and to balance the pH of blood. It is harder to discharge acids than bases. Acidic foods and drinks should therefore be consumed moderately. Pickles, sour foods, sodas, and other fizzy drinks should not be eaten in excess. It should also be remembered that acidic foods and drinks can cause kidney stones.
• Smoking. One of the primary harms of the nicotine in cigarette smoke is the fact that it causes blood vessels to contract. Smoking is the main reason for vessel stiffness. Nicotine causes kidney vessels to contract, hence a decrease in blood circulation in the kidneys. When blood circulation in the kidneys decreases, blood is no longer cleaned and blood pressure rises.
• Alcohol. Alcoholic beverages raise acid levels in the blood and causes acidosis, which damages all the organs and primarily the liver. Alcohol has the same effect as smoking on kidney vessels and causes them to contract. Not only does excessive acid damage kidneys but it also facilitates kidney stones.
• Drugs. Of the body’s organs, the kidneys are the most sensitive to drugs. Using antibiotics in high doses may lead to kidney damage and acute kidney failure. It is a common mistake in public to use antibiotics without consulting with a doctor. Using painkillers for every pain also causes chronic damage in our kidneys. It is normal for a person to have certain pains in daily life. They should consult with a doctor to identify the cause of the pain and should refrain from using painkillers unless absolutely necessary.
• Vitamins. A lack of vitamin B₆ is known to cause kidney stones. Thankfully, vitamins are among the innumerable blessings bestowed upon humanity. Vitamin B₆is abundant in sunflowers, pistachios, chickpeas, fish, and starchy vegetables.

As human life expectancy has grown longer, it has led to the emergence of disease that were once quite rare. One of these is Alzheimer’s. At the beginning, Alzheimer’s manifests as a decrease in overall everyday activity. It becomes more apparent as mental functions decrease and cognition weakens. In advanced stages, it leads to senility, a tragic condition induced by the deterioration of neurons.

Memory loss is a leading symptom that emerges at the onset of the disease. At first, past memories remain intact and little memory lapses occur. Then mental abilities gradually disappear. Speaking and hand gestures, which are primarily controlled by the frontal and temporal lobes of the brain, start to fail, accompanied by problems with recognition.

Although the underlying pathological processes in the brain tissues are not completely identified, it is known that there are disconnections between the limbic system and the frontal and temporal lobes. The intensive deterioration of the side cortical regions (the temporoparietal cortex) becomes visible in the amyloid plaques and the coiling nerve fibers as neurons degenerate and advance toward death.

Causes of Alzheimer’s

The exact cause of the disease is not known. It is in 2-4% of people over 65, and this rises to 20% of people over 85, indicating the relationship of the disease with advanced age. 1-5% of the cases are known to arise from genetic factors. A dominant mutation was identified in three different genes in a few cases diagnosed in the early stages of disease. A gene called ApoE was identified to be oversensitive in patients diagnosed with the more common type of Alzheimer’s at later ages.

One of the hypothesized causes is prions, proteins 100 times smaller than viruses that became known thanks to mad cow disease. Neither a virus nor a bacterium, prions are pathogens formed by the mutation of normal proteins produced in neural cells. Prions can be contagious. It is believed that prions can pass from person to person during a blood transfusion or dental treatment through unsterilized tools.

Dementia might be a single disorder for the layperson, but in medicine it refers to several disorders with different underlying causes. Alzheimer’s dementia is one of the neurodegenerative diseases in which neurons are destroyed; it is classified separately from frontotemporal dementia, dementia with Lewy bodies, dementia from Parkinson’s disease, vascular dementia, and dementia originating from Multiple Sclerosis (MS) or a metabolic disorder.

Demographic studies have identified several factors that increase the risk of Alzheimer’s disease. The energy source of neurons can be disrupted because of a decrease in blood flow into the brain resulting from circulatory damage, especially in patients who have high blood pressure and are overweight. Therefore, recommendations for a healthy way of life hold true for this disease.

