Howard Chang, MD

Medical & Health Writer

Medicine & Health

HealthToday •

Can Spondyloarthritis Cause Right or Left Hip Pain Related to Bowels?

Imagine you’re 25 years old and have had low back pain for a few years. Your doctors haven’t been too concerned about it until you begin experiencing pain in your hips and bowels. You even start to have some blurry vision and constantly feel fatigued. After seeing more doctors and getting tests done, you finally receive a diagnosis of spondyloarthritis (SpA) from a rheumatologist. 
How did it take so long to figure this out? SpA is challenging to detect because no single test or symptom provides...
HealthToday •

Can Blood Pressure Variations Be the Side Effects of High Potassium?

We all need potassium to survive—it’s an electrolyte that our cells use to produce energy and perform numerous other functions. Your body tightly regulates the level of potassium in your blood. If it’s too low or too high, serious consequences like heart, muscle, and nerve problems can occur. When potassium levels are above 5.5 mEq/L, we call this condition hyperkalemia (1). Based on data from over 2 million U.S. patients, the prevalence of hyperkalemia in 2014 was 1.57 percent (2). 
According t...
Healthnews •

TMG Supplement: Science, Benefits, Dosage, and Picks

TMG (trimethylglycine) is a supplement used by some longevity scientists, such as Dr. David Sinclair, for its purported benefits like improving organ health and physical and mental performance. How does TMG work, and can it really prevent conditions like heart attack and stroke?

TMG, which also goes by betaine or betaine anhydrous, is a natural component found in humans, microorganisms, and some plants including beetroot. Humans consume an estimated 1–2.5 g of TMG from their diet per day. Struc
Healthnews •

The Insider’s Guide to Bryan Johnson’s Supplement Stack

Bryan Johnson is a controversial American entrepreneur and self-proclaimed “most measured man in history.” By this, he refers to the extensive testing he receives on a regular basis to measure many biological parameters of health and performance. Currently, at age 46, Johnson claims that he is in the top 1% of all people when it comes to speed of aging; for every 365 days, he says, he ages 277 days.

Johnson attributes much of his good health to the benefits of supplements. Calling himself a “mo
Healthnews •

Metabolic Syndrome: Causes, Health Impact, and Prevention

Metabolic syndrome is a high-risk group of conditions affecting 12.5–31.4% of adults worldwide, with a higher prevalence in the Americas and Eastern Mediterranean regions. Most commonly, it occurs in people who have obesity. Evolving research aims to clarify what exactly causes metabolic syndrome and how to treat it, but people with the syndrome benefit from lifestyle modifications and preventive strategies that can help reduce its complications.

In 1988, American endocrinologist Gerald Reaven
Healthnews •

What Causes Dry Mouth in People With Diabetes and How to Treat It

Dry mouth (xerostomia) is an uncomfortable sensation that becomes increasingly common as people age. Low saliva production (hyposalivation) is one of its primary causes. Dry mouth is more than just an unpleasant feeling — it can lead to oral problems and be a major issue for people with diabetes.

What is the link between dry mouth and diabetes?

People with both type 1 and type 2 diabetes are more likely than non-diabetic individuals to report dry mouth. A 2016 systematic review found that 12.5
Healthnews •

Science Behind Red Light Therapy for Neuropathy Pain

Have you ever wondered what light can do for your health? Red light therapy has gained traction in recent years due to its potential ability to promote skin health, hair growth, wound healing, and other proposed benefits. But can red light therapy also relieve pain due to neuropathy? Research suggests this may be so.

Does red light therapy help with neuropathy?

Red light therapy (RLT) is a type of alternative therapy that applies light with low wavelengths (600–750 nm) to the body for the mana
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HealthToday •

How to Detox Your Body From Sugar: Basics and Commitment Tips

Do you ever feel like you need your morning Starbucks Frappuccino to get through the day? Or those doughnuts at lunchtime to energize you in the afternoon? If you go without your typical sweets and notice that you begin to feel down, have low energy, or develop intense cravings, you may be experiencing sugar withdrawal. This is a telltale sign of sugar addiction, a phenomenon that occurs due to sugar’s effects on the reward systems of the brain (1). Like in any addiction, you can develop toleran
Healthnews •

Breast Implant Side Effects: What Are the Possible Complications?

