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The Rise of Lung Cancer in Non-Smokers: What You Need to Know

The Daily Desk — Mon, 09 Jun 2025 01:11:01 +0000

The Rising Mystery of Lung Cancer in Non-Smokers: What’s Behind This Growing Threat?

Lung cancer is often linked in our minds with smoking — but what happens when people who have never smoked start getting diagnosed more and more? The surprising rise of lung cancer among non-smokers is turning heads in the medical world, challenging old assumptions and raising important questions about causes, risks, and treatment.

Martha’s Story: A Wake-Up Call

Take Martha’s experience. At 59, she never considered herself a smoker — sure, she’d occasionally lit a cigarette at parties, but nothing regular. So when her cough changed and her mucus thickened, she thought it was just a flare-up from a rare lung disorder she already had. Doctors initially agreed it was nothing to worry about.

But after an X-ray revealed a shadow on her lung, things quickly escalated. A CT scan and bronchoscopy confirmed a tumour. Four months after she first mentioned symptoms, Martha was diagnosed with Stage IIIA lung cancer. The tumour had invaded nearby lymph nodes but hadn’t spread further.

“It was a total shock,” Martha says. And her story isn’t unique.

Lung Cancer Beyond Smoking: A Growing Global Concern

Lung cancer remains the world’s most common cancer and the deadliest, with around 2.5 million new cases and 1.8 million deaths in 2022 alone. While smoking still accounts for the majority of cases, smoking rates have dropped in many parts of the world over the last decades. At the same time, lung cancer diagnoses among people who have never smoked now make up 10 to 20% of cases — and that percentage is rising.

Dr. Andreas Wicki, an oncologist from the University Hospital Zurich, explains, “Lung cancer in never-smokers is emerging as a distinct disease, with unique molecular features that affect treatment and outcomes.” Interestingly, younger lung cancer patients—those in their 30s or 40s—are more likely to be non-smokers, and the cancer type tends to differ as well.

A Different Type of Lung Cancer

The kind of lung cancer common among smokers—squamous cell carcinoma—used to dominate until the mid-20th century. But in never-smokers, nearly all lung cancers are adenocarcinomas, which originate in mucus-producing cells.

The catch? Adenocarcinomas are often diagnosed late because small tumors don’t cause obvious symptoms. Persistent cough, chest pain, and breathlessness only show up once the tumour grows or spreads. “Because most people associate lung cancer with smoking, non-smokers may dismiss early warning signs, delaying diagnosis until advanced stages,” says Wicki.

Why Are Women More Affected?

Non-smoking women are more than twice as likely as men who never smoked to develop lung cancer. This may be linked to differences in lung anatomy, environmental exposures, and genetics. A key player is a mutation called EGFR, which is especially common in women and notably in Asian women.

Scientists suspect female hormones and genetic variants affecting estrogen metabolism might explain this higher incidence, though research is ongoing.

The Role of Genetics: Driver Mutations and Targeted Therapies

Cancer cells in non-smokers often carry “driver mutations” that fuel tumour growth. EGFR mutations are the best-known example. Once these mutations were identified, drug companies developed targeted therapies—EGFR inhibitors—that block the mutant protein’s activity.

“About 20 years ago, these drugs showed great promise,” Wicki says. “Many patients responded well, but resistance often developed, leading to relapse.” Newer generations of these drugs are now improving survival, with some patients living more than 10 years after diagnosis—an incredible leap from the less-than-12-month survival rates seen two decades ago.

What’s Causing Lung Cancer in Non-Smokers?

Without smoking as a cause, what else is driving lung cancer? Experts point to a mix of environmental and genetic factors:

Radon exposure and second-hand smoke
Indoor air pollution from cooking fumes and burning wood or coal, especially in poorly ventilated homes
Outdoor air pollution, which is now recognized as the second leading cause of lung cancer worldwide after smoking

Air pollution—specifically tiny particles called PM2.5 found in vehicle exhaust and fossil fuel smoke—has been linked to lung cancer, particularly among those with EGFR mutations.

How Air Pollution May Trigger Lung Cancer

New research from the Francis Crick Institute in London sheds light on how air pollution might kickstart lung cancer in non-smokers carrying the EGFR mutation. Instead of directly mutating DNA like cigarette smoke, PM2.5 particles activate immune cells called macrophages. These cells release signals that “wake up” dormant mutant cells in the lungs, pushing them to grow into tumors.