The disease, which gradually destroys the neurons and the brain, severs the connections between cells. A typical symptom of the loss of neurons in Alzheimer’s begins with the loss of the sense of smell. The death of the cells spreads slowly to regions associated with memory and then to the entire brain surface. One-fifth of brain mass might be lost as a result.

The olfactory (smell) center and the bottom part of the brain are affected at an earlier stage. The Meynert basal nucleus in the central nervous system produces a substance (neurotransmitter) required for communication between neurons. The presence of this substance is important for retrieving memories from the archives – that is, for remembering. An apparent decrease in acetylcholine levels prevents processing of information, and because short-term memory is negatively affected, it may become very hard to remember events that have only recently happened.

As losses increase, the acetylcholine produced in the basal nucleus decreases. A remarkable finding about Alzheimer’s is the protein buildup in neurons and gaps in certain regions of the brain. Some doctors believe that this protein buildup causes the disease, while others argue that it is the body’s response to the disease. The result is the same: protein plaques act like poison that damage the metabolism of neurons, and the patient’s cognitive performance decreases because neurons cannot communicate with each other.

Increasing risk for relatives

Kinship seems to be an important risk factor for almost a third of Alzheimer’s patients. The probability that an Alzheimer’s patient’s siblings and children will have the disease is four times higher than for other people. The genes that indicate genetic factors have been identified in some families. For example, the epsilon-4 allele is found in 40% of Alzheimer’s patients, while it is present only in 10% of the healthy population. Yet this finding does not necessarily mean that everyone who has this gene will get sick. As researchers put it, the highest risk factor for Alzheimer’s is age. The older a person gets, the greater the risk of developing Alzheimer’s. Although the effect of gender is not exactly known, women have been found to be twice as likely to have the disease.

Among factors that increase the risk of Alzheimer’s are nicotine, alcohol, obesity, high cholesterol levels, diabetes, thyroid function disorders (hypo- or hyperthyroid), frequent concussions, unhealthy diet, heart attack, and paralysis. It is also interesting that depression, anxiety, and increased nervousness may develop at the onset of the disease.

Alzheimer’s and loneliness

In Alzheimer’s as well as other types of dementia, dementia is found to be triggered by lack of mental activity, which is in part connected to loneliness and isolation from people. In fact, loneliness is considered to be a preliminary symptom of Alzheimer’s. A study performed with 79 older people (43 female and 36 male) who had symptoms of dementia found that the amount of amyloid plaque was seven times higher in the brains of the participants with a greater decline in mental abilities. In addition, these patients suffered from severe cases of loneliness.

Is poor sleep a risk factor?

Observations in sleep laboratories indicate that prolonged periods of poor sleep increase the risk of Alzheimer’s. Even a single restless night without deep sleep can increase the beta-amyloid concentration, or Alzheimer’s protein, in the brain fluid. In case of several subsequent nights of restless nights, an increase is observed in the levels of tau protein, a second protein associated with the illness. The findings obtained by a team of specialists led by David M. Holtzman from Washington University Department of Medicine show that sleep disorders that are untreated for a long time increase the risk of Alzheimer’s.

The brain may not be cleaned sufficiently without deep sleep, hence the increase in the levels of protein particles. Yet it has been found that the amounts of beta-amyloid return to normal after a few days of sound sleep. The risk increases after a prolonged lack of deep sleep. It is thus believed that the risk of Alzheimer’s increases in people with sleep apnea who wake up repeatedly during the night because of problems breathing.

Yet it is not clear whether the increase in the amounts of tau and beta-amyloid proteins is related with the onset of the disease and how the findings should be interpreted. The reason for the confusion is that the two proteins also change shape and cause buildups in healthy people, not just in patients. It is therefore not known whether risk of Alzheimer’s can be lowered with a night of sound sleep.

We can say that warning signs can be found in sleep. Neuroscientists at the University of Toronto have discovered one of the early signs of sleep behavior. They have found that people who beat or kick themselves in their dreams are 80-90% more likely to develop a neurodegenerative disorder such as Parkinson’s and dementia at a later age, and this condition, also known as REM sleep disorder,[1] could be early signs of a brain disorder that may emerge within fifteen years.