Breast implant surgery is the most common plastic surgery procedure performed worldwide among women. And its popularity is increasing: compared to 2000, breast augmentation procedures rose by 41% in 2021. Yet in October 2021, the FDA took steps to increase public awareness about the complications associated with breast implantation. So, what potential risks should you be aware of if you have had or are considering implants?

Complications of breast implants range from mild, short-term inconvenie
HealthCentral •

Understanding the Origins of CIDP

Maybe you’ve been experiencing unexplained tingling in your arms or toes. Or maybe you suddenly find yourself struggling to power up the stairs. Multiple trips to your doctor and more specialists later, you have a diagnosis: Chronic inflammatory demyelinating polyneuropathy (CIDP). This rare autoimmune disease occurs when the body’s immune system attacks myelin, the insulating layer surrounding the nerves in the arms and legs. As a result, people with CIDP experience loss of sensation, trouble w
HealthCentral •

Is It CIDP? Early Warning Signs to Know

If you’ve been diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP), you’re joining a rare club: CIDP, an autoimmune disease affecting the nerves in the arms and legs, occurs in 8.9 per 100,000 people. Seen more commonly in men than women, there is no specific age when people get CIDP, but the incidence peaks between ages 40 and 60.

So what is CIDP? In short, this disease results from your immune system mistakenly attacking myelin, the fatty coating surrounding the axons of n
Healthnews •

Red Light Therapy for Weight Loss: Pros and Cons

Red light therapy (RLT) refers to the application of high wavelengths of light — in the red or near-infrared range — to the skin and body. It falls under the category of low-level laser therapy or photobiomodulation, which describes the use of light sources (including laser and LED) to alter cellular processes for potential health benefits. RLT has shown promise in treating skin conditions, such as wrinkles and acne, as well as pain and inflammation. Increasingly, people are turning to RLT for w
Healthnews •

Breaking Down Myths: Can You Live Without a Pancreas?

Nestled within the abdomen, between the spine and the stomach, the pancreas plays a crucial role in digestion and blood sugar regulation, ensuring the body receives vital nutrients while maintaining glucose levels. However, circumstances may necessitate the removal of this crucial organ through a surgical procedure known as pancreatectomy. Despite the challenges posed by pancreas removal, individuals can navigate this new reality through medical interventions and lifestyle adjustments, fostering
HealthCentral •

Which Type of Talk Therapy Is Best for Bipolar 1 Disorder?

Around 1% of people in the United States will face a diagnosis of bipolar 1 disorder (BD1) during their lifetime. If you’re among them, you know the challenges of this condition. Episodes of extremely elevated mood called mania can disrupt relationships and endanger your health and safety. Depression can also make performing daily activities a real struggle. What’s more, manic and depressive episodes can occur unpredictably and make someone feel out of control. But, with talk therapy, many people with BD1 can learn helpful ways to manage their symptoms and improve their relationships.
HealthCentral •

How Cognitive Behavioral Therapy Works With Medication to Treat Bipolar 1 Disorder

If you have bipolar 1 disorder (BD1), you’re not alone. The National Institute of Mental Health estimates that 2.8% of U.S. adults have some form of bipolar disorder. BD1 usually begins before age 25 and affects slightly more women than men. Living with BD1 means that you may experience episodes of elevated mood, called mania. You might also have periods of depression or bouts of psychosis. While these mood changes can be challenging to deal with, they are treatable. With the right help, you can
Healthnews •

Preventive Chemotherapy: What It Is and How It Works

Kate Middleton recently revealed that she has been undergoing ‘preventive chemotherapy’ for cancer following abdominal surgery in January. What is preventive chemotherapy, and why is it performed even after successful cancer surgery, as in the case of the Princess of Wales?

Preventive chemotherapy is medically called ‘adjuvant chemotherapy,’ which is the term we will use for the remainder of this article.

Preventive chemotherapy is chemotherapy given to destroy any remaining cancer cells in th
Healthnews •

Type 4 Diabetes: Causes, Signs, and Management

Type 4 diabetes — it’s not a typo. In 2015, researchers at the Salk Institute for Biological Studies published research suggesting that many cases of diabetes may not be associated with obesity as commonly thought. Rather, this form of diabetes — which they termed type 4 — is determined by older age.