This discovery opens exciting possibilities for new ways to prevent lung cancer by targeting the lung environment, not just the cancer cells themselves.

The Bigger Picture: Air Pollution’s Growing Impact

Air pollution’s connection to lung cancer isn’t new—it was mentioned as a possible cause as early as 1950. Yet for decades, anti-smoking policies dominated lung cancer prevention.

Today, 99% of the world’s population lives in areas exceeding the World Health Organization’s air quality guidelines. Rising pollution in places like India and China means the lung cancer burden from environmental factors may grow.

In the US, wildfires are causing spikes in PM2.5 levels, linked to increased lung cancer cases. Experts agree that shifting away from fossil fuels is critical not only for climate change but also for lung health.

Looking Ahead: Changing Perceptions and Hope

As treatments improve, lung cancer in never-smokers is becoming more manageable, challenging the stereotype that lung cancer is a smoker’s disease or a death sentence.

Martha, now almost three years post-diagnosis, takes an EGFR inhibitor. It’s not easy—side effects like fatigue and skin issues make daily life challenging—but the drug works. “The fatalistic view of lung cancer is changing, and that’s a hopeful sign,” she says.

With ongoing research and growing awareness of environmental risks, the future may hold better prevention and longer survival for those diagnosed with this mysterious form of lung cancer.

Source: BBC – The mystery rise of lung cancer in non-smokers

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Iron Deficiency: A Global Health Crisis and the Ongoing Debate on Supplements

The Daily Desk — Thu, 13 Mar 2025 17:04:06 +0000

The Global Challenge of Iron Deficiency – Why Scientists Can’t Agree on Supplements

Iron deficiency is one of the world’s leading causes of disability, yet experts remain divided on when it becomes a serious issue and the best approach to treating it.

When Megan Ryan, a single mother from upstate New York, first experienced constant fatigue, she attributed it to the challenges of balancing full-time work and raising a three-year-old. She dismissed her exhaustion as just part of motherhood—until a routine medical check-up in June 2023 revealed that she had iron deficiency anemia.

Looking back, there were other warning signs: breathlessness during routine hikes and an unusual craving for ice—an indicator of pica, a common symptom of iron deficiency.

Ryan’s experience reflects a broader global health issue. Iron deficiency is the most common micronutrient deficiency worldwide, affecting one in three people. The condition is particularly prevalent among children and women of reproductive age, including pregnant women.

Iron is essential for red blood cell production and oxygen transport throughout the body. Without enough of it, various health problems can arise:

Pregnant Women: Increased risk of premature birth, low birth weight, and impaired fetal brain development.
Infants & Toddlers: Long-term developmental delays, behavioral issues, and reduced cognitive abilities.
Adults: Fatigue, weakness, and in severe cases, life-threatening complications.

“It’s a major global problem,” says Michael Zimmermann, a professor of human nutrition at the University of Oxford. “It’s very common, it’s not going away fast, and it’s associated with significant disability.”

Some populations are more susceptible to iron deficiency than others:

Women: Menstruation and pregnancy increase vulnerability. One study found that 46% of UK women had anemia at some point during pregnancy.
Athletes: Endurance sports increase iron needs, putting athletes at higher risk.
Vegetarians & Vegans: Plant-based diets often contain less bioavailable iron than meat-based diets.
Frequent Blood Donors: Repeated donations can deplete iron levels.
Individuals with Certain Medical Conditions: Kidney disease and celiac disease can reduce iron absorption.

Children are especially vulnerable due to rapid growth. “Infancy is the most rapid period of growth in our entire lifespan,” explains Mark Corkins of the American Academy of Pediatrics. “Without enough iron, the body struggles to produce the red blood cells necessary for proper oxygen delivery.”

Studies in Africa show that up to 70% of babies aged 6–12 months suffer from iron-deficiency anemia. Even in wealthier nations, the condition persists—affecting up to 4% of toddlers in the U.S.

Iron deficiency and anemia are not the same thing, though they are closely related.

Iron Deficiency: Occurs when the body lacks adequate iron stores but may not yet impact red blood cell production.
Iron-Deficiency Anemia: The stage where iron levels are so low that they affect hemoglobin levels, leading to fatigue, weakness, and other symptoms.

Diagnosis is typically made through blood tests measuring ferritin (a protein that stores iron) and hemoglobin levels.

