When LGBTQ+ patients are unsure if they can be open about their identity[1] and related health needs, it becomes more difficult for them to access high-quality health care.
In our recently published research, my colleagues and I[2] found that how LGBTQ+ people are treated at the doctor’s office[3] has a measurable effect on whether they stay up to date with lifesaving preventive care like flu shots, colorectal cancer...
A new study from Hebrew University reveals that acetaminophen doesn't just work in the brain -- it also blocks pain at its source by acting on nerve endings in the body. The researchers found that its active metabolite, AM404, shuts down specific sodium channels in pain-sensing neurons, stopping pain signals before they reach the brain. This discovery not only reshapes our understanding of how one of the world's most common painkillers works, but also opens the door to developing safer, more targeted pain treatments.
A breakthrough study from the Hebrew University of Jerusalem, published this week in the prestigious journal PNAS (Proceedings of the National Academy of Sciences USA), reveals a previously unknown peripheral mechanism by which acetaminophen (also known as paracetamol, Tylenol®, or Panadol®) relieves pain.
The study was led by Prof. Alexander Binshtok from the Hebrew University's Faculty of Medicine and Center for Brain Sciences (ELSC) and Prof. Avi Priel from its School of Pharmacy. Together, they uncovered a surprising new way that acetaminophen -- one of the world's most common painkillers -- actually works.
For decades, scientists believed that acetaminophen relieved pain by working only in the brain and spinal cord. But this new research, published in PNAS, shows that the drug also works outside the brain, in the nerves that first detect pain.
Their discovery centers on a substance called AM404, which the body makes after taking acetaminophen. The team found that AM404 is produced right in the pain-sensing nerve endings -- and that it works by shutting off specific channels (called sodium channels) that help transmit pain signals. By blocking these channels, AM404 stops the pain message before it even starts.
"This is the first time we've shown that AM404 works directly on the nerves outside the brain," said Prof. Binshtok. "It changes our entire understanding of how acetaminophen fights pain."
This breakthrough could also lead to new types of painkillers. Because AM404 targets only the nerves that carry pain, it may avoid the numbness, muscle weakness, and side effects that come with traditional local anesthetics.
"If we can develop new drugs based on AM404, we might finally have pain treatments that are highly effective but also safer and more precise," added Prof. Priel.
Creatine, the supplement popular with athletes for its ability to help build strength and power, is increasingly being recognized for its broad health benefits.
The compound's usefulness extends well beyond the gym, according to Dr. Richard Kreider, professor and director of the Exercise & Sport Nutrition Lab at Texas A&M University. Kreider has spent more than 30 years investigating the effects of creatine, a naturally occurring compound stored in the muscle that combines with phosphate to form creatine phosphate, which is needed for cellular energy.
"When the body is stressed, like in exercise or under metabolic conditions like some diseases, creatine phosphate is needed to maintain energy in the cell, and therefore has a lot of protective and health benefits, in addition to the exercise performance effects that have been seen," Kreider said.
How Much Creatine Do We Need?
Our bodies create about a gram per day, but it's recommended to get two to four grams of creatine per day, depending on muscle mass and activity levels. According to Kreider, most people fall short of getting enough creatine from diet alone. The best sources of creatine in the diet are meat and fish.
"You only get about a gram of creatine per pound of red meat or fish, like salmon, so it's expensive and takes a lot of calories to get a gram," Kreider said. This is why supplementation matters, especially for vegetarians or vegans who do not consume enough creatine in their diet.
For athletes with performance-related goals, Kreider said it's recommended to supplement 5 grams, four times a day for a week. Supplementation "helps load the muscle up with more energy," which makes for improved high-intensity exercise, recovery and even cognitive function. After that, consuming 5 to 10 grams per day will maintain creatine stores and provide enough creatine for the brain.
Beyond boosting athletic performance, creatine is important for everyone as they age throughout their lives, Kreider said. It can help older adults who lose muscle mass and cognitive function as they age, he said, and in adolescents, low dietary creatine intake is associated with slower growth, less muscle mass and higher body fat.
Is Creatine Safe?
In a comprehensive review published in February in the Journal of the International Society of Sports Nutrition, Kreider and colleagues analyzed 685 clinical trials on creatine supplementation to assess its safety and the frequency of reported side effects. The analysis showed there were no significant differences in the rate of side effects for participants taking a placebo and those taking creatine.
As for anecdotal concerns like bloating or cramping, Kreider says those claims don't hold up under scrutiny, and studies have shown creatine can actually prevent cramping because it helps the body retain more fluid.
Despite the strong evidence base, Kreider said creatine has long been the subject of misconceptions and misinformation. He's among the members of the International Society of Sports Nutrition who recently issued a letter affirming the safety and efficacy of creatine, urging lobbyists and policymakers not to restrict access to it.
"There's absolutely no data supporting any negative side effect anecdotally reported about creatine on the internet and in the media," he said. "Creatine is safe, and it's important for everybody, not just bodybuilders and athletes."