Like other forms of diabetes, type 4 diabetes (T4D) is characterized by insulin resistance leading to high blood sugar. However, the underlying cause of insulin resistance is different in T4D compa
Healthnews •

Addressing Your Concerns: Does Diabetes Cause Hair Loss?

By age 50, approximately 40% of men and women experience some degree of hair loss due to genetic factors. But could hair loss also be related to diabetes? Research suggests the answer may be yes.

Diabetes affects 1 in 10 people worldwide and contributes to vascular diseases involving the heart, brain, eyes, and skin. By compromising blood flow to the skin, diabetes can impact hair follicles, leading to thin and brittle hair or loss of it altogether. Here, we explore the relationship between dia
Healthnews •

Is Falling Asleep After Eating a Sign of Diabetes?

Feeling sluggish after a hearty meal is a common experience for many, but could it signal more than just a full stomach? Diabetes, a condition where the body struggles to regulate blood sugar levels, poses this question. In diabetes, either the pancreas fails to produce enough insulin (type 1) or the body's cells become resistant to insulin's effects (type 2). Insulin is crucial for ushering glucose into cells for energy, so when its function is compromised, blood sugar levels soar, potentially damaging organs like the heart and nerves.
Healthnews •

How to Use Essential Oils for Your Health?

Aromatherapy, the use of essential oils to improve health, is a popular and natural form of alternative medicine. In 2023, the global market of essential oils was valued at 23.7 billion U.S. dollars. But what evidence supports the use of essential oils, and are they safe?

Essential oils are natural oils derived from plants that capture their core aroma or ‘essence.’ Their use dates as far back as ancient India, Persia, and Egypt. Throughout history, essential oils have served various functions
HealthCentral •

Do You Know the Warning Signs of Alzheimer’s Disease?

Everyone has trouble remembering things sometimes. Still, in older adults new or worsening forgetfulness that disrupts daily life may be an early sign of Alzheimer’s disease (AD), the Alzheimer’s Association warns. People with AD have memory, thinking, and/or behavioral problems that progress over time due to, most scientists think, the abnormal buildup of proteins in the brain. Alzheimer’s affects about 11% of Americans aged 65 and older and is the most common cause of dementia worldwide. While
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Perspectives

ABIM Foundation •

I Hurt Like You

How would your trust in your physician change if they disclosed that they had the same health condition as you?

Physician self-disclosure – wherein the physician tells the patient something personal about themselves – is an understudied phenomenon in healthcare communication. Yet, it occurs so frequently and innocuously within clinical encounters, especially in the form of “small-talk” (family or hobbies, for example) that its impact is often unnoticed.1

But what if the physician reveals a per
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CLOSLER •

The Forgotten One

As medical students, many of my peers and I can recount transformative moments with patients that have guided our vocational pursuits, including our chosen specialties. Our patients inspire, challenge, and refine us. They help us discover great needs within medicine that we may not have otherwise appreciated.

Less often do such defining instances centralize not the patient, but the person sitting next to them: the caregiver. More unusual is that a caregiver’s silence can be the transformative m
Biomedical Odyssey •

The Uncovering of Essentials: An Unexpected Gift from 2020

To say that 2020 was a difficult year would be the understatement of a lifetime for many. While there may not have been as many countdown parties on New Year’s Eve, the cause for celebration has perhaps never been greater. And if you’re like me, you are feeling something like a mix of relief, gratitude and apprehension as we tread into the start of a new decade.

It may be easy to look back on 2020 and point out all the bad that happened. And it may be trite to reiterate the importance of reflec
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CLOSLER •

The Pros and Cons of Clinician Self-disclosure

Years ago, I sought medical attention for some odd paresthesias in my feet. When they didn’t resolve on their own, I became concerned since I had no evident medical problems, injuries, or medications that could explain my symptoms. After my neurologist did an extensive work-up and found no physiological or structural abnormalities to explain my symptoms, I decided to see another physician. He must have sensed my worry, so he shared with me that he’d gone through something similar in the past. He
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ASBMB Today •

Walking Through This Pandemic

This year my movements have been restricted more than any other time in my life. Physical distancing mandates have made it challenging to exercise.