The role of iron supplements is a topic of ongoing debate. While supplementation is often recommended for those with diagnosed deficiency, some researchers question its necessity for individuals without symptoms.

A review co-authored by clinical hematologist Sant-Rayn Pasricha found that while iron supplementation improved fatigue in women who reported feeling exhausted, it had no effect on women with iron deficiency who did not feel fatigued.

“For those who are clinically unwell with iron deficiency, treatment is beneficial,” says Pasricha. “But for those without symptoms, it’s unclear if supplementation improves health.”

This uncertainty is particularly relevant for children. One large study in Bangladesh found that iron supplements improved iron levels but did not enhance neurodevelopment. Another study revealed that infants who received high-iron formula performed worse on cognitive tests years later compared to those on low-iron formula.

Some experts argue that supplementing iron unnecessarily could have downsides, including digestive issues and altered gut microbiomes. Zimmermann warns that excessive iron supplementation in infants could encourage harmful bacterial growth, such as E. coli.

Given these risks, many experts advise consulting a doctor before starting iron supplements.

A balanced diet remains the best way to maintain adequate iron levels.

Heme Iron (Easily Absorbed): Found in red meat, liver, poultry, and fish.
Non-Heme Iron (Less Absorbed): Present in beans, lentils, nuts, and iron-fortified cereals.
Vitamin C Boosts Absorption: Pairing iron-rich foods with sources of vitamin C (such as citrus fruits or bell peppers) enhances absorption.

In the U.S., the American Academy of Pediatrics recommends that infants aged 6–12 months consume 11 mg of iron daily, while toddlers need 7 mg per day. Many pediatricians advocate for breastfed babies to receive iron drops starting at four months, as breastmilk alone does not provide sufficient iron. However, some researchers question this approach, citing potential drawbacks.

For those diagnosed with iron deficiency, recovery takes time. Megan Ryan, for instance, required iron infusions every two weeks for five months before her energy levels improved.

“It wasn’t a quick fix,” she says, “but I finally started feeling normal again.”

While iron deficiency remains a significant global challenge, ongoing research aims to clarify when and how supplementation should be used—ensuring that people receive the right treatment at the right time.

Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult a healthcare professional regarding any concerns about your health or nutrition.

Source

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Iodine Deficiency: A Growing Health Concern for Pregnant Women and Kids

The Daily Desk — Sat, 18 Jan 2025 11:36:16 +0000

Doctors Raise Alarm Over the Return of Iodine Deficiency

Doctors are concerned that iodine deficiency, once a major health issue in the early 20th century, is making a comeback. A recent case in Rhode Island highlighted the problem when a 13-year-old boy arrived at the clinic with a rapidly swelling neck. Initially puzzled, doctors soon discovered that the cause of his condition was iodine deficiency.

Iodine: A Vital Nutrient

Iodine is a trace element essential for proper thyroid function. It helps regulate metabolism and plays a crucial role in brain development, especially in children. A deficiency in iodine can lead to an enlarged thyroid, commonly known as a goiter, which causes the neck to swell. This condition was once widespread in parts of the United States, especially in areas known as the “goiter belt,” stretching from Appalachia to the Great Lakes and the Northwest.

The widespread iodine deficiency in the early 1900s was associated with stunted growth, intellectual impairments, and a condition known as “cretinism.” The solution came in the form of iodized salt, introduced in 1924, which effectively ended the iodine deficiency problem for most Americans by the 1950s.

A Shifting Diet

However, modern diets have changed, and iodine deficiency is once again becoming a concern. With the rise of processed foods, many Americans are consuming salt that is not iodized. Additionally, popular bread brands no longer add iodine, and many people now opt for non-iodized salts like kosher salt or Himalayan salt, unaware of the iodine it once provided.

Dr. Elizabeth Pearce, a leader in the Iodine Global Network, points to a significant drop in iodine levels in the U.S. population. Between the 1970s and the 1990s, iodine levels fell by 50%, primarily due to changes in diet and food production methods.

Vulnerable Groups: Pregnant Women and Children

Though most Americans are still getting enough iodine, experts are particularly concerned about pregnant women and children. Iodine is crucial for proper brain development in fetuses and young children, and even mild deficiency during pregnancy can have lasting effects. Studies have linked iodine deficiency to lower IQs and language delays in children, though the exact threshold for when problems occur remains debated.