Another study by Boston University researchers has revealed a correlation between REM sleep and Alzheimer’s. The researchers have found that a reduction in REM or dream-sleep phase increased the risk of disease. On the other hand, not every nightmare is a symptom of the disease. The predictive factor is the desire to move taking place during REM sleep. We spend about a quarter of our sleep in the REM phase.

The more efficient the sleep, the less the amyloid plaques

How long we sleep at night might predict how well our memory will work when we get older. According to Dr. Yo-Elju, sleep disorders seem to contribute to the formation of amyloid plaques. A two-week study conducted at the Faculty of Medicine at Washington University in St. Louis collected data from about 100 people aged 45-80. Researchers used sleep behavior surveys and machine measurements. A quarter of the participants had signs of amyloid plaques.

The participants spent eight hours a night in bed. They were disturbed by being woken at different intervals. It was seen in the end that those who were woken more often had greater amyloid plaques. Interestingly, those who slept more than 6.5 hours had the same condition. The correlation between poor sleep and amyloid plaques is striking, yet the findings in this study do not provide evidence for a cause-effect relationship. Therefore, longitudinal studies are needed to find out whether sleep disorders contribute to formation of plaques in the brain. To sum up, these studies indicate that quality of sleep matters more than length of sleep. It seems more important to have a shorter sleep with a complete REM phase than a ten-hour sleep without REM sleep.

An important advice

It is important for families to take care of their elderlies in their old age. It is worth noting that the Qur’an refers to weakness of mental faculties in old age followed by an advice to give in charity and reminding of His favors including spouses, children, and good, healthy sustenance:

God has created you, then He causes you to die. And among you are those who are deferred to the age of senility so they do not know, of what they once knew, anything at all. Surely God is All-Knowing, All-Powerful. And God has favored some of you above others in provision. And yet (while it is We Who provide them), those who are more favored do not consent to share their provision with those (slaves) whom their right hands possess, so that they might be equal with them in this respect. How then do they deny God’s grace and bounty (and associate partners with Him)? God has made for you, from your selves, mates (spouses), and has made for you from your mates children and grandchildren, and has provided you with good, wholesome things. Do they, then, believe in falsehood and deny the blessings of God? (16:70-72)

This allusion to family as a favor makes much sense thinking of the huge difference in the quality of life and health the elderlies have depending on the company of children and grandchildren and the lack thereof. As an example, I can cite my own father who lived to the age of 102 with his six children and fifteen grandchildren in the same apartment building. He never felt loneliness thanks to his many visitors, who conversed with him every day. He never became senile. 

Another interesting point to note is that this chapter of the Qur’an is Nahl, which means “honeybee.” Considering the fact that the main nutrition for our brain is glucose, consumption of honey and other food mentioned in the same chapter, like dates and grapes, may be considered useful to prevent mental diseases like Alzheimer’s.

References

Nancy J. Donovan ve ark. (2016): Association of Higher Cortical Amyloid Burden with Loneliness in Cognitively Normal Older Adults. JAMA Psychiatry, 2016; DOI: 10.1001/jamapsychiatry.2016.2657.

[1] REM (rapid eye movement) sleep is the period of sleep that starts 30-90 minutes after falling asleep in which one has dreams. This phase of deep sleep takes up about 20% of one’s overall sleep. It is the most refreshing period of sleep during which muscles are completely relaxed, eyelids move rapidly, and noradrenalin and serotonin are absent.

There are two types of pain. One is called sharp or acute pain, which for example might be caused by the prick of a needle, an injury from broken glass or a sharp object like a knife, or contact of skin with a hot object like an element. Such sharp pain is especially important to protect the body through reflex. Similarly, sharp pain in internal organs such as the stomach or intestines may result from a puncture or blockage that prevents the transport of oxygen, or leakage of toxic material such as the stomach acid.

Another type of pain is continuous or chronic pain, of which one obvious example is rheumatic pain. Cancer pain is mostly chronic, although cancer may also cause sharp pain. Whether chronic or sharp, cancer pain can be unbearable, and only endurable with morphine.