When the gyms shut down, I quickly adopted a resistance band workout routine at home that has been a sufficient substitute for strength training with weights. But I worried about finding a form of cardiovascular exercise that was both sustainable and enjoyable. Years ago, I tried high-intensity interval training, but I could only keep it up for a fe
Photo by Una Laurencic on Pexels
Biomedical Odyssey •

Honoring the Personal Response: Experiencing Art Museum-Based Learning in Medical Education

“Find a work of art that inspires you,” my prompt read. Making my way through the Cone Collection at the Baltimore Museum of Art, I kept my eyes peeled for a portrait or sculpture that evoked such a feeling. I was joined by my peers — first- and second-year medical students at Johns Hopkins — each of whom had their own preselected objec
Photo by Nathan Cowley on Pexels
CLOSLER •

How to Manage Difficult Emotions

Sometimes the intensity of our thoughts and emotions can be difficult to manage, especially during stressful times like these. To cope, it can be helpful to recognize, allow, and reflect on our feelings.

Due to the pandemic, most of us are spending more time at home—alone or with a few others—than ever before. During the pre-pandemic “normal” hustle-and-bustle of life, social interactions were sometimes a distraction from our emotions. Being by ourselves for long periods of time can be particul
Biomedical Odyssey •

The Human Behind the Body: A Medical Student’s Experience with Cadaveric Dissection

The hardest part about dissecting Sir was when he no longer looked human. When we had cut and sawed and scraped to the point when I could not see Sir’s face — or a semblance of any face — I felt, for the first time, that I had taken something inviolable from him. How many smiles had illumined this face over the 79 years that it was still perceptibly human? What distinctly human joys and sorrows had this face conveyed throughout Sir’s life, even past the point of death, with the ineffable express

Academic Publications (First-Authored)

American Journal of Psychiatry Residents' Journal •

Stimulating the Brain, Healing the Mind

It was a mesmerizing scene: a patient with treatment-resistant schizophrenia whose hallucinations and delusions were being titrated in real time by a neurologist operating an iPad. A click here, and her hallucinations would improve; a click there, and they would worsen. In that moment, she might have said that her physician was influencing her thoughts by transmitting electrical impulses through electrodes implanted in her brain. Such a statement would ordinarily be construed as a classic delusi
Journal of Patient Experience •

Should Physicians Disclose Their Own Health Challenges? Perspectives of Patients With Chronic Pain

Physician self-disclosure is defined as a physician’s sharing of personal information with the patient, ranging from casual comments to intimate private revelations (1). Although physician self-disclosure may influence the patient–physician relationship and patient outcomes, its utility as a communication tool remains controversial (2). Self-disclosure may expand typical professional boundaries, shift focus from the patient onto the physician, and lead to loss of trust in the physician; alte
Psycho-Oncology •

Depression predicts longitudinal declines in social support among women with newly diagnosed breast cancer

Among breast cancer survivors, low social support is associated with adverse clinical and psychosocial outcomes. This study prospectively examined longitudinal trends in perceived social support in women with newly diagnosed breast cancer as a function of depression status prior to initiation of cancer treatment.

One hundred ten patients with newly diagnosed breast cancer and 59 age-matched noncancer controls completed behavioral measures at four assessments: prior to treatment and at 1 month,
JNCCN •

Secondary Neoplasms of the Female Lower Genital Tract After Hematopoietic Cell Transplantation

The female lower genital tract (cervix, vulva, vagina) is a common cancer site within the general population.1 Cervical cancer is the second most common cancer among women worldwide, while vulvar and vaginal cancers are much rarer, accounting for 7% of all gynecologic malignancies.2,3

More than 90% of cervical cancers and at least 60% to 70% of vulvar and vaginal cancers are caused by the human papillomavirus (HPV), the most common sexually transmitted infection.4–6 Because of the viral etiolog
RNA Biology •

A cis-regulatory antisense RNA represses translation in Vibrio cholerae through extensive complementarity and proximity to the target locus

With an estimated 3–5 million cases a year, cholera represents a global public health concern as well as a paradigm model for known and emerging diseases.Citation1-3 Vibrio cholerae, the causative agent of cholera, is a bacterium that resides mostly in the marine habitat but also thrives in the human gastrointestinal (GI) tract and in freshwater environments endemic to cholera.Citation4-6 The life cycle of V. cholerae involves repetitive transitions between aquatic environments and the host GI t