The American Academy of Pediatrics recommends that pregnant and breastfeeding women consume 150 micrograms of iodine daily. However, a study from Michigan State University found that about a quarter of pregnant women in Lansing were not getting enough iodine, which highlights the growing concern.

Many prenatal vitamins do not contain iodine, which is why doctors advise women to check the labels of their supplements to ensure they are getting the recommended amount.

A Growing Concern

In recent years, doctors have reported more cases of iodine deficiency, particularly in children with restricted diets, such as those who are picky eaters. Dr. Monica Serrano-Gonzalez, who treated the Rhode Island case, has observed several other cases of iodine deficiency in her clinic. “We’re concerned this may be increasing,” she said, urging more attention to the issue, especially for vulnerable groups.

While iodine deficiency was once a problem of the past, it’s making a quiet return, and health experts urge the public to pay attention to their iodine intake—particularly for pregnant women and children.

Source

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Alcohol Linked to Cancer: US Surgeon General Issues New Warning

The Daily Desk — Fri, 03 Jan 2025 16:52:16 +0000

US Surgeon General Warns About Alcohol’s Link to Cancer Risk

US Surgeon General Dr. Vivek Murthy has issued a new advisory, urging Americans to be aware of the significant cancer risks associated with alcohol consumption. In a statement released Friday, Dr. Murthy highlighted that alcohol is a preventable cause of cancer, responsible for approximately 100,000 cases and 20,000 deaths annually in the United States.

“Alcohol is the third-leading preventable cause of cancer in the US, after tobacco and obesity,” Dr. Murthy said. Despite these statistics, many Americans remain unaware of the connection between alcohol and cancer. Alcohol consumption is linked to at least seven types of cancer: breast, colorectal, esophagus, liver, mouth, throat, and voice box. The risk increases with greater consumption, regardless of the type of alcohol consumed.

The new advisory highlights the growing body of evidence that challenges the previous perception that moderate alcohol consumption—especially red wine—could have health benefits. While alcohol’s potential effects on heart health have been debated, the Surgeon General’s office notes that even moderate drinking can elevate the risk of certain cancers.

For cancers like breast, mouth, and throat, the risk may begin with as little as one drink a day. The Surgeon General’s office emphasizes that an individual’s cancer risk is influenced by various factors, including biology and environmental exposures.

A recent Gallup poll indicates that younger Americans are increasingly aware of alcohol’s health risks. Nearly half of all Americans now believe that drinking one or two drinks a day is bad for health—the highest percentage recorded in the poll’s 23-year history. Younger adults, in particular, were more likely to consider drinking harmful.

In response, the Surgeon General is calling for updated alcohol consumption guidelines that consider the cancer risk, and for greater public awareness of the issue. Dr. Murthy has also recommended updated health warning labels on alcoholic beverages to reflect the cancer risk, though these changes would require approval from Congress.

The Surgeon General has previously issued advisories on other pressing health issues, such as firearm violence, loneliness, social media’s effects on youth mental health, and the mental health of parents. As the conversation around alcohol and health continues to evolve, the Surgeon General’s office is determined to provide the public with the information needed to make informed choices about alcohol consumption.

Source

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Doctors Warn Against Honey Packets: A New College Sex Trend That Could Be Harmful

The Daily Desk — Thu, 28 Nov 2024 00:48:31 +0000

The Dangerous Trend of ‘Honey Packets’ Among College Students

A new trend among college students is raising alarms among health professionals. The trend, which has gained attention on TikTok, involves the use of honey packets marketed as a sexual enhancement supplement. Students at Arizona State University have posted videos discussing their use of these packets, which have garnered over 400,000 views. Some students joke about using them, while others openly mention taking them on campus.

However, doctors are not laughing. The Food and Drug Administration (FDA) has warned against several honey packet brands, which contain hidden drug ingredients.

What’s Really Inside the Honey Packets?

While some honey packets contain natural ingredients like maca and ginseng—which may not have much of an impact—others include pharmaceutical drugs such as tadalafil, the active ingredient in Cialis, a medication for erectile dysfunction. According to Dr. Peter Leone, a professor of medicine at the University of North Carolina, “I’m all about people having good sex and sexual pleasure, but I prefer safer ways of doing it.”

Dr. Jesse Mills, a clinical professor and director of the Men’s Clinic at UCLA, agrees. He points out that these packets can be easily purchased at liquor stores and truck stops, but consumers have no idea what’s inside. The danger lies in the unpredictability of these products, as tadalafil can cause serious side effects—such as dangerously low blood pressure—especially when combined with other medications or alcohol. In some cases, it can even be deadly.