What can we do about pain?

Medication should be our last resort when dealing with pain. We should remember that every drug is potentially a poison, and drugs, especially when used for a long time and in high doses, can have numerous adverse effects. Thus no drug, including aspirin, is fully innocent.

The cause of pain must first be diagnosed by a physician. A pain in the chest may simply be a muscle pain, or conversely may be as deadly as a heart attack.

After diagnosis comes the required treatment or operation. Intense pain from appendicitis, for example, is easily treated with an operation. Pain from a heart attack, which causes pain in the left part of the chest, left shoulder and left arm, must be dealt with very seriously under the supervision of a cardiologist.

The first measure to be taken in case of a headache, backache, or neck ache is to avoid the position or movement that causes the pain. Consider the following analogy: the wheels of your car are not properly aligned. One side of the tire is worn due to friction, and thus blows out or loses traction. This result is inevitable, unless one corrects the misalignment leading to friction and wear. The damage cannot be prevented by putting on ear plugs and pretending it doesn’t exist.

If your neck has an ache, you should consult a physician to diagnose the cause. The pain may be related to how you use your pillow; so you can get rid of the pain by simply adjusting the pillow based on your preferred sleeping position, or you may need to buy a new pillow. The pain may also be caused by keeping the head in the same direction for prolonged periods to watch TV or looking into the monitor, we may just need to do some simple physical exercise and sit up right. Desk jobs and extended cell phone use are primary causes of neck aches. Resorting to painkillers immediately is not the right thing to do in such cases. A drug may ease the pain temporarily, but as in the car analogy, we may end up with a flat tire. Painkillers do not resolve the injury to the neck and what is worse, despite the intensifying pain you may not be aware of the body’s warnings, and finally have a serious case of hernia that may require an operation that runs the risk for death or paralysis.

The most important cause of backache is a vicious circle of inactivity and obesity. If a person does not exercise, they will put on weight and as one puts on weight they cannot exercise. Carelessness when picking up something is one of the most common causes of backaches. Obesity is one of the most common causes of herniated disc. Obesity prevents doing exercise; back muscles weaken as one does not exercise, and this leads to a herniated disc. If we do not take necessary care about these and look to drugs for treatment, we may not feel the pain, but the injury and hernia continue to exist. The risk is much lower among those who observe meditation and other religious practices that include physical activity like bowing, prostrating, sitting and standing upright. Eating little and leaving the table before being full are among many prophetic advices that are useful for our health.

The same is true for knee injuries such as meniscus tears and ligament sprains. Our knees are some of our most precious assets. We should be careful about our knees when standing up from a squat or getting on or off a car so that they will not slip sideways. Dangerous, rigorous exercises or movements that may harm the bones and cartilage in the knees, such as lifting heavy weights and jumping off a height, should be avoided, especially after a certain age. Sitting crossed-legged or squatting for long periods may stretch cruciate ligaments too much, and a slight move may cause their rupture.

One of the most common types of headaches is stress-related headaches. In these headaches the muscles in the head become tense, causing the vessels to contract and leaving tissues without oxygen. If we learn how to deal with stress, we can ease the headache and become happier. We should fight stress consciously and actively. We can overcome headaches not by sitting idly but by mental preparation and activity targeting stress.

Cupping and other complementary treatments can be tried before medication. Performing regular prayers may help relieve the aches in the head, neck, and knees, because these prayers reduce stress and are a form of exercise. Washing yourself as a part of prayers includes exercise, cleaning, and getting rid of the stress-related static electricity through water. Cleaning the top of the head, massaging the ears inside out, and washing the face and feet are known to reduce stress and discharge static electricity.

Endorphins, a group of hormones secreted within the brain, are in fact given the task of acting as painkillers in our body. They are thousands of times more powerful than morphine and help us fight headaches. Most of the ache, especially in chronic pains, is eliminated by the “pain-control systems” which were installed in our brains; what we feel as pain is in fact whatever remains after this elimination. Were it not for this mechanism, which is a sign of great compassion, life would be insufferable because of pains.