Why Are College Students Using Honey Packets?

In the viral TikTok video, one ASU student mentions taking multiple honey packets in one night. While the packets have been around for some time, they are gaining more popularity among young people looking to enhance their sexual experiences. Dr. Mills highlights the risk, noting that young men, especially in college, are unlikely to suffer from erectile dysfunction, so there’s no real medical reason for them to use these products.

Instead, the trend reflects a deeper issue: insecurity. Many college students feel pressure to perform sexually, particularly in hookup culture, and may use the packets to boost their confidence or compete with previous sexual partners. But using a honey packet isn’t the solution.

Dr. Mills explains that for college students experiencing sexual performance issues, it’s important to consult a professional. A sexual health specialist can help determine whether the problem is physical or psychological, offering proper treatment or support.

The Bigger Picture: Why It Matters

The interest in honey packets raises concerns about the pressures young men face regarding their sexual performance. Many are worried about how they compare to their partner’s past experiences, fueling a sense of competition rather than focusing on healthy, consensual intimacy.

For students who may be struggling with sexual health, the solution isn’t to rely on a risky supplement but to seek help from a medical professional. Dr. Mills advises, “If a college student is having difficulty achieving or maintaining an erection, that’s a serious health issue that needs to be addressed. But if they think a honey packet will help them last longer or perform better, it probably won’t—unless they truly believe in it, in which case, the placebo effect can make anything seem effective.”

In short, while the honey packet trend might seem harmless, it can be dangerous, and it’s important for young people to understand the risks involved and seek proper medical advice if they’re concerned about their sexual health.

Source

USA Today Watch Video

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Understanding Mycoplasma Pneumonia: Symptoms, Treatment, and Prevention Tips

The Daily Desk — Thu, 31 Oct 2024 14:49:14 +0000

It all began with a persistent cough. “We just kind of watched it progress until she had this very lingering, deep, disruptive cough,” recalls Sharma.

This cough was a sign that her daughter might have mycoplasma pneumonia, an infection caused by the bacteria Mycoplasma pneumoniae. According to the CDC, cases began rising in the U.S. during the spring and summer, and this trend has continued into fall. In Dallas, Sharma noticed a significant increase in cases after children returned to school.

“Kids are spreading it to one another in schools, and they are likely bringing it home to their families,” Sharma explains.

Mycoplasma pneumonia often presents with upper respiratory symptoms, but some children may also experience red eyes or rashes, along with headaches.

Caleb Ward, a pediatric emergency medicine doctor at Children’s National Hospital in Washington, D.C., reports a tenfold increase in mycoplasma pneumonia cases this year. The good news is that many cases are mild, which is why it’s often referred to as “walking pneumonia.”

“People may assume they just have a mild cold, but they might actually have mycoplasma pneumonia,” Ward says.

New York City has also experienced a surge in cases. Dr. Adam Ratner, who heads the pediatric infectious diseases division at NYU and Hassenfeld Children’s Hospital, notes that while the infection typically affects children and teens aged 5 to 17, there has been a noticeable rise in cases among younger children aged 2 to 4 during this current spike.

“That’s consistent with what we are seeing nationwide,” Ratner says, and he is also a member of the American Academy of Pediatrics’ Committee on Infectious Diseases.

Most children can be treated at home. Parents should ensure their kids stay hydrated, give age-appropriate fever medication as needed, and encourage plenty of rest. For children over one year old, honey can help soothe a cough.

Parents should contact a doctor if they notice their child has difficulty breathing, isn’t drinking enough fluids, seems excessively sleepy, or has a fever lasting more than five days.

Mycoplasma pneumonia is easily treated with antibiotics, but it’s important to use the correct one. Amoxicillin, commonly prescribed for other types of pneumonia, is ineffective against mycoplasma pneumonia; instead, a macrolide antibiotic like azithromycin is necessary.

Sharma advises that kids can return to school once they have been fever-free for at least 24 hours without using fever reducers, provided they feel well enough.

However, it’s important to note that symptoms such as cough and runny nose can persist for weeks, and children may continue to spread the bacteria during this time. This is one reason why outbreaks of mycoplasma pneumonia tend to last a long time.

Now is a good time to remind children—and ourselves—to wash our hands frequently and cover our coughs and sneezes, as the winter respiratory virus season is just beginning.

Source

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Top 5 Facts About Testosterone in Women, Explained by an MD

The Daily Desk — Fri, 25 Oct 2024 08:24:01 +0000

Testosterone is quite the misunderstood hormone, probably because there isn’t much education about hormones outside of stereotypes in general. However, we’re here to help change that, just a little bit.

To come, five things you may not know about testosterone in women, from Harvard-trained board-certified internal medicine physician and chief medical officer at Modern Age Anant Vinjamoori, M.D.:

We carefully vet all products and services featured on mindbodygreen using our commerce guidelines. Our selections are never influenced by the commissions earned from our links.

To come, five things you may not know about testosterone in women, from Harvard-trained board-certified internal medicine physician and chief medical officer at Modern Age Anant Vinjamoori, M.D.:

1. It’s not solely a “male hormone”

It’s no secret that many people associate testosterone with male rage and muscle building. However, it’s not just a male hormone, and it has many more functions in the body than you might think.

“In reality, it’s the most abundant hormone in a woman’s body 1 and begins to decline in most women by their mid-30s, well before estrogen and progesterone,” Vinjamoori says. However, the latter two hormones are most often discussed in relation to women’s health, leaving testosterone out of the conversation.

2. It doesn’t just impact sex drive and muscle gains

This hormone impacts many bodily functions. Below, Vinjamoori explains a few of the most important testosterone functions in women:

3. Fact: You can be deficient in testosterone

Much of the hormone-balancing conversation in women’s health focuses on estrogen and progesterone, but balance is needed with testosterone as well. In fact, you can even be deficient in testosterone, which Vinjamoori sees quite often in women over 30.

4. Birth control can change testosterone function

If you are concerned about testosterone balance, you’ll want to start by making sure any medication you take isn’t impacting your testosterone levels. Or, if it is, make sure you know that your hormone levels may not be able to be accurately measured because of it.

One common medication that can interfere with testosterone measurement (and hormone measurement in general) is oral birth control pills, so make sure you take that into account when looking at results from testosterone tests.

“The suppression of testosterone is often a downstream effect of birth control’s inhibition of gonadotropin-releasing hormone (GnRH) from the hypothalamus and luteinizing hormone (LH) from the pituitary gland, which are hormones crucial for the natural production of testosterone,” Vinjamoori explains.

5. PSA: There are ways to support it naturally

Hormone replacement therapy may be an option for some women who have testosterone deficiency, but that doesn’t have to be the first step when it comes to balancing this hormone. Instead, look to a combination of lifestyle factors.

“To naturally promote healthy testosterone levels, two of the most effective strategies are high-quality sleep and resistance training 5,” Vinjamoori says.

You may also look to DHEA supplements. “The body synthesizes DHEA before converting it to testosterone, making it a reasonable choice for supplementation,” Vinjamoori says. However, it’s best to consult your health care provider before starting this supplement to ensure it’s a necessary part of your routine.

The takeaway

Stereotypes aside, testosterone balance is an important part of women’s health. This hormone impacts physical and mental health and may even be an undiagnosed deficiency in women over 30. To support your testosterone levels, prioritize sleep, try resistance training, and consider DHEA supplementation if recommended by your health care provider. Here, more on hormone balancing 101.

Source

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Common Gesture May Indicate Concussion, Researchers Warn

The Daily Desk — Thu, 24 Oct 2024 07:18:48 +0000

A quick shake of the head after a hard hit could signal that a person has a concussion, a new study suggests, based on the experiences of young athletes.

It’s an easily recognizable movement that could help significantly reduce the number of concussions that go undiagnosed if added to official evaluation guidelines, according to researchers from Mass General Brigham and the Concussion Legacy Foundation.

“We describe it in detail as a time that after a hit to the head, someone laterally shakes their head at a speed between two and eight Hertz. But that’s complicated medical terminology for something we’ve all seen,” said Dr. Dan Daneshvar, a study co-author and co-chair of sports concussion at Mass General Brigham.

Cartoons often depict a circle of birds that fly away after the character shakes their head, for example.

“There’s such a strong lay understanding of this being associated with concussions,” he said, but it’s not included in guidelines or medical literature.

To better understand this movement – dubbed a spontaneous headshake after a kinematic event, or SHAAKE – and its relationship to concussions, the researchers surveyed hundreds of young adults who had played a sport at the high school, collegiate or semiprofessional level.

They found that the vast majority of the young athletes were familiar with the gesture and had experienced it themselves, more often than once. In nearly three out of four cases, the individuals surveyed said that they got a concussion at the time of the SHAAKE.

The concussions that the survey participants reported were often self-diagnosed, but the underlying reasons they typically reported for making the head shake – such as disorientation or confusion, or changes to spatial perception – lined up with symptoms that are known to be associated with concussions.

Recognizing this head shake and its link to concussions in a more formal way is “long overdue,” said Dr. Julie Stamm, a clinical assistant professor at the University of Wisconsin-Madison who was not involved with the new study.

“Going back a few decades, we used to think that you had to lose consciousness to have a concussion,” she said. Now, the science shows that concussions very rarely result in severe symptoms like this. Instead, more subtle signs are known to be more common – and the severity of the symptoms doesn’t always line up with the severity of the injury, she said.

“People would try to shake off a ‘bell ringer’ or shake off ‘seeing stars’ and kind of reset,” Stamm said. “We didn’t always consider some of those injuries to be concussions, and now we do.”

Based on the survey responses, researchers suggest in the new study that more formal recognition of SHAAKE as a sign of a concussion could help identify up to a third of undiagnosed concussions.

“Based on our data, SHAAKE is a reliable signal that a concussion may have occurred, like an athlete clutching their head after contact, being slow to get up, or losing their balance,” said Daneshvar, who is also chief of brain injury rehabilitation at Spaulding Rehabilitation and Harvard Medical School. “Just like after these other concussion signs, if athletes exhibit a SHAAKE, they should be removed from play and evaluated for a potential concussion.”

The National Football League and the NFL Players Association agreed to update the league’s concussion protocol in October 2022 after intense scrutiny over decisions made following a hit that knocked Miami Dolphins quarterback Tua Tagovailoa to the turf.

A sideline doctor initially concluded that Tagovailoa’s fall was due to a previous injury to his back, and he was allowed to return to the game, only to be hospitalized for a concussion later. The imbalance he was experiencing was later attributed to ataxia, which describes a lack of coordination caused by a neurological issue. Under the new NFL concussion protocols, players are unable to compete if they are experiencing ataxia.

But the researchers of the new study, published Wednesday in the peer-reviewed scientific journal Diagnostics, suggest that the diagnosis and decisions for Tagovailoa may have played out differently if the head shake were part of the official concussion protocol.

“In this instance, the SHAAKE he exhibited would be difficult to attribute to a prior back injury,” the researchers wrote. “Any of the doctors that saw Tua, both on the field and in the subsequent days, may have reconsidered and, based on this additional evidence, determined that a concussion diagnosis would more appropriately cover both his imbalance and his SHAAKE.”

A board of independent and NFL-affiliated physicians and scientists developed the league’s official Game Day Concussion Diagnosis and Management Protocol in 2011, and it’s “reviewed each year to ensure players are receiving care that reflects the most up-to-date medical consensus on the identification, diagnosis, and treatment of concussions,” according to an overview on the NFL’s website.

“The NFL’s medical committees regularly review new research, and we have been in touch with the authors of this study,” NFL Chief Medical Officer Dr. Allen Sills said in a statement about the new study. “As with any new research, we will discuss these findings with our experts and look at our own data to see if these findings can be replicated.

Our concussion protocol, a conservative process developed from internationally accepted guidelines, is reviewed annually to ensure players are receiving care that reflects the most up-to-date medical consensus on the identification, diagnosis, and treatment of concussions.”

For the researchers of the new study and other experts, including SHAAKE as a potential sign of a concussion – in sports protocol and medical guidelines more broadly – would bring very significant benefits at very little cost.

“Our understanding of how concussions look is evolving,” Daneshvar said. “From my perspective, this is one of those things where it doesn’t cost anything to pull an athlete out and evaluate them. But the potential negative consequences of not evaluating an athlete who has a concussion could be catastrophic – for themselves, for their career and for their life.”

Concussions are frequently unreported, and recognizing more signs in official protocol could help, Stamm said.

“It really gives the clinicians the power to say, ‘No, this is real,’” she said. “It both gives the clinician more reason to take them off the field, and if the athlete understands that shaking their head is happening because they’re having symptoms, maybe they’ll actually realize it’s a concussion if they didn’t know that before.”

Source

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